[Almost] Everything you need to know
This book is not intended as a substitute for the medical advice of physicians. The reader should regularly consult a physician in matters relating to his/her health and particularly with respect to any symptoms that may require diagnosis or medical attention. Although the author and publisher have made every effort to ensure that the information in this book was correct at press time, the author and publisher do not assume and hereby disclaim any liability to any party for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause.
Copyright: © 2015 Rick Dale [Shakespir]
Cover: Image ID : |
I am indebted to Deborah Helton for all her suggestions and contributions to this book. Deborah also wrote Chapter 11 regarding mindfulness and self compassion, the possible need for some self love when it comes to weight loss. I also acknowledge authors who have gone before, and all those that are quoted in this book, for without the intellectual insights of others none of this would be possible. My thanks too, to all readers, for taking the time to read or at least consider books written with the best of intentions. Above all, my thanks to everyone who reads this book.
ABOUT THE AUTHOR
I am a Kiwi, born in New Zealand, but I have lived more that half my life in Australia. I undertook post-secondary study as a mature age student, and my qualifications include a degree in communication studies, and a masters degree, both majoring in sociology. Intellectually sociology is about understanding “the big picture”, and I wish to think that this may have been achieved in part with this book, a critical weight studies reflection, because weight control is not a simple matter of just finding the right diet: often perhaps, it is about finding ones own ‘self’. I have also been a runner for some decades and as such take an intense interest in weight control. I also hold a professional library science qualification. I have worked as a retail assistant, clerk, driver, welfare officer, information and communications technology manager, librarian, and library manager.
“Sadly, the signals that allow men and women to find the partners who most please them are scrambled by the sexual insecurity initiated by beauty thinking. A woman who is self-conscious can’t relax to let her sensuality come into play. If she is hungry she will be tense. If she is “done up” she will be on the alert for her reflection in his eyes. If she is ashamed of her body, its movement will be stilled. If she does not feel entitled to claim attention, she will not demand that airspace to shine in. If his field of vision has been boxed in by “beauty”—a box continually shrinking—he simply will not see her, his real love, standing right before him.” Naomi Wolf,
“What really knocks me out is a book that, when you’re all done reading it, you wish the author that wrote it was a terrific friend of yours and you could call him up on the phone whenever you felt like it. That doesn’t happen much, though.” J.D. Salinger,
“Strategy and culture should have breakfast together.” Max McKeown,
Weight control, or weight loss, can most usefully be considered in the overall context of obesity because of the attention it receives from science and other areas. Therefore, what applies to obesity and being “fat” has implications for any of us wishing to lose weight; therefore, I tend to use the term “obesity” throughout the book as a general term regarding overall weight issues. You may not be obese but just want to lose some weight; however, the principles are virtually constant for everyone. Not that obesity is a straightforward matter, as Dr. Sylvia Karasu (2014), Clinical Professor of Psychiatry, Weill Cornell Medical College, explains:
The study of obesity lends itself to difficulties not only due to our imprecise ability to measure body composition, food consumption, and physical activity but also, even more important, due to complexities involved in defining and conceptualizing obesity. For centuries, obesity has been considered a disease, although researchers and clinicians cannot agree on definitions of “disease” or, if it is one, whether obesity is a disease of metabolism, inflammation, brown fat, chronobiology, the blood-brain barrier, the right brain, or even of infectious origin. The concept of “obesity” as a disease remains controversial to some because not everyone who has excess adipose tissue has any evidence of disease. Obesity, though, has also been considered a sin, a crime against society, an aesthetic crime, a self-inflicted disability, an example of body diversity, a failure in the regulation of energy balance, an appropriate or even inappropriate adaptation to our increasingly obesogenic environment, a genetic disorder, and a psychological/behavioral disorder of overeating involving self-regulation or even addiction. Five major paradigms—medical, sociocultural, evolutionary, environmental, and psychological/behavioral, all with their own subcategorical models—have been identified. All five paradigms are required because we are dealing not with “obesity” but with a plurality, the “obesities.”
While on its face, Dr. Karasu’s commentary may create more questions than it answers, it does suggest that weight loss is not merely a matter of self-control and willpower. But it is also not a matter of simply following a diet or a number of diets. A Paleo, Mediterranean, or any other diet is not, in and of itself, necessarily the answer to eliminating the extra weight.
“The whole world has a weight problem,” says the USA Today headline (Painter, 2014), an example of the “moral panic” (Woods, 2014) associated with weight and shape, fat and obesity. Messages such as these are part of a dominant global multi-billion dollar discourse that portrays fat and obesity as a highly visible pathology of epidemic proportions. Have you tried unsuccessfully to lose weight? Perhaps several times, and you feel anxious, blaming yourself for your personal diet “failures”? If so, perhaps you are at the center of this worldwide weight related “perfect storm”. It is time to rethink. At a personal level, weight control, or loss, may not only be about diet, but about a cluster of factors that could be contributing to the issue, such as the “obesities”.
Libraries, bookshops, and the Internet are full of resources that promise the ideal diet for quick weight loss or how to exercise yourself into clothes several sizes smaller. This is not one of those resources. Rather, while weight control is indeed biological, it is also something that occurs in the space between our body and our social environment. On one hand, our selves—who we think we are—are a reality that is socially constructed through the discourses and messages we hear, such as the USA Today ‘weight problem’ article.
This is all in the context of our gender, racial, ethnic, religious, and educational backgrounds, our socioeconomic arrangements, and our family and friends. On the other hand, our physical selves, with their unique genetic, biochemical makeup, our diets, and whatever else goes on in our lives, with all its stresses, etc., also play a significant role. This is reality as we know it, and I will deconstruct much of that to offer insight that can contribute to long-term sustainable weight loss.
