Threading the Needle

Addressing Obesity: Blunt, Objective, or Evasive?

It feels like we’re threading a needle anytime we’re addressing obesity. BBC asks, “Is it wrong to be blunt about obesity?” And the short answer is, probably so. That’s because blunt usually means rude. And rude means you’re adding to the problem.

But the answer is not to avoid the subject. The answer is to find ways to be objective, truthful, and helpful. And that can be tricky.

An Object Lesson: Cancer Research UK

Cancer Research UK launched a public awareness campaign about the link between obesity and many forms of cancer. Many people have no idea that cancer is a complication of untreated obesity. So it makes sense that broader awareness might be a good thing. They gave it a try.

But the pushback was swift – and not too delicate. Danish comedian Sofie Hagen wrote:

Right, is anyone currently working on getting this piece of s— Cancer Research UK advert removed from everywhere? Is there something I can sign? How the f—ing f— is this okay?

The charity seemed honestly blindsided in its lame self-defense. “This is not about fat shaming. It is based on scientific evidence,” said Professor Linda Bault for the organization.

What’s the Real Problem Here?

Is it a problem to dispense purely objective information? In our view, no.

But the messaging above mixes scientific fact with some false assumptions. The fact is that cancer is an unrecognized complication of untreated obesity. But the imagery – french fries in a cigarette box – promotes weight bias. The implicit, false assumption is that french fries are the root cause of obesity. The copy says it’s “preventable.” Easy peasy. Cut the fries. Obesity will be gone.

Unfortunately, it’s not that simple. Obesity is not so easily “preventable.” Nearly a third of the UK population already has it. The number in the U.S. is closer to 40%. Everybody’s been talking about preventing obesity for decades, but nobody has succeeded. It’s not as simple as no more fries and the problem goes away. If only.

Obesity is the product of complex adaptive systems that promote it in susceptible individuals. For someone whose physiology makes them resistant or immune, the message that it’s preventable is somewhat affirming. It suggests they’ve done their duty and won the rewards of “clean living.” But it’s not true. And it’s a subtle assault on people who are living with the disease.

Too Much Problem, Not Enough Solution

The problem with this kind of sensational messaging about obesity as a “preventable” problem is that it offers nothing in the way of real solutions. Awareness of obesity and excess weight is hardly a problem. People with obesity get reminders every day. The gap lies with solutions.

This is a complex chronic disease. Good obesity care can reduce the health impact, but cures are rare. So the energy behind these awareness programs should go toward making care more accessible. And before folks start claiming that obesity is “preventable” they need to come up with prevention that actually works.

Click here for more from the BBC and here for more on the problem with obesity awareness campaigns.

Threading the Needle, photograph © Markus Grossalber / flickr

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March 14, 2018

5 Responses to “Addressing Obesity: Blunt, Objective, or Evasive?”

  1. March 14, 2018 at 6:47 am, Angela Meadows said:

    This campaign is hugely stigmatising and scientifically inaccurate. I personally haven’t even see the french fry version. We are being inundated by simple visuals on billboards and TV, and non-stop radio ads stating that obesity is the second biggest cause of cancer. Yes, cause. Despite Cancer Research UKs own website being clearer about the difference between risk factor and causation. We are being told, if you are fat, you will get cancer. No nuance, no quibbles. It is a huge campaign and this harmful and problematic message is being blanketed across UK media.

  2. March 14, 2018 at 7:37 am, Ted said:

    Public health guerillas have no time for subtlety or factual nuances.

  3. March 14, 2018 at 9:40 am, David Brown said:

    A few weeks ago I ordered “Biochemistry of Arachidonic Acid Metabolism”, edited by William Lands, PhD. When the book arrived, two things surprised me. The book was published in 1985, seven years prior to discovery of the endocannabinoid system and the main thrust is cancer.

    I’ve been perusing endocannabinoid system research for two years now and I find it astonishing that this branch of science is so poorly publicized. I suggest readers of this comment do some web searches using these word combinations: arachidonic acid cancer, arachidonic acid obesity, endocannabinoid system cancer, and arachidonic acid endocannabinoid system.

    The information acquired during my first year of investigation inspired me to restrict my meat (turkey) intake. The first half-year I cut daily intake from 3 or 4 slices to 1 slice. I experienced substantial reduction in shoulder pain so the second half-year I switched to cheese. I am now pain-free and weigh about ten pounds less than I did a year ago. Normally I gain about 20 pounds during the cold months and lose a similar amount during the warmer months when I’m actively gardening. One wonders if others wouldn’t similarly benefit from self experimentation if they were aware of the arachidonic content of animal products. It’s inordinately high because of this:

    “We now know that major changes have taken place in the food supply over the last 100 years, when food technology and modern agriculture led to enormous production of vegetable oils high in ω-6 fatty acids, and changed animal feeds from grass to grains, thus increasing the amount of ω-6 fatty acids at the level of LA (from oils) and arachidonic acid (AA) (from meat, eggs, dairy). This led to very high amounts of ω-6 fatty acids in the food supply for the first time in the history of human beings.” http://openheart.bmj.com/content/3/2/e000385

  4. March 15, 2018 at 12:20 pm, John DiTraglia said:

    “cancer is a complication of untreated obesity” Is there any evidence that it is less of a complication of treated obesity?