What’s the big picture on obesity?

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Reports on the ‘obesity epidemic’ are fuelled by a growing body of scientific evidence that obese people have a higher risk for developing chronic diseases such as arthritis, high blood pressure, type 2 diabetes, repetitive strain injuries, depression, musculoskeletal disorders and coronary heart disease.That there is a higher incidence of chronic disease in obese people is undisputed. But why, exactly, is not clear. Obesity itself does not seem to make you sick. Some people who are considered obese are healthy, active people, healthier than some very thin people. Obesity and its relationship to poor health is a highly complex issue, not easily dealt with by simply telling people to ‘eat right and get fit’.

Some researchers are exploring how complex this issue is. They are looking at how poverty, ethnic origins, where people live, the environment around them, and other socioeconomic factors are related to obesity and disease.  While more men are overweight than women, overall, in this country, there are more very obese women than men in Canada. They are also finding that poor women are more likely to be obese than richer women, as well to suffer from chronic diseases related to obesity, but this does not apply to men. Ethnicity and racial background also play a role. In Canada, the highest rates of obesity are among Aboriginal people and African-Canadian women. The reasons for this have not yet been sufficiently researched. There may be a myriad of related factors including lower income among these populations, which can lead to poor nutrition and physical inactivity.

What has come to be called the ‘Big Food’ industry – the industry that produces fatty, salty, sweet, nutritionally vapid food and drinks – also bears strong scrutiny when we look for causes of obesity. Women, who do most of the shopping and feeding, along with children, are prime targets of this far-reaching industry. Researchers are also looking at the possible links between obesity and early puberty in girls and chemicals in the environment, such as bisphenol A (BPA) found in plastic bottles, thermal paper, the linings of most canned foods, and a range of household and personal care products.

Some critics of the ‘war on obesity’ argue that the widely used body mass index (BMI)* measure is an inaccurate predictor of poor health. Others charge that calling it an ‘epidemic’ is a form of fear-mongering by politicians and business interests (e.g., the weight loss industry).  They argue that this approach is not effective at reducing obesity rates and is merely succeeding in stigmatizing overweight people. This stigmatizing particularly affects women and girls, many of whom already struggle with culturally-imposed ideals of thinness and suffer far more than men and boys from eating disorders and body image issues. The ‘Health at Every Size’ (HAES) proponents are offering a more positive approach. They maintain that the cause of poor health is not weight, but unhealthy behaviours, and that changing those behaviours – not trying to lose weight or ‘fight obesity’ – should be our focus.

*BMI is a person’s body weight divided by the square of his or her height. The resulting number is used to define whether or not someone is ‘underweight’, ‘normal weight’, ‘overweight’ or ‘obese’. 

NEXT:

Why (and how) are women likely to be obese?
How is obesity related to poor health in women?
Does the environment play a role in obesity?
How can we prevent obesity? 
Is obesity really an epidemic? Should we wage war on it?
Health at Every Size:  Can we make peace with obesity?