Opposing Viewpoints on Childhood Obesity: Critical Essay

Childhood/Adolescence

As habits and problems of childhood often follow the individual through adulthood, childhood obesity gets a great deal of ink. The perspectives on the issue, however, vary dramatically. For example, Elizabeth Poskitt and Laurel Edwards wrote Management of Childhood Obesity for Healthcare The upshot of the work suggests that if parents are not willing to change behaviors around food, the healthcare professionals are not likely to succeed. This pessimism is countered somewhat in Fed Up!: Winning the War against Childhood Obesity, by physician and journalist Susan Okie, who provides readable success narratives of communities and parents who boost the activity levels and intake of fresh fruits and vegetables of their children. The storytelling makes it appropriate for lower division undergrads and technical schools, though a bit lengthy for busy healthcare professionals. Preventing Childhood Obesity: Evidence Policy and Practice, published by Wiley, also focuses on the prevention of obesity. For upper-level students and researchers, it is especially helpful for those who are learning how to assess evidence and how evidence is produced. Another perspective focuses more on the contours of the problem.

Obesity and Adolescence: A Public Health Concern, a book edited by four physicians, is more concerned with multiple aspects of the problem of obesity, including medical, sexual, physical, and nutritional, and even the international perspective. The solutions it does propose are social rather than familial in character. While the whole volume will not be generally read, its individual articles are useful even in a community college setting. The vision of childhood obesity as a public health concern that may be responsive to legal remedy is addressed in two books both published by the National Academies Press. The first of these, Legal Strategies in Childhood Obesity Prevention, provides an overview of many possible legal angles to prevent childhood obesity, discussing taxation, civil rights, product liability, and public health policies. While not always easy to read, the work does provide an introduction to different perspectives on childhood obesity. A second title, Local Government Actions to Prevent Childhood Obesity, provides a set of interventions that local governments might enact to combat childhood obesity. This would be a useful volume for professors interested in helping students connect global, national, and local analyses and for schools interested in community-based learning projects. A very different perspective from any of these, Education, Disordered EatingandObesityDiscourse, is edited and written by several academics (primarily education professors), such as John Evans, who teaches sociology of education, and Emma Rich, who lectures in sports education. The work generally argues that the “discourse” about obesity in schools creates more problems than it solves by creating eating disorders in young people without a consequent loss of weight. They suggest that the focus of the discourse is on the control of bodies and moral disapprobation and is not conducive to health.

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History/ Discourse

Discourse analysis is much less unusual in the humanities-based view of obesity. For example, Alcohol Tobacco and Obesity, an anthology edited by Kristen Bell, pools the expertise of anthropologists, sociologists, and public health professionals from various parts of the world to examine how alcohol, tobacco, and food came to be viewed as “problems” and their users as problem citizens. This is an anthology that brings into question the reigning narrative of obesity as a public health issue. Similarly, another anthology, Biopolitics, and the ‘Obesity Epidemic’: Governing Bodies, takes as its starting point a Foucauldian view of discourse as a method of control. Edited by two professors of education, Jan Wright and Valerie Harwood in Australia, it provides fourteen different articles by multiple social scientists who analyze the discussion of obesity as a means to control bodies. In addition to these contemporary perspectives, Culture of Obesity in Early and Late Modernity: Body Image in Shakespeare, Jonson, Middleton, and Skelton by Elena LevyNavarro provides cultural studies that look back at the early modern period in England. There we see that “fatness” has not always been understood with the moral disapprobation from which it is stigmatized today. Sander Gilman also provides a history of various cultures’ understanding of obesity in his works, Fat: A Cultural History of Obesity, and Obesity: The Biography. Though they cover much of the same territory, Obesity: The Biography is organized chronologically using accepted historical periods, beginning with the ancient world and moving through the Medieval and Renaissance, etc., while Fat: A Cultural History of Obesity is organized thematically, looking at concepts such as epidemic obesity, childhood obesity, etc. These titles provide a useful cultural studies humanities framework for students of this issue, whether lower-level undergraduates or researchers, with less specificity than Levy-Navarro’s and therefore of more interest to a general audience. A more contemporary history of obesity and cultural analysis is provided in Rise of Obesity in Europe: A Twentieth-Century Food History by Derek J. Oddy and Peter J. Atkins, both of whom are professors in the U.K., along with Virginie Amilien, Senior Researcher at the National Institute for Consumer Research (SIFO) in Oslo, Norway. Less focused on a discourse analysis, this book is broken into three sections—trends in food consumption, industrial and commercial influences on food consumption, and social and medical influences. While it focuses on Europe, the book addresses many of the issues current in the United States, including issues about labeling, public assistance, and consumer choices. The question of whether or not obesity really is an issue we should be concerned with is nicely set up in two anthologies that are quite appropriate for junior college. DebatingObesity: CriticalPerspectives, edited by Emma Rich, Lee Monaghan, and Lucy Aphramor, is a two-hundred-page volume published by Palgrave Macmillan that calls into question the urgency of the fat crisis in fourteen essays. These essays regard askance many of the basic premises of the reigning discourse, including whether or not being obese is really bad for one’s health, whether we need to be so concerned about childhood obesity, and other such issues. This volume might serve as a useful starting point for debates for some lower-level students. Similarly, Obesity, a title from the “Opposing Viewpoints Series,” edited by Scott Barbour, addresses whether obesity is a true problem, what may be its possible causes, with whom the responsibility for obesity lies, and alternative methods of reducing obesity. These are basic texts that address some of the major components of an issue and are useful in teaching young people the elements of an argument. The additional reading list is also a plus. Another historical perspective is provided by Evolution of Obesity written by Michael L. Power and Jay Schulkin. These writers, both from the American College of Obstetricians and Gynecology, take us slowly through the evolutionary biology of weight. They expose the reality that our bodies are meant to store fat and discuss the changes in our environment regarding food and exercise in light of this biological fact. Though it will be useful even to graduate students, it is written for a general audience.

