Let's encourage little girls to diet! Brilliant!

Although I pilfer most of my links from Jezebel, and I'm trying very hard to stop doing this, I found this GEM through my daily reading of that site.

The book, which ostensibly encourages youngsters to eat appropriately and exercise, is ... well ... appalling.

I remember when I was in my early teens ... yeah, that's right, that's when my eating disorder started. Let's remember that environmental factors are not the only components to eating disorder development, but I can guarantee you that books like this would have just made things worse for me (and the other, what, 1/3 of girls who have disordered eating patterns). I had problems just going to the doctor and finding out I was "overweight," even though I played 3 sports.

Furthermore, let's remember that a large percentage of our nation's young women would rather be hit by a truck than be fat. Information here.

So, what about those girls who play sports, like Maggie did (and I did), and still don't lose weight? This book implies that it's their fault ... although they might just be sturdy little soccer players like me! What about those of us who remain physically fit, yet straddle the clinical definitions of overweight/obese?

I just can't see this book as anything but a mortifying and appalling excuse for a "positive health message." Read a health marketing book, lady. Guilt doesn't work to change behavior, and you're expecting kids to have the cognition to understand the concepts in this book without adopting harmful strategies. #facepalm

If people like this keep dominating the health communications marketplace, we're all doomed.

It's Junk Food Day ... are you getting yours?

It's National Junk Food Day! I found this out as I was browsing the news sites this morning, here and here.

Now, as a public health professional, I know you're all going to expect me to sit up on my high horse and preach "eat your veg!" and "leave junk food alone!"

But I'm not going to do that. In fact, I find that perspective overly simplistic and frankly more than a little upsetting.

Junk food has a place in your diet. It has a place in my diet. It has a place in everyone's diet!!! *sound of shocked public health professionals everywhere* Yes! Really! It does!

If anyone has ever heard of the Health At Every Size movement (HAES), or Intuitive Eating, you would know that by perpetuating the idea of the "food police" we are just harming our natural drive to eat what our body needs. That's right, we should trust our bodies to tell us what we want to eat. Sometimes I eat chocolate cake for dinner for a week straight. Yes, I admit it. I'm not the strictist dieter, and I don't beat myself up when I want chocolate cake. I don't eat it every day, but there are times in life when you want a sweet or salty treat! It's OK!

After I've eaten all that chocolate cake, though, it's generally not surprising that I reach for oranges, quinoa, spinach, and other delicious alternatives for a long time. When I was going through eating disorder treatment, I ate chicken wings and pie for about 3 weeks straight, because I was finally "allowed" to do so. I haven't had them since. I don't feel guilty about either choice.

I eat what I want, as much as I want, when I want to. Really. Sometimes it's a lot, sometimes it's a little, sometimes it's in the middle. And my life's better for it.

Point being, if you deny yourself junk food when you really want it, I think you're more likely to binge on it later. The whole point of public health is to create normal eating patterns and provide adequate access to reasonable food options ... for everyone. Now, someone tell me that junk food is not part of a normal American diet ...

Yep, didn't think so.

Let's acknowledge junk food, celebrate its importance in satisfying our sweet tooth, and stop vilifying everyone who cracks open a package of Oreos every once in a while. Isn't our overall health a little more important than maintaining a perfect weight all the time?

I'm overweight. I eat junk food. I'm a vegetarian. I'm also pretty darn healthy (mentally and physically). So Happy Junk Food Day! Throw back some Lay's, Twix, Skittles, SnoCaps, Milk Duds ... you get the picture.

You're not a bad person for wanting some junk food. Don't beat yourself up endlessly about it.

For more, see what The Fat Nutritionist has to say.

Should obese children be removed from their homes?

The most recent post at our friend Dances With Fat deals with a controversial JAMA article that asserts that grossly obese youngsters should be taken away from their parents. Ragen pretty much nailed the main points that I wanted to discuss, and she's kind of an expert on this one, so I'm ceding to her opinion.

One thing I would like to add, however, is my never-ending argument that obesity is sometimes a symptom of a more serious illness; individual with certain mental disabilities, for example, overeat because of malfunctions with their brain structure. Similarly, hormone conditions, endocrine disorders, brain tumors, and other conditions all pose as simply "eat less, exercise more," and they are commonly dismissed (in my opinion) by the medical establishment.

