Co-author Jimmy E. Ramos Valencia
The metadiscourses, in which discourses are projected to interact with recipients, disseminated by the media and “social networks” represent body weight as a consequence of lifestyle. These equate “fatness” with “disease” and “thinness” with “health,” and consequently “fat people” would be lazy people who do not follow “healthy” lifestyles. Obesity, associated with being overweight, is therefore understood as a disease that people should control and avoid. In neoliberal societies, in which the “autonomous and self-regulated individual” is highly valued, the social construction regarding “fat people” is especially condemnatory.
In 2015, according to Healthdata, there were 107.7 million obese children and 603.7 million obese adults in the world. And since 1980, obesity has doubled in more than 70 countries and has steadily increased in most other countries. Obesity, however, remains for societies an aesthetic and behavioral problem, according to the specialized media, Medwave.
This is a warning light for Latin American countries which, at the dawn of the third decade of the 21st century, show statistics that reflect a significant increase in the problem. The two countries that best represent the relationship between neoliberal politics and the increase in weight of the population in Latin America are Chile and Mexico. For example, in the case of Mexico, one of the most affected countries, in 1993 the Metabolic Syndrome, associated with risk factors for heart disease, diabetes and other health problems linked to obesity, affected 30% of people over 20 years of age, according to the National Health and Nutrition Survey (ENSANUT), while in 2012 seven out of ten adults were overweight and obese.
Two decades after the state declared an alert regarding obesity–a term coined by the World Health Organization to refer to the growing pandemic of overweight people–the increase in obesity has not stopped increasing and its spread is much more complex. This reflects the failure of the strategies implemented in countries such as the United States and the United Kingdom, which have always approached the problem from an individual sphere associated with behavior, instead of tackling it in a comprehensive manner by proposing changes in the economic, food and political subsystems. A great example of an increase in this health problem, associated with changes in economic and social policies, took place in Ireland.
Obesity versus lifestyle
The complexity of social studies on obesity can be summarized in the results found by the renowned obesity specialist Arnaiz in 2014. His results show that obese people, despite being overweight and obese, consider their state of health to be “healthy.” Despite this, people also internalize predominant conceptions regarding “fatness” as a bad and unhealthy condition, which in turn establishes contradictory conceptions about their own body and state of health.
Beyond differences, the current reductionist approach to health and the global “war on obesity” are problematic and potentially harmful. While environmental risks, as the specialists Costa-Font and Mas state, are empirically measured in the globalized production and distribution system, “lifestyle risks” are based on the use–or misuse–that individuals voluntarily make over the long term of risky goods that are legally distributed in the market.
In the United States and the United Kingdom, the approach to the problem did not take into account that it is a systemic condition that transcends psychological (individual), economic (social) and political (societal) spheres. This hardened the debate and limited the implementation of efficient public policies to counteract the increase in the disease.
Who is to blame?
The definition, importance and consequences of obesity as a disease have changed drastically in recent decades. Once considered a common comorbidity of other chronic diseases, obesity is now defined as a specific medical condition that deserves public attention and resources.
The etiology–the science focused on the study of disease causation–of obesity is consistently attributed to the triumvirate of overeating, decreased physical activity, and lifestyle factors. Recent research places some 22 million children under five years of age as overweight due to sedentary lifestyles and Western eating habits. Developed countries are experiencing unprecedented rates of comorbid chronic diseases and the earliest onset of type 2 diabetes among children and young adults.
Although obesity rates have stabilized their increase, the prevalence of this disease remains a public health problem for current and future generations. In terms of economic cost and public awareness, obesity has acquired a prominent position in the realm of social problems by raising concern and controversy, and stimulating public action on behalf of affected citizens. Socially, the medicalization of obesity defined obese people as “sick” because of the risk to their personal health, the cost to society and social marginalization. Obesity remains a private matter without a socially constructed or informed solution.
The institutionalization of obesity as a public health problem in the late 1990s reinforced medical expertise in treatment and prevention efforts. Biomedicalization promoted a depersonalization and destigmatization of the condition of obesity as an outcome solely attributable to personal habits and individual responsibility.
Therefore, proposals to curb the spread of obesity in Latin America must take into account that the social representation of obesity by experts went from being a moral problem to a disease that must be explained and measured scientifically. And above all, it must be comprehensively addressed.