Focus on childhood health, not obesity

Paul Campos has an article in the New Republic arguing against Michelle Obama's declared war on childhood obesity. He tends to use overheated rhetoric, and I don't feel equipped to judge his claim that obesity is not harmful (I do, however, think it is at least worth questioning whether obesity is a cause of ill health or a correlation with it).

I do, however, feel equipped to agree with him that there is overwhelming evidence that the proposed solutions for childhood obesity are ineffective at solving obesity. More exercise and better nutrition positively impact health, but they do not, in the long term, reduce weight.

Given that we don't really know why obesity is increasing, and we don't know how to solve it, but we do know how to improve health - I totally agree with Campos that Michelle Obama has the wrong focus. Making a focus on health more generally will make a positive change, without stigmatizing heavier kids or their parents.

Update [via Dan]: Ambinder weighs in. (See what I did there? Oh, never mind.)

Update II: Electric Bugaloo [via Elizabeth again]: I think Ambinder has some good points. I would like to be clear. I am by no means saying we should throw up our hands about children and nutrition and health. I also do not wish to say that childhood obesity rates do not indicate there's a problem. I'm just not sure whether the obesity rate is merely an indication, or the root cause. I strongly believe in the benefits of a diet of whole foods (by which I mean non-manufactured, non-processed), home-cooked meals eaten together as a family, healthy foods in school, and exercise. Reduced TV is good, too. But I am in favor of these measures not because they reduce obesity, but because they promote health.

If FLOTUS were to focus on the nutrition and exercise issues, I think that would be far more useful. Success would also be much easier to achieve, and therefore people would stick to it longer. It is far easier to persist in eating healthily when your goal is to eat healthily, then it is to wait for the scale to move down (and such a wait is often in vain). Success in eating healthily is achieved on a daily basis. Success in losing weight is extremely hard won, and almost never maintained. Again, look at the statistics here.

Such a focus would also encourage parents of skinny kids to sit up and take note.


  1. Begark! You beat me to this article.

    All in all, I do think it is more helpful to focus on improved health than it is to focus on obesity per se. I think Campos (who is clearly quite partisan on this issue) fudges his discussion of the numbers a bit, but I don't necessarily disagree with his conclusion. Yes, I think it's important to improve nutrition, increase physical activity, etc., but we should probably change our outcome measures.

    That being said, it is relatively clear that being obese increases one's risk of being hypertensive, having orthopedic problems and even of suffering from kidney disease. We do not yet have data on the impact of childhood obesity on the rates of these illness, as the cohort in question has not aged sufficiently to collect them. But we do know that children who are obese are very likely to remain obese throughout their lives, and so I remain supportive of the FLOTUS's efforts in general.

    [Editoral memo: frequent commenters who do not like the POTUS are free to continue with their campaign of general disdain. They are discouraged from broadening their attacks to include the First Lady, as certain blog administrators would consider that unseemly.]

  2. I think if we keep hiding the obesity epidemic behind phrases like "we need to be healthier," we deny a huge reality in this country...we're eating stuff that isn't food, and government spends a great deal of taxpayer money supporting companies who make this not-food food. And that it's killing us. And it's raising the cost of health care above what we can afford with our broken system, but also way beyond what we should have to pay with a system that will ideally have different priorities.
    The leading cause of death in this country is heart disease. Men and women. half of the top ten killers can result from obesity and poor diet: heart disease, cancer, stroke, hypertension, diabetes.
    It doesn't particularly matter whether Ms. Obama is pro-health or anti-obesity. She's getting us all talking about the terrifically poor eating habits of American children, and that's a good thing.
    I don't particularly care if people's feelings get hurt when they are told they're doing terrible things to their bodies and their children's bodies. These are not immutable characteristics---she's not demonizing race or gender or personality or illness. She's focusing on choices. It's actually very both-sides-of-the-aisle and pull-your-health-up-by-the-bootsraps-y, so I hope it makes a difference. We need education about how to make better choices. All of us.

