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Brianna Rooths

Professor Casey Flores

English Composition II

10 July 2020

Obesity a social disease

When the word obesity comes to mind, one often has negative thoughts surrounding this

disease. It has become common to think of obese people as lazy, uneducated, unsuccessful, and

unmotivated. Often those who struggle with this disease face issues of discrimination in social

settings, jobs, and even their access to healthcare. The testing for obesity is biased and inaccurate

with factors that contribute to obesity not considered specifically, how they often cannot be

controlled. The diagnosis of obesity creates negative circumstances in a person’s life that affects

the obese person’s livelihood and ability to correct this issue. Let's take a look at how the

diagnosis of obesity creates negative circumstances in a person’s life.

The American Medical Association voted to recognize obesity as a disease in 2013,

because it requires treatment and preventative efforts. The Mayo Clinic defines obesity as “a

complex disease involving an excessive amount of body fat,” while also using the controversial

body mass index (BMI) method to diagnose this disease. Obesity is often caused by genetics,

lifestyle choices, and can result from other diseases. Sometimes medication required to treat

other diseases can also have the adverse effect of obesity. Social and economic issues can

contribute to the lifestyle choices that lead to obesity. In 1968,Werner J Cahnman published the

article entitled “The Stigma of Obesity,” where he wrote: Obesity is hardly ever mentioned in the

writings of sociologists, and not at all in the literature on social deviance. This omission is

amazing… Clearly, in our kind of society, with its stress on affluence and upward mobility,
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being overweight is considered to be detrimental to health, a blemish to appearance, and a social

disgrace” (qtd. in Hojjat ). Cahnman, like many others, view obesity as something that is

personal and should be determined by the person and their doctor. Treatment and prevention for

obesity include working out, healthy eating habits and being consistent in monitoring and

tracking an individual’s weight loss and gains. Doctors who are concerned about health issues

that can occur due to obesity, are often harsh on patients experiencing the symptoms of obesity.

These health concerns include diseases caused and heightened by obesity, and mobility issues

like arthritis and joint pain. The biggest cause of concern for obesity is diabetes and the many

illnesses that can occur because of or simultaneously with obesity.

One reason why obesity can have negative effects on someone’s livelihood would be

discrimination or fat shaming. For obese people looking to find work, they often run into

problems with how they will be perceived. Perception is not the only issue an obese person may

face, they also experience receiving less pay than those who are perceived as having a healthy

weight. A study conducted by researchers at the University of Florida and the London Business

School estimated that, “compared to the annual incomes of women of average weight, the

incomes of women who were obese or overweight were lower and the incomes of women who

were perceived as thin were higher”(Gale in Context Obesity). Jobs like acting, background

dancing, and military careers often have specific guidelines for employees with a focus on

physical appearance. Typically, obese actors receive roles that would be a comic relief and less

often receive serious roles that are for main characters, or a role involving intimacy. For the

military, they require that their personnel are physically fit even if they are working in intel or

other regular desk jobs all while taking yearly fitness tests. Go-army.com says “Poor body

composition, especially obesity, has a negative effect on appearance and self-esteem, and
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negatively influences attitude and morale”. This institution believes that an obese person would

not fit into the image and criteria the army requires of its recruits. With the rise in cases of

obesity, doctors warn against normalizing obesity, which may be interpreted as body shaming.

Body shaming has been proven to be ineffective in receiving the desired results, such as a

decrease in obesity, and has increased the amount of suicides and mental illness among those

who suffer from obesity.

