Dr. Sharma's Obesity Notes

While in India, I have plenty of time to read the Indian newspapers and magazines, that have circulations Western publications can only dream of.

Not surprisingly, “health and beauty tips” are a staple feature with articles proclaiming the benefits of everything from yoga to bariatric surgery.

And of course, when it comes to traditional Indian herbs or spices, almost every ingredient is offered as a panacea.

Here, for example, are the virtues of using coriander (dhanya or cilantro), a commonly used spice and garnish (taken from a recent article in the Times of India):

- It lowers blood sugar levels

Yesterday was the beginning of the 3rd Canadian Obesity Student Meeting here at the University of Alberta in Edmonton. Regular readers may recall previous posts on the 1st meeting in Laval and the 2nd at the University of Ottawa.

This year’s meeting, organised by the Canadian Obesity Network’s Students and New Professionals (CON-SNPs), once again brings well over a 100 of Canada’s brightest and finest students and trainees from across Canada for three days of intense scientific and social exchange.

The local CON-SNP organisers, Becky Mercer, Nicole Glenn, and Angela Coppola, have done a tremendous job of pulling the program together. Thanks also to their faculty advisors Bill Colmers and Kim Raine.

The over 100 oral presentations and posters at this meeting cover every conceivable topic from sedentariness and physical activity in kids to school interventions, maternal and infant health, food insecurity and aboriginal health, fat tissue biology and neuroscience, body image and mental health, cancer, inflammation, fatty liver and cardiovascular disease, as well as behavioural, medical and surgical treatments.

Accompanying the conference is an art exhibit ‘The Big Idea‘, featuring a visual exploration of contemporary culture and obesity by ten Canadian, US and UK artists (selected from over 60 submissions), curated by Julian Forrest.

The opening reception for The Big Idea, featuring the noted US performance artist, writer and sociologist, Kimberly Dark, will be held at the Peter Robertson Gallery, June 21, at 7.30 p.m.

I look forward to a couple of exciting and engaging days here in Edmonton,

AMS
Edmonton, Alberta

Jonathan Antoine and Charlotte Jaconelli on Britain's Got Talent 2012

As the video will not embed on my site – you will have to click here to watch it on YouTube.

I ask you to watch it and send me your take on why the expectations of the panel and the audience (especially when they see Jonathan) were so low and their following response so enthusiastic. Would the expectations and response have been different had Jonathan not had an obvious weight problem? Why, does his weight even matter on a show that is about talent?

I very much appreciate your responses.

AMS
Edmonton, Alberta

Hat tip to Tony for pointing me to this video

Whatever the intentions of the producers, there is accumulating evidence that public display of weight loss as in competitions, challenges, and reality TV do little else than promote anti-weight bias by promoting stereotypes, unrealistic weight loss goals, and simplistic (diet and exercise) messages about possible solutions.

This notion is again supported by a recent study by Domoff and colleagues from Bowling Green State University, Ohio, USA, published in OBESITY.

The researchers examined how exposure to 40-min of The Biggest Loser affected participants’ levels of weight bias amongst 59 participants (majority of whom were white females), who were randomly assigned to either an experimental (one episode of The Biggest Loser) or control (one episode of a nature reality show) condition.

Levels of weight bias as measured by the Implicit Associations Test (IAT), the Obese Person Trait Survey (OPTS), and the Anti-fat Attitudes scale (AFA) at baseline and following the episode viewing (1 week later), showed that viewers of The Biggest Loser had significantly higher levels of dislike of overweight individuals and more strongly believed that weight is controllable after the exposure.

Interestingly, amongst the participants, those who had lower BMIs and were not trying to lose weight had significantly higher levels of dislike of overweight individuals following exposure to The Biggest Loser compared to similar participants in the control condition.

These results clearly indicate that anti-fat attitudes increase after brief exposure to weight-loss reality television, especially perhaps in people with lower BMI.

Given the impact that anti-weight bias has on all aspects of trying to find solutions to obesity (from public health messaging to funding for obesity research or treatments), not to mention its devastating emotional and physical impact on people living with excess weight, perhaps it is time to revisit social norms and acceptability of this form of entertainment.

These shows are not a solution – they are part of the problem!

