Changing Perception of Obesity in Kuwait

Introduction

Obesity is a condition when the body accumulates excessive fat resulting to a gain in weight to an extent that it poses grave health risks. There are different approaches to effectively measuring obesity such as assessing the skin fold thickness or checking the water displacement of the body. However, the most accepted standard that is used is by comparing a person’s weight with reference to height (Ross) commonly referred to as the body mass index (BMI) in which BMI focal points have been agreed to define what is obese or underweight which is dependent on age, gender, race, and height.  This standard however is much complicated among children because of the diversity of these factors.  Children have different growth patterns and unique genetic physique.  Generally however, obesity among children is pegged at weight-for-height in excess of 120 percent of the ideal.

Dietz (1985) adhered that skin fold measures are more accurate in determining obesity.  Aside from the fact the obesity is visibly discernible by simply looking at the body of a person, skin fold measures are easier to conduct school or clinical setting.

Apart from these obesity Tests, doctors perform other diagnostic procedures in assessing obesity such as an evaluation of family’s health history i.e. diabetes that may directly influence health conditions of the child as well as the eating habits and activity level of the child.

Causes of Obesity

Although there are hereditary and hormonal factors of childhood obesity such as Prader-Willi and Cushing’s syndromes (Kopelman), genetics alone is not the only factor in determining obesity.  The most acceptable and indubitable cause of obesity is the improper diet or high Sedentary intake of energy-dense micronutrient-poor foods and inactivity or the lack of physical exercise.  Following these two accepted factors, different researches were conducted to evaluate the more underlying factors that lead children to eat too much and exercise a little.  One such research highlighted the biological cause for Childhood obesity. Kolata (1985) proposes that people have fat cells that signal the body to overeat.  Thus, accordingly the recidivism rate among obese patients that are already treated is approximately 66 %.

Other biological approaches considered intracellular mechanisms that are related to the conditions of being hungry and process of regulating food. However, the studies only demonstrated body mechanisms that result to different eating patterns or behavior in different people, which do not directly substantiate the cause of obesity.  (Mayer). While essential discoveries have been produced as to the role a person’s biological make up in the development of obesity, the sociological approach provided more in depth explanation to the cause of obesity by evaluating the external factors the lifestyle of person that is constituted among others by eating habits and activities that has a direct impact on obesity.  One study suggested the evolving perception of obesity in modern society which is marked with improvement in food production.  At one time, earlier societies considered women, with the biological capacity to store fat as advantageous or an asset.  “Fat functions as a cushion against food shortages, pregnancy and lactation and became a welcome sign of beauty, health and prosperity.”  (Zerbe)  In modern society where food is promptly obtainable, that advantage posted by an obese body before is no longer relevant.

Perception of Obesity

Obesity has become a major concern particularly in Europe and America. Obesity among children is even a growing concern because of health risk involved, economic repercussion and psychological outlook of our future generation.

Economic: Households with lower incomes have less access to good education and health care which results to lesser knowledge about obesity and its prevention.  Moreover, children from low-income families have parents that are deficient in resources to provide healthy eating lifestyle or exercising. Moreover, as the parents are so preoccupied with working for survival, the need to keep up or be conscious about family appearances is not really a main concern (Kinston).

In terms of the children’s food intake, the selection of the quality of food is ultimately made by their parents.  Because the parents are not so conscious about their appearance or their health as their principal goal is to bring food to the table so that their family has something to eat, low income parents are not very selective in their choice of food.  The quality of the food such as calorie-dense foods i.e. high-fat foods, and fast foods are principal sources of excess caloric intake (Dietz) In terms of physical activity on the other hand, low income people may not have the resources to join health clubs as well as the purchase facilities i.e. exercise machines, among others which will allow their children to exercise and burn fats.

