When I was growing up, teasing and bullying was a normal part of the childhood experience.
One of the groups that were consistently singled out for this type of behaviour were children who were obese. They were often mercilessly subjected to taunts around their size and physical appearance.
While our society has come a long way in addressing bullying behaviour towards people based on factors such as race, ethnicity or sexual identity, judgements of people based on their size is still prevalent. We have built up a multi-billion dollar industry devoted to promoting dieting to become thin in order to be socially accepted.
There is hope that this may be changing here in Canada.
Last week, the Canadian Medical Association Journal released information that presented new clinical guidelines for the treatment of obesity that may provide a new direction in how patients dealing with obesity are perceived and treated. In the past, such patients have often been seen as unmotivated and lazy with the belief that they just needed to change their behaviour by eating fewer calories and exercising more often and their obesity will go away if they keep at it.
The new guidelines take a more holistic approach and encourage physicians to treat obesity as a chronic illness that may require a number of medical interventions beyond diet and exercise. Viewing obesity through the lens of a chronic illness takes away much of the stigma attached to it and should allow patients to access treatment options that address the many factors that may be underlying this condition.
As an example, I have noticed during my decades working in mental health that there are some psychiatric medications that cause patients to put on significant weight and can lead to obesity. Because of the stigma surrounding obesity, many patients stopped taking their medications and I have heard many times that they would rather deal with the negative consequences of poor mental health than deal with how people treat them when they are obese. The anti-obesity prejudice in our society is so powerful that people are choosing to sacrifice their mental health and we should all be worried at the long-term consequences of such a pattern.
We should also be accepting of the fact that human beings come in a wide variety of shapes and sizes and this is something to be celebrated rather than judged. Just because someone is thin does not mean they are healthy and, likewise, just because someone is overweight does not mean they are not healthy. If we could get past the tendency to only look at the outside and instead consider the entire person, we would allow people to focus on what they need to be healthy and functioning in their own lives and in the bodies in which they live these lives.
If we can get past the judgements around obesity, we may be able to effectively help people who want treatment for their condition. If a patient presents to a doctor with any other chronic illness, a number of treatment options would be offered to them and they would work with the doctor to come up with the most effective treatment program for them. Why would we think it wrong to offer the same approach when it comes to obesity?
Helping people to increase their health is a much better approach than one that focuses on reducing their weight and can give patients the power to make decisions that support their wellness. What we have been doing over the past 50 years or so has not been effective in addressing obesity and has led to the commercialization of a weight-loss and diet industry that has, in many ways, exacerbated the problem it purports to treat by setting up unrealistic expectations and continuing a cycle of yo-yo weight change that negatively affects the body.
With these new guidelines, we can help do away with fat-shaming and change the focus to health improvement for all people regardless of their body type.
Brian Hodder works in the field of mental health and addictions. He can be reached at [email protected].
