Thursday, October 25, 2012

Did the OMA Go Too Far With its Childhood Obesity Recommendations?

The uproar has been furious. Literally.

And I certainly understand why. But it's not because the Ontario Medial Association (OMA) went too far, it's because the OMA lost control of the message.

For readers who aren't aware, on Tuesday the OMA held a press conference where they outlined multiple initiatives that they hope if enacted, will help in preventing further increases in Canada's rates of childhood overweight and obesity, and perhaps even help to lower them.

The initiatives they recommended included (verbatim from press release):
  • Increasing taxes on junk food and decreasing tax on healthy foods;
  • Restricting marketing of fatty and sugary foods to children;
  • Placement of graphic warning labels on pop and other high calorie foods with little to no nutritional value;
  • Retail displays of high-sugar, high-fat foods to have information prominently placed advising consumer of the health risks; and
  • Restricting the availability of sugary, low-nutritional value foods in sports and other recreational facilities that are frequented by young people.
The OMA's calls to action stemmed from what they described as "Lessons learned from anti-tobacco campaigns" where indeed the use of graphic imagery, taxation, retail display changes and advertising bans did have a tremendous collective impact on smoking rates.

The challenge would be in implementing these sorts of interventions without vilifying people with obesity - and it would indeed be a challenge, but not one that I think would be insurmountable. Moreover I think dealing with that challenge might serve society well in terms of truly exploring the stigma and bias faced by those with weight.

So could the OMA have simply left out "obesity" from this initiative altogether? After all, the consumption of the products targeted by this campaign are no less unhealthy for skinny folks than for fat ones. Could the OMA have simply focused on the fact that as a society and perhaps especially with our children, over the past 50 years or so, we've completely normalized the regular consumption of junk food, of highly processed boxed meals instead of cooking, of frequent meals out, of no-name fast food in school cafeterias, of chocolate-milk school milk programs, of pizza days, and at the same time created a Food Guide that specifically states juice is a fruit? I think that in an ideal world the campaign could have targeted those normalizations all by themselves, but in our real world, I don't think it would have garnered much attention or cultivated much discussion.

Putting the actual recommendations aside, what the OMA is really saying here is that we need to get off our collective asses and actually do something - because talking isn't getting us anywhere.  How and what we do is certainly up for debate, but losing sight of the need to start doing, of the need to formatively change the incredibly unhealthy landscape in which we raise our children, and instead exclusively focusing on whether or not the graphic imagery is a good plan, is missing the forest for the trees.

And that's definitely where the OMA struggled some. The media, and indeed even some of my colleagues, have latched onto this notion that the OMA is suggesting that obesity is the new tobacco. Ultimately I don't think that's the message they're promoting, but admittedly it was their backdrop and call to action. Actually reading through their materials, and speaking with the folks involved, I think their real message is that junk food, not obesity, is the new tobacco. That just like with tobacco we need to denormalize junk food's provision, marketing and consumption and that were we to start exploring recommendations like those they put forth, we'd be starting down that very important road of doing rather than simply sitting around and casually talking about it while our children suffer.

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  1. It seems like the media (and alas, some of your colleagues) need to go back to high-school for some SAT (American college aptitude tests, sorry if it doesn't translate!) verbal training. The whole "A is to B as X is to Y" thing.

    Obesity is not the new tobacco... Bad food is to obesity what tobacco is to lung cancer (and COPD, bladder cancer, etc)... Get a handle on the first, and you significantly decrease the second.

    1. I don't think the links are as direct as they are with smoking. Eating bad food *can* lead to obesity (not always), and obesity is linked to many different types of health problems. Eating bad food (whether or not you gain weight) can also lead to many different health problems. So I agree with Yoni that linking junk food to obesity somewhat misses the mark.

  2. The word obesity is an attention grabber, particularly when it comes to the source of the money to support these initiatives. I believe that if they were to try this campaign without linking it to obesity it would be considered a "feel good" campaign by those who are choosing which programs they are going to financially back. It would like be be condescended to and only given negative press by those who are dismayed at having to pay more for their junk food.
    By putting the word obesity into it, they are making it a health issue that can save money in the long term. That will get them a lot more support from both the policy makers and the general public.
    They were well aware of all this when they wrote the program and that is likely why the word obesity is not used much throughout, but is a definite attention grabber for those who read just the headlines.

    Personally, as a parent to two small children (one of whom recently admonished her Grandmother for claiming that a cheeseburger was healthy) I love it. My kids are being raised to know what is junk and what is healthy. They are good at making the right choices. As my 6 year old gets older though, she is seeing junk normalized in her school environment and I can already see the impact that is having.

  3. I think you hit the nail on the head there. We need to reinforce healthy eating at home for the generation we're currently raising. Taxes and warning labels are lost on a 6 year old :) Also, teaching them what bad choices look like, even those offered and taught at school, is important so that they can differentiate.

    1. Andrew education only doesn't work that has been done for years here in Portugal and the obesity problem is still rising. We need regulations and we need healthy food available. At the moment in my country there isn't any cookie in the market that is near healthy. Most processed foods are just junk and that needs to be stopped. Food industry only looks at profits they won't change by their good will.

  4. "So could the OMA have simply left out "obesity" from this initiative altogether? After all, the consumption of the products targeted by this campaign are no less unhealthy for normal weight folks than for fat ones."

    Exactly so. After all, obesity is not the cause of any disease; it's merely a symptom of either hormonal disturbance or excessive caloric intake. The former is associated with noncommunicable diseases of many sorts. The latter is associated with a big appetite or a psychological obsession with food.

    Unfortunately, a food supply so heavily laced with added sugars and separated fats deranges the appetites of slender and fat alike. Fat people who overeat are regarded as gluttons. Normal people who overeat are envied. Both are likely to die early from noncommunicable disease since they routinely consume foods dilute in micronutrients(1) and overly rich in omega-6 industrial seed oils(2).


  5. Anonymous9:26 am

  6. I think these are good measures, but as a parent I think the first priority should be getting junk food out of schools. My son's school 'cafeteria' looks like your video of the Walter Baker Centre canteen, only they don't salt the fries and all the pop has to be diet. I cannot understand how that makes sense to anyone? Add in to that a 10:30am "lunch" break and recess for the last half hour of the day (dismissed to the yard with school bags, just to hang out and wait for the bus"... the whole system is so frustratingly broken.

  7. I think this is a very positive step. Some might think this sort of government intervention is unnecessary but we are in a sorry state of affairs and such intervention is timely! We, in the US, need to take a page out of your book!

  8. Anonymous3:35 pm

    All of the recommended initiatives sound excellent. Wonder if some of the uproar was being generated by the manufacturers of junk food. The intiatives suggested are much better than whats happening in New Zealand, currently the push is to "educate" pregnant mothers on how to eat better, due to scientific research that points to disease risk starting in the womb. Awful stuff!! Wish there was more of an out cry against it, especially as I feel it could stigmatize pregnant women and takes away from the real problem the environment.