Another week, another "obesity is the enemy and it's going to kill us all!" message. Earlier this week, the Robert Wood Johnson Foundation released the statistic that by 2030, adult obesity rates could be as high as 60 percent in 13 U.S. states. The grim prediction went viral within what seemed like minutes.
In many people's eyes, this could serve as a public health "wake-up call." I don't agree; if anything, in large part due to our society's obsession with obesity (whether with endless commitments and promises to "end it" or body-shaming "humor"), many of us have become desensitized to such catastrophic information. Hasn't every American by now seen the famous Centers for Disease Control and Prevention color-coded obesity maps? Haven't we all been exposed to endless TV specials on obesity, complete with stock video footage of overweight people (from the neck down) walking on a crowded sidewalk or stopping at a crosswalk?
As a nutrition professional, I am discouraged and frustrated by the endless banging of the obesity drum (whether by health conferences, extreme weight-loss shows, or fearmongering headlines). Despite the good intentions by many to increase awareness of the fact that Americans are getting sicker, this focus is erroneous and plagued with problems that actually impede the process of the health movement.
When obesity becomes the focal point of a discussion on public health, it opens the door for tired, clichéd, and "blame the victim" arguments ("Americans are lazy," "Get off the couch and put the potato chips away!" or "Is it really that hard to eat more fruits and vegetables?"). Very little thought is given to socio-political and environmental factors that pose a threat to our health (more on those in a bit).
Even worse, the rhetoric surrounding the anti-obesity crusade is so neutral and apolitical that the food industry considers itself part of the dutiful troops, whether it's with "commitments to physical activity" or reduced-calorie, minimally nutritious processed foods that feature artificial sweeteners and "fat replacers" made from genetically modified corn.
Since the majority of discussions on obesity focus on the personal rather than collective forces at work, Big Food has ample room to foster the insidious illusion that it -- not just its products, but its practices and tactics -- is in no way responsible.
The true epidemic here is not obesity; obesity is simply the most visible symptom of other, more troubling epidemics -- including, but not limited to industry lobbying, Big Food predatory marketing, and misguided agricultural subsidies.
Unfortunately, most discussions on obesity don't make such connections. We are instead encouraged to applaud "solutions" like 100-calorie packs of cookies and complimentary pedometers at fast-food restaurants.
If obesity is "the problem," then what is the solution? A population that is of normal weight? I won't deny that some medical and health risks increase with obesity, but it is possible to be at a "healthy weight" while subsisting on minimally nutritious foods.
Thinness does not mean one eats enough fiber, gets a sufficient amount of minerals from their diet, or limits added sugars. In my nutrition career, I quickly learned from working with patients that size doesn't tell the tale. I can think of many overweight individuals with great blood glucose and blood pressure numbers, and several thin individuals with poor dietary habits who presented with hypertension and pre-diabetes.
And, while many people rang the alarm this week with obesity predictions, they may have missed out on a much more important article in this week's New York Times on how fitness is much more important than weight.
So, how do we step up conversations about public health to tackle true problems rather than symptoms? Rather than an aimless war against obesity, efforts should instead be used towards a movement "for" something. Such a movement can't afford to be vague. A movement "for health," for instance, can too easily be easily appropriated by the food industry ("Baked Cheetos are healthy!") and quickly nosedive.
The "war on obesity" is in desperate need of reframing and reconceptualization if it hopes to progress and fix some gargantuan wrongs.
To move forward, we must focus on -- and voice support for -- concrete concepts, such as accessibility to healthful foods for disenfranchised communities, regulations that don't make it so easy for Big Food to have almost unilateral control on health messaging, and agricultural policy that supports nutrition policy. While we're at it, let's make it clear that public health threats (from genetically modified foods to high intakes of sugar) are equally real for everyone, regardless of waist size.
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Susan Blumenthal, M.D.: Weighing in on Sugary Beverages and Obesity
Michael Goran and Emily Ventura: Obesity and Liver Disease in the Hispanic Community
Robert Doar: We Need a Stronger Message in the Fight Against Obesity
IMHO, and Chris Christie the exception that proves the rule (how many other politicians are fat?),poverty is the #1 cause of obesity in this country. Fats and sugars are the cheapest form of the calories needed for survival and to keep hunger at bay. If you work two jobs, you have no time to eat anything but fast food, and you don't have time or energy for a gym.
We don't have an epidemic of obesity in this country, but we do have rising poverty. The incessant drum beating about obesity is just another way of dumping on the poor. The secret ingredient to end obesity is very simple: Money.
HBO's 4-part documentary, "The Weight of the Nation," connected obesity and poverty and noted that public health officials can reliably estimate average weight and obesity levels by zip code. But more disturbing was that they've seen lifespan differences of over 20 YEARS between poor neighborhoods on one side of town and affluent ones on the other. So being born into poverty and unable to climb out has essentially become a Death Sentence. Watch the video at http://www.mhealthtalk.com/2012/06/americas-obesity-epidemic-a-big-problem-updated/.
As a nation, we are recognizing the need for proper exercise and nutrition, but it alone is not enough to offset the growing obesity epidemic. Low-socioeconomic status plays a major role, yet is not well understood. We need to advocate a wider behavioral understanding of obesity among overweight and NORMAL weight citizens.
You cannot compare a 9 year old white male raised by well to do parents with a 9 year old second generation Hispanic male living on Medicaid. More emphasis is needed on the inequality in such comparisons. Over decades, this heightens the disdain in one class, while increasing shame in the other. It exacerbates the problem and decreases the desire to seek help when there is fear of rejection.
Knockout Obesity is a program in NYC that started this summer and focuses on obesity, and advocates mental and physical change. It unites five New Yorkers in the fight against obesity via boxing, and documents their progress through an online reality series (64,000+ views to date). Watch the episodes on http://www.KOobesity.com.
Knockout Obesity was founded by Dimitrios Verteouris, a Brooklyn Chef who was told he would not live past the age of 35 if he did not shed the weight. He lost 85lbs in 3 months, as featured on Food Network's "Fat Chef." KO Obesity is community partners with the American Diabetes Association, and will present at the NYC Diabetes EXPO November 3, 2012.
There is an evidence-based compassionate alternative to conventional dieting: Health At Every Size®. Please consider this alternative prior to making a decision that may result in weight cycling.
I would also like to recommend the free NAAFA Child Advocacy ToolkitSM (CATK) and other written guidelines/resources. The NAAFA Child Advocacy Toolkit shows how Health At Every Size® takes the focus off weight and directs it to healthful eating and enjoyable movement. It addresses the bullying, building positive self-image and eliminating stigmatization of large children. Additionally, the CATK lists resources available to parents and educators or caregivers for educational materials, curriculum and programming that is beneficial for all children. It can be found at:
http://issuu.com/naafa/docs/naafa_childadvocacy2011combined_v04?viewMode=magazine&mode=embed
For more information on Health At Every Size, you can find a general explanation on Wikipedia (http://en.wikipedia.org/wiki/Health_at_Every_Size) or find in-depth research-based information in the book Health At Every Size - The Surprising Truth About Your Weight by Dr. Linda Bacon (http://www.lindabacon.org/HAESbook/).