Reader Kerri alerted me to a new program in Ontario which calls for higher taxes on “junk food” and warning graphics on food that “lacks nutritional value” as a way to fight obesity. You can read the article here [Trigger warning: Fat Bashing, conflating weight and health, many bad things etc.] I think that this article is representative of all of the mistakes that are being made in this area so I’m going to answer it bit by bit. The (potentially triggering) quotes from the article are in block quotes, you can skip them and you’ll still understand the blog.
Physicians in Ontario are approaching the issue of obesity with renewed determination, calling for higher taxes on junk food and graphic warnings on food with no nutritional value. “We need to treat obesity like the public health epidemic that it is,” Doug Weir, president of the Ontario Medical Association, said at a news conference Tuesday.
Obesity, as currently defined, is the end result of a mathematical equation – weight in pounds times 703 divided by height in inches squared. Obesity is a ratio of weight and height, it is not a health diagnosis, it is a body size. We’re also taller than we’ve ever been but physicians in Ontario are not attacking the “tallness epidemic”. Healthcare treats health conditions, not body size.
The only way that you can call body size a health epidemic is if you are willing to ignore all of the evidence that shows that there are healthy fat people and unhealthy thin people, and that people of all sizes get the diseases that are correlated with obesity, and ignoring a bunch of evidence doesn’t sound to me like something that a group of physicians should be doing.
The proposed anti-obesity measures– touted by the OMA as some of the most aggressive to be suggested in Canada– include changes to legislation and the availability of junk food.
Being “Anti-obesity” means that the Ontario Medical Association supports the eradication of fat people with or without our consent. I think that Medical groups should concern themselves with helping people of all sizes have options for health and healthcare, not trying to make us all the same size, or eradicating people of a particular size.
Among the proposed measures, the OMA suggests:
- Limiting the marketing of sugary and fatty food to children
- Placing information about obesity-related health risks on high-sugar and high-fat foods
- Restricting access to junk food at sports complexes, and other recreational venues that children regularly frequent
Even if we assume for a moment that a junk food tax will cut down on eating junk food, unless these doctors believe that these foods are healthy for thin people who eat them and don’t get fat, but unhealthy for fat people, then the mention of obesity here is completely superfluous to any actual health message, and serves only to create stigma against fat people. The words “obesity-related” are misleading. What they mean is that these diseases have been correlated with obesity (meaning that they sometimes happen at the same time but are not proven to be caused by obesity. This is observable since there are fat people who don’t have these diseases and there are thin people who do. Murders and ice cream eating are also correlated – for a series of Augusts there were more murders and more ice cream eaten. Using the OMA’s approach, we would remove ice cream from store shelves and expect the murder rate to go down. Without causation we don’t know if changing one thing will affect the other at all.
Health doesn’t need body size as a middle man. In fact, it’s dangerous. It gives thin people the message that they are healthy as long as they don’t get fat and tells fat people that they can’t be healthy unless they get thin. That’s not what the evidence tells us at all.
Speaking of evidence, I’ve not seen any convincing evidence that this type of messaging on food has any measurable outcome on public health. I’m pretty concerned at the number of “anti-obesity” interventions that are passed off as public health interventions that have no evidence-basis. This is how people become non-consenting victims of experimental medicine.
There is some evidence that I think Team Tax-the-Fatties is not taking into account:
Peter Muennig from Columbia University found that the stress of stigma and shame were correlated with the same diseases with which obesity is correlated. Muennig’s research also found that women who were concerned about their weight had more mental and physical illnesses than those who were fine with their size, regardless of their weight. So telling people to be concerned about their weight may be, in and of itself, dangerous to their health.
Shame and stigma create all kinds of problems. For example, when doctors shame fat people for their weight, it leads to fat people not going to the doctor, they miss out on preventative care and end up not getting treatment until an issue is very advanced (which gives them even less time to wade through doctors who ignore their actual health issues and just tell them to lose weight, and some of them will die before they are able to obtain actual evidence-based healthcare.). When we shame people for getting sick, then they are too embarrassed to get the treatment they need. We will never know how much shame and stigma affects fat people until we stop shaming and stigmatizing them.
From the comments: “if there was a new tax, charge it to the obese people”
This is a major consequence of health campaigns that focus on body size. It encourages weight stigma and bullying including making it seem rational to some people to actually tax people based on a loose combination of how they look.
All of this mess could be avoided if public health work was focused around creating access – to a variety of foods, safe movement options, and evidence-based, stigma and shame free healthcare; and if public health messaging was about giving evidence-based information, about healthy behaviors rather than patting yourself on the back for creating the program that most aggressively stigmatizes a group of people for whom stigmatization may already be having negative health consequences.
Happy HAES Holidays Teleconference Workshop – Registration is Name Your Own Price – Nov 13 and 15
During the holiday season I get a ton of e-mail from people asking about everything from how to set resolutions that aren’t about weight loss to how to deal with the family food police or their partner’s office party. I’ve put together a group of speakers to give you information to support you through the holiday season and into the new year. All calls will be recorded so registrants can listen Details and registration are here, registration is name your own price.
Like the blog? Check this stuff out (and you can help support my work which I would really appreciate):
The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here to order
The Dance Class DVDs: Buy the Dance Class DVDs (hint: Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)! Click here for the details
Become a Member and Get Special Deals from Size Positive Businesses
I do size acceptance activism full time. A lot what I do, like answering over 4,000 e-mails from readers each month, giving talks to groups who can’t afford to pay, and running projects like the Georgia Billboard Campaign etc. is unpaid, so I created a membership program so that people who read the blog and feel they get value out of it and want to support the work I do can become members for ten bucks a month To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.