Much of the obesity debate – its causes and solutions – is heavily tainted by conflicts of interest – the most important one perhaps lurking among those, who put their beliefs and ideologies before scientific fact.
An essay by Kathleen Kendall-Tackett, published in (of all places) Clinical Lactation, nicely summarizes how conventional political ideologies and belief systems colour this discourse.
Apart from commenting on the often “moralistic” nature of the obesity debate (thin = good, fat = bad), Kendall-Tackett also reflects on the racist, gender and class overtones of this discussion.
With regard to political ideologies, she notes that,
“For some on the right, the obesity epidemic merely reinforces their beliefs about the cause of the ever-widening gap between the rich and poor or between whites and minorities. After all if African Americans, Latinos, or the poor are becoming fatter than America’s predominantly white elite, it is only more proof that they lack responsibility to take care of themselves…if middle-class Americans, particularly middle-class children, are getting fat, it surely indicates the frailty of their own class status.”
“And for those on the left, the growth of obesity is further proof that large, multinational corporations are running amok, fattening a hapless public with their billion-dollar advertising campaigns and super-size value meals. The American people, particularly the poor and minorities who have the highest obesity rates, they argue, need to be protected from these corporate behemoths.”
Both positions reek of,
“…paternalistic condescension towards fatness and fat people—not only do people with this view assume that fatness is inherently bad, but they also presuppose that fat people (that is, minorities and the poor) are too ignorant to know that they should be thin.”
Or, in words of Paul Campos,
“And what is it with these skinny uptight Anglos, anyway? Who exactly deputized them to be the fat police at their local fast-food emporium?”
Indeed, it is easy to see these ideologies reflected in the political discourse around obesity.
In prevention, policies run the gamut from de-regulation (“consumer choice” and “free market forces”) on the right to “shame, blame, tax and ban” policies on the left.
Never mind that neither one of these approaches is supported by hard evidence – indeed, most of the evidence is so poor that it may as well be ignored when it comes to deciding who is right and who is wrong.
While the anti-sugar witch hunt is nearing its climax (the same folks were shouting for anti-fat bans just a few decades ago), those who ignore the mass of data showing the rather modest (if any) effectiveness of “lifestyle change” as a means to tackle excess body weight, continue to propagate “eat-less-move-more” solutions to this epidemic.
Caught in the centre (with nowhere to go) are those who actually bear the weight of the problem (pun intended).
While those calling for better access to and greater investments into pharmacological and surgical obesity treatments are called out by the left for “medicalizing” the issue, those on the right cry out against “coddling” people living with obesity – after all, they are only getting what they deserve given the “poor choices” they have made (you made your bed – now sleep in it!).
Again, both sides of the argument are heavily influenced by the firm belief that everyone can (and should) be a master of their own weight (after all, its just calories and calories out, right?).
No wonder I am wary of ideologies and beliefs as a source of conflict of interest – particularly as these are seldom declared or disclosed.
Hat tip to Noreen Willows for pointing me to this article.