Introduction to Obesity and Weight Management
Obesity is one of a relatively small number of diseases which is often on plain view to the public. The sufferer cannot conceal the problem. Moreover, it is also in most societies a value-judgement, a diagnosis which carries major personal stigmata. The word ‘obese’ is a perfectly ordinary adjective, from the noun ‘obesity’, whose latin derivation tells a causal story: ob – on account of, esum – having eaten. Although that remains entirely correct in every case, there are many other factors which give some people greater likelihood of predisposition to weight gain. So the victim-blaming approach to obesity, still evident in the way the disease is viewed and treated in may settings, is very wrong, and alienating if it is detected among healthcare staff. Surveys have shown that members of the general public associate obesity with a wide range of negative concepts, often including laziness, lack of self-control and untrustworthiness. People who are obese know very well that they are, but the lay associations are largely negative and accusatory, so it is a diagnosis they often prefer to ignore or try to blame on some route other than over-eating. In the English language, there are huge numbers of words and euphemisms used to refer to obesity itself, many invoking cynical humour. The term ‘obese’ is routinely used by professionals, in scientic research and public health statement, with ‘overweight’ as an intermediate pre-obese stage. However, with individual patients, the less provocative catch-all word ‘overweight’ is used to include the obese. Oddly, many obese people, and patients themselves, however, are often more comfortable using the simpler lay term ‘fat’. To break the ice, it is helpful to ask individuals which term they are most comfortable with.