When we think of an obese person we often think of an extremely large, sagging body and a round chubby face. Images of someone sitting on a sofa, being inactive; eating fast food or drinking soda may come to mind. It might be assumed that the person is either lazy, greedy or from a lower socioeconomic group. Imagining an overweight person is likely to bring on similar mental pictures.
Just Google 'obesity' and those are the, often faceless, images that will pop up - the physical, external result of obesity.
What we often can't see are the internal health issues that accompany that excess body fat: diabetes, high blood pressure, heart disease, low self-esteem, anxiety and depression. And what we certainly don't see or know is the cause of someone's obesity.
"The problem with obesity is that it's a condition that you wear on your sleeve...With obesity it's with you all the time, and people can see it.”
“Obesity is a disease driven by genetics,” says obesity physician Professor Joe Proietto in the three-part documentary series, The Obesity Myth on SBS. The series will challenge our view of obesity as it follows the lives of several patients being treated for the disease by Prof Proietto at the Austin Health Clinic in Melbourne.
What's the difference between overweight and obese?
The Australian Institute of Health and Welfare reports 63 per cent of Australians are overweight or obese.
Although there are other ways of assessing obesity, the Body Mass Index (BMI) is still the standard method of measuring a population. But it's not perfect.
“Clinicians all know that there are caveats on the use of BMI," says Prof Caterson. "So in the very young and the very old it's not nearly as good and similarly, in the very fit and muscular it's not as good. Bearing those caveats in mind, if you do a waist measure [as well], it's a good indication for the potential of problems and presence of problems."
People with a BMI of 25–29.9 are considered overweight and BMIs of 30 and greater are in various stages of obesity. Waist circumferences of 94 cm in men and 80 cm in women pose greater risks to health.
That is the clinical way to determine excess weight and obesity but, there are many limitations such as height, athletic ability and ethnicity.
“If you came to me with a BMI of 32 and you were a rugby player or if you were Pacific Islander I would be less worried,” Prof Caterson explains.
“Different ethnic backgrounds have different obesity related problems at different BMIs. Some Pacific Islanders have more muscle; Asians are smaller and have less muscle.”
Changing the stigma surrounding obesity
Before we can move forward, society has to get used to seeing obese bodies says Dr Kathryn Williams, Adult Clinical Lead of the Nepean Family Obesity Services.
“We can't actually treat obesity properly until we get past the stigma that it has," says Dr Williams. "The problem with obesity is that it's a condition that you wear on your sleeve. It's not like diabetes or heart disease - nobody knows you have diabetes or heart disease. With obesity it's with you all the time, and people can see it.”
What we, as a society, need to remember is that people with obesity are human beings. Humans are made in all colours, shapes and sizes – sizes that are getting bigger. And that's something we can't ignore.
“I don't think we should walk away from the question as to what obesity looks like, because, in fact, we need to understand this. It's not as simple as we think.
“Society is so quick to judge the individual but it's important to understand that people with severe obesity aren't just overeating. It is far more complicated than this and it needs to be recognised as a disease - a really difficult to treat disease."
Watch The Obesity Myth on SBS on Mondays from 4 September at 7:30pm or after broadcast on SBS On Demand.
Note: The images that feature in this story are from The World Obesity Federation’s image bank, which aims to represent people with overweight and obesity in a fair and non-stigmatising way.