World Obesity Day 2025: Seeing the bigger picture when tackling obesity

Published on 4, March, 2025

“Responses to tackling obesity have focused on individuals, but it is the systems that need changing” – that’s the message from a University of Sunderland bariatric surgery expert this World Obesity Day (Tuesday 4 March).

Professor Yitka Graham, who is also Head of the Helen McArdle Nursing and Care Research Institute and Professor of Health Services Research at the University, discusses how her research and work with local and international partners supports World Obesity Day’s campaign theme for 2025 – Changing Systems, Healthier Lives – which aims to shift the focus from individuals to failing systems driving the obesity crisis.

“For too long, responses to tackling the obesity crisis have focused on individuals, but it is the systems that need changing. Systems that are failing those living with obesity, such as governments, healthcare services, food environments, and the very environments we live and work in directly contribute to the increasing global rates of obesity.

I feel strongly about obesity being framed as a disease, and not a lifestyle choice. There is a complexity to the origins of excess weight including biological, environmental and social factors, many of which are out with peoples' control. Factors which include the government allowing too many fast-food outlets while good quality food is too expensive for people and families living on the breadline. There is a lack of education not only in schools but amongst parents about nutrition and how to cook simple healthy meals on a budget.

Therefore, blaming individuals for their weight is cruel, and we need to work across healthcare systems, public health, governments and the media to tackle weight stigma, with appropriate policies and education to change mindsets.

Complex health conditions such as obesity require understanding of the wider causes, and solutions to tackle obesity require a move away from individuals to a systems-based approach and putting onus on the systems that directly influence the drivers of obesity and related chronic diseases to act. 

The University’s Helen McArdle Nursing and Care Research Institute’s work with the NHS and Sunderland City Council are slowly changing conversations.

The Institute has strong, sustained and dedicated research in the field of obesity and bariatric surgical care, which supports this year’s World Obesity Day systems campaign.

We have worked with people living with obesity and who undergone bariatric surgery on many studies, including to understand the social aspects of life after surgery, and to evaluate specialist services provision such as the role of the pharmacist in bariatric surgical care.

These studies have helped to shape services to become more personalised and embed the lived experience into clinical care to improve communication between healthcare professionals and patients.

The Institute’s systems-based approach extends internationally, with research partners in Spain, India, China and Argentina, extending our Sunderland-based research into other countries and sharing learning to help build a healthier future for people all over the world.

As an Honorary Specialty Lead for Health Services Research at South Tyneside and Sunderland NHS Foundation Trust since 2016, I work closely with specialist bariatric surgeon, Kamal Mahawar, who is also a Visiting Professor at Sunderland and an External Advisory Board Member of the Helen McArdle Nursing and Care Research Institute.

Together we have over 80 peer-reviewed publications and collaborate with international partners on a range of research relating to metabolic and bariatric surgery for the treatment of obesity and related conditions which have influenced surgical practice and patient care.

I know from Kamal and his colleagues that they support patients who live in some of the most deprived areas of our country. It is often cheaper for them to buy processed foods than to cook meals from scratch. Their struggle with their weight is often a result of the environment they live in and the circumstances they are born into.

The surgeries and procedures the Trust's Bariatric Team offer are the last resort to control their weight, and it is no easy option for those they care for. Taking a surgical step is not just about the physical change for a patient, but that there has to be a plan to help them succeed in living a better lifestyle though education and support. 

University of Sunderland Research Associates Dr Ellen Gambles and Robyn Jones have worked with Sunderland City Council on a funded Weight-friendly Workplaces project, exploring the needs of employees and employers, to develop policy recommendations for work environments in this area.

As Vice Chair of the Sunderland Healthy Weight Steering Group, I have delivered training on weight stigma for council staff and advised on council policy with respect to non-stigmatising language for weight.

However, there is still so much more work to be done system-wide, and it has to be a collaborative effort.

From my work with people living with obesity, I know only too well how the fear of, and impact of weight stigma, prevents people from seeking the help and support they need, which ultimately leads to poor quality of life and social isolation. 

No one deserves to live in fear. The latest UK government figures show that 26% of adults are living with obesity. We need to take action to challenge stigma and address systemic issues in the treatment of obesity to provide person-centred, compassionate care for everyone.

The Helen McArdle Nursing and Care Research Institute is proud to support World Obesity Day and fervently believes that together we have the power to transform systems and continue to advocate for building a healthier future to manage and prevent obesity globally.”

Commenting on the work Professor Graham and the Helen McArdle Nursing and Care Research Institute are doing to help create positive change system-wide for those living with obesity, Helen McArdle CBE, Patron of Institute, said:

"My vision for the Institute is to produce meaningful research that helps us to understand and tackle some of today’s most important health issues, such as obesity, which is so often misunderstood.

“I am proud that the voices of people living with obesity are at the heart of our research, which ensures that the impact of what we do as an Institute is people-focused challenges misconceptions about obesity."

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