Medicalization & Pharmaceuticalization in Sociology of Health

[00:00:00]hi everyone welcome back to week six of our course this week we'll be talking about some really Core Concepts to the sociology of health and illness or associate medicine medicalization and pharmaceuticalization a couple big words there but these are going to be really really crucial um very Core Concepts as we move forward through this class so let's jump into it all right so medicalization what does that mean this is essentially a process hence the isation suffix by which conditions processes body functions or experiences and emotional states are redefined and and treated as medical issues so essentially a non-medical issue or a just general Human Experience exists it becomes redefined as a medical issue through the process of medicalization and then it is from their forward understood as a medical issue and something in need of treatment medical research and potentially seen as a pathology when it might not necessarily be anything other than a typical human experience another core facet of medicalization is this growing influence and Authority that the health industry has particularly within the West within the United States we have this idea that um you know the experts the doctors the medical professionals they are the end all be all authority on um bodies on biology on medical issues and that if something is labeled as a medical issue by these medical authorities then that is true that is the case but we'll see that it's not quite so cut and dry not quite so black and white and this process is a little bit messier than it might seem on the surface there's also a lot of reasons why something might become medicalized or be reframed as a medical issue Beyond just um you know hard objective biological evidence of something such as like a viral infection when we look at other examples such as menstruation menopause cause body weight and so on so here we have a few examples to really solidify what this concept of medicalization looks like we have some conditions such as sexual dysfunction and libido particularly in afab individuals or those assigned female at Birth we have this in the DSM labeled as female sexual arousal disorder um that's just one of many examples of medicalization but essentially in this case we're taking the Human Experience of having a low libido and then labeling it as sexual dysfunction or a pathology and giving it that diagnostic label of female sexual arousal disorder interestingly we've got this gender element here as well this is not something that exists in the DSM the diagnostic and statistical Manual of mental illnesses the book that psychiatrists and psychologists use to diagnose mental disorders um it's very interesting here that we see this diagnostic label present or available only for afab individuals we also have other examples such as learning difficulties being labeled as different kinds of intellectual or possibly developmental disabilities Eating Disorders have been heavily medicalized addictions as well we often hear addiction discussed as a disease really interesting to think about you know what is a disease and why does addiction possibly fit or not fit into that kind of label we also see PMS premenstrual syndrome menstruation and menopause being medicalized um a certain moods or intensities of moods in particular like anxiety and anger at certain levels of intensity we might start to label those as possibly mental illnesses or other kinds of pathologies we also see childbirth being heavily medicalized we will dive into that in a little bit more detail in the following slides aging and of course deaf and dying also have been very heavily medicalized all of these things are just normal parts of the human experience they're not necessarily medical until we understand them that way and understanding them as medical issues or at least as something that the medical sphere can have a part in assisting with there are benefits to that but there can also be some downsides and this can be kind of a messy process so let's talk a little bit more about what medicalization can look like in practice so one of the big reasons why medicalization is so prevalent especially in the western world and in the United States is that it is profitable that's not to say that all doctors who are diagnosing people are just trying to make a quick Buck um but this is to say that the Medical Institution does make money off of the process of medicalization leading to more medical conditions existing more patients being treated because the more people who are diagnosed with something the more people are going to be returning to their practitioners um you know putting in insurance claims buying Pharmaceuticals buying treatments so we see the outcome even the kind of a roundabout way in a correlation kind of way that when medicalization occurs profits can and do increase for the medical industry and so we have to consider in this case um is there a possibility that medicalization might in some cases take place for the sake of generating profits and the answer would be yes in some cases we do see a lot of examples of this which we'll discuss in the following slides this is not to say that of course every single time medicalization occurs or that every time a human experience is medicalized that it is for the sake of profit alone right there are a lot of doctors there are a lot of practitioners and researchers out there who are really just trying to help people and learn more about the human body and about um disease illness and different treatments for diseases and illnesses but um what we will see in kind of a roundabout way again as maybe a side effect of this process is that profit for the medical industry it's not always ethical but it's not always unethical either there's some gray area and it really kind of depends just like so many things in sociology Switching gears for a moment to talk about pharmaceuticalization um try to spell that word backwards pharmaceuticalization is again another process hence that isation suffix of essentially