queen latifah wants to change the way we talk about obesity
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queen latifah accepts the lifetime achievement award during the bet awards at microsoft theatre in los angeles, california, u.s., june 27, 2021. reuters/mario anzuoni org xmit: mexsin
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queen latifah wants to talk.
the hollywood icon recently launched it’s bigger than me with danish pharmaceutical company novo nordisk, a campaign with the goal to create “open and shame-free conversations about weight and obesity.”
“when i was diagnosed as being in an obese category about 20 years ago, i didn’t see myself that way. it was a shock, kind of, to me,” says latifah. “having learned more, i understand. and i’ve kind of created a journey to really understand my body and how it reacts to certain things when it’s feeling a certain way.”
throughout her journey, latifah says that she has constantly had to push through barriers to achieve her success. now, she’s looking to hold the door open for others and is addressing her experiences head-on, including common misconceptions about living with obesity.
latifah says she’s felt shame and self-loathing connected to obesity
stigma associated with obesity can carry a significant psychological toll that carries an effect on both physical and mental health.
“i remember throughout my life, at periods of time, i would get this flash of … this self-hate, self-loathing. it was just weird. it was scary,” says latifah. “and it was something that i had to really try to control. i couldn’t control when it happened to me, but i try to turn my mind around and try to get out of that space.”
while latifah found love for herself and chose to stand up for both her career and personal life, she says she is concerned about kids who are grappling with harsh words and assumptions directed their way.
and her concerns are well-founded. a 2020 review published in current obesity reports emphasized that weight stigma, rather than weight itself, causes psychological distress in teens that can lead to depressive symptoms, low self-esteem and suicidal ideation. for example, a survey of 13,740 adolescents in the netherlands reported teens with a higher weight were at a greater risk of bullying, which led to a greater risk of suicidal thoughts.
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“i grew up thinking i’m not good enough,” remembers priti chawla, executive director of advocacy organization obesity matters. “ … i still grapple with those thoughts that i’m not good enough. and that definitely has an affect on you mentally, because then you always feel you’re lazy. you’ve been told you’re lazy, you’ve been told you’re stupid, just because you have this weight.”
ian patton, phd, director of advocacy and public engagement for obesity canada, adds that the shame and stigma associated with obesity can also impact a patient’s connection to health services.
“you’re told for a really long time that there’s something wrong with you because of your weight, or because of your size and that you should be able to fix this on your own,” says patton. “ … there’s a lot of shame attached to that. so when we go to a doctor or health professional, we’re not going to be open or super eager to have those conversations because we don’t feel like we deserve that help.” (obesity matters and obesity canada are not part of the it’s bigger than campaign)
‘diet and exercise are not cures for obesity’
suggesting that obesity can be changed simply by eating less and moving more is an oversimplification of a complex problem, says patton.
obesity is often associated purely with lifestyle choices, even though research has long since indicated the complicated relationship between genetics, environment and psychosocial factors. one 2017 review reported that approximately 50 per cent of weight variance is determined by genetics, and also pointed to hormonal mechanisms within the body that jump into action to reduce metabolism and increase hunger when a patient begins to lose weight.
“i’m a kinesiologist by training myself, so i’m someone who believes very strongly that diet and exercise are incredibly important for every human in terms of their overall health and well-being,” says patton. “but if you look at what the evidence and science suggests, diet and exercise are not cures or solutions for chronic disease. they are part of that equation, but in and of themselves they are not successful.”
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the role of metabolism in obesity
a famous example of the significant metabolic changes after weight loss involved the participants on the biggest loser — an american reality show that features contestants in larger bodies competing to win a cash prize by losing the highest percentage of weight.
a study published in the journal obesity (silver spring), reports the resting metabolic rate (rmr) and body composition of participants at the start and end of the 2016 reality tv season. while metabolism is expected to slow with weight loss, this study found that participant’s rmr decreased by an average of 789 calories per day — more than 500 calories more per day than what was expected from basic height-weight predictions. a follow-up six years later found that the decreased metabolism effects largely remained.
“so let’s say someone [was] 400 and some odd pounds, and they got down to 200 pounds,” explains patton. “to maintain 200 pounds — just throwing numbers out there — a ‘normal person’ would need 2000 calories a day to maintain that. the participants on that show, their maintenance calories that they would require were found out to be like 500 calories less, or 1500 calories.
“so if they were eating what was recommended by everyone in the world … they would actually gain weight because their metabolisms didn’t line up with the average person of that size. that’s essentially a meal a day.”
recognizing obesity as a chronic health condition
advocates say wider recognition of obesity as a health condition is a simple change that can help canadians live longer, healthier lives.
in 2018, 26.8 per cent of canadians 18 and older reported height and weight that are classified as obese, while 36.3 per cent had a height and weight classified as overweight, according to stats canada. together, this means a majority of canadian adults have greater health risks due to their weight.
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the who recognized obesity as a chronic disease in 1997, with the american medical association calling obesity a “disease state with multiple pathophysiological aspects,” in 2013. meanwhile, in canada, the canadian medical association recognized obesity as a chronic disease in 2015, followed by saskatchewan in 2015, the yukon in 2019, ontario in 2020 and alberta in 2021. still, there remains a gap for preventive and maintenance treatment. instead, health dollars are largely directed to diagnosis that could have been prevented had the obesity been treated in time.
“roughly 63 per cent of canadians are living with increased health risks due to excess weight,” says chawla. “ … no treatment indicated for overweight or obesity are currently reimbursed on the regional drug plans. it’s frustrating … that weight stigma seems to play a major role in patients seeking equitable care.”
understanding the complexities of this condition aren’t meant to be defeatist. instead, advocates point out that recognizing obesity as a complex chronic disease, similar to how hypertension and diabetes are viewed, leads to more treatment options and better long-term health outcomes. it can also help prevent the use of unregulated weight-loss traps and the dangerous effects of yo-yo dieting.
“we can treat it as a condition and talk to our doctors about it and do something about it, and live healthier lives,” says latifah. “ … that’s what the goal is — you want to be happy, you want to be healthy, and you want to live your life.”
lisa machado, executive producer of healthing, sits on the advisory board of obesity matters.
emma jones is a multimedia editor with healthing. you can reach her at emjones@postmedia.com or on instagram and twitter @jonesyjourn.
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