Changes needed to government anti-obesity strategies

Beat, the UK’s eating disorder charity, has published a report on the risks to people with eating disorders caused by government anti-obesity strategies. The report outlines the ways in which anti-obesity measures have the potential to cause distress to people at risk of developing an eating disorder, and may exacerbate eating disorder behaviours in those already diagnosed. While acknowledging the importance of obesity as a public health issue, the report notes that strategies harmful to people with eating disorders appear nevertheless to be ineffective at reducing obesity.

Previous and proposed anti-obesity strategies, such as changes to menus and food labels, information around ‘healthy/unhealthy’ foods, and school-based weight management programmes all pose a risk to those with eating disorders. A person with lived experience of an eating disorder told Beat that: “Encouragement of calorie counting and fear of obesity in public campaigns was the main source of the beginning of my eating disorder. As someone growing up with a perfectionist mindset, it truly made the fuel behind the fire worse.”

In the report, Beat calls for future public health strategies to take a holistic approach to addressing obesity that is informed by evidence from the field of eating disorders, including input from people with lived experience, and makes the following recommendations:

  • Professionals from the eating disorder and weight management fields to work together to design evidence-based campaigns that view obesity as a complex interaction between multiple factors, rather than an individual’s choice or something to be ashamed of.
  • Campaigns to follow the principle of “first do no harm”, and to be subject to an assessment of the potential they have to trigger eating disorders.
  • Campaigns to shift away from being weight-focused and weight-shaming, to those that focus on positive behaviour changes and improving self-esteem.
  • Policy makers to be mindful of the language used when discussing weight, shape, food or exercise, due to the potential for this to promote the thin ideal, body dissatisfaction and calorie restriction.
  • Public Health England and Public Health Wales to acknowledge that their childhood measurement programmes are exacerbating the risk of eating disorders among children and to either abandon them or revise them to a format that avoids that risk.
  • Public Health Scotland to provide guidance to Health Boards on how to implement their childhood measurement programme in a way that avoids exacerbating the risk of eating disorders, or to abandon them.
  • In the meantime, when implementing child measurement programmes, schools should ensure that guidelines intended to protect the wellbeing and privacy of children are rigorously followed.

Beat’s Chief Executive, Andrew Radford, says:

‘It is clear that the current insensitive and ineffective approach to anti-obesity campaigns urgently needs to change. While we recognise the importance of reducing obesity, shaming the public into losing weight is ineffective and risks severe harm to people with eating disorders. We call on the UK’s governments to ensure all campaigns instead take an evidence-based, multi-disciplinary approach.’

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