Managing Obesity
Pause to Reflect
In teaching this section of the book, it will be useful to contextualize the information about the causes of obesity.
In pairs or small groups, ask students to brainstorm answers to the following questions.
- What kinds of behaviors do people typically attempt to change?
- Why do people work to change behaviors?
- How easy is it for people to change behaviors such as study habits, diet, exercise, sexual behaviors, and smoking, alcohol, or drug use?
- How do people actually change their behaviors?
- What types of behaviors have you tried to change?
- What motivated you to change your behavior?
- What was your experience with behavior change like?
- What kind of challenges did you face in trying to change your behavior? ⦁ Were you successful the first time you tried?
- Did you ever relapse, or return to the old behavior?
- What aspects of your own experience may be helpful to remember when you work on changing a particular habit?
- In debriefing small groups’ answers as a larger class, it will be useful to highlight that a broad range of factors complicate or get in the way of successful behavior change. As necessary, add in additional information about each of the following areas of human experience: society, community, relationships, individual.
- What do each of these areas involve?
- Individual factors: Knowledge, past experiences, competing needs or desires, the lack of self confidence or hope, addiction, or signs and symptoms of illness including pain, depression, and lack of energy
- Relationship (family and friends) factors: Cultural values and customs, family income, peer pressure, how families shop and prepare meals, responsibilities to care for other family members, stress, social support, exposure to risks such as domestic violence, and so on.
- Neighborhood and community factors: The availability of green spaces such as parks, public transportation, affordable and healthy food, safety, community organizations, and so on
- Societal factors: Political and economic forces and decisions that determine access to key health resources including healthy environments, safety, housing, food, employ ment, income, and civil rights
As a class, consider this example:
Maria wants to eat healthier and exercise more. What are some obstacles in each of these community areas as she tries to change this behavior?
The following text is something of a case study that dramatizes these ideas. It is excerpted from “Being Black in America Can Be Hazardous to Your Health” by Olga Khazan in The Atlantic.com July/August 2018. Read through the text together and identify where Kiarra is “stuck” in the state of obesity by individual, relationship, community, and societal factors.
- One morning this past September, Kiarra Boulware boarded the 26 bus to Baltimore’s Bon Secours Hospital, where she would seek help for the most urgent problem in her life: the 200-some excess pounds she carried on her 5-foot-2-inch frame.
- To Kiarra, the weight sometimes felt like a great burden, and at other times like just another fact of life. She had survived a childhood marred by death, drugs, and violence. She had recently gained control over her addiction to alcohol, which, last summer, had brought her to a residential recovery center in the city’s Sandtown neighborhood, made famous by the Freddie Gray protests in 2015. But she still struggled with binge eating—so much so that she would eat entire plates of quesadillas or mozzarella sticks in minutes.
- As the bus rattled past rowhouses and corner stores, Kiarra told me she hadn’t yet received the Cpap breathing machine she needed for her sleep apnea. The extra fat seemed to constrict her airways while she slept, and a sleep study had shown that she stopped breathing 40 times an hour. She remembered one doctor saying, “I’m scared you’re going to die in your sleep.” In the haze of alcoholism, she’d never followed up on the test. Now doctors at Bon Secours were trying to order the machine for her, but insurance hurdles had gotten in the way.
- Kiarra’s weight brought an assortment of old-person problems to her 27-year-old life: sleep apnea, diabetes, and menstrual dysregulation, which made her worry she would never have children. For a while, she’d ignored these issues. Day to day, her size mostly made it hard to shop for clothes. But the severity of her situation sank in when a diabetic friend had to have a toe amputated. Kiarra visited the woman in the hospital. She saw her tears and her red, bandaged foot, and resolved not to become an amputee herself.
- Kiarra arrived at the hospital early and waited in the cafeteria. Bon Secours is one of several world-class hospitals in Baltimore. Another, Johns Hopkins Hospital, is in some respects the birthplace of modern American medicine, having invented everything from the medical residency to the surgical glove. But of course not even the best hospitals in America can keep you from getting sick in the first place.
- It was lunchtime, but Kiarra didn’t have any cash—her job, working the front desk at the recovery center where she lived, paid a stipend of just $150 a week. When she did have money, she often sought comfort in fast food. But when her cash and food stamps ran out, she sometimes had what she called “hungry nights,” when she went to bed without having eaten anything all day.
