{image source :: rudd center for food policy}

Our airwaves, our water coolers, and even dinner tables are full of discussion about this supposed massive threat to our collective health and wellbeing called obesity. In fact, we don’t often hear the term “obesity” without hearing “epidemic” jammed into the same sentence.

For all of the hollering going on, you would think that fat people were dropping like flies and infecting others are their way down. In fact, the director of the Center for Disease Control (CDC), Dr. Julie Guberding, warned us in 2002 that obesity would be comparable to the bubonic plague. I’m not sure if Dr. Gbererding needs a lesson in history, but the Black Death took the lives of almost 200 million Europeans, approximately 50% of the population, in a four year period.

Meanwhile, obesity is associated with an estimated 26,000 deaths per year, a number that has been drastically revised since the CDC initially claimed that obesity was the cause for 400,000 deaths per year. [Note too that many studies assert that the risk of death associated with obesity is the same for individuals in normal weight categories, and less than those in low weight categories, but we don’t hear those statistics.] Have our shaming treatments for obesity worked that quickly to reduce the number so dramatically? No, not at all. Instead, the obesity epidemic stakeholders were forced to more honestly report the findings.

So why all the fuss about obesity as an epidemic? Once you start to peel back the layers, you start to see just how many individuals and organizations stand to profit from treating obesity as the next SARS or cholera. Government entities gain funding and public approval. Politicians gain supporters who see a leader being “proactive” and “tough” on health issues. Doctors gain patients being more interested in their surgical interventions and medications. Pharmaceutical companies boom with business. And the diet and weight loss industries? Puh-lease…

Who doesn’t benefit from the myth of the obesity epidemic? Well, obese people for one (and all of us for two). Individuals of a large body size or weight are further stigmatized by labeling supposedly increasing waistlines an epidemic. Just like the HIV/AIDS epidemic, the culture of panic that surrounds the condition leads to individuals being feared, reviled, and isolated. Large people in our society today are told they represent what is to be avoided. They are ascribed with labels of being “lazy,” “unmotivated,” “lacking willpower,” and assumed to eat much, move little, and be a drain on healthcare. Needless to say, all of these assumptions are incorrect.

With it clear that obesity and weight itself is not a crisis, it is important to acknowledge that we do have an issue on our hands. As a society, we have a distorted relationship with food and our bodies. I’d like to propose that what we have in our society is not an obesity epidemic, but a hunger crisis.

We hunger for the taste of real, non-processed food. We hunger for the days of our childhood when we were able to listen to and trust our bodies to tell us when to start and stop eating. We hunger for a connection with our bodies. We hunger for joyful movement that makes us feel alive and unencumbered. We hunger for sensibility and rationality among those who lead us and care for us. We hunger for honesty within and between ourselves. We hunger for food to be a part of celebration but not all of it. We hunger for time to spend with ourselves in quiet reflection. We hunger for peace in our bodies and minds.

Until we can recognize the hunger crisis, we’ll be forced to continue wandering the labyrinth of manipulated statistics, threatening claims, and fear mongering. Until we recognize that our cultural struggle is with our individual relationship with ourselves as embodied creatures, we get mired in the battle of the bulge that the weight loss industry and our government would have us believe to be true. From that place, the likely outcome is getting stuck in a vicious sequence of weight cycling and shame. However, if we can recognize what it is we are truly hungry for, we might just be able to satiate ourselves.

How has all of the media attention on the “obesity epidemic” impacted you? Do you think we have a hunger crisis going on?

As the alarm bells have grown louder and more piercing over the last several years, warning us that Obesity kills! and Fat is the devil!, a quieter voice has been breaking through the noise. If we can allow ourselves to turn down the volume on the anti-fat rhetoric for a moment – and I recognize that’s asking a lot – we learn from this voice that, oh… maybe, it’s possible, perhaps… we got it all wrong?

It’s one thing to challenge the diet and weight-loss industry, but to also rock the entire medical community’s entrenched belief system about what healthy means… Well, that’s a big job. Fortunately for us, there is another, strong community fighting this battle. The movement is called Health at Every Size, which I’ve told you about before here, and it’s founded on the idea that fat does not equate to unhealthy.

Even those of us for whom this concept doesn’t sound totally bizarre sometimes find ourselves falling into fat stigmatization, even in subtle ways. We accept the fact that our workplaces are hosting a weight-loss competition among employees or we complement a friend who’s slimmed down, often without even knowing the circumstances.

To do the work required of us – which is to fight and defeat these untrue assumptions about weight – we need resources. That’s why I was so thrilled when the Association for Size Diversity and Health launched the Health at Every Size Blog.

Since it’s first post last June, the blog continues to grow in the complexity and richness of ideas. It offers a space for a thorough look at some of the issues that crop up when thinking about weight and health (which we all too often think about in these days of disgusting and shaming campaigns).

One of the strengths of the site is that it is a collaborative effort of some of the most talented and brilliant minds in the HAES field. Deb Burgard, PhD, Linda Bacon, PhD, Jon Robison, PhD, and Michelle May, M.D. are all on my totally nerdy idols list (the list is nerdy, not them!), and they have each contributed incredibly thought-provoking pieces to the site.

Some of my favorite have included whether BMI is a good measure of health, if it’s possible to love your body and still want to lose weight, and whether we have it all wrong when it comes to treating binge eating.

