Michael Buerk’s controversial comment suggesting the NHS should let fat people die because obesity should not be classed as a disease, unfortunately represents a common misconception about the complicated nature and causes of obesity.
People seem to accept that other disorders relating to food intake, such as anorexia or bulimia, are diagnosable and serious mental health conditions, but for some reason, some people cannot accept that obesity is genuinely a medical illness with foundations in psychological and physiological pathologies. Sadly, there is the misunderstanding that obesity affects only those who live a slothful existence which is far from the truth. There is little sympathy generally for those who choose to live a sedentary lifestyle, but it is important to remember that human behaviour is complicated to understand, and as a psychologist, I would seek to ascertain why someone would choose to live their lives in that way. It may be that they require help and support to enable them to make healthier life choices.
There are many physiological reasons as to why an individual might gain weight; this could be related to medical conditions, genetic factors and side effects of medications. However, food provides a sense of comfort for most of us. In our westernised society, we live in an obesogenic environment which enables us to lead the fast-paced lifestyles that we lead and consequently this encourages regular intake of high fat foods. From a neurobiological perspective, foods that are higher in fat, facilitate the release of dopamine in the brain. Dopamine is the chemical that is released in response to all activities that make us feel good such as sex, drugs, exercise or even watching our favourite film, which is why we tend to repeat these behaviours.
Nevertheless, putting aside the environmental and neurobiological factors which drive us to eat unhealthily, when you consider how our relationship with food is inextricably linked to our cultural and societal norms and our familial relationships, you can start to see how complicated each individual’s relationship with food is.
For people who struggle with obesity, this may be symptomatic of a combination of factors such as their lifestyle, genetic makeup and the obesogenic environment which they inhabit, but for others, it is a serious and genuine psychological problem. Many people, when they are unhappy search for something to counteract that painful feeling, for example, some turn to drugs, some turn to work, some turn to exercise and some turn to food. As a psychologist, if I worked with someone who was diagnosed as clinically obese, the aim would be to understand their life history in order to help them to gain insight into their current relationship with food and how this developed. Taking into consideration the relationship that they and their family members had with food throughout their developmental years is an important part of that process. It is a complicated illness and should be treated with the same respect as other food related disorders, or any other mental health condition.
I think it’s also necessary to add that it is important that those with high profile media presence use their influence responsibly. The last thing that we need right now are people shaming others with mental health conditions simply because they have a lack of understanding about what they are commenting on. This can make it harder for people to come forward and reach out for help, which is the exact anthesis of what mental health professionals are trying to achieve at present.