In this second guest post for the ‘Stand Up to Weight Stigma’ campaign, Dr Zofia Bajorek highlights steps key stakeholders must take to ensure active and fair participation in the labour market for people living and working with obesity.

The Purpose Programme (Promoting Understanding and Research into Productivity, Obesity Stigma and Employment) launched by the Institute for Employment Studies (IES) focuses especially on the way in which employment and the labour market outcomes for those living with obesity can be improved.  

The first report Obesity Stigma and Work: Improving Inclusion and Productivity’, provided an analysis of the level of weight-based stigma that people living with obesity experience in work, and highlighted the wage penalty that was calculated, especially evident for women.  

However, one of the main goals of the Purpose Programme believes that a mere analysis of the problem is no longer sufficient, and it is now time to move the dial from analysis to action, to shift the thinking of government policy makers, employers, healthcare professionals and people living with obesity themselves, to enable the best chance of living fulfilling working lives. 

There is an accumulation of evidence now showing that good work is good for our wellbeing, but now is the time to widen this definition to add dignity and inclusion at work, so that workplaces can become settings free from stigma and discrimination. There is also no shortage of clinical, psychological, economic and epidemiological evidence on the nature, extent and consequences of obesity as a public health issue, but more needs to be done to promote better labour market outcomes for employees with obesity.  Furthermore, joined-up thinking is required when discussing action to reduce discrimination against employees living with obesity in the workplace.  As such our research has set out a number of steps which key stakeholders must take to ensure active and fair participation in the labour market for people living and working with obesity.

Recommendations for Employers

  • Obesity and overweight should be included explicitly in Equality, Diversity and Inclusion (EDI) policies. Obesity is a risk factor for many health conditions that fall under the Equalities Act. This means that recruitment, progression, pay and access to workplace adjustments should be open to all employees and discrimination based on disability, health conditions or impairment related to obesity may violate these provisions.
  • Workplace health and wellbeing practices and health promotion policies should be reviewed to ensure they are supportive of, and not stigmatising towards, employees living with obesity.  Additionally, employer-sponsored weight-management programmes, no matter how well intentioned should be designed, implemented, and evaluated in conjunction with employees, so any risk of these perpetuating weight-based stigma is eliminated.
  • Focus should be on an individual’s capacity and not incapacity – employees living with obesity can make a great contribution to work if they are given a voice and are supported and not subject to stereotypical attitudes or expectations.
  • Safe and supported disclosure of work-limiting health conditions by employees, including those health conditions related to overweight and obesity should be encouraged.  Employers should recognise that fear of stigma, and self-stigma, may inhibit some to come forward.  Employers who intervene early and with compassion regarding decisions on rehabilitation and workplace adjustments based on evidence and expert opinion find that early interventions can benefit both employers and employees.

Recommendations for Employees

  • If you feel you have been subjected to unequal treatment, discrimination or bullying which you attribute to weight-related bias or stigma, it is helpful to find a support or advocate who could help you navigate employer policies, and employment law to help you assess whether you have been treated unfairly. It may be useful to have informal discussions with a line manager, HR professional or a trade union rep who may be able to help you reach an amicable resolution of a problem. If you fear that making a more formal complaint could lead to further stigma or anxiety, then there are trusted bodies that could aid and advise you about raising a grievance and keeping day-to-day employment relationships.
  • If you have health conditions related to your weight, it is important that you play an active part in their management. People who play an active part in the management of their health conditions tend to have fewer days of sickness absence and can return to work more quickly.
  • It is important to know your rights and what you are entitled to both as a patient and a worker.

Recommendations for Government

  • The Government should provide clear guidance to employers about the legal status of obesity discrimination in employment. If obesity is not to be included as a protected characteristic under the Equalities Act, then guidance is needed to clarify what obesity related conditions are included within its scope and the legal obligations for employers.
  • The government could, as part of the obesity strategy, embed the principle that work is a clinical outcome of care, recognising the benefits of staying in, thriving in and returning sustainably to work. The voice of people living with obesity should be used to help shape and evaluate government policy relating to obesity and employment.
  • Better measures are needed to assess the social, economic and work impact of obesity, to allow for appropriate action to understand the benefits of full and active labour market participation.

Recommendations for Media

  • For too many commentators, it remains acceptable to use stigmatising language to describe the causes and consequences of obesity. We recommend that all major media outlets (print, broadcast and online) adopt and adhere to the guidelines on people first language.
  • Non-stigmatising images when reporting on obesity should be used. Images used when discussing obesity in the media are often depersonalising and only continue to contribute to weight-based stigma. The media should instead use appropriate photographs, videos or images that show people living with obesity (of all ethnicities) engaging in diverse activities, careers and lifestyle behaviours, in appropriate fitting clothing and appearing wellkept, and in an environment that is free from any additional characteristics.
  • It is important to consider what is published and accessible to audiences. The media should refrain from publishing articles that contain stigmatising attitudes, and report or condemn other outlets who publish stigmatising articles, as is already done for other protected characteristics such as race and mental health.

Recommendations for Healthcare Professionals

  • Healthcare professional need to identify where job retention or early return to work is good for patients for whom obesity and related health conditions are causing sickness absence from work or are associated with work-related impairments. They should always ask themselves whether helping an employee with obesity or related health issues to stay in or return to work is a positive clinical goal of treatment, referral or commissioning.
  • There is also a need to think beyond physical symptoms of obesity, and should seek to refer patients to specialist teams or support services as early as practicable, to enable the management of the condition to begin in ways which support continued working.
  • Early action is important. When working in partnership with the person living with obesity a healthcare professional can help achieve a balance between an individual’s need for treatment, respite and work.

The Purpose Programme has further research planned on this issue of obesity stigma and employment. The Programme aims to publish evidence-based guidance, tolls and research reports on the consequences of obesity across the UK’s working age population for employment and the labour market. The programme hopes to engage a range of stakeholders in an enlightened debate to make work a more fulfilling experience for people living with obesity.

Dr Zofia Bajorek is Senior Research Fellow at the Institute for Employment Studies. Zofia’s research interests include the role of line managers and the development of the employment relationship, the management of the psychological contract, the temporary and flexible workforce, and the health and wellbeing of the workforce, including the promotion of good work practices.

Novo Nordisk has provided funding to the Institute for Employment Studies (IES) to undertake the creation of the PURPOSE programme. IES retains full and final editorial control all aspects of the PURPOSE programme.

This blog post is part of OEN UK’s ‘Stand Up to Weight Stigma’ campaign 2021-2022. You can find out more about the campaign here.