Understanding Obesity Understanding Obesity through Sociologythrough Sociology

Dr Abir YoussefDr Abir Youssef

Understanding Obesity Understanding Obesity through Sociologythrough Sociology IntroductionIntroduction World Health Organization (WHO) World Health Organization (WHO)

definitions for obesitydefinitions for obesity Causes of obesityCauses of obesity Socio-economic Environmental Socio-economic Environmental

Explanation Explanation Cultural – behavioral ExplanationCultural – behavioral Explanation Ethnicity and ObesityEthnicity and Obesity Tackling Obesity Conclusions

IntroductionIntroduction

Obesity is a major public Obesity is a major public health problem across the health problem across the world.world.

Obesity results from Obesity results from excessive caloric intake, excessive caloric intake, decreased energy expenditure decreased energy expenditure and/or from a combination of and/or from a combination of the two.the two.

World Health Organization World Health Organization (WHO) definitions for obesity(WHO) definitions for obesity

BMI = Weight kg/Height mBMI = Weight kg/Height m²² Underweight: <18.5 BMIUnderweight: <18.5 BMI Healthy weight: 18.5-24.9 BMIHealthy weight: 18.5-24.9 BMI Overweight (Grade I obesity): Overweight (Grade I obesity):

25.0-29.9 BMI25.0-29.9 BMI Obese (Grade II obesity): 30.0-39.9 Obese (Grade II obesity): 30.0-39.9

BMI BMI Morbidly obese (Grade III obesity): Morbidly obese (Grade III obesity):

40 or above BMI40 or above BMI

Causes of obesityCauses of obesity

The etiology of obesity The etiology of obesity includes both genetic and includes both genetic and environmental factorsenvironmental factors

The followings are the The followings are the main factors:main factors:

Environmental factors related Environmental factors related to lifestyle and cultural or to lifestyle and cultural or socio-economic conditions socio-economic conditions

Psychological factorsPsychological factors Metabolic factorsMetabolic factors May also be induced by drugs May also be induced by drugs

(high dose glucocorticoid)(high dose glucocorticoid) Secondary to a variety of Secondary to a variety of

neuroendocrine disordersneuroendocrine disorders

Socio-economic Socio-economic Environmental ExplanationEnvironmental Explanation

Obesity is strongly influenced Obesity is strongly influenced by environmental factors, by environmental factors, such as , poverty, housing such as , poverty, housing condition, and work situation.condition, and work situation.

Housing conditionsHousing conditions

There is clear recognition of There is clear recognition of the association between poor the association between poor housing and poor physical housing and poor physical and mental healthand mental health

IncomeIncome

Obesity is strongly linked to Obesity is strongly linked to poverty. poverty.

Poorer diets among poorer Poorer diets among poorer groups can be explained by groups can be explained by the lack of opportunities, the lack of opportunities, stress, and level of stress, and level of knowledge.knowledge.

IncomeIncome

Poverty and overcrowding Poverty and overcrowding can inhibit parental can inhibit parental supervision of children and supervision of children and negatively affect their health negatively affect their health in general and increase in general and increase obesity.obesity.

Unhealthy fast food is both Unhealthy fast food is both available and affordable.available and affordable.

Work situationWork situation

Work allows for the financing of Work allows for the financing of household necessities and leisure household necessities and leisure pursuits and provides status and pursuits and provides status and self-esteem for the individual. self-esteem for the individual.

There is a decrease in energy There is a decrease in energy consumption at work, as most of consumption at work, as most of our jobs now require much less our jobs now require much less physical effort, compared with physical effort, compared with 1970.1970.

Work situationWork situation

Travel to work by cars and/or Travel to work by cars and/or other modern public transport other modern public transport

Calorie intake and the Calorie intake and the ambient temperature at home ambient temperature at home and at the workplace have and at the workplace have increased.increased.

Cultural – behavioral Cultural – behavioral ExplanationExplanation

TheThe Cultural – behavioral Cultural – behavioral explanation of health explanation of health inequalities point out class inequalities point out class difference indifference in

beliefs about healthbeliefs about health health behaviour health behaviour life-style life-style

Lack of public informationLack of public information

Some people can not judge Some people can not judge which products are high in fat which products are high in fat and by how much. and by how much.

Food manufacturers display Food manufacturers display macronutrients in grams, macronutrients in grams, when the correct way would when the correct way would be to express their be to express their contribution in energy.contribution in energy.

Lack of public informationLack of public information

Advertising gives children Advertising gives children confused messages about confused messages about nutrition, and can change their nutrition, and can change their food preferences and buying food preferences and buying behaviour. behaviour.

Subsidies of agricultural products Subsidies of agricultural products play an important part, as children play an important part, as children as well as adults, are influenced by as well as adults, are influenced by cheap prices. cheap prices.

Ethnicity and ObesityEthnicity and Obesity

Psychosocial factors associated with Psychosocial factors associated with the incidence of obesity in ethnic the incidence of obesity in ethnic minorities include minorities include

inadequate social supportinadequate social support cultural barriers to communicationcultural barriers to communication racism and discriminationracism and discrimination stress and lack of knowledgestress and lack of knowledge language difficulties to understand language difficulties to understand

the health promotion message.the health promotion message.

Tackling Obesity on Tackling Obesity on different levelsdifferent levels

individuals individuals community community local government local government national levelsnational levels

Tackling ObesityTackling ObesitySociety-wide ApproachSociety-wide Approach The WHO’s 1997 interim report argues that it is The WHO’s 1997 interim report argues that it is

not enough to tackle obesity at individual not enough to tackle obesity at individual level and that a society-wide public health level and that a society-wide public health approach needs to be employed.approach needs to be employed.

Medical profession Medical profession Government should work with the food Government should work with the food

industry to promote a healthier diet for industry to promote a healthier diet for everyone from childhood to adult life. everyone from childhood to adult life.

Management of obesity in Primary Care by a Management of obesity in Primary Care by a motivated well-informed multi-disciplinary motivated well-informed multi-disciplinary team could achieve and maintain weight team could achieve and maintain weight loss by promoting sustainable changes in loss by promoting sustainable changes in lifestyle.lifestyle.

Tackling ObesityTackling Obesity The government should work to reduce The government should work to reduce

health inequality and improve the health inequality and improve the environment factor. environment factor.

Controlling safety and making the streets Controlling safety and making the streets safe for walking or cycling.safe for walking or cycling.

Promoting and improving access to sport Promoting and improving access to sport and leisure facilities.and leisure facilities.

Education programmes for all, advertising to Education programmes for all, advertising to promote healthy lifestyles and highlight the promote healthy lifestyles and highlight the risks associated with obesity.risks associated with obesity.

Tackling ObesityTackling Obesity

Individual parents of Individual parents of overweight children should be overweight children should be helped to take responsibility helped to take responsibility and encourage healthy eating and encourage healthy eating and physical activity.and physical activity.

ConclusionsConclusions

Obesity is not a disease, it is Obesity is not a disease, it is a public health problem and it a public health problem and it is a risk factor for several is a risk factor for several chronic diseases.chronic diseases.

Understanding environmental Understanding environmental factors can contribute to a factors can contribute to a better understanding of the better understanding of the nature of obesity as well as nature of obesity as well as contribute to tackling it.contribute to tackling it.