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23 January 2013

Stigmatising obese may 'help' them

A controversial article says that the public health community can learn from one of the most successful public health campaigns: the anti-smoking campaign.

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Arguing that obesity "may be the most difficult and elusive public health problem the United States has ever encountered" and that anti-obesity efforts having made little discernible difference, Daniel Callahan, co-founder and President Emeritus of The Hastings Center, proposes a bold and controversial approach to fighting the epidemic.

Callahan says that the public health community can learn from one of the most successful public health campaigns: the anti-smoking campaign. A primary strategy has been to stigmatise smokers, he says, making it clear that their behaviour is not only unhealthy for them but is also socially unacceptable. While the public health community has decisively rejected the stigmatisation of obesity, Callahan directly challenges that rejection.

'Lite stigmatisation'

In "Obesity: Chasing an Elusive Epidemic," an article in the Hastings Center Report, Callahan says that what he calls "stigmatisation lite," if used carefully, could provide an important strategy in the strikingly unsuccessful effort to help the 67%of Americans who are overweight or obese lose weight. He cites estimates that no more than 10% of those who try to lose weight succeed in the long run.

Callahan does not deny that stigmatisation can do harm, such as increasing the risk of discrimination in the workplace and health care. But he believes that that risk would be minimised by "stigmatisation lite," in which people who are overweight consider the threat of discrimination itself as a danger to be avoided: "don't let this happen to you!" His aim is to complement, not replace, public health strategies that would bring to bear a strong government hand, making use of laws and regulations and subsidising healthy foods, good medical counselling, and special efforts at obesity prevention programs for children.

(EurekAlert, January 2013)

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