queen latifah wants to change the way we talk about obesity

the hollywood icon recently launched it’s bigger than me with danish pharmaceutical company novo nordisk, a campaign with the goal to create “open and shame-free conversations about weight and obesity.”

throughout her journey, latifah says that she has constantly had to push through barriers to achieve her success. now, she’s looking to hold the door open for others and is addressing her experiences head-on, including common misconceptions about living with obesity .

latifah says she’s felt shame and self-loathing connected to obesity

stigma associated with obesity can carry a significant psychological toll that carries an effect on both physical and mental health.

and her concerns are well-founded. a 2020 review published in current obesity reports emphasized that weight stigma, rather than weight itself, causes psychological distress in teens that can lead to depressive symptoms, low self-esteem and suicidal ideation. for example, a survey of 13,740 adolescents in the netherlands reported teens with a higher weight were at a greater risk of bullying, which led to a greater risk of suicidal thoughts.

“i grew up thinking i’m not good enough ,” remembers priti chawla, executive director of advocacy organization obesity matters . “ … i still grapple with those thoughts that i’m not good enough. and that definitely has an affect on you mentally, because then you always feel you’re lazy. you’ve been told you’re lazy, you’ve been told you’re stupid, just because you have this weight.”

ian patton, phd, director of advocacy and public engagement for obesity canada , adds that the shame and stigma associated with obesity can also impact a patient’s connection to health services.

“you’re told for a really long time that there’s something wrong with you because of your weight, or because of your size and that you should be able to fix this on your own,” says patton. “ … there’s a lot of shame attached to that. so when we go to a doctor or health professional, we’re not going to be open or super eager to have those conversations because we don’t feel like we deserve that help.” (obesity matters and obesity canada are not part of the it’s bigger than campaign)

‘diet and exercise are not cures for obesity’

obesity is often associated purely with lifestyle choices, even though research has long since indicated the complicated relationship between genetics, environment and psychosocial factors. one 2017 review reported that approximately 50 per cent of weight variance is determined by genetics, and also pointed to hormonal mechanisms within the body that jump into action to reduce metabolism and increase hunger when a patient begins to lose weight.

the role of metabolism in obesity

a famous example of the significant metabolic changes after weight loss involved the participants on the biggest loser — an american reality show that features contestants in larger bodies competing to win a cash prize by losing the highest percentage of weight.

a study published in the journal obesity (silver spring) , reports the resting metabolic rate (rmr) and body composition of participants at the start and end of the 2016 reality tv season. while metabolism is expected to slow with weight loss, this study found that participant’s rmr decreased by an average of 789 calories per day — more than 500 calories more per day than what was expected from basic height-weight predictions. a follow-up six years later found that the decreased metabolism effects largely remained.

recognizing obesity as a chronic health condition

in 2018, 26.8 per cent of canadians 18 and older reported height and weight that are classified as obese, while 36.3 per cent had a height and weight classified as overweight, according to stats canada . together, this means a majority of canadian adults have greater health risks due to their weight.

the who recognized obesity as a chronic disease in 1997, with the american medical association calling obesity a “disease state with multiple pathophysiological aspects,” in 2013. meanwhile, in canada, the canadian medical association recognized obesity as a chronic disease in 2015, followed by saskatchewan in 2015, the yukon in 2019, ontario in 2020 and alberta in 2021. still, there remains a gap for preventive and maintenance treatment. instead, health dollars are largely directed to diagnosis that could have been prevented had the obesity been treated in time.

understanding the complexities of this condition aren’t meant to be defeatist. instead, advocates point out that recognizing obesity as a complex chronic disease, similar to how hypertension and diabetes are viewed, leads to more treatment options and better long-term health outcomes. it can also help prevent the use of unregulated weight-loss traps and the dangerous effects of yo-yo dieting .