Tuesday, October 21, 2014

The Cultural Drivers and Context of Obesity

sharma-obesity-family-watching-tvIn my continuing review of not too recent publications on obesity, I found this one by Hortense Powdermaker, Professor of Anthropology, Queens College, Flushing, New York, published in the Bulletin of the New York Academy of Medicine in 1960.

The following quotes could all have been written last week:

“We eat too much. We have too much of many things. According to the population experts, there are too many people in the world, due to the decline in mortality rates. A key theme in this age of plenty-people, food, things-is consumption. We are urged to buy more and more things and new things: food, cars, refrigerators, television sets, clothes, etcetera. We are constantly advised that prosperity can be maintained only by ever-increasing consumption.”

“…physical activity is almost non-existent in most occupations, particularly those in the middle and upper classes. We think of the everincreasing white-collar jobs, the managerial and professional groups, and even the unskilled and skilled laborers in machine and factory production. For some people there are active games in leisure time, probably more for males than females. But, in general, leisure time activities tend to become increasingly passive. We travel in automobiles, we sit in movies, we stay at home and watch television. Most people live too far away to walk to their place of work.”

“The slender, youthful-looking figure is now desired by women of all ages. The term “matronly”, with its connotation of plumpness, is decidedly not flattering. Although the female body is predisposed to proportionately more fat and the male to more muscle, the plump or stout woman’s body is considered neither beautiful nor sexually attractive.”

“The desire for health, for longevity, for youthfulness, for sexual attractiveness is indeed a powerful motivation. Yet obesity is a problem. We ask, then, what cultural and psychological factors might be counteracting the effective work of nutritionists, physicians, beauty specialists, and advertisements in the mass media?”

“Although there are probably relatively few people today who know sustained hunger because of poverty, poor people eat differently from rich people. Fattening, starchy foods are common among the former, and in certain ethnic groups, particularly those from southern Europe, women tend to be fat. Obesity for women is therefore somewhat symbolic for lower class. In our socially mobile society this is a powerful deterrent. The symbolism of obesity in men has been different. The image of a successful middle-aged man in the middle and upper classes has been with a “pouch”, or “bay-window”, as it was called a generation ago.”

The paper goes on to discuss some (rather stereotypic) notions about why some people overeat and others don’t – an interesting read but nothing we haven’t heard before.

Nevertheless, given that this paper was written over 50 years ago – one wonders how much more we’ve actually learnt about the cultural aspects of this issue – it seems that we are still discussing the same problem as our colleagues were half a century ago.

Perhaps it really is time for some new ideas.

@DrSharma
Edmonton, AB
ResearchBlogging.orgPOWDERMAKER H (1960). An anthropological approach to the problem of obesity. Bulletin of the New York Academy of Medicine, 36, 286-95 PMID: 14434548

 

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Monday, October 6, 2014

Obesity Tip Sheet For Occupational Therapists

OT obesity tip sheet AHS Oct 2014

October is Occupational Therapist Month, an event celebrated by the Canadian Association of Occupational Therapists in a nation-wide campaign involving billboards and bumper stickers.

Reason enough to turn my readers attention to a “tip sheet” developed by members of the Alberta Health Services’ Bariatric Resource Team that explains when to refer their patients with obesity to an occupational therapist.

The preamble to this sheet notes that,

“Occupational therapists promote health and well being for people with obesity by facilitating engagement in occupations of everyday life, including addressing occupational performance issues in the areas of self-care, productivity and leisure. This can impact quality of life, including how people with obesity participate in their daily lives and in health and weight management activities.”

Occupational therapy referral may be indicated for a person with obesity presenting with challenges ranging from occupational engagement to completing simple activities of daily living.

To download this OT referral tip sheet click here.

Happy OT month!

@DrSharma
Hamilton, ON

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Tuesday, September 30, 2014

Practical Guide To Obesity Prevention in Schools in Developing Countries

Practical Guide To Obesity Prevention in School-Aged ChildrenObesity in school-age children is not just a problem in the affluent West – this issue if of growing importance in countries where one may not quite expect this to be an issue like South Asia or Africa.

