Health is Beautiful

Obesity is growing, and more and more children are falling prey to this social disease.  Why have we not seen this before?  Why now?  Is it as a result of the bountiful post-war period, or a shift towards more sedentary life-styles?  Is it the symptom of addiction to highly flavoured, brightly coloured fast foods?  Is it all of these things, or is there something else? 

I believe it is all of these things but with a subtle difference - namely, the underlying association of food with comfort, warmth, love and rewards, and an ever increasing need for these things in our society.  As far as I can tell, there has never been a period in history where life-styles have been so easy and yet morale has been so low.  As a therapist, the causes of the morbid obesity that I have treated have all, without exception, had their roots in low self-worth. 

We already know that the inclusion of flavour enhancers such as Monosodium Glutamate, sugar substitutes such as Aspartame, along with the preservatives and other additives, in our food, is affecting behaviour and moods.  The brightly packaged, highly flavoured snacks have moved from being regarded as occasional treats, due to their original scarcity, to everyday expectations, creating a feeling of deprivation if we can’t have them.  Gradually the nation has seduced itself into a mass desire for unnatural food products – perhaps even a dependence?  Why?

Here’s one simple explanation:

As newly born infants, we, as a species, are completely dependent for everything – we have a built in mechanism to alert those around us to our needs – we cry – to be cleaned, to be fed, and to have any other basic needs attended to.  The time when we are most comfortable is when we are being fed – we are held close, cuddled, our tummies our filled so the pain of hunger is assuaged and we are warm and satisfied.  We are also in control of our environment and feel ‘replete’.  This association with food is reinforced throughout our very early development.  It should be no surprise then that we easily fall into the behaviour of seeking out food later in life when we are in need of those feelings of comfort – whatever the reason.  The ‘sugar-rush’ experienced with sweet foods makes these prime candidates for ‘comfort-eating’.

The statistics are staggering:

‘The number of people who are obese is rising.  About 1.2 billion people in the world are overweight and at least 300 million of them are obese, even though obesity is one of the 10 most preventable health risks, according to the world Health Organisation.  In the United States, more than 97 million adults – that’s more than half – are overweight and almost one in five adults is obese.  Among teenagers and kids 6 years and older, more than 15% are overweight – that’s more than three times the number of young people who were overweight in the 1970’s.  At least 300,000 deaths every year in the United States can be linked to obesity.’ http://www.kidshealth.org/teen/food_fitness/dieting/obesity.html

The incidence of childhood obesity has risen to such a degree that various remedial procedures have been adopted, some of which are extremely invasive:

‘Operations: A number of operations have been devised over the years and modifications have been made. This diversity is one complicating factor when trying to analyse the evidence. Criteria for acceptance or rejection for operation vary. Another problem is that the surgery is just one of many components of the management plan. A PubMed search for "bariatric surgery systematic review" yielded over 100 references published in 2005 alone. It is valid to ask why the world needs so many systematic reviews and the answer would seem to lie in the interpretation of the data.

Surgical procedures can be divided into categories:

•       Malabsorptive surgery bypasses parts of the gastrointestinal tract to limit the absorption of food.

•       Restrictive surgery reduces the size of the stomach so the feeling of fullness occurs with less food.

Malabsorptive procedures include jejunoileal bypass, gastric bypass and biliopancreatic diversion, while restrictive procedures include gastroplasty and gastric banding. There is an increasing trend towards using laparoscopic rather than open techniques.

•       Endoscopic placement of something in the stomach. This tends to be a shorter procedure, requiring sedation rather than general anaesthesia.’ http://www.patient.co.uk/showdoc/40025123/

Other procedures involve medication such as appetite suppressants, diuretics and so on:

‘There is no evidence of the effectiveness of orlistat, sibutramine, and rimonabant in the long-term treatment of obesity. Bariatric surgery is more effective than non-surgical treatment for long-term weight loss and control of some co-morbid conditions, particularly diabetes, in severely obese patients. However bariatric procedures differ widely in terms of long-term effectiveness and safety and important gaps in scientific knowledge exist in this field. Risks can be high. A volume-outcome relationship has been described for most bariatric procedures including gastric banding. There is no evidence that gastric banding has a better risk/benefit ratio than the current standard Roux-en-Y. Long-term residential care of severely obese children (on average, one school-year) is effective in the short-term, but is very expensive, might have some disadvantages (less family involvement), and no data exist to assess its long-term effectiveness.’ http://nhscrd.york.ac.uk/online/hta/20060812.htm

For those who have no problem with over-eating or with maintaining a healthy body weight, the problem has a simple remedy – just reduce the amount you eat.  So why is it not that easy?

I believe it is because the issue is not about the food, but about low self-worth and low self-esteem – feeling of no value, unwanted, unattractive, and unable to achieve.  If these things are true, then how have we managed to create a population of people who feel inadequate, and what can we do about it? 

Perhaps the following should be part of our national curriculum:

* caring about people and caring for people,

* learning about what our bodies need to keep us healthy

* learning parenting skills way before we are able to become parents,

* respecting each other,

* focussing on our strengths rather than our weaknesses, and

* fostering a culture where everyone can achieve ie skills for employment opportunities

* ensuring that everyone feels a valued member of society.

Surely, prevention is better than cure?

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