#LivingWithObesity Day Speaker Videos

We are happy to bring you the content of the #LivingWithObesity webinar which took place on 21 October 2020. Here you can watch the contact from all of the individuals who took place on the day.

The Weight of Stigma.

Director of Research & Policy, Obesity Canada and Research & Policy consultant for EASO.

Dr. Ximena Ramos-Salas


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Hello, my name is Ximena Ramos-Salas and I’m the Director of Research and Policy at Obesity Canada. I’m also a consultant for the European Association for the Study of Obesity. It is my pleasure to be here today and be part of this important awareness campaign.

If you’re following us on social media, please use the hashtag livingwithobesity so that we can spread the word widely. The Living with Obesity campaign is important to me for several reasons. On a personal level, I have many family members that live with obesity and I have seen the many challenges they face on a daily basis.

On a professional level, I’m a public health researcher working in the area of weight bias and obesity stigma. Today, I wanted to share my story about how I became an advocate for obesity and why I decided to focus my entire professional career on ending weight bias and obesity stigma. I first trained as a nurse assistant in Sweden and as a kinesiologist in Canada where I learned about the importance of healthy living for prevention of chronic diseases.

My academic training took me down the road of promoting healthy lifestyles and as a kinesiologist, I was trained on the importance of physical activity specifically for obesity prevention and also for chronic disease prevention. This was in the early 2000s and after graduating, I started working for the Canadian Institute of Health Research which is a national research funding agency. There, I worked for the Institute of Nutrition, Metabolism, and Diabetes which focus all the strategic research funding in the area of obesity and healthy body weight.

Working at CIHR, I traveled around the country and met scientists working in nutrition, physical activity, basic science, clinical research, and public health. I learned very quickly that obesity is a very complex chronic condition. I did my master’s in health promotion with Dr. Kim Rain at the University of Alberta in Edmonton, Canada and there I learned about the factors that influence behaviors at the individual level and I learned very quickly that the context in which we live matters for individual behaviors.

It is not just a matter of educating people about healthy eating and exercise. We also need policies in place to make these behaviors accessible for everyone in an equitable way and using a health promotion lens, I realized although health is a basic human right, it’s really not accessible to all. In 2008, I started working with Obesity Canada and this experience opened up a whole new reality.

The reality of people living with obesity who are stigmatized in our society. In 2009, the board of directors of Obesity Canada concluded that weight bias and stigma was a major barrier for improving health equity in people living with obesity. Since then, weight bias and stigma has become our number one priority and my doctor research, which I wanted to contribute to our work at Obesity Canada, also opened up my eyes to the harsh realities in which my family members who have obesity as well as my friends and colleagues have on a daily basis.

For four years, I lived along people living with obesity listening to their stories. Together, we explored how their experiences had influenced how they perceived themselves and how these experiences also influence their behaviors, health outcomes, and well-being in general. This experience made me confront my own personal biases I had about obesity.

I quickly realized that although through my entire academic career and education, I had operated under the lens of obesity being preventable through individual behavior such as diet and exercise. And even when I was using a health promotion, sociological, and gender lens, I was still thinking that we need to make policies to change the environment in order to make it easier for people to make the healthy choice. And that healthy choice narrative ultimately puts the responsibility on the individual to choose to eat healthy and to exercise more as a way to prevent obesity.

So, I have to tell you that this realization hit me like a brick wall. I started to think about my role in contributing towards a narrative that promoted individual responsibility for obesity. And I started to think about my interactions with my nephew who had lived with obesity all his life and who had experienced bullying throughout his childhood and how I had encouraged him to lose weight by eating healthy and exercising more.

My doctoral research was transformative in that it was an experience that made me question my understanding of obesity and my behavior and my professional practice in obesity prevention and management. Since then, I have become very outspoken about changing the public health narrative from eat less and live more towards a more person-centered, equitable, and less stigmatizing narrative. I owe this shift and my focus to all the individuals living with obesity who have shared their experiences with me.

If they had not opened up to me to show me and to take me down the path of their realities, I would not have been able to change my perspective and approach. This is why I believe this campaign is very important. It is key for us to understand what people are living through in their daily lives in order for us to understand why we need to change our behavior and practices.

For those living with obesity, this is also important to do. Reflecting on how your understanding of obesity influences your actions and beliefs about yourself. In my research, I learned from many people living with obesity that they felt that obesity was their fault because society, their friends, family, health providers, public health policy makers, the media, they all tell them that obesity can be prevented by eating less and moving more.

They told me that they believed this themselves and that since they were not able to manage their weight, this was their fault, that they had simply failed the advice that public health makers were giving them. This led them to continue to try diets and exercise programs as well as to continue on this endless yo-yo dieting cycle that made them feel ashamed, embarrassed, and disappointed in themselves. They told me that the judgmental looks, the fat jokes, the critical comments from friends, family, health professionals, left them feeling alone and isolated and that they felt that they were not normal and that they did not belong in this world.

These experiences of weight bias are like many traumas for people living with obesity and they can affect the perception they have about themselves as well as their health outcomes. These experiences are not helpful. They believe, research shows that people who experience weight bias and shame for their weight will put on more weight because of the body’s response to this stress.

I heard stories from people living with obesity that after experiencing weight bias and stigma all their life, they felt that they had nothing left in them to keep going. My own nephew who experienced weight bias and weight-based bullying in schools throughout his life really reached the point where he felt he could not live in this world anymore and that he was not accepted and he attempted to commit suicide. This personal experience compelled me even more to use my professional voice to eliminate weight bias and stigma and to promote equity for all people.

From a public health perspective, our role as health professionals is to do no more harm and to promote health for all. This is why I think it’s important for public health professionals and healthcare professionals in general to critically reflect on their understanding of obesity and to question how this understanding influences their professional behavior and practice. In public health, we can also move beyond awareness about the impact of weight bias and obesity stigma by creating policies and laws that prevent weight-based discrimination.

And through my research at Obesity Canada and through my doctoral research, I developed tools to help public health policymakers use a weight bias lens to assess the consequences or unintended consequences of policies which may indirectly contribute to a weight bias narrative and stigmatizing policies. Through Obesity Canada, we’re also engaging with the Human Rights Commission of Canada to help us enforce existing laws and legislation to prevent weight-based discrimination. And through my personal life, I make the effort to challenge weight bias, especially in my family.

When I hear fat jokes, for example, I immediately point this out to my son as this being unacceptable. I also explain to him the consequences, the severe consequence these fat can have for people living with obesity. These can be life-threatening consequences.

I hope that my story helps you reflect on how you as an individual can do something about eliminating weight bias and stigma in your personal and professional lives. If you’re a person living with obesity, or if you have a loved one who’s living with obesity, consider how you can change and how you can take action to improve the lives of people living with obesity by eliminating weight bias and obesity stigma. Join the European Coalition for People Living with Obesity and help create this change.

Prevalence of Obesity in Childhood from President of APCOI in Portugal.

Mario Silvia.


