HIV-infected Cell

Three Insights for Obesity from HIV Stigma

In the early days of the epidemic, HIV stigma was one of the key barriers to progress on every front against HIV. While stigma remains a challenge, much has been learned and in many ways it has been overcome. The same is not true about dealing obesity stigma. If anything, the stigma and bias that people with obesity experience has grown over time.

A recent lecture (above) at the National Academies by Janet Turan of the University of Alabama at Birmingham shines a light on three key insights into reducing HIV stigma. She gave the lecture as part of a workshop on changing behavioral health social norms. These insights have potential to inform efforts to get stigma out of the way of efforts to address obesity.

  1. Address Key Drivers. Shame and blame were key drivers of HIV stigma that hindered early efforts for treatment and prevention. It’s worth noting that in the early days of the HIV epidemic, a disproportionate emphasis on prevention alone provoked a fierce backlash from people with HIV and their advocates. At one point, protests over barriers created by FDA to new treatments shut the agency down. Other drivers of stigma are misinformation and fears.
  2. Connect People Affected to Policymakers and Experts. Policymakers and experts with no connections to people with HIV made terrible early decisions that enraged the community. The resulting distrust took years to overcome. When people with HIV took a place at the table, real progress began to be made.
  3. Put the People Affected at the Center. Health policies that were not centered on the people affected by HIV served only to isolate them, caused further distrust, and increased stigmatization.

Let's Move!In a typical Let’s Move! photo op, it’s all about skinny kids. Way too many efforts to address obesity are formulated solely by people who have never confronted severe obesity themselves. Some of the worst of such efforts led the leading authority on weight bias, Rebecca Puhl, to ask in a 2013 publication if we are fighting obesity or fighting people with obesity.

Progress in obesity will come when we apply best practices for reducing health-related stigma.

Click here for more about best practices for reducing HIV stigma and here for Puhl’s 2013 publication.

HIV-infected Cell, photograph by Helma et al. DOI: 10.1371/journal.pone.0050026

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2 Responses to “Three Insights for Obesity from HIV Stigma”

  1. April 12, 2015 at 6:25 am, Joe Gitchell said:

    Thanks, Ted–I look forward to carving the time to watch Prof. Turan’s lecture.

    And the relevance of these lessons for other health behaviors (thinking psychoactive drug use of all types) is substantial.

    Nice brain food to start the day!

  2. April 12, 2015 at 6:47 am, Ted said:

    Good point. We wouldn’t want nicotine addicts at the table, now would we?