The problems of overweight and obesity

Historically, a moderate degree of overweight was considered desirable. In a society in which food was scarce, fatness demonstrated greater than average wealth and prosperity.

This attitude persists in many developing countries today; food is scarce, and few people have enough to eat, let alone too much.

There is a good biological (evolutionary) argument in favour of a modest degree of overweight. A person who has reserves of fat is more likely to be able to survive a period of food deprivation or famine than a person with smaller fat reserves. So, at least in times past, fatter people may have been at an advantage. This is no longer so in developed countries, where there are no longer seasonal shortages of food. Widespread hunger is not been a problem in Western Europe or North America, although, as discussed in Chapter 8, lack of food is still a major problem in many countries.

Figure 6.3 shows that in 1998 (the most recent year for which data are available) more than half of all people in Britain were classified as overweight (i.e. BMI > 25); 17% of men and 21% of women were classified as obese (i.e. BMI > 30). Perhaps more seriously, the proportion of people who were classified as obese increased almost threefold in the period 1980 to 1998, and there is no evidence of any reversal of this trend. There has been a similar increase in the prevalence of obesity in most developed countries over the same period.

1991

1998

1991

overweight

1998

overweight

1991

1998

Figure 6.3 The increasing prevalence of overweight and obesity in UK, 1980—98, from UK Department of Health data.

1991

obese overweight

1998

Figure 6.3 The increasing prevalence of overweight and obesity in UK, 1980—98, from UK Department of Health data.

6.2.1 SOCIAL PROBLEMS OF OBESITY

As food supplies have become more assured, so perceptions have changed. Fatness is no longer regarded as a sign of wealth and prosperity. No longer are the overweight in society envied. Rather, they are likely to be mocked, reviled and made deeply unhappy by the unthinking comments and prejudices of their lean companions.

Because society at large considers obesity undesirable, and fashion emphasizes slimness, many overweight and obese people have problems of a poor self-image and low self-esteem. Obese people are certainly not helped by the all too common prejudice against them, the difficulty of buying clothes that will fit and the fact that they are often regarded as a legitimate butt of crude and cruel humour. This may lead to a sense of isolation and withdrawal from society, and may frequently result in increased food consumption, for comfort, thus resulting in yet more weight gain, a further loss of self-esteem, further withdrawal and more eating for compensation.

The psychological and social problems of the obese spill over to people of normal weight as well. There is continual advertising pressure for 'slimness', and newspapers and magazines are full of propaganda for slimness and 'diets' for weight reduction. This may be one of the factors in the development of major eating disorders such as anorexia nervosa and bulimia (section 8.3.1.1).

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