If HBO ran a miniseries called "Health of the Nation," seriously, would anyone watch? An extensively-researched documentary pointing out our many failures to wash our hands, floss, eat well, exercise more and, um, maybe watch less TV -- how well do you think that would go over?
But with the cable network's debut this week of Weight of the Nation (WOTN), a multi-part documentary with accompanying book, websites and government-hosted conference, America has settled in on the national couch. Like ancient Romans in the Colosseum, expect them to stick around to the end to see who survives and who gets torn apart. After all, on even the cheapest bleacher seat or rattiest futon, you're still a notch above the Other, those hapless schlemiels in the arena.
In Rome, the stadium fodder tended to be slaves or Christians or baited animals. In WOTN, they're fat people. And not just fat but, given the nature of health economics in this country, likely to be poor and people of color, too. I write in advance of the debut, but we've all seen enough "obesity crisis" coverage to know that the lens won't capture many of the people who can shell out for HBO subscriptions, unless they're the expert talking heads.
I shudder to imagine how this will intensify the already rabid prejudice against fat people in this country. Of course, the producers claim to be all about concern for fat people and redressing the many harms obesity supposedly causes, but as author and attorney Michele Simon writes elsewhere on The Huffington Post, the program's misguided attention to weight rather than health "... ensures the focus stays on the individual instead of the food industry" (or other concerns, I add). "What do you think when you see a fat person? That it's their fault, they just need to eat better and exercise more." (There. I just spared a bunch of folks having to write that last bit themselves in the comments.) And along with Big Food, there are plenty of targets WOTN could legitimately take on, like unequal access to health care, discrimination and the extra stressors of poverty that might impair Americans' health. But, like the taxpayer-supported agencies that helped fund it, the series simply reinforces the blame and the "if-they-only-tried-harder" stigma.
Whatever remedies the show proposes won't work, so long as they aim to change the shape of 100 million or more Americans. How many diets do we have to try, how many miles do we have to log, before we realize that these just don't result in sustained weight loss for the majority of people? Still, we plow on with talk of "moderate" diets (which don't work any better than extreme diets) and "educating" Americans that they're fat. Proponents may think they mean well by deploring the size and appearance of roughly half our nation, but it's easier to rail about fat than it is to examine the commercial and class motives that create the real health and wellness divides we live (and die) with.
The real message of all the hand-wringing is not that obesity is a risk for health and the GDP. It's that fat is a cultural signifier: Just as swarthy skin and accents marked the lower classes 100 years ago, today we identify the Other by waistlines and thigh bulges. And that's what you'll be seeing on HBO this week.
To justify this exercise in prejudice, you'll hear a string of familiar-sounding "solutions" born from the same biases, myths, and false cause-effect constructs that already give us terrible obesity-based medicine and public policy. Many will rely on the self-serving pretension that there's a sort of fat-brain myopia out there that keeps fat adults from knowing they're considered too big (with the false implication that education leads to downsizing). When it comes to children, the fat-brain myopia premise assumes we can rail against obesity but somehow shield kids from internalizing the deep disdain for fat (and prevent inevitable increases in bullying and in body shame that follows, for fat and thin kids alike).
The first three of the HBO series' four sections (as quoted here from the documentary's website) rely entirely on such self-justifying myths. Only in the final section does the documentary appear to begin examining the many non-weight-related issues that may affect the health of our society:
"... CONSEQUENCES, examines the scope of the obesity epidemic and explores the serious health consequences of being overweight or obese."
Actually, that so many are "obese" is a matter of semantics and a function of how we choose to define obesity (which has little to do with health). The real consequence of being "overweight," or of moderate "obesity," as defined on government BMI charts, may just be that you live longer. (This is according to the CDC, which in defiance of its own data, is hosting this week's WOTN hand-wringing conference.)
"... CHOICES, offers viewers the skinny on fat..." [oh, what a tired phrase!] "... revealing what science has shown about how to lose weight, maintain weight loss and prevent weight gain."
In fact, what science has shown on these questions is that most people cannnot maintain weight loss even when sticking to diets and exercise programs. That fact should surprise no one and is readily explained by biological mechanisms that resist sustained weight loss. The one well-established fact about attempts to reduce is that they will more likely result in weight gain than sustained loss. (Seven prospective studies of dieting behavior indicate this; none show the opposite!)
