Contexts Crawler

ABC News explores some possible causes of obesity that are often overlooked.

Sure, most of the nation needs to eat less and move more. But is that the only reason America is so fat?

As more scientists and sociologists look at our bulging waistlines, some unusual explanations for the nation’s weight gain in the last 30 years are popping up.

The article discusses an intestinal bacteria that may contribute to weight gain and particular genes that may influence the success or failure of dieting.

Beyond these physical explanations, social factors may also contribute to obesity. A Harvard medical sociologist weighs in:

In 2007, an article in the New England Journal of Medicine used 30 years of data on 12,000 people to show obesity and weight loss may actually be contagious — things that spread among people who know each other.

“They key idea is that people are influenced by the behavior and actions of those around them. This applied to something that people may not have thought of, which is body size,” said Dr. Nicholas A. Christakis, author of the recent book “Connected,” which looks at how various phenomena from depression to obesity spreads through society.

Over the three decades, Christakis showed how obesity in one person in a circle of friends statistically meant more people in their circle of friends would become obese. The same was true of weight loss.

“We’re not saying we found the cause of the obesity epidemic. We’re not,” said Christakis. “Social networks have a general property that they magnify what they are seated with.”

While Christakis could show an obesity epidemic spreading through friend networks, he could only make an educated guess why.

“One possibility is that you start doing things — certain behaviors that I copy,” said Christakis.

So if one friend starts serving beer and cookies all the time, perhaps another friend will pick up the habit. Or if one friend joins a running club, perhaps another friend will join it too.

Christakis said another possibility is that “What’s spreading between people is an idea, or a norm.”

For example, if most people a person associates with are overweight, then that person’s idea of “normal weight” is likely to be bigger than what is actually healthy.

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Many skinny Americans are fed up with obesity, reports the Los Angeles Times:

“Americans as a society are getting fed up with the matter of obesity. No doubt about it,” said Douglas Metz, chief of health services for American Specialty Health, a San Diego-based company that offers wellness programs to employers. “Some pockets of society are taking positive action, and unfortunately others are taking negative action. That’s what happens when a society hasn’t figured out what the fix is.”

Recent notable actions include:

* A recent and ultimately unsuccessful plan at Lincoln University in Pennsylvania sought to take the body mass index of every enrolling student and require the obese to lose weight or take a fitness class before they could graduate.
* In Mississippi, legislators tried to pass a bill to let restaurants prohibit obese people from dining.
* In an interview with the New York Times last August, Toby Cosgrove, chief executive of the Cleveland Clinic, one of the nation’s largest medical centers, provoked national outrage when he said that, if it were up to him, he would stop hiring the obese. He later apologized for his remarks.
* Last summer in Florida, animal rights activists at People for the Ethical Treatment of Animals (PETA) took aim at heavy women in a “Save the whales” billboard campaign that featured an overweight, bikini-clad woman. It read: “Lose the blubber. Go vegetarian.” Angry reactions caused the organization to remove the signs.

Statistics about obesity are being assessed in the current debates on how to reduce the nation’s health care costs:

A report by Emory University researchers projected last November that by 2018 the United States could expect to spend $344 billion on healthcare costs attributable to obesity. Obesity-related costs would account for 21% of healthcare spending, up from 9.1% today, said the report, sponsored in part by the United Health Foundation and the American Public Health Assn.

Providing a different take on the issue, it’s time to call in the sociologist:

“In our society, being heavy has become more of a stigma lately because we’re struggling with other issues of consumption,” says Abigail Saguy, associate professor of sociology at UCLA.

The economic climate, a recent history of people buying more than they can afford as well as environmental issues, including the depletion of our planet’s resources, are making people feel more angry about society’s overconsumption, she says. Obviously overweight people are an easy target.

“They’re almost a caricature of greed, overconsumption, overspending, over-leveraging and overusing resources,” says Saguy. “Though it’s not entirely rational, it’s an understandable reaction, especially in a country founded on the Puritan ethics of self-reliance, sacrifice and individual responsibility. If people feel they’re sacrificing, then see someone spilling over an airplane seat, they feel angry that that person is not making the same sacrifices they are.”

Research indicates that discrimination based on weight has been increasing in recent years:

Rebecca Puhl, a researcher at Yale University’s Rudd Center for Food Policy and Obesity, published [two papers] last January — one in the journal Obesity, the other in the International Journal of Obesity — Puhl reported that weight discrimination in the United States increased 66% over the prior decade.

“Weight discrimination is highly prevalent in American society and increasing,” said Puhl, who cites several possible reasons. Among them are a lack of legislation to prohibit weight discrimination and an increase in media coverage of obesity (up fivefold from 1992 to 2003). Most media framed the problem of obesity as one of personal responsibility, she reported.

New research on the social network effects of obesity was recently reported in the Guardian UK:

Children at schools where older students are obese or otherwise overweight are significantly more likely to suffer weight problems themselves, researchers report.

