Anticipating unintended consequences of public health nutrition policy: Implications for disordered eating and weight stigma

The prevention of weight gain continues to be a predominant focus of public health nutrition policy, often with approaches that aim to improve individual eating practices. However, policies emphasizing weight-related behaviour change may have unintended consequences, including increased weight stigma and disordered eating risk. This paper proposes a framework, guided by complex systems science, to inform nutrition policies that can improve eating practices with minimal unintended consequences for weight stigma and disordered eating. Eating- and weight-related practices are interconnected and complex, and interventions that aim to shift weight without considering complexity can increase stigma. Systems science, rooted in complexity and chaos theories, is valuable to inform a framework that considers the interactions among the drivers that underlie eating- and weight-related practices and outcomes. Such a framework can highlight how weight-centric approaches can result in policy resistance (e.g., messaging related to maintaining a healthy weight may encourage unhealthy dieting that leads to poor health outcomes), with unintended consequences for population health. Drawing upon two public health interventions, educational nutrition campaigns and nutrition labelling, we demonstrate how this framework can be applied to anticipate unintended consequences for weight stigma and disordered eating. Once potential unintended consequences have been identified, interventions can be modified and accompanying mitigation strategies can be implemented. This framework empowers public health nutrition researchers and practitioners to recognize the interconnectedness and complexity of eating- and weight-related practices and to identify approaches to promote nutritional health and overall wellbeing that do not increase disordered eating, weight stigma, and their consequences.