medicalization with a pharmaceutical Focus so we're in this case um seeing an increase in the recommendations for use of different Pharmaceuticals the sale of more Pharmaceuticals as treatments for different kinds of conditions particularly conditions that have been medicalized or when we see a condition become medicalized it is very likely that we will also see an increase in the development research prescription and use of different kinds of pharmaceuticals this does of course generate profits for the pharmaceutical industry or big Pharma as a lot of people like to say that doesn't have to be a bad thing but it is something we should acknowledge sometimes medications are developed and sold with purely the purpose of um increasing profits and so we have to think you know where is this research coming from who is doing research on these medications and why what is the purpose of this medication what's it meant to treat and is it effective um whenever we see new Pharmaceuticals coming out on the market it's really important that we look at the stakeholders in the development of those Pharmaceuticals who funded that research and is there possibly any kind of conflict of interest where a company is funding research on their own products that they want to sell for a profit that can be potentially problematic and potentially unethical so it's really important that we dive into um those details when we're looking at this process of pharmaceuticalization and this increased use in Pharmaceuticals to treat a lot of different kinds of conditions medical or medically recognized or otherwise um because there are some potential downsides to the use of pharmaceuticals if it's not the appropriate pharmaceutical for a particular condition or if it's just not really well researched um the FDA is pretty good in the United States about making sure that safe things end up on the market but there are a lot of supplements out there that are in a sense part of the pharmaceutical industry but that are not FDA regulated so it's important um you know when we're engaging with pharmaceutical use that we are aware of all of these different kinds of facets and factors in the safety and efficacy of these kinds of treatments a couple examples of pharmaceuticalization to make this concept a little bit clearer we have a lot of medications that have been developed for ADHD Attention Deficit Hyperactive Disorder Ritalin is just one of many that is of course not to say that Ritalin is not useful or that ADHD is not real or that medicalization of ADHD is um you know faulty in some way but what we do see is that a lot of people with this diagnosis are automatically given prescriptions for these types of stimulant medications and we need to make sure that we're being very careful as prescribers or as medical practitioners that when we do these Diagnostics we are being very careful not to misdiagnose over diagnose under-diagnose or really just try to avoid mistakes in that process because there are major consequences to using prescriptions that are not appropriate for a person's individual situation so we see this increase of prescribing Ritalin for ADHD as well as other stimulant medications kind of this process of saying Pharmaceuticals are the answer are the solution to this so-called problem um ADHD for many people might be seen more as a neurotype or a form of neurodivergence rather than a pathology or a disease or something that's wrong with that person it could just be a different form of experiencing um you know human life The Human Experience we also see of course weight loss drugs we see first the medicalization of body weight especially higher body weights and then the prescription of weight loss drugs or the use of those Pharmaceuticals whether by the recommendation of a physician or otherwise a lot of psychiatric medications also are being prescribed at really really high rates that's not to say that they're not helpful but for a lot of individuals particularly with mood disorders certain moods and certain intensities of moods certain experiences of emotion have been labeled as pathological have been turned into or given the label of different mental disorders and so in those cases you know we can look to the DSM and see all these different human experiences all these different emotions that have been medicalized and then that pharmaceuticalization where we're saying okay here is the solution Pharmaceuticals um we also see examples like Viagra a medication used for erectile dysfunction again another human experience that we have medicalized and start to see as a pathology or a problem nicotine gum could be used for quitting smoking we also see a lot of different sleep aid medications for insomnia or trouble sleeping we see this really huge prevalence of prescribing and using the pharmaceutical intervention and again we need to question if that's always the best approach Pharmaceuticals Pharmaceuticals can be really really useful for a lot of individuals in a lot of different situations but the rate at which they're being prescribed is incredibly high and so sometimes we have to think you know is this kind of a Band-Aid approach and is there potentially something underlying that we could also do as far as lifestyle adjustments talk therapy interpersonal communication or changing other things in a person's life that could potentially benefit their health in a way that does not necessitate or does not rely so heavily on the use of pharmaceuticals for a lot of people Pharmaceuticals are life-saving but for a lot of people they are also uh not necessary or not the most helpful treatment and so this concept of pharmaceuticalization is a little bit critical um at least in sociology of Medicine of this really heavy Reliance on Pharmaceuticals rather than any other options getting a little bit more into the topic of mental health and medicalization we can talk a little bit more about the DSM the DSM is notorious within the sociology of medicine I'm sorry for any psych managers out there but it's really important that we be critical of these social constructs of