Now, researchers from the University of Montreal and McGill University have released a comprehensive practical guide to developing and implementing obesity prevention programs for school-aged children and adolescents in developing countries.

As the authors discuss,

“What is most challenging in low and middle-income countries is the urgency of preventing obesity while also tackling the problem of malnutrition. Again, the school setting is likely the most appropriate to address the dual burden of malnutrition, but interventions are needed at different stages of the lifecycle, beginning with girls, in order to break the intergenerational cycle of malnutrition and its impact on vulnerability to obesity and other chronic diseases.”

This guide is a product of TRANSNUT (for nutrition transition), a WHO Collaborating Centre comprised of 10 researchers from the Department of Nutrition and other units of the University of Montréal.

In the words of the authors,

“This manual is designed to provide a hands-on guide for health and nutrition professionals to plan, implement and evaluate obesity prevention programmes for school-age children and adolescents in developing countries, particularly in the school setting. Several practical tools are suggested, including for the assessment of obesity and of its proximal determinants, that is, eating and physical activity patterns. Models and conceptual frameworks are discussed because action has to be grounded in sound theory. We provide a 5-step guide to planning healthy nutrition promotion and obesity prevention interventions, which we adapted from the PRECEDE-PROCEED of Green. The steps consist of community and individual assessments, identification of targets for change(community, family, individual level), choice of objectives, design of programme methods, and procedures for theevaluation. In order to foster effective programmes to promote healthy nutrition and lifestyle among school-agechildren and adolescents, we discuss theoretical models of behaviours change that may be appropriate (Health Belief Model, Theory of Planned Behaviour, Social Cognitive Theory, Stages of Change, Transtheoretical Model).”

This document should provide an interesting read to anyone interested in the prevention of childhood obesity in developing countries or elsewhere.

A copy of this guide can be downloaded here

@DrSharma
Charlottetown, PEI

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Wednesday, September 24, 2014

Obesity Tip Sheet For Physiotherapists

PT Tip Sheet Octb2013

Many people living with obesity experience significant physical limitations that can be addressed with appropriate physical therapeutic approaches.

Now, the Bariatric Resource Team of Alberta Health Services has compiled a “Tip Sheet that briefly highlights the role of physiotherapeutic interventions in the care of people with obesity.

The sheet includes recommendations on the following topics:

- Challenges With Movement, Pain or Daily Function

- Obesity Related Co-morbidities that Affect Daily Function

- Energy Management

- Posture and Positioning Issues

- Activity Counselling Needs

- Equipment Issues

- Access to Community Resources

This “Tip Sheet” should be helpful to anyone involved in the care of bariatric patients.

@DrSharma
Winnipeg. MB

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Thursday, August 28, 2014

Call For Abstracts: Canadian Obesity Summit, Toronto, April 28-May 2, 2015

COS2015 toronto callBuilding on the resounding success of Kananaskis, Montreal and Vancouver, the biennial Canadian Obesity Summit is now setting its sights on Toronto.

If you have a professional interest in obesity, it’s your #1 destination for learning, sharing and networking with experts from across Canada around the world.

In 2015, the Canadian Obesity Network (CON-RCO) and the Canadian Association of Bariatric Physicians and Surgeons (CABPS) are combining resources to hold their scientific meetings under one roof.

The 4th Canadian Obesity Summit (#COS2015) will provide the latest information on obesity research, prevention and management to scientists, health care practitioners, policy makers, partner organizations and industry stakeholders working to reduce the social, mental and physical burden of obesity on Canadians.

The COS 2015 program will include plenary presentations, original scientific oral and poster presentations, interactive workshops and a large exhibit hall. Most importantly, COS 2015 will provide ample opportunity for networking and knowledge exchange for anyone with a professional interest in this field.

Abstract submission is now open – click here

Key Dates

  • Abstract submission deadline: October 23, 2014
  • Notification of abstract review: January 8, 2014
  • Early registration deadline: March 5, 2015

For exhibitor and sponsorship information – click here

To join the Canadian Obesity Network – click here

I look forward to seeing you in Toronto next year!

@DrSharma
Montreal, QC

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In The News

Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

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