A saying, famously attributed to Peter Drucker is that, “Culture eats strategy for breakfast.” If we see our “self” as fat, if we identify as being obese, this may undermine our long-term success with weight control without realizing why. If you have dieted, lost weight, then put it back on, you had a strategy for change, but perhaps did not change your culture, your identity, and your preexisting reality. Awareness of the social construction of weight and making cultural changes as necessary, coupled with some sound weight maintenance or loss strategies can provide some confidence about effective weight control.
Contemporary lifestyles create competing demands, which often means too little time or opportunity for exercise and a diet of nutrition-poor processed food. Nevertheless, long-term weight maintenance or loss should not always have to mean a severe restriction of food—although some calorie control is typically required—or excessive exercise. An optimal diet should be sustainable, satisfying, and selected from a range of nutrient rich food groups, coupled with other lifestyle choices, such as exercise. We eat to live, so we should gain as much satisfaction and enjoyment from it as possible.
I have used the terms overweight, fat, and obese throughout this book in a non-pejorative or judgmental sense, or as it is used in the literature. I will also use the term ‘overweight’ based on the assumption that you may have made such a self-assessment; therefore, weight loss is a goal. It also assumes, however, that being fat does not always mean being unfit or unhealthy (the obesity paradox). Given the diversity of the each of our individual experiences, I do support the Health-at-Every-Size (HAES) approach (Bombak, 2014).
Chapter 1 discusses the bio-politics of the ‘self’ in contemporary culture, where certain body types are privileged, a culture of discourses, such as fashionable diets, and where science and medicine tend to stigmatize those who are not a good “fit”.
Chapter 2 looks at the social construction of our ‘self’ and our thoughts about our body shape and image. Because of discourses about fatness or obesity, we may have unconsciously internalized a number of negative, fat-related social messages. The zeitgeist privileges thinness while at the same time punishing overweight people, particularly women.
Chapter 3 gets personal, taking a look inside our heads, our mindset, the “locus of control”, our body image. It is about the unique mind maps we have developed over time, which may be central to our weight control. It is about being in touch with our own bodies—for example, are we telling or asking our body, as some disassociated entity, to get rid of weight, to walk a few miles, etc.? Are we sufficiently self-integrated for success?
Chapters 4 and 5 consider diet, the various categories and type in general, the quantity and quality of food we consume now and in the future. Our diets, coupled with lifestyle issues, may be pushing us into nutritional deficit, preventing our bodies from operating optimally. For example, the stress levels we encounter in our home lives, our work, and excesses of certain foods, including alcohol, may be a greater weight on us than we realize. We will learn about intermittent fasting, as well as fiber, our second genome and brain, and what the implications of this might be for us.
Chapter 6 is a review of a number of food groups and foods from biblical times as a way of suggesting the wide range of dietary options available to us. It compares and contrasts how foods may have changed and the possible benefits of adhering to some foods and minimizing others. Generally the chapter builds on chapters 4 and 5 to suggest where a focus may be the most nutritious and effective for well being and weight loss.
Chapter 7 considers various diets according to the experts, which are the best diets overall. It also considers strategies for weight loss, and the influence of our “second brain or genome”. The gut-brain nexus is one of the frontiers of neuroscience, and could impact significantly on us. For example, food cravings and how diet, or even our environment might be factors in our weight control.
Chapter 8 extends the discussion of food cravings. How we might deal with cravings is a matter of how we might eat. This is very individual, with no two persons necessarily responding to a diet in the same way. The role of antibiotics is also examined, in the way that its use has in many ways paralleled the rise in a number of other issues, such as obesity. The science is developing to assist in this however.
Chapter 9 considers the necessity of supplementation, particularly because of dietary deficits, and the “triage theory” of aging. The focus is on vitamin D3, and the supporting cast of supplements that make it effective, as it appears to be deficient in obese people, those in many geographic locations, and/or those with darker skin.
Chapter 10 reviews some aspects of cardiovascular exercise and the benefits of undertaking some level of exercise on a regular basis. We may not like exercise, but a certain level of overall activity might be possible without being overwhelming.
Chapter 11 considers what it is about our perceptions that may influence how we feel about ourselves, particularly when these feelings lead to a lack of self-worth and disrupt our best efforts at weight loss. Mindfulness and self-compassion are examined as ways of alleviating negativity, perhaps lifestyle choices that enable us to be more in touch with our environment, ourselves, and foods and food choices. In effect, to make realistic assessments about what may be effective and workable practices for weight control in our daily lives.
There is nothing prescriptive about this book. You can take from it whatever you wish because the chapters are independent of each other and can be read in whatever order you wish. I have referenced mostly readily accessible material, many relatively populist, and I apologize if I misrepresent or misquote anyone in any way. Wikipedia is used as a source, not for its academic rigor but because of its accessibility as a tertiary level entry point for further research. I acknowledge my selections, along with the corresponding silences, and I voice my own particular beliefs and prejudices. Further, while topical from time to time, I have avoided the consideration of specific medications that may change brain hunger signaling and other factors.
When Timothy Ferris (2011) published his popular book, The 4-Hour Body (the Kindle edition was published in 2011) he made some rules for his readers, a couple of which I thought were very useful: one was to be skeptical, and another was not to use that skepticism as an excuse for doing nothing.
