Obesity is a challenging issue affecting a growing number of people globally, but as common as it is, it often comes with negative stigma and a lack of understanding. Obesity is often assumed to be the outcome of laziness, personal choice or lack of willpower, but there is often a number of elements that contribute to obesity that go far beyond a person’s conscious thoughts and decisions.

This can include things like genetics, environment, psychology, and social and economic conditions. Whatever the contributing factors are, obesity can have serious consequences for a person’s health, well-being, and quality of life, as well as being linked to health inequalities, which are the unfair and avoidable differences in health outcomes between different groups of people. 

Why are we talking about this? 

Obesity is a pressing public health issue that requires immediate attention on a national and global scale. According to the World Health Organisation (WHO), obesity has nearly tripled since 1975. In 2016, more than 1.9 billion adults were overweight, and of these, over 650 million were obese.  

Living with excess weight has been highlighted to increase a person’s risk of chronic diseases, such as type 2 diabetes, cardiovascular disease, some cancers, and musculoskeletal disorders. It can also have a negative impact on someone’s mental health, as there are links for it leading to depression, anxiety, low self-esteem, and further stigma, leaving a lot of people stuck in what could be described as a vicious cycle.

According to the Wirral Intelligence Service in 2017, there was data to suggest that 2 in every 3 adults were an unhealthy weight – with the survey showing higher rates among women than men, higher rates among people living in the poorer areas than the affluent areas, and also higher rates among those with lower academic achievements.

Obesity isn’t solely a health concern; it has big links to wider social issues. It’s shaped by social health factors, impacted by where people are born, develop, reside, work, and age. These circumstances can widen the health differences between various population groups, such as income, education, job type, gender, ethnicity, and geographical location.

For instance, people in poverty often come across barriers to accessing nutritious food, safe places for physical activity, and high-quality healthcare services. People from ethnic minorities may experience discrimination and cultural challenges that affect their health, as well as people in rural areas may have fewer resources and chances compared to those in cities.

Factors to consider with obesity

How are health inequalities affected by obesity? 

On one hand, obesity can be seen as a consequence of health inequalities, as people who are socially disadvantaged are more likely to experience obesity and its potential knock-on effects. On the other hand, it can also be seen as a cause of health inequalities, as people who are obese may have more disadvantages and discrimination in various areas of their lives.

Some examples of how obesity affects health inequalities in Wirral are:

• Education: Obesity can negatively affect performance at school and achievements among younger people. They may also have more absences from school due to physical or mental health problems. All of these can limit their educational opportunities and future prospects. Also, 80% of obese children go on to become obese adults, which means it’s really important to help support education and understanding at an early age.
• Employment: Obesity can reduce employability and earnings among adults. People who are obese may have lower productivity and higher absenteeism due to health issues or stigma. All of which can then have financial impacts.
• Health care: Obesity can increase the demand for and cost of health care services. People who are obese have more frequent and complex health needs than non-obese patients and may also face barriers in accessing quality and appropriate care due to physical or psychological factors. For example, some medical equipment or facilities may not be suitable; some obese patients may avoid reaching out for help due to fear of judgment or shame. 

What can we do to address obesity and health inequalities? 

Many people in Wirral have problems with their weight and health, and we need to work together to make Wirral a healthier place for everyone. Here are some ideas on how we can do this: 

• Help people learn about their health: Supporting people and healthcare professionals in Wirral to know how to take care of their health and reduce obesity. Through our prehabilitation programmes, our practitioners give people clear, useful and usable information including encouraging activity and dietary advice that can improve understanding.  
• Make health care better: We want people in Wirral to get the best care possible for their weight and health issues. Our staff are able to provide training for healthcare professionals to know how to help people with obesity and treat them with respect. We want them to work with other professionals who can offer different kinds of help. We want them to listen to what patients and families want and need. 
• Stop weight stigma: We want to teach people that obesity is not necessarily a personal fault, but a complex problem with many causes and effects. We want to show people that being obese does not mean being lazy, or bad.  

In its most simplistic form, obesity can be prevented and treated by adopting a healthy lifestyle that involves eating a balanced diet, limiting the intake of energy-dense foods and drinks, drinking plenty of water, avoiding or reducing alcohol consumption, being physically active for at least 150 minutes per week, getting enough sleep, and seeking professional help if needed.

However, as we’ve discussed, it’s not always as simple as that, because there are so many more factors that need to be taken into consideration and spending the time getting down to the root causes of why someone is over-consuming. There needs to be support and health coaching opportunities available to support people on their behaviour cycle changes – poor communication with people living with obesity impacts engagement, motivation and relationships. 

We need to stop blaming individuals and start looking at the bigger picture and the other factors that affect weight. We need a different way of thinking and doing things that includes everyone. People who are obese or overweight need help from their surroundings, their knowledge, their health services, and their society, and we can be part of that help.