Diversity: History of Obesity

Historical Perspectives of Obesity

Pre 500AD- 1800s

500-1500

Pre-500AD

1500-1700

1800s

Medieval Period

Renaissance to Enlightenment

Ancient Civilizations

Industralization

Obesity was viewed through a cultural and social lense, rather than a medical lense, typically represinting wealth, accesss to food, overindulgence, and the privildeg of not having to do physical labor.

Historical Perspectives of Obesity

Early to Mid 20th Century

1960s

1950

1953

1900-1940s

1945

Early 20th Century

Bariatric Surgery

National Obesity Society

Weight Loss Pills

Weight Watchers and Social Change

Hollywood influenced society by promoting thinness and making obesity underiable. This resulted in more medical awareness and obesity was linked to chronic conditions like heart disease, diabetes, and hypertension.

Historical Perspectives of Obesity

1980s- 2010s

2013

2000s

1997

1988

2017

Complex Chronic Disease

A Global Epidemic

Body Mass Index

Media and Diets

Childhood Obesity

As processed foods became more affordable, obesity became synonymous with lower socioeconomic status, while being thin was associated with having the time and resources to prioritize fitness.

Historical Perspectives of Obesity

2020s and Beyond

2024- Beyond

2021

2018

2020

Increasing Obesity Rates

Weight Loss Drug Growth and Popularity

Obesity Crisis Continues

Pandemic

Obesity became a leading cause of death in the United States, highlighting its connection to various social factors such as lower socioeconomic status and environmental influences. During this same time, the Body Positivity Movement began to view obesity through a more empathetic lens, focusing on challenging societal stigma.

References

• Fulton, M., & Srinivasan, V. N. (2023). Obesity, Stigma And Discrimination. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554571/ • Gillam, S. (2018, January 12). Do you Bant? The original low-carbohydrate, high-fat (LCHF) diet. Royal College of Surgeons. https://www.rcseng.ac.uk/library-and-publications/library/blog/do-you-bant/ • Hartman-Munick, S. (2023, March 31). Eating disorders in teens more than doubled during pandemic. UMass Chan Medical School. https://www.umassmed.edu/news/news-archives/2023/03/eating-disorders-in-teens-more-than-doubled-during-pandemic/ • Kyle, T. K., Dhurandhar, E. J., & Allison, D. B. (2016). Regarding obesity as a disease: Evolving policies and their implications. Endocrinology and Metabolism Clinics of North America, 45(3), 511–520. https://doi.org/10.1016/j.ecl.2016.04.004

• Akil, L., & Ahmad, H. A. (2011). Relationships between Obesity and Cardiovascular Diseases in Four Southern States and Colorado. Journal of Health Care for the Poor and Underserved, 22(4A), 61–72. https://doi.org/10.1353/hpu.2011.0166 • CDC. (2024). Childhood obesity facts. CDC. https://www.cdc.gov/obesity/php/data-research/childhood-obesity-facts.html • Definition and history of metabolic surgery. (n.d.). ACS. https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2019/01/definition-and-history-of-metabolic-surgery/ • Fulton, M., & Srinivasan, V. N. (2023). Obesity, Stigma And Discrimination. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554571/

References

• National Institute of Diabetes and Digestive and Kidney Diseases. (2018, December 13). Overweight & Obesity Statistics . National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Health. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity • Pray, R., & Riskin, S. (2023). The History and Faults of the Body Mass Index and Where to Look Next: A Literature Review. Cureus, 15(11). https://doi.org/10.7759/cureus.48230 • Rasmussen, N. (2008). America’s First Amphetamine Epidemic 1929–1971. American Journal of Public Health, 98(6), 974–985. https://doi.org/10.2105/ajph.2007.110593 • Schvey, N. (2019). Weight Bias in Health Care. AMA Journal of Ethics, 12(4), 287–291. https://doi.org/10.1001/virtualmentor.2010.12.4.jdsc1-1004. https://doi.org/10.1002/hsr2.1670