CHAPTER 1 – SOCIAL CONSTRUCTIONS AND BIOPOLITICS
“hyperreality … an image or simulation, or an aggregate of images and simulations, that either distorts the reality it purports to depict or does not in fact depict anything with a real existence at all, but which nonetheless comes to constitute reality”
Our shape and weight, what and when we eat, and how we see each other are topics of endless commentary in general conversation and in science and medicine. Bookshops, newsagents, and the Internet are awash with information about health, diet, well-being, supplements, and exercise, informing our discussions with family and friends. Nevertheless, if we want to manage our weight, diet, supplement, and exercise arrangements, the information about what really works is often confusing.
This confusion exists because the global obesity “crisis” continues to grow, despite multiple billions of dollars being budgeted worldwide by governments and organizations associated with health, medicine, and science, and all the other associated industries (World Obesity, 2012). This is a clue, surely, that there are no real answers about weight control. Each of us is so unique, with our individual biochemical needs, yet we are oftentimes unnecessarily swayed by the promises of this diet, that report, someone’s comments, but all the while the real answer may lie with our own selves.
One’s “self”? During the Enlightenment period of the 1800s, the human body began to be “mapped” in a scientific manner, i.e., in a supposedly uninterested and objective way, but in reality such “science” merely hides from view the underlying dominant beliefs and practices of the culture that enables it, the zeitgeist. The zeitgeist is not neutral; it has underlying philosophical and ideological assumptions about what is “normal” and what is not.
Modernism, the “good old days,” followed from about 1900 to the end of World War II, with the rise of big ideas and stable truths, what Jean — François Lyotard called meta-narratives, or “grand narratives” (Wikipedia, 2015b). These are socially constructed understandings between people, organizations, and the media, where we are portrayed as rational, autonomous, independent individuals, as “selves.” It was also believed that reason and knowledge—particularly scientific knowledge—would create a better society, and it has in so many ways, but some of us would like answers about how to better control our weight.
Then came Post-modernism, marked by the radicalization of the 1960s, the feminist movement of the 1970s, and a great deal of social upheaval. While in Modernism the “self” was a stable entity, independent of but interacting with culture and society, the Postmodern self was actually mythic (like a fiction with underlying truths), a product of its social and cultural context. Coincidentally, this about the time obesity started to become the “crisis” it is today.
Rather than being sentinel beings, we are social constructions, consumers of fashionable diets as defined by our culture, which in turn, is largely determined by the politics of power and prevailing ideologies. Therefore, under appreciated understandings about the way things are and are “meant” to be are relative, social constructions in which we find certain body types and shapes idealized and privileged over others, and we tend to judge them, and our selves by such standards.
We are revealed through our various racial, sexual, and gender roles, which, instead of being scientifically determined, are also constructed through “socio-cultural passageways” (Deterritorial Investigations Unit, 2013). This may all seem natural and normal and, thus, we take them for granted. Therefore, the terms overweight, fat, or obese may seem like “natural” labels, but they are really part of a discourse of pseudo-scientism, a construction that perpetuate[s] its own existence, coloring our perceptions about weight and shape.
Dave Elder-Vass (2012: 4, 11) indicates that Postmodernism is dead, which may well be the case, but the sociological view remains that discourses shape the world we live in. For example, language is a set of tools to express meaning, while discourse is the, “regulation of the content of what we say [emphasis in original].” Elder-Vass (10) continues, “the meanings that we associate with linguistic terms and structures are fixed, not by reference to the world, but as the outcome of social power battles [emphasis added].”
To control discourses requires power sufficient enough to ensure a discourse is developed and maintained, even in the face of counter-voices. Manuel Castells (2007: 238), a sociologist, states, “Throughout history communication and information have been fundamental sources of power and counter-power, of domination and social change. This is because the fundamental battle being fought in society is the battle over the minds of the people. The way people think determines the fate of norms and values on which societies are constructed.”
It is not that the media, as such, is all powerful, or that we always follow or agree with what is disseminated. Media businesses are typically diverse and competitive because they seek market share with products and content that are usually limited or proscribed by political, legal, religious, or social forces or constraints. Nonetheless, the media’s product is not only about discourses that deliver messages, but also about silences, what is tacit or unspoken, as well.
Castells (241) states, “What does not exist in the media does not exist in the public mind, even if it could have a fragmented presence in individual minds. Therefore, a political message is necessarily a media message. And whenever a politically related message is conveyed through the media, it must be couched in the specific language of the media.” We tend to be embedded in media messages, but each will seem different, with various contours and effects, because of the influence of the political and business strategies and the conflicts of each telecommunication network as they try to control access to markets and ratings to protect and further their business interests.
So what? Who are we then, really? Well, it may help to explain our understanding of our own identity, how we might be positioned at the cross hairs of various powerful discourses. The media that, on one hand, constructs labels about weight matters, idealized texts and images, then throws into relief other bodies, such as those that are “too fat” and “too thin.”
This acts in concert with all the messages from significant companies and organizations that want to “construct desire” for their foods, their fitness equipment, their diet products, and their supplements. They want to sell us things, but some are contradictory. For example, you might gain weight, which portrays you (negatively) as “overweight” presumably because you did not each right, and then you feel the need to consume weight loss industry products and foods, perhaps failing in this too, and the yo-yo dieting process starts.
Paradoxically, we may consume for image, desirability, fashion, etc., which creates a disconnect between ourselves as consumers and what we might desire, being thin, for example. This reality is constructed and realized through language. The most important thing about all this is that there is usually a claim of some truth, which is indeed a construction; therefore, there are always alternative discourses and potential constructions. The alternative discourses exist, but of course, they may be suppressed or regulated into a sort of uneasy silence.
