Families are one's ultimate support system, but this may not always be the case with obese individuals. Families, especially extended families, apparently play a key role in "weight-based victimization" — the politically correct term for Parvati's experience.
Overweight people have always complained of bullying or victimization from peers and friends, but new research from the US shows families and teachers too contribute to the victim's tears. A research paper based on a survey of 360 teenagers at weight-loss camps found that 92% said their peers taunted them, 70% blamed friends, 42% pointed to sports teachers, 38% to parents and 27% to teachers.
A funny observation at the dinner table or the sports teacher's insensitive remark about sluggishness could start an overweight or obese person's descent into depression.
Indian doctors say the findings of the paper, published in the January edition of Pediatrics, the medical journal of the American Academy of Pediatrics, hold true here as well. "Indians don't acknowledge that victimization exists within their homes, but what do you call it when a parent asks his or her overweight teenager to look for a shop that sells clothes of larger size?" says Ramen Goel, a bariatric surgeon.
The Pediatrics paper says: "Even well-intentioned parents may inadvertently criticize or tease their overweight children in ways that are extremely damaging."
Consider the case of Pratik Desai. He was 21 and weighed over 120kg when he decided to undergo bariatric surgery. But just when the medical staff trooped into Pratik's room to wheel him to the operation theatre, he decided he didn't want his stomach cut down to a tenth of its size. But his father couldn't stand this last-minute turnaround and loudly admonished his son. "Doctor, tell my son he is very fat," the father went on in front of strangers. "Tell him he doesn't look good." Pratik didn't say anything to his father but managed to get discharged without surgery.
A counsellor says parents accompanying obese children invariably say things like: "Isse gym nahin hota (He cannot maintain a gym routine)." "The youngster invariably starts crying after that," says the counsellor.
Delhi-based endocrinologist Anoop Misra, who has conducted extensive surveys on obesity in schoolchildren, says: "Obesity continues to be a social stigma globally, and particularly in India. Many such children suffer from depression because of victimization." He says weight-based victimization is so prevalent that during school-based health programmes his team counsels obese children separately (not in front of others) and in the presence of their parents.
Goel says people find it easy to be judgmental because in the case of obese people "the diagnosis is written on the body". "People feel you will lose weight if you stop eating, not realizing that the obese person has a medical condition," he says.
Psychiatrist Harish Shetty says: "In India, weight and skin colour are considered important. Sarcasm, though unintentional, begins within the family. Grandmothers will call their dark-skinned grandchildren 'kali', while uncles and aunt will rib someone about the inability to lose weight." These barbs, he says, worsen the child's self-image and result in humiliation.
The Pediatrics study says weight-based victimization has many negative consequences: ranging from weight gain because of binge eating to low self-esteem, depression and poor academic performance.
Goel says the general population should be sensitized about weight-based victimization. "Our society is getting mature," he says. "Now is the time to bring about a sensitization in our people about such subtle victimization."
But Dr Sanjay Borude, bariatric surgeon at Breach Candy Hospital, Mumbai, judges Indian parents more generously, saying they are not guilty of weight-based victimization. "Indian parents are protective about their overweight children," he says. "They learn about nutrition and try to help their children. They are most supportive parents."
(Names of patients have been changed to protect identities)
