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Does Let’s Move stigmatize fat children?

[ 330 ] January 4, 2013 |

Michelle Malia Sasha

Lindsey Beyerstein writes:

If I recall correctly, Paul was very critical of Michelle Obama’s “Let’s Move” program for supposedly being fat stigmatizing. Which is odd because “Let’s Move” is about the warmest fuzziest, least fat-shaming initiative in public health history. It’s all about how great it is for everyone to run and play and add eat veggies.

Yes it is about that. But what it’s mainly about are the following claims, which have been front and center of the campaign from Day One:

(1) There are way too many fat kids in America — so many that it’s a full-blown social crisis.

(2) Being a fat kid is bad, because you are going to have lots of health problems and probably die several years earlier than thin kids.

(3) If we get kids to run and play and eat more veggies then we can reduce the percentage of fat kids in America by two thirds, back to the levels of fatness observed among children in America in the 1970s. This will save enormous sums of money in health care costs, because thin kids will end up costing much less to society than fat kids.

From the Let’s Move web site:

Solving the Problem of Childhood Obesity Within a Generation

Let’s Move! is a comprehensive initiative, launched by the First Lady, dedicated to solving the problem of obesity within a generation so that kids born today will grow up healthier and able to pursue their dreams.

As part of this effort, President Barack Obama established the first-ever Task Force on Childhood Obesity to develop and implement an inter-agency plan that details a coordinated strategy, identifies key benchmarks, and outlines an action plan to end the problem of childhood obesity within a generation. The goal of the action plan is to reduce the childhood obesity rate to just five percent by 2030 – the same rate before childhood obesity first began to rise in the late 1970s.

What inspired the First Lady to pursue this goal? It turns out the personal really is political:

WASHINGTON — Her daughters were 6 and 9, and Michelle Obama was like any other working mom — struggling to juggle office hours, school pick-ups and mealtimes. By the end of the day, she was often too tired to make dinner, so she did what was easy: She ordered takeout or went to the drive-through.

She thought the girls were eating reasonably well — until her pediatrician in Chicago told her he didn’t like the weight fluctuations he was seeing.

I was shocked because my kids looked perfectly fine to me,” Obama says. “But I had a wake-up call.” Like many parents, however, “I didn’t know what to do.”

Today, the self-described “mom in chief” is launching Let’s Move, a campaign to help other parents deal with a national health crisis she describes in epic terms.

The goal: to eliminate childhood obesity in a generation.

“It’s an ambitious goal, but we don’t have time to wait,” the first lady said in an interview with USA TODAY in her spacious office in the East Wing of the White House. “We’ve got to stop citing statistics and wringing our hands and feeling guilty, and get going on this issue.”

She says she intends to “sound the alarm” about the epidemic.

Once upon a time — a time known as the 1970s — America wasn’t like this. Again, the Let’s Move web site:

Thirty years ago, most people led lives that kept them at a healthy weight. Kids walked to and from school every day, ran around at recess, participated in gym class, and played for hours after school before dinner. Meals were home-cooked with reasonable portion sizes and there was always a vegetable on the plate. Eating fast food was rare and snacking between meals was an occasional treat.

Now call me paranoid, but some people might find just a hint of a fairly reactionary social agenda lurking amid that idyllic picture of the way we were. (It should be unnecessary to add that there’s practically no evidence for this portrait of a bygone age. We don’t actually know if kids or for that matter adults are less physically active than they were a generation ago, or if they consume more calories).

In all seriousness, note how this is being framed: It’s Mom’s job to solve this “crisis,” by making sure the kids have a magically obesity-repelling home cooked meal every night. (It would also help if there were somebody home to make sure the kids are safe when they bike or walk home from school, and that they don’t spend all afternoon with the X-Box).

Let’s Move is about creating an America with as few fat kids in it as possible — with “fat” here being defined in such a way as to put kids like Malia and Sasha Obama in a problematic weight category. (BTW the reason that five percent of American kids were “obese” in the 1970s is that the definition of childhood obesity invented ten years ago by a CDC task force simply took the 95th percentile of childhood BMI in the 1970s as the cut point for their definition of childhood obesity. Science in action!).

The campaign is defined by its very name as a campaign against fat kids. Its description of the “crisis,” and its explicit goals in terms of measuring effectiveness and ultimate success in the fight against that supposed crisis, are defined exclusively in terms of creating an America with as few fat kids as possible. And it does so within the context of a not so latent reactionary social frame, in which the problem is in significant part that Mom works outside the home and isn’t “there” for her kids to whip up a delicious and nutritious home-cooked meal that would win Alice Waters’ seal of approval.

How this isn’t supposed to be stigmatizing of fat children is beyond me. How it reflects anything that could be described as a progressive social agenda is if anything even more mysterious.

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  1. cooperstreet says:

    Can you please present evidence that these claims are not true?

    1) There are way too many fat kids in America — so many that it’s a full-blown social crisis.

    (2) Being a fat kid is bad, because you are going to have lots of health problems and probably die several years earlier than thin kids.

    (3) If we get kids to run and play and eat more veggies then we can reduce the percentage of fat kids in America by two thirds, back to the levels of fatness observed among children in America in the 1970s. This will save enormous sums of money in health care costs, because thin kids will end up costing much less to society than fat kids.

    I just watched the HBO documentary on obesity in America, and came away convinced that obesity is a serious health issue in this country, and a really serious health issue for kids. Why am I and all the experts in that documentary wrong?

  2. Walking to school and vegetable courses are reactionary. Almost fascist, if you think about it.

    (The guy who moves effortlessly between “against obesity” and “against fat kids” is now going to accuse me of misrepresenting what he said.)

    • ajay says:

      Walking to school and vegetable courses are reactionary. Almost fascist, if you think about it.

      Well, you know who else liked forcing people to walk long distances and eat vegetables?

    • Scott Lemieux says:

      Again, nobody is criticizing encouraging children (or, for that matter, adults) to exercise and eat healthier diets. They’re criticizing these things as not being ends in themselves but being part of a counterproductive campaign to stigmatize people who are overweight.

      • Richard says:

        How is Lets Move being counterproductive? I understand Paul’s point that efforts to get adults to lose weight don’t work (I think the evidence is inconclusive there but I see his point) but where is the evidence that a program like Lets Move wont cause obese children to lose weight or, just as importantly, wont lead to less children gaining weight? And while I totally disagree that Lets Move stigmatizes obese children, explain for me how this, even if true, is counterproductive to the goals of Lets Move. Are obese children going to feel so bad about themselves that they will choose not to exercise and eat healthier food?

        If the program works, more children will eat healthier food and exercise more. Explain to me the counterproductive argument because I dont understand it. Isn’t it like arguing that a non-smoking campaign will cause smokers to be stigmatized, dig in and smoke more?

        • Scott Lemieux says:

          I’ve given up hope that anyone will respond to this, but again, exercise and healthy diets are good things in themselves. Suggesting that they’re only positive as part of the end of reducing obesity is not merely pointless but counterproductive. It stigmatizes a class of people, it suggests that if healthy eating and exercise don’t make you “thin” (which they very often won’t) they’re a waste of time, and suggests that as long as you’re thin being sedentary is OK.

          • Suggesting that they’re only positive as part of the end of reducing obesity

            I defy you to find a single person who has ever said that eating healthy and exercising are only positive as part of reducing obesity.

            One. Anywhere.

            • Scott Lemieux says:

              Why is obesity the end goal, then? Why can’t exercise be presented as a positive end in itself, when in fact it is?

              • Superking says:

                Scott, obesity is a negative in itself in terms of health consequences.

                • Sherm says:

                  Not level 1 obesity which constitutes a majority of the allegedly obese, as per yesterday’s discussion.

                  But that doesn’t change the fact that there is no reason to stigmatize “obese” children where promoting exercise and healthy eating is sufficient in and of itself.

                • BobS says:

                  That may or may not be the case regarding level 1 obesity (I think that jury is still out), but no one goes to bed one night 6ft 180 lbs and wakes up the next morning 6ft 320 lbs. Level 1 obesity is often not a plateau but a point on a continuum, just as far too often pediatric obesity is a point on a continuum that ends with grossly obese adults and all the concomitant health problems. I don’t see a problem with educating kids as to the why of healthy eating and exercise- it can be done without stigmatizing.

              • Suggesting that they’re only positive as part of the end of reducing obesity

                I defy you to find a single person who has ever said that eating healthy and exercising are only positive as part of reducing obesity.

                Everyone please note that he didn’t answer the question, or take back his assertion.

                Why can’t exercise be presented as a positive end in itself, when in fact it is?

                It is repeatedly presented as a positive end in itself. The Let’s Move site does this; as do the Let’s Move ads; as to the Play 60 ads. You are making up this supposed solitary focus on obesity.

          • Richard says:

            Scott, I admire many of your arguments but you’re off the wall here. The Lets Move program encourages everyone- obese, thin, “normal” – to exercise and eat healthier. It doesn’t make any moral judgments about obese kids (that they’re lazy,lack ambition, are couch potatoes, etc). It expressly states that there are good things that come from exercise other than weight loss (bone strength, less tension). It doesn’t say that exercise and better food habits are a waste of time if they dont lead to weight loss (and talks about the long term health benefits of bettter diet). And I still dont see the counterproductive argument. You seem to be saying that if obese kids follow through with the program and dont lose weight, they are likely not to do the things that are being promoted? How is that different than no program at all? The program may not work (not being a health expert, I really have no opinion on that at all) but I dont see how the program, as presently constituted,advertised and promoted can be counterproductive.

            • djw says:

              he Lets Move program encourages everyone- obese, thin, “normal” – to exercise and eat healthier. It doesn’t make any moral judgments about obese kids (that they’re lazy,lack ambition, are couch potatoes, etc). It expressly states that there are good things that come from exercise other than weight loss (bone strength, less tension).

              It may well do that, but deploying those messages under the frame of the an obesity crisis undermines those otherwise positive messages. I really do think many commenters here are deeply underthinking the adverse psychological consequences of the message to young children that “the shape of your body is a social problem”. (This message will, of course, be sent to them by society in a number of ways, many of them much nastier than the framing of public health initiatives, but the cumulative effect of all those messages. (This has been rather on my mind recently, as a friend of mine has a daughter who was a little chubby (at least according to contemporary obesity crisis definitions) at 8 and showing clear signs of anorexia at 11.)

              • Richard says:

                They already get that message from their peers, from high fashion, from movies, etc. Nobody here is arguing that those messages are good. What we are arguing is that the Lets Move program doesn’t add to the messages they already receive and seems designed to, as much as possible, attach no stigma to childhood obesity.

                You can’t just have a program that says exercise and eat healthy without stating why that should be done. There is nothing inherently good about exercising and eating healthy – they are only good because they lead to positive physical or mental health results

                • djw says:

                  You can’t just have a program that says exercise and eat healthy without stating why that should be done.

                  Exactly right. They should be done because they improve your health. Such lifestyle changes are likely to improve the health of some individuals who do not experience significant changes to the shape and size of some individuals bodies. (I don’t want to argue about how many, but surely we can agree it’s a number between 0 and 100% of all cases).

                  Do you believe that exercise and healthy eating have no benefit–no point–for people who don’t lose significant weight when they make these lifestyle changes? Because this comment seems to imply that you don’t.

                • Richard says:

                  No. Not at all and I don’t see how that can be implied from my post. Exercise can lead to weight loss, as well as bone strength, increase in energy, lessening of tension and probably others that I cant recall right now.

