This issue of
Citylife

Fat to the Future

Fatso, porky, piggy . . . obese, corpulent, overweight . . . larger framed, robust, strong. Adjectively rotund, euphemistically well rounded, fatness has a language all of its own. Our weight is now a way of life, it’s a pastime, a recurring issue, especially in the weighty west where people often spend more time fixated on their weight than they do say, the reason why their 80 kilos of flesh even exists. Prior to the inclusion of ‘dietician’ into our vocabularies we spent a couple of comfortable decades stuffing ourselves stupid, and now stuck with the pounds it seems we are not happy with the way we look, constantly made miserable by the medical harbingers expatiating on heart disease, cancer, diabetes, brain damage, rheumatism, impotence, flatulence, ulcers, and of course, blisters . . . and don’t forget the intangibles, the extremely painful condition of being labelled ‘fat f**k(er)’ in the mean high school halls.

The Thais, not usually privy to the western decorum used around larger people, not educated in polite ‘fat’ parlance, don’t think twice about telling anyone they’re a fatty, or pointing out they’ve gained a couple of pounds. “You’re fat, ouan,” they tell you and laugh, which of course is true, but not exactly accepted small talk over a cup of tea; alternative Thai fat terms include moo/mee-kwai/chang, pig/bear+buffalo /elephant. Until recently fatness in Thailand was more an anomaly than a physical staple, seemingly limited to well off kids whose parents may have thought it a social feather in their cap to show off a well fed sprog, this may explain why fat taunts here seem less insulting.

In the last few years a plethora of reports have been informing us that constellations of chubby kids have fallen on Chiang Mai, stating that Thailand’s future generations are in danger of eating themselves into oblivion. In 2005 a Mahidol report on obesity in children stated that “effective preventive measures in social, economic and political levels are not being taken,” adding that the “new generation of Thai children are considerably overweight.” While just last April an article in the Nation reported, “In young Thais obesity has shot up from 2.9 to 21.7 per cent in recent years.” And those formidable scaremongers, the WHO, in 2008 pointed out that the “the situation in Thailand is particularly serious,” referring to obesity in the new Asia.

To the untrained western eye this may come as a surprise, to the average resident from say, Houston _ one of America’s fat spots _ it would surely sound like unmitigated tripe. Finding just one student in Houston who might fit into the uniform of any CMU student has fairytale connotations. In fact, the CMU main uniform outlet does not even stock large size uniforms. “We just do three sizes,” said one assistant, “but none of them are large.” It’s either smallish, small, or very small. Overweight kids, the same assistant said, have to tailor their own over sized uniforms or find a special seller who works in the Kad Luang market.

The Thai Health Promotion Foundation states that Thai kids are not only gorging out on deep fried crap for their after school activities, but the more affluent, of which there are a growing number, are opting for Big Macs, Chili Dogs and Zingers over bowls of boiling water and noodles. The foundation noted that “changing diets have clearly contributed to the development of the pandemic.” Pandemic!? A well touted word these days, grab onto your fat mask . . .

Deep Fried Fat

At a local English language institute where kids from hundreds of high schools in Chiang Mai turn out to conjugate verbs _ (“I like to eat…”) _ I discovered a salient, if not completely unremarkable, fact: Thai kids are in love with junk food. Out of the mass of giggling teens interviewed all but a small handful didn’t say deep fried chicken, deep fried (dubious) pork balls, deep fried chicken skin, or even deep fried pork fat, were top of their snack list, which, most admitted, they ate everyday, often a few times a day. Most kids said they’d eat pizza or KFC if they could afford it but those things were rare treats. The director of the school echoed the kid’s (un)sensibilities, saying that he thought the boys over the years had stacked on the pounds, though he assumed that it was more likely the Thai deep fried snacks to blame, rather than stodgy western fare.

Dr. Prasong Tienboon, possibly South East Asia’s most venerable authority on nutrition, President of the Asia Pacific Clinical Nutrition Society and also Editor in Chief of the Thai Journal of Clinical Nutrition, talked to Citylife about the rise of the overweight Thai kid. The doctor explained how after returning home to Chiang Mai subsequent to finishing his PhD in Australia he noticed a change in the size of the kids around his hometown. This led him to undertake various studies throughout the nineties where he focused both on wealthy kids: mainly students of PRC, Dara, Montfort and Regina, and also on kids living on the fringes of the city in poorer districts such as San Patong. “This was the first study to realise obesity as a problem in Thai children,” he told us, stating that the later media frenzy and academic studies were all an aftershock from his first study in Chiang Mai. The results showed that a change had taken place. In the eighties a large percentage, around 30%, of kids in the Chiang Mai area, were suffering from malnutrition, 50% were the normal weight and around 5-10% obese. Though in the late nineties his study showed that even though there were similarities in the amount of kids suffering from malnutrition there was a significant rise in the number of kids with obesity, a rise from the estimated 5-10% to 30%, though only in ‘well-to-do families’. The results gleaned from the ‘poorer kids’ research showed only about 4% to be overweight.

He ascribes this to the wealthier kids having more money to spend on snacks and also having a much more sedentary lifestyle than the poorer kids. He went on to list the whole gamut of diseases consequential to obesity, from hair falling out to gout of the toes; the usual suspect: high cholesterol, to the lesser known Acanthosis nigricans, a condition in which the skin turns scaly and black, apparently not uncommon. “The rich kids can afford to eat all sorts of food, KFC, Pizza Hut, lots of fried snacks,” he added, and also stated that in some rich families, mostly of Chinese extraction, kids are still fattened up by their parents as ‘chubby’ kids are quite the ‘in thing’ amongst the Thai/Chinese wealthy milieu. Dr. Prasong runs a Weight Management clinic at Lanna hospital on Tuesdays and Thursdays, it’s multinational, and for kids or adults that want to lose or put on weight. He assures us that patients of his often show impressive progress.

And so, we await the Thai Jamie Oliver to balance out the after school fried chicken skin with a healthy and nutritious school lunch. Though as Chiang Mai people in their hordes move up the class ladder it’s foreseeable that around the corner we’ll be looking at a nation of plump people talking wistfully about fitness plans; maybe they’ll even come up with some polite euphemisms. And while the west simmers in saunas and slims down to an nth of its former size, the east says good riddance to the skinny past, and opens its arms, and mouth, to a fat future.

Lanna Hopsital Weight Management Clinic Tel: 053 999777.