Obesity report calls for changes in treatment and attitudes
A new report from the British Psychological Society has called for widespread changes in attitudes to obesity. Having examined the causes of rising obesity, the BPS suggests society should destigmatize obesity, which it insists “not simply down to an individual’s lack of willpower.”
What are the causes of obesity?
The report states that obesity is “not a choice”, but results from a “a complex combination of biological and psychological factors combined with environmental and social influences.”
High genetic risk: Molecular genetic studies have identified more than 100 genes involved in weight difference; many appear to impact the neurobiology controlling appetite regulation. Some genes prime some individuals to overeat in response to triggers such as stress.
Trauma and major life challenges: Up to half of adults using obesity services have experienced childhood adversity. Exposure to chronic stress - like financial insecurity, family discord, mental illness or being stigmatized - can trigger the stress response system, risking weight gain.
Work, school and social environments: Many modern environments promote eating and inactivity. Many who live in deprived areas experience a higher than average level of stress, but their surroundings offer few opportunities for physical activity and affordable healthy food.
Stigma around obesity: Negative stereotypes and weight discrimination have impacted and compromised not just individuals but also the design of support services. Behavior change is central to the prevention, management and treatment of obesity.
How should we deal differently with obesity?
The report outlines a number of recommendations for improving the mechanisms and attitudes around obesity.
Reducing weight-related stigma: Policy-makers and journalists should avoid using language and imagery that stigmatizes obesity, as this affects public adoption. Messaging should promote healthy behaviors and refer to “a person with obesity” rather than “an obese person”.
Government action: All strategies and statements should demonstrate an understanding of the causes of obesity from psychological as well as biological and socio-environmental factors.
Standards and guidelines: Psychologists should help design services and guidelines, which should include evidence of psychological factors in obesity, including past trauma, unhelpful attitudes and behaviors toward food, and managing setbacks for long-term maintenance.
Training and supervision: All employees helping people with obesity should undergo a nationwide training and supervision programme (delivered to undergraduates by health education bodies, and later as part of continuing professional development) in the provision of psychologically-informed behavioral support.
Weight management services: Interventions must be evidence-based and designed and delivered by people with the right training, namely integrated multidisciplinary teams including psychologists. Services for children should also engage parents.
