Global Health Asia-Pacific September 2020 September 2020 | Page 52

Feature
The obesity conundrum
A new public narrative on the nature of obesity is needed to avoid stigma and help people focus on what really matters – their
overall health
Besides being
often bullied
and ridiculed,
people with
obesity are “less
likely to be hired
for jobs and to
get promoted
than thinner
individuals,
and they’re
more likely to
get wrongfully
terminated from
their jobs”
Is obesity a matter of personal choice or the result of
factors beyond a person’s control?
While the answer is not always straightforward,
even people who hold the highest o�ces in the land
can offer overly simplistic opinions on the subject. �ust
take a look at what the former Prime Minister of the
United �ingdom had to say on this some years ago.
“We talk about people being ‘at risk of obesity’
instead of talking about people who eat too much and
take too little exercise…Of course, circumstances
– where you are born, you neighbourhood, your
school, and the choices your parents make – have
a huge impact. �ut social problems are often the
consequence of the choices that people make,”
declared David Cameron in 200�.
Far from going against the grain of public opinion,
as Cameron claimed, his comment publicly reinforced
a widespread notion that the causes of obesity are a
clear-cut matter of personal responsibility.
If you’re obese, in other words, it’s because you did
something wrong. �ou indulged in too much junk food
while logging hours of screen time instead of going out
and exercising.
This view, however, is profoundly misleading
because unhealthy lifestyles are just one of the many
drivers of obesity. As a result, it’s contributed to
enormous emotional pain and led to increased health
risks for obese people.
“People with obesity commonly face a pervasive,
resilient form of social stigma,” a group of international
researchers wrote in their study on the subject in
Nature. �They are often subject to discrimination in the
workplace as well as in educational and healthcare
settings.�
Roughly 19 to 40 percent of people with obesity
report they’ve been treated unfairly or discriminated
against because of their weight, Dr Rebecca Puhl,
a weight stigma researcher at the University of
Connecticut and one of the study authors, told
�lo�al �ealth �sia��aci�c. �These are pretty high
percentages and they increase as a person’s body
size increases.�
�esides being often bullied and ridiculed, people
with obesity are �less likely to be hired for jobs and
to get promoted than thinner individuals, and they’re
more likely to get wrongfully terminated from their
jobs,� said Dr �uhl.
Even some doctors hold negative stereotypes,
viewing their obese patients as lazy, unmotivated, and
non-compliant with treatment.
“Patients often feel blamed by a provider because
of their weight. They feel that providers don’t believe
that they’ve been trying to lose weight even though
they did improve their eating and exercise.
“Lots of patients are aware of these negative
stereotypes, and so they feel reluctant to talk about
body weight with their doctor. They’re also more likely
to avoid seeking healthcare because of stigmatising
experiences they’ve had in the past,� she explained.
This translates into poorer mental and physical
health, with the result being that people with obesity
are at higher risk of anxiety, substance use, suicide,
and mortality than slimmer individuals.
The experience of Corissa Enneking demonstrates
this harmful notion that we can totally control our
body weight, especially when medical experts give
their stamp of approval to detrimental weight-loss
practices.
Enneking told the �u��ost that in order to lose
weight she used to eat so little that she often felt
exhausted and dizzy from hunger. Though months of
semistarvation helped her shed some pounds, she
would still wear plus sizes. And she was so stressed
out that she would get panic attacks while eating.
When her mother brought her to the hospital
because she was worried about her health, the doctor
simply urged her to keep it up because the extreme
diet was working and it was only a matter of time
before she would get small enough to add a few more
calories to it.
“If you looked at anything other than my weight,”
Enneking told the �u��ost, �I had an eating disorder.
And my doctor was congratulating me.�
The complex causes of obesity
While weight stigma is partially rooted in widely held
beliefs that people can control their own weight,
obesity is a much more complex condition and is
caused by the interaction of behavioural, genetic,
biological, environmental, and psychological factors,
stressed Dr �uhl.
This means changes in weight can be in�uenced
by elements beyond sheer willpower. It doesn’t simply
depend on the quality of the food we eat but also
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