Carolena Trocchia, MD1
Culture of Obesity – Overeating vs. Undereating. Part II of II
Carolena Trocchia, MD1 Student at Geisinger Commonwealth School of Medicine
Carolena Trocchia, MD1, originally from Long Island, NY, is a first-year medical student at Geisinger Commonwealth School of Medicine. Carolena received an undergraduate degree in science from Stony Brook University and a Masters degree in public health from SUNY Downstate Medical Center. She has participated in research projects on obesity and the role of health equity on disease. She hopes to pursue a career in pediatric oncology upon graduating from GCSOM.
Special Feature “ Health & Exercise Forum” with Geisinger Commonwealth School of Medicine the 3rd Monday of every month!
It is no secret that the United States is currently suffering from an obesity epidemic. More than 1 in 3 adults (greater than 30%) and 1 in 6 children are currently considered obese. Obesity, in medical terms, is considered to be a form of hyperexia or a condition of overeating. Within the past 20 years (roughly 1995-2015), we have seen obesity rates more than double in most states, with some areas fairing worse than others. Some experts feel that obesity is a complicated condition that includes political, psychological, social, financial, and biologic factors.
Thanks to new research findings, we now understand that there are a host of factors related to obesity that move so much farther beyond the individual’s behavioral habits. Obesity is an issue of socioeconomic status: those who have lower income tend to have higher rates of obesity. This can be for many reasons that include where you live, what food sources you have access to, what types of food or exercise facilities you can afford, and even access to and type of medical insurance. Studies also show that race, gender, and immigrant status has an impact on socioeconomic status, which effects obesity. Another major influence is an individual’s biological and genetic composition. Research recently published in The Journal of the American Medical Association shows the effects of genetics on obesity levels. There are certain genes, diseases, medications and other biological influences that contribute to a person’s weight gain and weight loss ability. The research shows that the interplay between individual genetics and the environment, both of which contribute to an individual’s eating behavior must be studied in more detail. It appears that not all individuals with ‘obesity-promoting genes’ develop obesity due to the influence of their surroundings (lifestyle, access to healthy foods and opportunities to exercise, income and occupation status etc).
Studies also show that in recent years, the term ‘weight stigma’ has become progressively more popular. It refers to the negative judgment based on a person’s weight, shape or body size. Amazingly, this judgement is observed as young as 3 years old and only progresses through the elementary and high school years. Once in college, many students with a weight stigma see overweight individuals as lazy, unattractive, having low-self-esteem and unmotivated. These negative stereotypes do not change among genders, ethnicities, ages or even occupation. We can see evidence of this weight stigma on a social level in terms of what body types our country promotes, what we decide to be ‘attractive’ and even how we portray obese individuals in the media. Think of a time when the news ran a piece relating to obesity: did it show an obese person in overly tight clothing, eating some type of fast food, or demonstrate them as inactive? Therefore, we need to begin to break the stigma against obesity (and against anorexic conditions as they exist as well) using a multi-factorial approach.
Raise Awareness – Change AttitudesLooking forward, we need to approach obesity with a fresh and comprehensive attitude that discourages so called ‘fat shaming’ or scare tactics. We have begun to use strategies that target the many variables that contribute to obesity (i.e. access to healthy foods, affordability, geographic location, culture etc) and must continue to push in this direction. On a social level, we must reduce the weight stigma associated with this condition and replace it with a healthier perspective. Interestingly, we have observed that in conjunction with the rise in prevalence of obesity, is the rise in culture of the “Fat Acceptance’ Movement”. This campaign promotes the social acceptance of different body sizes, shapes and encourages individuals to love and accept their bodies. Although this is a very positive movement, it has become a concern for some health professionals in the field who fear this movement will mislead individuals into thinking that obesity is a healthy state of being, and may tip the perspective too far in the other direction. Thus, we want to find a balance between finding self-esteem and acceptance, and understanding what a state of true health means for each and every individual.
Lastly, I’d like to encourage you to reflect on your own perspectives towards weight in general. Is it something you struggle with or fear? Do you notice you have different opinions towards overweight individuals? What approaches do you think will be most beneficial to combat this epidemic: providing patients with medication, offering more affordable means for diet and exercise, or just telling people they need to change their habits due to risk of disease? Let’s make an effort to reduce weight stigma by changing our perspectives of others who struggle with their weight, whether it be from one extreme to the other.
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Read Dr. Mackarey’s Health & Exercise Forum – every Monday. This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com
Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice and is an associate professor of clinical medicine at Geisinger Commonwealth School of Medicine.
