16 Nov Why Size Really Matters
There are very few things in which Malta can compete and win hands down against other bigger and mightier countries but when it comes to child obesity, we seem to have no decent competition.
29.5% of Maltese children aged between 11 and 15 are overweight or obese. The EU average is only 13.3%, and whilst Greece is behind us in second place, they only hit 17.7%.
When it comes to adults, we’re not far from the pole position either. We rank 3rd out of all the EU countries, with 22.3% of Maltese adults being overweight or obese, when the EU average is 15.5%. (Health at a glance report, 2010)
Ms. Maria Ellul, a Public Health Nutritionist, says that although this seems to be a global epidemic, the Maltese population is amongst the heaviest in the world. A conservative figure for Malta’s costs related to the present obesity figures is around 18 million Euros a year, and this does not include the pharmaceutical cost component arising from the treatment and management of the related co-morbidities.”
We all know what causes obesity. We all know the do’s and don’ts, and though it sounds like a very simple formula to follow, so many struggle against it and so many fail.
John Borg* is an intelligent professional with a thriving business. He is more than aware about the medical dangers of being overweight, and yet is still struggling with shedding off the weight that he has carried for most of his life.
“Being a big person is quite a burden!” admits John who prefers to remain anonymous because he doesn’t want his size to be the main feature with which people identify and refer to him.
“Your size really matters,” he says. “No matter how hard you try, people are challenged by it, and the nasty stereotypes are difficult to bear. As a junior professional, I did not have a name, clients used to refer to me as ‘the fat lawyer’*.”
“People with mobility problems generate a degree of pity, usually disguised as empathy. Some might offer their help by giving way or by offering an extra smile, but from my experience, big people are not granted the same pleasantries. Heavy bodies provoke negative reactions, and your body becomes your alter ego, living a life of its own – your shadow cast on the masses.”
An optimist by nature, John still considers himself lucky, because he managed to find the stamina to cope with school bullying, with instant recognisability, and with all the run of the mill remarks. “Thankfully I have the gift of the gab,” he adds, “this allows me to strike back in an instant, and after years of training I have a remarkable array of ‘weapons’ with which I can hurt, deflect, rationalise or acknowledge a snide remark.”
John has also come to learn that different people react differently at the sight of a big person. “The morons run away, the superfluous keep their distance, and the actors get their chance to change their act. I can surely live without these types and would love to have this self-selection done for me gratis, thus leaving me with my real friends who have been challenged and have risen to the occasion.”
Lisa Sciortino (39) is a highly qualified medical professional. She’s 39 years old and has been obese for most of her life. At the end of last year, she decided to do something about her situation and this time she’s trying to do it the right way. “No fad diets,” she explains. “I’ve tried so many of those before but I’ve learnt that the faster you lose the weight, the quicker & mightier it comes back. This time I have not subscribed to a gym either, because I usually end up going for the first week and then it’s history. This time I’m going for the blessed life style change. It’s what I need, so I’m investing a lot of time, energy & money in it. Last October I had my first appointment with my personal trainer, and I’m afraid that if this fails, there’s no turning back.”
Lisa is still far from reaching her target weight, but she has already come a long way. “I’ve lost about 30kg since last October, and I’ve already experienced the first little satisfactions of weight loss. I’m now fitting into clothes that I haven’t worn in ages, I’m sitting more comfortably in chairs, and I’m walking with my head held a little bit higher.”
“People who have never struggled with weight issues have absolutely no idea how difficult it is,” says Lisa. “Food is not something you can give up completely like cigarettes, alcohol, and gambling. You have to eat but at the same time you tease and frustrate your taste buds with grilled chicken breast instead of having it stuffed with mozzarella and mushrooms and wrapped in prosciutto. Not to mention that adverts for food are all around us and that socialising is usually centred around food and drink.”
Dr. Claudette Portelli, a Clinical Psychologist & Psychotherapist who specializes in Brief Strategic Therapy, thinks that it is very difficult to be obese in a world that idolizes thinness. “The great majority of severely overweight and obese persons hold a poor body image,” she says. “This often impairs their self-esteem and social interactions. Fortunately, not everyone who struggles with obesity feels this way, but more often than not they experience anxiety in social situations, so they dread meeting new people, and give every excuse in the book to avoid social encounters. The only place they feel comfortable and tranquil is at home, where they can let themselves go, abandoning themselves to their uncontrollable demon – food.”
According to Dr. Portelli anxiety is part and parcel of the obese person’s life. “For most, food becomes the only solution,” she explains. “It is the only thing that calms their anxiety but at the same time it is also what fuels it even further – the infamous vicious circle. The more weight they put on, the more worthless and undesirable they feel, and thus isolate themselves avoiding social situations. Food becomes their surrogated pleasure, taking the place of other natural pleasures such as self-pampering, social encounters, and intimacy. They become totally dependent on the exclusive pure pleasure that only food gives them.”
