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A pledge to end the social stigma of obesity

In a paper published in Nature Medicine on World Obesity Day 2020, a team of experts, led by Professor Francesco Rubino from King’s College London, outline an International Consensus Statement and related Pledge to Eradicate Weight Stigma.

The consensus statement and Pledge have been developed through a conference jointly organised by the World Obesity Federation, American Diabetes Association, American Association of Clinical Endocrinologists, American Association for Metabolic and Bariatric Surgery, Diabetes UK, European Association for the Study of Obesity, International Federation for the Surgery of Obesity and Metabolic Disorders, Obesity Action Coalition, Obesity Canada, The Obesity Society.

On behalf of all our partners, we invite organisations and single individuals to sign up to take the Pledge and help eradicate weight-based stigma and discrimination

Pledge to eliminate weight bias and stigma of obesity

We recognise that:

  • Individuals affected by overweight and obesity face a pervasive form of social stigma based on the typically unproven assumption that their body weight derives primarily from a lack self-discipline and personal responsibility.
  • Such portrayal is inconsistent with current scientific evidence demonstrating that body weight regulation is not entirely under volitional control, and that biological, genetic and environmental factors critically contribute to obesity.
  • Weight bias and stigma can result in discrimination and undermine human rights, social rights, and the health of afflicted individuals.
  • Weight stigma and discrimination cannot be tolerated in modern societies.

We condemn:

  • The use of stigmatising language, images, attitudes, policies, and weight-based discrimination, wherever they occur.

We pledge:

  • To treat individuals with overweight and obesity with dignity and respect.
  • To refrain from using stereotypical language, images, and narratives that unfairly and inaccurately depict individuals with overweight and obesity as lazy, gluttonous, and lacking will power or self-discipline. 
  • To encourage and support educational initiatives aimed at eradicating weight bias through dissemination of current knowledge of obesity and body weight regulation.
  • To encourage and support initiatives aimed at preventing weight discrimination in the workplace, education, and healthcare settings.

Sign the pledge

Project team

Francesco Rubino, Rebecca M. Puhl, David E. Cummings, Robert H. Eckel, Donna H. Ryan, Jeffrey I. Mechanick, Joe Nadglowski, Ximena Ramos Salas, Phillip R. Schauer, Douglas Twenefour, Caroline M. Apovian, Louis J. Aronne, Rachel L. Batterham, Hans-Rudolph Berthoud, Camilo Boza, Luca Busetto, Dror Dicker, Mary De Groot, Daniel Eisenberg, Stuart W. Flint, Terry T. Huang, Lee M. Kaplan, John P. Kirwan, Judith Korner, Ted K. Kyle, Blandine Laferrere, Carel W. le Roux, LaShawn McIver, Geltrude Mingrone, Patricia Nece, Tirissa J. Reid, Ann M. Rogers, Michael Rosenbaum, Randy J. Seeley, Antonio J. Torres, and John B. Dixon 

Summary of findings

Executive summary

Grade of Consensus (GoC): U = Unanimous; A = >90%

Weight stigma is reinforced by misconceived ideas about body weight regulation and lack of awareness of current scientific evidence. Weight stigma is unacceptable in modern societies, as it undermines human rights, social rights, and the health of afflicted individuals (GoC: A).

Research indicates that weight stigma can cause significant harm to affected individuals. Individuals who experience it suffer from both physical and psychological consequences, and are less likely to seek and receive adequate care (GoC: U).

Despite scientific evidence to the contrary, the prevailing view in society is that obesity is a choice which can be reversed by voluntary decisions to eat less and exercise more. These assumptions mislead public health policies, confuse messages in popular media, undermine access to evidence-based treatments, and compromise advances in research (GoC: A).

For the reasons above, weight stigma represents a major obstacle in efforts to effectively prevent and treat obesity and T2D. Tackling stigma is not only a matter of human rights and social justice, but also a way to advance prevention and treatment of these diseases (GoC: A).

Academic institutions, professional organizations, media, public health authorities, and government should encourage education about weight stigma and facilitate a new public narrative of obesity, coherent with modern scientific knowledge (GoC: U).

Impact

Over 100 medical and scientific organisations have endorsed the statement and pledge. See the list below of individuals and companies who have pledged and given consent for their details published online.  

