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One-third of US adults have faced fat-shaming in the past year

(Credit: Obesity Action Coalition)
Stigma may influence how people view and seek obesity treatment

According to a new national survey conducted by NORC at the University of Chicago and sponsored by Ethicon, more than one-third have experienced fat shaming or weight bias either personally or through someone they know. The nationally representative survey findings were released on World Obesity Day 2018, a day established by the World Obesity Federation to raise awareness about the prevalence, severity and diversity of weight stigma. The Centers of Disease Control and Prevention (CDC) reports that nearly 40 percent or 93.3 million US adults have obesity with 7.7 percent of them having severe obesity.

The nationally representative survey of 1,059 adults was funded by Ethicon and used AmeriSpeak, the probability-based panel of NORC at the University of Chicago. Interviews were conducted between September 13-16, online and using landlines and cell phones. The majority of Americans stated that fat shaming - a term that describes the act of humiliating someone based on their weight by making mocking or critical comments about their body size - is a common occurrence.

Key findings of the survey include:

  • Over half (52 percent) believe people with obesity are fat shamed all or most of the time and 34 percent say that they themselves or someone they know have experienced it first-hand. Among those with obesity, that number rises to 43 percent of respondents.
  • Eighty-five percent of all Americans, regardless of their own weight, consider fat shaming to be a serious issue - 48 percent of them think it’s extremely serious or very serious.
  • The majority of adults (58 percent) believe that stereotyping or shaming of people with obesity occurs in the media and in social situations (37 percent).
  • Twenty-nine percent say it frequently affects hiring decisions and work promotions (22 percent).
  • About one in five say people with obesity are often provided a lower quality care by doctors and other medical professionals (18 percent).
  • Nine out of ten Americans believe people with severe obesity think the best way to lose weight is through diet and exercise, either on their own or in consultation with a doctor or a personal trainer.
  • Little more than half (55 percent) support bariatric surgery, which medical experts consider the most effective long-term treatment for severe obesity.
  • The public is torn about whether or not obesity is a disease – 53 percent think it is and 46 percent think it’s a lifestyle choice, despite that in 2013, the American Medical Association, the nation’s largest physician group, officially recognised obesity as a disease that requires a range of interventions for treatment and prevention.

“The way people feel about obesity may affect how they themselves or people they know go about trying to lose weight,” said Dr Christopher Still, an obesity medicine specialist and director of the Center for Nutrition and Weight Management at Geisinger Medical Center in Danville, PA. “People are often reluctant to seek treatment beyond diet and exercise out of shame or embarrassment, so more effective treatments are left unexplored or are viewed more negatively. This is particularly concerning when it comes to treating severe obesity, where diet and exercise alone have been proven to be largely ineffective over time.”

Christopher Still

While the vast majority of Americans (79 percent) consider bariatric surgery to be medically appropriate for severe obesity, 19 percent still think it’s a cosmetic procedure and 24 percent say they would actually oppose a family member’s or close friend’s decision to have it, while 57 percent would be proud of their decision and 10 percent say they would be disappointed or ashamed.

Obesity medications are even less popular with the American public. Less than half support the use of prescription obesity medications and only a quarter support a friend or family member taking over-the-counter diet pills. In fact, the use of over-the-counter diet pills is opposed by more people (54 percent) than any other weight loss method.

Elliott Fegelman

“People’s perceptions of obesity and weight-loss surgery may be one reason that less than 1 percent of the eligible patient population have weight-loss surgery each year and why obesity continues to be the major public health threat that it is,” said Dr Elliott Fegelman, Therapeutic Area Lead for Metabolics, Ethicon. “Prevention is important, but access and an openness to effective treatments beyond diet and exercise are critical for those with the disease.”

In an effort to support people seeking treatment for severe obesity, Ethicon has developed a digital platform and smartphone app called Health Partner for Weight Loss Surgery which offers resources and decision-making tools for patients considering weight-loss surgery. The company is committed to advances in patient care and breaking down the perceptual and societal barriers that prevent people with the disease of obesity from obtaining treatment.

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