Saturday, October 29, 2011

Weight And Blame

Personal Responsibility And Obesity: A Constructive Approach To A Controversial Issue, Health Affairs, March 2010
"The concept of personal responsibility has been central to social, legal, and political approaches to obesity.

[The concept of personal responsibility] evokes language of blame, weakness, and vice and is a leading basis for inadequate government efforts, given the importance of environmental conditions in
explaining high rates of obesity.

These environmental conditions can override individual physical and psychological regulatory systems that might otherwise stand in the way of weight gain and obesity, hence undermining personal responsibility, narrowing choices, and eroding personal freedoms."
Maybe it's my years of public health training that make me defend this position - that environment plays a larger role in our chronic disease crisis.

If I lived in, say, an Arctic village where there was one store and it sold only fruits and vegetables, that's what I would eat. Maybe a few fish. If it sold double cheeseburgers, sweetened breakfast cereals, oreos, ice cream sandwiches, soda, and chips, that's what I would eat. Maybe a few fish.

By the way, this paper advocates taxing food as a way to reduce obesity. I think reducing the cost of, and increasing the accessibility to fresh foods is a better idea. I don't know how ... maybe tax breaks for farmers who grow market produce or for retailers who stock produce in food deserts.
Photo of an Arctic village on the eastern shore of Baffin Island, Canada, is from Ultima Thule


Dr. Mel said...

But what if you lived in a bustling city or town w/ shopping centers & other stories where a large variety of foods were available? I'm talking relatively affluent suburban. Believe me, I know, from working at a very upscale farmers' market that sells expensive fresh produce as well as upscale cookies, sodas, ice cream, etc., that the majority of our upscale customers are overweight. It seems to me that *that* is a matter of personal responsibility and making choices. There might be the odd person here and there who has some condition, genetic or otherwise, that predisposes them to adiposity/obesity, but *not* ~80-90% of our customers.

Dr. Mel said...

And btw, IT'S SNOWING!!!!!!!!!!!!!!

Bix said...

I hear what you're saying. I think personal responsibility plays a role. I like how Brownell said it, that society can create conditions "that support personal responsibility." Taking the positive spin on this, we can make it easier to choose healthier foods, instead of making it easier to choose crap, like the McRib sandwich I'm about to post about.

"Default conditions now contribute to obesity, a reality that no amount of education or imploring of individuals can reverse."

Default conditions ... I think children growing up in this obesogenic environment have it especially hard.

When I look at old photos, of my family growing up or really anyone from several decades ago, I don't see the degree of overweight that I do now. Something in the environment is contributing. At the very least, making overly-refined calorie-dense food so cheap and abundant isn't helping.

Bix said...

The snow. Holy sugar and beans, the snow. We lost power for hours and hours overnight. I type this with trepidation.

Dr. Mel said...

You're so right about, say, 30 or 40 years ago--there was *very* little obesity. Not only did most people eat more rounded meals in moderate portions, but everyone got more physical exercise, just in the course of a normal day. Holy sugar and beans, Batman!

Dr. Mel said...

OMG, I clicked through to Ultima Thule! Being the winter-lover that I am, imagine my joy in discovering a blog that's entirely about the coldest parts of the world!!!!!!!!! If you go back to the homepage, take a look at the beautiful Orthodox Church of the Holy Trinity in Antarctica! The southernmost church in the world! It's beautiful!

Bix said...

Absolutely gorgeous blog. It's wonderful what people do, their hobbies, their joys.