“Healthy overweight and obesity do not exist”: the medical look on the cover of Faces and the Princess of Holland

Maxima Zorreguieta and her daughter Amalia in the cover of Caras

A wave of criticism on social networks and various media raised the magazine’s latest edition Faces who chose as protagonists Maximum Zorreguieta, the Queen of holland, and his eldest daughter, Amalia, 16 years old, since at the time of the headline, she focused on the image of the teenager affirming: “Máxima’s eldest daughter proudly shows off her ‘plus size’ look.”

And in the descent he adds: “Amalia (16), the heir to the throne of Holland, victim of bullying, faces criticism with strength and the unconditional support of his parents. A princess who lives her adolescence without taboos and defends her figure of ‘real woman’”.

Beyond the commotion generated, the trend in social networks and the defense of the editors of the publication, the gaze of health professionals was necessary, who also gave their opinion on the cover and remarked “the serious errors that must be avoided when addressing these pathologies that affect 60% of the Argentine population”As well as stigmatization and discrimination, which are still current problems that need to be addressed.

King William of the Netherlands, along with his daughter, Princess Amalia (Reuters)

King William of the Netherlands, along with his daughter, Princess Amalia (Reuters)

“Showing people who are overweight or obese in pleasant attitudes, as is the case of the cover of the magazine Caras, where a mom is seen walking with her daughter, happy, that’s fine with me. But the title is not adequate because it is talking about a person based on their size. We would have to get used, once and for all, to not pointing out people for their bodies or for any other condition, “he stressed. Infobae the doctor Ana María Cappelletti, doctor specialized in endocrinology and obesity, director of postgraduate courses in Obesity at Favaloro University.

The expert emphasized that The obesity is an illness, that it is not recognized as such by the health system, even by many health professionals and neither by patients, who, sick with obesity, feel guilty for having it or for not being able to do treatments effectively in the long term, adding: “Obesity is not a consequence of people’s lack of will and it is not simply about forcing yourself to eat less and move more. It is a problem that has multiple causes, complex, and complex treatment. “

Dr. Pedro Martínez Duartez, brand-new president of the Argentine Society for Obesity Surgery (SACO), specified that “there are more than 100 components that cause this disease, which include genetic, environmental, psychological, social, economic, and political factors” “Type 2 diabetes, hypertension, dyslipidemia, sleep apnea, heart disease are some of the main metabolic diseases associated with obesity,” added Martínez Duartez.

According to Caras, Máxima also suffered as a girl due to obesity (Shutterstock)

According to Caras, Máxima also suffered as a girl due to obesity (Shutterstock)

Meanwhile, the graduate Marcela Casabella, psychologist and coordinator of the SAC Mental Health commission He stated that “Limiting the human characteristic through an image game from what is expected or not expected by an arbitrary social parameter, is to minimize a person and generate a new bullying, in this case socialized through the cover of a magazine, that in itself is a new form of discrimination ”.

In our country, 6 out of 10 people are somewhat overweight, while one in four suffers from obesity. “Therefore, a minority with normal weight discriminates against a majority that does not. It is a kind of paradox“Warned Dr. Cappelletti. “On the other hand, it’s not okay to internalize the idea that being overweight and obese is part of normalcy. From the moment you are overweight, the risk that obesity is associated with other diseases that make up the quality and life expectancy of people increases, “says the doctor.

There is no healthy obesity

Specialists claim that there is no healthy obesity (Shutterstock.com)

Specialists claim that there is no healthy obesity (Shutterstock.com)

The specialists recalled that “healthy” obesity does not exist because scientific evidence shows that “people who are overweight or obese and who are metabolically healthy, the majority evolve to have metabolic complications over time.”

Regarding the risks associated with overweight and obesity in adolescence, Cappelletti said that it is a situation that should be of concern because it conditions future health. “In addition, obesities that occur from childhood, when boys grow up and go through the puberty period with excess weight, are more difficult to treat,” he added.

Data from INADI show that among people who say they perceive themselves as “stigmatized”, obesity is the second most frequent reason, second only to poverty. When you consider who experienced stigma, that is, who was openly differentiated, discriminated against, obesity ranks fifth. However, among the complaints made at INADI for discrimination, obesity is in 14th place. “This means that people with obesity internalize the stigma. Because in addition to existing stigma at the social level, social discrimination, people with obesity self-discriminate, “evaluates Cappelletti, adding that” there is a kind of social judgment to which is added the moral judgment itself “.

