Monday, November 15, 2010

Obesity, diabetes and an image problem

In a recent story from the People's Daily, more young Chinese are becoming diabetic. The story goes on to ascribe this trend to the changed lifestyle that many young urbanites have switched to:
Two years ago, Ke Li, was living a life typical to many office workers. He frequently worked until late at night, ate junk food and hardly did any exercise. The 6-foot-tall young man never thought he would be a candidate for diabetes.

"Who would pay attention to blood sugar at that age?" 27-year-old Ke told the Global Times. "I went to hospital because I had fatigue and always felt thirsty, even in summer, but I was soon told I had diabetes after a blood test."

Ke was not aware that his growing weight, which had hit 94 kilograms when he was diagnosed, was a warning.
Okay... so this isn't too surprising. After all, type 2 diabetes has been linked to obesity, and obesity has been linked to unhealthy lifestyles (not enough exercise, eating junk food, high stress, etc.). It would, therefore, make sense that, in a country with an urban population of several hundred million people exercising less and having more ready access to Western junk food, type 2 diabetes would become more prevalent.

So what makes this something more interesting? Well, according to the story, Ke Li is 6 feet (~183 cm) tall, and weighed 94 kg (207 lbs), which gives him a BMI of 28.1 (if I use 183cm as the actual height). Assuming that the guy's height is as low as 177 cm (which he rounded to 180 cm when talking to the reporter, who then rounded up to 6 feet when writing the story), the guy's BMI is exactly 30.0. At the end of the story, Ke Li is reported to have lowered his weight to 78 kg... which would (using the 177 cm low estimate) put him at a BMI of 24.9: right at the cut-off point of the "normal weight" category. Why point this out? Well, the People's Daily is a state-run newspaper, and it seems kind of odd to me (a 6'3", 226lb person) that the main diabetic interviewee had a BMI that just barely (possibly) registered as "overweight" before just managing to sneak back into the "normal weight" category. Similarly, the image that accompanied the story (below) was of a young, female urbanite that clashes with a Western image of "obese".

This image was copied from the People's Daily news story, in case it is no longer shows up in the future. (Not that I think that my blog is that important or visible, just that some websites remove images from stories after a certain amount of time passes.)

For a country to which image portrayal is highly important, it wouldn't surprise me if there was some amount of editorializing with the numbers and choice of image. Depicting a woman who stretches the image of obese and presenting a man who barely wanders into the "obese" category of BMI might - independently - not strike me as too odd, but not when they occur together.

China - I would argue - doesn't like to be put in the spotlight with things that it finds embarrassing. Thus the angry rhetoric that accompanied the Nobel Peace Prize announcement. Thus, too, the huge embarrassment about the tainted milk scandal that just couldn't be handled quietly. Same with their condemnation of anything written with even a slight whiff of negativity about Tibet. I would argue that there is some of that coming through here. Although there are explanations as to the current Chinese obesity increase being tied to traditional Chinese culture (which was shaped by famine, and in which an obese person would be an obvious sign of wealth), the association with obesity in the traditional sense focused on the positive implications (i.e., more wealthy) than on the negative (i.e., increased risk of heart attack, stroke, or diabetes). In the light of this potential link of obesity with disease, it makes sense to me that the images (in text and in print) proffered by the state would show as rosy a face as possible, as opposed to the images one finds when doing a search for "obesity China".

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