  3. One last little thing occurs to me. One might quibble with the outcomes one is striving for in a public health campaign, but it is churlish to describe the First Lady's efforts as "picking on fat kids," or to us any of the other overblown rhetoric Campos employs.

  4. Campos's rhetoric is overblown, and I think it likely that obesity is correlated with health problems. But the reasons I support the basic principle behind him (and why I disagree with Naptime Writing) are twofold: 1) we don't really know whether obesity as such causes health problems, or are correlated with them, and 2) calorie reduction and exercise do not work in the long term.

    Eating fruits and vegetables should be done for their own sake. So should exercise. They definitely make one healthier, but they don't definitely make you lose weight. So why focus on the weight? Why not focus on nutrition?

  5. One more thing. I think Campos makes a good point here (I agree she's not "picking on fat kids.") One of my kids is super-skinny, no matter what he eats. I'm sure there are plenty of other kids like him. If we focus solely on obesity, it sends the message that as long as kids are skinny, their eating habits are just fine. Which is of course, not the case.

  6. Wait. Does obesity qualify as one of my Andrew Sullivan-esque bee-in-bonnet topics?

  7. You sound insufficiently unhinged to be truly Sullivanesque. Try harder.

  8. I am with naptime, in China you simply used to see no fat children (now with McD's and KFC you are), and it wasn't due to poverty but diet, the same with Japan. What I don't like is the assumption that eating healthy means eating food that doesn't taste good.

    I simply don't understand this statement: calorie reduction and exercise do not work in the long term.

    Who says calorie reduction? When I lived in China I lost 30 pounds in a matter of months without once feeling deprived, and I kept it off until I left China and returned to a western diet. It is not how many calories, it is what kind of calories. Naptime is right, we live off of empty calories.
    (and Chinese food in America is not like Chinese food in China, lets get that clear if anyone wants to be smart and say I should just eat Chinese from now on)


  9. Charo, I agree with you. Eat fewer calories and exercise more is the only weight loss program available. I positively guarantee that if you give me control over all the food you eat, you can lose weight and keep it off. You won't like it, and that's the problem. Diet is not based upon rational choice, and that's why education isn't all that useful. Everyone with a room temperature IQ and up knows that McDs food is loaded with fats, sugars, and empty calories, yet McDs serves tons-o-food worldwide. Humans evolved to crave fats, sugars, and salt, which are rare in the hunter-gatherer world. But those are what most restaurants and prepared foods feature. Customers don't make rational choices, they make instinctive/emotional choices. Hunger is one of the most powerful of human drives, and that's why obesity is a huge problem in the West (and will be in the East as the cost of food goes down). And it is also why, for most people, education never has and never will do squat for weight control. Eating less and exercising more is unsuccessful in longterm weight control because people don't use their rational brains to choose food. The FLOTUS isn't going to change that.

  10. I agree with gadfly.

    Charo, there is TONS of evidence that shows that only 2% of people who lose weight are able to keep it off after ten years. That's why I say calorie reduction and exercise work. You can say it would work if people did it. But they don't do it. WHich has to be part of the equation.

    Actually, I think you're right that going off a western diet helps. That's not the same thing as calorie reduction and exercise.

  11. Rather, that's why I say they DON'T work. THey are only a short term solution.

  12. elizabeth, as we age our metabolism slows so pretty much everyone puts on some pounds (and they are less active). Again, I said who says calorie reduction? I am not talking about calorie reduction, but changing the kinds of calories. A Chinese or Japanese is nutritious and delicious and healthier.


  13. Charo, I agree TOTALLY thatwe should switch the kind of diet. I am one of those 2% who has lost it and kept it off for years. Switching to lowfat milk and exercising and calorie counting - which are the most frequently recommended methods - don't work. It is my belief (although unproven) that a whole foods diet does keep pounds off. It has worked for me. I do not count calories and eat plenty of fat. I eat whenever I am hungry or even just when I feel like it. But it works.

    Even it does not keep pounds off, it HAS been demonstrated to be healthy. WHich is my point.

    You know what? I'm going to write a whole post on this.