Is the scale wrong? or our approach wrong?

The most common New Year’s Resolution that people make is to lose weight, and with good intention. Nearly one third of the population are overweight or obese and due to this, health issues and chronic conditions caused by excess weight has more than doubled since 1980 (WHO obesity and overweight). Obesity can lead to several chronic conditions like diabetes, chronic heart diseases, and some cancers. Apart from its detriment to general health, obesity related illnesses can also overwhelm and overburden the health care systems.

Obesity is commonly measured using BMI (body mass index) which is a measure of weight in relation to the height (Canada, 2006). Although there is ambiguity on the validity of this as a measurement, the WHO uses as it as the standard measure for overweight and obesity. According to their guidelines, an individual falls within one of six BMI categories. A body mass index of 25 to 29.9 is considered to be overweight and the health risks are increased in this category. A body mass index of 30 to 34.9 is considered to be obese Class I and aligns with high health risks. Obese class II has a BMI of 35 to 39.9 and aligns with a very high risk of health risks. Individuals in the sixth category are classified as obese class III and live with an extremely high risk of health risks. (Canada, 2006)

Statistics Canada conducted a survey in 2004 and the results were published in the “Health Reports Vol. 17 No. 3” from statistics Canada”. In that report in 2004, 59.1% Canadians were overweight or obese and 23.1% of Canadians were obese (Canada, 2006). In other words a quarter of Canadians are obese and a half of the Canadian population is either overweight or obese. In comparison in 2002 29.7% of Americans over age 18 were obese. (Canada, 2006) In 2002 32.7% of the female population was obese and according to statistics Canada, 23.2% of Canadians women were obese. (Canada, 2006)

According to the YouTube video “Obesity health risks” (Appendix A) obesity can lead to diabetes, cardio vascular problems, hypertension and metabolic diseases. However 53% of American men and 48% of American women still do not believe that their weight may be a contributor for the chronic disease.

The WHO considers obesity as a health risk and an epidemic (Organization, 2000). Current research identified that increasing obesity rates and rising complications associated with obesity could lead to an unhealthy and unproductive population, as well as put unnecessary pressure on health care systems (Terry T. Huang, 2019). Thus, obesity is no longer an individual health issue but a complex social health burden in which individual behavior is affected by multiple socioeconomic factors. Therefore, this complex issue requires a multilevel approach. (Terry T. Huang, 2019)

The socio-economical model approaches weight management by, examining the factors affecting the obesity, and subdividing them into the following categories.

1. Public policy

2. Community

3. Organizational

4. Interpersonal

5. Individual (balancedweightmanagement.com)

The Socio-economical model introduce the environmental and social factors affecting individual weight and attempts examine the issue from a multileveled perspective. Under public policy the socio-economical model considers national, states, and local laws. Under the community socio-economical model considers relationship among organizations.

Public Policy/Community

Local and federal government should play a major role in combating obesity epidemic. Federal and provincial governments should fund and support meaningful research, promote health education, and implement healthy eating programs in schools. Fighting the obesity in Canada should start at the municipal level as the most recreational programs are organized by the municipal government. Encouraging children to live healthy-active lifestyles could be achieved by municipal governments introducing free sports drop-in classes at recreation centers or physical activity classes. To support these municipal initiatives, provincial government should support physical activity programs instead of slashing the school or recreation budgets.

Furthermore, at the provincial and federal levels, there should be government involvement in organizing programs to manage adult obesity. These programs can involve more informative and clear food labeling or meal preparation classes. These programs should also aim to involve family physicians and other healthcare professionals to consider lifestyle modifications as treatment options.

At present, Ontario health care and health promotions are operated by different health care units, each which understand and interpret health determinants differently, and therefore execute their health research and promotions according to their beliefs and perceptions. At present there are no proper co-ordination and leadership among the Ontario public health units. (Brassolotto, 2013)

The Socio-ecological model considers organizations and social institutes and family friends and social network under Organizational and interpersonal categories of the socio-economical model.

Organizational

Organizations and Social institutes can contribute to control the obesity by promoting healthy behaviors and lifestyles. The communities, schools and health care sites should introduce policies and procedures that supports worksite wellness programs, walking clubs and health cafeteria meals. (balancedweightmanagement.com) currently, there are some attempts in Ontario to start children’s’ days with a healthy breakfast; such as free breakfast programs in some Ontario schools. With substantial support from provincial governments, these efforts to promote healthy eating should extend beyond primary schools to universities and colleges. Post-secondary students are vital to target because their food habits during their late teens to early twenties will solidify their food habits in the future.