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I appreciate the introduction, Vicky. And today, I would like to share with you my experience over the last 10 years educating almost half a million children in Portugal about obesity as a disease that like any other disease needs to be treated and prevented properly. But first, I would like to tell you when was the first time that obesity entered in my life.

Even when I still didn’t know how to name it. It was right in my first school year when one of the boys of my class was frequently called the fatty instead of his name. And it didn’t make any sense for me at that time.

So I made a point of always calling him Diogo, which was his name. And for example, he was usually the last to be chosen for the football team until of course he gave up. And I became the only one that always invited him to play with me during school breaks.

And although nobody told me at the time, I already knew that Diogo was in need of support and treatment, not judgment, just like my grandmother needed because in addition of living with obesity, she also lived for many years with another disease, diabetes and later cancer. Fortunately, since 2004, the National Health Service in Portugal has recognized obesity as a chronic disease that everyone at any age can develop. And it’s a disease that needs long term strategies for its effective prevention and management.

But when I launched Portuguese Association against child obesity 10 years ago, the percentage of children who according to World Health Organization was still living with this disease in my country was 37.9%. And at the end of last year, Portugal has already managed to reduce this percentage to 29.6%, which means a decrease of 8.3%. And for these results, Portugal was considered by WHO reference of good practices for the rest of the world, as it is closer to reach the global goal of halting the growth of childhood obesity to 0% increase by 2025. But do you know what is far from reaching zero? Stigma, even though it is considered a chronic disease in very few countries like Portugal, obesity is still used as a reason for social stigmatization. Every day in each school, thousands and thousands of de-yogers are continuing to suffer from fat shaving instead of being supported in seeking help to live healthier.

And I’m not just referring to bullying among children, which by the way, is growing each year and becoming more strong and more dangerous other times like cyber bullying. I’m also talking about the discrimination that are happening inside schools. When I have seen so many teachers making inappropriate comments in front of the class, asking for example, a child with obesity to try harder in physical exercises, because according to them, they need more than other children.

Or when I go to a school cafeteria and I always find someone from the staff saying to a child with obesity, that is not worth to put salad on the plate because certainly this child doesn’t like it instead of encouraging to try it. So of course, when I’m there present in the situations or my team, we always take these opportunities to educate adults, no matter they are teachers, school staff, or even parents. But so often, none of us are there or is anyone that can defend these children from stigma.

And stigma has so direct consequences in children’s self-esteem. And if it’s not stopped, it can cause depression and so other mental health problems. And now that you’ve heard how difficult and upsetting stigma is for children, I am looking to hear more now from Dr. Alderson on speaking with children and parents about their obesity.

How to communicate effectively with children & adolescents, Icelandic Society for Obesity Research and Prevention (FFO) President.

Dr Tryggvi Helgason.


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Well, thank you, Vicky, and thank you, ECPO, for inviting me to talk about this, well, interest of mine about childhood obesity that I’ve been working on for some years. It’s an insightful listening to what Mario is experiencing with his work and with children. And what I was asked to share, would like to share, is a bit more of how we can open a discussion with parents and children, because that’s often what I’m asked of by health workers, let’s say, those who are there in the first line, the school nurses, the home doctors, the family doctors that see or measure that a child is growing faster than it should be.

Then they are sometimes in trouble with how they can enlighten people or ask them what, if anything, should be done about that. So that’s something we have worked on in our clinic to use language that’s not disturbing, because it’s very important for us as health care workers to build a good and healthy relationship with our clients to keep them on the long distance coming back so we can help them lead the way into more healthier growth. So my main point is more or less in that angle.

You always have two partners when you are a pediatrician or a kid’s doctor. You talk to the child, but you also talk to the parents. And both the parents and sometimes the older children come into the room with their own prejudices and with their own experiences, either from their own childhood or growing up self or from earlier contacts with health care workers or even with people in society, on their grandmas or neighbors or whoever.

So my, let’s say, opening line, if you want to use that word, is usually that I show people just on a growth chart that the child is growing too fast according to what the others are doing or, as I usually say, they’re growing unnecessarily fast in weight. I show them that the height is growing just according to what other kids are doing, but if the weight is growing too fast, it’s unnecessary. And when we put it that way, we just show them they are growing faster than the other children.

It’s usually not stigmatizing and it’s usually not something that we can argue on because that’s more or less a fact. The child is growing faster than the growth line is doing. And sometimes, of course, I work with children that are growing slower than the growth line because I’m also a general pediatrician.

And that’s something that’s much more accepted. If your weight is growing slower than expected or needed, everyone is aware of that. That’s not good, but we should be just as aware that if you’re growing faster than necessary, then there’s usually an explanation.

So sometimes you don’t have to do anything. It’s something that’s just temporary and you don’t have to worry about it, but usually it’s something that’s sometimes visible. Sometimes we have to dig very deep to see the explanations or understand why this child is growing faster than necessary.

And in that line of language, we usually never get people against us because we are just discussing how the child is growing. And in that way, we can build a much more healthy long-term relationship with the family because that’s what’s needed. If you’re working with a child with obesity, you have to follow a family more or less until they’re grown up or at least for a very long time.

So if we measure a child growing too fast, that’s not a disputable fact. So it’s much, much easier to discuss than if you use language like too fat or obese or something. I usually don’t hesitate to use those words because for me, they are just facts as well.

But I know in some people’s minds, it can be stigmatizing. And what we need is, like the hashtag says, hashtag should support not stigma. And we need to build a relationship with these families to be able to support them on their way to, let’s say, healthier growth for their children.

Because if kids are growing for a long time faster than the others, they are going to have problems like the grown-ups have with sugar or a lot of things, at least a large percentage of the kids. So I usually don’t have to share that fact that, let’s say, that the steady, fast growth is not usually not a surprise when they come to me. But when you are a first-line healthcare worker, it’s usually something you have to address that your relationship with the parents is good for a long time.

So that’s maybe the main point, just to have an easy opening line, because that’s something that a lot of parents have, let’s say, described to me later on in life, that they have had sometimes, either self or on the way with a child, that just the opening line close all the doors on that particular healthcare worker. So if you discuss the growth of a child, it’s usually not stigmatizing. So I would advise that.

So on that line, Vicky, I would like to give it back to you to see how others are doing it. I look forward to seeing more of the discussions from Dr. Crotty in Ireland shortly and would like to wish you all luck with your work. It’s nice to see how you’re helping us as healthcare workers to see how support and stigma can have different effects on our relationship.

Thank you.

Obesity Stigma in Media from Irish TV and media personality.

Elaine Crowley, Elaine Show Virgin Media.


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Good afternoon, Elaine. It’s an absolute honour to have you here with us. Thank you so much.

Thank you so much for inviting me. It’s a pleasure. It’s quite odd for me because the tables have turned.

I’m on the other side now because normally we’re swapped around and you were the presenter. So it’s really, it’s an honour for me. So, do you know, I wanted to start this off by, I suppose, bringing somebody with your experience in television, in media, in listening to listeners and viewers from all over Ireland and seeing weight bias and stigma as it’s come across in many different shapes and forms from, you’ll see it, I suppose, in newspapers, you’ll hear, you know, personal talks about it, you know, from friends and family.