Individuals:

  1. Colin Simpson, Medtronic
  2. Valentina Vitiello, King’s College London
  3. Eva Pereda-Pereda, University of the Basque Country (UPV/EHU)
  4. Elena Ruiz-Úcar, Fuenlabrada Universitary Hospital Madrid
  5. Riccardo Dalle Grave, MD, Department of Eating and Weight Disorders, Villa Garda Hospital, Garda (VR), Italy
  6. Prof Pierre DECHELOTTE, Clinical nutrition departement, Rouen University Hospital
  7. Jacob C. Seidell, Department of Health Sciences, Vrije Universiteit, Amsterdam, The Netherlands.
  8. Engeli, Stefan, Hannover Medical School, Hannover, Germany
  9. LUCA BUSETTO, DEPARTMENT OF MEDICINE, UNIVERSITY OF PADOVA
  10. Sara FL Kirk, PhD, Dalhousie University, Halifax, Canada
  11. Raghav Bansal, King’s College London
  12. Mirto Foletto, MD, Bariatric and Metabolic Surgeon - Padova University Hospital, Italy
  13. David Sánchez Carracedo, Universitat Autònoma de Barcelona (Spain)
  14. Alessandra Valerio, University of Brescia, Italy
  15. Prof Harry Rutter, University of Bath
  16. CATERINA CONTE, SAN RAFFAELE ROMA OPEN UNIVERSITY
  17. Desmond Hughes, LLM Alumni - King’s College London
  18. Lucia Frittitta, University of Catania, Italy
  19. Bethany Glassar, Kings College Hospital
  20. Michelle Vicari, Chair, Obesity Action Coalition, USA
  21. Nina Stuart, Medtronic
  22. Robin Quinn, Medtronic
  23. Isabel Silva, Universidade Fernando Pessoa
  24. CECILIA PRIETO BRAVO, UNIVERSITY OF EDINBURGH
  25. Alba Xhixha, Cambre Associates
  26. Jacques HIMPENS, MD, PhD, CHIREC Hospitals, Brussels, Belgium
  27. Laurie Twells PhD, Memorial University, Newfoundland and Labrador, Canada,
  28. Michael Vallis, Dalhousie University
  29. Amy Smith RN CDE, HPHA
  30. Melody Harding, Associate of Obesity Canada
  31. Francesco Baggiani, Pedagogista
  32. Jean-Philippe Chaput, University of Ottawa
  33. Sharon A. Krzyzanowski, AdventHealth Celebration
  34. Hellas Cena, University of Pavia Italy
  35. Daniel B. Jones, MD, MS, FACS, Professor of Surgery, Harvard Medical School, Beth Israel Deaconess Medical Center
  36. Jennifer Brown, The Ottawa Hospital, Ottawa, Canada
  37. Allen F. Browne, M.D., FACS, FAAP, Diplomate of the American Board of Obesity Medicine
  38. Ian Patton, Obesity Canada
  39. Jacqueline Jacques, CB2 Therapeutics
  40. Mary Forhan, University of Alberta and Obesity Canada
  41. Sarah Nutter, University of Victoria
  42. Stephanie McCarville, Nova Scotia Health
  43. Marcela Rodríguez Flores, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán.
  44. Dawn Hatanaka, Obesity Canada
  45. Karlijn Burridge, GainingHealth.com
  46. MOHAMMAD ALKILANI, POLICLINICO MDC
  47. Ashley McCarthy, Boston Medical Center
  48. Fatima Waqar, General Physican at Sehat Kahani-Telemedicine
  49. Michael Sutker, MD
  50. Catherine Lin, Registered Dietitian
  51. Emilie Boisvert
  52. Raffaele Limauro, Azienda Sanitaria Locale Napoli 3 sud, Italy
  53. Christel Glinker, retired Primary Health Care Nurse practitioner
  54. Dr Lynne Johnston, South Tyneside and Sunderland NHS Foundation Trust
  55. Rochelle Blacklock, King’s College Hospital
  56. Dr Hilda Mulrooney, Kingston University London
  57. Monique Romon, Lille University France
  58. Julie St-Pierre, MD PhD, FAHA, FRCPC McGill University Hospital Center
  59. Matthew M. Hutter, MD, MBA, MPH, FACS, FASMBS, Massachusetts General Hospital, Boston MA USA, President, ASMBS
  60. Lauren Wedekind, DPhil student at University of Oxford
  61. Danielle Lefebvre, University of Calgary
  62. MOHAMMAD ALKILANI, POLICLINICO MDC
  63. Patricia M. Nece, Obesity Action Coalition
  64. Paul Davidson, PhD, Brigham and Women's Hospital/Harvard Medical School
  65. Inés Alonso, OCMI, Argentina
  66. Anna Dayer Jankechova, Hôpital Riviera-Chablais, Rennaz, Switzerland
  67. Cristina Parrino, Medici Oggi - Springer Healthcare Communication
  68. Gregory Pacyk, MD, Ph.D., Aalborg Universitet Hospital, Aalborg, Denmark
  69. Susie Birney, ICPO & ECPO, Dublin Ireland
  70. Simone Davies, King’s Health Partners
  71. Jean-Philippe MmK Magema, MD, CHU UCL Namur, Dinant, Belgium
  72. Stefanie Gerlach, German Obesity Society
  73. Heather Angell PDT CDE Nova Scotia Health
  74. Bernadette Keenan, ICPO (Irish Coalition for people living with obesity)
  75. Veronika Benesova, University of Amsterdam
  76. JP (JUTHIKA PAL), ETHICON, JOHNSON & JOHNSON
  77. Andrew Tsang, North West Anglia NHS Foundation Trust.
  78. Jenny Cargiuolo, Medtronic
  79. Beth Greenslade, Somerset NHS Foundation Trust
  80. Christine Hellendy, St Joseph’s Healthcare Hamilton
  81. Zaher Toumi
  82. Massimo Cuzzolaro, MD, Formerly University of Roma Sapienza, Eating and Weight Disorders - Founding Editor
  83. Gail Pinnock - Freelance Specialist Obesity and Bariatric Surgery Dietitian
  84. Jonathan Gabor, Concordia Hospital, Winnipeg, Canada
  85. Jose Eduardo Garcia-Flores, MD, FACS, MTYBariatrics
  86. Ali Zentner, Revolution Medical Clinic, University of British Columbia
  87. Ben Whelan, ICPO
  88. Jennifer Laberge, CIUSSS de l’Est-de-Montréal (Québec, Canada)
  89. Mr Mike Pellen, Hull University Teaching Hospitals and Spire Hull and East Ridings Hospitals
  90. Maria Letizia Petroni, University of Bologna, Italy
  91. Mohammed Al-Anati
  92. Elena Ruiz-Úcar, Fuenlabrada Universitary Hospital Madrid
  93. Karen Gaynor, HSE Ireland
  94. Olivia Sewell, OEN UK
  95. Jilla King, Portsmouth Dietitians