health and illness particularly mental illness and so in the DSM we see a lot of human experiences that are labeled as mental disorders or mental illnesses and this is not to say that mental illnesses do not exist but we want to be we want to acknowledge the fact that all of these labels are socially constructed they are decided on by a committee of people at the American Psychiatric association and we need to think about you know who are the people making these determinations creating these diagnostic criteria creating these labels and why how are these diagnostic categories helpful how might they be potentially not helpful why do they change so often so this diagnostic criteria it is socially constructed it is um something that is essentially made up by people um to categorize and understand our experiences and our world and it can be a little bit messy it could be a little bit problematic at times and so it's really interesting to look at the history of these processes of medicalization with mental health a couple examples that we've talked about female sexual arousal disorder is currently in the DSM to describe low libido among afab people we also saw homosexuality up until 1980 it was listed as a sociopathic personality disturbance we can see of course now how problematic that perspective is but for quite a long period of time homosexuality was seen as a pathology or a disease or a problem with a person or with their their brain their body their existence in a way that was very heavily medicalized we also see that a lot of transgender people or gender non-conforming individuals today are diagnosed with gender identity disorder we also have seen a gender dysphoria as one diagnostic label in the DSM as well and again all these labels are created by a committee of people trying to label categorize and understand our experiences and our world but it's really important that when these decisions are being made that people are being included and represented in that committee and that's not always the case um I don't know for sure who is sitting on the board at the APA right at this moment but we do know that throughout a lot of our history with medical research and Psychiatry um really the whole medical field in general there was not a lot of representation of lgbtq plus individuals women gender non-conforming people people of color there were a lot of um you know straight white men who were feeling these kinds of roles and even today that is still the case in a lot of scenarios and so the results that we see from that population being those who contribute to medicalization and construct these diagnostic criteria I think it has kind of a skewed and different perspective than people within those communities or who have those experiences themselves might develop instead um these diagnoses probably anything in the DSM but particularly the ones listed here as well are treated with different uniformaceuticals different therapies that can be helpful but of course we know that things like homosexuality in like the 70s and 80s was being treated through things like conversion therapy um spending time in asylums and a lot of other really problematic practices another thing that is important to acknowledge as well within the whole field of psychology and Psychiatry um and I say this as someone who I was a therapist for a little over half a decade so I spent quite a lot of time in this world um it is very very individualized and that is um you know we can blame neoliberalism for that if we would like to we can blame uh the western individualization or individualism for that but really the way that we approach psychology and psychiatry in the US is very individualized that's not necessarily a bad thing but what that does tend to give us is a lack of focus on social and cultural factors that lead to mental health struggles or potential mental illnesses a lot of individuals have things going on outside of themselves outside of their coping skills their lifestyle habits or their own biology that is really like the main contributing factor to their experiences of mental illness or struggles with mental health so of course the DSM is a product of our culture those who are developing it are not in a vacuum they're not perfectly objective these are things that are being socially constructed and um these are experiences that are being medicalized to um potentially be a very helpful tool but there can also be of course these tricky and potentially problematic outcomes as well all right here we have a quote straight from one of our readings this week I'll read to you it says disorders become medicalized when it is claimed without any supporting research evidence that they are caused by genetic deficiencies chemical imbalances or other biological phenomena again this is kind of criticizing that very um you know medical model bio essentialist and individualistic approach to Diagnostics where we're looking at things like genetics and chemicals within that individual's brain rather than looking at their sociocultural context or things outside of that individual because we really do need to include that to get that full well-rounded picture of a person's Mental Health and so medicalization is something that is pretty heavily criticized within the sociology of medicine when it is done for reasons such as profit seeking or in ways that ignore that social and cultural context because that's really just missing a big part of the picture um here we of course can't have an actual discussion over video but I'd like you to think about what are some things that can contribute to mental health struggles besides these biological explanations we tend to focus on these things like genetics or chemicals or biology but there's a lot going on besides just the biology of an individual when it comes to mental health difficulties someone who is completely so so-called healthy with their biology could have mental health struggles because of the situations that they're living in maybe their socioeconomic status is causing stress and they've got this um you know maybe potentially