‘New Year’s resolutions’ offer little effect on obesity
Experts call out negative impact of ‘it’s your fault’ attitude to obesity
There is an urgent need to tackle ‘Obesity Stigma’ – and understand the condition as a disease that needs to be treated medically rather than by will power, or New Year’s resolutions.
Research on attitudes carried out by IrSPEN, the Irish Society for Clinical Nutrition and Metabolism, found that people with the condition are looked down on as lazy, over-indulgent, and deserving of what they get – and this prevents effective treatments from being publicly funded.
IrSPEN said that 25% of Irish adults are obese with a further 25% at risk, meaning the condition is an epidemic across Irish society.
Spokesperson Professor Carel le Roux said research carried out by IrSPEN in 2019 identified a ‘moral judgement’ among the general public, within the medical profession and even among patients themselves – that those with obesity ‘deserve their condition’, that it is of their own making, and therefore not deserving of healthcare funding.
Professor le Roux said that this attitude prevents proven and cost-effective treatments from being made publicly accessible in Ireland, which has the lowest per capita funding of obesity care in the EU.
“Half of the population has not suddenly become lazy and lost its will power. Genetic and also environmental factors are critical in the chance of being obese. The disease is inheritable and we have also seen a huge shift to sedentary jobs, car-based transport and highly processed food.
“Medical evidence shows that some people are at a far higher risk of obesity than others and that this has nothing to do with their willpower.
“We need to change and see obesity as a medical disease which we must treat, both to improve quality of life for patients and also to save the health system the enormous costs of treating life-long secondary conditions. For example, type 2 diabetes is a complication of obesity and affects 200,000 people. This single obesity complication accounts for more than 10% of the overall healthcare budget.
“Proven treatments, such as surgery, cost-effective medicines, and scientifically proven diets are available. While a New Year’s burst of diet and exercise is certainly welcome, we know that it will have little long-term impact on most patients’ disease.
“For most people an effective treatment can be identified. And in turn complications of obesity such as diabetes can be reversed and put into remission.”
St. Vincent’s University Hospital Consultant Surgeon and IrSPEN member Professor Helen Heneghan said that for the vast majority of patients the response to obesity needs to re-framed away from a ’move more, eat less’ approach, to ‘seek help with clinical treatments’.
“Patients, parents, teachers, doctors, colleagues, school-friends, and everyone else needs to be informed that obesity is not a mark of failure or lack of commitment, but a disease response to a genetic heritage, a metabolic illness, an unhealthy environment, or combinations of these.
“People living with obesity need to understand, that ‘it’s not your fault’ you have a disease – that their own self-control is not the sole determinant of weight gain or weight loss, and that their doctors can help.
“Doctors, nurses and other healthcare providers are aware that obesity is a disease. However, the evidence is that they don’t treat it like one: obesity is rarely diagnosed, follow-up appointments are not scheduled, referrals to medical specialists are unusual, and in Ireland there are no reimbursable drugs or diet approaches which can be prescribed.
“Ireland has had excellent success in recent years with health messaging to improve public health, particularly with smoking.
“A similar programme to change public and professional attitudes is needed for obesity, so that body shape does not lead to stigma, that patients are comfortable looking for medical help, doctors address it with the best therapies available, and the healthcare system invests in treatment today, to avoid the complications of obesity and their associated high-cost tomorrow,” Professor Heneghan concluded.
The IrSPEN position paper The impact of obesity stigma: an Irish Society for Nutrition and Metabolism report is available at www.irspen.ie