8.2: Obesity- A controversy
- Page ID
- 116456
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)You have no doubt read or heard a lot about the "obesity epidemic" in the United States (or worldwide). It seems like the discussion of obesity as a terrible health risk is everywhere. The concern seems to cut across the political spectrum, though different administrations may take different approaches. (You could compare, for example, former First Lady Michelle Obama's influential campaign "Let's Move," with its emphasis on increased physical activity and access to healthy food, to the current campaign of HHS Secretary Robert F. Kennedy, Jr.'s, to remove food dyes and other additives in the food supply.)
Obesity is so commonly discussed, you might not think there's any controversy.
It's not surprising that some of the recommended remedies are controversial (Ban fast food? Tax soda? those proposals are definitely controversial!).
There is also a controversy about the basic science here. Does the rise in average weight that we have seen over the past 40+ years have a negative impact on health? How much of an impact? How serious of a health problem is body fat, after all? Once someone is fat, is weight loss the best way to improve health? And what are the true causes of the rise in body size?
The majority of the public health world would place their bet on the side (in this controversy) that says obesity is a very serious health issue.
Yet, there is some persuasive evidence that obesity itself is not the problem. Rather, poor nutrition, sedentary lifestyles, changes in industrial food production, and other factors may be the true causes of changes in population health - not fat or size, per se. In addition, discrimination against fat people is an under-researched factor that may explain some of the poor health outcomes we see in fat people who are inactive. After all, we have seen that racism and other forms of discrimination cause chronic stress that raises cortisol levels, and that's bad for health. The researchers on this second side of the controversy say that the public health focus on OBESITY may increase that discrimination, harming health.
Keep in mind, discrimination doesn't just make people feel bad - although that's "bad enough." It alters the way plaque builds up in the arteries. It changes the way insulin is produced. It makes a person's resting (sleeping) blood pressure higher. In children, it can impair the development of brain cells. It contributes to chronic disease. It contributes to depression. In an earlier chapter, we viewed the impact of discrimination in relationship to class and race (see Unnatural Causes)- could the same thing be true of persistent and systematic discrimination against fat people?
We can't ignore the fact that in the US, class, race and fat are related. Obesity levels in the US are higher among the less educated and less wealthy, and higher among Latinos, African Americans, Native Americans, and Pacific Islanders than among whites. Obesity is on the rise among some groups of Asian Americans as well, including Filipino/a/x and South Asian populations. When the health risks of obesity are assessed, how are the effects of racism and class disadvantage taken into account, if at all?