• Somayeh Marghoub, Sarvin Sanaie, Mark, Seyed Aria Nejadghaderi, Saeid Safiri, & Reza Mohammadinasab. (2023). Obesity from a sign of being rich to a disease of the new age: A historical review. Health Science Reports, 6(11). https://doi.org/10.1002/hsr2.1670 • Stunkard, A., LaFleur, W., & Wadden, T. (1998). Stigmatization of obesity in medieval times: Asia and Europe. International Journal of Obesity, 22(12), 1141–1144. https://doi.org/10.1038/sj.ijo.0800753 • The Devastating Impact of Weight Stigma and Fat Shaming. (2024, February 27). Ncoa.org. https://www.ncoa.org/article/how-do-weight-bias-and-stigma-affect-patients-with-obesity/ • Vigarello, G. (2013). The Metamorphoses of Fat. https://doi.org/10.7312/viga15976

Announced a Complex Chronic Disease

Obesity was identified as a complex chronic disease by the American Medical Association, prompting additional research into its causes and negative consequences.

2017- Childhood Obesity

Prevalence of obesity among U.S adolescents increased by 19.7%. 1 in 5 children were obese, with 1 in 16 being severely obese. The education system began promoting healthier eating in schools and lessons as well as encouraging more exercise.

2018- Increasing Obesity Rates

- 1 in 3 adult are oveweight. - 2 in 5 adults are obese. - 1 in 11 adults have severe obesity. This increasing rate put a large strain on the healthcare system due to the related chronic conditions. Obesity was linked to social stigma, recgonzing the negative impact on mental health, leading to issues like depression and anxiety.

2000s- Media and Diets

In the 2000's, social media started to gain a heavier influence on daily life. The prevalence of unrealistic beauty standards and glorifying thinness contributed to body image issues and dieting culture. Social media platforms were also used to share dieting tips, "healthy" eating habits, and lifestyle advice. This caused immense pressure on society, especially women, to fit into unrealistic ideals, engraining the idea that thinner is better.

Fat Liberation and Weight Watchers

Along with other social movements, Fat liberationists contested the treatment of fat people in the workplace. Social movements challenged previous standards. Weight Watchers was created offering “support” to those who were trying to lose weight, considering extra weight as something that could be lost through calorie deficits.

https://guides.lib.uw.edu/FatActivism/Manifesto

The National Obesity Society

The first medical society created, dedicated to obesity known as the National Obesity Society. This organization was founded to advocate for equal treamtent, promote awareness, research, and policy change.

• Akil, L., & Ahmad, H. A. (2011). Relationships between Obesity and Cardiovascular Diseases in Four Southern States and Colorado. Journal of Health Care for the Poor and Underserved, 22(4A), 61–72. https://doi.org/10.1353/hpu.2011.0166 • CDC. (2024). Childhood obesity facts. CDC. https://www.cdc.gov/obesity/php/data-research/childhood-obesity-facts.html • Definition and history of metabolic surgery. (n.d.). ACS. https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2019/01/definition-and-history-of-metabolic-surgery/ • Fulton, M., & Srinivasan, V. N. (2023). Obesity, Stigma And Discrimination. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554571/ • Gillam, S. (2018, January 12). Do you Bant? The original low-carbohydrate, high-fat (LCHF) diet. Royal College of Surgeons. https://www.rcseng.ac.uk/library-and-publications/library/blog/do-you-bant/ • Hartman-Munick, S. (2023, March 31). Eating disorders in teens more than doubled during pandemic. UMass Chan Medical School. https://www.umassmed.edu/news/news-archives/2023/03/eating-disorders-in-teens-more-than-doubled-during-pandemic/ • Kyle, T. K., Dhurandhar, E. J., & Allison, D. B. (2016). Regarding obesity as a disease: Evolving policies and their implications. Endocrinology and Metabolism Clinics of North America, 45(3), 511–520. https://doi.org/10.1016/j.ecl.2016.04.004 • National Institute of Diabetes and Digestive and Kidney Diseases. (2018, December 13). Overweight & Obesity Statistics . National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Health. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity • Pray, R., & Riskin, S. (2023). The History and Faults of the Body Mass Index and Where to Look Next: A Literature Review. Cureus, 15(11). https://doi.org/10.7759/cureus.48230 • Rasmussen, N. (2008). America’s First Amphetamine Epidemic 1929–1971. American Journal of Public Health, 98(6), 974–985. https://doi.org/10.2105/ajph.2007.110593 • Schvey, N. (2019). Weight Bias in Health Care. AMA Journal of Ethics, 12(4), 287–291. https://doi.org/10.1001/virtualmentor.2010.12.4.jdsc1-1004. • Somayeh Marghoub, Sarvin Sanaie, Mark, Seyed Aria Nejadghaderi, Saeid Safiri, & Reza Mohammadinasab. (2023). Obesity from a sign of being rich to a disease of the new age: A historical review. Health Science Reports, 6(11). https://doi.org/10.1002/hsr2.1670 • Stunkard, A., LaFleur, W., & Wadden, T. (1998). Stigmatization of obesity in medieval times: Asia and Europe. International Journal of Obesity, 22(12), 1141–1144. https://doi.org/10.1038/sj.ijo.0800753 • The Devastating Impact of Weight Stigma and Fat Shaming. (2024, February 27). Ncoa.org. https://www.ncoa.org/article/how-do-weight-bias-and-stigma-affect-patients-with-obesity/ • Vigarello, G. (2013). The Metamorphoses of Fat. https://doi.org/10.7312/viga15976