Health coverage and biases against obese patients often can deter patients from receiving

the care that they need and can discourage the desired effect doctors will try to promote. Doctors

have prescribed medication to help obese patients lose weight but sometimes these patients are

not able to afford the out of pocket costs that come with these treatments. In an effort to save

money, insurance companies promote weight loss and clean eating to help avoid costly medical

procedures. The Gale Opposing viewpoints states that “According to the 2016 Gallup-

Healthways Well-Being Index, medical expenses related to overweight and obese adults in the

United States contribute more than $142 billion in annual health care costs. Compared to

individuals with lower BMIs, people who are overweight pay an additional $378 in annual health

care costs while people with obesity typically pay an additional $1,580 each year.” Patients who

require medication for weight loss are often rejected for help with payment from their insurance

companies because it is viewed as cosmetic. With the negative perception of obesity, doctors

often are impatient with obese patients and even if patients come into appointments for unrelated

issues, doctors often associate any problems they experience back to their weight. According to

the Journal of the American Medical Association, “...weight bias among medical and health care

providers as a serious problem with potentially fatal consequences. Encountering weight biases

in health care settings has been shown to have detrimental effects on overweight and obese
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patients, who may find unhealthy habits harder to break and treatment plans harder to follow.”

Obesity, if left untreated, can cause an increase in likelihood of other serious diseases such as

Type 2 diabetes, certain cancers, digestion problems, heart disease and many other

complications. Health insurance companies can cut down on these diseases by allowing coverage

for preventative medication and in some cases surgery.

The social image of obesity is problematic and causes those affected by it to become less

confident and have a negative self-image. With the rise of social media, criticism and blatant

disrespect of the obese population has increased while these critics are able to hide their identity

behind fake pages on social media. “Media has a direct link with how obesity is perceived and

though we are not told what to think or believe about this subject, there are examples showing

the media can convince us what to think about” (qtd. in Raisborough). These perceptions as well

as mistreatment cause people labeled as obese to suffer from mental illness at higher rates then

those who are at a healthy weight showing in a 2015 study published in the journal

Psychological Science, “researchers reported that body shaming can increase the likelihood of

developing mental health conditions that make it more difficult to lose weight” (qtd. in Gale in

Context Obesity). Body positive activists believe that “a person can more effectively address

health concerns by accepting their size and concentrating on improving overall health” (Gale in

Context Obesity). With a negative self image comes an increase in stress which has been linked

to an increase in weight. These links between stress and obesity were identified in a 2017 study

published in the journal Obesity showing “that during extended periods of stress, people reported

both overeating and eating more foods high in sugar, fat, and calories. The relationship between

stress and eating habits is compounded by the fact that cortisol, the stress hormone, slows

metabolism and can cause the body to store more fat” (Gale in Context Obesity).
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The body mass index is a common tool used to diagnose obesity. Raisborough defines the

BMI as “a calculation derived from weight divided by height squared. Despite its inability to

distinguish fat from mass (muscle and bone) and its ‘stature bias’ (as height, the denominator, is

squared, higher denominators will secure lower scores), the BMI has taken a life of its own as a

measure of fat”. Although it has proven to be a useful tool in some individuals, it can also be

misleading in consistently diagnosing obesity in various populations based on different physical

attributes. According to betterhealth.com BMI can overestimate the amount of body fat in

individuals who are bodybuilders, high performance athletes and pregnant women. BMI is

underestimated in individuals who are elderly and people with a physical disability such as but

not limited to being unable to walk and experiencing muscle wasting. Also, BMI is inaccurate in

diagnosing people who have eating disorders and those with extreme obesity. The reasoning for

the inaccuracy of the use of the BMI method would be, for individuals with a lot of muscle they

tend to have a higher BMI value, but are not defined as overweight. A 2016 study published in

the International Journal of Obesity “assessed the health of more than 40,000 adults by

examining six different metrics for health, including blood pressure, cholesterol, and blood sugar

levels. Of these adults, 47 percent who were classified as overweight by their BMI and 29

percent of those classified as obese were found to be healthy when using the other metrics. Over

30 percent of those classified as having a healthy BMI, meanwhile, were found to be unhealthy

according to the other metrics” (qtd in Gale in Context Obesity). Those who are physically

debilitated experience muscle atrophy, which is defined by Medline Plus as the wasting

(thinning) or loss of muscle tissue. Since they are unable to walk the muscle wastes away. When

disabled people are measured using the BMI, the conclusions are inaccurate since the test doesn’t

consider the dead muscle tissue. These conclusions can either define a patient at a healthy weight
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without regard to the muscle atrophy or conclude that these patients are obese without

consideration of muscle atrophy. In regard to the elderly, as a person ages towards that age

category, they typically lose muscle mass because they may not be as active as they once were.

