October 20, 2015

SUSSER | Don’t Hate on the Obese

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By PHIL SUSSER 

“A more accurate perception of the obesity epidemic is that people are responding to their environment, rather than lacking will power or self control.” — Dr. Deborah Cohen

In a time when the American political conversation centers on economic inequality, immigration and Bernie Sanders resemblance to Larry David, it’s easy to pinpoint some issues that haven’t gained much traction. With persistently high healthcare costs and body image issues on both ends of the weight spectrum, the stigma of obesity and body weight is a neglected conversation in America’s movement towards a healthier, more physically active nation.

Obesity is a complex social and health issue. We live in a society where socially constructed ideas of beauty are incongruous with reality, where the cards are stacked against those who are fat and we collectively shake our heads, attributing a glaringly fatal medical condition to a lack of self-restraint. Being fat is looked upon as unfavorably as smoking and drug addiction — stemming from morally flawed behavior that not only affects one’s personal health, but impacts society through gargantuan medical costs and decreased workplace productivity.

If I told you that obesity was a completely genetic condition, that the stock of America’s obese were at the mercy of an unfavorable set of genes, you would likely take a more empathetic stance toward the overweight. Indeed, it has been shown that we have much more pity for individuals with completely genetically based conditions such as Alzheimer’s, which destroys one’s mental functioning, than those who are obese. Yet, recent studies that examined the genomes of thousands of individuals noticed a group of genes that were highly related to one’s body mass index. While this is a promising discovery in our path towards a more understanding and constructive understanding of this disease, the fact of the matter is, external environmental factors still contribute significantly to obesity.

The biggest flaw of popular perspectives on the obesity epidemic is that many equate environmental factors with individual decisions. We easily forget about insidious social pressures that are outside personal control: the pricing and taste of food, sedentary jobs and entertainment, long work hours and neighborhood designs that discourage walking to name a few. Yet, obesity interventions seem to be frustratingly simple to the medical community. Why does a doctor need to tell a patient to get more exercise when their blood pressure is high? Isn’t it obvious? What isn’t obvious, though, is how that patient will change their work schedule, afford both a gym membership and a healthier diet and overcome the embarrassment of being an overweight person in a gym. It’s no wonder that most current dietary programs and medications can do no more than reduce weight by 10 percent.

The ill will that the medical community has had towards obese individuals is a big part of the problem. Obesity is not a disease that hides within someone’s cells; we can see it. There is a difference then, between a patient with kidney failure and a patient who needs a wheelchair to enter the exam room because they cannot walk on their own two feet. Understandably, doctors may feel frustrated and discouraged by such patients. This impacts both quality and quantity of interactions. Doctors have less respect for patients who are obese, and consequently spend less time with them and offer less information. That’s negative feedback if I’ve ever heard one.

Because doctors, who are deemed moral actors within society, have such attitudes (conscious or subconscious) towards the obese, they are implicitly endorsing a societal shunning of a third of the American population. Stigmatization is not a form of treatment, and can only lead to adverse health outcomes and worse mental health states.

Although I am not obese, I can imagine the struggles of those dealing with weight issues. In the progressive, accepting culture Americans live in today, demeaning attitudes towards obese individuals are not consistent with other accepting attitudes we now have towards other groups. While obesity is undeniably a health problem that needs to be solved, an attack on the individual must be avoided for any constructive change to occur.

Philip Susser is a senior in the College of Human Ecology. He can be reached at pss226@cornell.edu. An Ithaca State of Mind appears on alternate Wednesdays this semester.

One thought on “SUSSER | Don’t Hate on the Obese

  1. This week I have been teaching about cell signaling in protists, plants, animals, and humans. That is, how a stimulus and a response are coupled. There are many biophysical, biochemical and genetic factors involved and I will teach many lines of equations. However, I start by mentioning such people as Viktor Frankl and Martin Niemoller, both of whom were courageous and responsible in a time when the environment was designed by Hitler. I ask my students, what was it that made these two people act they way they did–not like Paramecium that all do the same thing in response to a small change in their internal calcium concentration, but like unique and courageous individuals with a sense of responsibility. Was it a few calcium ions, a genetic mutation or free will?

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