Respectful, evidence-based care for women with a high BMI increases satisfaction and reduces physical and psychological morbidity

“Health is never simply ‘health’; instead it can easily become a means of moralising, of normalising and of regulating.” (Parr 2002: 373, cited in Evans 2006: 259). Fatness, unlike smoking or drug use, is highly visible and, in our thinness – obsessed culture, often incurs immediate moralising and judgement. The language of official publications constructs women with a high BMI as a ‘problem’ to be managed 1 , incurring a strain on the already over-stretched NHS (HOC 2004). As the state retreats from supporting the most vulnerable in society, and cuts funding for health services, it also perpetuates a discourse of individual responsibility for a ‘healthy lifestyle’, thereby creating feelings of guilt and shame for many who cannot achieve this for whatever reason.