AsianScientist (Oct. 24, 2014) – Being overweight is a choice.
How often have you heard that?
Too often, I would say.
It is all too easy to ignore the growing non-communicable disease burden attributed to lifestyle and diet choices, especially if you are constantly surrounded by yuppie, corporate types. Types who can easily saunter through run three-hour marathons and eat kale leaves for lunch. Types who will judge you quietly for eating fried chicken and fries for lunch. Types who are all too enthusiastic about running 13 miles in East Coast Park (ECP) every Sunday morning. To some people, being overweight/obese would certainly seem like a terrible choice.
However, this situation is rare. A significant fraction of the world’s population, some of whom live in countries that are 50-70 years behind the rest of the world, do not have access to proper infrastructure or the knowledge to exercise or eat healthily. Would this significant fraction have a choice when it comes to their lifestyle choices, or has it already been spelled out by their circumstances?
The burden of non-communicable diseases attributed to lifestyle and diet choices has risen dramatically in developing countries in the past decade. Ischemic heart disease is the number one cause of death in the world now. Over the next decade, if not addressed effectively, chronic diseases will increase by 27 percent in Africa, 25 percent in the Middle East and 21 percent in Asia and Pacific, accounting for 75 percent of all deaths globally.
The answer to the new spectrum of lifestyle-related diseases that befall developing and developed countries should be easy: move more and eat less.
Life isn’t always that straightforward.
Cultural, socioeconomic and genetic determinants of obesity
Obesity and overweight populations are a result of a myriad of social and economic determinants around the world. Less manual labor, more physical inactivity. More food industry giants in power, larger portions, higher consumption. More Internet, more late nights. Our lives have evolved faster than our bodies, and so our bodies begin to suffer.
We are products of a greater picture. Fresh foods are placed around the supermarkets, where processed and junk foods are placed in the middle. Chocolate bars and sweets are placed near the cashiers to capture the attention of children as their parents are waiting in line. We may have a choice, but, alarmingly, it seems that the choices have already been made.
Food choices are informed by culture, too. Large portions are very much ingrained into the American culture, as are a love of carbohydrates and frequent all-day eating in Asian countries. It is not just the United States who struggles with overweight and obese populations. Developing countries also now face this epidemic.
For instance, my home country of Malaysia has some staggering statistics: 45.3 percent of Malaysians are overweight or obese. Nearly one in two Malaysians are overweight or obese and at risk of heart disease. Although the figure is still lower than that of the US (68 percent of Americans are obese and overweight), the figure will only increase if no effort is explicitly made to curb the epidemic.
How far is being overweight and obese a choice? Even if we choose to eat salads everyday, our colleagues would mock us endlessly unless they, too, do the same. Health seeking behaviors among our peers—and among society—need to be encouraged. In a 2009 paper in the New England Journal of Medicine, it was found that no matter what macronutrient-emphasized diet a person employs, the only tried and true method that worked was a caloric restriction, and this only worked if the person adhered to attending the support groups every two weeks.
Our genes are also another component of the overweight/obese problem. Obesity is a polygenic disease. One can be genetically susceptible to obesity by having a poor regulation of appetite, a lower than average metabolic rate or have a high fat storage capacity. However, this stage is where it becomes an excuse for people to stop working out and eating less, because “it’s not in my genes”. It may be in your genes, but the obesity epidemic has grown alarmingly in the past 50 years. This is not long enough for the body to evolve genetically.
The luxury of choice
Being overweight and obese, and therefore being “healthy”, to a certain extent, is a choice. We can choose to stop eating when we are full, we can choose to lace our running shoes go for that run in ECP, and we can choose to not indulge in that lava cake after work. However, we cannot assume that everyone else is afforded the luxury of choice.
Sometimes, it really isn’t.
The article can be found at: Sacks et al. (2009) Comparison of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates.
This article is from a monthly column called Our Small World. Click here to see the other articles in this series.
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Copyright: Asian Scientist Magazine; Photo: FBellon/Flickr/CC.
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.
