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Obesity: Raising awareness but at what cost?

The UK's leading cancer charity, Cancer Research UK, recently launched a campaign which set out to highlight the problem of obesity. The overall message was clearly well-meaning, and the shock tactics used were effective in raising public awareness of the issue, but at what cost? Dr. Emma Sharpe, Lecturer in Psychology at the University of Derby, discusses the implications of the campaign in terms of the promotion of weight bias stigmatisation and discrimination of those who are overweight/obese.

By Dr Emma Sharpe - 29 July 2019

Globally, 39% of the world's adult population is overweight, and 13% is obese. These rates are increasing, and it predicted that by 2050 more than half of adults will be affected by obesity.

In the UK alone, an estimated 63% of the adult population is classed as either overweight or obese. Being overweight or obese can increase the risk of developing a range of health problems and generally reduce quality of life. The chronic and acute health conditions associated with excess bodyweight also incur substantial health care costs and lost productivity within the National Health Service.

Calls to change the campaign focus

In an attempt to reduce this growing epidemic, Cancer Research UK launched a billboard campaign which claims that obesity plays a greater role in the development of four of the most common cancers (i.e. bowel, kidney, ovarian and liver) than smoking.

Health professionals and academics alike have been extremely vocal in highlighting the potential implications of the campaign in terms of the promotion of weight bias, stigmatisation and discrimination of those who are overweight/obese. Specifically, blunt campaign messages such as these have been criticised for fat-shaming and undermining much of the previous work in the sector which has aimed to reduce the harmful effects of weight stigma and discrimination. In fact, disapproval with the key message of the campaign has been so widespread that a number of key health professionals have now appealed to the charity to change its focus entirely.

As both a psychologist and an expert in the field of eating behaviour, I tend to agree with my colleagues. Using fear-based messages to tackle this issue is too simplistic and overlooks many of the factors that we know are associated with the development of obesity. In essence, this campaign promotes the message that being overweight is akin to smoking and that obesity can and should be tackled in the same way.

The unspoken factors contributing to obesity

One reason why this message is so frustrating from an academic perspective is that to compare smoking and diet is not only inaccurate but extremely harmful. Unlike smoking, research has shown that a number of factors are implicated in the development of obesity, including socioeconomic status, physiology and genetics.

Whilst it is vital to educate the general public about the potential consequences of obesity, the most damaging aspect of the Cancer Research UK campaign is that the focus is on personal responsibility. Specifically, it assumes that people will see these statistics and simply stop overeating or start eating healthily as a result. Furthermore, it encourages discrimination or judgement towards individuals who are not able to do this successfully by fuelling the perception that weight gain is caused by a lack of will power.

Alongside the aforementioned economic and societal determinants, research within the field of psychology has identified a number of behavioural traits and characteristics that are implicated in the development of obesity. Of these, one of the most widely researched is the link between eating and emotion. Specifically, we know that emotion can suppress or initiate eating behaviour.

There are many examples in the media of people eating in response to stress, heartbreak or even boredom. Typically, individuals viewing this type of behaviour would deem this as a relatively normal response to negative emotion. However, research has suggested that those who are overweight or obese frequently turn to food as a way of coping with daily stress or emotion.

Obesity and emotions

Findings from a recent study I conducted in collaboration with colleagues at the University of Derby has shown that individuals who are overweight (as indicated by a Body Mass Index of 25kg/m2 or higher) were more likely to struggle when dealing with difficult emotions.

The results of this study also demonstrated that these individuals lack access to effective coping strategies (such as problem-solving and emotional acceptance), so food becomes the source of comfort. In addition, our findings revealed that these individuals are highly self-critical and display low levels of self-compassion. This creates a vicious cycle, whereby people who are overweight continue to struggle with negative emotion, overeat as a result, then criticise themselves for being unable to cope.

Importantly, these individuals may lack the self-compassion to accept these negative feelings and get themselves out of this destructive cycle of behaviours. Campaigns that promote weight stigmatisation can have a damaging effect by increasing feelings of guilt and shame in those targeted, which ultimately prevents healthy eating as individuals may overeat in response to these negative emotions.

This research is important in highlighting the variety of psychological traits and characteristics which might be implicated in overeating and obesity. As such, a key issue with the recent Cancer Research UK campaign is that these factors are largely overlooked in the simplicity of the campaign. By ignoring risk factors, this campaign not only undermines the importance of this research but promotes the idea that obesity is a simple problem that can be easily prevented by holding individuals to account for their own body size and weight.

Are we being counterproductive about obesity?

In summary, it is vital that we change the way we talk about obesity. We know that campaigns based on instruction are often ineffective at promoting health-related behaviour change. The focus on weight here is therefore counterproductive and may in fact encourage unhealthy eating behaviour. For example, weight stigma has been frequently linked to poor body image, depression, anxiety and eating disorders.

Therefore, rather than framing weight as the problem, future campaigns should focus on raising awareness of the vast array of social, environmental and psychological factors implicated in the development of obesity. A more inclusive (and more accurate) campaign should therefore emphasise wellbeing rather than weight, acknowledging the fact that for many it is not as simple as eating less or eating healthier foods. In many cases people don't have always have full control over their body shape and size; there are many factors which can dictate an individual weight and future campaigns need to be mindful of this to ensure they do not cause harm to an already marginalised group of individuals.

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About the author

Emma Sharpe, Psychology lecturer

Dr Emma Sharpe
Lecturer in Psychology

Emma joined the University of Derby as a lecturer in October 2015, having previously worked as a University Teacher at Loughborough University.

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