Obesity

Obesity is a serious health concern. Obesity and overweight occur when the body stores excess calories as fat, leading to weight gain.¹

Bias, stigma, and discrimination

Obesity can be caused by multiple factors

A common misunderstanding is that obesity is solely caused by factors within an individual’s control, such as eating unhealthily and not exercising enough. This belief is a fundamental driver of weight bias, stigma, and discrimination.^2,3

Weight bias and stigma manifest through negative attitudes, social stereotypes, and misconceptions about obesity and about people with obesity (including beliefs that these individuals are lazy, awkward, sloppy, non-compliant, unintelligent, unsuccessful, and lacking self-discipline or self-control). When these biases and stereotypes are enacted, they can lead to discrimination and affect individuals' access to education, employment, and medical care, causing health and social inequalities.³

The words we choose are important, and people do not always realise that the language surrounding obesity contributes to bias and stigma. Harmful language is commonly used when discussing obesity, affecting how people with obesity are perceived in various areas like media and entertainment.⁴ Using people-first language aims to eliminate bias by not labelling the person by their disease. Instead, the person is acknowledged first, followed by their disease (for example, say “person with obesity” and not “obese person”).^4,5

Living with obesity

Obesity increases risk of developing life-threatening conditions, such as heart disease, stroke, high blood pressure, type 2 diabetes, and some forms of cancer.⁶

It’s important to understand that obesity is not a choice, and each person’s journey to lose weight is unique. For some, especially those who have lost some weight, putting in more effort into a weight-loss program may not always lead to additional weight reduction due to the body’s adaptive mechanisms to resist weight loss.^7,8

Therefore, obesity management should focus on encouraging healthier behaviours rather than just lowering numbers on the scale. Using weight loss as the sole indicator of success is not only ineffective at improving health, but could also be damaging, contributing to food and body preoccupation, repeated cycles of weight loss and regain, reduced self-esteem, eating disorders, and weight stigma and discrimination. Success can mean feeling better, having more confidence, more energy, getting healthier, or just stopping further weight gain.^7,9

In the UK, the first step for individuals with overweight and obesity is receiving support in the form of behavioural and lifestyle management services, which incorporate diet and exercise guidance.^10,11 Your healthcare professional can advise you on how to lose and manage your weight safely, signpost you to local weight loss groups, and refer you to a local active health team.¹²

Diet

In the UK, the Eatwell Guide shows the different types of foods and drinks to consume, and in what proportions to have a healthy, balanced diet.^13,14

The recommended daily caloric intake for adults including all food and all drink:^13,14

Women: 2000 kcal
Men: 2500 kcal

Starchy foods and carbohydrates^13,14

Base your meals around starchy foods, such as potatoes, bread, rice, pasta, and cereals; they should make up just over a third of the food you eat
Choose wholegrain versions with less added fat, salt, and sugar where possible

Fruit and vegetables^13,14

Fruit and vegetables are a good source of vitamins, minerals, and fibre and should also make up just over a third of what you eat
Eat at least 5 portions of a variety of fruit and vegetables every day

Beans, pulses, fish, eggs, meat, and other proteins^13-15

Proteins are essential for the body to grow and repair itself
Plant sources of protein, such as pulses, are naturally very low in fat and high in fibre, protein, vitamins, and minerals
Aim to eat at least 2 portions of fish a week, including 1 portion of oily fish

Dairy and dairy alternatives^13-15

Milk and dairy foods are good sources of protein and calcium, which helps keep your bones healthy
If choosing dairy alternatives, select those that are unsweetened and fortified with calcium
Consider choosing lower fat and lower sugar options

Oils and spreads^13,14,16

Dietary fat provides essential fatty acids and helps the body absorb some vitamins
Use in small amounts and choose unsaturated oils and spreads

Water and drinks^13,14

Drink 6-8 cups/glasses of fluid a day
Water, lower-fat milks, lower-sugar or sugar-free drinks and tea and coffee all count

When it comes to foods high in fat, salt, and sugar, eat less often and in small amounts^13,14

Physical exercise

Physical exercise is important for maintaining a healthy weight and has health benefits beyond weight loss.¹⁷

Adults^a should engage in daily physical activity. Recommended by the NHS:¹⁸

^aAged 19 to 64.¹⁸

Changing your behaviour

Weight loss can be more successful if it involves other approaches, alongside diet and physical exercise.¹² Behavioural interventions can help improve lifestyle habits such as exercise and diet, and lead to more effective and sustainable weight maintenance.¹⁹

These interventions can include:^12,19

Goal-setting: Set realistic weight loss targets to reduce your risk of obesity-related complications
Stimulus control and stress management: Avoid situations that may tempt you to overeat, eat more slowly, and be mindful of what and when you’re eating
Support systems: Involve family and friends to help motivate you in your weight loss efforts
Self-monitoring: Weigh yourself regularly to monitor your weight loss progress

Discuss with your healthcare professional

If you are living with overweight or obesity, you may consider meeting a healthcare professional who as per the guidelines can discuss and agree the level of intervention with adults who:

are living with overweight or obesity, or
have increased health risk based on their waist-to-height ratio.

They will take into account people's individual needs and preferences, and factors such as weight-related comorbidities, ethnicity, socioeconomic status, family medical history, and special educational needs and disabilities.²⁰

NHS=National Health Service.

References

NHS. Obesity: overview.
Puhl RM, Heuer CA. Obesity stigma: important considerations for public health. Am J Public Health. 2010;100(6):1019-1028.
Obesity Canada. Weight bias.
Obesity Action Coalition. What we fight for: people-first language.
Obesity UK. Language matters: obesity. February 2020.
Kastanias P, Mackenzie K, Robinson S, Wang W. Medical complications resulting from severe obesity. Psychiatric care in severe obesity: an interdisciplinary guide to integrated care. 2017:49-73.
Chaput JP, Ferraro ZM, Prud’homme D, Sharma AM. Widespread misconceptions about obesity. Can Fam Physician. 2014;60(11):973-984.
Hall KD, Kahan S. Maintenance of lost weight and long-term management of obesity. Med Clin North Am. 2018;102(1):183-197.
Wiechert M, Holzapfel C. Nutrition concepts for the treatment of obesity in adults. Nutrients. 2021;14(1):169.
Health Scotland. 2019. Standards for the delivery of tier 2 and tier 3 weight management services for adults in Scotland.
Wilding JPH. Beyond lifestyle interventions: exploring the potential of anti-obesity medications in the UK. Clin Obes. 2018;8(3):211-225.
NHS. Obesity: Treatment.
Public Health England. Eatwell Guide.
NHS. The Eatwell Guide.
NHS. Eating a balanced diet.
NHS. Fat: the facts.
Bays HE, Golden A, Tondt J. Thirty obesity myths, misunderstandings, and/or oversimplifications: an Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. Obes Pillars. 2022;3:100034.
NHS. Physical activity guidelines for adults aged 19 to 64.
Olateju IV, Ogwu D, Owolabi MO, et al. Role of behavioral interventions in the management of obesity. Cureus. 2021;13(9):e18080.
NICE [2023] Obesity: identification, assessment and management.

PP-OB-GB-0090 February 2025