Another factor that affects BMI calculation is height. For shorter people, BMI tends to be

overestimated and in taller people, BMI tends to be underestimated.

Unfortunately, there are factors that influence an individual’s affinity to become obese

that cannot be controlled such as food deserts. The United States Department of Agriculture

defines a food desert as “an area where people have limited access to a variety of healthy and

affordable food.” For most urban areas, they are considered food deserts because there is a lack

of food retailers that sell healthier options or even have grocery stores in these communities at

all. Sometimes vehicle reliability, higher poverty rates and low incomes also contribute to an

area being considered a food desert. Food deserts can be prevented with funds from the national

government while also using these funds to help educate and supply food to these impoverished

areas. Since there are not as many grocery stores available, the stores that feed these

communities are often overpriced and the quality of the food is below standard. A study

conducted by the US Department of Agriculture found “ access to affordable and nutritious food

may also be important for the effectiveness of government benefit programs: an analysis using

data from an electronic benefits transfer (EBT) demonstration in Dayton, OH, concluded that

improved access to large grocery stores can increase the welfare of Supplemental Nutrition

Assistance Program (SNAP) recipients by an estimated value of $2.78 to $7.76 per

month”(Dutko 9). Members of the community who rely on food assistant programs often must

be selective about how much of their benefits they can spend to feed their families. This means

that the option of feeding everyone in the family quality food will come at a greater cost than
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having more food to feed everyone even though the quality is not as great. In Trotwood, Ohio,

the recent COVID pandemic was hard on businesses like Food Town, the only grocery store left

in the community, and eventually led to it being shut down. This leaves behind Dollar Stores and

fast food options. This area can be referred to as a food swamp, “areas where retailers selling fast

food and junk food outpace those offering healthier options”(Opposing Viewpoints, Gale).

Fig. 1 T Templin. The overweight and obesity transition from the wealthy to the poor in low-

and middle-income countries: A survey of household data from 103 countries (2019).

“This image shows a change in the wealth distribution of the overweight population between

1995 and 2040. Each line displays World Bank Income group changes in overweight burden

across a wealth decile. Wealth deciles, where 1 is the poorest and 10 is the richest, are displayed

on the x-axis. The percent change in each wealth decile's overweight burden share from 1995 to

2040 is on the y-axis”(See Fig.1).

Diseases that can cause someone to become obese either through the disease itself or

through medication used to treat the disease are factors that influence obesity that cannot be

controlled. Heart disease, Type 2 diabetes, insomnia, polycystic ovary syndrome, Cushing
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syndrome and hypothyroidism are some diseases that can cause obesity. The Mayo clinic defines

Cushing syndrome to occur “when your body is exposed to high levels of the hormone cortisol

for a long time. Cushing syndrome, sometimes called hypercortisolism, may be caused using oral

corticosteroid medication. The condition can also occur when “your body makes too much

cortisol on its own” (Mayo Clinic Cushing syndrome). This disease causes fatty humps between

shoulder blades, weight gain in facial features and causes an increase of weight gain in

midsection. Hyperthyroidism occurs when this gland in your neck stops producing enough

hormones which in turn contributes to weight gain. Insomnia can cause your body to produce

hormones that cause you to gain weight and can also increase cravings of less healthy food

options. These diseases as well as environmental factors, social issues, and the lack of accuracy

in the BMI testing are all factors that contribute to obesity and cause a negative stigma behind

the disease.