And even as yourself as a media and personality, you know, you’re out there and people think, you know, it’s okay to actually, you know, put a little jive in there, a little comment in there, or, you know, fat shaming and jokes to anybody who isn’t a size six or eight pretty much, you know. So I kind of wanted to get your thoughts, like you’ve been in the media for 20 years now, good Lord woman, you’ve been absolutely phenomenal on daytime television in Ireland and you’re so well-known. So, you know, from your experience, what you’ve seen over the years, what has been your, I suppose, thoughts about fat shaming and obesity stigma jokes? Yeah, it’s, well, I’m not sure, do you want to talk about jokes or perhaps just talk about what it’s like in media first, because maybe I’ll address that first, because my very first day working in television, I remember I was a size 14, a UK Irish size 14, and, you know, I was always aware that that wasn’t standard size, because when I was growing up, people’s idols were like the likes of Kate Moss, heroin chic was really, and so being stick thin was fashionable.

It’s a bit different now, because having a bit of junk in your front casino is a lovely thing, back then it wasn’t the way at all. My first day in television, I was told that basically, yeah, I looked the part, but I’d really have to lose some weight, and it didn’t come as a shock to me, and I wasn’t even offended, because I expected it to happen. I was like, like, naturally, I level, I level at a 14 to 16, that’s what I am when I’m at my best, and I just went, okay, well, that has to be done.

And since then, even before then, I have spent most of my adult life on a diet of one shape or way or form. I was even in, where I work in Virgin Media now, which was TV3, we used to have Pancake Tuesday every year. I have never once had a pancake in the canteen on Pancake Tuesday, and I was actually thinking about it this year, because I’ve always, always been struggling and hating myself for eating, and you know what, it’s kind of exhausting, and it’s such a terrible, terrible way to be, and I think it’s even more difficult, because if you are prone to putting on weight, and some people are, we have to admit it, we’re not all born with the same metabolism or the same body or the same genetics, it’s kind of difficult to explain to other people what it’s like having that constantly at the back of your head, and people thinking they can talk about it.

And every single time, I only did an interview last week, every single interview I have ever done in my adult life as a TV presenter, even as a producer behind the scenes, my weight has been brought up, how I gain it, how I lose it, how is this happening, how is that happening? And at this point, you know what, I’ve stopped getting offended by it, I just answer now, because it’s just like asking my name. Hello Elaine, how are you? What’s your weight like today? How do you lose weight? How do you gain weight? How do you do this? How do you do that? And it’s got to the place where I can’t let it hurt me or upset me anymore, because it’s never going to end, not in my lifetime anyway, unfortunately. Yeah, do you know, you actually made such a strong point there, because people tend to define people by how they look, their obesity as such.

I know myself, I’ve even let myself define myself by my weight. Everything was, well, I can’t do this because I’m a size 22 or 24, when actually I could. I actually pulled myself back and I’d stopped myself from doing certain things.

And as you said there, I’m Elaine and I’m a daytime presenter. Oh yes, and my weight today, this shouldn’t be the case. This is what we’ve seen in society for years.

And I think it’s probably fueled a little bit more now with people in lockdowns and these awful memes doing the rounds of, oh, well, we’re all locked down. So we’re going to be two sizes larger coming out of lockdown. And on top of that, this is my bikini body at the end of lockdown, showing somebody who has weight on them.

And it’s just not all right, because as you said, and actually I remember doing a show with you where you’re talking about hormones yourself. And we know obesity is genetic, it’s psychological, it’s socioeconomic, environmental, sleep plays a huge part, hormones and stress plays a huge part. And you spoke a lot about hormones yourself and how you’ve managed that and how you reflected on that.

And what has your experience been with that? Because I think that was a bit key for you, wasn’t it? Yeah, it was, because I’ll go back to basically the first time I would have put on a significant amount of weight. I was a very active child. I was a very active teenager.

I was doing basketball. I was a running champion. I did, you name it.

I did every sort of exercise under the sun. My mother’s shed is full of trophies and medals that I won when I was younger. Just one night, I jumped over a wall at home.

I landed on a shovel, sounds bizarre. I broke my ankle and I had to put on a cast. And in three months, I put on three stone.

I went from nine to 12 stone as a young teenager. And that’s just from not exercising. Now, that should have probably given me a few hints because I wasn’t consuming enough calories to put on that much weight so quickly.

But that was the start of my issues with weight. And no one really understood what it was or what caused it. They just thought, oh, my God, Elaine must be eating a load while she’s sitting on her backside at home.

And I thought that myself. But I went to college quite early. I did my leaving at 16.

I went to college when I just turned 17. So I was living away from home for quite a long time by myself from a quite young age. And always weight would come up.

I was never as thin as my my compatriots in college. I was always struggling. And I never actually investigated perhaps what would have caused that, because I think when I put on the weight, depression would have kicked in as well to a certain extent.

And I don’t think anyone can understand if you’re a fit and healthy young girl and all of a sudden you put on three stone for no apparent reason other than just not being able to run around the place at your normal rate. Like the amounts of calories I must have been burning every day through exercise was phenomenal to keep me on that level. Now, I like fast forward, like 30 years later, I finally get to the bottom of it.

Well, 25 years later, I’d probably discover syndrome as well as a thyroid and a few other hormonal issues as well. But if I had known at that age that I was PCOS. That would have changed the landscape of my life, and I think people do not understand that something that might be perceived as simple as that, like I could lock myself in a press for six months, I wouldn’t lose very much weight.

I did Slimming World at my sister’s once and they lost two and three stone respectively. I put on a pound and we were all doing the same thing. I and it took actually a dietician and an endocrinologist to tell me, Elaine, you can no matter what you do, if you live in bread and water, it will be extraordinarily difficult for you to lose weight.

And you know, it was it was kind of a revelation to me. I stopped hating myself for being myself. Because I love food.

I love my meals. I’m never going to be skinny. I have never wanted to be skinny.

If I’m like healthy and not feeling disgusting about myself, then I’m quite happy. And and that doesn’t necessarily correlate to the way I am. It’s the way I feel about the way I am.

And I knew all something just wasn’t right all along. I mean, I should have been a clear indication when I was that 14, 15 year old that this happened to me. And now I’m like in my 40s.

And then I finally realized this is why you’re you’re my metabolic syndrome. My I can’t process insulin very well. All these little things that make perfect sense to everybody else.

And their lives are not dealing with these sort of things. And I am. And I wish to God I knew years ago, but I can’t beat myself up too much because I haven’t.

But the landscape of my life, I often wonder would have been a lot different had had I actually been diagnosed as a teen. Do you know what is so important about what you said there? Right. So we’ve seen from the likes of and I know Jason is going to talk about it.

There’s no. Well, the action I used to be. So the action I used to be had 14 and a half thousand patients or people who were living with and affected by obesity in it.

And it had two and a half thousand health care professionals. Now, in that study, what we’ve seen was that the average person is most likely to avoid getting any kind of medical intervention or asking for any help or any kind of treatment. And from first struggling with their weight, the average person is six years before they seek out medical intervention.

