The History of Obesity – The last 100 years Global

shutterstock_20163661We have discussed global views of the history of obesity from the Stone Age to 1910, a time in history when fatness or obesity was viewed as beautiful, healthy, and a sign of prosperity. This post discusses the 3rd era, the past 100 years.  The 3rdera is divided into two parts, with the first the USA and this the rest of the world, termed global for this post.  There are major differences in views on obesity in the US and other areas of the world.  This piece was contributed by a SERMO physician.

Some of the material presented in this piece is “oral history.”  I have been able to talk with people from other areas of the world, as well as research various countries and their belief systems on obesity.

The UK’s views on Obesity have been similar to the US, with the rest of Western Europe following closely.  But Eastern Europe had a different view of obesity during the past century.  As djacobmd commented in https://app.sermo.com/posts/posts/231700,

During the 1970s, the Russians viewed plump or obese women as more attractive.  This was the norm for the Eastern European countries, where food shortages, and very cold winters led to a desire to have extra weight for “protection” against possible starvation.  Both men and women were viewed as more attractive and prosperous and certainly of higher status if they were obese.

Like the poor of the US during the past century, women and men in Eastern Europe (first the serfs of Russia pre Revolution, then the workers) lived hand to mouth, ate when food was available, and added extra weight for times of possible starvation.

The Great Depression loomed, and it impacted Europe as it did the US.  The Europeans also found it difficult to find needed food during the 1930s.  Europeans, like Americans have told me stories of going to bed hungry and hoarding food when they were able to get some.

Much of Western European history of the past century (with the exception of WW-II which left many hungry) has paralleled that of the US.  I will not repeat the information about the 1920s – today, but will refer you to a prior post on the last century of obesity in the US – https://app.sermo.com/posts/posts/234084.

Other areas of the world have had a very different view of obesity than we have and do have in the US and Western Europe.  Today, several countries of the world embrace obesity as a symbol of attractiveness, wealth, and status.  Many of us are familiar with photos of the very obese people from Samoa, but other countries also view a large body size as normal.

India viewed obesity as a sign of strength, wealth, and status.  There has been a change in this view with the inroads of the movie industry, but much of rural India continues to embrace obesity as best. (1)

In the small South Pacific island of Tonga, beauty is marked by large physical size. This idea, coupled with a reliance on fatty, nutrient-deficient imported foods and a decrease in activity has caused the nation to embrace obesity. (2)

Moving across the world in the Middle East, we learn that Kuwait is not only home to rich oil deposits but is also home to significant obesity in its people. Cardiovascular disease is the leading cause of death and 52% of Kuwaiti women over 15 are obese. Historically, these nomadic desert people came to prize fatness as a sign of health and wealth–a trend which clearly continues to this day. In a country where women exercising is a taboo, wives are frequently prized as decorative items to fill up the house: the bigger, the more opulent. (2)

Moving toward the Caribbean, we come to Jamaica, another country of obesity.  “With nearly 65% of Jamaican females classified as obese, the ideal beach body is nearly twice its medically-appropriate size. In this island nation particular emphasis is placed on generous hips and hindquarters.  In rural Jamaica, thinness is associated with sadness, but heaviness with happiness, kindness and social harmony. There is also a burgeoning pill market which caters to young women desiring to gain weight. “(2)

As American physicians, we discuss weight loss medications, but the Jamaicans have the opposite issue in their country.  They use pills to help gain weight.   (Pills to make you fat and pills to make you thin – our world sounds like an old 60s song).

Off to Egypt, we find another obese population.  A 2008 survey revealed that “More than half of Egyptian men and women are either overweight or obese, the percentage being higher among women.  Egyptian Culture is steamed with ideas of the goodness of obesity.  The Egyptian perspective towards body size has always favored the kershas a sign of wealth dating back to ancient times, as evidenced by this relief from Karnak of a noble man with skin folds of fat and mobs.” (3)  The men today still find obesity to be good and important.

And now, we will take another swing across the world to South Africa.  This most modern African country values obesity.  “Due to the prevalence of AIDS, the association between weight loss and illness has contributed to South Africa’s negative view of thinness. The centuries-old correlation between higher weight and higher wealth was not overcome by the post-Apartheid introduction of European size ideals. Large women continue to be favored as their heft lends insight into both their health and financial status.” (2)

The most obese country in the world is not the US by far, but it is Mauretania.  “In this drought-ridden West African nation, female obesity is synonymous with beauty and wealth. Though less common, “gavage” (borrowed from the French to describe fattening a goose’s liver destined for foie gras) is still practiced, with young girls imbibing vast qualities of fatty camel milk daily. Women unable to pack on the pounds at fat farms routinely take antihistamines and animal steroids to induce appetite. Exercise is frowned upon and women are frequently divorced for their inability to sustain excessive girth after childbirth.” (2)

Other Polynesian countries – Nauru, Tahiti, and Samoa are also among the top 10 obese countries in the world today. (2)

Interestingly, the South Pacific is an area where obesity is highly valued, but this emphasis on fattening people and the association of obesity with health and wealth spans the globe from South Africa to the South Pacific to the Middle East to the Caribbean and even areas of India.  Most of the world outside of the US and Europe continues to view obesity in positive terms of wealth, status, and beauty.

Clearly, the world is facing an epidemic of obesity that impacts health.  However, cultural, financial, social, and other factors must be addressed as we as physicians work with our obese patients.

 

If you’re a physician, please join us inside SERMO.

 

Bibliography

1:         Presentation on India and Obesity – Indian cultural group – Los Angeles, 2013.

2.         http://www.toptenz.net/top-10-countries-celebrating-female-obesity.php

3:         http://dhsprogram.com/pubs/pdf/FR220/FR220.pdf

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