"... CHILDREN IN CRISIS, documents the damage obesity is doing to our nation's children. Through individual stories, this film describes how the strong forces at work in our society are causing children to consume too many calories and expend too little energy; tackling subjects from school lunches to the decline of physical education, the demise of school recess and the marketing of unhealthy food to children."
If the latter are problems, why not train the lens on the food companies that profit from those school lunches? Why not divert the billions of public dollars wasted on fruitless and stigmatizing anti-obesity expenditures to more spending on phys ed, sidewalks, and playgrounds? Why not help kids of all sizes make good health choices? When the focus is on weight, it's not obesity that damages our children but fear mongering about their bodies that puts them at risk -- for eating disorders, discrimination, sedentariness, and lifelong discomfort in their bodies.
The fourth section:
"... CHALLENGES, examines the major driving forces causing the obesity epidemic, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the strong influence of the food and beverage industry."
The problem with these influences is not that they make people fat (thin people are subject to the ravages of biology and the food industry too); it's their health impact.
Fat may or may not hurt you, but fat stigma sure will, and Weight of the Nation bids to worsen it immeasurably. It's a wild, crowd-baying mob frenzy disguised in a white lab coat. Don't watch it.
The solution? If it's health we're concerned about, let's talk about health -- not weight. From my book, Health at Every Size:
"The only way to solve the "weight problem" is to stop making weight a problem ... The real enemy is weight stigma, for it is the stigmatization and fear of fat that causes the damage and deflects attention from true threats to our health and well-being."
By focusing on health, we can address real health concerns, giving both fat and thin people the support they deserve and avoiding stigmatizing people and worsening the problem.
For more information on shifting the focus to health -- not weight -- check out the Health at Every Size movement, consider the peer-reviewed evidence which demands a shift in medicine and public policy, or read my book, Health at Every Size: The Surprising Truth About Your Weight. Marilyn Wann's critique appears in the Exhibitionist (SF Weekly's blog) and The Association for Size Diversity and Health, an organization for professionals committed to changing the paradigm, provides a more detailed debunking of WOTN, including Dr. Deb Burgard's guide to stereotype management for the people who will be victimized by this WOTN-inspired onslaught.
For more by Linda Bacon, Ph.D., MA, MA, click here.
For more on personal health, click here.
Follow Linda Bacon, Ph.D., MA, MA on Twitter: www.twitter.com/LindaBaconHAES
Linda Novick O'Keefe: How to Address the Obesity Epidemic: Start Young
Marianne Cusato: No, This Is Why We're Fat!
Michele Simon: Why I Am Not Attending or Watching 'Weight of the Nation'
Review: HBO's 'Weight of the Nation' pounds away at obesity ...
HBO's Weight of the Nation: A New Solution to an Old Problem ...
'Weight of the Nation' takes a realistic look at a looming crisis | Grist
I am in general agreement with the comments of mybustedpancreas
That is really the crux of the problem. The link associated with "biological mechanisms" references Leptin and the regulation of body weight. Leptin affects receptors in the hypothalamus to inhibit appetite.
Energy balance or energy homeostasis is the issue. People should be able to moderately overeat, or under-eat, without much weight gain/loss. The body's metabolism should adjust accordingly.
A reason that diets fail is because the person feels hungry. If a person is feeling hungry, the mechanisms affecting energy homeostasis is going to reduce metabolic activities.
Something is causing the energy homeostasis to normalize at the wrong body weight.
http://wholehealthsource.blogspot.com/2008/12/leptin-resistance-and-sugar.html
I think there are multiple causes, but top on the short list is the fructose component of table sugar and high fructose corn syrup. If someone is overweight, that would be the first thing to look at.
I have struggled much of my life to avoid obesity, with a little success. Telling human blimps that they look beautiful is a lie, even if well-intentioned. The correlation between excess weight and shortened life is generally accepted in medicine except for a few cranks.
Or to call dissenting opinion backed by evidence "cranks"?
Go look at Flegal et al. (CDC scientists) and the data showing that people in the "overweight" category live the longest and how the "underweight" category is as problematic as the highest weight category. http://www.ncbi.nlm.nih.gov/pubmed/15840860
I wish you well in your journey to expel the toxic ideas that are obviously oppressing you. Perhaps you are more beautiful than you can believe right now with these ideas weighing you down.
