Tuesday, January 11, 2011

The Pedagogy of Obesity Reality Shows

One of the consequences of the obesity epidemic is the proliferation of “reality based” media aiming to lay bare and expose the unhealthy behaviours that lead to obesity and tout “solutions” primarily aimed at changing individual lifestyles.

Notable examples of this ‘”entertainment” genre include television programmes such as Jamie’s School Dinners and Jamie’s Ministry of Food, You Are What You Eat, Honey, We’re Killing the Kids, Supersize and Superskinny, Fighting Fat Fighting Fit, and The Biggest Loser. In Canada we have our own examples like X-Weighted and the most recent CBC addition, Village on a Diet.

Given the mass audiences that these shows command, it is worth considering how the causes, consequences, and possible solutions to obesity are portrayed in these shows. Perhaps even more importantly, the implicit and explicit portrayal of  people with obesity in these shows and the “narrative” around obesity deserves exploration.

This is the topic of a paper by Emma Rich from Loughborough University, UK, just published in the latest issue of HEALTH, which explores how reality media portrays and perpetuates the interdependent connections between parenting, social class and broader political discourses of parenting and health risks relevant to obesity.

As Rich points out:

“Reduced activity and poor diets are repeatedly reported as leading to escalating rates of overweight or obese populations and related mortalities resulting from associated conditions such as hypertension, diabetes, stroke, heart disease and cancers. This is asserted without reference to work which reveals that many of the ‘certainties’ populating obesity are based upon scientific evidence which others claim is either inconclusive or incorrect. Within this discourse, it is routinely declared that the health of western society is facing imminent decline unless measures are taken by individuals to eat less, lose weight and exercise more.”

Furthermore:

“The imperatives around ‘eating well’, exercising regularly and monitoring our bodies, carry powerful moral overtones about how individuals ought to behave. These imperatives are strongly associated with body size, such that the thin or slender body is taken to represent not only a state of ‘good health’ but also reflect control, virtue and good citizenship.”

Drawing on specific examples, Rich looks at how these shows reduce the complexity of obesity to rather simplistic messages often with strong moral and judgmental overtones. These simple solutions are offered by so-called “experts”, who seldom appear to fully appreciate the reality of the participants lives.

To illustrate this point, Rich cites a dialogue from an episode of Jamie Oliver’s Ministry of Food, in which

“Jamie returns to Natasha’s house to find that she is once again feeding her daughter cheese-chips. ‘Sorry, I’m just embarrassed’, Natasha says eventually. ‘I don’t know how it gets like this. I really try with money, I do.’ Jamie, looking confused replies ‘Look’, he begins, ‘I’m not going to say to you that I understand, because … well, erm, I don’t.’ Natasha gets tearful, and explains that during the week she had spent all of her benefit money on bus fares and overdue bills, and had little left to buy the ingredients for the recipe that Jamie had taught her. As Jamie stands in the kitchen Natasha cries. ‘Come here’, he says, moving towards her to hug her. ‘Get off’, she says, pushing him away.”

Or an episode in which another woman explains to Oliver ‘The thing with you, Jamie, is you live in a bubble. You’ve got no bloody idea what it’s like for us.

As explained by Rich:

“Natasha’s rejection reveals how public pedagogies such as those functioning with Jamie’s Ministry of Food can be at odds with the realities of individual lives when health is abstracted from the social contexts which shape it.

For example, the class association of food choice is given little regard in Jamie’s Return to School Dinners when he routinely inspects teachers’ and children’s bags for junk food, telling one young teacher caught with junk food ‘That’s no way to live, darling. You’ve got to have some pride in yourself.’ There is no acknowledgement of the cultural value that chips (albeit in the British context) as ‘a white working class food’ might have for Natasha, or that they might ‘be cheap and filling’ thus meeting her financial needs.”

Similarly, Rich draws on specific examples from other reality shows with similar narratives.