And when we look at actually the opinions of the health care providers in comparison to the patients, the patients, they were motivated. They wanted to lose weight. They tried at least for at for mean good, like serious attempts.

Whereas the health care providers, eight out of ten of them said that they didn’t think their patient was motivated to lose weight. And I think that’s why, because people, people perceive if you’re so-called fat, people think you’re lazy, goes hand in hand. It’s almost the last socially acceptable bias that we have, that if you’re fat, you’re you’re just not energetic.

You’re not getting up off the couch, not running. You’re not doing any exercise. I’m a very active person.

I was at my heaviest. I was very, very active. But I mean, I think because we see someone who’s fat, overweight, obese, call it what you want.

Like I have no problem with any of those words anymore because I had to stop having issues with those words. But like, I think that people still look at it and go, and listen, I’m a bit guilty of that myself. It’s so ingrained into us all that if you see somebody who’s obese, morbidly obese, you have to.

Well, it has to be their own fault. How can anyone be like 20 stone if it isn’t their own fault? How can that happen without realizing the cycle that happens to go on with that? I mean, you can start off with a bad, a bad number of eggs in your basket. Be you like like me or you or whatever that hormonally, genetically, I’m predisposed to putting on weight, unfortunately.

Add to that, I absolutely love my food and I’m not even bad food. I’m not even talking about chocolates and stuff like that. I like my meals.

I don’t like depriving myself. And when you have two things like I love food, it gives me so much pleasure. I hate food.

It makes my life miserable because it’s making me fat. And if you don’t know the reason why, like it’s decades of your life hating the way you exist. And I’m thankful to God I don’t have that anymore.

But it took a dietitian. It took my endocrinologist. It took everything to finally make me realize what the hell was going on with my body.

I mean, obesity is a disease. No one wants to be carrying an extra 10 stone. It’s not healthy for any of us.

It’s not good for any of us. But, you know, sometimes we don’t have a choice. And I think the stigma that you’re right, the stigma that is out there and the bias that is out there stops people looking for the right help.

And that help might be going down the traditional route of diet, eat less, move more, which is a pain in the ass. Works for most people. But if you have a serious issue, by and large, it takes a little more than that.

If you want to go down the medication route, if you want to go down the surgical route, have bariatric surgery, I don’t care what you want to do. If it improves your life, you do it and make no apologies for it. And that’s what I think people need to be empowered to do.

If you want to take medication to reduce your obesity, if you want to have an operation to reduce your obesity, if you want to go off and run the Great Wall of China 20 times in a row to burn off some calories, knock yourself out and ignore what anyone else is saying to you. And don’t be ashamed of doing what you have to do, because I think on one hand, you have the shaming about people being fat and the next time you have the shaming about people doing something about being fat. You can’t win.

Do you know what I was about to say to you a moment ago? Because everything you say mirrors me, you know, like I’ve been on your show for donkey’s years now at this stage, and my weight has fluctuated up and down and up and down. And I have always admired you, because if you actually Google yourself, you will find yourself in pink T-shirts, running marathons and everything else, Elaine. And you’re an absolute role model in that sense, because there’s not a lot of people actually believe that you can run as a person who has obesity that I could run, for instance.

And this is the bias that we need to shift. We need to get rid of that, as you said, that ingrained societal idea that it is literally just get off your backside, eat less, move more, and you will lose weight, because that is not the way forward for everybody. Yeah, I would say, though, exercise is good psychologically for anyone, no matter what we’re there.

That said, I do not like running. I really hate running. I walk very fast now.

I like walking very fast to a destination, to or from something, or like all during lockdown, I was classified as an essential worker. So I was going to work every day. But I walked either to or from work or both every day.

And as it is, I still can’t eat a load of food, much at all as I would love to. I have to limit my calories quite strictly. And I have been doing I have to do a lot of exercise.

And I have been doing I mean, like. It’s it’s not there’s no easy answer to to to to my issues, I’ve had to work damn hard to keep a lid on it. But what I’ve stopped doing is the Sunday catastrophe.

Like I am doing this on Monday, I am going on a diet Monday, have to eat everything in the fridge and in the press, clear it all out. So I’ve done that nearly every Sunday for 20 years until I realized that you’re starving on Monday, then after the carbohydrate crash and you start again and it’s a cycle. I’m not beating myself up.

If I have an Indian followed by a packet of doughnuts, I don’t care anymore. I’m not beating myself up about it. But as long as I don’t get to the negative cycle of doing that over and over and over again, because food is not the enemy.

It’s the wonderful thing that feeds us. It nourishes us. It keeps us going.

It makes us happy. We enjoy everybody. And we have made food the enemy in our society.

We have made the food like it’s wrong to enjoy a slice of bread. It’s wrong to enjoy a slice of bread, but a couple of slices of bread won’t kill anyone. Do you know what I mean? And I think or I mean, if the diet industry went out, when it’s not, can you imagine what would happen if we decided we loved ourselves in the morning? Millions would be lost to industries, billions that we just liked ourselves as we are.

Yeah, I completely agree. Like, this is something that I’d often say to the team, you know, and we’re actually discussing this. We have a multibillion dollar industry out there of fitness and diet that is paid for by people like ourselves who spend all of their lives trying to diet, trying to exercise more, trying to follow what they the you know, the norm is whatever the cabbage diet or the soup diet or the latest Slimming World or not to this Slimming World or any of those organizations, because I absolutely love the recipes.

Some of them are absolutely fabulous, but it’s about being able to enjoy your food and not guilt yourself. But I think there’s a big difference that a lot of people don’t realize between maybe carrying an extra stone and carrying an extra three, four or five, six plus stone. And that’s where I would have been.

And that’s where you would have been. And and I think these a lot of these clubs, they work. If you’ve had a baby, you’ve put on some weight, you want to lose it.

That’s fine. Absolutely fine. It works for a lot of people.

But if you have a chronic, relapsing illness, which obesity is, then you have to look at it completely differently. You have to look at the long term of term effects of it as well. And even I think I know you mentioned a while ago that the memes and stuff about the cold with stone and bikini bodies and all that, you said they’re a bad thing.

I don’t think they’re a bad thing at all. I think because of lockdown and people didn’t move as much, they saw like people who’ve never had a weight problem in their lives. And I can’t call to my sisters amongst this.

They’ve never had to worry about it. They’ve never not been able to fit into their jeans. And all of a sudden they’re like, oh, Jesus, what’s wrong with me? Walking past a miracle.

How did I get this? And I think people who’ve never had an issue with weight in their lives have experienced maybe what we go through all the time now. And I think it has opened up a huge dialogue. And I think it’s been a huge education to a lot of people.

And you might and they might take the excuse my friends take the piss out of it. A good bit. But I think a lot for the vast majority of people out there, they’re going, you know, it’s not nice to be taken to make out of these sorts of things.

It’s just not nice. I got it. And it kind of got a taste of what it’s like for people every day of the week.

