Sunday, July 1, 2012

Why I Love Canada: Weight Debate Edition

Today is Canada Day. Yes, it's close to the 4th of July, but it's our birthday and it's today. So Happy Birthday to my wonderful homeland, Canada!

But what does loving Canada have to do with the "great weight debate"? I submit, for your viewing pleasure, the following youtube video. It's a debate between nutritionist/sociologist, Professor Jacqui Gingras (Ryerson University) and Dr. Arya Sharma, one of Canada's and the world's premier voices on bariatric issues (whether you love him, hate him, or you're somewhere in between...) on whether obesity is or is not a disease.

It's a long video--two hours, though you can skip the first twenty minutes or so of introductions and blah-blah to go right to the debate. Dr. Sharma can get a bit overly testy and Dr. Gingras can sometimes stray away from the actual questions, but what makes it such a great video is how Canadian it is: it's so civilized and polite and you get the impression that everyone there--debaters and audience alike--are looking for answers and not just to take the opposite side down.

So settle back, grab a cold glass of water because it's so darn hot out, make sure you're comfortably seated or on your elliptical trainer or whatever and enjoy this quintessentially Canadian discussion of a very hot-button issue.


  1. I really tried to watch this but 1:15, I could not take it any longer. A bunch of thin people arguing over obesity, and none of them clearly have a solution that can work long term. I have at least some of the solution, and now the next part of my solution, but am unwilling to do it yet. Oh well, they get paid, I do not.

    I cannot figure out how to make a dollar off my solution yet, as it is about changing thinking about this problem. The obesity entrepreneur, but not yet.

  2. Great post, NewMe! If only our U.S. politicians could be one tenth that cordial and civil during debate. *sigh*

    Dr. Sharma admits that much of the mental and emotional suffering (experienced as a result of the social category known as obesity) may be attributed to the social stigma, bias, and discrimination that larger people must endure every day, year after year. Thus, he moves in the general direction of recognizing ways in which "physical illness" can be socially constructed (made real) by oppressive forces in our cultures (such as widely held false beliefs about particular categories of people.) And for that I applaud him.

    However, the reductionist science that people use to legitimize (give power to the false beliefs) the "disease" model of body size operates, simultaneously, as an oppressive social force that helps to construct and maintain the social stigma against larger body size. This phenomenon (of a highly revered social paradigm, such as reductionist science, legitimizing and/or constructing an outcome), is one example of the social construction of human illness and health inequities.

    For example, when the human body repeatedly experiences chronic stress or trauma or perception of environmental threat (say, related to being a target of ongoing stigma, shame, discrimination, fear of harm, fear of illness, hate and self hate, disapproval, disgust, etc ), multiple body systems respond to that chronic stress in an attempt to defend against it and return the body to homeostasis, which is experienced physiologically by the body, not simply emotionally by the mind. The autonomic nervous system responses to threat or to perceived threat, for instance, automatically operate outside of a person's ability to control, and can have widespread impacts on multiple body systems and functions, such as endocrine, immune, inflammatory, circulatory (via blood pressure and heart rate), digestive, and so forth.

    Thus, the social forces that create the widespread false beliefs about body size are also the social forces that help to construct (make real) risk factors that develop as a result of those widespread false beliefs, and they are the same social forces that drive the "need" to "help" people prevent larger size, the same forces that legitimize the need for "care" for people in this group, etc. Size is thus medicalized and framed as a dangerous PHYSICAL condition, with multiple risk factors, in need of a cure--in need of specialized treatment to "help" etc.

    The whole circus is founded on an epistemological position--realism/positivism--which reduces human beings to objects that are manipulated and controlled (dominated) and harmed in countless ways, and the whole charade is accepted as reality, the way things must be and simply ARE, rather than understood as constructed by multiple social forces of bullsh*t. It also explains why humans put up with other massive forms of injustice and oppression without ever even realizing that our lives are damaged, controlled, and dominated while we continue to believe we are, more or less, free.

  3. You're right, NewMe, you Canadians are so civilized -- or at least that's my fantasy.

    I've been putting my two cents in over at BFB. I am not so sure that "medicalizing obesity," which Dr. Sharma does without intending extra stigma is the same as "pathologizing fat," which our society does indiscriminately and to everyone's social and medical detriment (as explained by hopefulandfree, above).

  4. Excuse my double dipping, please, as well as any derailing this involves, but while we're on the subject of Dr. Sharma, I'm still waiting for someone (ANYONE?) to explain to me what the following quote from Dr. Sharma's blog means:

    "Present data indicate that slightly over one-quarter of obese individuals may suffer from varying degrees of borderline personality disorder. Obviously, this has a number of clinical implications, particularly in terms of assessment, treatment strategies, and outcome."

    Dr. Sharma makes this claim while reporting what a colleague said at an "obesity and mental health" conference of professional health care providers.

    Here's the link:

    The meaning of the statement is hard to interpret because it is worded so strangely...what does "varying degrees" mean in relation to a psychological disorder? Do they fit the criteria or not? How was this fuzzy idea arrived at?

    I guess it is freaking me out, a little, LOL, because the psych lit usually indicates that only 2% (two percent) of the general public suffer from Borderline Personality Disorder. Yet over 25% of people meeting the classification criteria for a particular BODY SIZE are now presented in the media as having this serious mental illness, um, at least to some extent?

    The diagnosis of Borderline Personality is probably the MOST stigmatized psychiatric diagnosis other than the category which used to be called "sociopathic" (not sure what their newest label for that category is). Thus, there is now this double whammy stigma for "over one fourth" of "obese people."

    Even if the claim were proven valid, which I seriously doubt is the case, it would mean that a large percentage of people who are (potentially) expected to lose weight for "health" reasons already have MAJOR challenges to overcome and/or to try and cope with--and many of these people have been routinely treated with a wide variety of psychotropic meds, AND they may have serious endocrine regulation problems in connection with a disordered nervous system (see "chronic stress", above).

    The whole issue seems strange and creepy and sad, given that the media are now potential spreaders of this distressing perspective.

    Okay. One more *sigh*...

  5. Debra, I do not believe "medicalizing obesity" is the same as "pathologizing fat," particularly in the context of Dr. Sharma's stance that obesity should not be defined by a body size, but whether a person is experiencing adverse health consequences from their weight. Right now we have a blanket admonition for anyone over BMI 25 to lose weight "for their health." That's simply "pathologizing fat" in my book.

  6. Damn, I don't have time to watch the video; hoping for a quick analysis/synopsis (yeah I'm an impatient American: who won?? ;-)
    Guess I'll have to surf over to BFB won't I?

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