Obesity: a sociological guide for health practitioners
Samuel G. Grace
+ Author Affiliations
- Author Affiliations
Internal Medicine Department, Royal Brisbane & Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia. Email: samuel.grace@health.qld.gov.au
Australian Journal of Primary Health 26(5) 362-366 https://doi.org/10.1071/PY20100
Submitted: 28 April 2020 Accepted: 31 July 2020 Published: 28 September 2020
Abstract
Obesity is a condition of excess body fat that has been identified as one of the most serious public health problems of the 21st century. Obesity is a leading preventable cause of death globally and increases the likelihood of cardiovascular disease, diabetes and various cancers. Obesity worldwide has tripled in the adult population over the past 40 years, with 13% of the world’s adult population now obese, leading to calls for control of a global obesity epidemic. Causes of obesity can be delineated at individual, societal and systemic levels, highlighting the need for analysis that transcends the biomedical paradigm to explore the sociological influences of this condition. The pathophysiology of why obesity occurs has not changed within recent history, but the way that people live their lives and the cultural understandings that evolve within communities have. This article describes the interaction between obesity and the social environment, explores the meaning of obesity within the context of health and considers the social determinants of obesity within the community. It also discusses the influences of the professional–patient exchange in obesity, the comprehension of obesity as a disease and the challenges of addressing obesity within the healthcare system.
Keywords: health behaviour, health education, healthcare disparities, primary health care, social medicine.
References
Australian Institute of Health and Welfare (AIHW) (2004) The relationship between overweight, obesity and cardiovascular disease: a literature review prepared for the National Heart Foundation Australia. AIHW, Canberra, ACT, Australia.Australian Institute of Health and Welfare (AIHW) (2018) Overweight & obesity. Overview. (AIHW: Canberra, ACT, Australia) Available at www.aihw.gov.au/reports-data/behaviours-risk-factors/overweight-obesity/overview [Verified 25 July 2020]
Brown I, Flint S (2013) Weight bias and the training of health professionals to better manage obesity: what do we know and what should we do? Current Obesity Reports 2, 333–340.
| Weight bias and the training of health professionals to better manage obesity: what do we know and what should we do?Crossref | GoogleScholarGoogle Scholar |
Cernik L (2018) It’s not fine to be fat. Celebrating obesity is irresponsible. The Guardian 10 April. Available at www.theguardian.com/commentisfree/2018/apr/10/fat-pride-obesity-public-health-warnings-dangerous-weight-levels [Verified 25 July 2020]
Cheskin LJ, Kahan S, Geller G (2010) Weight-based stigma and physician bias. AMA Journal of Ethics 12, 258–262.
| Weight-based stigma and physician bias.Crossref | GoogleScholarGoogle Scholar |
Crandall C, Reser A (2005) Attribution and weight-based prejudice. In ‘Weight bias: nature, consequences and remedies’. (Eds K Brownell, R Puhl) pp. 83–96. (The Guilford Press: New York, NY, USA)
Epstein NE (2014) Multidisciplinary in-hospital teams improve patient outcomes: a review. Surgical Neurology International 5, S295–S303.
| Multidisciplinary in-hospital teams improve patient outcomes: a review.Crossref | GoogleScholarGoogle Scholar | 25289149PubMed |
Fabbrini E, Yoshino J, Yoshino M, Magkos F, Luecking CT, Samovski D, Fraterrigo G, Okunade AL, Patterson BW, Klein S (2015) Metabolically normal obese people are protected from adverse effects following weight gain. The Journal of Clinical Investigation 125, 787–795.
| Metabolically normal obese people are protected from adverse effects following weight gain.Crossref | GoogleScholarGoogle Scholar | 25555214PubMed |
Finkelstein EA, Strombotne KL (2010) The economics of obesity. The American Journal of Clinical Nutrition 91, 1520S–1524S.
| The economics of obesity.Crossref | GoogleScholarGoogle Scholar | 20237140PubMed |
Fox A, Feng W, Asal V (2019) What is driving global obesity trends? Globalization or ‘modernization’? BMC Global Health 15, 32
| What is driving global obesity trends? Globalization or ‘modernization’?Crossref | GoogleScholarGoogle Scholar |
Gabe J (2013) Consumerism. In ‘Key concepts in medical sociology’. (Eds J Gabe, L Monaghan) pp. 203–206. (SAGE Publications: London, UK)
Heinonen I, Helajärvi H, Pahkala K, Heinonen OJ, Hirvensalo M, Pälve K, Tammelin T, Yang X, Juonala M, Mikkilä V, Kähönen M, Lehtimäki T, Viikari J, Raitakari OT (2013) Sedentary behaviours and obesity in adults: the Cardiovascular Risk in Young Finns Study. BMJ Open 3, e002901
| Sedentary behaviours and obesity in adults: the Cardiovascular Risk in Young Finns Study.Crossref | GoogleScholarGoogle Scholar | 23794543PubMed |
Herzlich C (1973) ‘Health and illness: a social psychological analysis.’ (Academic Press: New York, NY, USA)
Hill JO, Wyatt HR, Peters JC (2012) Energy balance and obesity. Circulation 126, 126–132.