Because once you hit a certain weight, like I was always in and around where I am now, before my hormones went out of whack, I was kind of as I am now, maybe a stone or two lighter, but no different. And then as my 30s creeped on, my hormones got way more bonkers. I put on a ton of weight.

And at one point I actually didn’t care what I looked like. I was doing I do a lot of magazine and photo shoots. And I was like, well, my body is just it’s it’s an it.

There’s nothing attractive about it anymore. I just put on my nice makeup and earrings and they’ll all be about my face. And I kind of gave up what I was and didn’t.

I had to. I had to disconnect myself from the neck down. Yeah.

And so I get bored. And unfortunately, I know that now. But I had a conversation recently with my niece.

She’s she’s about to emerge into her teens. And she’s a beautiful child, an absolutely lovely girl. And she is going through what all of us go through.

She’s not a pick on her, but she hates her arms. She hates her legs. She hates this.

And I’m going, how has this happened? How is it still happening despite all the education that’s out there? What are we doing so badly wrong still? And I don’t have the answer to that. I know. Yeah, no.

You know, you made such a great point there. And I’m not going to keep it too much longer because and when when this goes out live later, you’ll be actually on air. So we’ll be able to flick between this and back over to yourself live on Virgin Media.

But as you said, they’re like teenagers. Can you imagine that world? Like I know myself from the moment I wake up in the morning. It’s OK if I’m going somewhere, where are the granny knickers are going to hold in all the lumps and bumps? So I actually look a little bit better.

And I’ve gone through that for years and years. And now I literally just get up and I try one, whatever I try one. And I I’m uncomfortable in my own body.

I wouldn’t wear a bathing suit for years. And now I love snorkeling. Now I don’t care who looks at me going down because I’m going out for a swim.

You know, I’m probably healthier than the ten people that are like stick tin that are sat on the wall, you know? And yeah, and I think for teenagers, like we’ve reached that age where we’re in our thirties and I’m in my forties. I know my shirts are well gone. That ship has sailed, girl.

Listen, I’m actually five weeks older, so you don’t own that one, right? But I think for teenagers, it’s incredibly difficult at the moment. We’ve got everybody is online, social media, all the Instagrams, the TikToks, everything. And it’s all about looking that kind of like shape and stuff like that.

And I think probably because we’re older, we have that experience. We’ve gone through it. We’ve accepted that we need to be healthy for us, for our bodies, for like everything about us, our mental health, the whole lot.

But for younger girls that are like teenagers in their early 20s, what would you actually say to them to give them a little bit of hope that they can get over this, you know, shaming their own body? I’m not going to be cliched and go love yourself and all that sort of stuff. Of course, that’s a given. But, you know, every society, every era has had a different definition of what beautiful means.

I mean, back in the day, the Rubens, I mean, we would have been the ideal. The ideal woman had loads of flesh in her bones and the bigger, the better. And that sort of stuff.

So no matter we can blame Instagram, we can blame the Internet. Now, it’s not anything. It’s just the way the way beauty is perceived, goes and ebbs and flows throughout the ages.

I think we need to build confidence. Forget about looks. If you build confidence in girls and educate them on what really matters, that’s right, because if you have confidence in yourself and if you are well educated in the ways of both the way the world works and the way your body works and the metabolism and everything else, then these little things.

Shouldn’t it’s and it’s not that it’s huge for a lot of people. They shouldn’t bother you as much anymore. I mean, I wish I was as I was wise back then as I am now.

That said, it would never have happened. There’s a rite of passage that goes on in every girl’s life that will keep happening throughout the ages. We’ve always used makeup.

Go back to the ancient Egyptians. We’ve always venerated different body shapes throughout the ages. That has happened as well.

I think if you teach somebody to be confident from a young age, assertive, resilient and resilience is very important. Then no matter what anyone says or anyone else does, it shouldn’t affect them too much. It will a bit.

We’re all only human. And I think we have to realize that as well. But to anyone out there, if you are a mother or an auntie like I am of girls, you’re really just be there, listen and try and educate them and tell them they’re wonderful.

Do you know on that note, that is a perfect note. Your nieces have an absolute role model of a woman. They’re very lucky, aren’t they? They are indeed.

Thank you so much, Elaine. You’re very welcome, Vicky. Thank you very much.

Let’s change people’s attitudes and advocate together for acceptance, education and disease recognition.

ECPO would like to thank our Sponsors Novo Nordisk and WW for making the #LivingWithObesity campaign & People First day possible.

Opening an empathetic conversation with patients, GP specialising in Weight Management & Bariatric Medicine.

Dr. Michael Crotty


Transcript to follow

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I’m delighted to be here today and I’d like to thank Vicky and the ECPO for inviting me to speak. What I’d like to discuss today is obesity in the healthcare setting and specifically opening an empathetic conversation with your doctor or between the doctor and patient. I think first of all, we need to acknowledge how difficult and daunting it can be for a lot of people to talk about their weight.

You know, it’s a very private and personal issue for people. It’s hard to share personal details about our life, our eating habits and our body. So I think as a doctor, I can never, you know, underestimate how difficult it can be for a patient to talk about these things.

Even though we know that obesity is not a lifestyle issue, it’s not a willpower issue, it’s a complex chronic disease. I think people who live with excess weight inevitably face the negative attitudes, stereotypes and weight bias. And this can often prevent them from getting the best care and treatment that they need and they deserve.

I think we also know that, you know, as a disease, obesity isn’t given the same time or attention as other chronic diseases, particularly in the primary care or general practice setting. And I think if we look at the reasons why a lot of doctors don’t bring up weight, I think there’s many studies in this area and the three main points that come up are number one, a concern about offending people by bringing up their weight. I think a lot of doctors feel that they have limited time and resources to bring up such a sensitive topic.

Perhaps the doctors have limited training or understanding about obesity as a disease and the effectiveness of treatment options. I know certainly when I was in medical school and during my training as a general practitioner, there was no specific training on obesity as a disease. And this is something I came to later in my career.

I think, you know, other reasons, some doctors may feel it’s not their role to discuss weight. They may have personal issues with their own weight and for that reason not want to bring it up. And maybe they live in an area where there might be limited referral pathways.

So by bringing up the conversation about weight, sometimes they may not know where to go with it after that. I think in the health care setting, it’s, you know, it’s fundamental to starting a discussion about weight for us as doctors to recognize the weight bias that exists in health care and for some doctors to recognize their own weight bias. We shouldn’t make assumptions about people based on their weight.

We can’t assume about their eating habits, about their lifestyle, their physical activity or even their health based on weight. You know, people are not defined by their weight. And I think we need to acknowledge this to help us open an empathetic conversation.

I think when I see a patient, the first thing I try and do is explore all the causes of somebody’s presenting problems and symptoms to not immediately jump to a conclusion that their symptoms are caused by their weight. I think a lot of patients that I meet have had the experience that no matter what ailment or problem they go to their GP with, it’s attributed to their weight. And, you know, we know that weight can have an impact on health, but we can’t automatically blame a person’s problems on weight.

