The Bio-psycho-social aspects of being Obese

Obesity is an illness that has a complex relationship with bio, psycho and social processes across the world.  Obesity is spreading across the face of the world, communities that were long safe guarded against obesity are now facing a huge increase.  Despite more information and education on safer food choices, people seem to prefer to choose unhealthier food items. Can people make safer choices around food or is consumer responsibility a myth? Is our modern way of living becoming increasingly more stressful and we are having to resort to food as means of quick affordable comfort?

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Many urban cultures have quick easy access to calorie dense food items. Convenience stores stay open later than ever before and many cases 24 hours, giving people around the clock access to unhealthy food items. 

Social Pressure

However, at the same time there has never been so much pressure to conform to social norms of remaining slimmer. Plastic surgery and diet programs have never been so inundated with requests to join. Many people live in a time where they are in direct comparison to people intimately via social media, even trainee surgeons flock to social media to show off their bikini bodies (Brusie, 2020).

Abuse as a Child

Being overweight at school is the most common reason for being bullied (Bacchini et al, 2015), the legacy of bullying leaves victims with worse outcomes as an adult in cognitive functioning, psychological health, physical health and quality of life. This often leads to a lower quality of life and poorer income as an adult (Arseneault, 2014).  Income and quality of life are directly associated with higher risk for obesity (Kim & von dem Knesebeck). Stigma and discrimination towards obese people continue into adulthood, also with many people who are overweight being blamed for their weight (Puhl & Heuer, 2010). Persecutors often feel justified in their abuse, partially because we live within a system that ignores bullying. In the USA 85% of all cases of bullying receive no further intervention (McNamee, 2014). Discrimination on the basis of weight is increasing at “disturbing rates” (Andreyava and Brownwell, 2008).  We’re effectively seeing a society that is getting more overweight and hates itself for it. 

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In the UK the government have stepped in to tax sugar in a similar way to the way cigarettes are taxed. Items like chocolate bars and carbonated drinks receive higher tax to help reduce their intake. The Pricing of food is thought to have a direct relationship on health (Lee at al, 2016). However, healthier food items have often been cheaper. The average price of 1kg of apples in the UK is £2.05 (“The Price of 1kg of apples in London”, 2021) and the price of 850g of chocolate is £9.00 (“Cadbury Dairy Milk Bar 850g, 2021).

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Although some critics point towards unhealthier more sedentary lives, people have never been so engaged with diet and exercise. There have never been more people trying to tackle their weight, more people than ever belong to a gym and most people attempt a diet at some point in their life.  We may be overlooking a more complex reason for obesity than just diet and exercise; we may be dealing with a population of people who have a unique set of stressors that serve as a barrier for weight loss. Enhancing position within a bio psycho and social model of weight management may serve to increase positive outcomes. 

References:

Andreyeva, T., Puhl, R. M., & Brownell, K. D. (2008). Changes in perceived weight discrimination among Americans, 1995-1996 through 2004-2006. Obesity (Silver Spring, Md.), 16(5), 1129–1134. https://doi.org/10.1038/oby.2008.35

Arseneault, L. (2014) Health Impact of Childhood Bullying Can Last a Lifetime : A new study shows how our bodies react in similar ways to the stress of bullying as they do to an infection. The Conversation. Accessed 31st Jan 2021: https://www.scientificamerican.com/article/health-impact-of-childhood-bullying-can-last-a-lifetime/

Bacchini, D., Licenziati, M. R., Garrasi, A., Corciulo, N., Driul, D., Tanas, R., Fiumani, P. M., Di Pietro, E., Pesce, S., Crinò, A., Maltoni, G., Iughetti, L., Sartorio, A., Deiana, M., Lombardi, F., & Valerio, G. (2015). Bullying and Victimization in Overweight and Obese Outpatient Children and Adolescents: An Italian Multicentric Study. PloS one, 10(11), e0142715. https://doi.org/10.1371/journal.pone.0142715

Brusie, C. (2020) Journal Apologizes For Sexist Article After Clinicians React By Posting Bikini Pics Online. Nurse.org. Accessed 31st Jan 2021 : https://nurse.org/articles/medbikini-response-to-medical-journal-backlash/

Cadbury Dairy Milk Bar 850g (2021. Jan 31). Retrieved from  https://www.cadburygiftsdirect.co.uk/cadbury-dairy-milk-bar-850g.html

Lee, A.J., Kane, S., Ramsey, R., Good, E. & Dick, M. (2016). Testing the price and affordability of healthy and current (unhealthy) diets and the potential impacts of policy change in Australia. BMC Public Health 16, 315. https://doi.org/10.1186/s12889-016-2996-y

Kim, T. J., & von dem Knesebeck, O. (2018). Income and obesity: what is the direction of the relationship? A systematic review and meta-analysis. BMJ open, 8(1), e019862. https://doi.org/10.1136/bmjopen-2017-019862

Puhl, R. M., & Heuer, C. A. (2010). Obesity stigma: important considerations for public health. American journal of public health, 100(6), 1019–1028. https://doi.org/10.2105/AJPH.2009.159491

The Price of 1kg of apples in London (2021, Jan 31). Retrieved from https://www.expatistan.com/price/apples/london

Published by Dylan Kerr BA ACAT FDAP DipHE MBABCP

Mr Dylan Kerr Addictions Counselor Bachelors in Clinical Counseling (Hons) Advanced Certified Addictions Therapist Member of the British Association for Behaviour and Cognitive Psychotherapist Member of the Federation of Drug and Alcohol Practitioners HeDip Health-care HeDip Psychology of Addiction Dip Counselling Diploma in Arts Therapy Diploma in Transactional Analysis CSAT III Dylan Kerr is a Certified Substance Abuse Therapist who is qualified in Counseling, Psychology of addiction from Leeds University and Healthcare from Birmingham City University. Dylan Kerr has been a senior Therapist at the River Rehab, Lead Therapist at Lanna Rehab in Chiang Mai and Head Counselor of Hope Rehab in Siracha. As well as working in Thailand for 7 years, Dylan has also been the on-tour counsellor for the the Rock band ‘The Libertines’. Dylan is now resident counsellor at an Asian rehab. Dylan has experience of working within the music industry supporting acts in therapeutic needs. As well as working around the world Dylan has over 13 years experience delivering substance use disorder treatment at various agencies around the UK. He is skilled in motivational interviewing, CBT, RET and guidance around 12 step philosophies. Dylan has worked with a broad client base and establish the rapport needed to effect change and sustainable progression. Dylan wishes to start this blog to help educate people on his observations within this field and debate the nature of work in the addictions field.

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