Rather than theorizing these interventions as imposed or regulated by neoliberal ideals of ‘responsible individualism, consumerism and self improvement’, Rich examines how these shows lead the participants

“to know themselves in relation to dualistic body knowledges which ‘abolishes multiplicities and variation’; as either fat or thin, healthy or unhealthy, failing or morally right/wrong.”

These discourses not only position individuals as blameworthy, but moralize and decontexualize health inequalities by glossing over the social and structural contexts that come to bear upon this.

…self-management is at the heart of reality television, thus as is revealed in Jamie Oliver’s School Dinners, a child’s diet becomes a reflection of parenting choice, rather than antecedent gender, class, cultural or ethnic localities. Those parents who do not comply with the sanctioned behaviours of the Oliver campaign become the figures through which affects associated with bad parenting choices flow (‘you’re an idiot’) within an obesity assemblage.

The complexities of health disparities which so strongly come to bear upon health, are often obfuscated in this discourse…reality TV positions the working classes as a maligned and ‘abject’ social category to be managed, controlled and ‘taught’ how to live better lives.”

However, as Rich also points out:

“This is not to suggest that all media focusing on weight and health are assembled in this way….Indeed, some media may lead to more critical or creative public pedagogies perhaps even disrupting neoliberal discourses on health.”

Perhaps it helps to always remind ourselves that even the best-intended tv shows need to capture the interest of its viewers.

Or, as Dr. Ali Zentner, the physician on CBC’s Village on a Diet, so succinctly summarized in her comment on my blog,

“what is “good tv” is not always perfectly accurate science.

AMS
Edmonton, Alberta

Rich E (2011). ‘I see her being obesed!’: Public pedagogy, reality media and the obesity crisis. Health (London, England : 1997), 15 (1), 3-21 PMID: 21212111

VN:F [1.9.22_1171]
Rating: 10.0/10 (16 votes cast)
VN:F [1.9.22_1171]
Rating: +17 (from 17 votes)
The Pedagogy of Obesity Reality Shows, 10.0 out of 10 based on 16 ratings

16 Responses to “The Pedagogy of Obesity Reality Shows”

  1. AcceptanceWoman says:

    This is an impressive line of thinking. Thank you for highlighting this article, I’ll seek it out.
    I’m excited to see that the summit on weight bias and discrimination is sold out. I wish I could be there (I am in Washington State with no travel budget).
    I admire the work you are doing to bridge the gap between the medical perspectives on obesity and the more “subjective” ones — it’s my belief that an approach that integrates the two (and helps people avoid entering the medical system when they don’t have to) will lead to the best health outcomes.
    I think increasing understanding and reducing stigma will go a long way in efforts to prevent unnecessary weight gain, and allow improved care for people who avoid seeing health care providers because of experiences of stigma and shaming.

  2. Louise says:

    Great post. The bottom line to me is ‘REALITY TV’ really is REALITY. Those social discriminations do exist, the judgement and all that goes with it are real for those out there dealing with weight issues.

    What these people need is true empathy and support. For crying out loud, most of us know what we need to do – ELMM! Why we don’t is very, very complicated.

    I am a Weight Watchers program leader – if you didn’t know it already, everyone who works for Weight Watchers (right up to the CEO) is a Lifetime Member – which means we have lost weight and continue to struggle to maintain it as we help our members succeed. We are real.

    That is reality.

  3. Anonymous says:

    No matter what political approach you take, it will still be necessary for an actual individual person to “eat less” (fewer calories) and probably “move more” ( if only for health benefits instead of using up calories), if they are going to lose weight.

    Rich refers to the “so-called ‘obesity epidemic’ ” in her abstract. What’s “so-called” about it? Of course there isn’t 100% scientific agreement on details, but I think the science is behind obesity being exactly a threat to Western society’s health.

    Re Jamie’s not recognizing a participant had not enough money to buy recipe ingredients, but had enough money to buy junk food
    – that was a bad move on Jamie’s part, not because he expected individual responsibility from Natasha, but because he didn’t give her the right recipe – junk food is more expensive than many types of healthy food.