                  Better eating habits can lead to weight loss as well as increased energy and probably some benefits (most likely long term rather than short term).

                  But I think you are going to have a very ineffective program if you only talk about the increased energy, bone strength, and decreased tension and dont talk about weight loss.

              • It may well do that, but deploying those messages under the frame of the an obesity crisis undermines those otherwise positive messages.

                This is a much better version of Scott’s argument, if only because it does not rely on misstatements of fact about the programs, their messages, and what they do and do not contain – “Suggesting that they’re only positive as part of the end of reducing obesity.”

                • Superking says:

                  It may be a clearer version of Scott’s argument, but ends up being very weak since the person maintaining now has to argument that the underlying framework has negative stigmatizing effects. And that is in no way obvious.

              • Scott Lemieux says:

                Eating disorders really are the elephant in the room here. What’s more likely to lead to easting disorders, a campaign encouraging exercise for its inherent value, or a campaign to encourage exercise because it’s crucial TO ELIMINATE OBESITY IN A GENERATION? If the goal is eliminating obesity, why isn’t starving yourself as good as exercise?

                • Richard says:

                  Because the goal is eliminating obesity in a healthy way. That is somewhat implied in the whole message of Lets Move (and probably doesn’t need to be explicitly stated since Lets Move’s message is all about health)

                • Brandon says:

                  The goal is to eliminate obesity because of the health problems it leads to (sake of argument etc.). Starvation leads to health problems itself and would not be a desirable alternative. Healthy diets and exercise do not lead to health problems themselves and thus don’t pose the same risk as starvation.

                  You don’t really appear to be discussing this in good faith.

          • Superking says:

            Scott, this is also just kind of dumb, because it ignores actual health consequences of obesity. As you know, obesity is associated with higher rates of type 2 diabetes, heart disease, etc, etc, etc. Being thin, even if you’re sedentary, largely avoids those problems. Being “healthy” in significant part includes not being obese. And let’s be clear. Being obese is not the same thing as being chubby or overweight or fat.

            I know Paul is trying to make the argument that obesity is a political identity in the same way that blackness or gayness is, but it’s not the case.

            • Sherm says:

              Being obese is not the same thing as being chubby or overweight or fat.

              You are obviously unaware of the flaws in such classifications.

              Scott, this is also just kind of dumb, because it ignores actual health consequences of obesity.

              And those consequences can often be ameliorated through exercise and healthy eating, so why not focus on promoting exercise and healthy eating, without stigmatizing obese children?

              • Superking says:

                I’m not unaware of those distinctions. I am frustrated by the conversation in this thread where even the primary posters, Paul and Scott, are using “fat” and “overweight” interchangeably with “obese,” when they are not coextensive. “Fat” is culturally defined and not medically relevant. “Overweight” has some use in some health areas, but it’s my understanding that it’s not well defined. Obesity is well defined, though. So, no, I’m more frustrated with especially Paul’s wildly varying use of imprecise terms. /shrug.

                And there is scant evidence here that anyone is stigmatizing obese children. So, meh.

                • Sherm says:

                  My BMI is 30.5 (obese), and I run about 20 miles per week and can drop on the floor right now and give you 40 or so push ups at the age of 45. So you might want to reconsider whether “obesity is well defined.”

                • Superking says:

                  Sherm, there is a clear standard that underlies the term, as you appear to be well aware. http://www.cdc.gov/obesity/adult/defining.html For me, that counts as being “well defined.”

                  There are not clear definitions of “fat” and “overweight.” Even though “overweight” does get used in medical contexts, per the link, it also carries a lot of cultural and subjective content that undermines it’s utility in discussions like this.

                • Sherm says:

                  “Overweight” is defined by the CDC as well. If I lose five pounds, I’ll be merely overweight rather than obese. I would have to lose another forty to hit “normal.” I would be a bag of bones at my “normal” weight.

                  But the problem is that these standards are way off, as I hope I helped demonstrate by admitting to my alleged obesity.

                • Superking says:

                  Sherm, it’s like you didn’t read what I wrote. As I noted in both prior comments, overweight is used in health/medical contexts, but it also carries a lot of cultural/subjective definitions that don’t coincide with the health/medical uses. Scott and Paul use “fat,” “overweight,” and “obese” interchangeably, and are not being clear in the arguments they are making.

            • Scott Lemieux says:

              Being thin, even if you’re sedentary, largely avoids those problems.

              Please to be citing evidence on this.

        • Brandon says:

          The idea is that being a heavier person isn’t some moral failing and isn’t even necessarily unhealthy. Not everyone needs to be Mr. or Mrs. Super-toned Athlete physique in order to be healthy. Paul and Scott seem to reject any causal link between weight and health altogether, but even without going to that extreme, it’s problematic to simply assume that someone who is heavier is necessarily unhealthy.

          Personally, I’m pretty skinny mostly due to my natural metabolism–runs in the family. Another guy in my office might be considered “husky.” Looking at the two of us, someone might assume that I’m in better shape and that he’s more likely to have health problems down the road. Yet I’d struggle to finish a 5k at a decent pace and he bikes about 100 miles a week. There’s social problems with stigmatizing someone for being ‘overweight’ beyond any rational health reasons, as well.

          But, imo, both Scott and Paul go much too far on this subject. There’s little or no health correlation to weight, it seems, nor is it reasonable to ever expect that someone could lose weight and keep it off long-term.

        • Paul Campos says:

          Where is the evidence that a program like Lets Move wont cause obese children to lose weight or, just as importantly, wont lead to less children gaining weight?

            • Brandon says:

              Can you cite the relevant part of your article there?

              • Paul Campos says:

                It’s 800 words long.

                • Brandon says:

                  I read it. I was asking for you to specifically cite the part that was meant as a reply to the post you quoted. Where in those 800 words to you specifically address the claim that campaigns like “Let’s Move” would actually be counter-productive?

                  You cite one study towards the end, but from what I can tell from the abstract available, it doesn’t quite support the stronger claim you’re making.

                • Paul Campos says:

                  I cite two intensive extremely well-funded interventions (Pathways and CATCH) that did exactly what Let’s Move recommends be done to “solve” the “problem” of childhood obesity, except these interventions were far more ambitious than anything that could realistically be done on a national scale.

                  Neither produced any significant weight loss whatsoever in the subject groups.

                • Brandon says:

                  Neither “Pathways” nor “CATCH” appear in that article once. Nor does “intervention.”

                  Are you going to bother supporting that claim or are we supposed to dig through all the links to find out exactly what you’re talking about?

                • Paul Campos says:

                  Second sentence of the fourth graph from the end contains links to the two studies.

            • Richard says:

              Can you cite anything other than your own writing for the proposition? Your own position is hardly a secret

              • Paul Campos says:

                See my reply at 12:34

              • Anonymous says:

                Okay, he linked to the Pathways study which is pretty damning evidence for the case that these sort of programs don’t work considering just how comprehensive that program was.
                Now, are you asking all the commenters who write things such as “Kids are a lot fatter than they were when I was growing up.” or “Kids don’t play outside any more.” for their supporting studies?

                • Richard says:

                  I will look at the links he provided (although the one on self-esteem seems firewall protected and its conclusion in the abstract – a “possibility” that feelings about weight gain are more important than weight gain – seems less strong that the position which Paul attributes to it.

                  With regard to the “kids are fatter” and “play inside more” comments, the statement of Lets Move (and many other health sites) has links to studies which it claims support those types of comments. I am sceptical of any anecdotal evidence offered by commentators here – on either side of the argument.

      • They’re criticizing these things as not being ends in themselves but being part of a counterproductive campaign to stigmatize people who are overweight.

        Wait wait wait – you just said that the stigmatization of children is the end in itself, and that the message about eating healthier and exercising is merely a means to achieve the end of stigmatizing overweight people?

        Tell me you didn’t mean it that way.

        • Scott Lemieux says:

          No, the end is reducing obesity, which stigmatizes fat people (because, in fact, exercise and healthy diets are good for everybody.)

          • Brandon says:

            Isn’t it incredibly likely that increasing your activity levels and eating a healthier diet will, for someone who is ‘overweight,’ also reduce their weight?

            • Sherm says:

              Yes, and that’s why promoting exercise and healthy eating is enough without declaring war on childhood obesity.

              • Steph says:

                The point about obesity is simply to explain why it’s considered important now to focus more on exercise and healthy eating — that there has been a change from the past. The program is to promote exercise and healthy eating, which are clearly good things.

                • Sherm says:

                  The point is that we can promote exercise and healthy eating without telling kids that there is something wrong with them and their bodies.

          • a counterproductive campaign to stigmatize people who are overweight.

            No, the end is reducing obesity

            OK. Better.

            Please stop saying that the end is to stigmatize people.

      • Brandon says:

        Again, here is what Paul said:

        [Let's Move] is defined by its very name as a campaign against fat kids.

        That seems to me that he’s arguing that simply by naming a campaign with a pro-activity name, something as simple and innocuous as “Let’s Move,” that you’re stigmatizing fat kids. If you can’t even talk about physical activity without inducing stigmas*, what the hell can you talk about?

        *ableist stigmas being a separate potential issue, of course

  3. ajay says:

    The campaign is defined by its very name as a campaign against fat kids.

    Just noting here that the name of the campaign is “Let’s Move”.

    And I love the “I am more of a feminist than Lindsay Beyerstein” thing. Trouble is, she’s too polite for it to be really fun, but please, please let me be around when you try this on Amanda Marcotte.

  4. Superking says:

    How it reflects anything that could be described as a progressive social agenda is if anything even more mysterious.

    Paul, I know you try to be provocative with these posts, but I think “progressivism” has a long history of concern about health, especially about the quality of food that people eat, but also the type of work that they do. See e.g. The Jungle and the labor movement. So, whatever, I guess.

    • Origami Isopod says:

      And bourgeois liberalism has a long history of paternalism when it comes to what “the masses” do. See e.g. smoking. Which, yes, is bad for you, but it’s also become a class marker.

      • AcademicLurker says:

        And bourgeois liberalism has a long history of paternalism when it comes to what “the masses” do. See e.g. smoking.

        Damn those patronizing liberals, thinking that they’re too good for lung cancer.

        Who do they think they are?

      • Lee says:

        Any functioning society is going to have a certain amount of paternalism/maternalism to keep things running. Sometimes people really do need at least some guidance in making decisions because of a lack of information. Sometimes people just need to be bluntly stopped from doing something risky to themselves and others. Was the campaign against drunk driving and smoking, paternalistic?

        The key is to prevent paternalism/maternalism from going overbroad and being either silly or moving into evil and dangerous directions like eugenics. One of the purposes of indivdualism, civil rights, and democratic government is to prevent bad paternalism.

  5. Julian says:

    My off-the-cuff impression is that we have vastly higher rates of obesity, diabetes of both types, blood pressure, etc., than we did several decades ago. My understanding was that increased rates of obesity are the most likely cause of the latter two. The fact that obesity has increased dramatically within decades suggests it is purely environmental and therefore reversible.

    If obesity is reversible and is causing bad things, and reducing obesity is the best and/or cheapest way to reduce the bad things, what’s wrong with reducing obesity?

    Or have I misunderstood, and are you in FAVOR of reducing obesity but against the manner in which “Let’s Move” is doing it?

  6. Cheap Wino says:

    How is promoting a healthy lifestyle for children “stigmatizing fat kids”? Isn’t this just the kind of thing that moved so many people on to the right back in the ’80′s — political correctness gone amuck? I know several people who started to move that direction at that time and would use political correctness as the lever moving them rightward. Now they are Ann Coulter fans.