Abigail Saguy (2012) draws on Foucault to suggest that obesity is about “biopolitics.” Body size, says Saguy, “intersects … with class, race, and gender in important ways.” For example, elite and middle-class white women are penalized for being overweight and generally have more to lose than do more marginalized and less affluent women. Messages about weight loss swirl all around us, from the meta-messages of the bio-politically motivated to those promising a better life with the latest diet or range of supplements—all passing through the various media.
Michelle Lelwica (2009), author of The Religion of Thinness, believes that an obsession with the ideal female body exists on a scale never previously seen or experienced in Western culture. At its extreme, this is realized in an Internet subculture in worship of the goddess “Ana,” as in “anorexia.” An Internet search for “Ana creed” will reveal the extent of that far end of the overweight-underweight continuum. As Lelwica suggests, such a worldview differs in degree, but not in kind from the thinking of many women and men who may increasingly define themselves by the size of their bodies.
In many ways, how we view where we are on the continuum is socially constructed, and so long as there is no real health risk associated with one’s position, then we might make a realistic assessment. For example, how did we arrive at a sense of being overweight? And are we seeking thinness because of social reasons or as a genuinely realistic assessment of benefit to our mental, emotional, and physical well-being?
In a conference paper based on a forthcoming PhD dissertation, Hannele Harjunen (2003) discussed the social construction of obesity from a Foucauldian theoretical position and from women’s personal experiences of being fat. Harjunen regards obesity as a social and political construction of “difference” that intersects with other bodily “significant differences,” such as disability, gender, and ethnicity. Obesity, continues Harjunen, can be a “marginalizing and violent cultural process” inhabiting a space between “normal and abnormal, health and disease, acceptable and unacceptable femininity, etc.”
For decades, obesity has been seen as a medical condition, presumably curable with the right treatment; the obese person is often seen as the object of medical treatment. Medically, an obese person seeing a doctor may automatically be labeled as ill or “pre-ill” and a candidate for any number of chronic, weight-related diseases. Therefore, an obese person may not be ill but the assumption is made that a medical problem exists. The obese person, it seems, must be redeemed by a need to normalize the obese body, rather than improving the health of the patient regardless of size.
Drawing on Harjunen again, we can argue that culture privileges the thin body, which is held up as the normal body, and obesity is a disruption. Often, for society and obese people themselves, the obese body must be redeemed or returned to a normalized state. Obesity as a temporary state is not recognized in reality; the moral panic of the statistics of recent decades reveals the very real possibility that many people will remain “permanently fat.”
Harjunen reveals that, according to her research, most women in the study had been more or less overweight, at least medically, all their lives, yet thoughts of losing weight, of repeated diets, talking about diets, and relapses remains constant. This observation reveals the culturally created expectation that obesity must be normalized, that an individual is aware of the “acceptable” weight and constantly intends to become thin, i.e., “normal.”
While Rebecca Puhl and Chelsea Heuer (2010) discuss the stigma of obesity and the implications for public health, Kelly King and Rebecca Puhl suggest that, in general, obesity is more stigmatizing for women than it is for men. As such, women are more likely to sense the discourse of the puritanical—that obesity is a matter of excess where “gluttony” should be a cause of significant guilt. Interestingly, Alexandra Sifferlin (2012) reported in TIME research showing that many may continue to feel stigmatization even after the weight is lost:
The researchers also found that participants’ fat bias increased when they were told, falsely, that weight can be easily controlled. That’s the controllability theory at work, Latner says: this theory suggests that stigmatized conditions are disliked more when they are perceived as easily controllable. When people think obesity is a matter of personal failing, rather than a result of physiology, genetics, and the influence of the food environment, they’re more likely to think negatively of the fat person.
Tension exists between the “power” of the doctor to heal patients (the biomedical model) and the right of a person to treat health as a product to be “consumed” (Davis Morris, 2000). In reality, modernist and postmodernist practices should be able to coexist happily. On a continuum, for example, if I have a heart attack, I am more than happy to be taken to the hospital and seek treatment to optimize my chances of recovery. Surgery, intensive care, and whatever measures might be deemed necessary will save my life in such instances. On the other hand, if I wish to preempt the possibility of heart problems, for example, I might choose from a range of alternatives.
This model of medicine, as described by Mike Mutzel (2014), an independent consultant, is the “acute care”, or “” model, which is reactionary rather than preventative. It focuses on prescribing medications or offering surgeries to present issues. Its strength is in the scientific paradigm, which can readily deal with structural issues associated with the human body, but these strengths are weaknesses in the more holistic approach to certain presenting and potential concerns. Mutzel says:
The framework that will help us succeed in the tug-of-war over body fat is called functional medicine. In general, this approach to health considers all possible contributing causes of disease, including suboptimal and over-nutrition, stress, poor sleep, environmental toxin overload, genetic programming, harmful epigenetic influences (environmental influences on genetic expression), gut microflora imbalances, and poor emotional and spiritual health. All these variables influence the “function” of the body, and when it is out of balance, the result is “dis-ease.”
For example, I am not yet showing signs of heart problems, although there is a family history, so a doctor may see little immediate reason to give me a prescription for any course of medication. Rightly so, too perhaps, but as a consumer, I may choose from a range of non-traditional, complementary, or alternative medicines.
Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method… It consists of a wide range of health care practices, products and therapies … using alternative medical diagnoses and treatments which typically have not been included in the degree courses of established medical schools or used in conventional medicine. Examples of alternative medicine include homeopathy, naturopathy, chiropractic, energy medicine, and acupuncture. (Wikipedia, 2015)
In practice, and in a very generalized way, health delivery and care can tend to de-personalize us and throw the attention on the problem rather than on the person. Therefore, a trip to the doctor for what we might identify as a problem with our weight might result in nothing more than a prescription for weight loss medication. Little attention may be given to us as a patient holistically, e.g., the psychosocial issues that surround us and might be contributing significantly to the problem.
