The dangers of obesity are widely known, from developing
Type 2 diabetes to coronary heart disease. In 1991, the government formally
recognised that obesity was a sufficient threat to the nation’s health to
require a targeted response.
But is obesity all about lack of willpower, or are other factors
at play?
New report says obesity is not a choice
In September 2019, the British Psychological Society (BPS)
published a report: “Psychological perspectives on obesity: Addressing policy,
practice and research priorities.”
This looked into the various and complex causes of obesity,
along with weight discrimination, changing behaviours, prevention and weight
management.
The conclusion was that obesity was not a choice, but could
be caused by a variety of different factors, which might be biological,
psychological and/or social. The best approach to combatting obesity, it
recommended, was a “biopsychosocial” one, rather than “fat shaming” – shaming,
blaming and stigmatising those who are obese.
How is obesity measured and what are the dangers of obesity?
Obesity is considered a chronic disorder and classed as a
disease. An individual is usually considered obese if they have a Body Mass
Index (BMI) of 30 or higher.
The NHS website states that it is estimated that one in
every four adults is obese, and around 1 in every 5 children between 10 and 11.
The dangers of obesity include developing any of the
following:
- Type
2 diabetes
- Coronary
heart disease
- Stroke
- Certain
cancers (breast, bowel, womb)
- Osteoarthritis
- Asthma
- Sleep
apnoea
- Liver
or kidney disease
- Mental
health issues
Obesity can also affect quality of life, for example by
limiting movement and causing shortness of breath, back pain or joint pain.
What are the causes of obesity?
While willpower can be a factor, there are many other more
pressing reasons for a person to become obese.
These include:
Genetics – this is considered a key factor in the
report: “Over 100 twin and family studies have established that 50-90 per cent
of weight differences between people can be explained by genetic influences.”
There are 100+ genes that can affect weight difference, from controlling
appetite regulation to emotional eating.
Stress – stress of any kind has been shown to be
linked to obesity, directly and indirectly. The report states that: “Chronic activation
of the stress response system results in greater accumulation of internal body
fat… Stress also influences a range of behaviours, such as sensitivity to food
cues and cravings that lead to eating more or choosing more calorific-dense
foods”.
Mental health – not only can mental health issues
lead to obesity but some of the drugs used to treat conditions such as
depression can increase appetite. It can also be a two-way street: poor mental
health can cause weight gain and vice versa.
While eating disorders such as anorexia and bulimia are
widely known about, Binge Eating Disorder (BED) tends to be under-recognised.
This is a serious but treatable disorder where someone has repeated episodes of
bingeing, including eating when they are not hungry or continuing to eat when
they are uncomfortably full. The bingeing is usually followed by feelings of
guilt and shame.
Ethnicity – government figures from 2017-2018 state
that “Black adults were the most likely out of all ethnic groups to be
overweight or obese.” This was followed by white British adults, with those
from the Chinese ethnic group least likely to be overweight or obese. The
number of those who were overweight or obese in the following groups: Asian,
Other white, Mixed and Other ethnic, was also lower than the national average.
See: https://www.ethnicity-facts-figures.service.gov.uk/health/preventing-illness/overweight-adults/latest.
Age – we’ve all heard the term middle-age spread and
there’s no doubt that factors relating to age can affect obesity. This might be
age-related changes to how easily we put on weight or changes to the type and
amount of exercise we do.
Hormones – the hormones that regulate appetite can be
affected by stress, overeating or binge eating. This can result in increased
consumption of food, as the balance of hormones affects our ability to
recognise when we are full and encourages the consumption of foods high in fat
and sugar.
Lifestyle – a sedentary lifestyle can contribute to
obesity through lack of exercise or spending long hours seated at work. Our
eating habits can also be rooted in our lifestyle, for example eating a fry up
every morning, overeating at business lunches and dinners or consuming excess
alcohol while socialising.
Physical activity – keeping active can help combat
obesity, from taking a walk every day to following a cardio fitness class to
weight training with a personal trainer. Physical activity often goes
hand-in-hand with lifestyle and diet, in that those who are interested in
keeping fit often exercise regularly and follow a healthier diet.
Diet – while other factors such as genetics are
important, the quality of our diet can be as important as the quantity we eat.
Additionally, the approach to losing weight often promoted by the diet industry
– short-term highly restricted eating – is mentioned in the report as a factor
that can cause physical and psychological harm.
Socio-economic – our food preferences and habits are
shaped in childhood and carried through to adulthood. These are often influenced
by socio-economic factors, such as food poverty, which can lead to the
consumption of more food that is high in energy and low in nutrition.
Conclusion
Obesity is a serious, life-limiting condition and the number
of people classified as obese is rising. However, the solution does not lie fat
shaming or blaming all weight gain on an individual’s lack of willpower.
Instead, the BPS report recommends a “biopsychosocial”
model, which takes into account the range of factors behind weight gain and offers
a framework that focuses on what causes certain types of behaviour rather than
the behaviour itself.
