La obesidad desde el modelo biomédico, las ciencias sociales y las ciencias de la complejidad

Palabras clave: obesidad, estigma, sistemas complejos

Resumen

Las organizaciones internacionales de salud y las instituciones médicas han declarado en los últimos años que la obesidad es una enfermedad, un problema de salud pública e incluso una epidemia mundial. Esto con base en los datos estadísticos y su influencia en otras condiciones que causan morbimortalidad importante e impacto económico. Este reconocimiento de la obesidad como una enfermedad ha sido bien recibido por las asociaciones médicas, al considerar que asegura una mayor investigación y promueve el acceso de las personas a los servicios de atención en salud con miras a mejorar el bienestar de los pacientes y a mitigar los efectos globales. Sin embargo, las ciencias sociales lo han criticado porque también ha suscitado estigma y discriminación contra las personas con exceso de peso y no han dado soluciones efectivas al problema. En este artículo se describen algunos aspectos relevantes del modelo biomédico de la obesidad, los aportes desde las ciencias sociales y a partir de allí se propone una visión desde las ciencias de la complejidad que propongan soluciones innovadoras.

Descargas

La descarga de datos todavía no está disponible.
Citas

Amao-Ceniceros, M., (2018). Contreras, Laura y Nicolás Cuello (comp.), Cuerpos sin patrones. Resistencias desde las geografías desmesuradas de la carne. Revista de Ciencias Sociales y Humanidades, 85, 201 207. https://doi.org/10.28928/revistaiztapalapa/ 852018/rl2/amaocenicerosm

American Medical Association (AMA). Recognition of Obesity as a Disease - Resolution: 420. American Medical Association House of Delegates. Available at: http://media.npr.org/documents/2013/jun/ama-resolution-obesity. pdf. Accessed on May 15, 2023.

Asociación Colombiana de Endocrinología, Diabetes y Metabolismo (ACEDM). Duque Ossman, JJ, Rosero-Revelo, RJ (Ed). (2023). Manual de bolsillo para el diagnóstico, abordaje y manejo de la obesidad. Bogotá, Grupo Distribuna.

Arrieta F, Pedro-Botet J. (2020). Recognizing obesity as a disease: A true challenge. Rev Clin Esp.,221(9):544-546. doi:10.1016/j.rce.2020.08.003

Bagnall, A.M., Radley, D., Jones, D. et al. (2019). Whole systems approaches to obesity and other complex public health challenges: a systematic review. BMC Public Health 19:8 https://doi.org/10.1186/s12889-018-6274-z”

Blaszczak A.M., Jalilvand A and Hsueh W.A. (2021) Adipocytes, innate Immunity and Obesity. Front. Immunol. 12:650768. doi: 10.3389/fimmu.2021.650768

Bray G. A. (1990). Obesity: historical development of scientific and cultural ideas. International journal of obesity, 14(11), 909–926.

Camacho M.I, I., Goikoetxea Bilbao, U. y Marauri Castillo, I. (2023). Estigmatización social en el tratamiento informativo de la obesidad en la prensa española durante la pandemia. Revista Latina de Comunicación Social, 81, 250-274. https://www.doi.org/10.4185/RLCS-2023-1895”

Campbell, S. M. (2022). Expanding notions of equity: Body diversity and social justice. Psychology in the Schools, 59, 2387– 2404. https://doi-org.ezproxy.unal.edu.co/10.1002/pits.22586

Chakhtoura M, Haber R, Rhayen C et al. (2023). Pharmacotherapy of obesity: an update on the available medications and drugs under investigation. The Lancet 2023, 58, 1-29. 101882 https://doi.org/10.1016/j.eclinm.2023.101882

Christiansen, M. L. (2018). “Homo Caloricus”: La construcción epistemológica del estigma lipofóbico en los discursos mediáticos de salud pública. Salud colectiva, 14(3), 623-637. https://dx.doi.org/10.18294/sc.2018.1602

Cairney, P. and Geyer, R. (2015). Introduction. in (eds) Geyer, R. and Cairney, P. Handbook of Complexity and Public Policy. Edward Elgar.

