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Not very NICE: deviance, stigma and nutritional guidelines related to healthy weight and obesity

Alison Hann, Ashley Frawley Orcid Logo, Gillian Spedding

The International Journal of Health Planning and Management, Volume: 31, Issue: 2

Swansea University Authors: Alison Hann, Ashley Frawley Orcid Logo

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DOI (Published version): 10.1002/hpm.2350

Abstract

This paper examines critically the current NICE and NHS guidelines on weight management and the avoidance of obesity (NG7). The advice and its stated context are distilled into four key assumptions: BMI is a valid indicator of ill-health, energy balance, or ‘calories-in, calories-out’, is the underl...

Full description

Published in: The International Journal of Health Planning and Management
Published: 2017
Online Access: http://onlinelibrary.wiley.com/doi/10.1002/hpm.2350/full
URI: https://cronfa.swan.ac.uk/Record/cronfa27554
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Abstract: This paper examines critically the current NICE and NHS guidelines on weight management and the avoidance of obesity (NG7). The advice and its stated context are distilled into four key assumptions: BMI is a valid indicator of ill-health, energy balance, or ‘calories-in, calories-out’, is the underlying driver of weight management, physical activity is an effective method of weight management, and failure to adhere to dietary/physical activity guidelines is exacerbating the ‘obesity crisis’. The paper provides a critical examination of these assumptions and concludes that the guidelines are unlikely to encourage maintenance of ‘healthy’ weights or prevent obesity, are not based upon particularly strong evidence and are misguided in maintaining a persistent focus upon weight rather than other indicators of health. Moreover, we suggest their promotion may have a number of consequences, including perpetuating body related stigmatisation and perpetuating highly moralised beliefs that bodily corpulence is primarily the result of laziness and gluttony.
Item Description: This is a co-authored article with Alison Hann and Jill Spedding of Swansea University. The author made a substantial contribution to the conception and design of the study, to the organisation of the conduct of the study, to carrying out the study (including acquisition of study data) and to analysis and interpretation of study data. The author helped draft the output.
Keywords: NICE;obesity;nutritional guidelines;healthy weight;dieting
College: Faculty of Medicine, Health and Life Sciences
Issue: 2