Why words matter in obesity policy-making

This post is written by Briony Hill, Deputy Unit Head, Monash University’s Health and Social Care Unit, and Mitchell Bowden, Engagement Lead – Policy and Projects, Monash University’s Health and Social Care Unit.

• The problem: Language within obesity policies which frames people living in larger bodies as responsible and/or blameworthy are based on outdated ways of thinking.
• Why it matters: This reductionist framing leads to ineffective solutions such as an overreliance on education and individual responsibility, and perpetuates stigma and other harmful attitudes and behaviours.
• The solution: Policy-makers and influencers should use mindful language and messaging when discussing and writing about weight and obesity, including when developing future policies and reviewing historical ones.

In an age of political correctness and ‘cancel culture’, it’s confronting to learn of the poor language used to describe ‘obesity’ and ‘weight’ in policy documents around the globe. Even more confronting is the profound impact this has on individuals living in larger bodies – both directly through their own experiences and internalisation of obesity messaging, and indirectly through the influence of language on the attitudes and behaviours of health professionals they interact with. It’s plausible that such documents, unlike other platforms that have higher visibility and public traffic (e.g. online, print, social media), have simply managed to avoid the attention of readers who can call out negligent, harmful wording choices - until now.

The evidence is clear that the words used in policy documents are not merely syntax, nor can decisions about their use be considered simply a matter of style. Rather, governments and other entities involved in making, reviewing or influencing obesity policy have an ethical obligation to get their language right. This calls for the review and editing of existing policies that are currently perpetuating weight stigma and its harms, as well as being mindful and deliberate about how weight is framed in the development and implementation of future policies. Words matter!

The words used in policy documents are not merely syntax, nor can decisions about their use be considered simply a matter of style.

Recent evaluations of obesity-related policies across Europe, Australia and Canada, highlight the way ‘responsibility’ or ‘blame’ for obesity is framed – either explicitly or implicitly – as the most significant issue.

Words, words words

Frequently, a lack of thoughtful wording implies not only that individuals living with obesity are responsible for their weight and that they lack self-control or are lazy, but that they are also responsible for the broader societal impacts of obesity, such as harm to the economy. These assumptions position people living in larger bodies as “blameworthy” for their weight, and in doing so run the risk of giving political commentators and policy-writers permission to discuss obesity, weight and expected behaviours in judgmental, loaded and/or biased ways.

Victim-blaming language can perpetuate harmful attitudes, beliefs and behaviours by those who read it.

This framing, whether obvious or implied, also ignores the decades of evidence articulating the significant impact that social and environmental factors such as socioeconomic status, education, housing, and access to transport all have on health and wellbeing. Concerning obesity specifically, these factors – all of which sit mostly outside of an individual’s control – are consistently linked with low levels of health and nutrition literacy, help-seeking and self-efficacy for health behaviours.

So, why does this all matter?

To answer this, we need only look at the well-documented link between ‘victim-blaming’ and stigma. While mass media communications often blatantly reinforce a societal view that living with obesity is an individual’s fault, stigmatising language is also commonly found nestled subtly in policy material – and the impact is similar. Victim-blaming language can perpetuate harmful attitudes, beliefs and behaviours by those who read it. In the context of obesity, this can lead to bias, discrimination, stereotyping, social exclusion, and devaluing based on an individual’s weight – that is, weight stigma. In turn, weight stigma has been linked to a range of psychological and physical health issues by its victims. Most notably it can exacerbate stress-related behaviours, emotions and biological responses such as unhealthy eating or sedentariness that contribute to further weight gain and stigma.

Fixing the problem

While many policies recognise the impact of social and environmental factors in the development of a complex condition such as obesity, advice to address them often highlights individual autonomy. It’s essential that future obesity policy creation pays deliberate and mindful attention to addressing these intricate structural factors, and does so by using positive, person-first language to discuss health. Meanwhile, many policies that were written before the emergence of framing and communication science also require attention. With these and other insights in mind, governments should review and retrospectively update such policies.

Final thoughts

• Many of the factors that lead to weight gain are outside the control of individuals living in larger bodies. Their lifestyle choices and nutrition literacy are rarely the sole drivers.
• Internationally, policies that seek to prevent obesity fail to adequately address social and environmental contributors, positioning individuals living in larger bodies as ‘responsible’ for their weight status, and as the most appropriate target of policy responses. This perpetuates weight stigma and other detriments to health and wellbeing.
• Governments and other policy-makers should be mindful to place responsibility for addressing obesity where it belongs; and use positive, person-first language to frame health, weight and expected behaviours.

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(Image Credit: Unsplash)