Well, you have to say one thing about Michelle Obama’s recent announcement of the Let’s Move! campaign to end childhood obesity: it’s gotten a lot of people talking.
Let’s Move!:
has an ambitious but important goal: to solve the epidemic of childhood obesity within a generation.
Let’s Move! will give parents the support they need, provide healthier food in schools, help our kids to be more physically active, and make healthy, affordable food available in every part of our country.
On its face, it’s hard to criticize the idea of getting kids moving more and choosing healthier foods. But dig just a little, and very legitimate concerns are being raised.
First, there is just the enormity of the problem. Education, while important and useful, is the tool of choice when literacy is the fundamental problem. And while it’s true that many/most Americans aren’t particularly literate when it comes to nutrition, it is not at all clear that that is the fundamental problem.
The Atlantic’s Marc Ambinder raises the question of environmental triggers (emphasis mine):
A fascinating new study by the CDC figured out that childhood obesity growth rates could be curbed by three behavioral changes: eat dinner as a family, make sure kids get 8 hours of sleep a night and reduce the amount of TV that kids watch. Unfortunately, in the communities where obesity is most problematic, family structures aren’t intact (either because mothers are raising their children without fathers or because both parents work, many parents don’t pay attention to their child’s weight gains or losses and the health infrastructure is poor; television and Internet are ubiquitous). Neither a lecture from the government nor a laissez faire approach will solve this inherent gap between what works and what people can actually do. If you’re prepared [to] accept the fact of childhood obesity in society as a given, then you can move on. If you’re not — if you see a moral dimension inherent in the question, you cannot treat this policy issue like others; it is not matter of choice for the people who are hurt the most by it.
Michelle, the fat nutritionist (really, that’s her title!), also has issues with education as the primary tool when it comes to poor communities:
The reality is that people who don’t have enough money (or the utilities and storage) to buy and prepare decent food in decent quantities, cannot (and should not) be arsed to worry about the finer nuances of nutrition.
Because getting enough to eat is always our first priority.
Over on Salon, Kate Harding has other concerns with Let’s Move:
Specifically, my issues are with how you’re framing this as a strategy to “solve the epidemic of childhood obesity within a generation,” rather than to improve health and well-being across the board, and whipping up fear and disgust of the very fat children you’re supposedly trying to help. You’ve gotten so much right, but here are five things I think you and your partners are getting wrong.
Fear-mongering part 1: Exaggerating the crisis …
Fear-mongering part 2: Exaggerating kids’ laziness …
Conflating fitness with thinness, and using BMI as a measure of individual health …
Assuming that people will respond to all this hullabaloo in a reasonable, healthy way …
Underestimating the impact of body shame and fat hatred …
Oy, I am not doing Kate’s piece justice, please do go read the entire thing! (And also see my previous post on the real problem of obesity stigma.)
But put together, these concerns really sum up to a major problem: because it is the children who are overweight or are obese, it’s all about their personal responsibility (or their parents’) to eat less, move more, and lose weight.
And that’s where they lose me. It’s not about the kids. Or well, it is, but it’s not what they are doing, it’s what we’re doing to them. We’re putting them in a toxic environment (aka, the standard Western diet) and then faulting them for not having the good fortune (through circumstance or genetics) to have been better able to tolerate it.
As Michael Pollan says, the Western diet is particularly unique:
[T]he human omnivore is exquisitely adapted to a wide range of different foods and a variety of different diets. Except, that is, for one: the relatively new (in evolutionary terms) Western diet that most of us are now eating.
What an extraordinary achievement for a civilization: to have developed the one diet that reliably makes people sick!
Over at Refuse to Regain, Barbara Berkeley sums up why science hasn’t figured this out:
Say you want to know if the Mediterranean Diet makes people leaner in the long run. You pick a group of people to study. You train them in the elements of the Mediterranean Diet. You ask them to follow that diet for six months and keep food records. You devise a control group that will eat as they always do so that you can compare the two. But problems immediately arise. Each person in the study is different and some may have medical conditions that affect their weight. Some of the people don’t show up for training. Others forget to submit food records. Of the people who do bring records, you can’t be at all sure if they are truly eating what they write down. You notice a few people are losing weight, but some of them have started exercising because they are inspired by being in a study. Is their weight loss related to diet or to more moving around? Two subjects develop the flu during the study period and lose five pounds each. How does that factor into your results? In other words, the variables are endless and impossible to control. …
We are overweight in America and in increasing numbers all over the world because our entire concept of diet is so reckless and unexamined. It’s impossible to completely figure out what part of the western diet is so toxic. It’s probably a whole lot of things.
It may not be a “whole lot of things” — but it is probably more than one or two. And that’s what is at the crux of the problem. The Titanic is sinking, and we can’t man the lifeboats, because all we have right now are partisan, polemic fights over the amount and types of carbs, the amount and types of fat, and how the laws of thermodynamics apply to humans and energy balance.
Over at Nutrition Education Project, David Brown calls out some specific targets (emphasis mine, see original for cites):
Regarding the obesity problem, I have some good news and some sad news. The good news is that at least a few scientists have identified the dietary factors responsible for the current epidemic of obesity and chronic disease. The sad news is that their voices are not being heard. In fact, the scientific evidence that supports their views has been ignored for at least four decades. What evidence? It’s the data that demonstrates that excessive omega-6 fat consumption is responsible for the sort of metabolic impairment that promotes fat storage and that excessive sugar consumption is responsible for the sort of appetite derangement that leads to overeating. In other words, it’s a big mistake to replace saturated fats with polyunsaturates and added sugars which is generally what happens when people try to eat according to the Dietary Guidelines for Americans.
Those may not be the only two factors (I find Stephan Guyenet’s theories very compelling), but whatever the ultimate cause, I find it bordering on obscene that our focus in the “war” on obesity is personal responsibility (“eat less, move more”) and not on the actual cause! (And the question of whether the government is essentially complicit in a policy that causes what it’s meant to cure is a whole other question.)
Zoe Finch Totten agrees that we are focusing on the wrong thing:
Our country’s persistent and pervasive focus on obesity, rather than on food quality and preventable chronic disease, allows us to blame the individual, the eater, rather than to address the root cause and to then put our energy and resources toward the systemic solutions required. Any widespread problem is first and foremost a cultural problem: when two thirds of a population is suffering from the same problem (overweight and obesity), this signifies not mass individual failure but rather the failure of our culture and our systems to meet the real needs of our population.
The only way we are going to improve public health and prevent diet-driven type 2 diabetes, heart disease, high blood pressure, cancer, dementia, mood disorders, skin disorders, heartburn, and on and heartrendingly on, is to eradicate our primary dependence on cheap, highly refined and health-depleting foods.
Ultimately, although childhood obesity is a wicked problem without an easy solution, we do need to test different approaches and find what works.
I’m not sure what those approaches are, but I’m with Totten: making this primarily about education and personal responsibility is missing the forest for the trees. Because it’s not just the overweight and obese who are at risk because of our standard Western diet. They are just the canaries in the coal mine.