We need to look past weight. I think as a doctor, weight is often brought up obliquely in a consultation. We might be discussing another medical problem such as diabetes or high blood pressure, and we use this as an opportunity to discuss weight.

But for me, weight is an incredibly important issue in its own right, and it deserves time and attention, and it deserves its own consultation. My first step in opening a conversation is always to ask permission to the patient sitting in front of me to discuss weight. I might, you know, I might ask them, would you mind if we talk about your weight today? How do you feel about your weight? You know, how does your weight affect you? I think this is integral to starting a sensitive and non-judgmental conversation, and I think it needs to be done at the appropriate time.

Like I said, you know, somebody comes in and sees us, it’s not the first thing we’re going to do. We need to deal with the issue at hand first, and then if the patient is open, we can start a consultation. And if somebody is open to starting a consultation, you know, weight is not a door handle issue.

It’s not something that we discuss as somebody’s leaving the consultation. It deserves time and attention, as I said, and I often will advise people to make a follow-up appointment specifically to discuss their weight so that we can focus on that and not get sidetracked by other issues. When doctors are discussing weight, it’s absolutely paramount that we don’t use stigmatizing language.

We need to use person-first language. And, you know, we may find this uncomfortable initially. It may not be the way we’re trained, and certainly in society, it’s not the way a lot of people speak, but I think we need to lead the charge in promoting person-first language.

It’s very, very important that when we’re starting a conversation about weight, we need to consider a patient’s previous experiences discussing weight. A lot of patients that I have met in the past might have had harmful or negative experiences talking to doctors about weight. Again, you know, their weight is blamed for all their problems.

Maybe they’re blamed or shamed or they’ve been patronized for years with the outdated and oversimplistic message that, you know, you need to eat less and move more, which we know long-term isn’t a treatment for the chronic disease of obesity. After we have acknowledged or asked the patient about their previous experience and, you know, shown that there is a lot of change that needs to happen in the healthcare setting, I think this opens us up to have a good conversation. As a general practitioner, one of the key skills that I think we possess is the ability to listen to our patients.

Every person’s journey and experience in life is unique, so listening to the person sitting in front of us, you know, can give us an incredible insight into the challenges and barriers that they’ve faced. It can help us to collaborate, to come up with a personalized strategy to help them manage their weight. I think we need to also acknowledge that a lot of people living with obesity have made many repeated efforts to lose weight in the past and with some varying success, and maybe they’ve experienced weight regain.

So again, going back to those assumptions that we make in our weight bias. When I’m discussing weight, I try to employ the 5As framework for obesity management, which was spearheaded and developed by Obesity Canada and the University of Alberta, and I think this is a fantastic tool to help to structure the way we think about weight and help us, you know, come up with a plan that is agreeable to the doctor and the patient. As I mentioned, we start off by asking permission to discuss weight.

We may explore somebody’s readiness to change, you know, do they feel that weight is an issue for them? Would they like to change it, and are they ready to do it now? I think following this, we’ll do an assessment, we’ll assess, we’ll talk about their history, maybe we’ll do an examination if it’s appropriate, we might arrange investigations. Really, we want to grade or assess the severity of somebody’s disease. We want to look at the root causes and drivers and barriers that they experience, and the 4Ms of obesity management are instrumental in this.

We look at the impact on the quality of life and perhaps the comorbid or associated medical conditions they may have or complications that are associated with their weight, or just, you know, other things that contribute to difficulty managing the weight, like medications or, you know, mental health issues, there’s, you know, the list is huge. When we move on to advising somebody, we can talk about the health benefits of managing weight and how a relatively small reduction weight can have a significant effect on medical outcomes long-term. We talk about, you know, we advise people on the long-term strategies and treatment options, and we agree on a collaborative approach, looking at expectations, goals, and personalize the plan for each individual.

And after this, we can assist them, you know, it might be education, it might be pointing them in the direction of resources, and often, you know, I think one of the most fantastic things about collaborating with my patients is some of the best information and resources in education that I have come across has been shown to me by my patients. So I think, you know, always being ready to learn, always being ready to open our mind is integral. I think, you know, assisting people in identifying and coping with barriers and definitely arranging for a follow-up.

The chronic disease of obesity is not something that happens overnight. It’s certainly not something that we can cure. It’s something we manage long-term, and it’s something that, you know, in 15 minutes of a consultation, if that’s what we have, we’re not going to solve the problem.

Our initial consultation, we might open the discussion, we might explore the patient’s experience and, you know, make a plan, but we’re going to need repeated visits to, you know, tackle this issue. I hope that I take a holistic approach to looking at things, you know, we mentioned looking at the root causes, why somebody might struggle, the barriers that they encounter, but I think it’s incredibly important that we don’t just focus on the scales and the numbers that we see. It’s important that we try and help people to improve their health and not just lose weight.

You know, in my opinion, you know, there are many other markers of success, not just the numbers on the scales. I think, you know, as a doctor, we have to be conscious in the consultation that we have to be careful not to maybe share our own weight loss stories or anecdotal, you know, helpful tips that people, you know, don’t often find as helpful. You know, this can add to weight bias and stigma.

We need to focus on evidence-based treatments. In our clinic environment, you know, it’s very important that we make this friendly and welcoming and a safe space for people, and this might mean removing stigmatizing material from the waiting room, magazines, posters, you know, making sure that it’s accessible, making sure that we have perhaps armless chairs that can support somebody living in a larger body, you know, with their size or shape. The equipment that we use, you know, having appropriately sized blood pressure cuffs, gowns.

If we’re going to, you know, ask somebody if it’s okay to weigh them, we need to have scales in a private setting that maybe the display is not immediately visible to the person if they don’t want to see. But again, this is another thing that I think it’s important to ask is, you know, how do you feel about us checking your weight? And some people will be okay with it and some people not. I think the staff in our practices need to be kind of coached and guided in person first language also.

The other thing that has really come out in recent times, you know, particularly since the start of the COVID pandemic is the opportunity for virtual consultations, you know, telemedicine, communicating with our patients in a different way. And a lot of doctors might find this unfamiliar territory. They may feel out of their comfort zone, but it really does remove a lot of the barriers for our patients.

It’s a safe, comfortable environment. They’re in their home setting. It’s convenient for them.

And really, this is the essence of patient-centered care. You know, although the doctor might feel a little bit more uncomfortable, I think you can get a and you can still build that one-to-one collaborative approach and trust. When I’m talking to people about, you know, bringing up the conversation about weight with their doctor, there’s a few kind of, you know, tips that I’ll often discuss.

I think it’s very important that we do book a visit specifically to discuss weight and make sure that weight is highlighted as the topic for discussion so the doctor knows in advance that this is what’s going to be discussed. Having, you know, thought about and maybe prepared a list of questions or concerns, thinking, you know, before the consultation, anticipating, you know, the questions that the doctor might ask. So thinking about our past history, the pattern of weight change, maybe looking at, you know, what might some of the triggers or factors be that influence our weight and, you know, what have we done in the past to try and control our weight? Bringing a list of current medications can be very helpful too, particularly if it’s not your regular doctor.

