a war on obesity or a war on obese people?

Soundtrack in my head: Bow Wow Wow, “I Want Candy”
Woman Fat Plus Size Portuguese
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Can Big Brother succeed where Weight Watchers, Nutri-Systems, the Atkins Diet and Dr. Phil have failed? Or is the “war on obesity” a new scapegoat for spiraling health care costs being created?

When there seems to be excessive focus on a particular subject in the news, when people seem altogether too quick to talk about a certain “trend” or “epidemic,” a part of me has learned to ask, “What agenda is being advanced and who benefits?”

A few months ago, I began to notice CNN airing a lot of stories about different aspects of “the obesity epidemic” and the “war on obesity.” I found amusing the repeated loops of CNN’s stock video showing ample mid-sections of various people walking down the street.

But my amusement turned to a more uneasy feeling a few weeks ago when a study talking about obesity being “contagious” was aired on CNN and other mainstream media outlets. The study claimed that people in social networks with obese people were more likely to become obese themselves. The researchers had merely pored through old data of a completely different study to draw an association. They associated A with B, but could not identify the causative factor between A and B. Instead, they introduced some rather wild speculation, suggesting that the “disease” that was “spreading” between people was social acceptance of obesity.  Anyone who remembers seventh-grade science class would know that it is necessary to determine whether A causes B, B causes A, or whether other factors, like C, D and/or E, might be causing both A and B at the same time.

Journalism used to be a profession in which tough questions were asked of anyone making broad assertions. The City News Bureau in Chicago was famous for the adage, “If your mother says she loves you, check it out.”

Media acquiescence in the months leading up to the U.S. invasion of Iraq showed how deficient that characteristic is in modern American journalism. Few in the news media were asking the Bush administration, “Why Iraq? Why is this suddenly important now? What has changed? And what does this have to do with the ‘War on Terrorism?'” And the degree to which the mainstream media uncritically printed and aired the story on obesity being “contagious” shows me that little has changed.

An article by Gary Tauber in New York Times’ magazine, “Do We Really Know What Makes Us Healthy?” (9/16/2007)  shows the methodology of these studies, saying that, “the investigators monitor disease rates and lifestyle factors (diet, physical activity, prescription drug use, exposure to pollutants, etc.) in or between large populations “¦They then try to infer conclusions – i.e., hypotheses – about what caused the disease variations observed. Because these studies can generate an enormous number of speculations about the causes or prevention of chronic diseases, they provide the fodder for much of the health news that appears in the media.”

He goes on further to say that “they can distinguish associations between two events “But they cannot inherently determine causation – the conclusion that one event causes the other”¦ As a result, observational studies can only provide what researchers call hypothesis-generating evidence – what a defense attorney would call circumstantial evidence.” This is exactly what I was saying about the “obesity is contagious” study a few weeks ago. Yet, Tauber points out that “they have come to play a significant role in generating public-health recommendations as well.”

Not scared yet? Recently I read two more articles referencing “obesity epidemic,” that further scared me.

Kate Harding’s blog highlights a situation in Washington D.C. where a youth is closely monitored by authorities and frequently taken away from his home because he is obese.  Sandy Swarcz, a medical professional who writes the excellent blog “Junkfood Science,” has been following reports out of Britain about children being taken from their families and put into the care of the state because of their weight. According to the Daily Mail, doctors at the British Medical Association’s conference last June put forward a motion that parents of obese children under the age of twelve be targeted under child protection laws. The motion failed to carry. And consider this chilling quote: Dr Colin Waine, chairman of the National Obesity Forum, said: “Taking children into care for this reason should never be necessary. What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken” But if the parents refuse to collaborate and the child becomes obese, I consider that a form of child abuse and taking them into care may be the last resort.”

A recent article in the Wisconsin State-Journal just last week, “Worker’s fume about employers’ nosiness,” (can’t link–Madison.com’s search engine is not user-friendly) talked about how workplaces are refusing to hire or penalize people for smoking and exceeding certain blood pressure, body mass and blood glucose levels. According to the article, Clarian Health in Indianapolis charges penalties if employees smoke (even outside the workplace!) or exceed specified levels of cholesterol, blood pressure and other measurements, with penalties potentially reaching $30 per paycheck. Michigan-based Weyco fired four employees in 2005 who used tobacco-another tried to quit smoking, failed, and left the company because she said she “saw the writing on the wall.”

These practices are frighteningly intrusive and involve an unprecedented invasion of privacy. Worse, they punish people for a condition whose cause is not necessarily clear and whose cure is even less clear.

The diet industry would like to have you believe that they have the cure for obesity, if only people would obediently follow their programs. The fact of the matter is that there is wide disagreement on what causes people to gain weight and what causes people to lose weight.

I experienced this personally when I discovered after nine years of being a vegetarian that wheat was making me gain lots and lots of weight. I cut wheat completely out of my diet and, without making any other changes, I lost 30 pounds in three months. But then I began to develop sensitivities to other grains, and I gained back the weight and more. In 2001 I joined a health club and went to the gym three times a week for an hour workout each. At the end of the year I gained twenty more pounds and noticed that I was becoming more sensitive to soy. In the last two years, I’ve had no exercise program and have minimized, but not eliminated wheat and other grains, and my weight has been stable.

So Weight Watchers, Dr. Phil, and my new friend Big Brother, what does that tell you about me? Do you really think you have the answer for me? By the way, I have been eating three eggs every morning for about a decade now and my cholesterol level is 170. Okay you fancy-pants nutritionists: what do you really know about what my body needs and how it operates?

