The Gap Between Science and Culture in Obesity

Mist in the CanyonThis is a note of gratitude to Julia Belluz. In a guest essay for the New York Times, she writes beautifully and accessibly about a great gap. It is the gap between science and popular culture in the matter of obesity. She does it while reporting on the recent Royal Society meeting about the causes of obesity.

“Since the meeting, I’ve been struck by the profound gap between the talks I heard and the weight conversation happening in our culture. No scientist spoke of any of the supposed fixes that currently fill diet books and store shelves‌‌, with the exception of the carbohydrate discussion. There wasn’t serious dialogue about cleanses, diet apps‌‌ or intermittent fasting. No one suggested that supplements could help people lose weight or that metabolisms need boosting. The sole presenter on the gut microbiome argued that the human trials in obesity to date have mostly disappointed.”

Fixated on Shame and Blame

Belluz astutely describes the preoccupation with personal responsibility for obesity – as if blaming and shaming people will cure the problem. It doesn’t. In fact, it makes it worse. This blame and shame rises up in both explicit and implicit forms.

For the explicit form, you can look to a recent example published in The Times of London. Matthew Parris confidently tells us that “fat shaming is the only way to beat the obesity crisis.” Rubbish, say the obesity scientists of the UK and all of Europe. Their scientific society, EASO, quickly issued a statement explaining that the words of Parris are both highly inaccurate and potentially dangerous.

More Than Just the Trolls

Parris is a troll and easily recognized as such. But his trolling taps into implicit bias that is much more common these days than the explicit forms of shame and blame. This surfaces regularly when someone living with obesity visits the doctor. All too often, they encounter a series of reminders that they are not really welcome. That they should turn around, go home, and fix their problem with obesity first.

Belluz describes her conversations with a man whose brain tumor went undiagnosed for months because it was causing extreme weight gain. “Diet and exercise” was the prescription.

Ineffective Public Policies

In health policy, CDC promotes breastfeeding as an effective way to prevent obesity in children, even though any possible benefit is small at best. One more dose of shame for mothers who themselves might live with obesity in circumstances that can make extended durations of breastfeeding impossible. Regressive taxes to prevent obesity are popular so long as they target downscale food and beverages – not upscale sugary lattes.

Thus we avoid embracing the science of obesity and keep pursuing strategies based on implicit bias about this disease and the people who have it. So long as we keep the gap wide between obesity science and popular culture, the problem will continue to grow and undermine public health.

Click here for the excellent essay by Belluz.

Mist in the Canyon, painting by Thomas Moran / WikiArt

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November 22, 2022

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