Saturday 20th May 2017

Tackling Obesity Together

tot-what-patients-sayStigmatisation of people who have obesity increases daily. Research shows that stigma leads to shame, which in turn leads to stress and therein a number of risk factors and chronic diseases – the very diseases often related to obesity.

If only the physical body required attention, one might succeed in achieving at least temporary weight-loss through dieting.

Dieting involves starving the body, restricting both the amount and the quality of food, which is a contradictory, since food can be the biggest single contributor to health!

But obesity involves more than the body! It is a person who is asking for help.

The common belief “just lose weight and you will be happy” has no basis in reality. For many patients who have had a long-term experience of obesity, often since childhood, it is not only weight that changes; there is also an impact on their personal identity. Nothing fits – clothes, shoes, even their social life can be affected. They have changed and can sometimes even be seen as a threat by those around them, and even to their family. Without support to change, there is a high risk of “failure”.

For patients the most important actions that can be taken for a healthier future are:

Respect. Patients often complain that they often are not treated respectfully. This originates from poor knowledge about the disease, even among the obese, about its chronic character, and about the fact that for some people there is no cure for the visible aspect of the disease.

Acceptance. Patients want acceptance that obese people are worthy members of our societies and should on all levels be protected from abuse. This could help generate the respect that patients now lack. There needs to be a campaign of respect among politicians, healthcare workers, scientists, media and the obese population itself.

Recognition. Patients need recognition that obesity is a chronic disease in the sense that one cannot make a person stop being obese. Consider that 90% of the successfully treated obese remain visibly obese. Realise that even with extensive weight loss, where the condition is no longer obvious from the outside, this identity will be there for the rest of ones’ lives.

A stop to stigmatisation. The result of the lack of respect enhances stigmatisation, which via separation and bullying in turn leads to discrimination on a personal, national and international level by media, social peers, researchers, health professionals and those in charge of governing schools, cities and countries. An action plan for fighting stigmatisation is required across entire society.

Impartial discussion. Influential stakeholders – industry, media, the economy, insurance companies, governments – all avoid discussion by making the problem increasingly less transparent. Financial costs become a more important issue than the well-being of patients. (Ironically a patient who feels well is less expensive to care for).

Shared responsibility. Consistently successful cures, treatments or health programmes have not yet been developed and society as a whole must bear the responsibility for this failure. Yet today, it is the obese person who shoulders the entire blame. We should work together for improvements and we need recognition that scientists, clinicians, managers and legislators as well as patients must all be part of the process. Success requires a joint effort. At present we fail together but together we could make a change.

Additional points that should be kept in mind

Obesity is a chronic disease that requires treatment. It can be managed with appropriate support and it is possible to take small steps to a healthier future.

Help and treatment is available for people who have obesity.

  • It is important to ask your doctor for advice or ask to be recommended to an obesity specialist.
  • Ask your national obesity association for details of local support groups in your area.

It is important to understand the facts of being overweight and having obesity.

  • A healthier lifestyle, including a healthy diet and regular physical activity can help maintain a normal weight.
  • However, obesity is a chronic disease and should be treated as such. Furthermore it is the gateway to many other diseases including type 2, cardiovascular diseases and certain cancers. [1]

It is important to offer support and understanding to people who have obesity. It is a chronic disease.

  • Causes of obesity range from genetic [2] and endocrine [3] conditions, to environmental factors [4] such as stress, diet and increasingly sedentary working patterns.
  • Accepting and supporting people with obesity will help them seek the help and treatment they need.

By sharing stories, people with obesity can support others affected by the disease.

For more information

The EASO Milan Declaration: A call to Action on Obesity

For a selection of patient stories please see the EASO Patient Portal and the EASO Patient Spotlight videos

Resources

[1] http://www.who.int/healthinfo/global_burden_disease/GlobalHealthRisks_report_part2.pdf. Page 17

[2] Genetics of obesity and the prediction of risk for health, Andrew J. Walley, Alexandra I.F. Blakemore and Philippe Froguel, 2006

[3] Obesity and endocrine disease, Kokkoris P, Pi-Sunyer FX. 2003

[4] http://www.who.int/mediacentre/factsheets/fs311/en/