Coping with obesity : Research and practice realities

The health and economic burdens associated with obesity are given regular (and often sensationalised) coverage in the popular media, supported by statements from high profile bodies like the World Health Organization, which has described this condition as a serious epidemic facing developed countries (WHO, 2000). In the UK, the government of the day commissioned a review of future trends in terms of obesity. The final report (Foresight, 2007) predicted that if things remain the same, half of adults in the country will be obese by 2050, costing the National Health Service £10 billion per year. Modern lifestyles were identified as a major contributor to the current rise in obesity: “People in the UK today don't have less willpower and are not more gluttonous than previous generations. Nor is their biology significantly different to that of their forefathers. Society, however, has radically altered over the past five decades, with major changes in work patterns, transport, food production and food sales. These changes have exposed an underlying biological tendency, possessed by many people, to both put on weight and retain it,” (Foresight, 2007). Individuals with a Body Mass Index (BMI) = 30 are confronted by psychosocial as well as physical challenges due to their weight, including discrimination and stereotyping (Puhl and Brownell, 2001), being blamed for a perceived lack of personal control, motivation and restraint. Yet research shows the picture is more complicated than this. For example, in England obesity correlates with socioeconomic status and household income among females; it is more likely to affect deprived women (The Health and Social Care Information Centre, 2010) and those from Black African, Black Caribbean and Pakistani groups (Gatineau and Mathrani, 2011). Given the negative social connotations surrounding obesity, broaching the topic of weight in a healthcare setting can be difficult (Heslehurst et al., 2007; Wadden and Didie, 2003), especially if practitioners feel inadequate in their knowledge, believe that weight management is a difficult clinical outcome to achieve (Brown and Thompson, 2007) or are concerned about a lack of resources to manage such cases