| Energy balance and obesity.Crossref | GoogleScholarGoogle Scholar | 22753534PubMed |
Huang J, Yu H, Yu H, Marin E, Brock S, Carden D, Davis T (2004) Physicians’ weight loss counselling in two public hospital primary care clinics. Academic Medicine 79, 156–161.
| Physicians’ weight loss counselling in two public hospital primary care clinics.Crossref | GoogleScholarGoogle Scholar | 14744717PubMed |
Krieger N (2001) Theories for social epidemiology in the 21st century: an ecosocial perspective. International Journal of Epidemiology 30, 668–677.
| Theories for social epidemiology in the 21st century: an ecosocial perspective.Crossref | GoogleScholarGoogle Scholar | 11511581PubMed |
Lee AJ, Kane S, Ramsey R, Good E, Dick M (2016) Testing the price and affordability of healthy and current (unhealthy) diets and the potential impacts of policy change in Australia. BMC Public Health 16, 315
| Testing the price and affordability of healthy and current (unhealthy) diets and the potential impacts of policy change in Australia.Crossref | GoogleScholarGoogle Scholar | 27067642PubMed |
Loring B, Robertson A (2014) ‘Obesity and inequities: guidance for addressing inequities in overweight and obesity.’ (World Health Organisation Regional Office for Europe: Copenhagen, Denmark)
Meadows A (2018) Discrimination against fat people is so endemic, most of us don’t even realise it’s happening. The Conversation 9 May. Available at www.theconversation.com/discrimination-against-fat-people-is-so-endemic-most-of-us-dont-even-realise-its-happening-94862 [Verified 25 July 2020]
Mohr P, Wilson C, Dunn K, Brindal E, Wittert G (2007) Personal and lifestyle characteristics predictive of the consumption of fast foods in Australia. Public Health Nutrition 10, 1456–1463.
| Personal and lifestyle characteristics predictive of the consumption of fast foods in Australia.Crossref | GoogleScholarGoogle Scholar | 17565763PubMed |
Mold F, Forbes A (2013) Patients’ and professionals’ experiences and perspectives of obesity in health-care settings: a synthesis of current research. Health Expectations 16, 119–142.
| Patients’ and professionals’ experiences and perspectives of obesity in health-care settings: a synthesis of current research.Crossref | GoogleScholarGoogle Scholar | 21645186PubMed |
Monaghan LF, Bombak AE, Rich E (2018) Obesity, neoliberalism and epidemic psychology: critical commentary and alternative approaches to public health. Critical Public Health 28, 498–508.
| Obesity, neoliberalism and epidemic psychology: critical commentary and alternative approaches to public health.Crossref | GoogleScholarGoogle Scholar |
Muttarak R (2018) Normalization of plus size and the danger of unseen overweight and obesity in England. Obesity 26, 1125-1129
| Normalization of plus size and the danger of unseen overweight and obesity in England.Crossref | GoogleScholarGoogle Scholar | 30204944PubMed |
Newton S, Braithwaite D, Akinyemiju T (2017) Socio-economic status over the life course and obesity: Systematic review and meta-analysis. PLoS One 12, e0177151
| Socio-economic status over the life course and obesity: Systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 29140996PubMed |
O’Donoghue G, Kennedy A, Puggina A, Aleksovska K, Buck C, Burns C, Cardon G, Carlin A, Ciarapica D, Colotto M, Condello G, Coppinger T, Cortis C, D’Haese S, De Craemer M, Di Blasio A, Hansen S, Iacoviello L, Issartel J, Izzicupo P, Jaeschke L, Kanning M, Ling F, Luzak A, Napolitano G, Nazare J, Perchoux C, Pesce C, Pischon T, Polito A, Sannella A, Schulz H, Simon C, Sohun R, Steinbrecher A, Schlicht W, MacDonncha C, Capranica L, Boccia S (2018) Socio-economic determinants of physical activity across the life course: a ‘DEterminants of DIet and Physical ACtivity’ (DEDIPAC) umbrella literature review. PLoS One 13, e0190737
| Socio-economic determinants of physical activity across the life course: a ‘DEterminants of DIet and Physical ACtivity’ (DEDIPAC) umbrella literature review.Crossref | GoogleScholarGoogle Scholar | 29351286PubMed |
Ogden J (2015) Are we normalising obesity? The Independent. 13 June. Available at www.independent.co.uk/life-style/health-and-families/features/are-we-normalising-obesity-10313776.html [Verified 25 July 2020]
Opie CA, Haines HM, Ervin KE, Glenister K, Pierce D (2017) Why Australia needs to define obesity as a chronic condition. BMC Public Health 17, 500
| Why Australia needs to define obesity as a chronic condition.Crossref | GoogleScholarGoogle Scholar | 28535781PubMed |
Opie CA, Glenister K, Wright J (2019) Is social exposure to obesity associated with weight status misperception? Assessing Australians ability to identify overweight and obesity. BMC Public Health 19, 1222
| Is social exposure to obesity associated with weight status misperception? Assessing Australians ability to identify overweight and obesity.Crossref | GoogleScholarGoogle Scholar | 31484511PubMed |
Patterson C, Hilton S (2013) Normalisation and stigmatisation of obesity in UK newspapers: a visual content analysis. The Open Obesity Journal 5, 82–91.
