HT to Childhood Obesity News for this great QOTD on obesity, diabetes, and evidence from across the pond’s EarlyBird Diabetes Trust:
Diabetes and heart disease are related to obesity, and everyone knows what causes obesity - or at least we think we do. But until we measure it, what we think we know is inevitably hunch, assumption or, worst of all, prejudice. … We must be receptive to what sometimes seems counterintuitive if we are to get to the bottom of childhood obesity. …
There is a frustrating lack of evidence to justify the seemingly endless raft of new initiatives to tackle obesity. Health strategists seek evidence-based solutions, but there is at present only a limited evidence base in childhood, where the process mostly begins. The outcomes of adding fruit to the lunch-box or of prescribing two hours of PE a week, while intuitively good, are in reality unknown. Action is needed, but there seems little point throwing money blindly at the problem until the underlying mechanisms - social and biological - are understood.
Only then will it become clear when, where and towards whom scarce resources should be targeted. Understanding the problem has to be a key issue.
Be sure to check out the Trust’s “novel and sometimes counter-intuitive findings” such as obesity “leads to inactivity, rather than the other way round.”
Weight Maven is written by Beth Mazur. Beth believes that obesity is more symptom than cause and that the real problem is our Western diet -- especially sugar, refined grains, and industrial oils. Beth writes about nutrition, ancestral health & food policy. And cats! 
A strange thing seems to be happening (more and more frequently) lately when I read summary reports from research teams—reports which claim to show one sort of outcome (the suggested surface appearances), and yet my own reading of their findings reveals starkly conflicting interpretations of those results. This experience happens so often now that I’ve begun to wonder if the report authors are trying to appeal to different “audiences” (with opposing opinions and beliefs) by making summary claims that offer perspectives which conflict with the longer versions of their reports.
I began noticing this phenomenon while writing research papers in nursing school, and then more recently I started seeing this (to me, a bizarre disconnect) across a much wider spectrum. (I make no moral judgement of individuals. I often wonder if I would even notice these discrepancies and conflicts if my formal education and post-grad work had focused elsewhere.)
In this report from Childhood Obesity News, for example, I see VERY few examples of truly “novel” or “counter-intuitive findings”—in spite of their rhetoric announcing the arrival of surprising and new “findings.” The rhetoric appears to suggest a concern and empathy (re: the fat stigma) that then disappear when I read beyond the point where the authors provide that (false) lens for the readers. Indeed, I observe findings that sound very typical of most status quo research about “childhood obesity”. I will spare you my long critical analysis of its oft-repeated rhetoric and popular notions (usually advanced by mass media sources). However, I strongly encourage readers to use a more critical lens before taking surface appearances as *reality*.
Perhaps readers can start by simply noticing the contrast between the (concerned, empathetic, we’re-all-in-this-together) rhetorical tone (“…or at least we think we do..”) and the broader, underlying message(s) that blame individuals (especially parents) and that incite fear (a major factor in keeping fat stigma alive and thriving.) The latter (our dominant discourse’s blame-and-shame-game-playing strategy) should not be all that difficult to spot once the rose-colored-uncritical-lens (provided by the authors) is set aside.
Unfortunately, there are almost no economic or social status gains provided for work that deconstructs (or attempts to de-legitimate) social stigma —but there will always be heaps of money and professional prestige available for *stakeholders* who are willing to (or who unwittingly) keep the fat stigma going strong—and growing stronger. Professionals who repeatedly demonstrate the most *effective* rhetoric skills (who can speak from both sides of their mouth without being detected, for instance) seem to be in great demand—which makes perfect sense when the social status quo depends on dominant discourse(s) (“effective” rhetoric) for its survival.
Please forgive my earlier comment’s harshness of tone, which I often forget may easily be interpreted as a criticism of the blogger rather than my own frustration with certain kinds of research—most especially anything concerning children. I’m so grateful, Beth, that you provide these kinds of (diverse) links because even when they strike me as so painful on first reading, they help me in the long run to process difficult issues that are always just below the surface for me.
I hope you won’t mind if I share a link to an article that appeared in a nursing journal, many years ago, and has made a big impression on me when it comes to remember that the damage from stigma (and from “civilized oppression”) is at least as great as any potential harm from, say, diabetes. At least with diabetes, if one has the resources then various treatments are available and help diminish the damage of the disease process. But the harm from social forces of oppression are much more insidious in my own experience.
Thanks again, Beth, for being understanding and kind and wise.
The following link allows you to read the entire article, not just the abstract:
http://journals.lww.com/advancesinnursingscience/Fulltext/2004/10000/Obesity,_Stigma,_and_Civilized_Oppression.6.aspx
Not to worry! Please forgive me for not responding more timely. I’ve been in the new digs for 3 weeks now, but I still have moving brain. Between that, the holidays, and having to get back to my job, I’m still not back to 100% on the blog front.
Your original comment surprised me just a bit, but then I realized that it’s all about perspective. What resonated for me were some messages that to me did seem counter-intuitive … or at least in terms of what’s the standard mainstream media line.
Anyways, thanks so, so much for taking the time to make such thoughtful and thought-provoking comments! I greatly, greatly appreciate them!!