Treat Obesity to Stop Body Shaming and Diet Culture

Improving access to compassionate, evidence-based and patient-centered care will fight weight stigma and end diet culture in obesity treatment suggests a recent commentary published in the Journal of the Academy of Nutrition and Dietetics.

"It is critical to unlink weight from diet culture," said co-author Katherine N. Balantekin, Ph.D., RD, an assistant professor in the Department of Exercise and Nutrition Sciences in the University at Buffalo School of Public Health and Health Professions.

‘Obesity treatment should focus on health, not on weight.’

Weight stigma is the devaluation of a person based on their weight is rampant based on previous research findings that more than half of health care providers attribute a patient's being overweight or obese to a lack of willpower. This kind of fat-shaming only reinforces negative stereotypes.

The debate extends far beyond health care settings. When Weight Watchers released Kurbo, a weight loss app for children and adolescents in 2019, dieting has negatively impacted the relationship they have with food and their body.

People think of dieting as being the same thing as an obesity treatment, when in fact they are extremely different.

The paper notes that a new definition of obesity, backed by Canadian guidelines and the World Health Organization, has emerged. Gone is the emphasis on a body mass index (BMI) of 30 or above.

Instead, obesity is now defined as having excess fatty tissue that is associated with negative impacts on quality of life or physical health.

This new definition takes a health-focused rather than a weight-focused approach, allowing for improved sensitivity to the nuance of the relationship between weight and health status.

It also allows for a shift toward supervised evidence-based obesity treatment, which favors sustainable changes to promote long-term health. This is instead of focusing on dieting or self-directed efforts to lose weight by restricting the amount or types of food consumed.

Whereas self-directed diets often promote unhealthy eating practices such as fasting or strict food restriction, supervised evidence-based obesity treatment improves health without increasing internalized weight stigma.

There has been a concern for a long time that weight loss can trigger or worsen eating disorders, but a large body of research suggests that evidence-based obesity treatment improves, not worsens, eating disorder symptoms.

Researchers also call for broad policies such as laws against weight-based discrimination, as well as efforts to further educate health care providers and the general public about the fact that numerous factors beyond self-control affect weight.

Obesity treatments should also screen for and address eating disorders throughout treatment so that individuals can receive specialized care as soon as possible.

It is critical to take a patient-centered approach to treatment with a focus on all health needs, which contrasts with the typical provider-centered approach with a focus on weight.

This means that health care providers need to respect a patient's wishes, including whether or not they want to discuss weight. It also needs to include a conversation where providers layout reasonable expectations for treatment, including how habits will need to be sustained long-term to see the maintenance of weight loss.



Source: Medindia