And I like people to think about the reasons why they want to lose weight. What values do they have? What are their, you know, goals long term? I think we need to have a realistic expectation for the encounter and, as I mentioned, this is a chronic medical condition and often the first step is opening the conversation. I think during the consultation, not just doctors but patients, I think, also need to be, you know, careful not to be self-critical in their language, you know, not to use stigmatizing language because we know that internal weight bias, you know, is a huge factor and certainly an incredibly negative thing that can help people or can, sorry, hinder people in managing their weight.

I think I always like when patients tell me if they feel comfortable with having their weight checked, I’ll ask, but it’s nice if they can tell me. I think, you know, perhaps the person wants to consider, you know, bringing up the topic of referral pathways or treatment options and definitely making a plan for follow-up. So in summary, I think, you know, we know that obesity is a complex chronic disease.

We need to end the weight bias and stigma that exists not only in society but in the healthcare setting. We can’t make assumptions about people based on their weight. It doesn’t define people.

We need to consider all the potential causes for somebody’s symptoms when they present to us and look beyond weight. We should not be, you know, shaming or blaming people or patronizing them with the, you know, outdated, you know, thoughts about obesity. We need to focus on evidence-based medicine.

We always need to ask permission to discuss weight. I love the Five As framework for managing obesity. We need to be supportive and encouraging in our advice and focus really on health gains rather than weight loss.

So thank you very much for listening to me and I hope that everybody can please continue to support the campaign using the hashtag livingwithobesity. Thank you very much.

ACTION IO and why obesity stigma needs to change from EASO President Elect.

Prof. Jason Halford


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Thank you Vicky and thank you ECPO. It’s great to be here and it’s great to hear the talks from these obesity experts and patient advocates from across Europe. Now I’m here to talk about the Action.io study and the Action.io study is an important study.

It was completed across 11 countries globally including four European countries and the data was collected till the end of 2018 and it was really looking around the beliefs, the perceptions of obesity and looking at those in terms of barriers and facilitators to treatment. Now interestingly and encouragingly most patients and even more healthcare practitioners believed obesity was a disease but unfortunately both patients and healthcare practitioners focused on individual lifestyle approaches to treatment which didn’t really seem to reflect the biological basis of obesity. Now what was more worrying is people with obesity believed it was their sole responsibility to lose weight by and large and only one quarter saw healthcare practitioners having some role or responsibility in this.

While looking at the healthcare practitioners many healthcare practitioners believed their patients, people living with obesity, were neither interested nor were they motivated to lose weight and why would that be? Well it might be that they’re looking at patient failure, that they advise their patients around weight loss and the patients come back and have not lost any weight so they assume patients aren’t following guidance. It might be because they don’t understand obesity as a disease and what underpins that and the treatment options available and it might be simply there is stigma at play here in terms of healthcare practitioners’ views around obesity. This doesn’t reflect the experience of people living with obesity.

Action.io show that people with obesity made four or more recent serious weight loss attempts so the people were engaging in self weight management seriously. Unfortunately it didn’t seem to result in significant weight loss or weight maintenance of weight loss over time and it took people with obesity six years from first struggling with their weight to having their first conversation with their healthcare practitioner whether they raised it with their healthcare practitioner or their healthcare practitioner raised it with them and why was that? Well it probably goes back to this idea of responsibility, this idea that it is solely my responsibility to deal with my weight problem. It might also to be related to stigma, fear of being judged by healthcare practitioners or actual experience, past experience of being judged by healthcare practitioners as well and finally there probably is an element of stealth stigmatization in there as well because this feeling of responsibility, all these efforts but ultimately the failure of trying to do it on their own without support and not succeeding in the long term.

So the consequences of struggling with obesity and not seeking healthcare practitioner advice and support is obviously obesity complications have time to develop and repeated failure in weight loss attempts will have an impact on self-efficacy and this in turn will make it harder in the future for those individuals to lose weight. So the sooner healthcare practitioners and people with obesity can have a constructive and respectful conversations around weight management the better. So that’s kind of my take on some of the important messages coming out of Action.io. Now back to Vicky in the studio.

Thank you Vicky.

Why awareness alone is not enough from Chair of Metabolic and Bariatric Surgery, King College London.

Prof. Francesco Rubino


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Thank you, Vicky. It’s a privilege for me to be part of this initiative. I do believe weight stigma and weight bias are fundamental issues, perhaps the most important issue for us to address if we really want to effectively tackle the problem of obesity.

Now, I’m here to speak about why raising awareness of stigma and weight discrimination is important, but it’s not enough to address this issue. The reason why this is the case is because personally, as a surgeon, I think it’s very important to understand and study problems or conditions when it comes to medicine, understand their causes in order to be able to address them effectively or to cure them and to eradicate them if we want. So if we want to eradicate the problem of stigma, it’s so important to understand what the cause of stigma is, where does it come from, why it’s so prevalent.

Now, as every form of bias, weight bias and the resulting stigma, it’s largely due to lack of knowledge. This is the case for all sort of other things. And there are other reasons and other factors that play a role.

But there’s something specific and special about the issue of weight stigma that makes it different than other things. And I think it’s because of the way we understand the relationship between lifestyle and weight issues and obesity. Now, if you take an example from other conditions or diseases that are clearly associated with lifestyle, for instance, cancer or trauma and other many diseases that have an association with choices we make in our life.

Well, the difference between those other diseases, say cancer, for example, and obesity, is that no matter what the causes of cancer is, no matter whether or not there was smoking, heavy smoking in the background or any other predisposing factors that has to do with lifestyle choices, once people get cancer, we do have sympathy for them because we know that without medical help, without our support, they can’t undo cancer. When it comes to obesity, we lack that understanding. We think obesity is linked to lifestyle choices, which is no different for cancer, if you wish.

But here with obesity, there’s something special. There is this misconception that no matter how severe obesity is, people could actually undo obesity at their will. It would just take a little bit of commitment, a little bit of effort.

And if they don’t succeed, just try a little bit harder. So is it true that that’s the case? Is it true that you can undo obesity as you wish? Well, all scientific evidence shows us that that’s not the case. That when you have severe obesity, it’s difficult to lose weight and sustain weight loss because our body weight regulation, our system that regulates body weight actually fights back.

It’s meant and it works by maintaining what we call homeostasis. Basically, our body tries to keep our weight within a narrow range, pretty much like our body does with our body temperature and other vital parameters. Every action we make to change these parameters are countered by other actions that the body puts in place through a mix of hormonal and other mechanisms that of course are not under the control of our willpower.

Now we know that for sure from scientific research, but the narrative that we still have about obesity has not incorporated that part of science. So we still think you can undo obesity even in the face of evidence showing that that’s not the case. Now, we recently ran a survey, an international survey with many, four countries, United States, UK, Australia, and New Zealand.

When we tried to understand exactly what is the main cause of weight stigma, we used a questionnaire which scores the level of stigma. It’s a validated stigma score. And we looked at how stigma score correlates with how people, individuals that responded to this questionnaire answered questions related to beliefs about obesity or attitudes towards people with obesity or treatments for obesity, et cetera, et cetera.