    Kids should eat healthily and exercise regularly. Where is the controversy here?

    • slappy says:

      The controversy comes from the fact that all the language used in describing the program comes back to weight as being the problem, and not health. It assumes that weight is a reasonable proxy for health, and it isn’t. Or at least, it isn’t as good a proxy as many people seem to think.

      If you want to promote a healthy lifestyle, then do that. But the undercurrent of the language suggests that a healthy lifestyle is only a means to an end – the end being, a lower weight.

    • T. Paine says:

      The controversy is framing these things as good for “reducing obesity,” rather than good in themselves. Eating three squares a day and walking more probably isn’t going to help you drop 10 or 20 pounds, but it will probably make you healthier. So, the problem is the conflation of weight with health, when the two are completely different (outside of people who, say, have extreme mobility impairments because of their weight).

      Or you could, y’know, read Scott’s post from yesterday.

      • Cheap Wino says:

        It may be that you and Slappy (and Paul) are right that the program, from a PR standpoint, is imperfect. But I think there’s some serious nitpicking going on in the critique.

        The main links across the top of the page are “Learn the Facts,” “Eat Healthy,” “Get Active,” “Take Action,” and “Join Us.” The rest of the page focuses on childhood obesity, which most definitely is a health problem. Not once is the word “fat” mentioned. Do we now have to find a politically correct phrase for obesity?

        To look at the site and the program overall and scream, “Stigmatizing fat kids!” you have to be searching pretty deeply for criticism.

        • Sherm says:

          Solving the Problem of Childhood Obesity Within a Generation

          Let’s Move! is a comprehensive initiative, launched by the First Lady, dedicated to solving the problem of obesity within a generation so that kids born today will grow up healthier and able to pursue their dreams.

          As part of this effort, President Barack Obama established the first-ever Task Force on Childhood Obesity to develop and implement an inter-agency plan that details a coordinated strategy, identifies key benchmarks, and outlines an action plan to end the problem of childhood obesity within a generation. The goal of the action plan is to reduce the childhood obesity rate to just five percent by 2030 – the same rate before childhood obesity first began to rise in the late 1970s. In total, the report presents a series of 70 specific recommendations, many of which can be implemented right away.

          That is not stigmatizing?

          • L2P says:

            If that’s where you’re going to find “stigmatizing,” the most delicate electron microscope might, just barely, be able to find the difference between “stigmatizing” and “non-stigmatizing” language in any healthy diet and exercise program.

          • Richard says:

            No. Not even close. Its not blaming obese kids for being that way. Its not calling them responsible for their condition. Its setting forth a goal and a plan. If that constitutes stigmatization of obese children, then any exercise and diet plan that mentions reduction in weight constitutes stigmatization.

            • Sherm says:

              The present day “obese” children have been deemed by the first lady as “unhealthy” and “unable to pursue their dreams” and have been told that kids like them should no longer exist within a generation. Yeah, that’s not stigmatizing.

              • John says:

                Surely obese children generally are unhealthy? Besides the idea that saying it “stigmatizes obesity”, is there an actual argument that childhood obesity isn’t a significant health problem?

                • Sherm says:

                  I don’t deny that there is a problem — but the problem will not be fixed by making kids worry about their weight. Focusing on weight fucks people up emotionally and is generally self-defeating.

      • Richard says:

        Or you could read the Lets Move website where it talks about health benefits of exercise other than reducing weight. Or you could read about how childhood obesity is easier to prevent than adult obesity because kids want to be given the chance to run around and about how childhood obesity is related to diabetes. I read Scott’s posts of yesterday and was thoroughly unconvinced by his defense of Paul’s crusade against every program that seeks to reduce weight by eating better food and exercising more

        • The Dark Avenger says:

          You could take into account that childhood obesity is a problem in this country:

          In the exam room Lustig encountered an overweight 14-year-old boy dressed in orange and black—it was Halloween and the San Francisco Giants had just won the World Series—with the telltale dark ring around his neck that signals insulin resistance. Lustig high-fived the boy, put down the old leather doctor’s bag in which he keeps his stethoscope and prescription pad, and asked what he was eating. The boy knew exactly what to say. No snacking, no fast food, no soda, no eating after dinner. “That’s good,” Lustig said nonchalantly. Patients’ self-reports of their diets are notoriously unreliable. “You want to know why you’re gaining weight?”

          The kid didn’t move.

          “Let me tell you what’s happening. You’re not a glutton. You’re not a sloth. But if you eat a lot of carbohydrate or drink those sweetened drinks, the sugar makes your insulin shoot up. You know that ring around your neck? It means your body has chronically high insulin. That’s not good. Insulin steals the energy from your blood and puts it into your fat. Say you eat 1,000 calories. Your insulin grabs 500 of those calories and stores them in your fat tissue. And guess what? You’re still hungry and you feel tired.”

      • Sherm says:

        To add to what Slappy and T. Paine have said, the problem is the focus on weight and obesity rather than health, particularly where our societal standards and medical definitions of “overweight” and “obese” are off base. I doubt that the Lets Move program would have any critics (with the exception of assholes such as Sarah Palin) if it focused solely on encouraging exercise and healthy eating habits, and left “obesity” out of the equation. “Fat” kids do not need to hear from the first lady that there is something wrong with them, and thin children do not need to have their prejudices towards “fat” kids reinforced. Many kids will be “fat” irrespective of any attempts to eat better and to exercise more, and they do not need to be stigmatized for their body-types, metabolisms, and genetics.

        Having said that, I fully support government programs such as this, but I appreciate Paul’s point. I just think that his point is often obscured by overzealousness.

        • Cheap Wino says:

          So the issue is that Let’s Move is focused on solving a problem rather than ignoring the problem and Michelle simply telling parents to just do it?

          • Sherm says:

            The issue is that Lets Move focuses on childhood obesity rather than healthy habits. Teaching kids to eat better and to exercise more was enough without bringing the “obesity epidemic” into the equation. There was no reason to reinforce fat prejudice by casting fatness as the enemy of the state. You can help overweight kids without telling them that there something is wrong with them and that they need to be cured. The more our society focuses on weight rather than health, the less likely it is that we will develop healthy relationships with food and our bodies.

            • JL says:

              This.

              Are people here honestly unaware of the way that fat kids are bullied, or the horrendous levels of anorexia and bulimia among [pre]teen girls (to a much lesser extent, among boys as well)? Do people not think that constantly harping on how fat is bad and you need to lose weight, reinforces this? I have absolutely zero objection to a program encouraging increased exercise and healthy eating among kids if it’s framed differently. People seem to think this is just a nitpick, that there aren’t serious potential negatives here.

              Is there a gender thing going on here? I’m a woman (an athlete of what is considered normal BMI, but I’ve still had people shout “Fattie!” and similar out their windows at me a couple of times while I run), and it seems self-evident to me that society is virulently prejudiced against fat people. And having been a teenage girl not all that long ago (I’m in my twenties), it seems self-evident to me that messages about being too fat are constantly pushed on teenage girls (sometimes by other teenage girls).

              • ajay says:

                Are people here honestly unaware of the way that fat kids are bullied, or the horrendous levels of anorexia and bulimia among [pre]teen girls (to a much lesser extent, among boys as well)? Do people not think that constantly harping on how fat is bad and you need to lose weight, reinforces this?

                If there’s one thing that everyone knows about teenagers, it’s that their attitudes and behaviours are primarily shaped by what they get told as part of national public health programs. That’s why they never smoke or take drugs.

                • JL says:

                  Reinforcing the prejudice that comes primarily from other, more-influential-in-the-lives-of-teenageers, sources, is still a problem.

                  I don’t think anyone here is accusing Michelle Obama of malicious intent (I’m certainly not). Sometimes good intentions have unintended effects, and all of us are swimming in and to some extent internalizing societal attitudes. I think it’s awesome that she wants to use her influence to get kids to exercise and eat better. It’s the framing that’s the problem.

                • Sherm says:

                  JL — Well said and agreed.

            • Superking says:

              But does Let’s Move actually tell fat kids that there is something wrong with them and they need to be cured? Does MObama go around teasing the fatties before demanding they do the dougie one more time? Does she circle problem areas on their bodies with sharpies like a sorority girl? Or does all the talk about obesity show up on a website directed at adults?

              • Sherm says:

                The goal is to end childhood obesity within a generation so that children can be healthy and pursue their dreams. Does that not send the message that there is something wrong with “obese” children?

                Look, I’m all for promoting healthy eating and exercise, and I’ve become a fitness freak of late. But the classifications of “overweight” and obese” are complete horseshit, and overweight children have a hard enough time without the federal government reinforcing the prejudices against them. Pretty hard to grow up without self-esteem issues and eating disorders if you spend your childhood worried about your goddamn weight. Kids shouldn’t be burdened with this bullshit, especially when many kids’ bodies are nothing more than the result of their genetics.

                • Superking says:

                  You may have missed my point. In order to prove that this stigmatizes children, I think you have to tell me something about the actual interactions between the program and children. The fact that the program says it is designed to help reduce childhood obesity doesn’t tell me what it is making children think, and stigmatization is about what people think. If the program, in its interactions with children, is about eating healthy and staying active, then there isn’t much room to claim that it is stigmatizing children. The evidence we have hear from Paul is a quote from a website where they talk about an end goal being a reduction in obesity.

                  Well, so what? Are you going to argue that the website is making all of us, children included, that fatties are bad people? The connection is very tenuous between this website alone and the thoughts of the people who have interactions with it. You are especially concerned about the effect it is having on children. Do you think that the website is being read by a lot of kids? Or do you think the people who are putting on Let’s Move programs, whatever they amount to, are going around and telling kids that their little fatties who suck? I seriously doubt that either is happening.

      • Joshua says:

        I don’t see how eating three squares a day and walking more won’t help someone lose weight, up to and including 20 pounds (depending on your starting point).

        This has been mentioned several times on LGM: the idea that people who eat better and exercise more won’t lose weight. I find this very strange, to the point of basically physically impossible for the vast majority of people.

        • Incitatus says:

          As I’ve pointed out before, Mr Campos should receive a Nobel Prize, since he has invented a perpetual motion machine.

        • T. Paine says:

          I guess I’m just exceptional then! I bike, lift weights, run, hike, etc. Hours and hours every week, because it’s fun (4000 bike miles last year!). I eat three squares a day, and yet somehow I’ve been the same weight (overweight, according to BMI, and my weight isn’t all muscle) for 15 years.

          What’s my prize for being physically impossible?

          • Sherm says:

            This is what many here fail to understand. There are surely people thinner than you who eat more and exercise less, and there are people heavier than you who eat less and exercise more. The effort it takes to be “thin” is not the same for all people, including children. There is thus no reason to stigmatize “fat” children when there is often little those kids can do to change themselves. Asking many “fat” kids to be thin is akin to asking me to be a brunette rather than a blond. We should ask them to be healthy, and hope that weight loss follows as a consequence of the healthy habits we teach them. But it is wrong to demand that they lose weight so that they are healthier. It puts the cart before the horse.

            • Superking says:

              This is a mess of poor thinking.

              This is what many here fail to understand. There are surely people thinner than you who eat more and exercise less, and there are people heavier than you who eat less and exercise more. The effort it takes to be “thin” is not the same for all people, including children.

              I don’t know anyone who is unaware of this. We all know people who have different success with exercise and diet, including ourselves.

              There is thus no reason to stigmatize “fat” children when there is often little those kids can do to change themselves. Asking many “fat” kids to be thin is akin to asking me to be a brunette rather than a blond.

