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Heavy Wallets make Heavy Men?



Low income and lower socioeconomic status is widely recognized as a risk factor for a wide range of medical conditions (referred to as the social gradient in health).

Curiously, however, at least in Canada, overweight and obesity appear to be more common in higher-income middle class men than in those who are less well off.

This at least is the result of a new analysis of the 2004 Canadian Community Health Survey, performed by Stefan Kuhle and Paul J. Veugelers of the University of Alberta for Statistics Canada.

The key finding of this study is, that in contrast to women, where the social gradient holds in that lower SES women tend to have more overweight and obesity, in men, there is a strong inverse relationship between SES in that higher income men are apparently at greater risk for excess weight.

This increased risk for obesity in higher-income men is associated with a greater tendency to eat out as well as a lesser likelihood to be smokers. Eating out has been identified as a strong risk factor for weight gain, while smoking cessation is well-known to be associated with weight gain.

Carly Weeks, who interviewed me about these findings for the Globe & Mail, quoted me as follows:

“That’s likely because men and women tend to have vastly different perceptions of their body image and how they should look, according to Arya Sharma, professor of medicine and chair of obesity research and management at the University of Alberta.”

“[Women] are more likely to be dieting and more likely to be working [out] and doing things about their weight,” said Dr. Sharma, who is also the scientific director of the Canadian Obesity Network. “Men are very cavalier about it.”

For the full Globe & Mail report click here.

The reason this report is alarming is because men (rich or poor) are so much less likely to seek obesity treatments than are women. Indeed, our clinic is dominated by overweight and obese women, rather than by the men, who probably need treatment as much if not more, given their greater propensity for abdominal obesity and risk for complications.

How do we get more men to seek obesity treatments? Look forward to any suggestions on this.

AMS
Edmonton, Alberta

2 Comments

  1. Hello Arya,

    Very interesting post today.

    These findings are particulalrly interesting, given that, historically speaking, the girth of one’s waistline was once indicative of the plumpness of one’s wallet – only the rich could afford to become overweight/obese. In the 17th century, for instance, when the ideal weight of men was higher than it is today, thinner men stuffed their shirts with bran and rags in an attempt to fit in.

    In the late 1800’s, The Fat Man’s Club was established – the most aristocratic of social clubs, whose collective members were the most prestigious, and powerful members of society, but also happened to be significantly overweight (could not join, otherwise).

    Only in the early 20th century, when abundant food supplies became available to even to lowest social ranks, did ideals take a sharp turn, and excess adiposity became unwanted.

    So apparently, history repeats itself – at least among Canadian men. I just may have to post on this on our blog:)

    Happy Holidays,

    Peter Janiszewski

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  2. Great post, and I see this in my practice daily. In fact many of the lower income women arrive with their thin husbands in tow, and the executive men arrive at the clinic with waist circumferences well over the magical 102cm mark. It is great to have observations confirmed with objective statistics. I agree that obese men are not likely to seek treatment as often as women, as it appears that the esthetic drive is not as engrained as the drive to be successful in career and wealth.

    Peter, thank you for your historical information. Great work.

    Sean

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