food insecurity or housing insecurity or interpersonal difficulties there are so many things that can contribute to poor mental health or mental health struggles besides these biological bio essentialists very individualistic kinds of explanations so it's very important that we recognize that and that we see in the social construction of mental illnesses that there's a little bit more to the picture compared to what we tend to let's focus on all right so now we come to one of my favorite topics of this lecture and of our entire class the medicalization of sex and gender this can be kind of a difficult topic for some people to learn about this is going to go maybe a little bit against things that you might believe or have heard previously so please try to keep an open mind as we journey through this topic a little bit of background information about some of the terms that we're going to use first sex this word refers to the biological categories that are determined by the traits of the physical body so a person's sex includes their internal and external anatomical structures so internal structures could be things like the uterus uterine tubes ovaries the vagina external structures could be testicles the penis clitoris labia all of those anatomical structures we also want to look for a person's hormone makeup when determining their sex so the different levels of things like testosterone and estrogen that that person has every single individual on Earth every human being has all different kinds of hormones everybody has testosterone everybody has estrogen we all just have it in varying levels and then we can also look at genetic factors such as sex chromosomes to determine a person's sex so it's not just any one of these bullet points we have to look at all three to determine what a person's sex is um and we'll talk a little bit about some of the variations that we can see when we're looking at all these categories when it comes to human biology when we're talking about gender specifically in sociology but also in general sex and gender are not the same thing they're not synonyms they are different gender refers to Identity categories that are aligned with your own personal debt identification with masculinity femininity and or androgyny this could be your internal sense of these experiences you're also it could also be your external expression of masculinity femininity or androgyny androgyny being kind of a blending between masculinity or femininity or kind of going outside of those categories as we typically understand them um and so gender and sex for the sake of our course and sociology in general they are not the same Sexes looking at biology gender is looking at identity masculinity femininity and androgyny so before we get into some details about medicalization in this process let's talk about a couple misconceptions let's bust some myths here one really common myth that we hear in the United States is that there are only two Sexes male and female and one of the really cool things about human biology is that biology really doesn't follow binaries biology and nature like to be on spectrums there's a lot more variation than we tend to see with the naked eye and that we tend to recognize in our society so there are actually a lot of different biological Sexes possible again looking at that biology of Interline external Anatomy hormone makeup and chromosomes we have six chromosomal sexes in humans and these are not incredibly rare not anything that is necessarily problematic or unhealthy these are just very normal parts of human variation and we tend not to talk about this very often in our society but a lot of individuals might have these differences in chromosomes um and they might not ever even know typically we hear that XX chromosomes are female chromosomes X Y chromosomes are male chromosomes or that the Y chromosome makes a person male but we also see x x y x zero so someone who has only one X chromosome x y y x x x y and there are a few other options as well but um some of the other options as far as chromosomal Sexes are a little bit rarer so these are the six most common that we see in humans another myth is that you can tell a person's gender identity just by their appearance again gender is about identity it's about your personal sense of self as well as your expression so this is very personal and a person's appearance the way that they present themselves to the world doesn't necessarily give you all of the clues as to how they identify or see themselves so um we really can't assume just based on somebody's appearance how they see themselves how they experience their gender how much masculinity they feel how much femininity or how much androgyny they're in touch with with their own personal identity so it's going to vary a lot depending on the individual from person to person um and so it's important that we don't have these assumptions that you know what a person looks like is really all there is to it there's a lot more going on under the surface amongst every single one of us all right so let's talk a little bit about intersex individuals this is a excellent example of medicalization of sex and gender so intersex people are individuals whose bodies don't fit directly into the binary categories of male and female particularly when we're looking at biology so we're looking at sex here there are over 30 different types of ways to be intersex so some of those chromosome differences that we talked about people who don't have X X or X Y but who might have x x y x y y x zero xxxy any of these other chromosomal differences they could be classified as intersex people a lot of people will actually never know that they are intersex one great example would be Caster semenya the Olympic runner she did of course find out and there was a whole um kind of debacle over that that we will discuss a little bit in a moment but um there are people who have X Y chromosomes that we typically understand to be male chromosomes who can have something called Androgen insensitivity syndrome and in that case you have XY chromosomes but