Uno degli articoli più approfonditi sull'argomento lo ha pubblicato Slate lo scorso ottobre, un pezzo che racconta lo scenario statunitense e che, con i risultati di ricerche cliniche e sociologiche, approfondisce quanto aggravi la situazione medica dell'obeso lo stress causato dalla discriminazione.
L'emarginazione sul lavoro, dove gli obesi guadagnano mediamente assai meno degli altri, così come l'essere fatti oggetto di scherzi più o meno pesanti, battutacce e umiliazioni, persino in ambienti come scuole ed ospedali, si traducono in una alta quantità di stress e nella produzione di sostanze chimiche da parte dell'organismo che nuocciono alla salute. Non ci si deve meravigliare, quindi, se molti obesi ricorrono al cibo come rifugio antistress, né se la pressione sociale vissuta giorno dopo giorno si traduca in una fuga dalla socialità stessa, tanto che gli obesi che si sposano sono assai meno di chi obeso non è.
L'articolo si aggiunge a moltissimi studi e analisi che negli USA hanno iniziato da diversi anni ad indagare sugli effetti reali della discriminazione ai danni degli obesi. Un tema in Italia del tutto trascurato, persino da chi si occupa di politiche anti-obesità: tanto forte è la stigmatizzazione dell'obeso e dell'obesa che neppure in ambito clinico si prende ancora in considerazione l'effetto dirompente della discriminazione. Al di là dell'Atlantico c'è chi si interroga quante delle patologie tradizionalmente associate all'obesità debbano invece essere riferite allo stress, a partire dalla quantità di persone sotto stress ma non obese che si trovano con patologie spesso identiche ai propri colleghi ciccioni.
Il pezzo di Slate si trova a questo indirizzo, qui sotto alcuni passaggi in inglese che mi sembrano particolarmente significativi:
A recent paper from Yale's Rudd Center for Food Policy & Obesity hints at the scope of this anti-fat prejudice. We know, for example, that if you're fat, you make less money. Lots of studies have shown how body size plays out in the working world: According to one, women who are two standard deviations (or 64 pounds) overweight suffer a wage penalty of 9 percent (PDF); another found that severely obese white women lose out on one-quarter of their potential income. There's also evidence that obese women are less likely to attend college or maintain romantic relationships, even controlling for socioeconomic background. (One survey found that a few extra pounds could reduce a woman's chance of getting married by 20 percent.)
Heavy people may face discrimination in medical settings, too. The authors of the review, Rebecca Puhl and Chelsea Heuer, cite numerous surveys of anti-fat attitudes among health care workers, who tend to see obese patients as ugly, lazy, weak-willed, and lacking in motivation to improve their health. Doctors describe treating fatties as a waste of time, and the staff at teaching hospitals appear to single them out for derogatory jokes. Unsurprisingly, many obese people avoid seeing their primary care providers altogether, and those who do are less likely to be screened for breast, cervical, and colorectal cancers. (That's true even among those with health insurance and college degrees.)
The victims of chronic stress or depression, whatever their size, tend to maintain higher levels of certain inflammatory chemicals in their bloodstream. Under normal circumstances—and over the short term—these cytokines help to control the body's response to dangerous situations like injury or illness. The chemicals create their own problems, though, when they stick around too long. A sustained or elevated stress response seems to increase your risk of heart disease, hypertension, and diabetes. That may explain some of the relationships between health and wealth: Blood tests show unusual cytokine activity among those of low socioeconomic status as well as patients with post-traumatic stress and panic disorders.
It turns out that obese people have unusual cytokine readings, too, and these are often taken as the cause of weight-related illness. According to one theory, the presence of visceral fat cells can set off a biochemical chain reaction that leads to the inflammatory response. (Fat cells may even secrete the cytokines themselves.) As a result, someone who's fat and someone who's chronically stressed will be at risk for many of the same diseases.
It may be that obesity and stress are independent risk factors that happen to affect the body in similar ways. Or maybe chronic stress leads to weight gain, which in turn causes inflammation. According to epidemiologist Peter Muennig, there's another pathway from excess weight to disease. In his 2008 paper "The Body Politic: The Relationship Between Stigma and Obesity-Associated Disease," Muennig argues that the stress and shame of being fat causes those cytokine abnormalities. In other words, obesity makes you sick by stressing you out.
Nessun commento:
Posta un commento