Obesity advice - Austral University Hospital

Obesity advice – Austral University Hospital

The specialists regretted that this situation is usually reinforced when health professionals tell the patient “You have to lose 30 kilos”, “Until you lose 30 kilos, those knees will not heal.” And, when the patient asks how he does it, they say “And, well, shut your mouth.”

Stigma creates a vicious circle. People who report experiencing weight stigma are more likely to gain weight in the future and achieve a BMI (body mass index) categorized as obese. The evidence is very clear that the stigma of obesity does not motivate obese people to lose weight. In fact, it is observed that they participate less in physical activity. What’s more, the stress associated with stigmatization can trigger an increase in diet, a decrease in cortisol self-regulation that leads to its increase, which contributes to a greater weight gain.”, Highlights Martínez Duartez, who also states that stigma due to weight can lead to not seeking adequate medical attention, and this lack of treatment leads to an increased risk or continuation of diseases related to obesity, with an increase in mortality. “The stigma also encourages the onset of eating disorders, such as binge eating disorder, bulimia or anorexia,” added the SACO president.

Along these lines, Casabella commented that one of the most serious effects of stigmatization on the person with obesity is the “loss of their identity”. “Generally the person with obesity gives up his identity, the deepest part of himself, to what the environment, the circumstance, the environment allows him, as a way of being accepted, loved, of being contained and allowed in the social structure where it has to be inserted. Much of her life lives a kind of borrowed life, which is what the environment enables her to feel that she belongs. The obese has no name, is “the fat”, now “plus size” “, reflects the psychologist.

6 out of 10 Argentines are overweight or obese

6 out of 10 Argentines are overweight or obese

The role of the media

In Cappelletti’s opinion, the media also helps to reinforce misconceptions about obesity many times. “While there is something that is changing and that has to do with the flag against discrimination and in favor of inclusion, there is still much to do.”

And, in that sense, Experts emphasized the importance of stopping showing obese people in gluttonous attitudes or as lazy people, lying on an armchair. “Let’s start showing them in real life. With this objective, free image banks have been created, against stigma, because overweight and obese people also have fun, they also go for a walk, many do physical activity, and they have the right to enjoy food and eat for pleasure. They suggested.

“In any case, there are many actions that must be implemented to change the obesogenic environment, which makes more and more sick people. We firmly need from governments, from health authorities, from health professionals, to install the idea that obesity is a disease, “they concluded.

The princesses of Holland, Alexia, Amalia and Ariane.  REUTERS / Piroschka van de Wouw / Pool

The princesses of Holland, Alexia, Amalia and Ariane. REUTERS / Piroschka van de Wouw / Pool

Keys against stigma

To address the obesity epidemic, we must address the parallel epidemic of weight stigma. To do this, you must:

· Refrain from using stereotypical language, images, and narratives They unfairly and inaccurately describe overweight and obese people as lazy, gluttonous, and lacking in willpower or self-discipline. Recognize the stigma of obesity in all aspects of life.

· Encourage and support educational initiatives, especially in health professionals, aimed at eradicating prejudices about weight by spreading current knowledge about obesity and body weight regulation.

· Change the behaviors and attitudes of those who stigmatize. Encourage and support initiatives to prevent weight discrimination in the workplace, education, and health facilities

· Use language: the person first. This is not new, it was used for other chronic diseases like mental illness and diabetes. The aim is to put the subject first “there are many people affected by obesity”, instead of “there are many obese”.

· Commitment as a society is essential to combat stigma in obesity and help those who suffer from it in an environment of respect, dignity and empathy, taking into account that obesity is a consequence of multiple complex causes in the context of uncontrollable factors, and without blaming people for this sickness.

· Opinion leaders, journalists, and social media users reporting on obesity issues can use balanced and responsive visual content, representing non-stigmatizing portraits of people with obesity.

· Campaigns against obesity should stop using guilt and shame and, on the other hand, should focus on respectful care of the whole body, allowing people to make changes that promote health, by emphasizing modifiable behaviors ( such as increased fruit and vegetable intake and physical activity), improved sleep patterns, and reduced stress. This will improve health for everyone, regardless of weight.

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