your body is insensitive to androgens meaning it doesn't respond to testosterone to develop in a way that is typically male so people can have X by chromosomes and develop typically female anatomy so you know an internal uterus ovaries they might menstruate they'll go through a female puberty and they will have X5 chromosomes a lot of people in that situation they can get pregnant they can have children they will likely never know that they are intersex so there's a lot of variation out there amongst biology and the way that human bodies can work it's really really fascinating um so of course we talked a little bit about chromosome differences there we also can see some anatomical differences amongst some intersex individuals some people will have what we call ambiguous external genitalia so this could be external genitalia that's visible um you know to the naked eye without any Imaging where a person might have um like blanket a little bit here um either what looks to be too small of a penis or too large of a clitoris kind of just this in-between type of genitalia that is not quite clearly a penis not quite clearly a vulva um and in that case that person may be considered intersex we can also see internal structures that don't fit in the binary so someone who has an external penis and testicles who also has internal ovaries and so on um we see a lot of different variation amongst this population we also can see of course hormone profiles that don't fit into the typical binary expectations so this could be like an afab individual if someone assigned female at Birth who has really high Androgen levels this could be someone with Androgen insensitivity syndrome this also could be somebody with PCOS polycystic ovarian syndrome that wouldn't necessarily make them intersex so there's a lot of variation here there's a lot of very colorful differentiation and it's really um it's such a spectrum it's not easy to chunk people into these clear categories when it comes to sex and I think that's really one of the biggest myths that we have in the west is that there's just nail and there's just a female and that's the end of the story um we have a whole lot more options we have over 30 different ways like dozens of options when it comes to just the biology alone we're not even looking at Identity or gender expression I think this fact is also really really amazing it is actually more common to be intersex than to be a redhead it's also about just as common as being a twin so about two percent of people like two out of every 100 people are intersex only one percent of people are redheads so if you think about every time you've met someone with red hair every time you've met someone who is a twin you have met intersex people more often or equally as often as you've met people who are redheaded or twins so it's actually pretty common and that's just the people that we know are intersex there are probably tons tons more people this percentage might actually be quite a bit higher because there are just a lot of individuals that will never know that they are intersex so really really important stuff here here I have just a few examples of some famous intersex individuals you may or may not be familiar with these individuals here I did mention Caster semenya just a moment ago down here at the bottom left of the slide she's an Olympic runner who had several medals and um then was discovered essentially to be intersex with Androgen and Sensitivity Syndrome so she had XY chromosomes but had developed a typically female body and had no knowledge of this prior to that Discovery through some testing and so um a very interesting case there she was originally stripped of her medals and they were eventually returned but there was a lot of debate about you know should we let intersex individuals participate is this Fair very similar to the debate that we hear about transgender athletes and this exclusion or this intention to exclude trans people from participating in sports um due to again a lot of misconceptions about how biology and sex work but also gender identity um so I really encourage you to look into the intersex Community more learn about it learn particularly from intersex creators personally I am not intersex as far as I'm aware and so I'm not speaking for the community as far as um you know it's not my personal experience but there are a lot of amazing creators out there that you can find on social media places like YouTube and stuff as well if you want that um longer video content and um you know it's just it's really cool to learn more about this community because they are a really really large community that gets uh pretty much overlooked by most of our society so looking kind of at a darker side of the history here with medicalization of intersex bodies we have seen that um you know while intersexuality is a normal part of human variation it is not unhealthy whatsoever there are no health concerns related to being intersex but we have seen the medical field take intersex people and say this is a pathology this is a problem you need treatment this is this is bad this is not okay um and some of the really terrible outcomes of that perspective of that medicalization have been IGM this is intersex genital mutilation which is uh non-consensual surgeries done on very young children or even babies people who are born particularly with that ambiguous external genitalia and so in these cases a lot of the time if a baby is born with that ambiguous genitalia um they will be non-consensually subjected to surgery to correct that Anatomy this is essentially just aesthetic plastic surgery there is no health problem no health risks associated with that kind of anatomy it's just part of being a human we also see hormone therapies a lot of the time intersex people are given hormone therapies this can be useful for a lot of individuals but a lot of people are given hormone therapies especially as children they may not even know why and this is intended to correct the hormone profile of that person or their body in a way that is really not necessary um so when