Epidemiology/Global Perspectives

Concerns about obesity as a public health and epidemiology problem are also regularly addressed in the literature. For example, in the anthology Geographies of Obesity: Environmental Understanding of the Obesity Epidemic, edited by Jamie Pearce, the focus is on how the environment, rather than personal choice, affects obesity rates. The collection begins with an introduction suggesting why we should think of obesity in these environmental or geographic terms. The second two sections of the book correlate with the immediate causes of obesity—including three essays on energy in or food eaten, and an additional three essays on the energy out or exercise done. The fourth section of the book builds upon these two elements of the environment to define what makes an “obesogenic” environment and how policy can ameliorate these conditions. The final section of the book suggests new pathways for exploration. Meant for those in public health, it may still be useful for junior colleges with allied health and nursing programs. Similarly, Obesity Epidemiology: From Aetiology to Public Health, a collection from Oxford University Press, covers major questions associated with obesity from the health profession’s point of view, including trends in obesity, its physical, psychosocial, and economic consequences, its causes, and methods of prevention, and whether targeting individuals or the physical environment or the food industry is appropriate. This is an overview for anyone in the health sciences interested in obesity. But while the two previous texts focus on “first world” issues, there are also a number of volumes that focus on “third world” obesity. For example, Emerging Societies—Coexistence of Childhood Malnutrition and Obesity is a collection of papers presented at a nutrition workshop sponsored by the Nestle Corporation. The articles shed light on why obesity often coincides with malnutrition among the poor in emerging economies. Contributors include researchers from India, China, Gambia, the U.S., the UK, Australia, and Brazil among other nations. The papers are broken into four parts: epidemiology, origins of malnutrition and links to obesity, mechanism of metabolic damage, and prevention of the epidemic of non-communicable diseases. The material represents a distinctive collection of interesting points of view. Though quite advanced for lower-level undergrads, it may be useful to include an international perspective.