Douglas VJ, Kwan MY, Minnich A et al. An examination of the link between empathy and weight-based victimization. Social Sciences & Humanities Open 5 (2022) 100247

Eknoyan, G. (2006). A History of Obesity, or How What Was Good Became Ugly and Then Bad. Advances in Chronic Kidney Disease 13, 421–427. https://doi.org/10.1053/j.ackd.2006.07.002

FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: a systematic review. BMC medical ethics, 18(1), 19. https://doi.org/10.1186/s12910-017-0179-8

Garrity, Julie T., “Obesity: A Growing Concern in America” (2021). English Department: Research for Change - Wicked Problems in Our World. 77. https://research.library.kutztown.edu/wickedproblems/77

Gerend, M. A., Stewart, C., & Wetzel, K. (2022). Vulnerability and resilience to the harmful health consequences of weight discrimination in Black, Latina, and sexual minority women. Social science & medicine, 315, 115555. https://doi.org/10.1016/j.socscimed.2022.115555

Goffman, I. (1963). Estigma. La identidad deteriorada. Buenos Aires: Amorrortu Editores.

Griffiths, C., Ells, L., Gilthorpe, M.S., Clare, K. and Coggins, A. (2022) A complex systems approach to obesity: A transdisciplinary framework for action. In: UK Congress on Obesity, 07 September 2022 - 08 September 2022, Lancaster. (Unpublished)

Gutin I. (2018). In BMI We Trust: Reframing the Body Mass Index as a Measure of Health. Social theory & health: STH, 16(3), 256–271. https://doi.org/10.1057/s41285-017-0055-0

Hammond, R.A. (2009). Complex systems modeling for obesity research. Prev Chronic Dis, 3. http://www.cdc.gov/pcd/issues/2009/jul/09_0017.htm.

Haqq, A. M., Kebbe, M., Tan, Q., Manco, M., & Salas, X. R. (2021). Complexity and Stigma of Pediatric Obesity. Childhood obesity 17(4), 229–240. https://doi.org/10.1089/chi.2021.0003

Hawkes N. (2008). National obesity strategy: what’s the big idea? British Med J 337, a2548.

Jimenez Jimenez, M., Silva, J.M. (2022). Mulheres gordas: gordofobia, violências e (Re)existências. Revista Corpografías: Estudios Críticos de y desde los Cuerpos, 9(9),149-161.ISSN 2390-0288 Doi: https://doi.org/10.14483/25909398.20255

Kanagasingam, D. (2022). Addressing the complexity of equitable care for larger patients: A critical realist framework. SSM - Qualitative Research in Health.

Karasu, S.R. (2013). An overview of the complexities in obesity: limitations and challenges. Am J Lifestyle Med. 7(3),192-205.

Lawrence, S.E, Puhl R.M, Schwartz M.B., Watson, R.J. & Foster, G.D. (2022). “The most hurtful thing I’ve ever experienced”: A qualitative examination of the nature of experiences of weight stigma by family members. SSM - Qualitative Research in Health, 2, 100073. https://doi.org/10.1016/j.ssmqr.2022.100073

Lupton, D. (2012). Medicine as culture. Illness, disease and the body. Sage Publications Ltd., London

Lupton, D. (2013). Fat Politics: Collected Writings. Sydney: University of Sydney.

Lupton D, 2018, Fat, second edition, http://dx.doi.org/10.4324/9781351029025

McGlashan, J., Hayward, J., Brown, A., Owen, B., Millar, L., Johnstone, M., Creighton, D., & Allender, S. (2018). Comparing complex perspectives on obesity drivers: action-driven communities and evidence-oriented experts. Obesity science & practice, 4(6), 575–581. https://doi.org/10.1002/osp4.306

McGlashan, J., de la Haye, K., Wang, P., & Allender, S. (2019). Collaboration in Complex Systems: Multilevel Network Analysis for Community-Based Obesity Prevention Interventions. Scientific reports, 9(1), 12599. https://doi.org/10.1038/s41598-019-47759-4

Mackert, N & Schorb, F. (2022) Introduction to the special issue: public health, healthism, and fatness, Fat Studies, 11:1, 1-7, DOI: 10.1080/21604851.2021.1911486”

Martos-Moreno G.A., Sierra Juhé, C., Pérez Jurado L.A., Aregente, J. (2017). Aspectos genéticos de la obesidad. Rev Esp Endocrinol Pediatr, 8 (Suppl), 3266

Moreno, M. (2012). Definición y clasificación de la Obesidad. Rev Med Clin Condes, 23(2), 124-128.

National Heart, Lung, and Blood Institute Clinical Guidelines on the Identification, Evaluation Treatment of Overweight and Obesity in Adults. (NIH publication 98-4083) The Evidence Report. 1998 http://www.nhlbi.nih.gov/guidelines/obesity/ob_gdlns.pdf

Neel J.V. (1962). Diabetes mellitus: a “thrifty” genotype rendered detrimental by “progress”? Am J Human Genet,14(4),353-62.

