To be­gin this dis­course, my first in­stinct is to speak about obe­si­ty as a dis­ease of glob­al pan­dem­ic pro­por­tions and to do so be­cause of the prej­u­dices and bias as­so­ci­at­ed with liv­ing with ex­ces­sive weight.

The re­search on this glob­al pub­lic health is­sue presents a lot of learn­ing which com­pels me to cu­rate a bet­ter-in­formed re­sponse to the sub­ject. It is a con­tin­u­ous guide to my fo­cus on the in­ter­re­la­tion­ship with men­tal health, well-be­ing, and men­tal ill­ness­es.

The preva­lence of peo­ple hav­ing both a men­tal health con­di­tion and obe­si­ty shows a bidi­rec­tion­al as­so­ci­a­tion of high mag­ni­tude. Peo­ple liv­ing with men­tal ill­ness­es have shown high sus­cep­ti­bil­i­ty to obese weight, and peo­ple with obese weights are more like­ly to be di­ag­nosed with a men­tal ill­ness than the gen­er­al pop­u­la­tion.

The lit­er­a­ture on the for­mer as­so­ci­a­tion is heav­i­ly fo­cused on de­pres­sion’s im­pact on obe­si­ty, but stud­ies on oth­er se­vere men­tal ill­ness­es (SMI) like bipo­lar dis­or­ders have shown an equal­ly high risk for de­vel­op­ing obe­si­ty.

The Obe­si­ty Ac­tion Coali­tion of Flori­da, USA (2017), re­ports that a study fo­cused on bipo­lar dis­or­der and schiz­o­phre­nia showed obe­si­ty as more preva­lent with SMI. It says 50 per cent of women and 41 per cent of men with SMI were found to be obese as com­pared to 27 per cent and 20 per cent of women and men re­spec­tive­ly, who did not have an SMI.

They al­so re­port­ed that “Lon­gi­tu­di­nal stud­ies cen­tred around de­pres­sion re­vealed the as­so­ci­a­tions in both di­rec­tions: peo­ple with obe­si­ty had a 55 per cent in­creased risk of de­vel­op­ing de­pres­sion over time, while peo­ple who were de­pressed had a 58 per cent in­creased risk of de­vel­op­ing obe­si­ty.”

See­ing the bidi­rec­tion­al link is not com­plex ei­ther, since some risk fac­tors for men­tal ill­ness­es are fac­tors that pro­mote over­weight and obe­si­ty: overeat­ing/emo­tion­al eat­ing, seden­tary liv­ing/low phys­i­cal ac­tiv­i­ty, and poor de­ci­sion mak­ing and self-man­age­ment.

A per­son man­ag­ing a men­tal health con­di­tion suf­fers from is­sues like low self-es­teem and a con­stant neg­a­tive de­fault of the mind, which both work to sab­o­tage an in­di­vid­ual’s health and well­be­ing.

A per­son man­ag­ing over­weight or obe­si­ty sim­i­lar­ly is im­pact­ed by sev­er­al so­cial, en­vi­ron­men­tal, bi­o­log­i­cal, and psy­cho­log­i­cal is­sues, among oth­er fac­tors, that lead to bad well-be­ing and men­tal ill­ness­es.

About obe­si­ty

A sim­ple de­scrip­tion would be that obe­si­ty is hav­ing ex­cess body weight for a giv­en height, which may im­pair health. In sci­en­tif­ic lit­er­a­ture, obe­si­ty is pre­sent­ed fre­quent­ly with the is­sue of be­ing over­weight.

Body mass in­dex (BMI) is the most com­mon as­sess­ment of over­weight and obe­si­ty. It is a ra­tio of a per­son’s height to their weight. If a body mass in­dex (BMI) score is over 25, a per­son is con­sid­ered over­weight, over 30 is obese, and greater than 40 is de­scribed as very se­vere obe­si­ty.

