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Patricia F. Sadio FRSA asks whether the Big Society is the perfect partner for combating obesity.

Obesity has become a popular issue in the last four to five years. We have had scare stories akin to voyeurism: camera angles of oversized stomachs, friction-creating thighs, headless crowds of fat people, half ton mums and sons, piles of calorific, fat-laden horrors masquerading as food and (literally) belly busting surgery.

Meanwhile, the Change4Life campaign, celebrities like Jamie Oliver and Davina McCall, and even Homer Simpson have been signed up to making a difference. But for who?

For a long while, almost every health condition seemed to be due to obesity. Emerging research showed links of just about everything to being too fat. Parents (mothers mainly) were blamed and vilified.

Yet, all this activity has failed to positively attract the attention of those living with obesity. Many have switched off or turned the other way, perhaps retreating just that little bit further. Many of the people I work with, who have spent years of their lives trying to lose weight, have only become more disheartened faced with all this noise and campaigning.

Those contacting our charity described increasing levels of depression and heightened feelings of fear: of leaving the house or attending social activities. Fear of verbal abuse, peer rejection and additional public ridicule. Many report finding comfort in the only way they know how; they stay silent, stay home and eat.

Those that shouted loudest led the way and these were generally academics and medics, able to attract the millions of pounds to produce another report to help solve the obesity problem. In this scenario, fat people were placed in the role of passive recipients of whatever ‘advice’ we think they are fit for.

This may not be surprising given prevailing attitudes: fat people deserve to be ‘told’ don’t they? Their weight is their own fault! School peers do not want to be friends with them. Companies do not want to employ them. The fashion industry does not know what to do with them. Airlines do not want to transport them and some health workers do not want to treat them.

A society where you struggle to attend school, college, university, where you will not be offered a job even with a fistful of skills and qualifications, where you cannot dress well or travel easily and are too afraid to visit a doctor or hospital, is not an empowering one. This is the reality for many obese people, and more so for those termed ‘morbidly’ obese.

Our response to this is to try and determine whether we think obesity is a lifestyle choice. What if we were to start from a different place? What if we were to support obese people to take the lead in combating obesity?

This means to respectfully include them in being a real part of the solution and not just the problem. The voice of obese people is usually broadcast as helpless, hopeless and hapless. The overwhelming stigma of obesity is choking them and throttling the voices of the next generation. I realise sensible, pragmatic, energetic and intelligent voices of obese people do not satisfy the appetites of the Roman arena but why don’t we change that? There are articulate fat people, able to talk openly and intelligently about combating obesity, who can talk about health and wellbeing. However the stigma, ignorance and prejudice surrounding this condition means anyone currently brave enough to put their head above the parapet, risks vilification.

There is much argument about what the Big Society means. But implicit in the government’s call to action is that it is about growing up, taking responsibility, being fully human, and drawing on the nice bits not the nasty bits of our neighbours and ourselves. A new approach to what is one of the biggest health challenges of our time, which recognises there is scope to involve everyone, would be a good start.

Medics and researchers of course play an essential role in this challenge however they can, alongside local councils, the voluntary sector and social enterprises, greatly improve their inclusion levels of obese and morbidly obese people. This will improve the overall health of our communities.

Over the years, the charity I work for has focused on involving morbidly obese teenagers and women in various challenges. Very often they have overcome their fears of taking part in - amongst other things - residential sailing trips and charity runs or walks, whilst learning about good nutrition along the way.

Many participants have chosen to give their time and skills to supporting others and becoming actively involved in the design, development and delivery of education and activity sessions. With sensitivity and sufficient privacy many obese people readily join in as they see this as a way of being able to contribute with dignity.

Patricia F.Sadio FRSA is a psychotherapist specialising in obesity, and Founding Director of charity Combating Obesity based in Yorkshire pioneering psychosocial approaches to obesity


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