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Residential Schools And Indigenous Obesity – More Than Just Hunger?

A recent CMAJ article, by Ian Mosby and Tracey Galloway from the University of Toronto argues that one of the key reasons why we see obesity and diabetes so rampant in Canada’s indigenous populations, is the fact that widespread and persistent exposure to hunger during the notorious residential school system may have metabolically “programmed” who generations toward a greater propensity for obesity and type 2 diabetes.

There is indeed a very plausible biological hypothesis for this,

“Hunger itself has profound consequences for childhood development. Children experiencing hunger have an activated hypothalamic–pituitary–adrenal stress response. This causes increased cortisol secretion which, over the long term, blunts insulin response, inhibits the function of insulin-like growth factor and produces long-term changes in lipid metabolism. Through this process, the child’s physiology is essentially “programmed” by hunger to continue the cycle of worsening effects, with their bodies displaying a rapid tendency for fat-mass accumulation when nutritional resources become available.”

While the impact of hunger may well have been one of the key drivers or metabolic changes, the authors failed to acknowledge another (even more?) important consequence of residential schools – the impact on mental health.

Oddly enough, in a blog post I wrote back in 2008, I discussed the notion that the significant (and widespread) physical, emotional, and sexual abuse experienced by the generations of indigenous kids exposed to the residential school system would readily explain much of the rampant psychological problems (addictions, depression, PTSD, etc.) present in the indigenous populations across Canada today.

The following is an excerpt from this previous post:

This disastrous and cruel [residential school] policy resulted in much pain and despair in the First Nations’, Inuit and Metis people that lasts to this day (known as the “generational effect”). Sexual, physical and mental abuse was widespread; students were broken in heart and spirit; culture and identities were destroyed.

Much (if not all) of what ails the Aboriginal peoples of Canada can be traced back to this policy – including possibly issues that affect Aboriginal health to this day.

It is no secret that obesity and its consequences (e.g. diabetes) are rampant amongst the Aboriginal peoples of Canada. While poverty, breakdown of traditional lifestyle and culture and even genetic factors (thrifty genotype) have all been implicated in this, I wonder how much the misery caused by the residential school program had to contribute.

Early traumatic life experiences including sexual, mental and physical abuse as well as neglect and grief have all been implicated in binge eating disorder (BED) – in its purest form – the uncontrollable urge to devour large quantities of highly palatable high-caloric foods in response to emotional hunger. This behaviour has been interpreted as an emotional coping strategy, “filling the inner void”, building a physical protective barrier, etc., the ultimate result being excessive weight gain with all its consequences (the typical binger does not compensate by purging or excessive exercise).

In “treatment-seeking” patients with obesity, the prevalence of BED is estimated at 20-40%. Although I was unable to find a study that has applied the DSM-IV criteria for BED to an Aboriginal population – my guess is: the rates are probably high!

Given its distinct psychopathology, BED is highly responsive to psychotherapeutic approaches. In contrast, educational initiatives based on simply providing information on healthy lifestyles are useless.

Obesity is never an issue of “choice”. I have yet to meet anyone who “chooses” to be obese. This is most certainly also true for Canada’s Aboriginal population.”

Edmonton, Ab

1 Comment

  1. Dr. Sharma
    As a consultant who gives workshops on cyberbullying, suicide prevention, depression, and drug abuse on remote Indigenous reserves in Northern Sask and Alta, I concur with you that obesity is at an epidemic level within those communities.

    The resulting, out of control Type 2 diabetes within the indigenous community, is evidence of the damage this disease is causing.

    The one point that came to mind when reading your blog about the biological response to residential school starvation in that generation, and the subsequent multigenerational metaphysical changes that may have occurred as a result, made me wonder if the same effect happened to those imprisoned, starved, and tortured in concentration camps during WWII?

    Did the subsequent, post WWII generations of Jewish people also suffer from these same metaphysical changes that our indigenous people had experienced due to their abuses, and PTSD?

    I don’t see that result among the Jewish community today. They have no different levels of obesity than does any other Caucasian group in this country.

    No doubt the horrors of the residential schools play a role in the obesity epidemic today however, like the disease of obesity itself, the causes are multifaceted and cannot be boiled down to one factor. Lack of healthy food on these isolated reserves, expensive fruits and vegetables play a huge role but there are other factors in play as well.

    A lack of parenting skills due to a generation of residential school kids because big removed, resulted in an entire generation bereft of any parenting examples, depression and other mental disorders, low self esteem, lack of initiative due to poverty, seeking by themselves as “victims”, lack of resilience skills, and systemic racism all play into the obesity problem on reserve.

    On almost every reserve I’ve been in, there’s one restaurant, a Chester’s Fried Chicken restaurant and each one is packed morning, noon and night. Great restaurant but not conducive to healthy eating.

    Great article. Gave me lots to think about as I approach this demographic of Canadians about battling obesity.

    Sent from my iPhone
    Brian Trainor
    CON-PEOC Member

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