Ancient Civilizations

Obesity was a sign of wealth, and good nutrition. Obese women were more desirable for marriage as it indicated access to abundant food. Obese men were viewed as wealthy, as their size suggested they had the means to afford excess food.

Renaissance to Enlightenment Periods

Even though women were strictly required to maintain their thinness, Enlightenment businessmen, financiers, and civic leaders were able to turn a noticeable belly into a mark of status. Within the lower class it was still considered a positive to be heavy set, as it showed good access to food.

2024-Beyond

Obesity used to be desirable as it represented wealth and social status. Today, the obesity epidemic has been recognized as a condition caused by multiple factors such as socioeconomic status, poverty, environment, and genetics but also exists as a consequence of other health conditions that include CHF, PCOS, and Hypothyroidism. Unfortunately, these factors only highlight the fact that obesity is an ever growing crisis.

The Industrial Age, 19th Century

As the middle class grew, food became more accessible, resulting in a larger population, shifting obesity from a status to a norm. Williams Banting Diet – The first widely used diet plan that was considered a treatment for obesity by cutting out sugar, starch, and fat.

The Body Mass Index was founded in 1832. The love of statistical analysis and Bell-shaped curves led Belgain statistician, mathematician, and astronomer, Adolphe Quetelet, (1796–1874) to develop measurable traits of the "normal man."

1988

Body Mass Index

The Body Mass Index (BMI) became the standard screening tool for obesity in the medical field, despite the creators being mathematicians and not intending for it to be used in medicine. The index does not factor in muscle, or other health factors.

First Bariatric Surgery

1953 The first surgical option that revolutionarily changed the methods of addressing morbid obesity. The gastric bypass restricts the food intake and decreases caloric absorption.

Obesity and the pandemic

The isolation that occurred during the COVID-19 pandemic and social influence of the media contributed to the near doubling of eating disorders diagnosed in adolescents and young adults, reaching its peak in April 2021.

Early 20th Century

• Thinness was a popular beauty standard in Western countires.
• A connection between cardiovascular disease (CVD) mortality and morbidity and obesity is found.
• A connection between high BMI and hypertension is also discovered.

Diet Pills

Half a million Americans were taking tablets of amphetamine salts daily for weight loss. Diet culture's wrongful use of pills and fad diets reflected the social obsession of being thin.

The Medieval Period

Since gluttony is one of the seven deadly sins, obesity was viewed as sinful because it was thought to be a sign of a lack of self-control. Because obesity was perceived as a weight-related problem rather than a medical or biological one, it carried a moral stigma.

Weight Loss Drugs

Wegovy, Ozempic, Semiglutides

As the years progressed and the rate of obesity increased there was significant production of weight loss pills and injections. In June 2021 weight loss drugs such as Wegovy, Tirzepatide, and Liraglutide were approved by the FDA following the previous introduction of ozempic and semiglutide in 2017.

Announced as a Global Epidemic

Obesity is classified as a global epidemic by the World Health Organization, posing significant health risks.