Despite these insightful explanations, research studies show that social class has no conclusive association with a child’s obesity. There is no one to one correspondence between being poor and being fat.  (Malnor) In fact, being poor will most logically lead to malnutrition instead of obesity because of the lack of healthy food on the first place. This is reflective in Kuwait as obesity is common among the affluent. (AI-Isa)  Moreover, a healthy lifestyle is not an expensive lifestyle.  (Edlin et al). Staying healthy does not entail taking supplementary pills for enhancing the body, taking gym classes or buying expensive equipment or hiring a fit doctor or instructor.  Staying healthy is a matter of knowing and doing the right activities and avoiding the wrong activities that is practically affordable to most people.

Social: Parents play a critical role in preventing obesity in their children.  Not only because parents are principally responsible for what the children eat, have they also served as role models for kids. Hence, if the parents are unmindful or neglectful of their health; children will most likely tend to be the same. In a study conducted by the Chronic Disease Nutrition Branch of the Centers for Disease Control and Prevention, “a mother’s perception of her overweight child can be tainted by gender”.  Study shows that more mothers perceive their daughters as being “overweight” than their sons. (Society for Women’s Health Research, 2003) This study is significant because it has vital repercussions for the youth’s misguided perception especially among women to combat obesity, which can lead to the development of eating disorders and inferior self-image/ depression because of negative reinforcement from media and peer pressure.

The media is a powerful force that influences and conditions people and shapes their behaviors and actions.   It has the ability to educate or miseducate the public.  Because of this, it can be used as a commanding and vigorous conduit for propaganda by institutions such as commercial companies and the government.  The media characterize the “thin body” as ideal and beautiful and depict the “fat” as funny and ugly. (Bryan)  In the film and fashion industry, both actors/ actresses and models embodies the ideal thin bodies that are attractive.  On the other hand, the “fat” actors/ actresses usually partake humorous roles while stories about fat people are often comedic.

Cultural: The role of culture is considered in analyzing eating habits and physical activity of people because these factors basically shape and influence a persons lifestyle as well as attitudes and beliefs toward exercise, food and nutrition, among others. (Ling)  For instance, the fondness of Japanese people to sushi and fish products or the Chinese people’s king fu tradition, which is as a healthful training exercise may possible contribute to a relative scarceness of obese Asian Americans compared to Whites, blacks and Hispanics.

Psychological: An unhealthy lifestyle which includes alcoholism, drug abuse and overeating can also be a symbol or symptom for a psychological impairment. (Wolman and DeBerry)   Some people resort to unhealthy activities or even dormancy i.e. overeat to cope or deal with psychological problems.  For instance a person suffering from Dysthymia, a form of depression that involves a loss of appetite for happiness and pleasure or loss of enthusiasm or interest to live one’s life so to speak.  It is marked by low mood, low self esteem, loss of energy that is further manifested by a change in appetite resulting to weight loss, lack of sleep or oversleeping, difficulty in concentrating and withdrawal from the social environment.  The depressed person feels one’s life worthless which may trigger thoughts of ending one’s life.   Nevertheless, the depressed person has remained in his/ her rationality or senses.  It is often long term condition however does not totally disable the person to function a normal life. However, depressed condition still affects the quality and quantity of effort, output and general productivity of the person.  In which case, obesity can be perceived as an indication of depression

Kuwait’s Perception of Obesity

To understand the Kuwaiti perspective on obesity, a survey to 50 people was conducted and revealed intriguing results about the general perspectives of Kuwaiti people about obesity. Random sampling was used and the age is used as the principal variable factor for the study.  25 respondents came from people between ages 45-65 and the remaining respondents from 18-35.  Generally speaking, the larger the sample size of the population to be surveyed, the higher the accuracy of the results of the survey.  However, due to financial and time constraints and simplicity, a sample of the population that is represented of the demographics of the area was not represented in the sample that was surveyed.  One of the major limitations of this survey is the sampling method.  The focus in sampling only considered age and not the educational background, economic status and gender.  The respondents were randomly selected from the acquaintances and friends of the researcher. As such, its findings may not necessarily be representative of the general sentiment of the people but it nevertheless provided insightful hints and trends on what to expect when a similar survey is conducted properly.

