With the occurrence of obesity almost trebling since the 1980s, Dr Wynnie Chan investigates the powerful role of 'fat teasing'

The World Health Organisation has described obesity as being a 'worldwide epidemic', and it has been estimated that around a quarter of a million people are obese (Obesity Resource Information Centre, 2000). In England alone, about one in five adults are classified as being obese and over half of women and nearly two thirds of men are either overweight or obese (National Audit Office, 2001).

In its report on 'Tackling Obesity in England', the National Audit Office last year stated that obesity is increasing more rapidly in the UK than other parts of Europe and that the deaths linked to obesity shorten lives by an average of nine years (obesity is a risk factor for many chronic diseases that can lead to death such as heart disease, strokes, diabetes and some cancers).

Weight 'mistreatment'
While the physical health risks of obesity are well established, the psychological relationship between this disease and emotional well-being has received less attention by researchers. Unfortunately many societies view overweight and obesity in a negative way, with obese people facing social rejection. According to Dr Andrew Hill, a chartered psychologist and senior lecturer at Leeds University School of Medicine, studies of stereotyping show that adults view obese people as undisciplined, inactive and unappealing; they are also associated with emotional or psychological problems.

These negative views tended to be expressed by people who are leaner, younger, female and from a higher socio-economic background. Weight 'mistreatments' are reported by over 40% of obese adults. Research conducted by Drs A Myers and J Rosen and published in the International Journal of Obesity in 1999 have reported the most common humiliating situations encountered by obese people:

• 'As an adult, having a child make fun of you.'
• 'A child coming up and saying something like 'you're fat'.'
• 'Having people assume you have emotional problems because you're overweight.'
• 'Not being able to find clothes that fit.'
• 'A doctor blaming unrelated physical problems on your weight.'

Dr Hill reports that 'fat teasing' occurs in one in seven adolescent boys and girls, their victims tend to be dissatisfied with their body shape and suffer from low self-esteem but, interestingly, only half are actually overweight or obese. According to Hill, adolescents express discomfort when dating peers who are overweight (this view being strongly expressed by men). Clearly this confirms the message that being overweight is considered unattractive, unhealthy and least acceptable in affluent social circles and goes some way to explaining the high levels of body shape dissatisfactions and dieting in pre-adolescent and teenage girls.

Studies have shown that moderate weight loss will help to lift mood and improve body satisfaction and self-confidence. Losses of 5-10% of initial body weight are usually associated with significant improvements to health, according to research published by Dr R Jung in the British Medical Bulletin in 1997.

Better treatment and advice
Clearly, treatment of overweight people and obesity has to include efforts towards improving the diet and exercise patterns of individuals but should also take in to account their psychological well-being. This is the philosophy of a new charity called Weight Concern, which was founded in 1997 by Professor Jane Wardle, Clinical Psychologist, and Lorna Rappaport, Dietician, University College of London.

Weight Concern aims to address both the physical and psychological problems of overweight people by promoting the better treatment and advice for people suffering from obesity. The charity also aims to provide a forum for overweight people to express their views about service provision. The public can subscribe to a quarterly newsletter for Friends. For more information visit www.weightconcern.com