    Re the disregard for the “cultural value” of bad food – is a nutritional disaster acceptable because it has “working-class” cultural cred?

    Re not accepting multiplicities and variations in bodies: this is not applicable in the case of obesity. Putting obesity in the same category as naturally different body sizes is denial.

  4. Theresa says:

    Excellent post Dr. Sharma. Jamie Oliver arrives on his white horse (or Jillian or Dr. Oz etc), give a list of what we should eat and then gallop off into the sunset.
    I have lost almost 100 pounds and can not find one resource of support for counselling help. I still see myself at 230 pounds. If I don’t change this and realize the person in the mirror now weighs 138 I will soon be a higher weight. That’s where the support is needed. Brain power. Not brute force. Not a magical formula. Anyone out there know of a resource? I’m in central Alberta and hear nothing but dead air on the phone when I ask counsellors if they have training in this field.

  5. Theresa says:

    To the anonymous poster,

    It is not more expensive to buy junk. One big bag of chips/crisps is still less money than all the ingredients of any of Jamie’s meals. If you have nothing in the pantry you still have to make that list and get everything on it to make a meal.
    The real question to ask is WHY would chips/crisps be cheaper in the first place? Kick backs to corn growers (corn syrup) and other billion dollar industries make it impossible for the cabbage grower to compete.

  6. eddie says:

    How much do you value yourself? In particular, and this seems to be missed quite often in the debate over jusk food / healthy food, how mush do you value your time. I’m sure that when jamie troews together a wonderful, healthy dish, he doesn’t have to also nurse, change a baby and supervise a junior schooler’s homework at the same time. Still, he can charge however much he does to make his programs.

    Meanwhile, in the real world, there’s working mothers on minimum wage, trying to do the best for their kids. It really matters when they can buy them chips, from a real chippy, no less. Someone else made it. Time and money was saved in a busy day and that money was well spent. And, hey, it’s a treat.

  7. Anonymous replies to Theresa says:

    Super Store flyer, this week: (Halifax, NS)

    big bag lay’s chips, 2 / $5.00
    2 lt Coke or Pepsi 2 @ 99c ea, $ 1.98
    Total $6.98

    Country Harvest 12 Grain bread – 2 Loaves @ $1.69, $3.38
    Kraft peanut butter, 1 kg $3.49
    Total: $ 6.87 (for lots of sandwiches)

    Catelli Healthy harvest pasta, 400g pkg $1.49
    Catelli Garden Select pasta sauce 99c
    sweet green peppers, pkg of 4, $1.49
    carrots, 3 lb bag $1.49
    Maple Leaf 156 g tin flaked chicken 99c
    Total: $6.45
    (I put a tin of meat into the spicy pasta sauce, for protein, it cooks up well with added chopped up green pepper and carrots. Not up to Jamie’s standards, but ok if you’re hungry, and more nutritious than pop and chips)

    onions, 3 lb bag, $1.49
    turnip, 3 lb @ 49c /lb $1.47 (or cabbage @ 49c / lb)
    soup mix (assorted beans, peas, lentils, barley) (not in this flyer), about $3
    Total: $5.96
    (add leftover carrots too)

    Club pack pork chops or roast, $1.99 a lb, could probably get one for about $7
    Have with leftover carrots/onions/turnips

    Trim Plan meal replacement bars, pkg of 6 for $6.99, ($1.17 ea)
    If you’re going for a grab&eat “meal”, you might as well get eat just 270 calories and get14 g protein and a bunch of nutrients – beats chips or ordinary chocolate bars.