              I actually agree with this, but not for reasons that you and I would agree on. Many children have difficulty making healthy choices because their parents and family make the choices for them. But I don’t think there is anything in Let’s Move that is asking fat kids to be thin. Rather, it appears to me to be trying to inform choices made, and to encourage people to be more active and to pick healthier food. I don’t see anything in Let’s Move that is telling fat kids that they need to be thin.

              We should ask them to be healthy, and hope that weight loss follows as a consequence of the healthy habits we teach them.

              This is what Let’s Move is doing as far as I can tell. So, where’s the beef?

        • UserGoogol says:

          Eating three square meals says about nothing about how much food you eat. You can eat 3000 calories a day in the form of three square meals, and 2000 calories a day in the form of snacking on pretzels and beer all day. The point is that “square meals” are healthier in the more general sense of vitamins and nutrients and all that good stuff. And on the other side, walking doesn’t really burn that much calories.

        • Henny says:

          Take my wife, please. (No not really) Wonderful woman who spends hours in the gym — and yet has tremendous trouble living up to ideal weight and shape. She is very healthy, but would still at a glance, be said to have obesity and BMI problems. Unfortunately, somewhere along the line she developed body image issues (I could speculate, but won’t). Long time ago, I too thought Paul was out to lunch on this. Having actually read carefully now, I get it. What part “obesity epidemic” being stigmatizing don’t you get?

    • Scott Lemieux says:

      I guess I’ll have to just keep repeating this:

      Again, nobody is criticizing encouraging children (or, for that matter, adults) to exercise and eat healthier diets. They’re criticizing these things as not being ends in themselves but being part of a counterproductive campaign to stigmatize people who are overweight.

      Again, exercise and healthy diets are good things in themselves. Suggesting that they’re only positive as part of the end of reducing obesity is not merely pointless but counterproductive. It stigmatizes a class of people, it suggests that if healthy eating and exercise don’t make you “thin” they’re a waste of time, and suggests that as long as you’re thin being sedentary is OK.

      • Holy crap, you actually do mean this.

        You actually do think that the end, the goal, of the Let’s Move program is to stigmatize people.

        It’s not just a side effect of trying to make people healthier. The stigmatization is not even a side effect of trying to make people thinner. You think that the goal of the program is to stigmatize people. That is the end they’re trying to achieve, you keep saying.

        That is nucking futz.

        • Eli Rabett says:

          Not even, what they really are doing is attacking capitalism.

        • gmack says:

          Help me out. I don’t see how this is an accurate translation of Scott’s point. As I understand it, Scott’s claim (and Paul’s claim) is that the stigmatization of fat people (or more accurately, the reinforcement of certain assumptions that tend to lead to stigmatization) is is one of the effects of the program’s rhetoric and how the program is justified. This is a far cry from saying that this stigmatization is the “goal” of the program. Or am I missing something?

          • Sherm says:

            No, you got it.

          • Help me out. I don’t see how this is an accurate translation of Scott’s point.

            OK:

            They’re criticizing these things (encouraging exercise and healthy eating) as not being ends in themselves but being part of a counterproductive campaign to stigmatize people who are overweight.

            What does Scott say is not the goal of the program?

            What does Scott say is the end of the program – that is, the campaign aims to do…what, according to Scott? What does he say it is a campaign to do?

            He does not say that the stigmatization is a side-effect. He says that it is a campaign to…to do what? Read his words.

            • gmack says:

              OK, I’ll agree that the formulation you cite is a misleading shorthand for the point I think they are making.

              However, I also think this is a pretty minor point and deserving of a bit more interpretive charity than you seem willing to extend. To my mind, the stigmatization that occurs around issues of weight is very real and destructive, and it can occur even when a program aims to be benign and well-intentioned. For this reason, I am interested in talking about those issues and am willing to overlook misleading rhetorical flourishes in comments sections.

              • A steadfast refusal to meet even a minimal level of interpretive charity is 99% of Paul and Scott’s argument.

                There is far, far, far more support in Scott’s comments for my interpretation than in Let’s Move’s web page for Paul’s interpretation.

          • Scott Lemieux says:

            You’re correct. JfL is just willfully misreading here.

      • Cheap Wino says:

        ” Suggesting that they’re only positive as part of the end of reducing obesity. . .” This is the conclusion you’ve drawn about the program (mostly, I think, to support your point), not found anywhere in the website. There’s not a chance in hell anybody associated with research on childhood obesity or involved in promotion of initiatives to curb the problem is advocating anything remotely like “as long as you’re thin being sedentary is OK.”

        I’m happy to grant that to some degree the Let’s Move program isn’t ideally sensitive to certain children’s potential psychological well being. But it’s far, far from an egregious example of insensitivity. As I’ve noted, the website is headlined by colored/highlighted links to the activities that we agree should be promoted, then refers to obesity below. Possibly the information about obesity could be moved behind a link rather than on the front page itself, but there will be people who go to the site and ask, “Why should I bother with this?” You can’t just ignore that question.

      • Superking says:

        Again, nobody is criticizing encouraging children (or, for that matter, adults) to exercise and eat healthier diets. They’re criticizing these things as not being ends in themselves but being part of a counterproductive campaign to stigmatize people who are overweight.

        This is question begging at its worst. The issue that most of us are having is whether Let’s Move is stigmatizing, and it seems like many of us find Paul’s argument to be unconvincing. Looking over the Let’s Move website that Paul uses as his primary evidence, it appears to me that it is focused on encouraging healthy diets and additional exercise without focusing on weight.

  7. Bassopotamus says:

    No, but calling them “fat” in your article title probably does.

  8. Steve says:

    Who amongst us has not pined for the Golden Age that was the 1970s?

    • Richard Hershberger says:

      I don’t, but there is a valid point that kids did a lot more walking and riding bikes back then. I read nowadays about parents agonizing over whether to let their school-age kids walk three blocks on their own to visit a friend. This leaves me utterly bemused. When I was in fifth grade I walked over a half mile to school every day, and thought nothing of walking a mile and a half to the library after school. My mother knew where I was going, but the idea that either one of us would expect her to chauffeur me around for such distances would have never occurred to us.

      Do that nowadays and people will cluck disapprovingly. “Things are different today” they will say. And they are right: crime rates are much lower, and we are far more likely to have identified the pedophiles. (In fact we have one on my block: all the neighborhood kids know to avoid that house.)

      I now have two pre-school daughters. I also live a bit under a mile from the public library, with very walkable streets in between. I fully intend to encourage them to go on their own, once they are ten or so years old. I will insist they stick to the streets rather than take the short cut on the train tracks, but the idea that they must cower in fear in the house is repellent to me. If people want to cluck disapprovingly at me for this, let them. But better would be for our culture to move beyond this absurd phase we are in.

      • Halloween Jack says:

        Can’t find it now, but someone in Britain came up with a map of what is/was considered a safe distance to roam from home for kids of different generations of his family, three or four of them (based on recollections from the family members themselves); it’s shrunk markedly from generation to generation.

      • Jon H says:

        When I was a kid in the 70s/80s, parents definitely didn’t hover at the bus stop with the kids, the way they do now.

        • Malaclypse says:

          Not that parent hovering actually changes activity levels, but also parents don’t have a choice. When I was a kid, we all walked about a quarter-mile to the bus stop, and back, all unsupervised. My kid’s stop is two doors down. And district policy is to not pick up or drop off if a parent is not at the stop. several times, Mrs Mal has run late in the afternoon, and every time, MiniMal ends up driven back to school and taken to the principles office.

      • cafl says:

        I agree with your description of the change in attitudes about allowing kids to walk places, and it isn’t so recent. I allowed my 25 year old daughter to walk to school by herself in 2nd grade (about 3 blocks away) and got a lot of horrified reactions from her friends moms. But regarding walking to the library … this presumes some adult is at home to do the permitting. After school care imposes many restrictions on what children can do on their own at certain ages, and would be unlikely to allow kids to walk off to the library on their own. As a working mom, I relied on after school care as do many or most moms.

      • Lee says:

        To be fair, kids are walking/bike riding less know because most suburbs and ex-urbs, especially the ever present cul-de-sacs, aren’t exactly pedestrian friendly. Most kids face a serious chance of being flattened by a car if they venture to far.

        I grew up in Long Island, in a suburb very close to
        Queens. There was a downtown area near the LIRR train station that my brother and I could walk to. The library was a bit farther but there were no interstates or highways to avoid in order to get there. Most American kids don’t live in areas that are that friendly towards walking and biking.

        • JoyfulA says:

          Precisely. When my parents moved from a small town to the suburbs, there were no sidewalks to walk on and nowhere interesting to go, if there had been sidewalks. To go to the library, the pool, the playground, a store, a restaurant, or even a bus stop required getting a parent to drive me. Suburbs are bad for children.

          • LeeEsq says:

            I agree with this but in many of the older metropolitan areas, particularly in the North East, there is not much of a divide between suburbs and proper towns because lots of the suburbs are pretty old themselves and developed downtowns before the car era. This makes them a bit more habitable, especially if in the inner ring, than the newer suburbs elsewhere.

      • cpinva says:

        you will, will you?

        I will insist they stick to the streets rather than take the short cut on the train tracks,

        short of following them (pretty much defeating your purpose), or having a camera posted every block, how, precisely, do you intend to ensure that they’re not taking said shortcut? clearly, this is your first time in the parent biz, or you wouldn’t make such an idiotic claim.

        i’m pretty certain it wasn’t the first lady’s conscious intent to shame fat kids. whether consciously or not, that’s what she’s done. obese is not a scientfically objective term, it just sounds slightly better than “fat”, at least on the surface. but then, so do “hefty”, “stout”, “large”, “chubby” (even sounds kind of cute), “chunky”, “full-sized”, “husky”, etc. ,etc., etc. the bottom line, everyone knows what you mean, and what you mean isn’t nice, and never has been, ever. if obese didn’t have a negative connotation, the fashion industry wouldn’t have come up with all these other terms, in an effort to avoid overtly insulting their “plus-size” customers.

        if the point is to get kids (and their families) to adopt a healthier lifestyle, obesity could have been omitted entirely, with the focus being solely on the “healthier lifestyle”, unless only fat people should adopt one, which i’m pretty certain isn’t the point she’s trying to get across.

      • Pete Mack says:

        +1. Letting your kids walk or bike to school is considered sufficiently outré that
        1. You are likely to be considered a bad parent
        2. There is resistance in towns to put up proper pedestrian crossings
        3. Crossing guards are a thing of the past.

    • Jewish Steel says:

      If I smoked like my family did in the 70s I’d be 15lbs lighter.

  9. Richard says:

    Paul doubles down on demonizing Let’s Move. Even Scott, so far Paul’s stalwart defender in the crusade against this “particularly vicious form of bullying” , may elect not to get on this bandwagon

  10. AcademicLurker says:

    I’m surprised by how much attention Michelle Obama’s program in particular has been getting. These Presidential Fitness Initiative things have been around in various forms since the 60s.

  11. BobS says:

    Paul, I work in an emergency room. With respect to our pediatric patient population, the only thing that I find more disturbing than the number of obese children I treat is the number of kids on (frequently multiple) psychotropic medications.

    • John says:

      Now you’re stigmatizing the mentally ill. Why do you hate mentally ill children and want them to be bullied?

      • BobS says:

        To be fair, I hate everybody.

        • Cody says:

          The general outlook of any doctor.

