The lazy language of 'lifestyles'

The Weight Stigma Heat Map: A tool to identify weight stigma in public health and health promotion materials

ISSUES ADDRESSED

Public health campaigns and health promotion endeavours have been criticised for perpetuating weight stigma by reinforcing misinformation and using deficits-based narratives about larger-bodied people. The aim of this project was to develop a 'heat map' tool to appraise existing health policy and resources for elements that promote weight stigma.

METHODS

Ten themes were identified from literature using inductive analytic review methodology including pictorial/photographic representation, weight-health beliefs, body weight modifiability and financial concerns. Each theme was divided into four appraisal categories: the demonstration of weight stigma (via negative stereotyping, prejudice or discrimination that limits access to opportunities or services), weight bias (via presenting smaller bodies as normal/natural/healthy/good/desirable), bias-neutral (via representation of people of all shapes and sizes and accurate and nuanced health information about larger-bodied and smaller-bodied people) and finally an anti-stigma approach (via use of strengths-based narratives and overtly positive representation of and leadership by larger-bodied people).

RESULTS

A colour coding schema (the 'heat map') to visualise stigmatising elements across materials and a scoring system was devised for future quantitative evaluation. To demonstrate the use of the Weight Stigma Heat Map (WSHM), the Australian National Obesity Strategy 2022-2032 was appraised.

CONCLUSIONS

It is likely that weight stigmatisation is an important but under-recognised factor influencing the effectiveness of campaigns and interventions promoting behaviour change. SO WHAT?: Public health and health promotion professionals should consider using the WSHM as a framework for the development of less stigmatising policies, campaigns and resources and to direct reviews of existing materials.

Upstream Determinants of Overweight and Obesity in Europe

PURPOSE OF REVIEW

To review the upstream determinants of overweight and obesity in Europe, including food and built environments, and political, commercial, and socioeconomic determinants.

RECENT FINDINGS

Overweight and obesity affect 60% of European adults, and one in three children, and are more common in individuals with low compared to high socioeconomic position (SEP). Individuals in low SEP groups are more exposed to unhealthy built and food environments, including higher exposure to unhealthy food marketing. Industries influencing the food system have much economic power, resulting in ignoring or silencing the role of ultra-processed foods and commercial practices in weight gain. Overall, effective policies to address overweight and obesity have been insufficiently implemented by governments. To accelerate implementation, strengthened political commitment is essential. Policies must also focus on the upstream, structural, and systemic drivers of overweight and obesity; be comprehensive; and target socioeconomic inequalities in diets and physical activity.

The Challenge of Weight Stigma for Women in the Preconception Period: Workshop Recommendations for Action from the 5th European Conference on Preconception Health and Care

Weight stigma is a well-recognised public health issue affecting many members of society including women during the preconception period. The impacts of preconception weight stigma on women are significant and may result in decreased access to and uptake of healthcare, and mental health concerns. The consequences of this weight stigma may translate to negative maternal outcomes and even intergenerational effects on the child. Eliminating weight stigma is therefore imperative. The aim of this paper is to report recommendations to reduce weight stigma for preconception women produced at a workshop with clinical and academic experts on preconception health and weight stigma at the 5th European Conference on Preconception Health and Care. The recommendations are related to two key areas: general societal recommendations prompting all people to acknowledge and adjust our attitudes towards larger-bodied people; and healthcare-specific recommendations imploring clinicians to upskill themselves to reduce weight stigma in practice. We therefore call for urgent approaches to address societal weight-stigmatising attitudes and norms related to both the general population and preconception women, while providing professional development opportunities for healthcare professionals relating to weight stigma. Eliminating weight stigma for preconception women may have positive impacts on the outcomes for mothers and children during pregnancy and beyond.

QATCHEPP: A quality assessment tool for critical health promotion practice

Background

The origins of health promotion are based in critical practice; however, health promotion practice is still dominated by selective biomedical and behavioral approaches, which are insufficient to reduce health inequities resulting from the inequitable distribution of structural and systemic privilege and power. The Red Lotus Critical Health Promotion Model (RLCHPM), developed to enhance critical practice, includes values and principles that practitioners can use to critically reflect on health promotion practice. Existing quality assessment tools focus primarily on technical aspects of practice rather than the underpinning values and principles. The aim of this project was to develop a quality assessment tool to support critical reflection using the values and principles of critical health promotion. The purpose of the tool is to support the reorientation of health promotion practice toward a more critical approach.

Research design

We used Critical Systems Heuristics as the theoretical framework to develop the quality assessment tool. First, we refined the values and principles in the RLCHPM, then created critical reflective questions, refined the response categories, and added a scoring system.

Results

The Quality Assessment Tool for Critical Health Promotion Practice (QATCHEPP) includes 10 values and associated principles. Each value is a critical health promotion concept, and its associated principle provides a description of how the value is enacted in professional practice. QATCHEPP includes a set of three reflective questions for each value and associated principle. For each question, users score the practice as strongly, somewhat, or minimally/not at all reflective of critical health promotion practice. A percentage summary score is generated with 85% or above indicative of strongly critical practice, 50% ≤ 84% is somewhat critical practice, and < 50% minimally or does not reflect critical practice.

Conclusion

QATCHEPP provides theory-based heuristic support for practitioners to use critical reflection to assess the extent to which practice aligns with critical health promotion. QATCHEPP can be used as part of the Red Lotus Critical Promotion Model or as an independent quality assessment tool to support the orientation of health promotion toward critical practice. This is essential to ensure that health promotion practice contributes to enhancing health equity.