Organización Mundial de la Salud (OMS). 2021. Obesidad y sobrepeso. Disponible en: https://www.who.int/es/news-room/factsheets/detail/obesity-and-overweight

Patterson m, Johnston J. (2012) Theorising the obesity epidemic: Health crisis, oral panic and emerging hybrids. Social Theory & Health 10, 3, 265–291

Peregalli-Politi, Santiago. (2018). Weight bias and weight stigma in the healthcare system: hypothetical case. Revista de Bioética y Derecho, (44), 135-147. Recuperado en 02 de junio de 2023, de http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1886-58872018000300010&lng=es&tlng=en.

Rathbone, J. A., Cruwys, T., Jetten, J., Banas, K., Smyth, L., & Murray, K. (2023). How conceptualizing obesity as a disease affects beliefs about weight, and associated weight stigma and clinical decision-making in health care. British journal of health psychology, 28(2), 291–305. https://doi.org/10.1111/bjhp.12625

Romano, K. A., Heron, K. E., Sandoval, C. M., MacIntyre, R. I., Howard, L. M., Scott, M., & Mason, T. B. (2023). Weight Bias Internalization and Psychosocial, Physical, and Behavioral Health: A Meta-Analysis of Cross-Sectional and Prospective Associations. Behavior therapy, 54(3), 539–556. https://doi.org/10.1016/j.beth.2022.12.003

Rutter, H (2018). The Complex Systems Challenge of Obesity. Clinical Chemistry 64:1, 44–46

Salas Valenzuela, M. & Castañeda Salgado, M.P. (2022). Obesidad/es: cuerpos, comidas y desigualdades. Inter disciplina, 10(26), 7-19. Epub 04 de abril de 2022. Recuperado en 02 de junio de 2023, de http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-57052022000100007&lng=es&tlng=es.

Sharma, A. (2023). Does this person have obesity? eClinicalMedicine, 58, 101935 https:// doi.org/10.1016/j.eclinm.2023.101935

Sherf-Dagan, S., Kessler, Y., Mardy-Tilbor, L., Raziel, A., Sakran, N., Boaz, M., & Kaufman- Shriqui, V. (2022). The Effect of an Education Module to Reduce Weight Bias among Medical Centers Employees: A Randomized Controlled Trial. Obesity facts, 15(3), 384– 394. https://doi.org/10.1159/000521856

Sturmberg, J.P. (2021) Health and Disease are Dynamic Complex-Adaptive States. Implications for practice and Research. Front. Psychiatry 12:595124. doi: 10.3389/fpsyt.2021.595124

Sumińska, M, Podgórski, R, Bogusz-Górna, K, Skowrońska, B, Mazur, A, Fichna, M. (2022). Historical and cultural aspects of obesity: From a symbol of wealth and prosperity to the epidemic of the 21st century. Obesity Reviews., 23( 6):e13440. doi:10.1111/obr.13440

Vajisha Udayangi Wanniarachchi, Anuradha Mathrani, Teo Susnjak, Chris Scogings. (2020). A systematic literature review: What is the current stance towards weight stigmatization in social media platforms? International Journal of Human-Computer Studies, volume 135, 102371. ISSN 1071-5819, https://doi.org/10.1016/j.ijhcs.2019.102371. (https://www.sciencedirect.com/science/article/pii/S1071

Walls, H.L. (2018). Wicked problems and a ‘wicked’ solution. Global Health 14, 34. https://doi.org/10.1186/s12992-018-0353-x

Westbury, S., Oyebode, O., van Rens, T., & Barber, T. M. (2023). Obesity Stigma: Causes, Consequences, and Potential Solutions. Current obesity reports, 12(1), 10–23. https://doi.org/10.1007/s13679-023-00495-3

Williams, O., & Annandale, E. (2020). Obesity, stigma and reflexive embodiment: Feeling the ‘weight’ of expectation. Health, 24(4), 421–441. https://doi. org/10.1177/1363459318812007

World Obesity Federation (WOF). World Obesity Atlas 2023. London: WOF; 2023. https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2022. Acceso: junio 1, 2023.

Yazdizadeh, B., Walker, R., Skouteris, H., Olander, E. K., & Hill, B. (2021). Interventions improving health professionals’ practice for addressing patients’ weight management behaviours: systematic review of reviews. Health promotion international, 36(1), 165–177. https://doi.org/10.1093/heapro/daaa039

Recibido: 2023-03-27
Aceptado: 2023-07-01
Publicado: 2023-08-31
Cómo citar
Tobler, C. A. (2023). La obesidad desde el modelo biomédico, las ciencias sociales y las ciencias de la complejidad. Revista Iberoamericana De Complejidad Y Ciencias Económicas, 1(1), 89-103. https://doi.org/10.48168/ricce.v1n1p89