This is a very controversial topic and it is more prevalent in today’s society than it has been in the history of man(woman)kind. Firstly, I would like to present a couple of different scenarios to you:
- A 16 year old boy with anorexia nervosa is being treated in hospital against his will as doctors and his family believe they are acting in his best interest. He is sectioned under the Mental Health Act 2007
- A 19 year old girl who exercises on a regular basis and is conscious of what she eats.
- A 23 year old girl who is clinically obese with a BMI of 31. She knows she eats unhealthily and doesn’t exercise often but she reasons that this is her choice and she loves her body the way it is.
- A 30 year old man with hypothyroidism (an underactive thyroid with weight gain as a symptom) is struggling to maintain a healthy weight even after eating a balanced diet and working out.
- A 45 year old lady who has been taking steroids (has a side effect of weight gain) for a long period of time is clinically classed as overweight. Her peers have mentioned her weight to her but she blames it on the medication that she’s taking.
I have come across similar scenarios to these either in clinical practice or on social media and they really have made me think about where my views lie when it comes to body image. You can argue both sides to all of the above scenarios and I’m going to try and explain why I think a good body image should reflect a healthy lifestyle.
There is a heavy burden (no pun intended!) of obesity on the National Health Service with direct costs of tackling this problem increasing from £479 million in 1998 to £4.2 billion in 2007; and it’s continuing to be on the rise. I know that money shouldn’t be the core of health care but unfortunately it is and without thinking about the economic burdens of our society, we can’t move forward and flourish on this wonderful planet that has been created for us.
I am all for creating a positive body image and I’m sure most of you are the same! But where do we draw the line? In my opinion, I strongly believe that a positive body image not only comes from loving the body that you have been gifted but also treating it like the most precious things on the planet. This means that you ensure that what you put into your body is of high quality without any additives and that you keep active. Now I know that this is easier said than done, believe me I do! When you’re doing something like medicine where free time to relax is a thing of the past (especially when you’re doing your finals), it can be difficult to keep healthy when the cheapest and easier options are so openly available. But I have lots of friends that are doing incredibly well on the course who eat healthy, go to the gym on most days and keep up with their social life. So it’s not impossible, you just need the willpower!
This leads me on to talking about social media. Now I have seen a number of videos highlighting women who are promoting a good body image and encouraging women to be more confident. I think that it’s great that they’re doing that but these women are clearly “clinically overweight/obese”, although it is important to not loathe your body, I firmly believe that women (and men) should be encouraging one another to live a healthy lifestyle so that we all live a long and peaceful life. I also think think using pre-existing medical conditions or medications that you may be on is not a valid excuse to blame your weight on. It is not impossible to lose weight regardless of this, yes it may be harder, but not impossible.
Me and my colleagues have had a lot of debates on our psychiatry placement regarding eating disorders and obesity. We have tried to understand how it is acceptable to section an individual under the MHA 2007 and force treatment upon them but you can’t do that to someone who is severely obese. I understand that the acute effects of a severe eating disorder can be fatal but so can obesity in the long run (heart disease, diabetes, stroke, mental health problems). The huge financial burden of obesity could be placed in a field of medicine that really needs it.
Having said all of that, it is known that this problem mostly affects those of a lower socioeconomic status. With junk food and sugary drinks being cheaper than the healthier options, ridiculously expensive gym memberships and a lack of sufficient health education; this is a societal problem that the government urgently needs to tackle.
With an ageing population, the current epidemic of obesity brings on a whole wave of new health promotion problems for the new generation of doctors.