How to communicate about obesity without promoting stigma

It’s not hard to tell when the CDC has released updated information on obesity rates in America. A quick scan of Facebook or Twitter and you’ll likely see headlines like “10 Fattest States in America,” and “Americans are getting even Fatter.”

obesity stigma

Examples of news images that promote obesity stigma.

The pictures published alongside these articles often show people with obesity, slovenly dressed and eating or carrying food. In this CBS News slideshow there’s a picture of a woman holding up a double-meat cheeseburger with the American flag in the background, while a Washington Times article shows a headless figure sitting on a bench eating. The text may be equally off-putting–a Los Angeles Times article started off by saying, “If you dread the prospect of hauling your lazy rear end to the gym…the extra weight you’ve been carrying around may be to blame.”

This matters: Judgmental and dehumanizing word and image choices promote stigma–as content analyses like these reveal. Research shows that a culture of prejudiced behavior toward people with obesity is not only linked with many negative outcomes like bullying and depression, it also makes it less likely that people with excess weight and obesity will seek treatment–not just for losing weight, but for even basic preventive care. 

Fortunately, by being mindful of the following points, journalists can help advance public dialogue about obesity and weight loss without stigmatizing people.  

Avoid ‘headless’ imagery

An example of an image that does not promote stigma.

Not showing a person’s face implies there is something shameful about what they are doing or who they are–yet that’s often what we see in news coverage about obesity. Videos like this one, accompanying a recent CNN news story can perpetuate damaging stereotypes about people with obesity. The video starts off with a climbing number on the scale, followed by an image of a person lying in a hospital bed, yet another person eating, and a headless figure seated on a bench wearing a shirt that leaves most of the person’s stomach exposed. An LA Times video similarly portrays people with obesity from the neck down, and in social settings where they are often eating.

To help remedy this, the Rudd Center for Food Policy and Obesity at the University of Connecticut created two free image and video databases with over 400 images and 88 b-roll videos of adults and children with higher body weight engaging in varied activities such as reading and delivering work presentations. The Canadian Obesity Network also has a free image bank of non-stigmatizing imagery. 

Weight loss is not a simple equation

There’s a common assumption that to lose weight, people with obesity simply need to eat healthier and move more. In reality, it’s far more complex for many people–long work schedules, food deserts, and unsafe neighborhoods can all stymie efforts to eat better and get more more physical activity. So, when writing a news story on obesity, it’s important to acknowledge the challenges that people may face, or alternatively, the abundant tools they’ll need when trying to lose weight.

A New York Times article from last year did a good job of addressing some of the environmental challenges that people with obesity face when trying to lose weight, such cheap, unhealthy food served in large portions. Another article published in The Chicago Tribune acknowledged the tools that people need to support their weight loss efforts, like community-based programs and policies.

Use words wisely

With body positivity and “fat acceptance” social movements, activists are attempting to reclaim power over use of the word “fat.” However, it is still a controversial term that can be used in derogatory ways. Try to avoid value-laden language like “fat” and “weight problem” when describing obesity, and rely on scientific terms instead.

For example, instead of saying “morbidly obese,” refer to obesity based on its “classes” as outlined by the CDC and NIH. Class 1 obesity refers to someone with a BMI between 30 and 35, class 2 obesity refers to someone with a BMI between 35 and 40, and class 3 obesity refers to someone with a BMI of 40 or greater.

In determining what counts as value-laden language, consider whether the language in question could potentially demean or embarrass someone. If it could, ask whether that language is needed to communicate the article’s main point. A Washington Examiner article published earlier this year could have made the point that the global prevalence of obesity is rising without referring to “French fry loving Americans” and how “…American children and adults are leading the obesity parade.”

In this instance, this type of language only serves to mock and embarrass people with obesity, making it inappropriate and unnecessary.

Finally, consider the label you’re using to describe people with obesity. It would likely strike you as odd to see an article reference a “cancerous” or “diseased” person, yet, so often we refer to “obese persons” in news stories about people with obesity. Try to put the person before the condition.

Headlines set the tone

While the headline may be the last part of a news story to be written, it is the first thing that readers see. Consequently, it sets the tone for the rest of the article. A headline like “F as in Fat: Top 15 fattest US states” makes for a poor choice for a headline because it equates fat with a failing grade.

A better headline would be this one from The Chicago Tribune, “American obesity report: 1 in 3 adults are beyond overweight.” This headline meets many of the criteria discussed above by focusing on the report’s main findings, and avoiding controversial or value-laden language.

Finally, focus on findings, not feelings

When focusing on the facts, the findings from research studies are put front and center like in this CBS News article. While photo selection could have been better, the article itself describes the findings of two different obesity research reports without introducing unsupported opinions or value judgments about people with obesity.

Conversely, when focusing on feelings, stigma emerges. That was the case in a UK Telegraph article with this judgmental headline, “Fat but fit is a myth, and big is not beautiful so stop making excuses for obesity.” The story states that people with obesity lack the willpower and motivation needed to make healthy lifestyle choices, with the author primarily basing this on personal experience. 

“Life is complicated, and if any amount of guilt, shame, blame, or even desire were sufficient to help patients cultivate permanent, intentional, behavior changes, the world would be a much thinner place,” says contributor Dr. Yoni Freedhoff, MD, an assistant professor of family medicine at the University of Ottawa, and founder and medical director of the Bariatric Medical Institute, which focuses on non-surgical weight management. 

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