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  • Writer's pictureSerena Booy

Obesity as a Socially Produced Phenomena

Is obesity a socially defined condition or is it a medically diagnosable disease?

What role does society play in the obesity epidemic?

Obesity is a multi-factorial condition, one that is defined by the World Health Organization as “abnormal or excessive fat accumulation that presents a risk to health.”.

Much confrontation stands as to whether obesity is a medical condition or a social condition. By labeling obesity as a metabolic condition, calling it a disease, it changes the dynamics of the condition from a personal responsibility to a medical condition that needs to be treated.

When we look at obesity as a socially constructed phenomena, as seen in social constructionism, we begin to understand that we are surrounded by external social structures that influence and impact on our lives and throughout our development, beginning at a young age.

It is through understanding social constructionism that we begin to see everything as ‘raw material’ that has no value until it is assigned value and worth. For example, our identity and who we are, is created through social interactions with others and formed by the reactions of those around us who dictate or assign us value. Society gives value to individuals and individual behaviors as seen in social status, socioeconomic status, body image etc.

Obesity is more a socially constructed condition than a medical disease state. As obesity is a socially constructed condition it is a public health issue.

Obesity amongst children and adolescence in Australia affects 1 in 4 children and is responsible for increased risk of musculoskeletal problems, sleep disorders, early onset Type 2 Diabetes, metabolic problems, poor self-image, low self-esteem, social isolation and depression, leading to long-term chronic health conditions and psycho social problems.

Obesity is a multi-factorial condition, the main cause of obesity being a metabolic imbalance; excessive caloric intake, coupled with decreased energy expenditure.

Obesity was not prevalent until the late 1700’s, early 1800’s when the Industrial Revolution came and now, in a post-modern era, we are seeing the outcome of the industrial revolution shown in the form of not only overweight adults, adolescents and children but also nations.

Over the decades, many public health and medical campaigns have addressed obesity as a chronic energy imbalance and the solution being to have smaller food portions and exercise more. These campaigns have shown to be ineffective as we are still seeing a statistical rise in childhood and adolescent obesity both within developing and developed countries. To effectively address the obesity epidemic, we need to take an upstream approach and address the key social determinants for obesity.

Many of our social structures within society have become social determinants of obesity. Obesogenic environments, are environments that promote poor physical behaviors and lifestyles. Obesogenic environments include, but are not limited to, the design of our urban area; are there parks? Are the roads/footpaths conducive to walking or riding a bike on? What are the transport systems like? Do people ride in cars to school/work? Do people ride bikes? Do people walk to the bus? Do people live in a house or a multi storey unit? Do people sit at an office desk all day? How many hours a day are people expected to work? Are people allocated lunch breaks where they can go for a walk? Do people sit in front of the TV at night?

Family structures play an important part as well. How many incomes are coming into the family unit? What is the socioeconomic status of the family? Is there a family social support network? Are there two parents or a single parent unit? How many siblings are in the family? What are the family beliefs and cultural practices? How are leisure activities defined?

Food choices: Who prepares the food? What are their beliefs and understanding regarding food preparation? How much impact does media and advertising have on food choices? How affordable and accessible is healthy food? What cultural belief/practices impact on food choices?

Social media, advertising and marketing strongly influence children and adolescents about their food consumption choices. A large percentage of the marketing is designed to generate feelings of excitement, worth, acceptance and a positive self-image by purchasing the advertised product. Peer pressure and influence is closely tied in and connected to individual food choices.

Social stigmatization associated with excessive weight gain/obesity unfortunately is a struggle that many overweight and obese children/adolescence.

Cultural barriers to multicultural groups within Australia include barriers to communication with English often being a second language, a lack of knowledge or an inadequate social support network that enables individuals to navigate around western cultural practices are considered overlooked social determinants to health and the obesity epidemic.

How children/adolescence view themselves or how their perception of how others view them also impacts of the prevalence of overweight/obese children.

Other factors such as maternal health of mother, health of baby in utero, how the baby was delivered and if the baby was breast fed also come into play when considering determinants of obesity.

It has been discussed that, “Obesity follows a socioeconomic gradient which adversely affects the poor.” To some degree, this is correct, limited resources often equate to having to purchase cheaper grocery items, resulting in poor food choices.

Latest research indicates that obesity is not necessarily an outcome of poverty but is shifting more to be a condition of affluence. Within Australia, many children and adolescence of multicultural origin are found to be overweight/obese. Studies are showing that as countries (i.e. the Pacific Islands) become more affluent, there is a decrease in traditional dietary practices and an increase in western food consumption and inevitably an increase in weight. Children coming in from other nations, not traditionally exposed to western foods, are leaving their traditional diets and partaking in energy dense, nutritionally devoid foods.

Other social determinant on a multicultural level that we are seeing in our diverse nation is cultural beliefs and practices where large women are perceived to be more appealing and highly valued for their child bearing abilities compared to skinnier women. This is a public health issue that is inter generational, affecting our current child/adolescent population and future generations as well.

‘DE normalizing’ the current sociably accepted view of body fat and obesity is a large undertaking for the public health sector. Society has been engineered in producing a population of people who are stressed, they no longer grow their own food, they do not have time to cook their food instead they buy take away food for the convenience accompanied by not having time, motivation or energy to get the level of exercise they need.

Obesity is a multi-factorial socially defined and produced condition. For there to be more of an awareness and statistical shift in overweight/obese children/adolescence, there needs to be a move from the reductionistic labeling of obesity as a medical state and address the multi-factorial social determinants to overweight and obese children within Australia on an individual, a community, a local government and a national government level.

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