Moving beyond eat less, move more using willpower: Reframing obesity as a chronic disease impact of the 2020 Canadian obesity guidelines reframed narrative on perceptions of self and the patient-provider relationship

Clin Obes. 2023 Dec;13(6):e12615. doi: 10.1111/cob.12615. Epub 2023 Jul 30.


Obesity is becoming recognized as a complex, chronic medical condition. However, the dominant treatment narrative remains that goal weight can be achieved by eating less, moving more using willpower, placing responsibility for change on the person with obesity (PwO). This study evaluated the impact of revising this narrative, to viewing obesity as a treatable medical condition, on internalized weight bias and perceived patient-provider relationship. PwO were recruited into an online study in which two videos were presented; the first showing a traditional doctor endorsing the eat less, move more approach, and the second showing a doctor describing obesity as a treatable medical condition. After each video participants were asked to imagine that they were being treated by that doctor and completed the Weight Bias Internalization Scale (WBIS) and the Patient-Health Care Provider Communication Scale (PHCPCS). A total of 61 PwO (52% response rate) completed the protocol. Compared to the traditional narrative video, the revised narrative video resulted in significant reductions in WBIS scores and significant increases in the PHCPCS scores and was preferred by participants. Within the context of this small-scale study evidence supports that the revised narrative promoting obesity as a complex, chronic but treatable medical condition that is not the result of personal failure has a positive impact on the perceived patient-provider relationship and is associated with reductions in internalized weight bias. This evidence supports the need to help PwO reframe obesity from a personal failure to a legitimate medical condition worthy of care.

Keywords: behaviour; obesity; revised narrative; stigma.

MeSH terms

  • Canada
  • Chronic Disease
  • Communication*
  • Health Personnel
  • Humans
  • Obesity* / therapy