Obesity and Stigma: Important Issues in Women's Health

By Price, Judy M.; Pecjak, Vid | Psychology Science, January 1, 2003 | Go to article overview

Obesity and Stigma: Important Issues in Women's Health


Price, Judy M., Pecjak, Vid, Psychology Science


Summary

The prevalence of obesity in women in the U.S. and Europe has reached epidemic proportions, and rates of obesity are growing rapidly even in the developing regions of the world. Consequences of obesity include negative health outcomes as well as economic, social, and psychological costs, affecting both the individual and the community. Etiological theories of obesity are discussed, and the current most popular weight loss therapies are described. Cultural and gender differences in the stigmatization of obesity are considered. Advances in knowledge of how obesity develops and is maintained point to the error in blaming the obese for their condition.

Key words: Obesity, Stigma, Overweight, Gender Differences, Cultural Differences

Introduction

In looking at women's health issues in recent years, one of the conditions that has been discussed most widely, and viewed most negatively, is obesity. Its widespread occurrence has led to its designation as a "global epidemic" (World Health Organization [WHO], 1998). According to current estimates, more than one-third of the adult population in the U.S. is obese. Europe does not lag far behind, with the average prevalence rate being roughly 18% (WHO). The World Health Organization's latest survey of 93 countries found that in the past 7 years the average rate of obesity has increased by about 15%. Ironically, even in countries where major proportions of the population experience famine, and suffer and die from chronic malnutrition, other segments of the population are becoming obese (WHO). And consistently in those areas where obesity exists, its prevalence is higher for women than for men.

This paper deals with the plight of obese women, particularly in the United States and Europe. Topics addressed include the prevalence of obesity, associated health problems, related economic costs, theories of etiology, and current treatments. Psychological and social aspects of obesity are emphasized, with particular focus on the stigmatization of obesity. The theoretical underpinnings and ramifications of treating obesity as a stigma, and why the manifestation of this stigmatization may differ in different cultures, are discussed. We argue that this stigmatization is particularly inappropriate given our current knowledge of the etiological factors of obesity.

Definitions and Descriptions

Obesity is defined by the World Health Organization (WHO, 1997) as an excess of body fat leading to negative health consequences. A number of different methods of measuring obesity have been used in research and clinical settings. Sophisticated techniques for accurately assessing degree of body fat include underwater weighing, magnetic resonance imaging, bioimpedance analysis, and total body electrical conductivity analysis (Heymsfield, Allison, Heshka, & Pierson, 1995). However, the most clinically relevant measure, and the one most frequently used at present, is the Body Mass Index, or BMI. Although technically not a measure of body fat, this height-normalized index agrees with other measures of total body fat. The BMI is calculated by dividing the individual's weight in kilograms by her height in meters squared.

The WHO has established a standard classification system for obesity based on BMI, as shown in Table 1. The Normal BMI range is 18.5 to 24.9, Overweight, or Pre-obese is 25.0 to 29.9, Obesity class I (moderate obesity) is 30.0 to 34.9, Obesity class II (severe obesity) is 35.0 to 39.9, and Obesity class III (very severe, or morbid obesity) is 40.0 and above. A BMI of 25 corresponds to approximately 115% of "ideal" weight/height, BMI of 27 to 120% of "ideal," and BMI of 32 to 140% of "ideal" weight. Because women's bodies have higher proportions of fat than men's-in young women typically 20 to 25% of total body weight is fat, while the proportion in young men is approximately 15 to 18%-at a given weight per height, slightly higher cut-off points for obesity may be used for men (Dwyer, 1994). …

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