Stigmatising and biased media coverage of obesity needs to stop
An article in the Guardian/Observer that was published on March 12 unfortunately contributes to the misrepresentation of obesity. This includes stigmatising imagery and language, and content that plays into a treatment narrative that casts blame with individuals and questions the ethics of committed experts and advocates around a disease which has been neglected and derided for far too long.
As is the case with most disease organisations and federations, our top experts also lead important research. Our past president Professor John Wilding is one of the leading researchers on obesity in the world and has been studying GLP1 (the basis for the new therapies) for over 25 years, long before any potential benefits to addressing obesity crisis were discovered. He has also led NHS clinical services for many years that focus on a holistic approach to supporting people living with severe obesity, including the use of diet and physical activity supported where appropriate by approved medical and surgical treatments.
Professor Wilding served as lead investigator on a study of the GLP1 receptor agonist semaglutide, that happened to conclude during his term as president (funds for his time on this were directed to his university). He gave evidence to NICE as a representative of the study in his role as investigator and as a clinical expert. His conflicts of interest were fully declared to the NICE guideline committee according to NICE standard procedures. NICE committees take a range of views when considering the risks and benefits of treatments and the guideline development committee made its decision based on the science - he had no ability to or role in influencing the NICE decision as he was not a member of the guideline development group.
The implication of the article seems to be that lifesaving benefits of medicines to treat any disease are constrained or “tarnished” by the fact that private sector companies are involved in their discovery and production; is this really the intent?
The continued stigma from the media is seen in this piece with the kinds of images and words that we have repeatedly and consistently asked to be changed – headless bodies, tape measures, obese as adjective rather than noun, all points that are addressed in our image bank guidelines. Even the use of the term “skinny jab” by Guardian misrepresents the benefits of treatment for a disease that is associated with 5 million deaths per year to mischaracterise and trivialise it as somehow optional and purely cosmetic.
Comments lamenting the medicalising of obesity echo other previously stigmatised diseases including alcoholism, depression and diabetes, also previously misattributed to personal failure of will or weakness until the science was more fully embraced. From a patient perspective, this patronising and inaccurate framing of obesity is part of what has prevented it from being addressed as a complex multifactorial disease as well as driver of other diseases including cancer and diabetes.
As our data show, obesity rates will continue to increase without integrated action, with more than half the world living with overweight or obesity in just 12 years at current rates. We are a federation with member societies and organisations working in obesity in over 100 countries. We certainly agree that the hyperbole around new products has been concerning and that there are no silver bullets, as we make clear in our position papers and educational programs.
In our advocacy not only do we not promote specific drugs, we rarely even mention pharmaceuticals as a category and define treatment as focused mainly on acknowledging obesity in health systems and ensuring integration into primary care. Within our discussion of UHC we speak about prevention and wider environments alongside management, and our overarching aim is, like any complex health issue, a comprehensive approach.