Why Public Health Advocates Need To Tackle The Ever Growing Pressure On Young People To Be Slim, Fair And Perfect

We have all been exposed to a variety of advertisements like “Lose 10 kgs in 30 days” or “Become 2 tones fairer in just 4 weeks.” And why not, over the ages human society has been obsessed with the concept of beauty—particularly themes related to body shape, size and colour. Inadvertently, this has led to varying conceptions and norms about what is “beautiful,” be it body size or colour of the skin. While holding certain notions about beauty is a perfectly natural thing to do, but it becomes a matter of concern when these are turned into normative parameters that are directly or indirectly enforced by society. This is particularly true in an Indian context, where certain stereotypes for beauty have become instrumental in shaping social relations like marriage and possibly professional mobility. Adolescent girls and boys are the first to feel the need to conform to the normative standards of beauty, coupled with aggressive marketing of “products” that seemingly provide a one-stop solution for all their problems related to body image.

Advertised as “pills,” “powders” and “shakes,” markets these days are full of weight loss products, whether sold in retail or through online platforms. As a light reminder, even auto rickshaws in India are seen with posters on their back, advertising for some pills offering “weight loss in just 30 days.” While in the online world, a simple google for weight loss pills and shakes will tell you the whole story. Scientifically speaking, dietary supplements marketed for weight loss or muscle building are not recommended by physicians. These products are not based on any rigorous evidence or clinical trials. Moreover, they turn out to be ineffective, costly and very often adulterated with dangerous chemicals such as the banned or unapproved pharmaceuticals like phen-fen and DMAA or even excess dosages of steroid.

Consumption of these chemicals has been associated with an increased risk of liver injury, heart diseases and in some cases even organ failure leading to death. Research done by Dr Austin Bryn of Harvard Chan shows that severe adverse events reported to the US Food and Drug Administration are much more likely among the user of weight loss supplement than users of vitamins which is also a dietary supplement.1 Moreover, American Academy of Paediatrics has also issued a report which states that under any circumstances, teens should not be advised to consume these products, whatever their weight range may be. This has led the researchers to identify the use of such supplements as “unhealthy weight control behaviors” which are potent risk factors for subsequently developing eating disorders. For example, studies have shown that young girls who were taking weight loss supplements were at high risk for being diagnosed with an eating disorder within just a few years 2. These findings are particularly relevant for countries like India where body-shaming for obesity, especially amongst young girls is not uncommon. Teens are often under great pressure from their families, peer group and the community at large to conform to a certain weight size. Such teens, obsessed with weight loss, often end up falling prey to the heavy advertising in favour of such products.

Similar is the case for the use of fairness cremes. Obsessed with a “white” tone, Indian markets have for long been a favourite destination for fairness products. With a history of colonisation and global references to racism, our own societal norms push for a “fair-and-hence-beautiful” stereotype. Fairness is associated with an upward social mobility and in some cases with improved professional selection. This is especially true for young girls who face the societal expectation to make futile attempts at lightening their skin tones. A simple reflection of that mindset can be seen in the numerous match-making websites where parents of the groom, almost always desires a “fair” bride. It is due to such demands that young girls are often compelled to look out for a fairness crème, soap or powder. If that was not enough, film actors and Instagram influencers add to this problem by advertising for such products, further convincing a teen of their efficacy. While science has for long shown that colour tones are a result of varying degrees of melanin present in the natural skin and that they cannot be changed using such cosmetic products, studies from social sciences and anthropology have completely refuted the scientific basis alleged to justify social hierarchies based on the colour of the skin. In addition to that, recent advances in research have shown that some of these fairness products also carry toxic chemicals3 that may result in health risks after prolonged usage.

In light of the scientific evidence, concerted efforts are required to de-bunk this pseudo-science and effectively communicate the public health risks associated with the use of such unregulated products. Future strategy may be two-fold. First and foremost, is to drive a policy change for scientific regulation of food and cosmetic products. Second, and the more important aspect, is to spread awareness within the communities, in a way that it generates demand for a scientific outlook towards the consumption of such products. As we all know, body image by itself is an evolving paradigm. We are now moving towards the idea of a more inclusive society which accepts diversity in beauty and size without a judgement on the colour or body type. Conclusively, this demand to be fairer and slimmer can be productively tapped by the public health community to encourage the younger populations for improved lifestyles, mindful eating and healthy living.

References

1: Or F, Kim Y, Simms J, Austin SB. Taking stock of dietary supplements’ harmful effects on children, adolescents, and young adults. J Adolescent Health 2019 (Epub ahead of print).

2: Levinson JA, Sarda V, Sonneville K, Calzo JP, Ambwani S, Austin SB. Prospective association of diet pill and laxative use for weight control with subsequent first diagnosis with an eating disorder in a cohort of U.S. young women.

3. Shroff H, Diedrichs PC, Craddock N. Skin color, cultural capital, and beauty products: An investigation of the use of skin fairness products in Mumbai, India. Frontiers in Public Health 2018; 5: 1-9.

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Author: Dr Ananya Awasthi is the assistant director of the Harvard T.H. Chan School of Public Health-India Research Center. Views expressed above are the author’s own.