The issue of obesity is most pressing in Kuwait especially so because the nation has the highest obesity level in the world with approximately 75% of its 2.5 million population suffering from obesity.  Moreover, the problem has an economic repercussion of at least $2.8 billion yearly, thus a policy to trim down obesity incidence is urgent. (Rotimi)

With this is mind, there is a general concern about obesity in Kuwait as revealed in the survey.  Majority of the Kuwaitis consider obesity as a growing concern.  Media and the government are the major factors in amplifying the severity of obesity as an epidemic through greater media attention and visibility that highlight on its disadvantages both in terms of health risks, economic consequences, social imagery implications.   Despite this general sentiment, a large number of respondents can be considered obese by virtue of sheer observation of the researcher.  Summary of survey results can be found in Appendix 1.

In a similar study conducted on obesity among Kuwait University students, “A.N. AI-Isa Kuwait ascribe affluence and modernization and the dynamic changes in the level of physical activity and caloric intake as the principal cause for obesity among students”. That increased levels of education and greater income are associated with obesity indicates that lifestyle factors play a critical factor in obesity among Kuwaitis. Moreover, in the study of Lafta  and Hayyawi, they reported that people in Kuwait tend to accept and tolerate obesity.  This can be supported by our survey findings. Many of the older respondents (75%) refuse to consider themselves as obese.  This is in contrast to the perception of the younger respondents; approximately 80% of the younger respondents were willing to accept that they are obese and are willing to undergo anti obesity programs.  This survey evinces that there is a changing perception about obesity among the younger generation of Kuwaiti population.  While the Kuwaitis generally consider obesity as a pressing problem, the younger generation were more willing to accept of their obesity.  And acceptance is the first step to solving the problem.

The difference between the perception of respondents from the older and younger brackets has something to do with the “social multiplier effect” of obesity.  Changes that increases average weight i.e. decrease in food prices, can in turn result to people adding weight because the conventional weight level regarded as normal or ideal also increase or vice versa. (Eckel)  Among the older respondents, the relative affluence that Kuwaiti had enjoyed have increased the average normal weight for Kuwaiti’s thus many of the older folks do not consider themselves as overweight. Hence, they may consider the increase in weight among Kuwaitis as normal and acceptable.  The younger respondents on the other hand focus on the social contagion of obesity brought about by media.  People manage their weight because of the desire to be healthy and look socially acceptable and attractive.  This is supportive of the modern trends where the new generation is more figure and health conscious. (Baughman)

Among the disadvantages that the respondents provided about obesity include social and fashion implications as well as health risks such as hypertension and coronary heart disease, skin related diseases and respiratory and circulatory functions and psychological consequences among others.

The younger generation is in the age of information technology where the power of information has the capacity to change the direction of the global society.  Media (cable television and the internet) plays a central function in partaking the power of information in molding opinions and behavior of the people across nations and across different cultures.  It has played a vital role in promoting against obesity among the younger generation through information dissemination and overload, which is a distinctive feature of the modern society.

Conclusion

Solving the problem of obesity entails understanding the people’s perception of fatness.  This is an important step in combating the problem of obesity in Kuwait, which currently leads obesity rankings.  Food consumption, lack of physical activity and sedentary behaviors are the direct cause of obesity. However, these factors are further shaped by economic influences, lifestyle and other social factors (i.e. media). Survey conducted revealed that there is a changing perception about obesity in Kuwait.  Majority of the older Kuwaiti respondents consider obesity as a consequence of prosperity with the greater food production, which explains their inherent predilection to tolerate fatness. The younger Kuwaiti respondents however gave a more promising perception.  With their more exposure to information and campaign about obesity (through media and the internet), they perceive obesity in terms of health risks and social attractiveness.  Consequently, they are also more disposed to accept their obesity and are keen to fighting obesity.  The changes in perception provides a more promising outlook for Kuwaitis as it suggests that the younger generation are more responsive to averting obesity in the country.

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