Interpersonal

Family, friends and social network contribute tremendously to lifestyle choices, specifically in their attitudes and habits. Parents should be role models and promote healthy behaviors like daily physical activities, walking when possible, cooking meals at home, and generally living health active lifestyles. Schools and the social environments also bear some responsibility to promote healthy lifestyles and healthy behaviors. A study conducted in Australia to understand parents and children perception about healthy life styles identified that both children and parents acknowledge that their schools and the local environment plays a major role shaping their physical activities and health. (K. Hesketh, 2005)

Finally the socio economical model considers individual knowledge, attitudes, and skills as individual level contributors for obesity.

Individual

Although the health care professionals are starting to realize that obesity is a complex health issue, most cultures are societies are still under the perception that obesity is simply an individual issue with over eating. According to Sara F.L.Kirk and L. Penney “this focus on individual responsibility in turn leads to a culture of victim- blaming that is particularly evident within society (Penn, 2013). The authors further explain how any story about obesity in the media reinforce the view that obesity is a result of over eating and under exercising. This culture of victim blaming needs to change if general society is to accept that obesity is a complex health problem. That being said, a great deal of self-regulation is still required at the individual level to live a healthy life. Individual knowledge, attitudes, and skills play a major role in fighting obesity and living a healthy lifestyle. Learning to cook and spending time to prepare meals, learning to exercise and learning to read food labels are some of the life style changes that should occur at individual level. In summary healthy living is a skill that should be developed with hard work and dedication. Home cook meals instead of buying out, cutting down the sugary drinks and snacks, reading the food labels and buying nutritional food are some of the changes an individual can make to lower the calories consumed. Americans spend half of their food budget in meals and drinks consumed outside homes and consumed about one third of their daily energy on meals and drinks consumed outside of their homes (Marion Nestle, 2000) Most of these restaurant made food contain 1000 to 2000 calories and which is equaling to the daily calories of an individual.

Not only is the calorie intake but, calorie expenditure a problem in the current society. Most jobs were becoming desk jobs instead of labor intensive work and more and more people spend their time in front of computers or televisions. Most people travel to work and for convenience use automobiles. Expensive and un- affordable Gyms and economical strains make it really hard to participate in any physical activities.

Obesity was recognized as a major public issue two decades ago and still the world has not tackled the issue. Obesity should be considered as a chronic disease, and fighting obesity should be one of the major priorities of the health authorities. There should be focused research and increased public policies to understand this complex and multilevel issue. The combined effort of the WHO, individual health agencies, and individual governments is essential for tackling this issue, and socio-economical model is a valid method to examine the obesity issue in a multilevel approach.

Appendix A

https://www.youtube.com/watch?v=wOGV6QA3_hQ

References

Rassolotto, J., Raphael, D., & Baldeo, N. (2013). Epistemological barriers to addressing the social determinants of health among public health professionals in Ontario, Canada: A qualitative inquiry. Critical Public Health,24(3), 321-336. doi:10.1080/09581596.2013.820256

Glouberman, S., & Millar, J. (2003). Evolution of the Determinants of Health, Health Policy, and Health Information Systems in Canada. American Journal of Public Health,93(3), 388-392. doi:10.2105/ajph.93.3.388

Hesketh, K. (2005). Healthy eating, activity and obesity prevention: A qualitative study of parent and child perceptions in Australia. Health Promotion International,20(1), 19-26. doi:10.1093/heapro/dah503

Huang, T. T. (2008). Transforming Research Strategies for Understanding and Preventing Obesity. Jama,300(15), 1811. doi:10.1001/jama.300.15.1811

Kirk, S. F., & Penney, T. L. (2013). The Role of Health Systems in Obesity Management and Prevention: Problems and Paradigm Shifts. Current Obesity Reports, 2(4), 315-319. Doi: 10.1007/s13679-013-0074-7

Nestle, M. (2000). Obesity. Halting the obesity epidemic: A public health policy approach. Public Health Reports, 115(1), 12-24. doi:10.1093/phr/115.1.12

World Health Organization Publications - World Health Organization Expert Committee on Onchocerciasis 3rd Report. Technical Report Series No. 752. 167 pages. ISBN 92 4 120752 3. World Health Organization, Geneva, 1987. SF 24. (1988). Parasitology, 96(3), 644-644. Doi: 10.1017/s0031182000080355

http://wedocs.unep.org/bitstream/handle/20.500.11822/18767/WHO_Obesity_and_overweight.pdf(n.d.).

(n.d.).balancedweightmanagement.com. (n.d.). Retrieved from

Organization, W. h. (2000). Obesity: Preventing and managing the Global epidemic. Geneva: World health Organization.

canada, s. (2006). Adult Obesity. Ottawa: Statistics Canada.