Biomedical Rationale for a Wellness Approach to Obesity: An Alternative to a focus on Weight Loss
| Autor: | Paul Ernsberger, Richard J. Koletsky |
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| Rok vydání: | 1999 |
| Předmět: | |
| Zdroj: | Journal of Social Issues. 55:221-260 |
| ISSN: | 1540-4560 0022-4537 |
| DOI: | 10.1111/0022-4537.00114 |
| Popis: | The direct medical hazards of obesity, although real, have been overstated. Because current remedies for obesity have little long-term effectiveness, no controlled clinical trial has demonstrated improved longevity after weight loss. In contrast, advances in drug therapy for diabetes, hypertension, and high cholesterol allow obese persons affected by these conditions to live healthier lives. Furthermore, weight cycling may cause much of the cardiovascular risk associated with obesity. Repeated loss and regain of weight increases human deaths from heart disease, and in obese laboratory animals weight cycling increases blood pressure, enlarges the heart, damages the kidney, increases abdominal fat deposits, and promotes further weight gain. Additional health risks in obesity may be caused by hazardous treatments for obesity, as illustrated by heart disease caused by diet pills. Obese patients often lack full access to medical services owing in part to social stigma and low self-esteem, which impair self-care activities, and the bias of health professionals. These barriers, along with the prevalence of poverty among the obese, may contribute to the association of obesity with poor health. Medical beliefs about obesity are shaped by expert panels that are highly selective in the data they consider. Experts included on government consensus panels have been disproportionately drawn from the ranks of diet clinic directors, which might explain the congruence between panel recommendations and the economic interests of the diet industry. One remedy is a wellness approach focused on healthy lifestyle, positive attitude to health and self-care, and a disregarding of predetermined weight standards in favor of preventing further weight gain and reducing risk factors. Medical conditions common in obese patients, including hypertension, type-2 diabetes, hyperlipidemia, and sleep apnea, are dealt with directly and aggressively rather than relying on weight loss as the primary treatment. This new approach should improve the physical and mental well being of obese patients. |
| Databáze: | OpenAIRE |
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