Addressing weight stigma in public health practice

Kristy Law and Dr Claire Pulker

It’s time to change the way we talk about obesity. As public health professionals we know there is no single or simple solution to obesity. It is a chronic relapsing condition that is influenced by more than 100 different factors, and most of these are outside an individual’s control.

The topic of obesity is commonly covered in mainstream media with the narrative often focusing on individual responsibility or the costs incurred to the health system, using shock headlines and inappropriate images to grab readers’ attention. The biological, environmental and societal drivers of obesity are rarely mentioned.  Recognising obesity as a public health priority and encouraging healthy behaviours is important, but the predominant media focus on the individual oversimplifies the causes of and solutions to obesity. Portraying weight in this way assigns blame or failure to the individual and not to our obesogenic environments, which perpetuates weight stigma.

Weight stigma is a pervasive and global issue. Often driven by underlying weight bias, weight stigma is the social rejection and devaluation that accrues to those who do not comply with prevailing social norms of adequate body weight and shape. People with obesity are often misrepresented in the media by photos of headless bodies, eating takeaway foods, or stereotyped as lazy, gluttonous or lacking will-power. Weight stigma occurs in a wide range of settings, not just the media, including healthcare settings, workplaces, public health and among health professionals and researchers.

People who experience weight stigma are more likely to avoid healthcare settings, make negative behaviour changes such as exercise-avoidance and binge eating, have an increased risk of mental ill-health, and experience greater psychological distress.  A summary of the health impacts of weight stigma, which are often independent of body weight, is provided in a guide we developed to assist media and communications professionals in Western Australia (WA) to talk about weight.

The guide: Shift. A guide for media and communications professionals was developed in partnership with the Health Networks Unit at the WA Department of Health, as part of the implementation of the WA Healthy Weight Action Plan 2019-2024 and East Metropolitan Health Service’s (EMHS) Obesity Prevention Strategy 2020-2025. Shift was developed with communications professionals to meet their specific needs and to address the local WA context. The guide aims to support communicators to work in a non-stigmatising manner when reporting and writing on obesity. It does not intend to censor, but rather provide guidance on how to start the conversation well, challenge weight stigma, and ultimately help improve the lives of people with obesity.

To develop Shift, we consulted with communications staff from across the WA Health system including primary health to understand how to make the guide relevant to their work and context. There was a growing awareness of weight stigma, but not much guidance on how to avoid it in practice. So, we worked with them to develop a fit-for-purpose guide, with key features for communications professionals. We also applied it in our own work when writing the EMHS Obesity Prevention Strategy.

Communication professionals have the power and agency to play an influential role in fostering better public perceptions of obesity. Within the health system, we have the opportunity to lead the way in changing how we talk about weight, with the ultimate aim of encouraging a shift in media reporting. The language and images used in our resources, public health messages and policy documents can help shape societal perspectives, so it is important that they are supportive, non-stigmatising and emphasise health for all.

 Recent strategies at both the Federal and State level call for a comprehensive systems approach to address obesity  and include efforts to reduce weight-based stigma. As public health professionals, we all have a part to play in shifting the narrative about weight. Our simple Shift guide can be applied in a wide range of settings, and the summary provided at the beginning is designed to be a quick checklist when writing or speaking about weight-related issues. Looking at our own practice when it comes to obesity, weight stigma and health cannot be undervalued. Taking up the pledge to end weight bias and stigma is also a powerful step. The conversations we have with our colleagues, friends and community members are all opportunities to help make the shift.


Author affiliations: East Metropolitan Health Service in Perth, Western Australia

Kristy Law is a public health dietitian with a background in community dietetics and global health. With experience in the not for profit sector in WA and USA, Kristy’s current role supports the implementation of the EMHS Obesity Prevention Strategy. She enjoys working at the intersection of public health and social change, using systems thinking and strategic planning to improve nutrition outcomes, particularly for people experiencing hardship. Her areas of interest include obesity, food insecurity, child health, public policy and implementation science.

Dr Claire Pulker is a public health nutritionist and strategic marketer. Her research has focused on evaluating food environments and the impact of corporate voluntary policies on public health.  In her current role as Principal Policy Consultant at Perth’s East Metropolitan Health Service she is responsible for leading the Obesity Prevention Strategy.  She has previously worked in marketing and communications roles in the private sector in WA, including as Associate Director Marketing for Curtin University where she led development of an innovative and award-winning digital marketing campaign The Box. She was head of corporate social responsibility for a start-up sustainable restaurant chain in London and New York, leading a PR team that generated global media coverage of the restaurant’s world-first carbon foot-printing of menu items to international standards. 






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