The Economics of Obesity

If one chooses to forego the Nestle collection, however, there are other titles that could provide an international perspective from a vantage point that is more critical of the international food industry. Raj Patel’s Stuffed and Starved: The Hidden Battle for the World Food System (2008) looks at the global food network, its enormous power, and local resistance movements around the world. Similarly, Marion Nestle’s Food Politics and Paul Roberts’s The End of Food provide strong critiques of the food industry closer to home. Let Them Eat Junk: How Capitalism Creates Hunger and Obesity by Robert Albritton argues that hunger for profit distorts and renders inefficient the global food market. Because the market’s goal is not to alleviate hunger and provide adequate nutrition, the world’s population suffers from two evils—hunger and obesity. Both of these cost the larger society both economically and emotionally. This is a compelling argument, accessible to undergraduates, that introduces a particular theoretical perspective students can easily grasp within this narrative. Julie Guthman works hard to nuance this vision in her work, Weighing In Obesity, Food Justice, and the Limits of Capitalism. Guthman suggests that the panacea to obesity may not be organic and locally grown foods because they are more expensive and frequently financially out of reach of the pockets of poor people around the country. She further argues for government involvement in the market to make healthy food available to all. This work is easily accessible to all readers. The vision of the food industry as peddlers of obesity for profit, however, is not the only economic response to obesity. Franco Sassi in his Obesity and the Economics of Prevention: Fit not Fat focuses on the costs of the obesity epidemic to society at large. Using statistical information available today and projecting these costs into the future, he appeals to the public policymakers to invest monies to ameliorate the problem and so spare society a larger and spiraling financial burden. Another alternative to the discussion of obesity and economics, still critical of capitalism, comes from Gary Egger and Boyd Swinburne who argue in Planet Obesity: How We’re Eating Ourselves and the Planet to Death that obesity is not a disease but a warning sign of a world out of balance. In this engagingly written book, they suggest that an economic system based upon endless growth and reflected in the endless growth of our bodies is fundamentally unsustainable because the world is finite. The anti-capitalism, pro-government involvement argument is much less apparent in another take on the economics of obesity in Managing Obesity in the Workplace by Nerys Williams. This slim work, written by a physician, provides basic information about managing obesity in the workplace, including basic background information, medical repercussions, possible discrimination, and methods of promoting health in the workplace setting. Written in an engaging manner, it provides students with a different perspective regarding this issue. Another business perspective is provided in the edited collection, Obesity, Business and Public Policy, which includes an introduction by Governor Michael Huckabee. The anthology explores the intersection of business, the individual, and the law concerning obesity, including costs both public and private, obesity and the labor market, taxes, and the similarities to anti-tobacco campaigns. It suggests the importance of public policy concerning obesity.

Psychology/ Exercise

Claude Bouchard edited Physical Activity and Obesity, which covers an obvious element of the obesity problem but about which little is available in monograph form. Therefore this book’s coverage of nine sections, each addressing an aspect of activity and its relation to obesity, is a welcome addition to any collection concerning the issue. Broader in scope and useful for beginners is ChallengingObesity written by Heather McLannahan and Peter Clifton. Both academics working in the UK, this OUP title takes a scientific approach to several aspects of the problem. This work covers energy in and out, food: digestion and absorption, metabolism, brain and behavior, individual differences, consequences, and reducing, treating, and challenging obesity. This is a purely physiological approach and is useful and accessible for beginners. PUBLIC POLICY Two titles about public policy that would be useful for communications students include Leveraging Consumer Psychology for Effective Health Communications and Brian Wansink’s Marketing Nutrition: Soy, Functional Foods, Biotechnology, and Obesity. Wansink’s book is about how to persuade people to do what is healthy for them by being very clear about what gets in the way of doing what works. This is backed up with research and presented in a very readable text. Leveraging includes twenty essays that suggest that how we speak of obesity may determine how effective we are in combating it. Using psychological research both communal and individual, these papers proffer methods of persuasion to influence the countless individual choices that combine to create an epidemic. The individual articles here may aid individual students in limited research projects about obesity. In contrast, other materials about public policy are less about communication than other methods of getting people to change their behaviors. Bridging the Evidence Gap is meant for public policymakers looking at evidence-based options for obesity prevention and interventions on the community level that influence individual choices about food and exercise. While it is not perhaps the best choice for most community college audiences, it does make interesting links between evidence and policy, as well as examines methods of researching and methodologies that seem incredibly important. The strength of all three books is their insistence on evidence to support programs. In contrast, is Neil Seeman’s program outlined in Obesity and the Limits of Shame. He argues for a public policy that would create a financial payoff for losing weight by means of a voucher. Seeman argues that this would persuade everyone to create their own appropriate weight loss program.

Social Class/ Gender/ Ethnicity

The questions of public policy tend to look at rates of obesity in different populations. We have then a number of studies that use these statistics go forward to either make policy recommendations or explain the distinctions among populations. In our country, public food assistance is often linked to obesity and hunger. Two books are available to look at this paradox. Hunger and Obesity: Understanding a Food Insecurity Paradigm from National Academies Press, is a workshop summary that addresses public nutrition assistance programs that include both hungry and obese people, analyzing this health dilemma sociologically through individual, familial, environmental, and institutional lenses. It is a useful introduction to sociologists and health fields. It raises the question that Obesity among Poor Americans: Is Public Assistance the Problem? addresses head-on by examining several alternative arguments within the debate including the idea that public assistance causes obesity; conversely, that obesity causes the need for public assistance; or that poverty causes both obesity and public assistance, dissecting each argument using empirical evidence from a variety of disciplines. The book does not come to a final conclusion, but its method is instructive in teaching argumentation. In contrast to the food assistance debate, another perspective looks at food culture in different ethnic groups and how this culture affects obesity rates.