Weight-centred approaches to health: harms and solutions

Background and aims: Past research has suggested that weight centred approaches to health (ie those that presume higher weights lead to poor health outcomes and advocate for the pursuit of weight loss) may lead to negative health outcomes such as eating disorders, mental health problems, harms from weight cycling and social stigmatisation. This paper analyses academic articles and documents in the context of Canadian Health Policy concerning weight and weight loss in order to reveal the dominant discourses that perpetuate weight centred approaches. Method: Five British Columbian obesity reduction policy documents were identified and discourse analysed in terms of textual analysis, discursive analysis and social practice analysis. Results: Discourses identified concerned 1) scare-mongering which emphasised the magnifies negative health consequences of overweight and obesity and 2) warfare in which the language of war against obesity (with all the aggressiveness that this entails) was evident. In addition, the warranting of claims concerning negative health consequences of overweight and obesity were poorly evidenced. Conclusion: This paper argues, in line with more recent evidence, that such discourses frame overweight and obesity as inherently unhealthy and obscures the notion that intentional weight loss is difficult to sustain and that health can be improved regardless of weight loss. The paper concludes with an analysis of the concept and potential benefits of ‘Health at Every Size’.