For each one per cent increase in the prevalence of obese students aged 16 to 18 years, the odds of a student at 14 to 16 years old attending that school also being overweight increased significantly.

“It was the one risk factor that held true across every school we looked at,” said Dr Scott Leatherdale, the chair of research at Cancer Care Ontario and lead investigator with the School Health Action, Planning and Evaluation System.

Commenting on the obesity connection between older and younger students, Leatherdale says:

It could be that younger students look up to older students, and so emulate their sedentary behaviour and bad eating habits and do not judge the older children’s body shape.  Or it could be that the school doesn’t encourage enough physical activity among its students, and the older students’ weight issues are an indication of that.

Sociologist Steve Fuller at Warwick University concurs with his assessment:

Obesity is one phenomenon that medical sociologists have nominated as an ‘epidemic’ that is transmitted by copying the behaviour of peers.  Certain connections between overeating and social activities become contagious. Young people gather together in more stationary modes than in the past: in front of computers and video games rather than sports.

The reason it’s called an ‘epidemic’ is because the pattern is reinforced by regular contact, so that if one is not in regular contact with the pattern, one doesn’t spontaneously do it The idea is that you overcome obesity by breaking up the networks where it’s transmitted.

Countries are looking for ways to boost organ donation, according to the New York Times. Most recently, Israel has created a policy to give priority for organ transplants to those who sign up to be organ donors themselves.

Officials hope the incentive will increase the supply of available organs — of which there is a shortage across the world, but especially in Israel, where only one in 10 adults carries a donor card.

This is sure to be a closely watched change, as most countries have tried different measures to increase willingness to donate organs. Here’s a rundown of some of those efforts, which include (1) creating markets for organs; (2) making all citizens organ donors by default, unless they explicitly exempt themselves; and (3) investing in more health care infrastructure.

Such plans have raised a few ethical eyebrows, however:

Proposals to change the organ procurement systems in the United States and Great Britain to “presumed consent” have frequently provoked ethical objections. Critics worry that such a system would effectively coerce people into donating organs, even over the wishes of the next of kin.

Ethics aside, it’s also not clear that such programs actually produce more donations.

A sociologist comments on the quandry:

Perhaps this is because — as Kieran Healy, a sociologist at Duke University has found — “opt-out” and “opt-in” systems are really not that different in practice. In both, doctors still typically defer to the wishes of the deceased’s family, whatever the official donor status of the deceased.

In a 2006 article in the DePaul Law Review, Professor Healy argued that presumed consent laws didn’t seem to be the key to improving cadaveric organ donation rates. Rather, infrastructure investments did.

Countries that experienced the biggest donation increases in recent years, like Spain and Italy, were those that hired more transplant coordinators, started public awareness campaigns, installed 24-hour organ retrieval teams at hospitals and improved training for doctors who talk to grieving families.

He concludes:

Arguments about altruism versus self-interest and disputes over presumed and informed consent together constitute a good portion of the public discussion about organ donation. Yet neither debate helps us explain why some countries have many more organ donors than others. As best we can tell, countries with high procurement rates do not owe their success to any distinctive legal conception of consent, nor to any special way of institutionalizing exchange in human goods. Rather, more fine-grained organizational differences– specifically in logistics and process management — are responsible for their success.

The idea that virginity has a high value harkens back to the days of early humans — if a man has sex with a virgin woman, he knows for sure that her children will be his, anthropologists reason. In early civilizations, women were also considered the property of men, said Laura Carpenter, assistant professor of sociology at Vanderbilt University in Tennessee.

Through the 1950s in America, women were expected to remain virgins until marriage, Carpenter said. But with the availability of the pill and the IUD in the 1960s, combined with youth counterculture and gay rights movements, it became more common for women to engage in premarital sex, she said.

Attitudes shifted toward the conservative side in the 1980s with the worldwide HIV/AIDS pandemic, which made the stakes much higher for choosing a sex partner, especially for men. Abstinence-based education programs also took off around that time, with government support, she said.

Today, about 95 percent of Americans have sex before they’re 25, Carpenter said. But worldwide, virgin prostitutes can claim larger fees, certain cultures still attach larger dowries to virgin brides, and some women undergo reconstructive surgery to restore their hymens.

In looking at Dylan’s auction, “To some extent it’s not new. The new part is the Internet,” Carpenter said.

And Dylan’s take?

Some men may seek virgins because they want them as trophies, or desire purity. But as to why men would bid so much money on virginity, she said she has no answer.

“I honestly don’t know what they see in it,” she said.

If you think Dylan’s auction amounts to prostitution, she completely agrees. She also said she’s not breaking any laws — after all, prostitution in Nevada is legal.

“I feel people should be pro-choice with their body, and I’m not hurting anyone,” she said. “It really comes down to a moral and religious argument, and this doesn’t go against my religion or my morals. There’s no right or wrong to this.”

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