          • BobS says:

            Yeah, let me see you cope with the very good wages/benefits/& working conditions that most er docs are forced to endure and see if you aren’t left embittered by the experience.

            • MPAVictoria says:

              Okay side note. I am getting pretty fucking tired of Doctors complaining about their wages. Doctors in North America are some of the most overpaid in the world. In fact, physician compensation is one of the main drivers behind our outsized healthcare costs.

            • Cody says:

              I wasn’t being sarcastic. The few doctors I’ve known i met in college – they came back to change majors.

              It sounds like an awful lifestyle to me, in addition to the awfulness of the actual profession. Of course, this is part of the reason I’m not a doctor.

              • BobS says:

                You have some pretty strong opinions about “any” & all physicians for someone who admits to knowing “few” actual practitioners and possessing little actual knowledge of the lifestyle or profession.
                You should have stuck to pretending you were being sarcastic instead of proudly trumpeting your ignorance.

        • cpinva says:

          that’s ok, we hate you too.

          To be fair, I hate everybody.

          i’m glad you weren’t my kid’s pediatrician, because you throw around unscientific terms, as though they actually possess empirically supported validity. kind of hurts your MD credibility. it’s possible the children you saw had a lifestyle that wasn’t as healthy as you thought it should be, but you’ve provided no evidence to that effect, we’re simply to assume (as you obviously do), that they were unhealthy, because you thought they were fat. this is precisely the point both paul & scott have been making, which clearly sailed right over your head.

          in fairness, this is what you’ve been taught, your entire life, not just in med school: fat people are, by definition, unhealthy.

          • You should dial it back.

            There have been some interesting questions raised about the link between health and overweight. Are we measuring it wrong? Are we ignoring confounding factors? It’s good that these issues are being raised.

            But bootstrapping that into calling the description of obesity as unhealthy “unscientific terms, as though they actually possess empirically supported validity” is a couple orders of magnitude too strong. There is a strong scientific consensus that being significantly overweight as a child leads to negative health outcome. This is not a myth; it is not a prejudice; it is not unscientific; and it sure as hell isn’t lacking in empirically supported validity.

          • UberMitch says:

            Note he doesn’t say he has an MD; he says “I work in an emergency room.” Bedpan orderly?

          • BobS says:

            My experience has been that obesity tends to be a predictor of certain problems. Some obese children already have medical issues of their own that are solely or partly functions of their weight, including hypertension and orthopedic problems. Many will grow to be obese adults, with those same and other risks.

          • BobS says:

            By the way, cpinva, I talk with many pediatricians. If you think most or all aren’t quite concerned about the weight of their patients and the health implications, you’re kidding yourself.

    • Darkrose says:

      And of course, there’s absolutely no connection whatsoever between the two.

  12. John says:

    Remember yesterday, when Scott was saying I need to provide examples of my claim that Paul opposes all actually existing initiatives to promote healthier lifestyles by saying they stigmatize fat people?

    I rest my case.

    • Incitatus says:

      The problem isn’t finding an example, it’s fitting them all into a blog comment. This is just the latest instance of Mr Campos’s effort to demonize even the mildest effort to help people have a healthier life.

      • gmack says:

        I think this is a misreading of the post. The objection is not to the specific proposals, but to the framing of these proposals as an effort to “end childhood obesity within a generation.” Now, the value of this framing is that it might encourage people to engage in useful reforms (reducing soda and candy bar consumption in schools, for instance). But at the same time, it also feeds into the assumptions that stigmatize fat and encourage people to engage in unhealthy and obsessive concern over weight issues.

        Or if I may invoke SEK’s arguments about rhetoric, Paul’s point is that, given the context and audience for the Let’s Move program, the rhetorical construction of the program invokes and reinforces all sorts of images and assumptions that one might find to be problematic, and should therefore be subjected to political critique.

        • JL says:

          This. Why is this point so difficult to get? It’s entirely possible to agree with the goals of healthy eating and increased exercise while critiquing the framing that centers a widely stigmatized attribute.

          • sibusisodan says:

            Perhaps it would help shove the discussion forward a touch if those who hold to the position that Let’s Move is a useful tool for encouraging healthy lifestyles wrapped in an unhelpful framing which may cause ancillary emotional problems could sketch out a program which manages the former and avoids the latter?

            This is good for two reasons:

            Firstly, it’ll be a helpful exercise for all involved (and as we know, exercises are beneficial in and of themselves) to tease out the pro-healthy goodness from the anti-fat wrapping in practice.

            And secondly, it’ll give those who hold to the position that the critique of Let’s Move based on framing concerns is becoming everso slightly unhinged from reality (to the extent that the framing being used to describe the framing of Let’s Move leads one to conclude that there is no redeeming feature of Let’s Move worth preserving) a chance to try critiquing these new proposals from a framing point of view.

            Then balance will have been restored, as the prophecy foretold.

    • Scott Lemieux says:

      Once again:

      Again, nobody is criticizing encouraging children (or, for that matter, adults) to exercise and eat healthier diets. They’re criticizing these things as not being ends in themselves but being part of a counterproductive campaign to stigmatize people who are overweight.

      • Brandon says:

        Paul criticizes the very name “Let’s Move” as fat-stigmatizing.

        Is the NFL’s “Play 60″ equally stigmatizing? What other names vaguely suggesting physical activity are stigmatizing.

      • John says:

        And, once again: in practice, Paul spends all his time attacking all actual efforts to encourage people to lead healthier lifestyles because they supposedly stigmatize the obese. He spends none of his time encouraging actual efforts to get people to lead healthier lifestyles.

        • T. Paine says:

          I seem to remember this line of argument from something else: Why aren’t you listing every bad thing Saddam Hussein has done when you point out attacking Iraq is a bad idea?

  13. Kids walked to and from school every day, ran around at recess, participated in gym class, and played for hours after school before dinner. Meals were home-cooked with reasonable portion sizes and there was always a vegetable on the plate. Eating fast food was rare and snacking between meals was an occasional treat.

    My biggest beef with this mostly (though not, I think, entirely) misbegotten anti-childhood-obesity crusade is that its strongest proponents look directly at some of the most relevant variables–see above–and then nearly always completely fail to respond to those already listed variables. In other words–how about thinking more about residential and commuter living patterns, suburban sprawl, family breakdown, maternal and paternal leave policies, the low wages which drive families to overwork and rely more upon fast food, the subsidies which make that sugary and processed-meat-heavy fast food relatively cheaper than that which is available at grocery stores, No Child Left Behind which squeezes out recess time, etc., etc., etc.? But no, of course, that would require us to think socially and structurally; it’s so much easier just to attack some poor girl’s body image than to actually ask the question as to why the child growing up in a lower-middle-class public school district never has the time or money to eat well or walk to school.

    • cooperstreet says:

      Well, for one, the HBO documentary about obesity does mention the lack of upkeep on many parks and how those from the lower classes don’t have easy access to public goods that help children stay active.

    • There has been quite a bit of attention brought to the issue of walkking to school.
      This group is working with a lot of municipalities.

      The American Planning Association is pushing your message pretty hard. Apparently, Agenda21 wants our children to be abducted!

    • daveNYC says:

      As much as I’d love to see major changes to how we handle city planning, sprawl, car centric transportation system, family leave, and public education, this is a FLOTUS sponsored program, and unfortunately ‘eat your vegies and run more’ is about as strong a policy statement as the FLOTUS is allowed to make.

    • nixnutz says:

      “it’s so much easier just to attack some poor girl’s body image than to actually…”

      I’m sorry, are you accusing someone in particular of doing that? Because the way I’m parsing this inflammatory sentence is, “the author of this comment is a truly monumental asshole”.

      Did you mean to say something different?

      • I’m sorry, are you accusing someone in particular of doing that?

        Not in the article itself, and not Michelle Obama, and not Let’s Move, which–contrary to Paul–I don’t think is a bad operation at all. But more than a few of those who bang on about childhood obesity aren’t really thinking about the environment which contributes to it; they’re just fat-shaming, and usually it’s young girls, particularly young girls of color, who become the poster children from such.

        the author of this comment is a truly monumental asshole

        Thanks! I don’t get that nearly as often as I used to these days, and it’s good to be reminded.

  14. MPAVictoria says:

    “We don’t actually know if kids or for that matter adults are less physically active than they were a generation ago, or if they consume more calories”

    Well we do know that serving sizes in restaurants have increased.

    http://www.divinecaroline.com/22175/49492-portion-size-vs-now

    • John says:

      If Americans are not heavier now because they are less physically active or consume more calories, then why would they be heavier now? What exactly is Paul claiming here? Given that basically the same genetic stock was much lighter 40 years ago, the explanation has to be environmental, right? I guess there’s other possible environmental explanations, but the idea that it’s because people are less physically active and consume more calories seems like a very good working assumption.

      • GFW says:

        Bingo.

        Not to mention that the statement “We don’t actually know if kids or for that matter adults are less physically active than they were a generation ago, or if they consume more calories” is pretty silly on its face. I mean, it’s not like we’re sifting through pottery shards here. We have survey data, school phys ed records, peewee sport registrations, 8mm family films … I’m not saying homogenizing such data is easy, but we really should be able to make such a judgement.

      • Darkrose says:

        One possible reason might be that more people are taking psych meds than there were 40 years ago. The SSRI’s–the drug category that includes Prozac–includes “weight gain” as one of the most common side effects. So, for that matter, do many non-psych meds that are commonly prescribed, such as birth-control meds.

  15. jon says:

    Time to take a deep breath and put the Cheetos down. Simple facts: more kids are eating more and exercising less. There are more obese kids now.

    When I was a kid in the seventies, people were moaning about how out of shape we all were compared to prior generations. So there was the President’s Fitness Program, or some such, allegedly started by JFK. Plus ca change, except there really are a lot more obese kids now.

    No the seventies weren’t some magic time of perfect homes and nutrition, far from it. Sad that it’s come to be perceived that way. Here’s another fact, though, most kids do get fed by their mothers, who also have a lot to say about their eating, exercise and nutrition.

    I’d love for Michelle to embrace her inner Panther and go all Kwaza-Zulu (or whatever it is that would get the Right most wound up) but she’s rather limited in the public role that First Ladies are permitted by our culture. Go take up your problems about that with someone else. She had to pick an issue to work on, and she has. You’d prefer she stick to redecorating the White House and picking out new china patterns?

    As for the First kids, the article said that Michelle’s pediatrician was worried about their ‘weight fluctuations’ – it does not say that the kids were/are fat. But I guess it’s a hate crime now, when a political figure tries to demonstrate a personal connection or understanding of a larger societal issue.

    • Richard says:

      Paul’s attack on Michelle for using personal experience as the impetus for her program is, in my mind at least, weird. What is wrong with that and isn’t that how most of us are motivated to take up a cause?

  16. Dave says:

    Of all the things you could waste your breath being against, you choose this? Tch…..

  17. Halloween Jack says:

    Paul, this is the least rational of your hobby horses. Law schools are still a problem, right? Why don’t you get back on that? There’s a lad.

    • John says:

      The specious mode of argument Campos employs on this subject always makes me suspicious of his other hobby-horses as well. How can I trust that his various law school arguments are intellectually honest when I know his obesity arguments are not?

  18. Bloix says:

    it’s so much easier just to attack some poor girl’s body image than to actually ask the question as to why the child growing up in a lower-middle-class public school district never has the time or money to eat well or walk to school.”