This new intrusion into the private lives of people is not going to cause many people to lose weight. Indeed, I believe the opposite will be true. Desperate people will take desperate measures to prevent themselves from being penalized, and try diets that may make their situation worse, as diets often do. Stress is often a cause of weight gain-I’ve seen that in my life-and the added stress caused by these external threats will only hurt, not harm.

Meanwhile, the food industry will increasingly give us more and more processed foods, so-called healthy cereals and “nutrition bars” with lots and lots of sugar, and pesticide-laden and genetically-engineered produce. Weight Watchers and Nutri-System will make a lot of money off the “obesity epidemic.” (I’ve noticed Nutri-System, in particular, advertise heavily on CNN just as the number of stories on the “obesity epidemic have gone up.” Coincidence?) And we’ll hear yet more and more stories about the “war on obesity.” But they won’t be fighting this “war” for our health.

Another recent new story is more comical than disturbing-after the movie “Sicko” was released Republican presidential candidate Mike Huckabee said, “Michael Moore is an example of why the health care system costs more in this country,” and then went on to describe how his own health care costs dropped dramatically after he shed more than 100 pounds over a period of several years. Yet in light of the other stories, I find myself wondering this might be part of a concerted effort to create a scapegoat for spiraling health care costs.

I would like to think that people have nothing to worry about. I would like to think that maybe I’m overreacting.  And I can’t rule out the possibility that at some point, somewhere, some kind of intervention may be needed.  But it really worries me that greater and greater levels of government and private-sector intrusion are being justified for smaller and smaller problems.  I really have to wonder–where is this increased intrusiveness going to stop?

One thought on “a war on obesity or a war on obese people?

  1. As long as we define obesity as the problem, we are eliminating the possibility of a solution.Instead of a “war on obesity” that often feels like a war on obese people, there is a new peace movement: “Health At Every Size” (HAES). We can make our GOAL healthy living behaviors, rather than choosing a goal of some specific weight.When we consider the problem of “childhood obesity”, there is great focus on how to get large children to lose weight. Again, body size is the focus and the definition of the problem. Often the result of this concern is harmful to large children as they are targeted for special programs (that stigmatize them), bullied by peers, even traumatized in gym class by teachers who want to make examples of the “fat kid” in order to deter others from becoming obese. Any adult who ever was a “fat kid” or had a friend or sibling who was large can tell many painful stories of these hurtful experiences. A focus on weight and body size during childhood is often the beginning of a lifetime of low self-esteem, yo-yo dieting, or eating disorders. But what can we do? We cannot just ignore all these obese children! Moreover, we cannot ignore the small and medium size children either. When we focus on “childhood obesity”, we are giving the small and medium sized children the message that they do not need to focus on healthy eating and fitness activities they do not have “the problem”. When we define the problem as obesity, we are telling our children that if they are thin, then they are the ‘correct size” and they don’t have a problem. We are implying to thin children that only the “fat kids” need to focus on health. This is not what the health professionals intended to happen. This is not a message likely to promote the actions of healthy eating and fitness for children of all sizes. Let’s understand how the “War on Obesity” CAUSES health problems instead of solving them. I would like to look at another health issue to demonstrate how this might happen.• The behavior or action: smoking• The associated characteristic: yellow teeth• The associated health issues: Lung cancer, emphysemaWhat if we launched a “War on Yellow Teeth” to prevent lung cancer and emphysema? People who had yellow teeth would worry about their health and be made to feel bad about their yellow teeth. They would be told how their yellow teeth were costing billions in health care and insurance premiums. They would be given teeth whitening potions and creams, programs to whiten teeth, even surgical removal of the offending yellow teeth. After all, missing teeth and the resulting health problems are not as dangerous as lung cancer or emphysema. What about those smokers who do not happen to have yellow teeth even though they smoke? They would be ignored by the “War on Yellow Teeth” because they do not possess the characteristic that has been defined as the problem. They would not get support or education on reducing lung cancer and emphysema.What about those people who did not smoke and just have yellow teeth due to genetics, medication, or other reasons? They would be targeted. They would be pressured, and chided, and even have recommendations to have their offending teeth surgically removed in order to save them from the awful impending lung cancer and emphysema.Now, let’s get back to the “problem of obesity” and consider it in a similar way.• The behavior or action: Poor dietary habits and sedentary lifestyle• The associated characteristic: Large body size, obesity, or high BMI• The associated health issues: High blood pressure, high cholesterol levels, metabolic syndrome, other cardiovascular risks, increases the likelihood of developing type 2 diabetes.We are experiencing similar results in the “War on Obesity” as would occur in the above scenario about yellow teeth. In both cases, by targeting the physical characteristic instead of the behaviors and actions, we prevent a solution from being found. The resulting policies hurt the people with and without the unhealthy behaviors. I propose that we end the “War on Obesity”, and begin a “Campaign for Healthy Eating and Fitness for Everybody of Every Size”. The new peace movement is Health for ALL Sizes (HAES)!This new definition of the problem has a solution built right in. This solution is based on the ACTIONS of the individual, rather than on the physical characteristic of body size. Notice the inclusive nature of this new definition of the problem and solution. Nobody is ignored who needs help. Everybody can be successful. Whether someone is small or large, the moment they participate in the actions of healthy living, they are in the process of succeeding. One success motivates another.

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