Obesity as a disease | Political economics

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Almost a quarter of patients who visit a public OPD hospital complain of back pain, knee pain or generalized weakness. These patients come hoping for a medical diagnosis, only to find that the only reason for their problem is their weight. Often you hear jokes from experienced doctors as they try to put obesity into perspective for the patient. One might find these jokes somewhat funny and true, but you can’t help but notice the insensitivity behind them. Body shaming isn’t limited to the doctor’s office – from mainstream media to family and friends to strangers – almost everyone finds it necessary to report your “weight problem”.

For a long time, obesity has been treated as a behavioral problem, one that stems from junk food consumption, overeating and inactivity. Although there is some truth in this, it is not the whole truth. Modern medicine has now described multiple causes of obesity, including genetic makeup and body morphology; socio-economic factors, such as lifestyle and ease of access to healthy foods and gyms; mental stress and coping behaviors; medical diseases and drugs; cultural preference for particular foods and serving portions, etc. An example of the latter is the difference in obesity rates between the American and Japanese populations. With foods high in carbohydrates and fats being the main components of fast food, the American population has a considerably higher rate of obesity than Japan, which consumes mainly protein and healthy vegetables. The South Asian diet is also high in fats and carbohydrates. So when a doctor warns a patient to eat less roast to lose weight, they do not understand what to replace it with because roast serves as the primary energy source.

Along with poor nutrition, the general attitude of our population towards obesity is one of indifference. Health and fitness are low on their priority list, even for those with access to healthy options. Although experts still struggle to understand the complicated science of weight loss, the lack of health awareness among Pakistani people makes it even more difficult. We often come across people practicing weight loss methods that are now outdated. The lack of professional nutritionists compounds this problem, leaving people to seek solutions on their own. With so much inaccurate information available online, those seeking self-education may become more confused.

Obesity as a disease

Although the WHO recognized obesity as a disease in the late 1990s, like many other issues, we have been slow to catch up. With extensive research available for multiple medical and surgical treatment options, doctors are now treating it like a disease. They are prescribing weight loss pills more generously than before, and morbidly obese patients now have the choice of undergoing weight reduction surgeries.

The complex nature of weight loss and the many obstacles make it difficult for people prone to weight gain to achieve and maintain a healthy weight. As a result, a journey of repeated weight loss followed by weight gain and self-loathing, disappointment and ultimately poor mental and physical health ensues. Increased blood pressure and blood sugar leading to complications, increased risk of cancer, body pain due to increased load on the legs and back, low self-esteem and impaired body image all lead to poor quality of life. lower life.

With multiple causes and a complex interplay of many causal factors, the question arises of who qualifies as a professional. For the most part in our setup, it’s your friendly neighbor or an aunt whose niece has actually tried this or that diet. If you’re lucky, it might be the trainer at your gym or an online business that sells a certain diet. The role of dietitians and doctors has so far been minimal.

Although the WHO recognized obesity as a disease in the late 1990s, like many other issues, we have been slow to catch up. With extensive research available for multiple medical and surgical treatment options, doctors are now treating it like a disease. They are prescribing weight loss pills more generously than before, and morbidly obese patients now have the choice of undergoing weight reduction surgeries.

As Pakistan has a fragmented healthcare system, there are fears that doctors may limit weight loss therapy to drugs and surgeries without the necessary lifestyle interventions. Undoubtedly, this is a possibility, so the role of clinical dietitians becomes even more crucial. Although they are not usually part of public hospital health care teams, hopefully a change in attitude towards obesity will create the need for clinical dieticians.

What makes this idea interesting to me is that it will take the weight loss burden off the patient’s shoulders. With the help and guidance of a professional team, patients will start their weight loss journey earlier, have realistic goals based on their condition, and find support in case they feel hopeless. It will also allow patients to avoid many health complications and improve their quality of life. As for the stigma associated with it, I understand that not only society but also professionals are far from developing an empathetic approach to the condition.


The author is a physician with a particular interest in mental health. She can be contacted at [email protected]om

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