If you haven’t had a chance to take a look, I urge you to check out what HAES is all about. Just remember that I warned you that it might turn your current paradigm on it’s ear. If you’re cool with that, click here.

{image credit :: haescommunity.org}

Would you pay $1.44 more for a six-pack of Pepsi? What about 50 cents more for your favorite french fries?

Mark Bittman, journalist and food activist, is banking on the answer being no – and yes. In a recent New York Times opinion piece, Bittman outlined a push for creating an excise tax on certain foods deemed to be unhealthy, with the subsidies used to promote healthier options.

Despite my initial cringe at the reference to “bad food” (I work tirelessly to eliminate the categorical and moral language of “good” and “bad” when it comes to food among my patients), I read on to learn more about Bittman’s theory.

And what he suggests makes sense – at least initially. He starts his argument by reminding us all of the dangers of obesity (another cringe, but still reading…) and the increasing health-care costs piling up due to our heavily non-nutritive U.S. diet of potato chips and doughnuts.

He suggests that the food industry is incapable of marketing healthier foods (and based on my analysis of the baby carrot gaffe, I would have to agree) and are not incentivized to do so. Thus, he says, it’s up to the federal government to intervene on behalf of the health of its citizens.

What makes a tax such as this more palatable is that the funds generated – which are expected to be in the billions – would help to subsidize healthy food options for the poor, something that is direly needed regardless of the means. Indeed, a substantial proportion of our nation lives in what has been termed food deserts, areas that lack access to affordable fruits, vegetables, whole grains, low-fat milk due to lack of transportation, proximities of grocery stores, or other reasons. (To determine if your area is a food desert, check out this locator.)

According to Bittman, as well as researchers at the Rudd Center for Food Policy at Yale, an excise tax would work to decrease the consumption of sugary foods, decrease disease and health-care costs, and raise funds for health-focused programs. Millions of Americans would benefit from having nutrient-rich foods more available and making feeding their children healthy options one less thing to worry about. The potential impact of this cannot be overstated.

But we’re still left with the difficult questions about the role of government in helping us make our food choices. Bittman suggests that public health has always been the role of government. But does public health call for making Red Bull less affordable?

Also, what is the long-term impact of beginning to categorize foods as good or bad, as would be required to decide on what items to tax? If one food is taxed and another is not, should that really inform our food choices? What about making those decisions based on our own body’s particular needs and desires?

I also worry about the implications of the data that has and will most certainly been used to popularize these types of initiatives. When we talk about posting calories at restaurants and other such (formerly radical) ideas, proponents frequently point to the “obesity epidemic” and the “war on obesity,” a term and movement fraught with bias and discrimination. Is there a way to propose a food tax without implying fat people make bad food choices unless made to pay more? Perhaps, but it’ll require more creativity than we often see in politics and the media today.

Those are some of my initial thoughts, but I want to hear yours! What do you think?

Make sure to share your reactions, thoughts, and ideas in the comment section below! We need to learn from one another.

In my work, I hear stories of the ways in which human beings are abused and mistreated nearly every single day. But I don’t work in a refugee camp or foster care or a domestic violence shelter. I work with people who struggle with food and weight. And every day I hear about discrimination based on body shape and size. And every day, my heart breaks into a thousand little pieces.

I’m left wondering, if the family members and the strangers on the street and the coworkers knew the people that I know, knew the intricacies of their personalities and the depth of their beauty, would they continue to treat them this way?

Just like nearly all forms of discrimination, weight stigma can be as insidious as it is blatant. And it happens everywhere – on the playground, in the courtroom, in the workplace, in the doctor’s office. We know that children who are obese are bullied more often than peers, and that these children go on to be less likely to be hired by employers. It can even happen in the illusory safety of one’s home.

If you ever wonder if you’ve been the victim of weight stigma, you probably have… But if you’re still wondering, here are recent examples that made the national news:

• A former waitress reported the restaurant placed her on “weight probation” and counseled her to join a gym so she could fit into her extra-small size uniform.
• A 19-year-old American Idol studio audience member, has claimed that she was kept from taking a front-row seat at a recent taping because a male studio employee told her that she was too fat.
• Overweight customers are being turned away from Universal Orlando’s “Harry Potter and the Forbidden Journey” roller coaster.
• Florida gynecologists turn away pregnant obese women.

In an ironic twist, discrimination of obese people leads to poorer health outcomes for those individuals, individuals. Which is why, and I’ll say this until the cows come home (who says that anymore, really??), shame-based initiatives to reduce obesity don’t work!

A few areas have enacted specific ordinances protecting citizens from weight discrimination, but individuals who are larger than average continue to be targeted and treated unjustly without recourse. The Binge Eating Disorder Association, however, wants to put an end to the shame and isolation caused by these practices. So, they established the first annual National Weight Stigma Awareness Week. The week will be held September 26-30, 2011 and its goal is to bring attention to the harm caused by weightism and bullying.

In honor of this historic week, BEDA is collecting stories of weight stigma. The stories should be 300 words or less and emailed to info@bedaonline.com (please cc: ellen@aweighout.com). When you submit stories, make sure to indicate whether you’d like to have your story on BEDA’s website along with your full name, initials only, or anonymously.