It's easy for us to put the onus of this problem on the parents of obese children instead of accepting that, as a society, we may all be the ones to blame. In fact, children's food choices are not totally dependent upon their parents, and studies have shown that more parental control over children's diet = higher likelihood of obesity. Here is an interesting study that discusses the complex nature of children's food intake and their relationships with their parents.

Ultimately, the question here is whether the community or the individual family unit is more responsible for children's welfare. Although it takes a village to raise a child, I wonder how much intervention our children should face from the government. Also, the costs associated with such an effort would be immense, and I find it hard to believe that health savings would outweigh the bureaucratic losses and legal implications involved with this action.

I see this study as a radical ploy to open discussion about this topic, instead of a realistic proposition for intervention. In that context, it is a useful, if culturally irrelevant, piece. Americans don't want the government in their refrigerator, and they frankly shouldn't.

In other words, just all public health problems, there is no easy fix for this quandary. Taking kids away from their parents for being fat is just an overly reactionary strategy with little basis in public health theory ... it's not an appropriate intervention. Behavior change is not fast or simple, and sometimes we need to allow our social programs time to work before we release such incindiary information into the public sphere.

Did you know ... political groups try to frame public health issues FOR you?

I have been researching common advertising themes that are effective among younger populations, and I came upon this Web site today. The Center for Consumer Freedom is an industry-funded site that purports to tell "the truth" about obesity ...

- The government is controlling you by calling out food manufacturers about their shoddy labeling;

- The government is interfering in your basic rights to be an American;

- Obesity is not caused by fatty foods;

- Exercise will cure all obesity;

- Sugary sodas are good for you because they help the performance of elite athletes (seriously, this is their argument. See study here and "unbiased" interpretation here).

I must admit that their ad campaign is incredibly clever, appealing to basic American principles such as freedom of choice, independence, liberty, etc., etc. However, it's important to recognize that this is all a sham, at least from a public health perspective.

The food lobby is using the same arguments that the tobacco companies used in the past few decades: Our product isn't dangerous for you because we say it isn't! Your freedom to eat (smoke) is being infringed upon! NO MORE BIG GOVERNMENT!!! BLAHHH!!!!

Have you ever wondered why they're using these outdated and ridiculous arguments? Maybe it's because many food giants are actually owned by tobacco companies (as you might find in this awesome article about marketing food to children). For example, Philip Morris, under its alias Altria, owns both Nabisco and Kraft foods. Are we surprised that they're using the same detrimental marketing and social influence techniques to make sure their products remain on the market?

I'm all about supporting individuals' right to choose, but I'm also all about them receiving accurate information about what they're putting in their bodies. If I know that my food is chock full of chemicals, and I understand the ramifications of eating that food, then I assume responsibility for my consumption patterns. If, however, I am coerced into believing that the food I eat is NOT HARMFUL, how can I be expected to make reasonable decisions about my diet?

Again, I think Twinkies and Ding Dongs have their place (i.e., occasionally on my plate), but I understand the risk associated with those products. I wonder whether the rest of the nation really "gets" what's going on ... or whether they're being manipulated by the same crappy companies that used to market cigarettes to kids and the urban poor.

Also, let's not forget that industry-sponsored initiatives often prompt the "boomerang" effect, encouraging people to engage in the negative behavior instead of preventing illness. Ex: The tobacco industry's anti-smoking ads actually encouraged more kids to smoke (as we addressed in an an earlier post on this blog). Do you think McDonald's or Coke's fitness initiatives are really going to promote health? Or are they a surreptitious way to promote inactivity?

Looks like a job for The Public Health Models. We'll keep you updated on this topic.

Fat women everywhere ... FREAK OUT!

Something my friend posted today on Facebook: Obese girls face tough career climb

Coming from an eating disordered background, I have to admit that this kind of thing hits a raw nerve for me. Weight loss efforts for PRESCHOOLERS?

Are you serious?

Can you imagine how messed up those kids are going to be if they start developing food issues at that age? I mean, I remember having serious body image concerns at about age 5, but I'm in the minority (one would hope). Why would we want to spark this kind of neurosis in a large (no pun intended) population of youngsters?

I understand that obesity is a problem in our nation today. I really do get it. Obesity, diabetes, yadda, yadda, the dethfatz are going to get you!

But I will say (as I always do) that obesity is not simply a function of what you eat or how much you exercise. Women with PCOS (ahem, moi) experience obesity as a symptom of their illness ... and this condition affects as many as 10% of women. Funny that you never hear about it, right? That's because too many of us are supporting bogus and dangerous diet ventures in an effort to eliminate our socially manufactured shortcomings.