Examining Argumentation and Evidence
Now that you have, as a class, discussed the way that an individual’s health can be considered a gauge of their access to resources, critique the following student essay.
The Epidemic of Obesity
Obesity has become a major public health concern in recent years, worldwide obesity has nearly tripled since 1975. Nearly 2.8 million people die a year as a result of being overweight or obese. Obesity is defined as an excessive accumulation of body fat and is typically measured using Body Mass Index (BMI). A BMI of 30 or above is considered obese. The causes of obesity are complex and involve a combination of factors, including unhealthy diets, sedentary lifestyles, and genetics. While overeating and lack of physical activity are important contributors, they are not the only factors. There are also environmental and societal factors that contribute to the obesity epidemic. For example, the abundance of unhealthy food options, such as high-calorie, high-fat fast food, and the promotion of sedentary behavior through technology and media.
Moreover, genetic predisposition also plays a significant role in obesity. Certain genetic variations can make individuals more susceptible to obesity, even with healthy eating and physical activity habits. Studies have shown that obesity can run in families, indicating a genetic predisposition to weight gain. Author Alex Haley, specialist in bio-information, with interests in the field of genetics (focusing on genome frequency), expresses through her studies, “There are three gene regions that have been found to be associated with body mass index in children but they appear to act together. One of these is the FTO gene region which increases the risk of obesity by 0-80% depending on whether or not you inherited harmful variants from both parents…This means that if both parents carry a harmful variant in the FTO gene and their child has inherited this variant they have an 80% chance of also inheriting it… In this research it was established that those who have this gene have a 70% greater chance of being obese than those without it. ” This shows how certain genetic variations can make a person more susceptible to weight gain, by affecting their metabolism, appetite, and the way their body stores and uses fat. For example, some genetic variations can slow down metabolism, making it more difficult for the body to burn calories and leading to weight gain. Other variations can affect hormones that regulate hunger and fullness, leading to increased food cravings and overeating.[This highlights the need for a personalized approach to addressing obesity, as a one-size-fits-all approach may not be effective for everyone.] It’s important to note that genetics are only one factor in the development of obesity, and a combination of genetic and environmental factors can influence a person’s weight.
The advertisement of fitness and healthy lifestyle habits is often portrayed as the solution to obesity. While promoting healthy behaviors is important, it can also contribute to stigmatizing individuals who are obese. This is because it can suggest that obesity is a choice and is solely the result of poor lifestyle habits. Goop, a lifestyle and wellness website, has often been criticized for promoting a narrow and unrealistic standard of beauty. The website frequently showcases young, white women with toned and healthy bodies, and often features images and articles that focus on fitness, diet, and self-care practices that contribute to this idealized body type. This narrow representation reinforces the idea that only one type of body is considered “good” or desirable, and can be harmful for individuals who do not fit this mold. This type of advertising can be damaging for people who are struggling with body image issues, as it reinforces the idea that only a certain body type is acceptable and desirable. Additionally, by not including diverse body types, the website fails to acknowledge and celebrate the diversity and beauty of all people, which can lead to feelings of exclusion and low self-esteem. It is important for media outlets, including Goop, to take a more inclusive approach to advertising and celebrate the diversity of bodies, rather than promoting a narrow and unrealistic standard of beauty.
To address the obesity epidemic, a multi-faceted approach is required. This includes promoting healthy lifestyles, such as healthy eating habits and physical activity, but also addressing the underlying environmental and societal factors that contribute to obesity. Governments can play a role by regulating the marketing of unhealthy food and beverage products, particularly to children, and by creating environments that support healthy behaviors.
In conclusion, the obesity epidemic is a complex issue that is not solely the result of poor lifestyle habits. A combination of factors, including genetics, unhealthy diets, sedentary lifestyles, and environmental and societal factors, contribute to the rising prevalence of obesity. Addressing the obesity epidemic requires a comprehensive approach that takes into account the multiple factors involved and seeks to promote healthy lifestyles and environments.
Comment on this student’s thesis formation, choice of quotes, and analysis of evidence. In small groups, ask students to answer the following questions:
- To what extent does the student take into account the complex, interrelated factors involved in an individual’s health?
- Where does the student lack textual support of their claims?
- Where does the student summarize the quote instead of doing a close reading?
- Where does the essay lack detail/development, stating general ideas but not providing examples to support the idea?