    I’ve seen some of Jamie’s recipies, and just the spices and herbs are expensive if you’re on a cheap budget.
    My meals probably wouldn’t pass a dietitian as nutritionally good, I’m just saying they’re better than chips.
    I don’t work for Superstore or any brand, I just wanted to back up my contention that for the price of pop and chips, you can get ok (not gourmet, not super-food nutrients) food.
    (I also love ice cold Diet Coke and Salt and Vinegar chips – that’s an occasional party, not a regular meal)

    P.S.WOW, Congratulations on your weight loss. I am very impressed. I have only lost 45 lbs so far. The “dead air” on the phone is probably awe, and they’re wondering what they can say to add to such success! I hope you find a good counsellor, but keep looking proudly in the mirror, and at the scale, and give yourself credit. If you lost 100 lbs, you can keep aware of your weight and deal with any lb that reappears.

  8. Louise says:

    Theresa – Have you looking into finding a life coach that works in the field of weight loss? They can do wonders by helping you see and accept what is right and expand on your capabilities.

    Congratulations on the weight loss, it is hard work to get it off and to keep it off – the journey never ends.

    On the junk food note. On the outside it seems cheaper to grab a super-sized something but in reality, the ingredients included in a healthy meal will make more, healthy and filling foods that will sustain you longer – better investment. It is a challenge to make the switch but once it is done, eating at home is always a cheaper and better choice.

  9. Ami says:

    To anonymous,

    Until I see some actual data about how the people telling me there’s an epidemic are DEFINING obesity, I’m still going to use the phrase ‘so called’. If someone tells me it’s BMI, I will not only use so-called, I’ll emphasize it. BMI is an idea that’s basically claptrap wrapped in a pretty bow.

    And no, not all people can lose weight by eating less and moving more and to perpetuate that idea that it’s so simple is outright damaging and already adding a moralizing component in a place that absolutely does not need it. Some people’s bodies do not work like that, or some people are taking medication that make their bodies not work like that,

  10. Mavis says:

    Recent research has found that obese individuals fail to follow their own readiness to change questionnaire. They have low motivation and are not subject to the same desire for attractiveness. (loss of hope) A new approach is to focus on frequency of counseling visits and more in-depth analysis of motivation for change. Most of my patients must reach a stage of inspiration to manage the weight loss/weight management proposal.

  11. Catherine Walsh says:

    Very interesting blog today, Arya. I had the privilege to attend a recent national workshop on body image at Mount Saint Vincent University and at one of the sessions introduced me to the term “healthism”. I would like to explore this in a bit more depth at some point as it appears to relate to what your reference discusses today. I did find this interesting abstract though. I work in the area of women’s health.

    ‘Taking charge of your health’: discourses of responsibility in English-Canadian women’s magazines
    Stephannie C. Roy
    This article presents an examination of the ways in which responsibility for health is constructed in popular English-Canadian women’s magazines. Women’s magazines are a unique media form, acting as guidebooks for women on matters relating to feminine gender roles and are important to examine as part of the corpus of societal discourses which frame our understandings of what it means to be healthy and how good health is achieved. Using discourse analysis several techniques were found which reinforce women’s individual responsibility to create and maintain good health for themselves and their families. The magazines instruct women/readers directly about their health-related responsibilities and outline the negative consequences of inaction or incorrect action. The magazines also use the traditional discursive technique of women’s personal accounts as both cautionary tales and inspirational stories to encourage readers to actively pursue healthy behaviours. Reflecting and reinforcing the discourse of healthism, women’s magazines consistently present health as an important individual responsibility and a moral imperative which creates an entrepreneurial subject position for women. The article concludes by discussing the implications for women’s magazine audiences within the ongoing feminist debate about this cultural industry
    Sociology of Health & Illness
    Volume 30, Issue 3, pages 463–477, April 2008
    Article first published online: 11 JAN 2008
    DOI: 10.1111/j.1467-9566.2007.01066.x

