Weight Stigma Local Case Study: Doncaster’s Compassionate Approach to Weight

29 Nov 2021 Weight Stigma Local Case Study: Doncaster’s Compassionate Approach to Weight

Holly Campbell is a Public Health Improvement Coordinator at Doncaster Council, and is currently leading on the Compassionate Approach to Weight across the borough. In this case study Holly will provide detail on how they went about this approach, how it has changed their current systems and any key learning along the way. 

Our vision is to create an environment where everybody in Doncaster is fully able to pursue their own health goals and are fully supported to do so by society, without judgement or assumptions. They feel valued as an individual just the way they are. Compassion is at the heart of how we move together towards a healthier society for future generations.

Doncaster’s Compassionate Approach to Weight has been endorsed by our Health & Wellbeing Board and is included in our new Borough Strategy – Doncaster Delivering Together – under the “Healthy & Compassionate Doncaster” wellbeing priority.

We are currently undergoing a “Doncaster Talks” consultation with residents and health professionals to support the development of this approach.

We are tackling weight stigma by:

• Reviewing our language around nutrition and exercise. For example, not moralising certain foods over others – “good”, “bad”, “cheat”, “clean” – and not framing physical activity as a means to “earn” food or to restrict or punish your body.
• Myth-busting. We are spreading the following messages in order to deconstruct the currently accepted relationship between weight and health.

1. 1. 1. Weight is not always an accurate indicator of health.
      2. Weight loss is not always a route to health.
      3. Stigmatisation is not an effective motivational tool.
      4. Diets are not effective for sustainable weight loss, nor improving health.

• Respecting the inherent diversity in body shapes and sizes and promoting the message that Health Gains are always a priority over Weight Loss, and people of all sizes are able to improve their health without needing to lose weight.

What we want to adopt:

• An approach that advocates for social justice and reducing inequalities
• Protect our citizens, where possible, from the unfair environmental, social and economic factors that constrict their lives
• Accept and respect the inherent diversity of body shapes and sizes, and that we can promote health and wellbeing without focusing on being a certain body size
• A ‘gentler’ approach to food and nutrition that supports a positive relationship with food and eating; does not place moral value on one food over another; does not shame or police​.
• Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose

What we want to reject:

• Interventions that create or increase inequalities
• Interventions that place the onus on individuals succeeding or that might shame individuals, bring feeling of failure/less self-worth (e.g. forced participation in Physical Activity; policing of food)
• The premise that being a certain weight equates to being healthy and that weight loss as the only route to health and wellbeing
• Use of government guidelines as basis for health promotion initiatives or as measures of success (e.g. minutes physical activity; portions fruit and veg eaten a day; BMI etc.)

Why we changed our approach

In the decades of public health intervention, nothing has made any long-term impact in reversing increasing rates of obesity.

The world is filled with mixed messages regarding food, weight, body image, and health. For the vast majority of people, dieting or restricting food for weight loss only works in the short term, potentially leads to harmful weight cycling and disordered eating patterns.

We want to try a new approach to issues of weight and health that is driven primarily by compassion, takes blames away from individuals and fully acknowledges the mental and financial burden poverty and inequality places on people.

What we have learnt

The challenge between being evidence-led – therefore not wanting to promote weight-loss initiatives when the evidence tells us they are ineffective – but also person-centred, and accommodating to individuals who will continue to pursue weight-loss due to society’s prevalent weight stigma. Can you be truly anti-weight-stigma and still endorse weight-loss?

Another challenge we are learning from continually is the importance of maintaining the integrity of this approach and not allowing the principles to be diluted. It is not enough to use the “Compassionate” label in your work – more needs to be done to truly align with the Compassionate Approach.

What would be your three things you would recommend to others interested in this approach?

1. Assess your own internal weight stigma! Weight stigma is pervasive throughout society so we will all hold some level of prejudice. Interrogate and amend your own beliefs first.
2. Be open-minded! A weight-neutral approach may seem radical. However, be led by the evidence, rather than assumptions the relationship between weight and health.
3. Talk to us! Please get in touch and learn more about how our Compassionate principles may be applied in your context. You can also join our Regional Group – a group of colleagues and partners who want to support the development of the Compassionate Approach – beginning in January 2022.

Further information and contact details

For more information, to join our Regional Group, or for an informal chat, please email publichealthenquiries@doncaster.gov.uk and ask to be directed to Holly Campbell.

You can also find more information on our website: Doncaster’s Compassionate Approach to Weight – Doncaster Council

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