Anyway, I would believe that young women face huge obstacles if they are larger. After all, our culture tells us that our size is a reflection of our self-control, our virtue, our ability, our dedication. How many studies have been done that prove that fat people (not just women) get paid less, are hired less frequently, and generally get the short end of the stick?

Arguing against these researchers' suppositions ... I wonder whether anyone noticed that lower-income women from disparaged populations are more likely to be obese, which is probably why they have a harder time graduating from college and becoming gainfully employed. ETA: The article says that the researchers said "It didn't seem as though economic situation was a factor," but I'm not sure how that's quantified. Another case of correlation being confused with causation. I mean, I know it's a tough concept, but it seems like a lot of researchers just can't stop sensationalizing phenomena that kind of coincidentally happen together. It's hard for me to believe that we can blame all of our problems on being fat.

Here's the crux of the whole thing for me: This kind of article perpetuates the "if only I was skinny" myth that so many eating disordered folks hear playing in their head ALL DAY EVERY DAY.

"If only I was skinny, I would get a better job."

"If only I was skinny, I would have more friends, and maybe even a partner."

"If only I was skinny, I could feel good about wearing a size ____ "

"If only I was skinny, everything would be better."

This is a dialogue that none of us deserves to hear. It's a bunch of baloney. Being skinny doesn't make your life easier if all you think about is remaining thin. In the case of folks like me, the push to be super thin can endanger your life.

It won't be until we, especially as public health practitioners, start to respect all types of bodies (including those that are naturally thin, fat, whatever) that we will truly begin to find a solution to the obesity problem. Treat these people with dignity, for heaven's sake.

One final thing: "He himself has studied the connection between body image satisfaction, and obesity and anorexia. People who have poor self esteem have difficulty controlling their eating habits, he said."

Yes, because obesity is analogous to an eating disorder? (WRONG ... not everyone who binge eats is fat, and not everyone who is fat binge eats). And the last time I checked, eating disorders weren't because of a lack of control over your eating habits, they're about a need to control something ... so you exert more control over your eating (i.e., not eating anything!). I'm really not impressed with this particular piece.


For more information on fat advocacy, visit:
http://fatnutritionist.com/
http://danceswithfat.wordpress.com/

More smoking, more eating = less economic burden?

Smokers, obese save us money!

So, in addition to the above picture of the ubiquitous headless fatty, I bring you one of the most controversial articles I've read all year. I tell all kinds of people about this study, but no one seems to believe me, and they also think I've lost my mind and/or soul when I bring up this important point:

Healthy people cost the healthcare system more money than chubbies/smokers do.

"How can this be?" you might ask. I was with you at first. I used to vilify people for making bad health decisions because I thought I'd end up paying thousands of dollars to fix their medical problems. I resented diabetes, lung cancer, hypertension, COPD and the whole panoply of medical conditions that accompany obesity and smoking. 

Consider this ... if you're eating healthy, exercising, and living to a ripe old age of, say, 90, you're ruining it for the rest of us. Would you rather pay for 2 years of cancer treatment (and die at, what, 65?), or 15 years of Medicare-sponsored assisted living expenses?

Our profession ostensibly strives to overcome health problems to improve the quality of life rather than simply its duration, which is the only argument I really have against allowing people to kill themselves earlier so we can reap economic gain. That, in itself, should be the fundamental tenet of public health, not saving the almighty dollar. Still, information like this is hard to ignore; again, as public health professionals, how are we supposed to "sell" improvements in health when they might actually harm society? Great question.

Articles like the link above provide us with stimulating information that ought to fuel our continuous debate about how to best spend our public health dollars. When it comes down to it, we really do have to think in economic terms; although it may seem cold, would you rather save 400 people with a guardrail (for example) or one child who needs a liver transplant (thus condemning 400 people to death)?

Economically, I'd go for the former, despite the plight of the kid tugging at my heart strings. But then everyone looks at you as though you shot their dog, accuses you of being heartless, and spends the money on the sick child anyway.

I feel very clinical and almost ... Third Reich-ish ... when speaking like this, but this is just another example of humans failing to examine facts and make decisions based on reality. I'm guilty of choosing with my gut more often than not, but when we're dealing with population-based health measures, that's a dangerous way of doing things.

Our responsibility is to serve the best interests of the general populace; can we do this best by saving money, or by lengthening lives?