When I was a young child, I was admittedly fat and lazy, which is not a great combination for developing a positive self-image.
Fortunately, those characteristics faded after the onset of puberty in my teenage years. But the sense of identity as a “fat person” has never left the back of my mind. So, I experienced some personal pain when I read of the state childhood obesity campaign, “Stop Sugarcoating It, Georgia.”
This campaign includes bus shelter posters of children with captions like, “Chubby isn’t cute if it leads to type 2 diabetes,” “Big bones didn’t make me this way, big meals did,” and “Fat kids become fat adults.”
The campaign ads were undoubtedly well-intentioned and meant to inspire change. But even though rates of obesity keep rising, I find it hard to get behind what I consider to be harsh and hurtful messages.
Public health efforts have generally focused on some combination of blame, shame or fear designed to motivate a person to take greater personal responsibility. However, doing so implied two things: first, that fat people lack willpower, and second, that blame, shame or fear can successfully motivate permanent changes to a person’s food and fitness habits.
But these things are not likely to be true. In fact, some research suggests that playing the “Blame Game” can be harmful, making change more difficult and worsening obesity and health problems.
From an economic standpoint, the fast food and junk food industry make their living by tempting us with tasty treats at affordable prices. So, there are some public health efforts geared at changing the food environment. For example, Chile led the way by implementing an 18% sugar-sweetened-beverage tax; placing black warning labels on food packaging for items high in sugar, salt, calories, or saturated fat; removing cartoon character mascots; and banning school-based junk food, all infant formula advertising, and junk food advertising between the hours of 6 a.m. and 10 p.m. They also banned toys from food sales, like Happy Meals.
In an effort to find a logical and unemotional approach to obesity, there was a study in two small French towns (Fleurbaix and Laventie) with a combined population of 57,819.
In 1992, schools in these two towns were recruited to teach children about healthy living, with lessons throughout the entire curriculum. Teachers received training from dietitians and cross-promotional programs, including cooking classes and supermarket tours. In addition, dietitian-led school-based family breakfast programs were launched.
In 1999, two dietitians were recruited to give presentations to town councils, committees and other meetings. The town councils then built new sporting facilities and created walking school bus (chaperoned walk-to-school route) programs, and local stakeholders (physicians, pharmacists, shopkeepers, and cultural associations) made healthy family living a focus and organized activities to support and encourage it.
Finally, in 2002, 5% of the residents of those towns received a free home-based healthy living checkup, and those deemed at risk were offered dietitian-led advice. If necessary, they were also referred to a physician to address specific health issues (including childhood obesity).
The local media was also involved: 212 articles appeared in local newspapers, 190 in the medical press and 208 in the national press, along with 25 television stories and 75 radio reports.
By 2005, childhood obesity rates in the control towns without these interventions had reached 17.8%, compared with 8.8% in Fleurbaix and Laventie.
If we want to see changes in the prevalence of diet-related chronic diseases, we need to make changes to our attitudes and approach to food. Since complex problems do not have simple, singular solutions, our approach needs to be multi-faceted and long-term.
In a world where portion sizes, front-of-package health claims, use of cartoon mascots, discounted prices and marketing in general are tools of the food industry (whose job is to protect and promote profits, not health), we all need to take personal responsibility for ourselves, our families and our communities.
If shame, blame or fear worked, obesity would be the exception, not the rule. So, we all need to learn how to manage our lifestyles in a positive way, including diet and exercise, every day.
It does not matter much how we got into the condition we are in. What matters is what we do next, based on what we have learned while getting to this point in our lives.