The doctor may also direct us to another service, such as a psychologist or a social worker, i.e., a therapist of some sort, and the root issues of our weight concerns may then be addressed, but this does not appear to be standard care in the consultation process. Part of this is politically or economically driven, as the doctor may only be paid for a specific time limit imposed on the visit.
Peter Conrad and Kristin Barker (2014), drawing in part on Foucault’s theory of knowledge/power, propose that the seeming natural, often under appreciated, medical diseases are universal and unchanging over time. However, by unpacking social realities and knowledge, we may see how our culture influences and affects how meaning is constructed at the intersection of a biological disease and illness with the social meaning attached to that condition. What is labeled as an illness is socially negotiated and may even be labeled a “social problem.”
This claim is made in the social context by various powerful groups, such as political parties, medical organizations, and large corporations, which make claims to control the illness, and construct and manage social perceptions. This effectively is “social control,” which is evident in medical discourses that construct “knowledge” of the body, disease, and illness, influencing how we think about and act on such things.
Cultural analysts point out that illnesses might also have metaphorical connotations assigned to them. For example, obesity metaphors include “battle of the bulge” or obesity is seen as “sinful.” Then, the association with “gluttony” affects social perceptions of public policy decision making and outcomes, such as whether it becomes stigmatized, socially contested, considered a disability, etc.
What follows may be problematic. For example, some obese women say that they avoid their routine gynecological exams because of the stigma attached to obesity and the negativity they encounter with health care professionals. When obesity, in and of itself, is defined as an illness, rather than being a risk marker for other issues, such as diabetes, cardiovascular disease, and so on, then the focus is misplaced. Health policy may be framed about obesity, ignoring alternatives that obese people themselves might choose to ameliorate the issue, such as various food options, gastric surgery, etc.
The health needs and aesthetics of our bodies, the funding and delivery of health policy, health research, health care, diet, supplements, and all such things are contested in a social world that is politically and economically determined. We can make some conscious assessment of our diet, exercise, and supplement program. Are we “consuming” diets and diet-related products because they are fashionable? When they do not work, do we then “consume” yet another diet? A fundamental part of successful and sustainable weight control is the level of support we receive from those close to us. We must constantly debate or question the dominant discourses in order to secure an alternative position for ourselves—a position in which we do not accuse or blame our “self” for our body shape, which is quite different from a realistic assessment that we genuinely want to be otherwise.
CHAPTER 2 – OBESITY AND FAT TALK
“The language of fat is a cultural language we speak. I can meet any woman anywhere and we can bond about the size of our thighs before I ever know her name.” Jessica Weiner,
Obesity in Perspective
University of Washington researchers led by Dr. Marie Ng (2014) conducted the Global Burden of Disease Study of overweight and obese children and adults between 1980 and 2013. The results were published in Lancet and reported that "the proportion of adults with a body—mass index (BMI) of 25 kg/m2 or greater increased between 1980 and 2013 from 28 — 8% (95% UI 28·4 — 29·3) to 36·9% (36·3 — 37·4) in men, and from 29·8% (29·3 — 30·2) to 38·0% (37 — 5-38·5) in women."
The United States has the highest proportion of the world’s obese people. In The Sydney Morning Herald, Lucy Carroll (2014) reported that, “Obesity rates in Australia and New Zealand have soared by more than 80 per cent in the past 33 years.” Almost one in three Australians is obese, and most notably, no country has succeeded in reducing obesity in three decades.
Kate Torgovnick May (2013) cites surgeon Peter Attia as saying:
“The greatest cause of obesity may be that we’re applying the wrong treatment. For about 40 years, health authorities have been telling people struggling with obesity to do the same thing over and over again: eat less and exercise more. This does not appear to be successful. This would suggest that either this treatment is incorrect or it is correct and no one can follow it. Either way, it’s probably time for a new treatment.”
If you assess yourself as ‘overweight’ or fat, perhaps obese, then you have probably thought of losing weight, changing diets, or trying a new one. For some time now, the issue has been one of moral panic, quite a shrill moral panic. The World Health Organization (WHO, 2015) fact sheet (No. 311), ‘Obesity and Overweight’, lists several key facts:
* 35% of adults aged 20 and over were overweight in 2008, and 11% were obese.
* 65% of the world's population lives in countries where obesity kills more people than malnutrition does.
Generally we know that being overweight is unhealthy. Or do we? And if we do, how do we know this? Abigail Saguy (2012: 15) answers that, “We only become aware of the facts through social processes.” If that is correct, then an understanding of how we might be positioned at the intersection of such processes should enable us, at least in part, to make better choices about our bodies, and how we regard our “self.”
Thibault Bossy (2011), a Postdoctoral researcher, says obesity is regarded as a disease of epidemic proportions. Not only that, but obesity has “for decades” been defined as an individual problem, carrying with it “strong moral dimensions” because of its linkages to food and health. Bossy says, “Obese people are stigmatized in Western societies because it is believed that they are lazy, weak, and unattractive. Since the 20th century, Western cultures in general tend to define thinness as the social norm and the symbol of health and social status.”
