The biological approach to obesity as a social problem

Obesity is a social problem that has reached “epidemic” proportions (Joe, 2014, p. 1). Although it is a personal and public health issue, being linked to a slew of issues like diabetes and heart disease, obesity is unique in that it is also a social issue. People who are obese suffer from psychological distress and report feeling social stigma too (Jou, 2014). Moreover, obesity is a complex issue with clear connections to socioeconomic class, making it important not to oversimplify (Pera, Ferrer, Juarez, et al., 2016). Yet for more than a century, researchers have recognized the biological and genetic precursors to obesity, and the biological approach remains one of the most important to apply to the study of this prevalent social problem. The biological approach to obesity helps shed light on the reasons why public health and awareness campaigns have generally failed to result in a decrease in obesity rates. Many public health and awareness campaigns educate the public about healthy eating and exercise, which is great for preventing obesity in the general population. Yet these awareness programs fail to take into account the genetic and biological factors, or the socioeconomic and infrastructural factors, that also impact disease etiology. Moreover, the biological approach to obesity shows why diet and lifestyle changes do not result in desired outcomes for a number of patients and why obesity remains difficult to treat (Pera, Ferrer, Juarez, et al., 2016). As Ochner, Tsai, Kushner, et al. (2015) point out, improved lifestyle choices can lead to “lasting reductions in bodyweight prior to sustained obesity,” but “once obesity is established...bodyweight seems to become biologically stamped in and defended,” (p. 232). Obese individuals “never truly recover,” even if they experience temporary weight loss (Ochner, Tsai, Kushner, et al., 2015, p. 232). The metabolism remains the biological system most culpable for creating the pathways whereby obesity becomes chronic. Genetics also play a major role in the biology of obesity. Studies of adopted individuals, and also studies of twins have shown how important genetics are in determining predisposition towards obesity (Joe, 2014). The biological approach also has additional social benefits, such as helping to reduce stigma and shame associated with obesity. When obesity is framed as a complex issue, the blame is shifted from the individual to the broader community to come up with feasible solutions for social change. Another benefit of the biological approach is that it tends to highlight the importance of programs that prevent obesity. After all, if it is known that some people are genetically prone to obesity, and that people who have been obese all their lives are unlikely to benefit from sustained dietary or exercise regimes because of physiological factors, then research could be devoted more to pharmacological or genetic interventions, even while local, state, and federal governments work hard to improve community infrastructure to promote more physical activity. There are some drawbacks to the biological model, though. One is that it promotes a mechanistic view of the body and discounts the social, economic, and psychological factors that contribute to obesity. Another is that the biological approach leads to the disease model, which “medicalizes food,” and leads to “dogmatically” applied dietary recommendations that are offered “independently of the sex or cultural group to which the obese person belongs,” (Pera, Ferrer, Juarez, et al., 2016, p. 957). Focusing on biology also obscures some of the other proximate causes or variables, which could lead to less interest in prevention and fewer physicians recommending dietary and lifestyle interventions for at-risk patients. The biological approach, if given too much credence, could be misinterpreted in ways to suggest that lifestyle, economics, and the environment do not matter when in reality an interplay between these factors is critical for understanding disease etiology for obesity.