People who are overweight are at increased risk of a range of chronic diseases, but are less likely to seek medical help. 91���� researchers are working with healthcare professionals to break stereotypes surrounding people with obesity, and ensure they receive the care they need.

Western’s Kate McBride at first became aware of this problem when she was doing her PhD research on the feasibility of cancer screening for Li-Fraumeni Syndrome, a hereditary predisposition to multiple types of cancers. “I became interested in this obesity space through breast screening,” she says. “We’ve shown that obesity is a barrier to breast screening. Often women with obesity will go once, but won’t return, because they didn’t have a particularly good experience. It’s really concerning because obesity is the number one risk factor for postmenopausal breast cancer.”

A large part of this reluctance to see medical professionals is the stigma associated with obesity. “Healthcare professionals might not see that a person hasn’t deliberately chosen to be obese,” explains McBride, who is a senior lecturer at Western’s School of Medicine and the Translational Health Research Institute. “There are many contextual factors like where they live, their economic status, their education level and their cultural background. All these factors contribute to whether a person is going to become obese or not.” McBride notes that healthcare professionals can sometimes exhibit a victim-blaming mentality. “They just tell that person: ‘You need to do something about your weight. Go and exercise. Go and eat healthily.’ But they don’t consider those contextual factors.”

This stigma can lead to dire outcomes. “Some people can’t leave their homes because they don’t have the support or motivation to get out there and even start to think about trying to lose weight,” says McBride. “They know that they’re dying because they’ve got high blood pressure; they’ve got high cholesterol; many of them have got diabetes. They can’t even go to the kitchen without feeling breathless and unwell, and they’re trapped in their homes.”

This problem is especially acute in parts of western Sydney, for example the Nepean-Blue Mountains region where the obesity rate of 29.3% exceeds the national average of 27.5%. This is due to factors such as low health literacy, an obesogenic environment, including a plethora of fast-food outlets, and a low socioeconomic demographic. This is creating a crisis in the public health system in western Sydney where hospital admission rates for chronic disease complications are soaring,” says McBride. “People tend to sidestep their GPs and then present at emergency departments when things get to a really acute phase.”

McBride and her group are attacking the problem on various fronts. They are constructing a comprehensive picture of how obesity affects healthcare access by measuring rates of presentation and analysing the issues faced by people with obesity and their healthcare providers. This information will inform the development of better healthcare management. The team is also working with the primary-health network in western Sydney to consider how to improve GPs skills to help them be more supportive.

But McBride realises that more is needed in the long term. “It requires a societal change in the way people who are overweight or obese are perceived because they suffer greatly by people being judgmental about them.”