Public health and nutrition experts are aware that obesity is a public health problem beyond the cultural definitions, and therefore, these issues should be addressed through public attention and policy. Nonetheless, according to Bossy, that policy tends to moralize against obese people in two ways. First, weight is defined by Body Mass Index (BMI), but BMI was never intended for medical diagnosis and larger and/or taller individuals always have a larger BMI. Second, as a policy objective, it conflates other considerations, such as any dangers associated with weight loss, and the demand that the individual take responsibility for the weight loss without any being taken by public authorities and big food companies that may be contributing to the issue. Thus, according to Bossy, “obesity policies are today essentially symbolic in the sense that they create fictions of life by assigning roles and prescribing behaviors.”
Natalie Boero (2012), a sociologist, calls obesity a “postmodern” epidemic with nothing contagious about it. She suggests that the moral panic about fat people blames them for all sorts of things, from higher airline costs to global warming. She notes too, however, that obese people are supposedly responsible for a dramatic increase in diet products (which largely fail, often meaning repeat business) and associated services; the U.S. weight loss industry expenditures reach about $60 billion annually. Further, a disconnect exists between the threat of fatness and the experiences of fat people themselves.
Mainstream media “fat” messages are pervasive in spite of alternatives, such as YouTube, Twitter, Facebook, and blogs, that sometimes “shame” companies into changing their messages. Media messages about how we should think and be—the construction of our realities—run deep and strong. For example is the Hollywood thin ideal for women and the muscular ideal for men, both body types people aspire to achieve. Wikipedia (2014) summarizes the situation we typically find ourselves in:
Body shape has come to imply not only sexual/reproductive ability, but wellness and fitness. In the West, slenderness is associated with happiness, success, youth, and social acceptability. Being overweight is associated with laziness, lack of willpower, being out of control, and unattractiveness. Women are expected to be slim, while men should be slender and muscular at the same time… Approximately 92% of women feel pressure to conform to the standards of beauty which the media perpetuates.
Somehow this all seems so wrong. Laura Stampler (2014), reports that a survey conducted by BlueBella—marketers of lingerie, sex toys, and accessories—reveals that while women prefer women who are slim, men prefer fuller-figured woman. The survey suggested that men admire well-muscled men, while women remain uncertain, generally preferring someone less muscled than the supposed ideal.
Gary Tippet and Carolina Marcus (2008) say that body image experts give qualified support to such findings. They quote Dr. Marika Tiggemann from Flinders University as saying, “We find women want to be thinner than what men find attractive… Unfortunately, a lot of people think being thin demonstrates being in control or being disciplined, while being fat is a sign you’re weak.” As it happens, pornography usually depicts relatively “full-figured” women, so there are certainly some mixed messages here. If we feel conflicted about our shapes or body weight, there seems to be good reason.
The Gaze is a psychoanalytical term made popular by Jacques Lacan, a French psychoanalyst and psychiatrist; it describes the anxious state that comes with the awareness that we can be viewed by others, with the subsequent loss of autonomy when we realize that we might be a “visible object.” John Berger (1972: 47), art critic and novelist, in his book Ways of Seeing, stated that, “according to usage and conventions which are at last being questioned but have by no means been overcome, men act and women appear. Men look at women. Women watch themselves being looked at.”
A woman becomes, says Berger (47), “an object—and most particularly an object of vision: a sight.” This links back to Lacan’s theory of the alienation that follows from the split between seeing one’s self and also seeing the supposed ideal of, for example, women to each other. Therefore, between women, says Natalia Mehlman Petrzela (2013), thighs are “one of the most fraught areas on women’s bodies.”
Speaking of the “female gaze” in an entry in the beheld, a blog focusing on beauty, Autumn Whitefield-Madrano says, “thigh-checking was more akin to a tic, like compulsively clearing one’s throat, or saying ‘you know all the time.” She had some awareness of it, but it seemed it was part of an overall checking-out of other women that many woman do.
In findings of a study undertaken by Salk and Engeln-Maddox (2011), “fat talk” is quite common and is associated with a degree of generalized body dissatisfaction and “thin-ideal internalization.” Fat talk is a disruptive “powerful social norm” that has made women, who are not fat, feel fat. The following is an imaginary scenario between two women, neither of whom is fat:
Friend 1: “Ugh, I feel so fat.”
Friend 2: “OMG [Oh my God]. Are you serious? You are NOT fat.”
Friend 1: “Yes I am, look at my thighs.”“
Friend 2: “Look at MY thighs.”
Friend 1: “Oh, come on. You’re a stick.”
Friend 2: “So are you.”
Christine Junge (2011), American Journal of Public Health, reports on a study showing that people we associate with influence our weight decisions. The study considered three factors: (1) collaboration, i.e., how, over time, people share ideas about body size, food (type and amount), and exercise; (2) peer pressure, i.e., feeling “bullied” into conforming to be like others; and (3) “monkey see, monkey do,” or changing habits to mirror what friends do. It was found that the body size of friends, family members, and colleagues influences us, and the stronger the connection, the stronger the link in weight.
What people do together is very important. An Internet search suggests that many couples gain weight together after marriage; however, there can be problems if just one partner gains weight. A study led by Tricia Burke et al. (2012) of heterosexual mixed-weight and matched-weight couples showed that mixed-weight couples experience more conflict in the relationship, but a supportive partner can buffer this conflict.
Couples in particular have certain implicit or explicit expectations of the significant other. A large part of feeling comfortable about one’s weight, or losing weight, may require negotiation with and support from those close to us. Perhaps it is the “Jack Sprat could eat no fat…” relationship where one partner prefers the other to be either more slim or larger, and the possible interpersonal difficulty experienced should they decide to lose weight.