Organisations:

  1. The French Speaking Society for Clinical Nutrition and Metabolism (SFNCM), Chairman: Prof Pierre DECHELOTTE
  2. HOBS- Hälsa oberoende av storlek
  3. Hughes Krupica
  4. La Ligue contre l'obésité
  5. Obesity Action Coalition
  6. Obesity Canada
  7. SOCIEDAD ESPAÑOLA DE OBESIDAD -SEEDO
  8. Obesity Canada
  9. London Bridge Hospital, part of HCA Healthcare
  10. Italian Society of Pediatrics, "Adolescence" study group
  11. Obesity Group of the British Dietetic Association
  12. Approach 180, Center of excellence in kids Obesity (Montreal, Canada)
  13. PCOS Vitality
  14. Société Française de Nutrition
  15. International Medical Press
  16. Tallaght University Hospital
  17. Irish Coalition for People Living with Obesity (ICPO) & European Coalition for People Living with Obesity (ECPO)
  18. ETHICON, JOHNSON & JOHNSON
  19. German Obesity Society (Deutsche Adipositas-Gesellschaft)
  20. MTYBariatrics
  21. Diabetes Training 101 Inc (Canada)
  22. LIGUE CONTRE L'OBESITE

Project team

Professor Rubino

Francesco Rubino

Chair of Metabolic and Bariatric Surgery

Reports

Partners

American Association of Clinical Endocrinologists

American Association for Metabolic and Bariatric Surgery

American Diabetes Association

Diabetes UK

European Association for the Study of Obesity

International Federation for the Surgery of Obesity and metabolic Disorders

Obesity Action Coalition

Obesity Canada

The Obesity Society

World Obesity Federation

Project status: Ongoing

Affiliations

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