Thursday, January 05, 2012

The Real Problem with those Controversial Atlanta Childhood Obesity Ads

The ads cut straight to the point - childhood obesity is real and we can't continue to turn a blind eye towards it.

The ads have also been rather soundly criticized by experts who worry about their impact on the already rampant biases that are endured by children with obesity.

But the ads may well be necessary. Georgia has the second highest obesity rate in the country, and there's no doubt finding a means to reduce those rates, especially the childhood ones, would be a worthwhile endeavor.

So will these ads help?

I sure don't think so.

Instead they steer parents and children to a website full of rather useless one line recommendations. If it were as easy as doing things like, "When you are watching TV as a family, get up and move during the commercials—try running in place, dancing or jumping jacks", do you really think we'd have a problem?  The website also encourages parents to speak to their children's doctors about the problem.  But given that the vast majority of medical schools and residency programs teach pretty much nothing about nutrition and obesity, I'm not particularly hopeful their doctors' advice will be any more sage than the website's.

Without a doubt, the question of whether these ads stigmatize obesity further is an important discussion to have (and for the record, I think these ads simply highlight the issue, not stigmatize it), but I guess what I'm trying to say is this:  Lost in the discussion of stigma, the reporters and experts have seemingly forgotten one very important fact. That fact? We simply don't yet have a reproducible and reliable treatment program that results in significant and sustained weight loss in children.

So while I'm all for public health campaigns to address childhood obesity, it's not the individual victims that I think we should be focusing on, it's the world they're growing up in.

To help illustrate my point, try to imagine childhood obesity as a flooding river with no end in sight. While teaching children how to swim might help temporarily in keeping them afloat, given that the flood isn't abating, chances are, even with the best swimming instructions, the kids are going to get tired and sink. So while swimming lessons certainly can't hurt, what we really need to be shouting about doing is actually changing their environment and building them a levee.

The real problem with these ads is that they suggest that we're going to solve this problem on an individualized case by case basis.

Childhood obesity is the symptom. The environment is the cause.

If we want a cure, it's the cause we need rally against, and not the symptom.

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  1. I've been waiting with baited breath to see if you were going to write about this topic! So glad you did. I appreciate your opinion and agree with you wholeheartedly.

  2. I totally agree and your "flooding river" analogy is apt. And I don't like the image in the ads one bit.

    I do wonder, though, if the website is completely useless. I am surprised how often I meet adults who really don't have a clue about what causes weight issues so I think any effort encouraging change can be useful.

    It is heartbreaking to see so many kids who are so overweight. Their future looks pretty bleak.

  3. In Atlanta, we are now super-sizing pizza. I attended a kid's birthday party at this pizza joint and was amazed by the size of the pizza and the slices.

    Sadly, many of the patrons were super-sized too.

    Here's a pic of the pizza ...

  4. You are so right. It's all about the world they are growing up in. And, if you don't get the parents to change (and food companies will change when people make different choices) the kids will not. What obese parent is going to talk to their child's doctor? Typically, the children have no choice. They are fat from food and from stress (broken homes, etc.) and terrible value system of instant gratification. I was a fat child, always stressed out, didn't even realize I was eating when I was eating. I'm no longer overweight. I and my brother both lost it when we left home and took charge of our own lives. Oddly, in our case our parents were thin, but very much a mess. So some of the obesity I believe is caused by emotional climate in the home. Of course, the food out there is so horrible, that normal sized children is a rarity now, even in my affluent neighborhood with stay at home moms.

  5. Grace Freedman of Eat Dinner included both of our posts about this campaign in a single tweet and I'm so glad she did because I was previously unaware of your blog. You'll see that you and I come from the same place, I think, and I think your river/levee analogy is quite apt. ( Glad to "meet" you!

  6. I like this sentence: "We simply don't yet have a reproducible and reliable treatment program that results in significant and sustained weight loss in children." Yup. Nor do we have a satisfactory one for adults either.

    By concentrating on "obesity" and not "health" the campaign does, indeed, stigmatize fat children and set them up for bullying. It also gives thin children (and their parents) a free pass to eat crap and do nothing if they're so fortunate to have the genetic/hormonal profile that allows them to do so without showing weight consequences. (But make no mistake, they ARE suffering health consequences if they're eating the standard American Diet and not exercising.)

  7. Alex G7:44 pm

    I find it unfair to say that obese children are symptoms of a sick society. They are more thant that. They are it's victims...

  8. Alex,

    Environment is the cause. Obesity is the symptom. Indeed, the children are the victims

  9. Anonymous10:11 pm

    I just wish SOMEBODY could bring cooking back- not just watching it on Food Network and buying magazines, but actually cooking, family dinner-style. If children ate home-cooked food instead of deep-fried mystery meat and pizza at school and home, if they had a bowl of oatmeal instead of sugary cereal or pastry for breakfast (kids can run a microwave and put some oats and fruit in a bowl), if soda and candy were a treat instead of daily school fundraising, maybe we could build the levee.
    And skinny kids do not fare well eating crap, either. I had chronic, painful digestive issues and looked malnourished throughout my childhood. People thought I was anorexic even though I could put away an entire pizza by myself. It just wouldn't digest and absorb properly. The closer I got to a plant-based diet, the better off I was. Now I weigh 17 pounds more than in high school- a thin-normal weight (BMI 20), but healthy.

  10. I really appreciate your comment on "flooding the river" as well, although I wonder, too, if the environmental factors aren't simply that we've got too much fast food and too few options for easy, healthy meals-- in the collection of essays, "Against Health,"
    Lauren Berlant's essay "On Obesity, Eating, and the Ambiguity of 'Health'" talks about overeating as a response to a lack of sovereignity in day-to-day life-- ie, if I feel tied down with work commitments or other such things, then overeating is my subconscious means of rebellion and doing what I want. I'd definitely recommend reading the book, if you haven't.

    -Kat (

  11. Part of the environment is the availability of fresh food, too, especially in urban areas. For people who don't have a car (surprise -- many don't, even outside of NYC), if the only food sources within a mile or more of home are a bunch of fast food places and a couple of convenience stores, it's hard to eat healthy, especially for parents working long hours and multiple jobs. Getting produce and healthy meats TO the people who need them most should be one of the first projects, but it's an urban development issue, not a medical one.


  12. Anonymous2:25 pm

    The parents are at fault for there kids obesity. Let's stop blaming everyone and everything because a kid is fat. If the environment is the cause than why isn't every kid obese? The parents need to take full responsibility for there kids actions.