Thanksgiving represents a time for family unity, togetherness, and moments for critical social dialogues.
This year there is an opportunity for a meaningful conversation. We must tackle the sensitive topic of obesity and its ensuing health care needs. Knowing more about the difficulties interwoven into the obesity epidemic—nationally and globally—creates desire and preparation for change.
This holiday season, we should aim to disconnect the comfort from food and allow a deeper connection with humanity. As a nurse practitioner, researcher, and current doctoral student with a background in nutrition, it is my opportunity to initiate a conscientious conversation caringly and respectfully. Although this is a sensitive topic it is a necessary one.
Our nation has an unhealthy relationship with food that negatively impacts our society. As a country and as global citizens, we need to consider re-prioritizing our health in response to this health crisis. Obesity is a major health concern globally and has nearly tripled since 1975. Obesity is one of the leading risk factors for premature death and is associated with heart disease, high blood pressure, diabetes, stroke, and certain types of cancer. In classrooms today, one out of every five students are obese. In the grocery stores, one out of every 3 shoppers is obese. The consequences are even greater when related to health equity and overlooked communities.
To end this obesity epidemic, we must first address systemic challenges such as food insecurity, equitable food systems, and lack of access to public areas for physical activity. These systemic problems contribute to twice the likelihood of death in Native Americans, Hispanics and African-Americans.
Responding to obesity is not simple. New guideline changes this fall from governmental entities have acknowledgedthe importance of prioritizing health equity. To address the urgency and complexities of treating obesity, recognizing factors such as patient’s race, metabolism (especially of sugar!), genes, excessive advertisement of sugar laden foods, and the environment play an important role.
Additionally, the stigma and discrimination that obese patients face increases their risk of unhealthy eating and the avoidance of healthcare and exercise. Responding to obesity is not simple.
The Greek philosopher Hippocrates long ago proclaimed, ‘let thy food be thy medicine.’ Yet, today many of the foods we eat or water we drink do not promote health. The pervasiveness of sugar promotion in American food supplies parallels how tobacco companies for 60 years targeted children and minorities for financial gains. Similarly, the food industry spends nearly $14 billion every year promoting unhealthy choices like fast food and sugary drinks which often target minority youth. There is also evidence that sugar addiction leads to chemical and behavioral addictions. Although the current state of the science of food addictions is that sugar addiction is not like drug addiction. Sugar cravings, and sugar withdrawal-like symptoms are hard to ignore. Regardless of your views, weaning a nation from sugar will take a concerted societal effort.
Here is a challenge for you: find a packaged food item, and locate the food label, which should be on the back of your packaged goods. If you have never read one, here is your opportunity. Your challenge is to see if you can find a food selection where sugar or a modification of it, including high fructose corn syrup, is NOT in the top ten ingredients. Keep in mind that ingredients on food labels are listed in order of measured volume. You should find this exercise both challenging and enlightening.
If you find the food label analysis thought provoking, can you guess when there is an increase in the use of emergency and urgent care services? The answer is during the holidays. In fact, there is an annual spike patterns of emergencies which is related to changes in patterns of traveling, eating, drinking, etc.
This trend is more apparent in underserved population which increases the burden that unhealthful food selections have in marginalized populations. In these populations, the patient’s social and economic circumstances influence the need to seek emergency health services, especially if primary care relationships do not exist.
Let us recall the historical context of Thanksgiving.
It was not an expression of overindulgence. Instead, Thanksgiving should be remembered as a symbol of Native Americans generosity and provisions to pilgrims, which unfortunately upended their historical way of life. This Thanksgiving, we can approach our meals with a conscious and mobilizing effort to begin a new tradition. We can become more aware and truly engage in comforting one another. We can dissociate food from the comfort and power we allow it to have.
With our “national family” uniting to challenge our current state of health policy, regulators will take notice and be compelled to play a role in efforts to reduce trends in our current obesity health crisis.
Teri Cesar is a graduate student in the School of Nursing and Health Science at the University of Miami. Read more about the inaugural “Op-ed Challenge.”
