Avoiding stigmatisation

Obesity

Beyond sometimes fevered headlines and an unfortunate tendency to stigmatise those affected, issues of overweight and obesity represent a significant health challenge. Even the World Health Organisation (WHO) struggles with this challenge, with its most recent projections for obesity levels in Europe attracting justifiable criticism. Its prediction for Ireland, suggesting some 89 per cent of Irish men will be overweight by 2030, putting them top of a European obesity table, was questioned on a number of fronts. Indeed, the organisation's most recent reliable data shows levels of obesity and overweight among Irish males rose by just one percentage point, to 66 per cent, between 2010 and 2014.

On the other hand, data from the Irish Longitudinal Study on Ageing (Tilda), based on the objective measurement of height and weight in some 8,500 adults, found that in 2011 some 83 per cent of men and 74 per cent of women over the age of 50 were overweight or obese.

Leaving statistics to one side, it is vital that efforts to deal with the public health aspects do not encourage an “us and them” attitude to obesity. Stigmatisation, involving a labelling of overweight people, must be resisted.

There is mounting evidence to suggest such an approach would also be scientifically suspect. Last week, researchers from St Vincent’s hospital in Dublin announced that obesity appears to lower the number of specialised immune cells that line the gastrointestinal tract. The same cells are known to increase in number after weight loss due to gastric bypass surgery, pointing to a probable role for the body’s immune system in weight loss and weight gain.

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Scientists are also exploring the role of inflammation in obesity. These discoveries, alongside the acknowledged role of cultural factors in weight, support the need for a more nuanced approach in tackling the issue of obesity in society. There must be no repeat of previous public health media campaigns focusing on individual blame for the “spread” of obesity in the Republic.