Many studies show that depression is especially higher in obese females, in fact according to a US study larger women even earn less than skinnier women, while wages don’t differ when men pack on the pounds.
“Depressive and anxious states often worsen because of lack of physical activity” adds Dr. Portelli. “Exercise is very effective in relieving emotional and physical distress, but obese people are less physically active, not just because it is more difficult for them to move around, but because it becomes embarrassing and mortifying to expose themselves in changing rooms, and they hate that they cannot keep up with the others during group exercise. All this makes them feel even worse.”
“This sense of worthlessness is further amplified by prejudice and discrimination encountered at work, at school and other places. Sometimes airlines make them book a double seat, and most clothes outlets do not cater for large sizes. Let’s be honest, our society holds a negative opinion of overweight and obese people. They are more often than not perceived as being lazy, not dynamic, weak-willed, careless, and addictive. Even if these are not true attributes of the person, obese people often grow to believe them and live up to them. A true self-fulfilling prophecy! All this debilitates further one’s self-esteem and consequently one’s quality of life. As Shakespeare so eloquently put it “Thou sees I have more flesh than another man, and therefore more frailty”.
“There is this misconception that if a really obese person starts watching out, the weight will just fall off” says Lisa. “I wish this was the case, but it really isn’t, definitely not in my case at least! Whenever I get on the scales and see little or no change from the previous week, I panic. It’s as if I expect that by this time to be unrecognisable. Then I hear this little voice in my head reminding me that it took you 38 years to pile it on and that I should be a little bit more patient with myself.”
“Coping at a social level is just one of the layers beyond the layers of fat that you have to deal with” explains John. “The most important layer is the deepest one; it’s your psyche and your personality. You learn to look deep inside and fathom all the resources you may have, cherish them, and accept that your life will not be like that of a pretty blonde. Later on, you discover that others have their own demons to deal with; it’s just that mine are much more visible but not necessarily the biggest.”
According to Consultant Paediatrician Victor Grech, though the general stereotype blames the obese person for his or her condition, it is a known medical fact that obesity is a self-perpetuating condition. At least a third of obese children remain overweight or obese for the rest of their adult lives. In addition, overweight and obesity in pregnancy tends to produce larger babies, and a high birth weight is itself a predictor of overweight and obesity in adult life, thereby completing the circle. (Journal of the Malta College of Pharmacy Practice Issue 12 Winter 2007)
Alan Parnis is a physical trainer specializing in children health and fitness. He runs The Spinach Fitness Club in Pembroke – the first and only gym built with children and their parents in mind. “The younger we get sports and exercise into a child’s routine, the better the chances of instilling the love for exercise in children. If we start them at a young age we will have more time to address or even prevent the problem. Although grandparents tend to over-feed their grandchildren I blame the epidemic rates of obesity on our new sedentary lifestyles. In my experience, hereditary cases are very rare, and weight problems are mostly due to lack of exercise and the excessive availability of food especially junk food. Many people think that children do not need to go to a gym, but in today’s world they do. However training needs to be tailor-made especially for them. They need more motivation and a different approach to adults. This is why we include play in all our programmes because it is the way to keep children interested.”
We have recently launched a weight loss program called “WE SHRUNK THE KIDS”. It is a program that targets the specific needs of every child on an individual level. It is accompanied by a training programme based on child-specific equipment together with a kid friendly environment. We also cater for the parents thus creating a unique environment where the family can spend time together in a healthy way.”
Sticking to a healthy diet is hard even for adults let alone children. “The journey is long,” explains John, “but one should remain positive. My food regime consists of frequent small healthy snacks, a good breakfast, 40 minutes of brisk exercise in the morning, and avoiding plenty of carbs in the evening. That’s the only diet that works,” he says “the rest is just a form of denial, wishful thinking and waste of time and money. It might sound simple but it is not. You need perseverance and self discipline – a non-commodity in short supply. The plus side of this is that once you get hold of it you would need it for pretty everything else that constitutes success.”
Lisa admits to being a pure contradiction to herself and to those around her. “Even though I work in the medical profession, I never worried much about the health effects of obesity. Even though, the harmful consequences are well-documented and undeniable, I very much believe that what’s meant to be will be. I’m not suggesting that we should test fate by throwing ourselves over a bridge, but we all know people who lived the healthiest lifestyle possible and yet, unfortunately, succumbed to horrible diseases. In my case the harm done by my weight was much more psychological than physical. It caused a combination of lack of self-confidence, depression, stupid comments and sometimes pity. My self-esteem had plummeted to the lowest of levels and the only way was up.”
“I dream of great-white-shark diving in South Africa or paragliding or rafting down the Colorado river, but you can’t really do that when your weight is written in 3 digits. Shopping is another passion of mine, and yet, when I walk into a designer shop I can only buy the earrings or the bag on the mannequin since there is no way I could fit into the little black dress I adore! It was high time for me to remove all these restrictions and find out who I really am.”
This article was first published in First Magazine – April 2011.