    “Children in the United States watch an average of three to four hours of television a day.”

    http://www.aacap.org/cs/root/facts_for_families/children_and_watching_tv

    “The average amount of television eight- to 18-year-olds watch is four-and-a-half hours per day.”

    http://www.childtrendsdatabank.org/?q=node/261

  19. Jim says:

    This is a massive discredit to this site. Unskewed polls territory here.

      • Scott Lemieux says:

        And, oddly, without any substantive reply on the merits. And, indeed, Richard throughout these threads has had no response other than “fat people are too icky!”

        • Sherm says:

          That’s not true. He has a fifty pound threshold of tolerance.

        • Richard says:

          BS, Scott. And you know it. My point is that the Lets Move program doesn’t stigmatize obese children and seems to be a well intentioned and well thought out program to deal with a significant health problem. Children are heavier than they used to be and that seems to lead to increased prevalence of diabetes and other problems. Whether it will work or not is beyond my expertise.

          On Paul’s original post about the JAMA study, my point was only that there seems to be legitimate scientific debate about whether obesity effects mortality and that Paul ignores this (and demonizes anyone who has a contrary view to his). As I pointed out several times, I’m a lawyer and don’t have the expertise to decide who is right in that debate. (I have two very good friends who are doctors and they believe that obesity does lead to increased mortality but I dont know whether they are wrong or right).

          On the general question of obesity, my position is that there are certainly health problems associated with significant weight gain but tend to agree with the position that the BMI standards characterize persons as obese who don’t seem to be belong in that category.

          On the general question of weight gain (or loss), I have made the point that one of the reasons some people strive to not gain weight or not lose too much weight is sexual attractiveness. If you gain too much or lose too much, you are likely to be less sexually attractive to those you desire. I don’t think that statement is the same as “fat people are icky”.

          • Bassopotamus says:

            On Paul’s original post about the JAMA study, my point was only that there seems to be legitimate scientific debate about whether obesity effects mortality and that Paul ignores this (and demonizes anyone who has a contrary view to his).

            I think the JAMA report is really interesting, and certainly leads to an opening for some changes in thinking (as in, perhaps our understanding of exactly where healthy weight ends and unhealthy begins needs to be reconsidered, as well as a serious discussion of the validity of using BMI as an indicator), but the discussion yesterday felt more like denialism than anything resembling a sensible scientific debate.

            • Richard says:

              You may be right about the general debate being denialism. My comments weren’t. I noted that several prominent doctors had a problem with the report and that I, a mere lawyer, wasn’t in the position to evaluate the merits of the respective positions. I certainly agree with you that the JAMA report is really interesting and should lead to a serious discussion about BMI and other topics.

              • Bassopotamus says:

                Man, I am really sloppy in my writing today. I didn’t mean to imply that you were engaging in denialism Richard. It was more a characterization of Campos’ post yesterday.

                Actually, based on my read of the discussion here, you and I appear to be in about 100% agreement.

        • Brandon says:

          About as far and accurate a reading of others’ posts as those who claimed Loomis literally wanted to murder LaPierre.

    • wengler says:

      Heh. Paul Campos BMI posts are an internet tradition. How dare you come here and try to change the tradition!

      Out with you!

  20. justaguy says:

    “BTW the reason that five percent of American kids were “obese” in the 1970s is that the definition of childhood obesity invented ten years ago by a CDC task force simply took the 95th percentile of childhood BMI in the 1970s as the cut point for their definition of childhood obesity. Science in action!”

    So, what’s your point of contention with this? Sure, defining obesity as people within a given percentile of BMI is problematic, because that means a certain percentage will always be obese by definition. The CDC solved this by basing it on a set BMI distribution, allowing the category of obese to be a marker of the change in the high end of BMI distribution. Even if you disagree with the meanings attributed to or interventions based on that category, what’s wrong with that specific way of defining obesity? Or is your argument against medicalizing a specific range of BMI independent of actual health issues in general?

    • Paul Campos says:

      The CDC task force that defined childhood obesity didn’t have any data-driven justification for doing so. At least with adults there were arguments put forth (bad arguments to be sure, but at least actual arguments) for setting the cut points for overweight and obesity where they were set. There were also arguments (even worse ones, but again, they took the form of actual citation to the literature) for lowering those cut points, as they were when the definition of “overweight” was expanded by tens of millions of Americans in 1998.

      But with “childhood obesity” there was never even this level of theoretical coherence. The definition of childhood obesity as the 95th percentile of childhood BMI in the 1960s and 1970s NHANES data, and of childhood “overweight” as the 85th percentile in that data, were both completely arbitrary. They needed definitions so they just made them up.

      • Brandon says:

        Any cut-off point is going to be arbitrary, though. And even if the chosen cut-offs are not ideal for some reason, we can still see changes relative to those less-than-ideal cut-offs over time. Is there no value to tracking such changes?

      • justaguy says:

        I’m feeling a little ambiguous about this. Defining obesity at the population level seems inherently difficult – there are any number of reasons where someone can have a high or low BMI. Because of this, I’m guessing that any definition is going to seem arbitrary. At the same time, there doesn’t seem to be any way to get more accurate population level data – body fat percentage isn’t as readily available in large data sets. But even with that in mind, tracking changes in BMI might be useful as the next best thing to more accurate measures which would presumably better correlate with health.

        So, while high BMI isn’t absolutely determinative of diabetes (there are people with diabetes and low BMI, and people with high BMI without diabetes), there is a positive correlation (more people with diabetes have a high BMI). And seeing a rapid increase in childhood BMI, and a rapid increase in childhood diabetes might be indicative of a trend that needs to be addressed – or at least studied closer.

        Where would you put the definitions of obese and overweight? Or would you do away with BMI based categories altogether?

      • Chris says:

        The CDC task force that defined childhood obesity didn’t have any data-driven justification for doing so.

        Either you haven’t read the published justification for the cutoffs, or you’re lying. If, as some suggest here, you’re making an argument about the rhetoric, you’d do well to just stick to that, because when you talk about the data, you are, as in this case, either ignorant or lying.

        • Paul Campos says:

          There were and are no risk-based cutoffs for the definitions of childhood “overweight” and “obesity” invented by the CDC.

          • Chris says:

            Yes, there were! Jesus, Paul, you should read the friggin’ write-up. It’s here:

            Here, in case anyone’s interested, is the write up of the recommendations by the committee:

            http://www.pediatricsdigest.mobi/content/102/3/e29.full#ref-13

            If you scroll down to “Choice of Appropriate Cutoff Value” you’ll find the cites. Some of the cites related to the choice of cutoff, all of which present data about various risks associated with the cutoffs, are available free without a subscription.

            http://ajcn.nutrition.org/content/59/4/810.abstract?ijkey=028117c028f63918a1c854c2f1a3a056fc0bfff4&keytype2=tf_ipsecsha (full article, free)

            It doesn’t detail them, but it presents the citations, which do detail the risks associated with the cutoffs. Seriously, take a step back, man, because at this point it’s clear you can’t evaluate this issue even remotely objectively if you can’t follow a few simple cites to the presentation of data in the friggin’ paper that details the choice of cutoffs.

            • Chris says:

              Sorry that got mangled. I started to write one then noticed your response.

              • Paul Campos says:

                You’re wrong about this. The cites indicate that the justification for setting a cutpoint at 95th percentile BMI for obesity was evidence that childhood obesity correlates with higher risk for adult obesity. One cite does reference a higher incidence of risk factors (hypertension and lipid levels) among older adolescents, but the justification is really that fat kids are more likely to become fat adults than thin kids. Pure bootstrapping in other words.

                • justaguy says:

                  I have no problem with arbitrary categories, so long as they’re analytically useful and aren’t misleading. Is there any reason to believe that these categories aren’t useful? Do you have less arbitrary categories that you feel would be more useful?

                • Chris says:

                  Except Paul, that’s the point. If you’re claiming otherwise, you’re talking about something other than what the report is basing its findings on. And your claim was that it was arbitrary and not based on data. Maybe it’s because I’m not a lawyer, but that looks like a lie to me, especially now that you know there is data, just not the data you want.

    • Regardless of the merits of either measure, changing how you measure something and then declaring that the different results show a trend is some sloppy reasoning.

      Imagine if a pollster switched from registered voters to a likely-voter screen, found a higher number for Romney, and then reported that Romney was surging.

      • ajay says:

        What change, joe?

        • Going from using the 5% cutoff as the definition of obese, to a BMI-based measure.

          Am I misunderstanding something?

          • justaguy says:

            No, what happened is that the top 5% of BMI from a historical average from the 60s-70s is used to calculate obesity. I learned this when i read that 15% of children today were in the 95th percentile for BMI, which seems impossible until you find out that they’re talking about the 95th percentile of historical data and not current BMI distribution.

            So, by using historical data, they’re doing the opposite of what you describe – they’re comparing current children to a historical BMI distribution, allowing them to track change. I’m not sure how much can be read into that, but it might be useful to track changing BMIs…

      • Craigo says:

        I think that’s called “last September.”

      • daveNYC says:

        Depends. If the pollster somehow had piles of data and was able to reconstruct his old polls using his new criteria, then he could legitimately say that with the new criteria (likely-voter) that Romney is surging. Heck, for a real life example, we’ve changed the definition of unemployed many times.

        The CDC has BMI numbers, so ignoring the elephant that is the dubious nature of BMI, I don’t see what is so invalid about saying that the percentage of children whose BMI is over their arbitrary cutoff is increasing. The quality of the cutoff is a better question, IMO.

        • True, but unless I’m mistaken (or Paul is wrong), the 5% figure from the 70s was not generated by applying the BMI standard to old data, but by using the old standard.

          • daveNYC says:

            It read as though they took some BMI distribution from the 70s and then used the 95 percentile as the cutoff for defining obesity. Now if the current population’s BMI is such that the cutoff now represents the 90th percentile, then I don’t see why someone couldn’t legitimately say that that indicates that more people are obese as defined by their cutoff number. As long as they’re comparing BMI to BMI, then at least that much does make sense.

            That’s totally ignoring whether BMI is worth a damn and if their cutoff number is a good one though.

  21. Parolles says:

    In all seriousness, note how this is being framed: It’s Mom’s job to solve this “crisis,”

    Actually, you’re framing it that way. Nothing in the excerpts you posted assigns the responsibility to Mom. You did.

  22. Joe says:

    Perhaps, Scott can follow-up to show the problem here is not Paul Campos’ going over the top but some commenter who just doesn’t get the point.

    At least Erik Loomis has that labor history cred to cover up his over the top comments.

  23. Data Tutashkhia says:

    I blame the abandonment of healthy duck-and-cover exercises.

  24. Svensker says:

    What’s the point here? It’s mean to suggest that overweight kids should eat better and get more exercise because that makes them feel fat, which is mean? So we should totally be OK with childhood obesity?

    Kids are fatter these days. All you have to do to see that is look around you. Adults are fatter, too. Personally, I don’t think that’s a good thing. But apparently you’re from the “everybody is winner no matter what!” school. Or something.

    Shorter me: worst non-wingnut post ever.

    • Scott Lemieux says:

      I think this comment is instructive. It understands that Paul isn’t wrong to say that a program that promotes the elimination of obesity stigmatizes fat children — he’s just wrong to think that this is a bad thing, because fat people are gross.

      • AAB says:

        Nowhere in the post you’re responding to does the commenter say being obese is “gross.” They said they didn’t think people being fatter was “a good thing,” presumably for health reasons. It seems to me that this is a fight over whether actual obesity has major health consequences that you’re trying to turn into an argument about whether fat people are icky. It’s pretty clear to me that pretty much everyone in this thread taking issue with Paul’s stance is doing so because they think that actual obesity is in and of itself unhealthy. The fight’s an empirical one, not a moral one.

