feetOnScaleIt’s high time, in my estimation, that we stopped talking so much about “obesity.” It’s a well-publicized public health crisis, the buzzword of the moment, but framing our national dialogues around a measurement of our citizens’ body sizes doesn’t seem to be helping much. Obesity rates are, at best, stagnant; at worst, possibly still rising in some segments of the population. You’d think that with all the anti-obesity rhetoric out there, something we’ve done as a country to combat our weight problem would have had a noticeable effect by now.

It hasn’t. And here’s why.

Obesity is only one measurement of a larger pervasive issue

We’re not fighting a cause; we’re fighting a result. It’s a tree-first-forest-later way of thinking. Obesity is a very visible and potentially troubling effect of a much bigger, more troubling issue. By focusing our efforts and attention on the size and shape of people’s bodies, we may be missing not only other, more subtle problems that are also deserving of attention – such as the effects of junk food on neurology, behavior, and learning, or the socio-economic implications of existing agricultural and marketing models – but actually the opportunity to deeply assess what the real problem, or problems, may be.

Obesity can be a symptom of poor health, but not the only symptom of poor health

Some people grow fatter on a junk food diet, while others don’t. Some thin people have diabetes, dangerously high blood pressure, arterial disease, and other poor health indicators that may go undetected because of their body type; some larger people have none of those poor health indicators, but are presumed to be highly unhealthy because of their body type. Obesity can tell you a lot about a person’s health, but then again, it may tell you only that someone is larger than others.  It can also be present in people with overall positive habits, such as a healthful diet and good exercise regimen. In other words, it’s not a 100% corollary to anything other than body size, so a “War on Obesity” amounts to little more than a war on people who are bigger than other people.

 The “War on Obesity” perpetuates negative stereotypes and attitudes about human beings

Notice how it’s not a “war on the health problems that are faced by some obese people” (as well as some non-obese people)?  It’s a war on obesity, itself – giving an ultimate free pass to those who are unhealthy but slim, as well as opening the door to arguments like the “energy balance” mantra. How many times have you heard a critic of, say, the new healthy school food requirements complain that “my kids are thin, so they should be allowed to eat the food they liked instead of the new, gross, healthy food?”  I’ve heard it more times than I can frankly stomach. There’s little push to help people recognize that feeding their skinny kids (or skinny selves) crap food can lead to poor lifetime eating habits, which may lead to poor health outcomes, and may even lead to – gasp! – the dreaded “obesity.”

Framing obesity as the main problem also creates a damaging and unhealthy divide among people. We, as a culture, feel somehow justified in serving donuts and Gatorade after youth soccer because those are “active” kids (there’s that blasted energy balance theory again!), but also perfectly justified in frowning upon a parent who takes her overweight child out for ice cream. We feel okay about serving soda and chips at class parties, but disgusted by the overweight low-income family who stretch their limited food dollars by purchasing the same soda and chips at the grocery store. We use the fatness of others as a distancing, dehumanizing tactic, and therefore the “War on Obesity” is beginning to look an awful lot like a “war on obese PEOPLE,” which I assume is not what any public health official intended.

When we unite against “obesity,” we fail to unite behind a shared goal

This is a big pet peeve of mine, when it comes to advocacy or activism in general. Something I learned early on, and which was borne out by a brief stint as a professional in public health programs, was that you can better effect change – especially behavioral change – by uniting around a positive goal rather than attacking a shared enemy. For example, it’s considered bad form to teach sexual responsibility by saying “Don’t rape people” (although “don’t rape people” is certainly a nice, desirable behavior). Instead, you build people who behave with sexual responsibility by teaching and modeling respectful behaviors, encouraging good bystander citizenship, and improving attitudes about sex and interaction with other human beings.

In declaring war on obesity, we’ve essentially said, “Don’t be fat.” How do we propose that people achieve that non-fatness? That’s certainly not a nut we’ve cracked, otherwise obesity rates would be down. So we’re throwing everything in the arsenal at the “don’t be fat” model, which produces different camps of people adhering to different schools of thought: Exercise more! Eat less! Eat no carbs! Eat no fat! Let’s move! Let’s not move! Let’s cleanse! Let’s…just stop now. None of those things, singularly, is making a significant dent, because none of them, singularly, addresses all of the complex factors that are at play in obesity.  They MAY, however, be impacting some of the health problems that make obesity a concern to us; which means we’re either doing the wrong things, or MEASURING the wrong thing.

The truth is, we’re not much closer now to figuring out all the causes of obesity than we’ve ever been; both science and anecdotal, experiential observation have proven at this point that the old “calories out, calories in” math doesn’t provide anything approaching a complete answer. Furthermore, while obesity can raise serious health risks, it doesn’t always; and it isn’t always the sole driver behind those same health risks, meaning that they can also appear in non-obese people. If we’re worried about the health and well-being of all of our citizens, we owe it to them – to ourselves – to change the dialogue to one that specifically addresses the things that most concern us: The heart disease, the strokes, the diabetes, the chronic and life-threatening and life-ending illnesses.  We need to make it clear that the war FOR our nation’s health is a cause that includes everyone, not just those above a certain number on the scale. Every one of us has skin in this game.  So why do we insist on focusing only on the skins of a few?