Understanding Obesity through Sociology Dr Abir Youssef Understanding Obesity through Sociology         Introduction World Health Organization (WHO) definitions for obesity Causes of obesity Socio-economic Environmental Explanation Cultural – behavioral Explanation Ethnicity and Obesity Tackling Obesity Conclusions Introduction  Obesity is a major public health problem across the world.  Obesity results from excessive caloric intake, decreased energy expenditure and/or from a combination of the two. World Health Organization (WHO) definitions for obesity BMI = Weight kg/Height m²      Underweight: <18.5 BMI Healthy weight: 18.5-24.9 BMI Overweight (Grade I obesity): 25.0-29.9 BMI Obese (Grade II obesity): 30.039.9 BMI Morbidly obese (Grade III obesity): 40 or above BMI Causes of obesity The etiology of obesity includes both genetic and environmental factors The followings are the main factors:      Environmental factors related to lifestyle and cultural or socio-economic conditions Psychological factors Metabolic factors May also be induced by drugs (high dose glucocorticoid) Secondary to a variety of neuroendocrine disorders Socio-economic Environmental Explanation Obesity is strongly influenced by environmental factors, such as , poverty, housing condition, and work situation. Housing conditions There is clear recognition of the association between poor housing and poor physical and mental health Income   Obesity is strongly linked to poverty. Poorer diets among poorer groups can be explained by the lack of opportunities, stress, and level of knowledge. Income   Poverty and overcrowding can inhibit parental supervision of children and negatively affect their health in general and increase obesity. Unhealthy fast food is both available and affordable. Work situation  Work allows for the financing of household necessities and leisure pursuits and provides status and self-esteem for the individual.  There is a decrease in energy consumption at work, as most of our jobs now require much less physical effort, compared with 1970. Work situation  Travel to work by cars and/or other modern public transport  Calorie intake and the ambient temperature at home and at the workplace have increased. Cultural – behavioral Explanation The Cultural – behavioral explanation of health inequalities point out class difference in  beliefs about health  health behaviour  life-style Lack of public information  Some people can not judge which products are high in fat and by how much.  Food manufacturers display macronutrients in grams, when the correct way would be to express their contribution in energy. Lack of public information  Advertising gives children confused messages about nutrition, and can change their food preferences and buying behaviour.  Subsidies of agricultural products play an important part, as children as well as adults, are influenced by cheap prices. Ethnicity and Obesity Psychosocial factors associated with the incidence of obesity in ethnic minorities include  inadequate social support  cultural barriers to communication  racism and discrimination  stress and lack of knowledge  language difficulties to understand the health promotion message. Tackling Obesity on different levels     individuals community local government national levels Tackling Obesity Society-wide Approach The WHO’s 1997 interim report argues that it is not enough to tackle obesity at individual level and that a societywide public health approach needs to be employed.  Medical profession  Government should work with the food industry to promote a healthier diet for everyone from childhood to adult life.  Management of obesity in Primary Care by a motivated well-informed multi-disciplinary team could achieve and maintain weight loss by promoting sustainable changes in lifestyle. Tackling Obesity  The government should work to reduce health inequality and improve the environment factor.  Controlling safety and making the streets safe for walking or cycling.  Promoting and improving access to sport and leisure facilities.  Education programmes for all, advertising to promote healthy lifestyles and highlight the risks associated with obesity. Tackling Obesity  Individual parents of overweight children should be helped to take responsibility and encourage healthy eating and physical activity. Conclusions   Obesity is not a disease, it is a public health problem and it is a risk factor for several chronic diseases. Understanding environmental factors can contribute to a better understanding of the nature of obesity as well as contribute to tackling it.