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Article

Analisa Arroyo and Kristin Andersen

Weight-based stigma is pervasive and is propagated via sociocultural and interpersonal messages that influence individuals’ identity. The ideals communicated in these messages place disproportionate value on appearance and have made weight an important component of attractiveness. Some cultures, particularly Western culture, hold a bias toward thin bodies and promote a bias against those who do not fit cultural ideals of slender or lean body shapes. This bias, judgment, stigma, prejudice, and discrimination toward individuals based on their size, shape, or weight is known as weightism. Most of the research regarding weightism has been conducted on obesity and overweight individuals because of the related public health concerns. However, because weight is a continuum on which individuals are frequently evaluated, stigmatization is experienced by individuals who are either over or under cultural norms for appropriate weight and toward those who engage in deviant weight-control behaviors (e.g., purging). Thus, because individuals with eating disorders are often underweight and have deviant eating behaviors, they also experience weight-based stigma and discrimination. There are a multitude of negative effects associated with being a part of these stigmatized weight groups, including lower self-esteem, less social confidence, greater body dissatisfaction, poorer mental health, and increased substance use and self-harm behaviors. These negative outcomes create a social divide between the stigmatized weight groups and others, wherein stigmatized individuals turn to negative health behaviors (e.g., bingeing and purging) in an effort to cope with their negative social experiences. Subsequently, they perpetuate their affiliation with their stigmatized weight group and the related health conditions.

Article

Anthropometrics is a research program that explores the extent to which economic processes affect human biological processes using height and weight as markers. This agenda differs from health economics in the sense that instead of studying diseases or longevity, macro manifestations of well-being, it focuses on cellular-level processes that determine the extent to which the organism thrives in its socio-economic and epidemiological environment. Thus, anthropometric indicators are used as a proxy measure for the biological standard of living as complements to conventional measures based on monetary units. Using physical stature as a marker, we enabled the profession to learn about the well-being of children and youth for whom market-generated monetary data are not abundant even in contemporary societies. It is now clear that economic transformations such as the onset of the Industrial Revolution and modern economic growth were accompanied by negative externalities that were hitherto unknown. Moreover, there is plenty of evidence to indicate that the Welfare States of Western and Northern Europe take better care of the biological needs of their citizens than the market-oriented health-care system of the United States. Obesity has reached pandemic proportions in the United States affecting 40% of the population. It is fostered by a sedentary and harried lifestyle, by the diminution in self-control, the spread of labor-saving technologies, and the rise of instant gratification characteristic of post-industrial society. The spread of television and a fast-food culture in the 1950s were watershed developments in this regard that accelerated the process. Obesity poses a serious health risk including heart disease, stroke, diabetes, and some types of cancer and its cost reaches $150 billion per annum in the United States or about $1,400 per capita. We conclude that the economy influences not only mortality and health but reaches bone-deep into the cellular level of the human organism. In other words, the economy is inextricably intertwined with human biological processes.

Article

Roger Shrimpton

Malnutrition is caused by consuming a diet with either too little and/or too much of one or more nutrients, such that the body malfunctions. These nutrients can be the macronutrients, including proteins, carbohydrates, and fats that provide the body with its building blocks and energy, or the micronutrients including vitamins and minerals, that help the body to function. Infectious diseases, such as diarrhea, can also cause malnutrition through decreased nutrient absorption, decreased intake of food, increased metabolic requirements, and direct nutrient loss. A double burden of malnutrition (both overnutrition and undernutrition) often occurs across the life course of individuals and can also coexist in the same communities and even the same households. While about a quarter of the world’s children are stunted, due to both maternal and young child undernutrition, overweight and obesity affects about one in three adults and one in ten children. Anemia, most commonly due to iron deficiency, is also affecting about a third of women of reproductive age and almost half of preschool children. Around 90% of nations have a serious burden of either two or three of these different forms of malnutrition. Malnutrition is one of the principal and growing causes of global disease and mortality, affecting at least half of the world’s inhabitants. Programs for tackling maternal and child undernutrition have gained impetus in the last decade with a consensus developing around a package of effective interventions. The nutrition-specific interventions, mostly delivered through the health sector, are directed at immediate levels of causality, while nutrition-sensitive interventions, directed at the underlying and basic levels of causality are delivered through other sectors such as agriculture, education, social welfare, as well as water and sanitation. Less consensus exists around the interventions needed to reduce overnutrition and the associated non-communicable diseases (NCDs), including diabetes, high blood pressure, and coronary heart disease. Prevention is certainly better than cure, however, and creating enabling environments for healthy food choices seems to be the most promising approach. Achieving “healthy diets for all,” by reducing consumption of meat and ultra-processed foods, as well as increasing consumption of fruit and vegetables, would help control rising rates of obesity and reduce NCD mortality. Adopting such healthy diets would also greatly contribute to reducing greenhouse gas emissions: the agriculture sector is responsible for producing a third of emissions, and a reduction on livestock farming would contribute to reducing global warming. Public health nutrition capacity to manage such nutrition programs is still widely lacking, however, and much still needs to be done to improve these programs and their governance.