As we are always in a social context, we will tend, unconsciously perhaps, to experience and interpret ourselves relative to the language and discourses that surround us: our family and social, economic, and political environments. Such is our enculturation. Weight control is not necessarily achieved in just one grand gesture in which we decide one day to diet or to lose weight. Weight control is best managed by considering all aspects of our lives and the impact of our environment.
Is obesity preventable? Janet Warren (1997), a physician, says that the Postmodern perspective “emphasizes the importance of language and asserts that much of knowledge depends on stories rather than on simple facts. Thus, the modernistic belief that we have access to an unmediated knowledge of the world is challenged by the postmodern view that knowledge is determined by language and sociocultural context.” Consumerism is our reality, and a medical doctor may only be one of a range of health care providers. We have choice and options. As David Ellis (2013) suggests:
They [doctors] will be joined, and eventually may be outnumbered, by nonclinicians inside and outside the health care industry, in particular by the hardware and software engineers and smartphone manufacturers who already are deeply involved in facilitating the “pre-primary care”…We can expect their involvement and their influence to extend into every aspect and every phase of care as the future accelerates.
In the opinion of Abigail Saguy, we experience obesity in socially constructed conceptual “frames,” and as such, we no longer tend to see obese bodies as good or healthy. Obesity is a problem frame, a medical or disease, and health crisis, a pathology, where fat currently has very pejorative connotations. The problem too, for those trying to lose weight and failing, is feelings of guilt and shame.
As Saguy sees it, women in particular are judged harshly for their appearance, at least more so than men are; therefore, women are the major consumers of weight loss diets, drugs, and even surgeries. Further, it is a class issue in that being thin, or the desire to be thin, is a “largely unconscious, taken-for-granted, and embodied worldview.” Being overweight is not necessarily the problem, being underweight too has its risks; rather, it is speculative because there may be other health issues associated with it.
Messages we hear include the comments and discussions overheard or made with significant others, friends, colleagues, or others as well as the voices in our own heads, which are constructed by our social interactions. If we have thoughts of weight loss or if we face pressure to undertake it, then there comes a need to make a context of it all, as to what should or could be done. That might range from drastic actions to doing nothing at all, but either way, the best assessment and decision about a course of action, if any, is a self-motivated one. The problem in large part is the pressure overweight people, particularly women, experience because of the social position they find themselves in.
CHAPTER 3 – THE SELF AND MINDMAPS
“Probably the best account of the origins of selfhood is that the self comes into being at the interface between the inner biological processes of the human body and the sociocultural network to which the person belongs.” Roy Baumeister and Brad Bushman,
Defining One’s “Self”
In The Bible New Testament, a lawyer is said to have tempted Jesus by asking, “Master, which is the great commandment in the law?” Jesus replied that to love God with all your being was the first and great commandment and the other was to love your neighbor as yourself. This was a New Testament summation of all the laws and prophets (Matthew 22:35-40 KJV).
Whatever you think of The Bible, the point is that we should acknowledge that it is a good thing to have some positive level of regard for one’s self. We become upset at the thought of others being hurt by unthinking words and actions, yet we often tend to be hard on ourselves for failing. We may have some sort of idealized body shape we think we should aspire to, yet this may differ from that which we see in the bathroom mirror. Why?
We need a good sense of our “self,” including our biological body, the concept of which has shifted over time. Sal Restivo (1991: 99-104), a sociologist and anthropologist, suggests that the self was a metaphysical and theological construct, with each of us being a soul consisting of a collection of “somative sensations.” Gradually, we became self-cognitive, at least in part, while at the same time being determined by “social processes”; therefore, we generally have a very real sense of our individual selves. I am “me,” yet at the same time, I am also a product of and a construct of my environment, my social world, the media, etc.
Restivo posed a series of questions we might ask when we want to get to know another or ourselves better: (1) Who do you know? (2) How often do you interact with others? (3) What activities do you engage in (both alone and with others)? (4) Are the people, things, and ideas you relate to central or peripheral in your life? (5) Which of these components are stable and which are changing?
A sixth question is possible, says Restivo, and that is what thoughts have faded, out-of-the-way, or out-of-mind, suppressed, repressed, and so on? He suggests that how well you can answer these questions is an indicator of how well-developed the sense of “self” is. It would reveal our awareness of all that presses in on us and might be exerting a degree of force on us to conform to something or someone, even when we do not wish to. Alternatively, we may feel a sense of power over our personal environment and our capacity to make useful, informed, and meaningful life decisions and choices. Therefore, the greater control we are able to exert over our environment and culture, the happier we are about our “self.” If our “self” is under-developed, we might experience some dissonance, uncertainty, and dissatisfaction with our capacity to bring about change in our lives.
Joel Anderson (1996), interpreting Axel Honneth, a professor of philosophy, discusses three distinct species of “practical relation-to-self”:
These are neither purely beliefs about oneself nor emotional states, but involve a dynamic process in which individuals come to experience themselves as having a certain status, be it as an object of concern, a responsible agent, or a valued contributor to shared projects… [so that] °ne’s relationship to oneself, then, is not a matter of a solitary ego appraising itself, but an intersubjective process, in which one’s attitude toward oneself emerges in one’s encounter with an other’s attitude toward oneself.
We are not merely psychological, biological beings, but we are entities at the intersections of, over time, millions of short- and long-term discourses in a verbal, visual, and kinesthetic sense. You might feel some sense of indignation at the suggestion that we can be likened to a computer program, responding appropriately to external stimuli. We believe we have a real conscious sense of who we are, that we can manage our environment, or at least our responses to it, and if that is indeed so, then there is a greater chance of success in meeting our weight goals.