      • Brandon says:

        If obesity represents, at least as a decent proxy, increased risks of health problems down the road, should their be any programs aimed at reducing obesity? Or would they all be fat-shamming?

      • Svensker says:

        Where did I say “fat people are gross”?

        What I did say is that obesity is becoming a problem in both kids and adults, in the US and other parts of the world. This is NOT an aesthetic problem, it’s a health problem.

        Pretending that obesity is not a problem because someone might feel bad about themselves seems like a terrible response. “Rather than risk hurting your feelings discussing the problems of obesity, you can suffer the awful consequences of diabetes, hypertension, heart disease, etc. We’ll both feel better now and I won’t have to see the consequences 20 years hence.”

        I have a nephew who is seriously overweight who has just been diagnosed with Type 2 diabetes along with hypertension. He eats too much bad food and doesn’t exercise at all. I hope Michelle Obama’s program gets him going. I love my nephew and would like him to be going to my funeral, not the other way around.

  25. Cody says:

    I have a hard time seeing how this program is explicitly stigmatizing.

    I’ll accept your premise that being “fat” as defined by social norms is not unhealthy.

    So I shouldn’t have my kids exercise because it might offend fat people?

    Should I start drinking bourbon all day at work and chain smoking because I don’t want my resident alcoholic and smoker to feel stigmatized by my healthy lifestyle?

    • Paul Campos says:

      What would count in your world as explicitly stigmatizing? The program is based on endlessly repeated claims that it’s bad for kids to be fat, and that kids won’t be fat if they’re physically active and have healthy diets.

      This achieves the remarkable feat of hitting the stigma trifecta in Erving Goffman’s famous schematization: It involves treating fatness as:

      (1) An “abomination of the body”

      (2) A product of personal weakness (if you had the self-discipline to eat right and be more active you wouldn’t be fat)

      (3) A kind of tribal stigma

      • Cheap Wino says:

        I have a question for you. Since this program is so off the rails, what form would an acceptable, non-stigmatizing program to address the childhood obesity problem take? I’ll assume that you agree that childhood obesity is actually a national public health program.

      • ajay says:

        Find me a single example of Let’s Move saying that “if you had the self-discipline to eat right and be more active you wouldn’t be fat”.

    • Scott Lemieux says:

      Again:

      Nobody is criticizing encouraging children (or, for that matter, adults) to exercise and eat healthier diets. They’re criticizing these things as not being ends in themselves but being part of a counterproductive campaign to stigmatize people who are overweight.

      • brewmn says:

        “Nobody is criticizing encouraging children (or, for that matter, adults) to exercise and eat healthier diets.”

        Yet that is what the OP explicitly does, critcize a program that encourages parents to see that their children eat better and exercise more.

        And I think we’re all still waiting for Paul to explain how Let’s Move! doesn’t simply do the former, but also “stigmatizes people who are overweight.” And no, handwaving nonsense like “The campaign is defined by its very name [which is, remember not “fat Kids Are Gorss” but rahter, “Let’s Move!” as a campaign against fat kids” doesn’t cut it.

  26. Dan says:

    The social stigma of being a fat kid has existed for a long time, completely independent of Let’s Move or any similar programs, and I don’t imagine it going away any time in the foreseeable future.

    Is it wrong to suggest that smoking, not wearing a seatbelt, having unprotected sex, owning a gun, etc. pose serious health risks? Do we worry about stigmatizing those folks too?

    • Paul Campos says:

      Is it wrong to suggest that smoking, not wearing a seatbelt, having unprotected sex, owning a gun, etc. pose serious health risks? Do we worry about stigmatizing those folks too?

      Is it wrong to suggest that analogizing a child who happens to have a body mass that would have been in the 95th percentile in the 1960s and 1970s (when low weight/failure to thrive as a consequence of malnutrition was much more common among children) to people who choose to engage in high risk activities is more than a little problematic?

      • Speak Truth says:

        …who happens to have a body mass that would have been in the 95th percentile in the 1960s and 1970s…

        Shorter Paul: “These children have no control over their weight. It just happens…out of the blue….for no reason.”

        Let’s be clear, being fat *is* a risky behavior. That’s the whole point of the First Lady’s program.

        • Paul Campos says:

          What percentage of the difference in body mass between fat children and thin children do you think is properly attributable to children choosing to engage in risky behavior? Do thin children choose to be thin? Do fat children choose to be fat?

          • Speak Truth says:

            Paul,

            It’s probably a great portion of the difference.If fat kids (or adults)have no control as you’re alluding to, then any program is for shit and is a waste of time and money.

            The Fist Lady thinks there is a lot of room on this and that’s why she has the program(s). Most health experts also disagree with you.

          • Brandon says:

            A child’s agency with respect to diet is obviously going to be seriously limited by their parents’ choices. To some extent, e.g. support (emotional and financial) and encouragement for participation in physical activity also control’s a child’s own choices. Yet they and their parents do not lack the ability to choose diets and activity levels.

          • Bassopotamus says:

            As someone who has been a fat child and a thin child, and a fat adult and a less fat adult, about 100 percent of the variance in my case was from diet and exercise.

          • L2P says:

            Do infants who don’t ride in infant carriers choose not to ride in car carriers?

            Do children killed by guns choose to be killed by guns?

            Do children who get lung cancer by breathing the smoke exhaled by their parents choose to smoke?

            We don’t generally consider anything that happens to children as their choice, it just happens to them and we need to fix it. That’s what we, as progressives, do.

            You make a lot of good points, but sometimes your arguments are almost sickening. Obesity rates in children have risen exponentially over the past 30 years. There are two 2nd graders over 120 pounds in my kid’s class; I don’t remember anybody over 100 pounds in my whole grade school.

            Are you seriously arguing that’s not a problem?

          • Sebastian H says:

            How are you using ‘choose’ in this sentence? We can all agree that children of that age are beset on all sides by social and societal pressures. Obama’s project appears to be a pretty good try at attempting to move some of those pressures in another direction. You don’t believe it is perfect, apparently. You further seem to think that a few sentences at the beginning overwhelm the general non shaming tone of the project. OK.

            That isn’t the same as characterizing the whole project as fat shaming. You’re like the right winger who characterizes any social program as COMMUNIST.

          • John says:

            Sophistry and straw men!

      • Malaclypse says:

        in the 1960s and 1970s (when low weight/failure to thrive as a consequence of malnutrition was much more common among children)

        I realize poverty rates and malnutrition don’t map perfectly, but childhood poverty is higher now than it was for any period between 1966 and 1981.

      • Brandon says:

        do you have support for your contention that the 70′s BMI statistics are significantly skewed due to malnutrition? Is our current 90′s and 00′s BMI a more “natural,” non-malnourished state?

      • Bassopotamus says:

        Percentiles aren’t particularly sensitive to this, as they are basically calculated in the same way as a median, just with more cut points. Changes at the low end of the distribution don’t do much to the high end of the distribution.

      • Dan says:

        No, I don’t. I don’t think that engaging in any of the other risk behaviors I mentioned early makes somebody an inherently bad person, but we’ve certainly seen the public health benefit of stigmatizing those behaviors.

        It seems that you are equating “fat = unhealthy” with “fat = gross”. I don’t see anyone saying that.

    • Speak Truth says:

      Oh, Dan…don’t get reasonable on us NOW!

      This blog is not for reasonable discussion of the issues. It’s for group mindthink and attempting to disparage anyone who has anything different to say.

  27. Bassopotamus says:

    From the Let’s Move Website

    Over the past three decades, childhood obesity rates in America have tripled, and today, nearly one in three children in America are overweight or obese. The numbers are even higher in African American and Hispanic communities, where nearly 40% of the children are overweight or obese. If we don’t solve this problem, one third of all children born in 2000 or later will suffer from diabetes at some point in their lives. Many others will face chronic obesity-related health problems like heart disease, high blood pressure, cancer, and asthma.

    All of that is tied to health, none of it to aesthetics.

    To deny connections between obesity and health outcomes is simply a case of the Ostrich Syndrome. Certainly yesterday’s study raises some interesting questions about being a little overweight, but lost in that discussion was that being obese is really bad for you. There is ample scientific evidence of this. My own personal experiences speak to this. I dropped 45 pounds last year, going from fairly high up the obese category to the cusp of being merely overweight. My blood sugar went from being pre diabetic to the low end of normal. The bursitis in my knees cleared up. My asthma cleared up. I know not to generalize from an N of 1, and that there are multicollinearity issues both in my case and in general with whether weight loss, diet, or exercise changes are the driving force, but there is ample evidence that 1. More kids are obese 2. People in general are eating more 3. People in general move less and 4. They are having more health problems.

    On the other hand, I haven’t seen any actual evidence presented that framing this issue in terms of obesity is damaging anybody’s self esteem.

  28. WorkingMom says:

    Let’s not forget how anti-feminist this is. In a family with two working parents, it ain’t easy to put “home-cooked” dinner on the table or get the kids out to afternoon soccer games. And when parents are able to work part-time to try and meet family needs (a luxury in itself in days of shrinking wages) its more often mom who takes the career hit. Childhood unhealthiness (lack of exercise, obesity, whatever form it takes) is part and parcel of an economic system that devalues the family (and especially moms, who are still lower paid than dads). Quality free universal childcare would be a good start. Maybe Michelle Obama could take that on instead.

    • Bassopotamus says:

      As a working father in 2 working parent household, I manage to get home cooked meals on the table 5-6 nights a week. I don’t like cooking that much, but it is totally doable with a little planning. It’s not like you have to do elaborate 4 course things every night.

      And while I sympathize with the fact that not enough dads contribute adequately to child care, it’s not clear to me that any government program can really address that.

    • Speak Truth says:

      Oh GOOD LAWD!

      When does one ever take responsibility?

      Is everybody just a victim?

      Every Stinkin’ Time?

      • UserGoogol says:

        For fuck’s sake yes, everyone is a victim, every stinking time.

        When a person chooses to eat more or less, (or whatever) that choice doesn’t just descend from the heavens, it comes from being the person they are. Being the person they are is of course partially the result of previous choices they made, but that in turn is the result of the person were, and so on. There is never an opportunity where you can simply stand apart from the universe and decide what sort of person you want to be from scratch. Of course, people sometimes change things about themselves, but only in so far as they are fortunate enough to be a person who is able to change things about themselves. There is no room for creation ex nihilo, so people are never fully responsible for their actions.

    • Marc says:

      It’s a matter of priorities and education. My wife and I both worked – two jobs in my case when the kids were young. And we managed to sit down with the kids for breakfast and dinner and serve fresh veggies. Of course, it did help that both of us cook.

      We really do have some screwed-up priorities and habits as a society, and it really isn’t a personal attack on people to point that out and try to change things.

      • Anonymous says:

        You’re using “priorities” and “education” as class- and race-based dogwhistles here. Most poor people can’t “prioritize” themselves out of poverty and magically create more time and money to produce home-cooked food five weeknights.

    • Richard says:

      Yes, a program sponsored by that ardent anti-feminist Michelle Obama. She should, rather than sponsoring a program that she believe will have concrete results and lead to healthier children, sponsor free universal childcare which, with just a little push from her, is sure to get through Congress this year.

      • Vance Maverick says:

        What is it about this discussion that sends us all round the bend?

        Yes, a program sponsored by that ardent anti-feminist Michelle Obama.

        This sarcasm seems to assume that someone with good intentions, even “credentials”, cannot make mistakes.