AMS
Vancouver, BC

CBC Commentator, Rex Murphy

Regular readers will recall a host of previous posts on the issue of weight bias and discrimination.

Canadian Obesity Network members will hopefully also be aware that for the past four years, addressing weight bias and speaking out against weight-based discrimination has been the #1 strategic goal of the network.

Rather than listing all of the activities that the Network has undertaken to address this issues (the latest one being the launch of the image gallery “Picture Perfect at Every Size“), in today’s post I would like to share a story and explain why I continue to believe that this is the central problem at the the very heart of finding solutions to the obesity issue.

I remember this as though it was yesterday. I had just arrived with my family in Canada, having accepted a Tier 1 Canada Research Chair in Obesity at McMaster University. I was just discovering Canadian television and was quite impressed the first time I saw Peter Mansbridge on the CBC’s “The National”.

Interestingly, that evening one of the news items that caught my attention was an announcement by then Health Minister Anne McLellan, that the Government would spend $15 million to support obesity research – certainly good news for an obesity researcher just arriving in Canada.

This brief sense of having arrived in the right place at the right time, however, was shaken by what followed – a scathing, derisive, and contemptuous commentary by Rex Murphy, Canada’s premier TV commentator – not known to mince words.

In brief, as far as I can recall, the gist of his commentary was that this funding for obesity research was another perfect example of wasteful spending of tax-payer dollars.

To paraphrase his words, “so now the Government of Canada is spending millions of dollars to show that Canadians get fat by eating fast food and lounging in front of their TVs“.

I don’t remember the exact wording or the many ‘humorous’ angles that Rex Murphy took in this typical meandering monologue but I do recall the immediate effect it had on me. In my mind I could see Canadians across the country nodding and agreeing with Murphy, that spending any money on obesity research was indeed a complete waste – we already know the reasons: ‘gluttony and sloth’ – what’s there to research?

It became blindingly obvious that Rex Murphy was simply stating aloud what most people think – no wonder governments would be hesitant to support obesity research, or worse still, actually consider providing obesity treatments to Canadians.

I admit that prior to hearing this commentary, I had not given much thought to the issue of how weight bias ultimately stands in the way of finding solutions to the obesity epidemic.

Unfortunately, while Rex Murphy could perhaps be forgiven for failing to recognize the true psychosocial and biological complexity of this problem, I continue to be baffled that so many of my professional colleagues continue to trumpet simplistic notions of “eat-less-move-more” as a solution to the problem.

Frankly, I do not believe that they fully appreciate how, by reducing the entire problem of obesity to simply a matter of diet and exercise, they do little more than reinforce what most people already believe – obesity is simply a matter of ‘gluttony and sloth’.

No talk of food insecurity, abuse, depression, stress, time-pressures, addiction, genes, incretins, adipokines, hypothalamic pathways, adipostats, mitochondrial inflexibility, medications, or any of the other countless ‘scientific’ intricacies that may indeed result in the ‘symptoms’ of overeating or undermoving.

By reducing obesity simply to a matter of ‘lifestyle’, they provide the perfect excuse for funding agencies to rather fund research on ‘real’ health problems, for regulators to tighten the criteria for obesity medications, for payers to deny or limit the access to obesity treatments, and for health professionals to not see obesity management as part of their job.

This is why there will be no solution to obesity without first solving the issue of weight bias and discrimination.

This is why, addressing this issue remains the #1 strategic priority of the obesity network.

To anyone unhappy about how much funding is going towards supporting obesity research, unhappy about availability or access to obesity treatments, unhappy about lack of obesity training for health professionals, unhappy about reimbursements to health professionals for obesity counselling, unhappy about integrations and accommodation of people struggling with severe obesity, or even just unhappy about the surprising fact that Canada’s only national obesity organisation receives virtually no government funding to sustain its efforts – I have one simple suggestion: begin by showing zero-tolerance for ‘fat jokes’ or ‘fat talk’, do not use language, images, or messages in your presentations and writings that further promote stereotypes or reduce this complex problem to simply a matter of ‘lifestyle’, and please do stand up and speak out on the issue of weight bias and discrimination.

If the Canadian Obesity Network does nothing else but bring awareness to this aspect of the obesity problem  - it will have well been worth the ride.

AMS
Edmonton, Alberta