Exploring health: is your lifestyle really to blame?
Exploring health: is your lifestyle really to blame?

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Exploring health: is your lifestyle really to blame?

5 Lifestyles and choice

Described image
Figure 7 Balancing scales showing that a healthy weight is achieved by burning more calories than we eat.

Obesity is frequently seen as a consequence of the poor lifestyle choices that an individual makes. Earlier in this free course, obesity was defined (as it often is in quantitative research) in terms of BMI: i.e. to be classified as obese a person must weigh over 30 kg/m2. However, the Oxford English Dictionary defines it in less definitive or measurable terms:

The condition of being extremely fat or overweight; stoutness, corpulence.

(OED Online, 2009b)

The underlying explanatory argument that has been put forth about adult obesity focuses on individual responsibility. This is where a person should address the imbalance between the ‘energy going in’ over ‘energy that is expended’ in their body, and this is the position which is highlighted in policy documents, for example, by the Department of Health:

Overweight and obesity are a direct consequence of eating and drinking more calories and using up too few. We need to be honest with ourselves and recognise that we need to make some changes to control our weight.

(Department of Health, 2011, p. 3)

Many people struggle with their weight, and with creating (as well as maintaining) a healthy lifestyle. In the next activity you will see a clip of the television chef Hugh Fearnley-Whittingstall (from the BBC/Open University co-production Britain’s Fat Fight). In this short video Hugh is assessed in terms of his weight by a general practitioner (GP) who he talks to about aspects of his lifestyle in relation to his weight that are helpful and not so helpful.

Activity 4 Lifestyle factors and obesity

Timing: Allow 20 minutes

Part A

Play Video 2, in which Hugh talks to a GP about his weight. Then answer the questions below.

Download this video clip.Video player: Video 2 Hugh visits his GP
Skip transcript: Video 2 Hugh visits his GP

Transcript: Video 2 Hugh visits his GP

[MUSIC PLAYING]

HUGH
Overeating has become so normal that more than half of all overweight men-- Hi, Joe.
DOCTOR
Hi, how are you?
HUGH
Don't even realise they're overweight. If I'm going to wage a war on waistlines, maybe I should start by looking at my own.
DOCTOR
There. Now make sure you're relaxed, please.
HUGH
81 exactly. Are we allowed to call that 80 with all my clothes on, or are you going to call it 81?
DOCTOR
I think I'll call it 81.
HUGH
That's harsh.
DOCTOR
And looking straight ahead. OK, that's fine. And walk away, please. There's not quite so good news. Your BMI, which is the measure of your height and your weight is unfortunately just slightly over where we'd want it to be.
HUGH
OK. How much over?
DOCTOR
Well, your result is 26.2. And I would like it to be under 25.
HUGH
That means I'm officially overweight, does it?
DOCTOR
You are in the overweight category. More worrying, to be honest, is your abdominal circumference. We want everybody to actually have an abdominal circumference under 90 centimetres.
HUGH
OK, and what have I got?
DOCTOR
It's 93 centimetres. And unfortunately, you do come out as increased risk of diabetes over the next 10 years.
HUGH
I cook a lot, I eat a lot of veg, but I do have a sweet tooth.
DOCTOR
Yeah.
HUGH
I drink cider, wine, almost every day, and probably more than a glass.
DOCTOR
Yep.
HUGH:
Sometimes more than two glasses.
DOCTOR
I think--
HUGH
I can't see myself counting calories, per se.
DOCTOR
No, it's a bit of common sense.
HUGH
But I need to lose weight.
DOCTOR
Yes. But you can do it.

[MUSIC PLAYING]

HUGH
I'm at increased risk of type 2 diabetes because of my weight and because of my diet. That's a surprise and a bit of a wake-up call. I'm in the stats.
End transcript: Video 2 Hugh visits his GP
Video 2 Hugh visits his GP
Interactive feature not available in single page view (see it in standard view).

Part B

1. According to his BMI, which weight category is Hugh in?

a. 

underweight: <18.5 kg/m2


b. 

healthy weight range: 18.5–25 kg/m2


c. 

overweight: 25–30 kg/m2


d. 

obese: >30 kg/m2


e. 

morbidly obese or severely obese: >40kg/m2


The correct answer is c.

Comment

Given Hugh’s BMI result he would be categorised as being overweight. This is because Hugh is 81 kg (12 st or 10.6 lb – we are not told what height he is) and we are informed he has a BMI of 26.2 kg/m2.

2. Following the GP’s assessment of Hugh, which result does he describe as ‘more worrying’ than Hugh’s BMI?

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Comment

The GP was more concerned about Hugh’s abdominal circumference than his BMI. This is an alternative metric for determining whether someone’s size is a concern in terms of their overall health. As Hugh’s abdominal circumference is over 90 cm he is at greater risk of health issues such as diabetes.

3. What behaviours or lifestyle factors does Hugh describe as being problematic in relation to him achieving a healthy weight?

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Comment

Hugh states that he has a ‘sweet tooth’ and that he drinks alcohol (specifically cider and wine) ‘almost every day’. He also drinks ‘more than a glass’ at a time.

Although lifestyles are seen as an individual’s responsibility, the social context in which people lead their lives exerts a powerful influence on people and their ability to ‘choose a healthy lifestyle’. Furthermore, the idea of choice and responsibility is not always straightforward, as you will see in the next section.

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