Various “authorities” have prescriptive ideas about what we should be or do, or should not be or do. Our responses to these factors, our resistance or compliance, shapes who we are. We have a biography that might reflect the tacit and active influences on our lives, and where we are will in many ways determine our success or otherwise with weight goals.
Is all of this important? Well, yes, quite possibly pivotal in successful weight control or loss. What it all points to is the idea of our “locus of control,” which is how we view the world around us and its impact or influence on us and the things that happen in our lives. Those with an internal locus of control believe that events are a consequence or result of their own actions. People with an external locus of control see events as under the control of external forces. If we feel that we lack control over events in any way, then we are probably less likely to be motivated about things in general and, perhaps, unable to find solutions to problems we encounter.
"Queen D" (2014) of Queendom.com, The Land of Tests, a subsidiary of PsychTests AIM Inc., posted survey data gathered from 1,252 women who responded to their Diet and Weight Loss Test. The results revealed that, "only 6% of women in our sample are happy with their body, with another 32% being only moderately content. Of the remaining 62% who are unhappy, 1% are underweight, 20% are at a normal/healthy weight, 42% are overweight, and 31% are obese."
The Queendom survey revealed that, “Unhappy women… [h]ave a more external locus of control. They feel they have some, but not complete control over their health (66 vs. 76 for happy women, on a scale from 0 to 100).” Findings also show that many of those women unhappy about themselves select what might be classified as unsatisfactory methods to lose weight, such as vomiting, laxatives, and fasting or starving. Unhealthy eating habits included using food for comfort and “mindless nibbling” or binge eating.
If indeed an external locus of control sets us up for failure, then self-loathing might follow, as we might sense that we are alienated from our own body in some way. As Dr. Cohen (1984), a psychotherapist, says, “Most compulsive eaters relate to themselves from the neck up. Their bodies are disowned, alienated, foreign—but not a part of the real self.” The answer to weight control may lay, in part, with a connected sense of self.
Sandra and Matthew Blakeslee (2008), science writers, speak of the “embodied self”; each of us has in our brains a whole range of “learned” maps of our body and its various parts and functions and the nearby environment. We have a complete map library, or “mandala,” not in a static sense, but one where maps can be readily accessed, added to, modified, replaced, but which can also be damaged. For example, the Blakeslee’s discuss Oprah’s weight loss, acknowledging her diet and exercise regimen, her personal determination, etc., but they also propose that she constructed a new body map to do so.
One of our maps, the “body schema,” is the felt sense we have of our own body and the other is our “body image,” the “learned attitudes” of our body. Confused? The body schema is the responses to stimuli that the brain recognizes, such as a touch to the cheek, but also various things outside of consciousness. Learning a sport, for example, involves the schema, where such things as muscle memory would enable us to return a tennis ball to an opponent without having to concentrate on the complete process of hand, arm, foot, and body placement and movement. The body’s mandala constantly computes movement to update the schema.
Where it becomes interesting on a much more personal level is where we might diet, experience weight loss, and then put it all that weight on again, which is the yo-yo diet phenomenon that frustrates attempts of sheer will and determination in many of us. Imagine: weeks of diet, deprivation it seems, and the weight comes off, clothes reflect a change of shape, the belt comes in a few notches; however, there is still the possibility that when we look in the mirror we simply do not see the slimmer self at all. Instead, there may still be a sense of the self being fat or overweight. We may have become slimmer in an objective sense, but the subjective body image we have of our “self” conflicts with the reality.
Food fills a need and is addictive. Body image is all about our personal attitude to aspects of the “self”: for example, am I a fat person? Good looking? Am I tall or short? The body schema is relatively specialized and contained, whereas body image is constructed from data, as diverse things, such as memories and beliefs, create more stable networks constructed around experiences (Blakeslee).
Reality, then, may be at odds with our perceived understanding of it. On the other hand, consider the anorexic person who may appear severely underweight to an objective observer, but still sees himself/herself in the mirror as carrying too much weight, even as severely overweight. Therefore, what we see, hear, and think is real and is profoundly shaped by the belief system we have constructed, our very expectations or “self.”
In Touch With Our Body
This is in part our realization of the discourses that crisscross us each day, the Hollywood Dream Machine projecting, in the most part, images of idealized (tall, muscular) men and (slim) women, which means my “self” may be not all it could or should be. What follows, perhaps, is shame, fear, and self-loathing, which can be, and may be, absolved by food, i.e., comfort food.
The article Body Image and Diets, the Better Health Channel of the Australian Government of Victoria (2015) states, “Your body image is how you think and feel about your body. Body image involves your thoughts, perception, imagination, and emotions. It does not necessarily reflect what you see in the mirror or what other people see.” Therefore, the mismatch is possibly one between our body image and our body schema.
Visit: http://www.Shakespir.com/books/view/604129 to purchase this book to continue reading. Show the author you appreciate their work!
This book is a timely read and summarizes many resources and approaches to weight control, loss, or maintenance. While not a "how-to" diet book, it offers many good ideas on how to make changes based on lifestyle considerations. If diets have failed to give you the weight control or loss you desire, this book is for you as it explores the failures of diets to deliver the body shape you want. Often yo-yo weight loss is not the result of failure to rigidly adhere to a diet, but is affected by a number of sociocultural, biochemical, and environmental factors. The book ranges across the politics of weight, mind maps, fat talk, the second brain or genome, along with beneficial food groups and diets. There are no empty promises made. Rather, this work explores the life-changing benefits of self compassion, and considers the role of self in the context of weight control. It takes you on a journey in a non-judgmental way to offer strategies that may lead to lifestyle changes and long-term success in regaining your self.