    Leaning a little away from evidence based medicine… I enjoy reading and am inspired by Christiane Northrup. In her book Women’s Bodies, Women’s Wisdom she writes in her section on Making Peace With Weight…
    “Most women have bodies that are meant to be larger than the cultural ideal. Women’s bodies have more fat on them than men’s… Since cultural expectations of women are that we can never be too thin, and since being thin is associated with self control, a life-long struggle with food and body weight is the cultural norm. Our bodies and their weight are the barometers by which society measures how good we are, how attractive we are, how worthy we are. How much self control and body abuse must women go through before it dawns on us that there is something deeply wrong with the entire approach to the “weight problem”? Will power and self-control are exactly the opposite of what we need. We need to see media images of normal, healthy women who are strong… Regardless of our body size, self respect and self-acceptance are the starting points for making peace with our size. We must know that we have the power to get off the weight treadmill and start enjoying our lives, no matter where we are not.”
    She quotes …” Louise Hay, who teaches that changes in our lives (and our bodies) that are loved into existence are permanent, while changes that happen through self-abuse and denial will always be transient”.
    Another wonderful author that I enjoy is Stephanie Dowrick. In her book Choosing Happiness, she has you ask yourself, “Is this kind?” On the VOD show I see glimmers of kindness especially in the community supporting each other and the little guy boxing with the trainer. That is nice. Hope to see more of that. Will continue to watch as the effort is being put forth by many and the discussion it creates I think is ultimately positive.
    For my part, I would love to see a show that celebrates women (and men and children) of all shapes and sizes. Weight is one aspect of a person and while that could be highlighted, other aspects of the person and their lives could be set to some really fun music, lighting, narrative and action. Maybe someone will do that some day.

  12. Theresa says:

    Back to Anonymous,
    This is EXACTLY what people need to read! I commend you for choosing a flyer and finding a one stop shop (shopper might be on a bus). These are the things that can help turn it around. Frankly the nutrition value of your choices look pretty good to me…… but I’m not a nutrition specialist either. Planning is key.
    Thank you for the kind words. PS. “only lost 45″ ……. that’s enough to change a lot in your world! Celebrate the success too. :)

    Louise thanks for the insights. :)

    Keep up the good fight Dr. S!

  13. Ann says:

    No, not all people can lose weight by ELMM. Agreed.

    On the other hand, MANY people CAN lose weight by eating less and moving more (if the eating less includes good nutrition for fewer calories, and the moving more is healthy).

    For those people it is very demoralizing to be told that there is nothing they can do to lose weight, obesity is too complex to deal with, weight loss is doomed to failure in them because ELMM doesn’t work for everybody. It is demoralizing to be told it is useless to control your diet and exercise without going for counselling and seeing doctors(specialists, at that). It is demoralizing to hear you have to unearth terrible childhood trauma, even if the worst thing that happened to you was a bad diet (ala Oprah, if you’re overweight there is has to be some horrible trauma in your background that causes it), or everything is useless without combating pervasive evil neo-liberal paradigms (or some other social theory).

    There are people who are overweight for reasons that make ELMM useless for them.

    On the other hand, there are some people who are overweight because they eat too many calories, and don’t move much. When they change their diets, and exercise, they will see their bodies change.

    If some people can’t lose weight by ELMM because there are other problems to deal with, that’s no reason to disparage diet control and exercise for those people who can and do control their weight that way.

    A medical bariatric practice, by definition, gets all the people who have all the non-diet-exercise causes of overweight and obesity, so ELMM for that section of overweight people is likely not to work. But that sub-set isn’t representative of the whole population of people who need to lose weight.

    Even if you get all the treatment, counselling, surgery, etc etc, you will still have to eat fewer calories, and get a bit of exercise, to lose weight. If you get all the medical intervention in the world, you still don’t get to EMML, or even ESMS – eat the same, move the same – and lose weight. Even after Bariatric surgery it still boils down to ELMM. (check out post-bariatric surgery diets)

    Some medical syndromes/diseases/medications can make it impossible to avoid overweight, but that’s no reason for giving up on other people.

