Stigma of obesity preventing people from treatment thus threatening heart health

Stigma and misunderstanding of obesity are preventing people from receiving adequate treatment for the disease, which is increasing the risk of cardiovascular disease (CVD), a new report from the World Heart Federation warns. 

The `World Heart Report 2025 – Obesity and Cardiovascular Disease`, launched at the World Heart Summit on May 17, highlights the myths that hamper efforts to treat obesity. The problem is compounded by systemic healthcare gaps and is contributing to an economic burden worsened by the aggressive commercial practices of companies making cheap, processed food.

The World Heart Report emphasises the trends that could send healthcare costs spiraling:
1. As the rate of child obesity continues to increase, children with a high BMI are 40 per cent more likely than their peers to suffer from CVD in midlife. 
2. The onset of obesity at younger ages can significantly reduce life expectancy while the psychological impacts of childhood obesity are profound – obesity is now the leading cause of bullying and discrimination in schools. 
3. CVD mortality attributable to high body mass index (BMI) is now highest among middle-income countries, with rates up to 67.5 deaths per 100,000 people in North Africa and the Middle East.
4. Across the globe, obesity cases increased in nearly every country between 1990 to 2022 and global deaths from cardiovascular disease linked to high BMI have more than doubled. 
5. If current growth trends continue, data projects that almost 2 in 3 adults over 25 years of age could be overweight or obese by 2050.
6. A shift in types of employment towards desk jobs is also associated with the development of obesity and CVD, as are long working hours and frequently working overtime.

The report expresses concern that stigma experienced by people living with obesity is preventing them from receiving adequate treatment through guidance, lifestyle support and appropriate medication. Obesity is not caused simply by a sedentary lifestyle and over-eating, it says. 

“To tackle the world’s mounting obesity crisis, governments must implement cost-effective public health measures that improve public awareness and decrease risk factors, recognising obesity as multifactorial and committing to making full treatment options available, accessible and affordable,” says Francisco Lopez-Jimenez, professor of Medicine at Mayo Clinic College of Medicine and one of the report authors.

A wide range of interrelated factors are referenced for contributing to the issue. They include access to healthy and affordable food, availability of recreational facilities and green spaces that are linked with levels of physical activity, BMI, hypertension and, in turn, CVD.

Studies have also found some health professionals to hold negative biases about obesity and to view patients as non-compliant with health advice. This can deter people with obesity from seeking medical care, including prevention and screening, and thereby compromise their overall healthcare for various CVD conditions.

The economic impact of obesity is projected to triple in high-income countries and increase 23-fold in upper middle-income countries while prevalence of obesity is increasing faster in rural areas. If coordinated and evidence-based action can reverse obesity and overweight prevalence to 2019 levels, it could translate into savings of US$2.2 trillion in costs every year between 2020 and 2060 globally, the report says. 

“To address the growing implications of the obesity crisis, we urge action and targeted investment by governments around the world. Health systems must be strengthened to ensure broader access to, and affordability of, medical care for obesity and CVD,” says Mariachiara Di Cesare, professor of Population Studies and Global Health, and Director of the Institute of Public Health and Wellbeing at the University of Essex, UK, and one of the report authors. 

Highlighting regulation introduced in countries from Rwanda and Latvia to Japan and the UK, the report points to the impact of zoning regulations to limit the density of fast-food outlets and the power of tax-based initiatives to reduce obesity and CVD. 

The report also highlights the success of community-based projects such as the Mana Tu project, co-designed with Maori and Pasifika communities in New Zealand. The programme provided support and guidance linked to effective disease management, including nutrition, prompting an increase in the consumption of fruit and vegetables amongst participants, alongside a 10&#37 average increase in physical activity.

“Longstanding weight stigma and discrimination have hindered efforts to tackle obesity and contributed to the rise of CVDs, so it is urgent to address both. Any policy to tackle obesity must address health disparities and support underserved populations who face greater barriers to heart-healthy living and obesity therapies, while taking care to not further entrench the stigmatisation of obesity,” says professor Lopez-Jimenez.

This article first appeared on Mid Day