Obesity Care: Moving Beyond the 'Eat Less, Move More' Myth

For many years, the standard advice given to individuals living with obesity has been to "eat less and move more." While this simplified guidance may seem intuitive, it fails to address the complex, multifaceted nature of obesity and can sometimes be counterproductive. Obesity is a chronic, relapsing health condition that affects approximately 26.5% of adults in England and 22.1% of children aged 10–11. The financial burden it places on healthcare systems is substantial, costing the UK an estimated £126 billion annually, encompassing reduced quality of life, healthcare costs, unemployment, and informal care expenses.

Recent research highlights that obesity is not merely a matter of personal willpower. It is influenced by a range of factors including genetics, early childhood experiences, cultural norms, socioeconomic status, mental health, and environmental conditions. The 'obesogenic environment' describes a world where unhealthy foods are readily available and physical activity has been engineered out of everyday life—especially impacting deprived areas with limited access to nutritious food, green spaces, and reliable public transport.

Despite growing awareness, UK obesity policies predominantly emphasize individual behavior change. This approach oversimplifies the issue, inadvertently perpetuating weight stigma and discrimination, especially among vulnerable groups like children and those living in deprived communities. Stigmatizing attitudes foster shame and judgment, which hinder effective intervention and support.

A comprehensive, stigma-free approach to obesity care is crucial. This involves recognizing obesity as a chronic disease requiring long-term management, implementing policies to reduce weight-based discrimination, and tailoring support plans to individual needs—considering cultural, psychological, and social factors. Equally important is addressing systemic barriers by investing in affordable nutritious food, improving access to physical activity opportunities, and tackling socioeconomic inequalities.

Obesity is shaped by biology, environment, and experience. The outdated narrative of personal failure must be replaced with a compassionate, evidence-based system that focuses on holistic solutions. Only then can we reduce stigma, improve health outcomes, and prevent the projected rise of costs to the health system, which could reach £150 billion by 2035.

Moving forward, the focus should shift from blaming individuals to implementing systemic changes that support healthier environments for everyone. Recognizing obesity as a multifactorial disease and adopting a supportive, inclusive approach is essential for meaningful progress in obesity care.