The other side of the story

Rohit’s uncle who lives in Bhopal has two very bright, chirpy, extremely lovable kids, 9 and 14 each. Of late we’ve noticed that they have acquired the look of mini sumo wrestlers, which to me isn’t a particularly good look if you can help it. So Rohit mentioned this to his Uncle one day. And got an incredulous look that translated in to ‘you’re either bonkers or under the influence of a cocktail of unmentionables.’ Followed by a retort “arrey khaate peete ghar ke hain to pata bhi to chalna chahiye.”


I live in a country (Scotland) which is second only to the US in terms of the number of Obese. The Americans have been the most obese in the world now for some years. It has been estimated that one out of every four Americans is now frankly obese as opposed to just being overweight – defined as having a body mass index of more than 30. (Body mass index is calculated as the body weight in kilograms divided by the height squared. So, it’s a true measure of how much weight there is in relation to height, in other words, body surface area. So, a shorter person will hit the high BMI mark of 30 with a lot less weight than a taller person.) Looks like the trend is catching up in India faster than anyone imagined.

One of the scariest adverts for me of recent times has been this:
“McDonald's India: As Indian as you and me……..”

This euphemistically worded ad conceals in it, a very deep intent to penetrate the Indian market and inundate it with what has been the undoing of health aspirations of a generation of Americans and more recently Brits. And looks like our folk have lapped it up like there’s no tomorrow. It used to be said that things that were happening in America reached India maybe with an 8-10 year lag. Now of course this gap is a lot shorter and in the case of practices with a serious potential for self harm, this seems to be instant. So upper class Indians have rushed into the race to be ‘fat and merry’. Even more alarming is the trend in children. In the UK, around 27 per cent of children are now overweight and research suggests the main problem is a continual reduction in the amount of exercise children take. Many overweight children have overweight parents - it's often a matter of family lifestyles. Obesity in the UK is now normal in society and someone with a bodyweight within the recommended range, stands out. How much longer before we start to boast of similar statistics? In adults, obesity causes increased risk of cardiovascular events, diabetes, arthritis and so on. The same risks are now beginning to emerge in children. Obesity increases the risk of insulin resistance and type 2 diabetes which is normally a disease seen in later life in adults. However, increasingly children in their teens are presenting with type 2 diabetes as a consequence of being obese. Young girls run the risk of Polycystic Ovarian Syndrome (PCOS) with long term sequelae of cardiac disease, diabetes and even cancer of the womb. Obesity in fact has moved on from being a ‘pre-disposing’ factor to certain health conditions to actually being part of a spectrum of diseases.

Indians when they emigrate to other countries, take their genetic risk, something called syndrome X which is commoner in South Asian populations, with them. They then adapt to the lifestyles and food habits in these countries and are consequently at even greater risk than the indigenous population. In the UK, an organisation called South Asian Health Foundation (SAHF) is working towards spreading awareness of these issues.

It’s a question of changing the outlook to health. Being a little chubby should no longer be seen as a matter of pride or a mark of affluence. On the other hand I am not for one instant suggesting that we should all join the size zero cult. That has problems of its own. In the UK, obsession with size zero has long been the bane of life for every impressionable teenage girl. Of late, there has been a counter offensive of sorts with a new pageant for plus size women. (http://www.youtube.com/watch?v=kEOuqjpQ5g8)

While it may just be a backlash against an unholy trend for unnaturally thin women’s bodies, the implications of this sort of ‘glorification’ of what’s essentially a health problem, are grave. It sends the wrong signal to women struggling with their body image. It seems teenage girls are no longer at risk of falling a victim to the epidemic of anorexia –but of obesity. It promotes a culture of overeating and not exercising as these are now considered ‘okay.’ Try telling these girls that in ten years time they would be in and out of hospitals with diabetes or angina and that might be a more realistic picture, albeit one that is bound to raise the hackles of a number of these proponents of ‘curvy’ figures. This is just political correctness gone crazy. In fact it got so bad at one point that a colleague was cautioned by the management when a patient complained about being ‘made to feel guilty’. The doctor in question, who is an obstetrician, had given the woman a fact sheet about the precise number of complications that increase in an obese woman in pregnancy…all substantiated by well validated studies. It is a crime if you so much as hint about losing weight, in order to minimise so many health complications. Of late, the trick I use is to pass on the counselling bit to my nurse who at a ‘plump’ 83 kgs, is seen by a lot of people as ‘one of them’ and is therefore not as unacceptable as me.

While I completely accept that someone who as a result of a medical condition cannot lose weight (women with PCOS, for example need a lot of extra support to shed those extra pounds) should not be blamed for the resulting health conditions, I can absolutely not believe that 30-40 percent of a nations population is destined to be obese and unhealthy and can do nothing about it. People need to take more responsibility for their own health. And this does not necessarily mean having a blame culture in healthcare, which is what many suppose this is all about