Now that we are through the season of holiday excess, we now enter the period of new resolve. Even our prime minister shyly gave his tummy a little pat to indicate what his new year’s resolution was going to be. But for a growing number of obese Canadians, a little bit of weight loss will not be enough to rebalance their system towards optimum health.
While obesity is recognized as a disability under provincial human rights law, Canadians are largely ignorant about its causes and the stigma and social discrimination that marginalizes this population. In fact, discrimination of obese people has been sited by Dr. Arya M. Sharma, scientific director of the Canadian Obesity Network, as a major factor in the lack of co-ordination of services to combat obesity and obesity-related illnesses. Discriminatory remarks and treatment by individuals in all areas of society including education, social services, and health services are so prevalent the network and other partners including the Canadian Public Health Agency have organized the first Canadian Summit on Weight Bias and Discrimination later this month.
Obesity is defined as a condition where there is an excess of fat in the body. How much is too much? A body mass index of 25 kg/m2 is considered to be overweight, 30 is considered obese, and a BMI over 40 morbidly obese. The common perception is that obesity is caused by laziness and over-eating. While lack of physical activity and an over-consumption of high-calorie foods causes obesity, once the body is conditioned to be overweight its internal signaling processes are compromised to demand a lot of food. So, getting rid of the weight is not quite as easy as having a little willpower to resist the danish at the staff meeting, or add a 20-minute walk into your daily routine.
Although there are some medical conditions that cause obesity, modern obesity is primarily a problem of wealthy societies where there is an abundance of inexpensive, high-calorie, high-fat food incorporated into family diets, and a lifestyle where physical activity is not required or promoted as part of one’s daily routine. And as sad as it is to admit, it is the obese child who turns into the obese adult. To judge a person as lazy or without willpower is terribly cruel. No child chooses to be an obese grown-up.
Treatment for obesity becomes a complex affair of changing food and physical activity habits, dealing with depression, as well as other health problems that may be caused by extra weight such as joint pain and diabetes. Interestingly, surgical bariatric procedures have only just begun to gain popularity because some surgeons thought it would be too difficult to operate on bodies that contained a lot of fat. These procedures are now gaining wider acceptance considering obesity, once it sets in, is such a stubborn problem. The success rate for diets is low. The only sure way to combat adult obesity is through surgery.
Of course treatments are not without their critics. Although there is a fat-acceptance movement that preaches that you can be fat and healthy, television reality shows about fat people are all focused on them losing weight. Thin is the preferred body type marketed to us through gym services, weight-loss products, and high-tech body girdles. It is big business. So when the medical community joins the club and begins to medicalize the problem and the solutions, it is only prudent to be wary. But after reviewing some of the literature on the subject, it is hard to deny a high BMI shortens life and compromises one’s quality of life by creating a number of serious health issues which require monitoring and management.
Different disabilities are the result of different factors, so it is important not to lump them all into one basket. The treatment for alcohol and drug addiction is to remove them from the diet. In the case of obesity, food cannot be removed; moderation is required. The food that is so unhealthy if eaten on a regular basis is relatively cheap and requires little to no preparation. For the time-stressed and the poor, this food is marketed as an answer. There are no additional taxes and few regulations regarding nutritional content on these foods to limit their damage. Families are reeled in through clever marketing that focuses on children.
In the end, anti-discrimination cannot provide a solution to the problem of obesity. It can, however, reduce the emotional scars of the obese, reducing the amount of self-blame and depression which discourages people from seeking treatment. In addition, it can open a space where we will see the enormous good sense of having a public policy discussion about how to regulate the content of fast foods and prepared foods. This seems to be much less invasive than gastric bypass or “stomach stapling” surgery.
Prevention should not only be the responsibility of individual Canadians but of all Canadians, including the food industry. Now, I wonder if they are willing to go on a diet with the rest of us. . . .
Sonya Nigam is the executive director of the Human Rights Research and Education Centre at the University of Ottawa. She can be reached at firstname.lastname@example.org.