Obe­si­ty is a dis­ease marked by ab­nor­mal de­posits of body fat—about 20 per cent above ide­al body weight—which is ac­cu­mu­lat­ed main­ly be­cause the en­er­gy con­sumed be­comes rou­tine­ly high­er than the en­er­gy ex­pend­ed.

Oth­er ex­pla­na­tions are con­sid­ered for de­vel­op­ing the dis­ease such as a per­son’s so­cioe­co­nom­ic sta­tus, poor health sys­tems, and en­vi­ron­men­tal fac­tors.

And it is a dis­ease.

Un­like what our blink­ered views may tell us and what me­dia have in­flu­enced us to be­lieve, it is not a re­sult or symp­tom of lazi­ness, greed­i­ness, or of peo­ple just not want­i­ng to get off their couch­es and ex­er­cise, but is a more com­plex con­di­tion that de­serves our in­vest­ment in time and (good) read­ing to im­prove our un­der­stand­ing and in­crease need­ed em­pa­thy.

The Obe­si­ty Med­i­cine As­so­ci­a­tion de­fines it as “a chron­ic, re­laps­ing, mul­ti-fac­to­r­i­al, neu­robe­hav­iour­al dis­ease, where­in an in­crease in body fat pro­motes adi­pose (fat) tis­sue dys­func­tion and ab­nor­mal fat mass phys­i­cal forces, re­sult­ing in ad­verse meta­bol­ic, bio­me­chan­i­cal, and psy­choso­cial health con­se­quences”.

Obe­si­ty is cor­re­lat­ed with mor­bid­i­ty, di­min­ished qual­i­ty of life and life ex­pectan­cy. Chron­ic obe­si­ty is as­so­ci­at­ed with meta­bol­ic dis­or­ders (eg di­a­betes), mus­cu­loskele­tal dis­or­ders (eg os­teoarthri­tis), and non-com­mu­ni­ca­ble dis­eases like can­cers. Obe­si­ty in­creas­es the risk of heart and cir­cu­la­to­ry dis­eases (eg heart fail­ure and coro­nary heart dis­ease) and is a pre­dic­tor for hy­per­ten­sion, which is al­so a risk fac­tor for many oth­er ill­ness­es.

Signs and symp­toms in­clude el­e­vat­ed con­di­tions as­so­ci­at­ed with fat ac­cu­mu­la­tion such as im­mo­bil­i­ty, sleep ap­nea, and low self-es­teem.

Mod­i­fiers pro­posed are usu­al­ly prop­er nu­tri­tion and in­creased and reg­u­lar phys­i­cal ac­tiv­i­ty. Sur­gi­cal and phar­ma­co­log­i­cal in­ter­ven­tions are pre­scribed in cas­es of ex­ces­sive obe­si­ty.

Re­gard­ed as a pan­dem­ic, obe­si­ty preva­lence in­creas­ing­ly presents an aus­tere glob­al health threat in both chil­dren and ado­les­cents (aged five-19), and in adults, and is pro­ject­ed for un­re­lent­ing growth. Sci­en­tists prof­fer, at cur­rent trends, about 50 per cent of adults glob­al­ly are pro­ject­ed to be over­weight/obese by 2030.

The preva­lence of obe­si­ty in T&T is es­ti­mat­ed in adults 18 and over as 29.6 per cent in women and 12.9 per cent in adult men, ac­cord­ing to the Glob­al Nu­tri­tion Re­port (glob­al­nu­tri­tion­re­port.org). A 2019 Joint Se­lect Com­mit­tee of the T&T Par­lia­ment re­port­ed the com­bined na­tion­al rate of over­weight/obe­si­ty (adults and chil­dren) here as 51.1 per cent.

(To be con­tin­ued next week)

Car­o­line Rav­el­lo is a strate­gic com­mu­ni­ca­tions and me­dia

pro­fes­sion­al and a pub­lic health prac­ti­tion­er. She holds an MA with mer­it in mass com­mu­ni­ca­tions (Uni­ver­si­ty of Leices­ter) and is a mas­ter of pub­lic health with dis­tinc­tion (UWI). Write to

mind­ful.tt@gmail.com.