we see this medicalization of intersexuality happening there are some negative effects there are some very harmful life-changing life-altering and unconsensual non-consensual practices that are being done to this population that is um really really concerning there is a lot of activism within the intersex community and the gender non-conforming Community pushing against these practices and things are improving in a lot of ways but um it's very slow progress I think also on this topic it's very interesting to compare um the acceptance of the um of IGM of doing surgeries on babies um to essentially fit them into the gender binary there's not a lot of outrage about that it's pretty accepted by a lot of individuals and on the contrary we see a lot of um outrage and upset about surgeries on transgender children which are actually not happening um surgeries especially you know gender reassignment surgeries or gender confirmation surgeries and hormone therapies are not typically being done on young children who are transgender or who have a gender identity outside of the binary or that doesn't fit you know expectations but those whose bodies do naturally intersects children are being subjected to these kinds of treatments so the injustices that are happening to both of these communities are similar in a lot of ways in a way that is definitely worth investigating and understanding so that you know the next time you get into a conversation with someone about these topics you could be a little bit more informed about um what is really happening you know and why is it happening and what are some of the problems that are taking place that we really should be working to correct so Switching gears now to talk a little bit about medicalization of body size as well as the concept of fat phobia in the west and specifically in the United States we have this perspective that looks at body size and body weight as an individual choice or an individual's fault and we also tend to see higher body weights as a medical problem or as a pathology and so we have this push to you know solve or correct or cure a person's weight problem and that individual is really seen as responsible for doing that solving you know you are responsible for seeking out the cure for the problem with your body in that perspective we can call Fat phobia within sociology of medicine and sociology in general we tend to say that people with larger bodies fat individuals are discriminated against and oppressed in our society we see a lot of evidence of that we can talk about some examples of that oppression um but that is the result of fact phobia as well as this medicalization of body size and body weight we see a lot of jokes in the media we've probably all seen movies or TV shows where um you know characters with larger bodies are kind of the butt of the joke we also see a lack of variety in clothing choices for those with larger bodies we tend to see either very uninteresting or unflattering or just you know not a lot of options as far as clothing choices that could be really really limiting to people who have larger bodies we also see of course the built environment being inaccessible plane seats or movie theater seats or chairs in general beds there are a lot of different kinds of infrastructure that are not built not designed for people with larger bodies or who need more space and um that could be seen as a result of fat phobia as well within our society finally we also have Healthcare mistreatment medical practitioners or professionals treating people with larger bodies badly doing you know medical gas lighting being dismissive or chalking up medical concerns purely to a person's body weight um these are all problems that we tend to see happening not just in the United States but these are very very prevalent issues within the U.S um I said finally about Healthcare mistreatment but we do have another example here of interpersonal discrimination um this could be fatsobia from one person directly to another um this could take the form of bullying um rejections for jobs rejections for um you know rental applications or mortgages or potentially in the dating sphere there's a lot of different examples that we could see of interpersonal discrimination against people with larger bodies and then finally of course social scientists as well as medical practitioners tend to overlook this population tend not to include people with larger bodies or fat individuals in research all the time and that can be really problematic because we're not getting that well-rounded representative sample when we're looking at um you know human interactions social phenomena we really want to include everybody and get these really representative well-rounded samples and we're doing research and so are reading this week really criticized that the um the lack of focus that a lot of those are scientists and sociologists have had when researching this population or researching other issues and just excluding this population from the sample all right so what does it really mean to medicalize body weight we have seen a shift over time over the last few centuries um particularly the last few decades even of this perception of larger bodies going from positive to negative through a lot of human history having a larger body or a higher body weight was seen as a positive thing and more recently especially in the last few decades we tend to see this as a very negative thing within our society we have this very fat phobic discriminatory kind of perspective we also saw in the last few decades the invention of BMI or body mass index I have a little graph here on the corner of the slide of BMI as it stands today um essentially the invention of BMI was creating this metric to label and categorize people's weight based off of their height and I'm sure a lot of you are aware of the potential problems with BMI especially for people who are very tall very short who have a lot of muscle mass potentially higher body weight because of that muscle mass as well um using BMI as a metric for health is potentially problematic