Thursday, April 27, 2017

[Second Opinion] Obesity: from self to society

by Gideon Lasco
Philippine Daily Inquirer

Some time ago, my 19-year-old cousin Roi Mammuad posted something on Facebook that touches on an important social and medical issue of our time: obesity.

Wrote Roi: “I’ve struggled with my weight all my life. I went from being a chubby kid, to an overweight teenager, to an obese young adult.”

His post was deeply personal: “During elementary and high school, I was always the ‘Big guy’ in class. Always the one who had a hard time climbing stairs, always the one who had a hard time fitting into the armchair… I’ve heard every possible insult about my weight from ‘Tabachoy’ to ‘Hindi kasya si Roi sa tricycle!’ Even if it came from my family and friends, it hurt a lot. It hurt so much that I experienced depression. I felt unloved and unwanted.”

He proceeded to describe a turning point in his life: He started jogging, exercising and dieting. He concluded thus: “To make this story short, after almost a year of working out, the hard work paid off. I started with a weight of 255 lbs and came down to 160 lbs… I hope I can be an inspiration to all of you especially those who are struggling with their weight.”

How do we respond to young people like Roi who struggle with obesity?

For one, his narrative points to social stigma as an everyday reality for many obese individuals. What we might dismiss as “mere jokes” in the classroom setting—and even beyond—cause emotional harm to young people. Some studies also suggest that obese individuals are less successful in the job market.

Further aggravating the social burden of obesity is the fact that many people perceive it to be caused by the person him/herself, through overeating and lack of exercise. Thus, the obese person attracts not sympathy but judgment.

What’s more, what prevents many obese individuals from doing physical activities is not laziness but how others treat them. Shunned, obese kids avoid sports—thus losing the chance to engage in an activity that can make them lose weight. Stressed because of bullying and negative emotions, many of them turn to food for comfort, further exacerbating their weight problem, and aggravating their feeling of being “not normal.”

But exactly what does it mean to be “normal”? Bodies that we would consider “fat” are seen as normal and even attractive in many parts of the world, from South Africa to Samoa. Our society, however, celebrates bodies that are increasingly leaner: James Reid with his “six-pack abs,” Pia Wurtzbach with her “hourglass figure.” For youths like Roi, the impetus to “improve” one’s body is not just medical but social.

At the level of individuals, it is clear that losing weight offers some form of redemption, or a mental and physical triumph. Thus, people find “before and after” stories like Roi’s and those of celebrities like Erwan Heussaff, who calls himself “The Fat Kid Inside,” inspiring.

But we also have to look more broadly at our society and ask why people are getting obese, in the first place. Most scholars agree that obesity is a “modern epidemic” ushered in by the unprecedented, unregulated, abundance of food, most of which are rich in flavor but poor in nutrition. All socioeconomic classes are thus at risk for obesity, and the poor are doubly burdened with under- and overnutrition, both of which have dire health consequences. Tellingly, the Food Nutrition Research Institute warns that 5 percent of Filipino children below five years are now overweight (from just 1 percent two decades ago), even as 20 percent are underweight.

It’s not just our food choices and circumstances. The social landscape, too, has drastically changed, especially in urban areas: Adults and children today engage in far less physical activity. While some have the resources and mindset to exercise and get their kids to play sports, the same cannot be said of many Filipinos. Alas, our cities don’t have parks where people can walk or exercise, even if they want to.

What does this tell us? When it comes to obesity, we cannot just look at individuals alone. Not when an unhealthy lifestyle is, as a Lancet editorial pointed out, “a normal response by a normal person to an abnormal environment.”

Originally published in the Philippine Daily Inquirer on April 27, 2017:

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