        And on the other side, even Scott, with whom I basically agree, can’t resist pushing the rhetoric too far, referring to a campaign which accepts “obesity” as a shorthand for the problem as a campaign to stigmatize obesity.

        • Richard says:

          My sarcasm was intentional but not intended to say that good people can’t make mistakes or that Michelle hasn’t made a mistake with this program (that decision will eventually be determined by the results of the program and whether it leads to healthier kids). Working Mom called the program very “anti-feminist”. Ms. Obama, to my mind at least, has never been called an anti-feminist and has called herself a feminist. The same with the other women associated with the program. If you are going to call this anti-feminist, then almost everything except working for a utopian tomorrowland is going to be anti-feminist.

          • Vance Maverick says:

            I’m in no position to argue about what’s feminist (nor are you), but there is a coherent distinction to be made between intentions and actions. Consider by analogy how activists in other equality struggles have often disagreed, not only about tactics and strategy, but about policy.

            • Richard says:

              I agree. Its possible that although not intended as such, the program could be anti-feminist as put into place. The point being made, however, was that because the program encourages children to be fed healthy meals at home every night, and since it is generally the case that women do this, the program is inherently anti-feminist. By this logic, any program that encourages healthy eating is anti-feminist since it is the case that women are more likely to be the food preparers in all families, even those without children. My sarcasm was directed at that type of reasoning.

    • daveNYC says:

      Yeah, I’m pretty sure that free universal child care is something that the FLOTUS can hack together. Especially seeing how easy it was to get the ACA passed.

      The diet section of the website is gender neutral with the exception of the part talking about the importance of nutrition during pregnance and breastfeeding.

      Two income households with women still being expected to do the majority of the housework on top of their paying job is BS, as is the fubar nature of child care in the US, but saying that Let’s Move is anti-feminist because it’s calling for healthier meals without solving major social issues first is just stupid.

      • Ed says:

        Yeah, I’m pretty sure that free universal child care is something that the FLOTUS can hack together. Especially seeing how easy it was to get the ACA passed.

        Nobody was suggesting that Michelle Obama can pass legislation on her own. The point is that too much emphasis on Mommy’s personal responsibility without addressing the larger social and economic forces at play in equal measure applies more pressure on women who are already feeling it.

    • cafl says:

      Working Mom: You are exactly right about the comments here, which turn the question into a parenting metric and a personal morality test for elementary school children, without acknowledging the real barriers working parents, especially low income parents, face. However, the actual “Let’s Move” program doesn’t do this:

      The Task Force recommendations focus on the five pillars of the First Lady’s Let’s Move! initiative:

      . Creating a healthy start for children

      . Empowering parents and caregivers

      . Providing healthy food in schools

      . Improving access to healthy, affordable foods

      . Increasing physical activity

      Everyone has a role to play in reducing childhood obesity, including parents and caregivers, elected officials from all levels of government, schools, health care professionals, faith-based and community-based organizations, and private sector companies.

  29. Anonymous says:

    Related: Does a War on Cancer stigmatize people with cancer?

    http://en.wikipedia.org/wiki/War_on_Cancer

    • Anonymous says:

      Does a Campaign to End AIDS stigmatize people with AIDS?

      http://www.c2ea.org/

      • Vance Maverick says:

        Does treating obesity as a scourge like those somehow not stigmatize it?

        • Anonymous says:

          Either all of these things stigmatize the health problems they’re fighting, or none of them do. Can’t pick and choose. And I’m pretty sure no one is going to argue that people with cancer and AIDS are stigmatized by campaigns to fight and eliminate cancer and AIDS. So no, I don’t believe a campaign to fight obesity stigmatizes the obese any more than a campaign to fight cancer stigmatizes people with cancer.

          • chris says:

            And I’m pretty sure no one is going to argue that people with cancer and AIDS are stigmatized by campaigns to fight and eliminate cancer and AIDS.

            Cancer, no, AIDS, yes. The difference is that practically no one blames cancer patients for having cancer; a few wingnuts blame AIDS patients for having AIDS; and almost everyone blames fat people for being fat.

  30. Anonymous says:

    For once I agree with an LGM front pager. The “obesity epidemic” is just another transparent excuse/ginned up moral panic for big-government medding. Moochelle Obama can butt the fuck out. I would be considered “obese” by these federal dipshits but am perfectly healthy. You can be healthy at ANY size.

  31. Steve S. says:

    These obesity-themed threads strike me as odd, something like arguing endlessly over how to talk to your kids about sex. I mean, you can dance around it all you want but sooner or later they’ll reach an age where you have to give them the brute facts about sexual intercourse, don’t you?

    Speaking for me personally, I don’t just pop pills into my mouth, I don’t even just pop pills into my cat’s mouth, I read about the drug first. The information is there and readily available so why not? Now, if I weighed 300 lbs and went to the doctor for a general checkup, and the doctor told me, “here’s a great idea, eat more broccoli and get a treadmill,” I can assure you that my response would not be, “sure thing, doc,” it would be, “why?” And if the doctor didn’t look me in the eye and tell me, “because the extra fat on your body is increasing your risk for deleterious health effects,” I would immediately lose respect for him as a doctor and never see him again. But maybe that’s just me.

    So I guess my question is, what is the proper way to tell the truth, both to parents and children, about the risks of too much body fat? I think we all agree that these risks exist, and I think we all agree that stigmatizing is bad, and I think we all agree that telling the truth is good. So what’s the way to talk about it, without sounding like a grownup talking to a four year old about penises and vaginas?

    • Vance Maverick says:

      By contrast with sex, the facts themselves about fat are a matter of bitter contention. Also by contrast, our own behavior w.r.t. fat and food is more difficult to analyze and monitor than is our sexual behavior. There are those who say “it’s just calories in and out”, but that’s a point of contention (see e.g. Gary Taubes).

    • Stan Gable says:

      I’m not sure that Paul & Scott agree that childhood obesity (as defined) is a risk factor – it hasn’t been clear from the posts that I’ve read.

      As for me, I’ve had diabetes for 25 years. It sucks. I’m also aware that until recently, the concept of a 14 year old with Type II diabetes was basically unheard of and that’s not true anymore. It would be a shock to me to find out that there are people who don’t see this as a problem.

    • Marc says:

      We don’t all agree about it. It’s extremely clear to me that Paul doesn’t think that there is any proven health consequence for obesity. He’s had plenty of chances to explicitly say that he does and he doesn’t take them. Just as he doesn’t define what an acceptable public health program to reduce the incidence of obesity. He’s had plenty of chances to include the obligatory disclaimers (“of course, there are negative health consequences associated with true obesity”) and they’re not there – check his NY Times editorial, which nowhere acknowledges any legitimate public health rationale for concern about obesity. There’s a reason for that.

      • Steve S. says:

        Vance, Stan, Marc, Campos does grudgingly acknowledge in the post from yesterday that some level of BMI carries an increased risk of mortality, which is why I was a little coy in saying, “I think.” What I’m looking for is some baseline language that can be agreed on. I’ve read through the comments quickly, skipping over a bunch on the way and I’m still not sure what he’d agree to.

        • Stan Gable says:

          Campos does grudgingly acknowledge in the post from yesterday that some level of BMI carries an increased risk of mortality

          Mortality isn’t the only negative consequence here.
          The increase in BMI among kids will lead to an increase in Type II diabetes.
          Some percentage of these kids will end up with impaired vision, kidney function, nerve conductivity, reduced mobility etc.
          All of these will lead to a reduced quality of life regardless of the impact on their life expectancy.

          • Steve S. says:

            “Mortality isn’t the only negative consequence here.”

            Agreed, which is why I’m wondering what statement he would agree with. And then once we have that statement, how to communicate it without “stigma.”

            • Steve S. says:

              This statement from his new post more or less covers it: “(1) Obesity does correlate with some increased health risks, and to a largely unknown extent, has a causal role in some of those increased risks.”

        • Vance Maverick says:

          I hope he’ll speak for himself on that. (I can see him saying that the genuine health effects of our weight increase, though real, don’t rise to the level of national concern.)

          • Stan Gable says:

            We don’t actually know if kids or for that matter adults are less physically active than they were a generation ago, or if they consume more calories

            So I read that as him saying the he’s dismissive of a change in weight, so it would stand to reason that he’s dismissive of any related consequence. In aggregate, an increase in weight is going to have a very strong relationship to calories consumed versus burned.

            With that, here’s some evidence that weight has increased by a significant amount:

            “That new weight, 185 pounds, is a full 25 pounds more than the previous average, 160″

            An increase of 25 pounds per person isn’t the least bit alarming?

    • Origami Isopod says:

      Because, surely, fat people don’t regularly hear from relatives, friends, doctors, the media, et al. about how they’re going to keel over. Nope!

  32. Cephalus Max says:

    Look, I get the point that Paul and the other front-pagers are trying to make: unnecessary stigmatization of kids (for any reason) is counterproductive, plus we are seeing increasing amounts of evidence that the mortality arguments against obesity don’t hold water. Fine.

    But look, being fat SUCKS! It deserves some level of stigmatization. About seven years ago (in my thirties) I started to gain weight pretty rapidly after a lifetime of being relatively thin and at least moderately fit. This was due to some combination of diet changes and decreased physical activity, plus perhaps just the usual metabolic changes due to aging. My BMI is now 30. I can no longer even casually play the sports I used to (not flexible and fast enough), even light jogging causes significant pain in my lower back and knees, and I can’t even bend over to tie my shoelaces without my belly fat compressing my diaphragm enough to cause me to lose my breath.

    I really can’t imagine the horrible consequences of being this fat during my physically active (and fun) childhood.

    I think the new research findings about obesity and mortality are fantastic news. But I don’t think it changes anything at all. People still should avoid being fat at all costs, and our public health messaging should convey that.

  33. Ed says:

    In all seriousness, note how this is being framed: It’s Mom’s job to solve this “crisis,” by making sure the kids have a magically obesity-repelling home cooked meal every night.

    Mrs. Obama did receive some criticism for those remarks, and I think she now avoids such framing (or repeating the stuff about how Doc said the girls were getting kinda fat, etc.) People make mistakes.

    I do remember an unfortunate comment she made concerning military recruiters having to turn away prospective recruits because they were too chubby, with the no doubt unintentional
    implication that the nation needs to get fit pronto so we can supply adequate numbers of young people to feed the military/industrial complex. You could also question her “partnerships” with corporations, wherein for example Mrs. Obama pats Walmart on the head for introducing organic and fresh foods, which they would be doing anyway, and Walmart, eager to move into urban areas generally unfriendly to the company, gets Michelle Obama’s seal of approval. Somehow I think Walmart’s getting the better deal.

    People still should avoid being fat at all costs,

    That bit about “at all costs” is a big part of the problem.

    • Cephalus Max says:

      That bit about “at all costs” is a big part of the problem.

      Fair enough. Undoubtedly “at all costs” was a poor choice of words on my part. But I think my primary objection to the original post still stands.

  34. Mike Schilling says:

    Americans are getting bigger all the time, and it’s because we don’t exercise and eat crap. If we exercised more and ate less crap we would be healthier and, as an unavoidable consequence, weigh less. Why does this bother anyone?

    • wengler says:

      I don’t know. People ate a lot of crap back in the ’70s too. It might have been less processed but it was a ton of calories. And not everyone was burning it off through intense exercise back then either.

      I think it’s some combination of portion size, less meal time/skipped meals, and corn in everything. People are more stressed out since the rich won the class war too.

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