Sun | Aug 25, 2019

Garth Rattray | That beastly word ‘obese’

Published:Monday | August 12, 2019 | 12:17 AM

Dr Alfred Dawes, general, laparoscopic and weight-loss surgeon, published a well-­researched and excellently written Gleaner column on Wednesday, July 31, 2019, dedicated to the topic of fat-shaming. He cited the surprising worldwide and local increase in ‘obesity’ rates and the ­attendant health-related risks.

He was very understanding of the lifelong psychological, physiological, physical and social uphill battle that overweight individuals must face. He decried those who make jokes and tease overweight ­people because their actions are hurtful and harmful. I want to reiterate several things about being overweight and add my earnest desire that the medical ­community condemns the word ‘obese’.

‘Obese’ sounds like ‘oh, beast’. That horrible word doesn’t goad anyone into losing weight. It’s a diagnosis, a description and a socially accepted stigma. It is counterproductive to weight loss because the label is oppressive, embarrassing, depressing, and causes some to give up efforts at weight reduction.

The word is derived from the Latin term ‘obesus’. The original meaning described someone who ‘eats until fat’. But science has proven that it’s an extremely complex problem with millions of victims. Therefore, it’s ridiculous to inaccurately simplify it. If losing weight were so easy, everyone would be thin. Only about five per cent of people can maintain weight loss permanently.

COMMON BIAS

Obese conjures up images of an extremely large person chowing down on a massive mound of foodstuff with a jug of beverage waiting in the wings. Many mistakenly believe that obese people are ­dysfunctional individuals with weak minds, incapable of exercising a little self-discipline. Obese individuals are often thought of as gluttonous and slothful – two of the seven deadly sins. They are considered food addicts.

Bias against overweight people is common. They are thought of as undisciplined failures, incapable of taking care of their bodies. Because some believe that fat people are in serious/imminent danger, they are sometimes denied employment, passed over for promotions and refused places to rent. Additionally, clothing, seats and various equipment are still mostly manufactured for slim individuals.

Other things, like diabetes mellitus, hypertension, hypercholesterolaemia, smoking, illegal drugs, excessive alcohol, a strong family history of some cancers, risky sexual behaviour, driving badly, involvement in criminal activities and so on, carry major health risks, but only ­‘obesity’ is easily ­visually evident. That, in and of itself, is very stressful.

Being overweight or significantly overweight is an extremely complicated affair. Scientists have recently identified genes that make it very difficult for some people to lose weight, easy for them to gain weight, and cause cravings for the wrong types of foods in the wrong ­proportions. Such people are programmed to become plus-size. In order to remain within the ideal weight for height range, they must exert superhuman willpower throughout their entire lifetimes by ­eating ­considerably less than the average human being and remaining very ­physically active.

Aside from our genes (a major ­contributor to weight problems), some other factors leading to excessive weight are – conditions within the mother’s womb, the nutritional environment during early life, socialisation, problems with the chemicals from fat cells and the stomach that significantly regulate ­appetite and fat storage, poor sleep patterns, ­anxiety, depression, financial constraints, ­infrequent eating, rapid eating, the bacteria that colonise the gut, reduced physical activity and poor food choices.

The reasons that there is an increasing number of overweight people today include the persistence of the fat gene, modern society with time compression, fast foods, high-calorie foods, expensive healthy foods, paucity of recreational spaces and time, stress, and many others.

We can’t all be slim, but we can all reduce health risks with some weight loss. Get support for weight-loss efforts and do some activity. Abandon the counter­productive word ‘obese’. Use ‘overweight’ or ‘significantly overweight’ instead.

Garth A. Rattray is a medical doctor with a family practice. Email feedback to columns@gleanerjm.com and garthrattray@gmail.com.