because of all of those different factors um because a person's weight and height alone really don't tell you too much about their health there are a lot of other factors at Play what we did see specifically starting in the 50s and really ramping up especially into the modern day we saw a lot of governments the US government included and pharmaceutical companies campaigning to promote this idea that BMI is the ultimate marketer of health and that people have to individually solve the problem of their weight if it's too high so this idea that you know once BMI was invented a bunch of people were automatically classified as overweight or obese and those individuals were then told okay you have been medicalized you now need to seek out treatments seek out Pharmaceuticals and um cure your problem we saw a lot of fear-mongering in these kinds of campaigns a lot of you know pushing for National Health campaigns that was done in a very fat phobic and problematic way a very victim blaming kind of way and there was a lot of fear-mongering a lot of misinformation a lot of very exaggerated information and the really tricky thing about this is that a lot of um individuals um excuse me a lot of pharmaceutical research is actually funded by the pharmaceutical companies that are seeking to sell and profit from those Pharmaceuticals particularly weight loss drugs those are very often researched by stakeholders who have um you know really have a stake in making sure that those drugs are you know promoted as safe promoted as weight loss treatments and that can be actually potentially pretty harmful to a lot of people's Health when that research is not done in a completely objective way that it's not funded by stakeholders in the um promotion and sale of those Pharmaceuticals it's really interesting that a lot of the research tends to skew in the direction of saying that higher body weights are unhealthy that being obese or overweight is really really bad for your health when we have very mixed research on this actually um we do tend to see that people who are classified as underweight um by that BMI scale actually have higher mortality than those who are classified as overweight but instead we have this Focus especially in the medical field on overweight or higher body weight people um instead of underweight people who actually have that higher mortality rate so we have this this bias this stigma against higher body weight people that is really skewing how we do our research what kind of pharmaceuticals are on the market and why who is selling them who is paying for that research and really just the whole picture is um not very objective right the information is very mixed we do have some evidence that higher body weights are associated or correlated with certain kinds of health concerns but we also see that for lower body weights or underweight people too so we need this well-rounded full picture of the topic as opposed to our medicalized perspective of just saying that higher body weights are bad higher body weights are unhealthy period end of story you know go take care of it go get treatment go use Pharmaceuticals when really it's um it's not that simple um you know obesity as well as BMI and these categories and these labels are all social constructs they have all been medicalized and so we really need to look at what are the stakeholders um doing this medicalization aiming for what is the purpose what is the goal why do we create these categories and why are they potentially important um all of these different factors so we talked about this a little bit already but um Health marketing and the incredibly profitable weight loss industry are huge reasons why the medicalization of body weight has been very profitable and potentially can be seen as very problematic so we have this huge huge industry that is marketing all these weight loss treatments products medications um you know weight loss shakes teas all kinds of stuff like that um You probably see it all the time you know Billboards advertisements on social media it's everywhere um this Health Market or the the health industry the weight loss industry it is huge it is super profitable and um the medicalization of body weight really facilitates the ability of this industry to continue to function as it does because as long as we're told that something really anything you know insert a thing is unhealthy is a medical problem people will seek out treatments people will believe there's something wrong with them and they will seek um treatments they will seek care they will try different things to try to correct that issue but we have to really think you know critically about this is body weight actually a medical issue um again the research is really mixed on this we see um different research telling us yes different research telling us no a lot of research saying it's inconclusive and so it's important to be informed it's important to do your own research and to take care of yourself in the way that is best for your own body and what we really need to do away with is the the shame the stigma and the pressure that we have in our very individualistic Society saying that high body weights are bad and that um you know it's this individual responsibility to correct um one's body weight because that is a really really harmful perspective that does a lot of damage to a lot of individuals regardless of their body size um we see of course a lot of Eating Disorders in the west particularly in the United States and we can tie that back to this medicalization of body weight and two fat phobia and the health marketing industry um so it's really important that we are critical of these processes and we look with a very Discerning Eye at these kinds of um practices processes and these industries as well when we're actually talking about things that contribute to a person's body weight there is a lot more to it than the pharmaceutical industry the weight loss industry and the medical field might really focus on on the surface big factors for body weight are going to be things like socioeconomic status we