Doctors argue the importance of not normalizing obesity and point out how this disease

can cause a patient to develop other diseases, experience mobility issues, and increase healthcare

costs for the general public. Doctors estimate “Around 700,000 new cancers caused by being

overweight or obese are predicted by 2035. And the estimated number of people living with

diabetes worldwide has topped 4 million for the first time, an increase of 119,965 compared with

the previous year, and a rise of 65% during the past decade” (Hojjat 8). All these different

cancers can be prevented with a healthier diet and including more physical activity. Some

doctors point out that “the increase in obesity also has profound economic consequences on

employers and government; the loss of productivity caused by obese conditions of employees is

as high as the medical expenses attributable to such conditions”(Hojjat 9). Doctors believe that

obesity can negatively affect the US economy because of mortality rates increasing as obesity
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and obesity related diseases increase mortality rates among citizens. Obesity can also affect how

efficient a person’s joints and tendons are. Obesity tends to put more pressure on joints and

tendons prohibiting them from working effectively and can have negative effects on a person’s

mobility. The ability to heal quickly also plays a role in things obesity negatively affects. With

an increase in fatty tissue, oxygen and nutrients are not able to get to wounds as quickly and this

can delay or prevents healing from occurring.

In conclusion the diagnosis of obesity creates negative circumstances in a person’s life

that affects the obese person’s livelihood and ability to correct this issue. In facing constant

biases in the workplace, healthcare and in social settings an obese person’s desire to lose weight

is often lost behind discouraging biases. It seems likely that discouraging the population to be

obese would have the desired effect for obesity rates to decline but through research conducted

on this matter, there are direct negative affects for constantly advising obese patents to lose

weight. The BMI test is not an accurate way to determine whether a person is obese or not and

shouldn’t be used in determining a person’s ability especially for employment. Other tests should

be taken into consideration before a doctor labels their patient as obese. There are sometimes

factors that can contribute to obesity that cannot be controlled like certain diseases and

medications. The disease of obesity should be met with a doctor whose only goal is better health

for their patients without equating each issue a patient has with their weight and BMI. When

simply correcting obesity is the goal of a society, this goal can often get lost behind defensive

patients and doctors who lack empathy. Instead society should focus on creating a healthier

lifestyle that can be accessible to everyone and more empathy for those who struggle with weight

gain.

Works Cited
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Centers for Disease Control and Prevention. Overweight & Obesity, Centers for Disease Control

and Prevention, www.cdc.gov/obesity/index.html. Accessed 30 June 2020.

Department of Health & Human Services. “Body Mass Index (BMI).” Better Health Channel,

Department of Health & Human Services, 16 Apr. 2018,

www.betterhealth.vic.gov.au/health/healthyliving/body-mass-index-bmi.Accessed 28

June 2020.

Dutko, Paula, et al. Characteristics and Influential Factors of Food Deserts, United States

Department of Agriculture, Aug. 2012,

www.ers.usda.gov/webdocs/publications/45014/30940_err140.pdf.Accessed 30 June

2020.

Hojjat, Tahereh Alavi, and Rata Hojjat. “Socioeconomic Factors: Poverty and Obesity.” The

Economics of Obesity , Singapore Springer , 2017, pp. 19–25.

Mayo Clinic. Obesity, Mayo Foundation for Medical Education and Research, 15 Feb. 2020,

www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742.

Accessed 28 June 2020.

"Obesity." Gale Opposing Viewpoints Online Collection, Gale, 2019. Gale In Context: Opposing

Viewpoints, https://link-gale-com.sinclair.ohionet.org/apps/doc/PC3010999129/OVIC?

u=dayt30401&sid=OVIC&xid=b4db0b7c. Accessed 10 July 2020.

Raisborough J. “Fat Gets Melodramatic: The Obesity Epidemic and the News.” In: Fat Bodies,

Health and the Media. Palgrave Macmillan, London, 2016

Templin, T, Cravo, Oliveira et al.2019. The overweight and obesity transition from the wealthy

to the poor in low- and middle-income countries: A survey of household data from 103

countries. https://doi.org/10.1371/journal.pmed.1002968
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