  14. closetpuritan says:

    “For those people it is very demoralizing to be told that there is nothing they can do to lose weight, obesity is too complex to deal with, weight loss is doomed to failure in them because ELMM doesn’t work for everybody.”

    But ELMM doesn’t work for everybody. Should we just pretend that’s not true? Don’t you think it’s unethical for doctors to withhold information about a treatment’s risks from their patients?

    It is very demoralizing–and presents health risks–for someone to try to lose weight and keep yo-yoing up to their original weight or higher, too.

  15. Links of Great Interest: 1/21/11 : The Hathor Legacy says:

    [...] is reporting an article by a Dr Sharma who is himself reporting on a paper by an Emma Rich criticising anti-obesity [...]

  16. Alicja says:

    Excellent post, Arya! You’re absolutely right – reality shows portray a painfully simplistic picture, especially when it comes to weight management! I really wish that as a society we could further develop our emotional intelligence and not judge people on every opportunity we get.

    Judgment is the enemy of understanding. It’s easy to pick a scapegoat and blame all our troubles on it. Many people find it gratifying to compare themselves to someone else who is in a much worse situation than they are, as it makes them feel better about themselves. Many people even go to the extent of criticizing the other person’s behaviour and then basking in the satisfaction that they themselves don’t do any of those “wrong,” “shameful,” “dishonourable” things. But that’s just self-righteousness. Criticism, lectures, shaming and patronizing advice will not empower people to make positive changes in their lives – it will only break them down even more. What people struggling with weight issues need is empathy and understanding, and others’ belief in them that they CAN make lasting positive changes in their life!

    Whatever the problem we seek to solve, be it disease, poverty, drug abuse or overweight / obesity, we will not solve it through judgment, condemnation and criticism. We can only get to the root of these problems through compassion, empathy and understanding. For anyone who hasn’t seen the children’s movie “How to Train Your Dragon” – I highly recommend it! Watch that movie and then think of any challenge you or your organization may be struggling with: any disease, any difficult or broken relationship, and business challenge, any system-level challenge, and yes, especially the challenge of overweight / obesity, as these challenges are plagued with so much misunderstanding! Think of these challenges as your “dragon:” the more you fight them, the more fierce they will get. The conflict will only dissipate when you seek to understand, to empathize with, and to work with “your enemy” to resolve the underlying issues. So, before you judge, condemn and criticize, ask yourself, “Am I really one to throw the first stone?”

Leave a Comment

In The News

Diabetics in most need of bariatric surgery, university study finds

Oct. 18, 2013 – Ottawa Citizen: "Encouraging more men to consider bariatric surgery is also important, since it's the best treatment and can stop diabetic patients from needing insulin, said Dr. Arya Sharma, chair in obesity research and management at the University of Alberta." Read article

» More news articles...

Publications

"Quantitative phase-contrast imaging through a scattering media."

» Browse and download more journal publications...

Watch Dr. Sharma in the News!

Dr. Sharma - NEWS Videos

Listen to Dr. Sharma!

Dr. Sharma - on CBC.ca

Watch Dr. Sharma on Listen Up


  • Subscribe via Email

    Enter your email address:

    Delivered by FeedBurner




  • Arya Mitra Sharma
  • Disclaimer

    Postings on this blog represent the personal views of Dr. Arya M. Sharma. They are not representative of or endorsed by Alberta Health Services or the Weight Wise Program.
  • Archives

     

  • RSS Weighty Matters

  • Click for related posts

  • Disclaimer

    Medical information and privacy
    Any medical discussion on this page is intended to be of a general nature only. This page is not designed to give specific medical advice. If you have a medical problem you should consult your own physician for advice specific to your own situation.


  • Meta

  • Obesity Links

  • If you have benefitted from the information on this site, please take a minute to donate to its maintenance.

  • Home | News | KOL | Media | Publications | Trainees | About
    Copyright 2008–2014 Dr. Arya Sharma, All rights reserved.
    Blog Widget by LinkWithin