2018- Increasing Obesity Rates

- 1 in 3 adult are oveweight. - 2 in 5 adults are obese. - 1 in 11 adults have severe obesity. This increasing rate put a large strain on the healthcare system due to the related chronic conditions. Obesity was linked to social stigma, recognizing the negative impact on mental health, leading to issues like depression and anxiety.

Obesity and the pandemic

The isolation that occurred during the COVID-19 pandemic and social influence of the media contributed to the near doubling of eating disorders diagnosed in adolescents and young adults, reaching its peak in April 2021.

2024-Beyond

Obesity used to be desirable as it represented wealth and social status. Today, the obesity epidemic has been recognized as a condition caused by multiple factors such as socioeconomic status, poverty, environment, and genetics but also exists as a consequence of other health conditions that include CHF, PCOS, and Hypothyroidism. Unfortunately, these factors only highlight the fact that obesity is an ever growing crisis.

• Akil, L., & Ahmad, H. A. (2011). Relationships between Obesity and Cardiovascular Diseases in Four Southern States and Colorado. Journal of Health Care for the Poor and Underserved, 22(4A), 61–72. https://doi.org/10.1353/hpu.2011.0166 • CDC. (2024). Childhood obesity facts. CDC. https://www.cdc.gov/obesity/php/data-research/childhood-obesity-facts.html • Definition and history of metabolic surgery. (n.d.). ACS. https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2019/01/definition-and-history-of-metabolic-surgery/ • Fulton, M., & Srinivasan, V. N. (2023). Obesity, Stigma And Discrimination. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK554571/ • Gillam, S. (2018, January 12). Do you Bant? The original low-carbohydrate, high-fat (LCHF) diet. Royal College of Surgeons. https://www.rcseng.ac.uk/library-and-publications/library/blog/do-you-bant/ • Hartman-Munick, S. (2023, March 31). Eating disorders in teens more than doubled during pandemic. UMass Chan Medical School. https://www.umassmed.edu/news/news-archives/2023/03/eating-disorders-in-teens-more-than-doubled-during-pandemic/ • Kyle, T. K., Dhurandhar, E. J., & Allison, D. B. (2016). Regarding obesity as a disease: Evolving policies and their implications. Endocrinology and Metabolism Clinics of North America, 45(3), 511–520. https://doi.org/10.1016/j.ecl.2016.04.004 • National Institute of Diabetes and Digestive and Kidney Diseases. (2018, December 13). Overweight & Obesity Statistics . National Institute of Diabetes and Digestive and Kidney Diseases; National Institute of Health. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity • Pray, R., & Riskin, S. (2023). The History and Faults of the Body Mass Index and Where to Look Next: A Literature Review. Cureus, 15(11). https://doi.org/10.7759/cureus.48230 • Rasmussen, N. (2008). America’s First Amphetamine Epidemic 1929–1971. American Journal of Public Health, 98(6), 974–985. https://doi.org/10.2105/ajph.2007.110593 • Schvey, N. (2019). Weight Bias in Health Care. AMA Journal of Ethics, 12(4), 287–291. https://doi.org/10.1001/virtualmentor.2010.12.4.jdsc1-1004. • Somayeh Marghoub, Sarvin Sanaie, Mark, Seyed Aria Nejadghaderi, Saeid Safiri, & Reza Mohammadinasab. (2023). Obesity from a sign of being rich to a disease of the new age: A historical review. Health Science Reports, 6(11). https://doi.org/10.1002/hsr2.1670 • Stunkard, A., LaFleur, W., & Wadden, T. (1998). Stigmatization of obesity in medieval times: Asia and Europe. International Journal of Obesity, 22(12), 1141–1144. https://doi.org/10.1038/sj.ijo.0800753 • The Devastating Impact of Weight Stigma and Fat Shaming. (2024, February 27). Ncoa.org. https://www.ncoa.org/article/how-do-weight-bias-and-stigma-affect-patients-with-obesity/ • Vigarello, G. (2013). The Metamorphoses of Fat. https://doi.org/10.7312/viga15976

Weight Loss Drugs

Wegovy, Ozempic, Semiglutides

As the years progressed and the rate of obesity increased there was significant production of weight loss pills and injections. In June 2021 weight loss drugs such as Wegovy, Tirzepatide, and Liraglutide were approved by the FDA following the previous introduction of ozempic and semiglutide in 2017.