tend to see higher body weights amongst people with lower socioeconomic status a lot of the time people who are low income have less access to nutrient dense foods but they might have a lot of access to calorie rich foods on the contrary also higher levels of stress and lower quality sleep are associated with higher body weight a person's age as well as people get older they tend to have a higher body weight as time goes on we also see a person's hormones and possibly also some genetic factors contributing to body weight as well we see a person's ability to exercise whether it's disability or time or anything else that gets in the way of their ability to exercise as well as a frequency and intensity of exercise that they can take part in being factors in body weight further access to health care and the quality of Health Care that a person has access to that can be a huge Factor as well in what happens with that person's health and body weight over time further we see the types of foods that a person has access to a lot of the time this is linked to socioeconomic status that could be a factor in weight as well and substance use habits such as use of drugs or alcohol particularly substance abuse depending on the substance that could affect a person's body weight as well so a lot of those things are actually not individual right those are things that are big scale socio-cultural factors they may be environmental factors they may be due to a lot of things that are completely outside of an individual's control so our very individualistic perspective on body weight and weight gain or weight loss that can be particularly problematic when we Overlook all of these other factors specifically in the medical sphere it's very important that we have this well-rounded perspective and approach to understanding body weight and looking at all of these factors all that social cultural and environmental context is really really crucial I mentioned a few of these already but some of the consequences of medicalizing body size can be things like eating disorders internalized fat phobia and people of all body sizes potentially unnecessary and risky bariatric surgeries or weight loss surgeries a lot of people might use dangerous or potentially Health compromising weight loss drugs Pharmaceuticals or other treatments this is also of course generating great profits for potentially predatory corporations on ethical corporations that are marketing these kinds of products to us and we also can of course be looking over the social causes of for health in favor of victim blaming individuals there are of course a lot of other consequences of medicalizing body size these are just a few but this is a very very serious issue this is one example of medicalization where we're taking something that is just a very normal human experience of just existing in a body and saying that certain bodies of certain sizes of certain types are unhealthy and then we get all of this just quick Cascade of all these different consequences so in summary there is a lot we could talk about when it comes to medicalization and pharmaceuticalization and we'll actually cover a little bit more next week as well but um when we're talking about the topics we covered today it's important that we know that um it's messy it's not a super cut and dry super clear process to medicalize or to diagnose or to find different disorders there is a lot of disagreement and a lot of mixed information out there um particularly about body weight and health I discussed this a little bit already but we are uh not super sure about this relationship between body weight and health we've got some correlation research um we're seeing that some research is showing that higher body weights are associated with different kinds of negative health events but um when we look at that research we have to of course look at who funded that study if a weight loss company gives money to researchers and says hey please go find out whether obesity leads to heart attacks um is that going to be completely objective research possibly not um so we need to make sure that we're looking at who is funding research and that we're really looking at is this an objective study when we're looking at these relationships between probably body weight and health but really any other factor in health we've seen a lot of research in the past that looks at race and health in a way that frames race as particularly for people of color as something that is related to um you know poor health um what we tend to see in those relationships is actually that discrimination disenfranchisement socioeconomic status and struggles with low income identities and depressions um economic depression all those kinds of factors are much more important a lot of these things are not really about biology it's really going to be about that social cultural and environmental context it's also of course it's super easy to become overwhelmed with all the information out there regardless of what we're looking at you know sex gender pregnancy body weight Pharmaceuticals there is so much information to sift through um hopefully this class will give you some good tools to sift through that information a little bit more um discerningly but um you know that media literacy fact checking those skills are so crucial when it comes to anything health related because there is so much misinformation out there finally I want to close this lecture on this for wholesome note here it's really important that you take care of yourself the best way that you can and the way that's best for you whether that be your mental health you know doing self-care having support and um leaning on those support people and trusted professionals if you do have any health concerns nothing in this lecture was meant to be Health advice or guidance this is just a sociological look at some of these issues some of these topics and how medical sociology in the medical field understands these things um so I'll see you all back again next week we'll talk a little bit more about medicalization and pharmaceuticalization