Obesity 'empathy blindspot' leading to abuse and discrimination

Others expressed frustration that every health concern was put down to being overweight and said that constantly being given the simplistic message to "eat less and move more" had made them reluctant to visit their doctor.

One woman is said to have delayed seeking help about a breast lump and her cancer was stage four by the time it was diagnosed.

Lucy Neiland, Research Director at Ipsos Mori, who led the study, said that people had reported feeling happier during lockdown because it meant they didn't have to go out and face public scrutiny.

The research found there is a "collective blindness" to weight stigma. Those who are overweight are seen as a lazy or a drain on society with weight gain regarded as a weakness or a lifestyle choice rather than as a complex, chronic condition.

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Previous research found that 94% of the UK public think the individual is responsible for obesity, rather than genetics, physiological or psychological factors or societal problems such as poverty.

One in four adults in the UK is estimated to be obese, as well as one in five children aged ten to eleven.

One woman who took part in a film released to accompany the study said:  "Obesity is a free for all, you can say what you like, do what you like. We all just feed our face constantly with the wrong things and it's our fault."

The study looked at the barriers people face in accessing support and treatment for weight loss. Researchers interviewed healthcare professionals and spent two weeks with people living with obesity around the UK.

"What we discovered was really that we have a massive collective blindness towards weight stigma," said Ms Neiland. "It's absolutely everywhere and for the most part if largely unquestioned and we just don't see how biased we are.

"We also found that we live in a society that idolises productivity and positions obesity as the opposite of those things, as a weakness, as a drain on society and as a burden.

"When we discuss things like the obesity crisis we are discussing who is responsible, whose fault it is, the cost to the NHS, the cost to the taxpayer.

"What we are really not discussing is that there is an obesity pay gap or people are seen as lazy or stupid.

"We heard stories from people who had been shouted at in the supermarket or have had groceries taken out of their shopping trolley and told what to eat, or what not to eat.

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"Sadly some told us they preferred lockdown because it meant they didn't have to go out into the public domain and be commented on by strangers.

"Obesity is considered a lifestyle choice and something that people can control rather than a complex disease with many causes."

She said the widely held "very punishing" view was summarised by former BBC news reader Michael Beurk who described overweight people as "weak not ill" and said discrimination was also apparent in the medical professional which was having serious consequences for those living with obesity.

It is common to withhold certain medical treatments such as IVF or transplants until patients have lost weight.

Other research has found people wait an average of three years to receive treatment for weight-loss issues after visiting their GP and in many cases it is nine years before they feel confident enough to raise it.

Stephanie De Giorgio, a GP with a special interest in obesity and women's health, said during an online event to launch the research findings that she felt "ashamed" of her profession.

She said that as well as ensuring GPs are educated about the science of obesity, surgeries should take practical steps to reduce the stigma such as ensuring seats and blood pressure cuffs are accessible.

She said: "We know that healthcare professionals are not immune to this.

"Weight is a cycle and lots of people will lose weight, then they will put weight on again and the inner weight bias is so pervasive that as someone who knows the science and teaches the science to medics I will still genuinely feel that I am a better person when I am thinner that when I have regained weight.

"If I put my doctor's hat on, we really need to think differently in the healthcare profession about this."

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Obesity and being overweight can lead to increased risk of developing type 2 diabetes, coronary heart disease, some types of cancer, such as breast cancer and bowel cancer, and strokes. 

Sarah Le Brocq, who describes herself as an Obesity Advocate and Patient Leader, said it is not about normalising obesity but ensuring those who are overweight "are treated equally".

Mark Prichard, Metabolic Lead for Johnson & Johnson, which funded the research, said ultra-processed foods rather than over-eating were to blame for the obesity epidemic and called for a whole-system approach involving governments, food manufacturers and health professionals.

When BBC TV presenter Dr Chris Van Tulleken took part in an experiment where he ate mostly highly processed food for a month brain activity scans showed the areas of Chris’ brain responsible for reward had linked up with the areas that drive repetitive, automatic behaviour.

A similar brain response is observed in those addicted to cigarettes, drugs and alcohol.

Mr Prichard said evidence shows that the cost of health service weight management interventions is returned to the NHS in three years.

Benefit claims among bariatric surgery patients are said to have dropped by 75%  in the 14 months after the treatment.

Dr Andrew Cowie, deputy chair of the BMA’s Scottish GP Committee, said: “Of course GPs should be prepared to discuss eating and weight with patients within the limits of a ten minute consultation, and to guide patients to support where it is available; but given the complexity of the issues it is particularly important to address this sensitively. 

“As a simplistic phrase ‘eat less and move more’ remains good advice, but of course this does not substitute for the more comprehensive weight and eating management services that we would like to see made available for all patients.”

Professor Francesco Rubino, Chair of Metabolic and Bariatric Surgery at King's College London, who took part in the film, said society will not solve the problem of obesity until the stigma is removed.

He added: "If we think we know what causes obesity - and we don't - we are not even looking for solutions, we are not looking for cures and causes.

"All the science from the last 40 years shows us that we are far from knowing the cause of this problem."