| Normalisation and stigmatisation of obesity in UK newspapers: a visual content analysis.Crossref | GoogleScholarGoogle Scholar | 30344798PubMed |
Rosengren A, Lissner L (2008) The sociology of obesity. Frontiers of Hormone Research 36, 260–270.
| The sociology of obesity.Crossref | GoogleScholarGoogle Scholar | 18230907PubMed |
Royal Australian College of General Practitioners (RACGP) (2018) General practice health of the nation 2018. (RACGP: Melbourne, Vic., Australia) Available at https://www.racgp.org.au/FSDEDEV/media/documents/Special%20events/Health-of-the-Nation-2018-Report.pdf [Verified 25 July 2020]
Saint-Pierre C, Herskovic V, Sepúlveda M (2018) Multidisciplinary collaboration in primary care: a systematic review. Family Practice 35, 132–141.
| Multidisciplinary collaboration in primary care: a systematic review.Crossref | GoogleScholarGoogle Scholar | 28973173PubMed |
Stuckler D, Nestle M (2012) Big food, food systems, and global health. PLoS Medicine 9, e1001242
| Big food, food systems, and global health.Crossref | GoogleScholarGoogle Scholar | 22745605PubMed |
Talley NJ (2017) National health summit on obesity calls for Australia to take action to stem the pandemic. Medical Journal of Australia 206, 106–107.
| National health summit on obesity calls for Australia to take action to stem the pandemic.Crossref | GoogleScholarGoogle Scholar | 28208031PubMed |
Taylor S (2007) Sociology, social research and health. In ‘Sociology of health and health care’. (Eds S Taylor, D Field) pp. 3–24. (Blackwell Science: Oxford, UK)
Thomas SL, Hyde J, Karunaratne A, Herbert D, Komesaroff PA (2008) Being ‘fat’ in today’s world: a qualitative study of the lived experiences of people with obesity in Australia. Health Expectations 11, 321–330.
| Being ‘fat’ in today’s world: a qualitative study of the lived experiences of people with obesity in Australia.Crossref | GoogleScholarGoogle Scholar | 18684133PubMed |
Thornton LE, Lamb KE, Ball K (2016) Fast food restaurant locations according to socioeconomic disadvantage, urban–regional locality, and schools within Victoria, Australia. SSM - Population Health 2, 1–9.
| Fast food restaurant locations according to socioeconomic disadvantage, urban–regional locality, and schools within Victoria, Australia.Crossref | GoogleScholarGoogle Scholar | 29349122PubMed |
Tsiga E, Panagopoulou E, Sevdalis N, Montgomery A, Benos A (2013) The influence of time pressure on adherence to guidelines in primary care: an experimental study. BMJ Open 3, e002700
| The influence of time pressure on adherence to guidelines in primary care: an experimental study.Crossref | GoogleScholarGoogle Scholar | 23585394PubMed |
Walsh M, Fahy K (2011) Interaction betwen primary health care professionals and people who are overweight or obese: a critical review. Australian Journal of Advanced Nursing 29, 23–29.
Waterlander WE, de Mul A, Schuit AJ, Seidell JC, Steenhuis IH (2010) Perceptions on the use of pricing strategies to stimulate healthy eating among residents of deprived neighbourhoods: a focus group study. The International Journal of Behavioral Nutrition and Physical Activity 7, 44
| Perceptions on the use of pricing strategies to stimulate healthy eating among residents of deprived neighbourhoods: a focus group study.Crossref | GoogleScholarGoogle Scholar | 20482857PubMed |
White P (2015) Appreciating your staff makes sound business sense. Human Resource Management International Digest 23, 31–33.
| Appreciating your staff makes sound business sense.Crossref | GoogleScholarGoogle Scholar |
World Health Organization (WHO) (2018) Obesity and overweight. (WHO: Geneva, Switzerland) Available at www.who.int/news-room/fact-sheets/detail/obesity-and-overweight [Verified 25 July 2020]
