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Thursday, 16 June 2011

'The Obesities'

Early in my studies, as I was starting research for my first Masters thesis, I came across a term 'the obesities' described by the members of the first Fogarty International Task Force on Obesity. The paper I was reading nicely delineated/described how 'obesity' is not really a single, cut and dry, frank presentation, but rather, a general term to get one into the 'ballpark', so to speak, whenever a person who was overweight or obese would present, and that the MULTIFACTORIAL and MULTIDISCIPLINARY nature of obesity -- both in its causes and approaches for best-treatments -- can never be overlooked when evaluating an individual.

NOW, this was in the 70's -- a time when obesity was not yet the full-blown epidemic that it is today. The whole 'foodie' culture with the increase in eating out and convenience foods/microwaving phenomena and internet and the increase in TV watching and channels was kind of in early stages, but, nevertheless, evolving at a rapid pace.

Thus, the folks who were obese, then, were mainly probably those who had strong genetic predispositions and/or those who were already into the overeating/under-exercising/sedentary way for one reason or another. But, the 'obesogenic environment' with its easy-and-everywhere access to active and passive environmental cues to enable SO MANY PEOPLE to be in the 'overeating/under-exercising/sedentary way' was not yet as ubiquitous and sustained as it has been in the last 20-25 years.

But, STILL -- even with FEWER people being obese -- experts KNEW THEN that obesity had to be assessed and approached differently depending on the factors causing it or contributing to it per individual OR, perhaps, targeted groups.

THIS concept of 'the obesities' STILL needs to be considered today -- even MORE so than ever, in my opinion.

Just when we need to be more sensitive to the needs of why and how people become obese in order to really help them effectively lose fat and keep it off -- we seem to be bombarding the public with the SAME messages and making everyone feel they have the SAME REALITY OF OBESITY.

People who have strong genetic predispositions and who may be in situations where they struggle with achieving and sustaining targeted weights and fat levels, super-obese people who are in the morbidly-obese range, and people who are overweight or mildly obese, and even those who have a few pounds to shed ALL SEE AND READ AND HEAR the SAME MESSAGES about how, why, and what-to-do regarding their 'obesity'. They are offered the same set of options for dietary plans and regimes, exercise recommendations and programs, and all the information out there now about stress and the psychological/emotional and psychosocial aspects that they need to be aware of and methods to address those factors/issues, as they strive to succeed in getting fit.

TV shows, social networking messages, internet adverts, gyms, commercial weight loss and diet centers, programs, and products, and even medical practices are all just seeing a person as 'obese' and then offer up THE solution(s) to make them NOT OBESE.

It's like the world has gone into panic mode in order to try to wipe out this epidemic at the expense of actually taking the time, genuine expertise, and discernment in truly arriving at the differentiated diagnosis of an individual's 'obesity' and proffering a plan that really meets their needs and appropriate goals.

Of course, there are targeted options for the classification of morbidly obese people -- bariatric surgery or procedures in all their variants, like gastric bypass, banding, stapling and/or fasting regimes,drugs, and other radical measures, BUT, what IS genuinely happening today is that many of the people who are mildly or moderately obese are ALSO able to get these procedures and operations. If one has the money or insurance coverage, it's become a personal choice to opt for procedures that should really just be targeted to the resistant few.

Likewise, people who are morbidly or moderately obese, but with genetic factors making diet and exercise interventions less effective than they should be or afflicting these folks with very high relapse/recidivism rates are being viewed EXACTLY the same as people who are just overweight and need to change their eating habits a bit and/or increase their physical activity to get back to the optimal weight they may have had a few years earlier.

People who are 300+ lbs are hearing the SAME messages about what to do to get 'fit' as people who are, perhaps, 25 lbs over their ideal body weight. Even the whole definition and image of 'fitness' is bombarded to the GENERAL PUBLIC as being the ULTIMATE for EVERYONE regardless of their baseline or starting point or where they REALLY need to get to in order to improve their HEALTH, but also THEIR LOOKS and IMAGE.

It is doing the general obese/overweight public a vast disservice by not making them aware that each individual case is different and that there are subtle, often blatant differences in how one needs to proceed in order to achieve an optimal and lasting body weight and body fat percentage and overall level of fitness and well-being relative to that person's needs and goals.

Certainly, there are principles, guidelines, and treatments that are common to all obese and overweight people. BUT, it is very important for those working with obese people and for obese people themselves to recognize their own OBESE HISTORY and REALITY and embark on a treatment plan that BEST WORKS for their individual needs and goals! Certain GROUPS may have similar needs and goals, thus,making GROUP TREATMENT entirely possible, but only if the OBESE HISTORY and REALITY of the WHOLE GROUP is similar.

'The Obesities' is very real and this concept must be respected as we strive to decrease the obesity epidemic.

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