At 540 kg, Carol Yager (1960 to 1994), is said to be the heaviest woman to have ever lived on planet earth. She received extravagant media coverage during her lifetime and appeared on many television shows. She is also said to have lost massive amount of weight by conservative methods. However, she died at the young age of 34 years due to complications related to clinically severe obesity.
Carol Yager
Of note, is the fact that, she was refused further hospitalization on the grounds that her “condition was not critical”, despite massive water retention and signs of incipient kidney failure, and these problems led to her death a few weeks later.
Carol Yager’s was a rare case of extreme obesity and 25 years ago, the medical profession failed to recognize it as a valid disease that required treatment just like any other. Today 603.7 million people suffer from obesity across the world. 107.7 million children are either overweight or obese. It is widely acknowledged that today more people die of obesity than of hunger. This is the first time in the history of medicine that a disease has attained epidemic proportions and is yet to be recognized as a “disease”.
When we talk about obesity, it is also important to understand people’s attitude towards it. Most obese patients are subjected to weight-based stigma, prejudice and discrimination. When it comes to employment settings and inter-personal relationships there is a palpable bias against people suffering from obesity. Society views them as people who are low on will-power and self-esteem. The attitude is extremely negative and the common perception even today is that obesity is something which is self-afflicted and does not deserve to be treated.
Most obese patients are subjected to weight-based stigma, prejudice and discrimination. When it comes to employment settings and inter-personal relationships there is a palpable bias against people suffering from obesity. Society views them as people who are low on will-power and self-esteem
On the other hand, patients suffering from obesity also have to deal with being repeatedly teased or victimized. This may make them vulnerable to binge eating patterns. Emotional clinical features of binge eating include feeling out of control during binge episodes and then feeling disgusted, depressed, or guilty due to overeating and eventually marked distress regarding the binge eating episode. Our media and diet industry has also fuelled this negativity by creating a perception that body weight is easily modifiable. Repeated failures at weight loss ultimately add to increasing negative self-perceptions in patients suffering from obesity [1].
I believe that before we talk further about obesity, we need to challenge the “self -inflicted and non-disease” nature of obesity. It is the need of the hour to identify misconceptions and gaps in our knowledge pertaining to obesity. At the same time, it is also important to understand the patient’s attitudes and perception about their disease. We need to treat obesity with the same respect and seriousness as we treat any other disease for example, chronic kidney disease, heart disease or cancer.
It is astonishing that while the mere mention of cancer ignites mass hysteria and leads to undivided political attention, obesity is being unbelievably overlooked and has been kept on a backburner by policy makers. While we are busy fighting known enemies, it has silently emerged as the new emperor of all maladies. We urgently need a paradigm shift in our thought process about the way we view obesity. Obesity must be recognized as a disease and must get its due from the medical and political fraternity. There is a lot of work ahead and it is time that we start breaking the walls of false perceptions created around obesity and its management and begin by building bridges, brick by brick.
(The writer is a bariatric and laparoscopic GI Surgeon, Mumbai)
References:
1. R.M. Puhl,1 R.M. Masheb,2 M.A. White, et al. Attitudes toward obesity in obese persons: A matched comparison of obese women with and without binge eating. Eat Weight Disord. 2010 Sep;