If Dr. Bacon is not in fact obese, I apologize. My experience has been that those who warble about "fat acceptance" generally have waists bigger than their chest/bust size.
I would rather be burdened with "toxic ideas" than 50 pounds or so of ugly, dangerous fat. Quite simply, fat is ugly. If you assure loved ones that is perfectly OK to have a 50" waist, you are in the same position as someone who enables an alcoholic or a drug abuser.
You would owe Dr. Bacon an apology either way. But I think you are probably about as hard on yourself as everyone else. I send you good wishes for a happier relationship with your body one day.
Before I was a "human blimp," I was still outraged at the attacks that larger people endure. And even now as a "human blimp," my chest size is still bigger than my waist. Go figure.
Am I thrilled about being overweight? Not particularly. But how is hating someone for their size helping you in any way? The worse problem is people being full of venom and searching for a scapegoat.
http://www.thedailybeast.com/newsweek/2012/05/06/why-the-campaign-to-stop-america-s-obesity-crisis-keeps-failing.html
The point is, these messages are about trying to ELIMINATE an entire demographic, continuing to blame them for all the ills of our society, and continuing to push the same old tired "solutions" that don't even sustainably change people's weight. I don't really care if they think the environment is to blame, they are still saying fat people are a terrible problem/burden and that is just blatant bullsh*t. It is not respect, they took no input from any grassroots civil rights group, and they are not seeing how they perpetuate the stigma that harms people of all sizes.
The changes that some of these communities are making are great - and those bike paths are not just for the fat people, those better food choices in the schools are not just for the fat kids. There is NO NEED to build these efforts on the energy of fat hatred and I find it cowardly and despicable that people in power are willing to trade on hatred in the name of promoting health.
Then, can we focus on health *not* weight - healthy, affordable, fun food and movement options available for all to choose as they wish.
That's how I am aiming to be a 5%-er (the 5% that keep the weight off after losing it). Why do the other 95% fail? They don't view changing their eating and exercising habits as PERMANENT changes that have to be made. In order to lose the weight, a lot of folks go on extreme diets that aren't sustainable, or they don't learn how to prepare food for themselves in the cases of Nutrisystem and Jenny Craig, so they end up being dependent on their products or re-gain the weight.
People can get healthier if they are willing to make the sacrifices necessary to get healthy...and there really aren't that many, at least in my experience. I put about 20 hours a week into it at the MOST(and some of it is even when I'm watching TV or listening to my favorite music!), and have seen a weight loss of almost 50 pounds since the end of December. I am no longer morbidly obese, and although I have a ways to go to hit "normal" according to the BMI, my main focus is just continuing my healthy eating habits (lots of fruits & vegetables, some lean protein, brown rice, and whole wheat bread/pasta on occasion) and exercise (cardio, strength training and stretching after every workout session). The rest will come in time.
This insanity of stigmatizing individuals is taking the focus away from the real issues, such as the impact that poverty has on food choice availability, to say nothing of how the food industry is getting away with murder.
Let's encourage a switch in focus to a more positive approach of healthy living and sustainable choices, AT ALL SIZES.
Traumatic events happen every day. The first step in resolving them is to be consciously aware of them. A nights sleep seems to help too. That two part process of 1 being conscious of the trauma*, and 2 Sleep, helping to resolve the trauma; was not available during infancy. We were not conscious of trauma between birth and the age of 3,4, or 5 when we develop memory. So we could not resolve the trauma during that time like we can as adults.
My suggestion is that this hidden and unresolved infant trauma may unconsciously influence our behavior without us knowing it. It's our 'gut' reaction to stress - that inner drive or behavior we are not consciously aware of.
Second the basic trauma may be lack of nurturing*. That may lead to all kinds of health problems, including both excess weight problems, and eating disorders. It may also lead to many chronic ailments and diseases we have in later life. This may also include not only some cancers, and heart stress, but most auto immune diseases.
if this is so, then it explains the strong resistance to change in all of us, even when that change seems so much more healthy. We have, over a life time, set up defenses to offset that hidden infant nurturing trauma.
Major change in diet, behavior, would break down those defenses. We rebel against that change.
And I will neglect to read this until you actually watch what you are complaining about.