So what we found was interesting. Not surprisingly, of course, people who tended to have higher stigma score also tended to believe that obesity is associated with gluttony or individual lack of energy in maintaining healthy lifestyle. And that goes with what we already knew.

But what was quite intriguing was the fact that there was a strong correlation between stigma scores, the higher the stigma, in other words, and the response to question, is obesity entirely curable by just deciding to do so, by self-directed intervention, the self-directed lifestyle changes. Those who responded yes to this question tended to have higher stigma, which means that if those of us who think or tend to think that it’s easy to undo obesity just by deciding to do it and by doing it yourself, in other words, you don’t need help to undo obesity, well, those people who have those beliefs tend to have much higher stigma, weight bias and stigma. So it’s important at this point to address this issue by exposing the gap between stigma and science, but most importantly, by exposing the gap between this narrative of obesity being easily done and undone by deciding to do so, and the reality, which science has shown over time and time again, that in fact, that is not so easy, that is not so simple, that reality of weight regulation, the reality of weight regulation is completely different.

So that’s why it’s important, in my opinion, to act. It’s important to not only raise awareness, but to address this, and each of us can do it, because every time we hear a narrative of obesity that is incoherent with the science, a narrative of obesity that makes it simplistically easy for people to undo it, to resolve obesity, and we know that that’s not the case, we should intervene and correct that narrative. With that view, we organized an international consensus conference, calling to the table the major obesity organizations, the most authoritative scientists in the field of obesity, clinicians, to just sit down and say, if the narrative of obesity is this, what does the science of obesity tell us? If there is a gap, especially along that particular issue of the ability to reverse, undo if you wish, or cure obesity by yourself, well, we should say that clear, we should speak up, we as a scientific community should speak up and say, that is not correct, that is inaccurate.

Unfortunately, so far, I don’t think the society, the media, et cetera, have heard of these scientific communities speaking with one voice about this. So it was very important for us with this consensus conference to really speak with one voice, to say the scientific community has looked at the narratives of obesity and is knowledgeable of the science around body weight regulation, and here is what we think. We think this narrative is completely inconsistent, completely incoherent with what science has shown us over the last several decades.

And based on that conclusion, we pledged and we asked many organizations, scientific journals, hospitals, academic centers, to join us in this pledge. We pledged to correct that narrative, wherever it happens. We pledged to address this issue of stigma of obesity at its very root cause, which is, again, the misunderstanding of the ability of individuals to resolve obesity by themselves.

It’s inaccurate to say that obesity is entirely due to lifestyle choices. We know that very well. There are many other elements to it.

But maybe even more damaging is this belief that obesity can be cured, resolved, completely removed if we just decided to do so. That is not the case, and I think it was important for scientists and clinicians to actually say that clear and loud. So that was an action.

Of course, it doesn’t end there. We have to continue to address the issue. We have to continue as a medical community in our individual interactions with others, as well as in more institutional interactions with other bodies and public health agencies, and everybody that has a say around obesity in our society that it’s time in 2020 to actually align science with the narrative of obesity.

Without that, unfortunately, I think we are not gonna see much progress in fighting stigma, but likewise, we’re not gonna see any progress in fighting obesity more broadly. Thank you.

Empowering patients to advocate and build a national patient advocacy team.

ECPO Vice President, Audrey Roberts & Dir. of Communications Andrew Healing


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Thank you, Vicky. It’s been great to listen to all the previous speakers today, in particular Professor Abino, who has been speaking about moving beyond awareness of stigma. My name is Andrew Healing.

I am a patient who is suffering with obesity. I have done for as long as I can remember, all the way through school. I was bullied and picked on, not only by my peers, but by the teaching staff within the school that I went for.

That makes obesity and obesity stigma and campaigning against obesity stigma high up on my list of priorities. I am currently a Director of Communications for ACPO and I’m also a patient representative of Scotland. So here with me today is Audrey Roberts.

Audrey and I met at a local support group for people who have undergone surgery as part of their weight loss journey. Audrey, how did you get into your role as patient advocate and how difficult has that been? Well, I joined an online community in 2003. It was formerly WLS Info, it’s now Obesity UK, and I went to their first AGM and found like-minded people who knew exactly how it felt and what it was like to live with obesity and all of the issues that came along with it.

We had nothing like that in Glasgow and so I started my support group where I met yourself. We’ve now got support groups in Aberdeen and Dundee, but what we’re looking to do is use peer support to make sure that people who live with obesity have a voice and the support systems around in the business. It wasn’t really called advocacy back then, it was just telling other people living with obesity my story and how it affected me.

They know how I felt and for once I felt understood and empowered. It’s been incredibly difficult because of the bias and the stigma surrounding obesity because essentially people think you eat less, move more, and that solves all the problems. If it was only that easy we wouldn’t be sitting here right now.

So how do you think we have progressed since the start of the support group in Glasgow? Me personally, I can only speak from my own perspective, but me personally it’s made me change as a person. After a few years working with WLS Info I became a committee member and eventually a trustee. This led me to become a Scottish rep like yourself for ECPO.

I would attend conferences in Scotland and Europe and I would hand out ribbons and speak about the importance of people’s first language and the barriers that living with obesity have and we have every day in our lives. Laterally I’ve spoken at the European Parliament on discrimination in the workplace which was incredibly important to me because I had been looked over for jobs and I had not been given promotion because of my obesity and I was told that, which is incredibly difficult to hear. More recently I’ve been invited to the committee of the ASO Scotland network which would never have happened if I hadn’t started these support groups and joined WLS Info back then.

The voices just weren’t being heard and I feel we’re in it, we’re getting there. Slowly but surely we’re getting there, we’re becoming more recognised. So when you join conferences, when you attend conferences as a patient advocate, what is involved when you’re at the conference? It depends what I’m doing, sometimes if I’m speaking it’s making sure that people who live with obesity have their voices heard on all of the issues and protect and promote their rights as people living with obesity to make sure that our views and wishes are genuinely considered when decisions are being made about their lives, whether that be on a political scale or surgical, GPs, anything that people, anybody who deals with obesity at a professional level have to know what we go through daily and the bias and stigma and also we need to have a voice so that people who live with obesity aren’t frightened, aren’t staying at home and aren’t feeling like a victim, they can be empowered to come and talk and share their journey with us.

Yeah, I think it’s very safe to say that there has been a lot of work that has been done in this level and we are starting to get our voice heard, not only at the professional conferences but also at a more local level and I think it is really important that we hold days like the Living With Obesity Campaign Day to raise further awareness within not only our own community but also externally with the wider audiences that may be able to view this. What I would ask is for anybody who is viewing us today, please share your experiences, share your comments using our hashtag, hashtag livingwithobesity. That really allows us to get the word across to the wider audiences just how difficult it is and how stigma affects a person who is living with obesity.

Thank you very much for your time today Audrey. We’ll pass back over to Vicky in the studio now. Thank you.