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Monday, June 4, 2012

Health Justice and Obesity Epidemic Language: The Temptation and Constraint of Available Rhetoric

This last week, Michelle Obama appeared on The Daily Show  (The interview begins around 11:36), to promote her new book on gardening and ended up discussing her quest to "End Childhood Obesity."

Though the interview is supposed to promote her book,  John Stewart begins the interview by talking about Michelle Obama's project as first lady, which he describes as a quest to "get children to eat well."  Almost immediately upon responding, The First Lady redirects the description of her program by first stating "It was really my experiences as a mother trying to get my kids to eat well." She then continues, "What most people don't know - we're seeing an epidemic of childhood obesity.  One in three of our kids will be overweight or obese, and we are spending Millions of dollars in health care costs for preventable illnesses."

              Now this statement is all kinds of problematic.  It projects that children that are now obese will become obese adults - which isn't actually supported by what we know about patterns of body weight (there isn't a one to one relationship between childhood obesity and adult obesity).  Although there is increased risk of becoming an obese adult if you were a "fat" baby - that relationship is only an increase in risk and not an imperative.  Further, the relationship between fat babies and fat adulthood is mostly confined to those at the extreme upper end of the bell curve.  This is just one of the problems with these sorts of projective statistics.

 The statement also conflates a message about health with a message about body size.  The unintended consequences of Michelle Obama's conflation of obesity and health has been discussed elsewhere.   Of further concern is the implication that obesity leads (as a cause) to particular health problems, which in turn cost an ambiguous "us" Millions of dollars.  This one is a whopper - and I think I will have to come back to it later.

Though the above statement  is ripe for a variety of analysis focused upon the dangers and difficulties of the "obesity epidemic" language - that is not what I want to talk about today.  Today I would like to do something different.  I want to think about why The First Lady may be using the rhetorical strategy she is using - because her intentions and the message are not always syncing up.

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I want to start off by saying I really rather like Michelle Obama - I always want to root for her when I see her in appearances.  This is why the above statement struck me right in the heart when she said it.  I want to be able to back The First Lady's plan - in part because it gets so many things right.   I mean, getting kids to eat better and exercise, pushing equity of access to activities to lead to health... These are things I can really support.

So why, WHY, the use of obesity epidemic rhetoric?  Why focus on the chubby tummies (appearance) if what you want is to effect the cute little feet(actions)? 

Well first lets review all the other things about health Michelle Obama said in her interview...


After her statement about the statistics of childhood obesity she then goes on to talk about her own observations about the causes of poor health for America's Children:

  • Two busy parents who don't have time to cook leading to eating out too much
  • Excessive television watching (or overall screen time)
  • Activity being eliminated from schools
Those all sound like behavior and action based observations - and ones that would fit into HAES (health at every size) approach to nutrition.
Further investigation at the "Let's Move" website indicates a similar preoccupation with trends that reduce the activity of children while increasing their caloric consumption.   So it has shades of calories in/calories out, and it insists on an idea that what one eats and activity are directly (And without mitigation) causal for obesity.  It is hardly fat positive - but if you look past the parts about obesity epidemic the focus upon eating in moderation and with variety and moving more to gain good health isn't such a bad one.  Also, the focus upon schools as a sight for activity is encouraging to me.

Mrs. Obama goes on to say, "It is a different world...with modern life things are changing.  Many kids are living in communities where their parents don't feel safe having 'em run outside.  You know fast food is the ... rule rather than the exception."

Her recommendations to solve childhood obesity
  • The garden as a way to start the conversation
  • Kids being involved in where their food comes from
  • (implied in conversation is getting children to move more)
And from the "Let's Move" website...
  • Move Every Day!
  • Try New Fruits and Vegetables
  • Drink Lots of Water
  • Do jumping jacks to break up TV time
  • Help make dinner
If you read through the Let's Move! website it becomes increasingly clear that the program is: 1) surprisingly HAES friendly and 2) contains a very strong social model of health. 

Now I am not saying that the methods presented in Let's Move! forgives the anti-fat rhetoric, nor do they compensate for the disservice that conflating size and health does. What I am saying is that the message about childhood obesity and the message given by the method presented are contradictory - and it made me wonder why?

And then I thought about the interview she did with John Stewart.  The way he introduced her was to say that she was on a campaign to make kids eat their vegetables.  So what does she do?  She jumps in with a rhetorical position that puts weight (no pun intended) behind her position.  She isn't "Momming" the world, she is tackling a serious problem that requires serious resources.

This is the double edged sword of the obesity epidemic language - this is the power it bestows!  When you evoke obesity as an epidemic you tap into a sense of urgency, professional medical authority, and moral righteousness that gives your claim power.  When you then link that rhetoric to concerns over finances (an increasingly popular tactic), particularly skyrocketing health care costs, your quest to get kids to eat their vegetables suddenly seems a whole lot more legitimate.  It becomes a crusade to save the Future of America - not a quintessentially feminine endeavor focused on the generalized welfare of children.

Thus, I think the simple answer to the question "Why is a project focused upon health behaviors, like Let's Move!, invoking childhood obesity as the problem it is solving?" is that linking Let's Move! to the existing hullabaloo about obesity gives it instant authority and urgency.  It is the most effective rhetorical trope available to make the public and press care - and to access funding.

Michelle Obama could have declared her project childhood health, or more pointedly Health Justice for Children.  The project that she could put into place for those goals probably wouldn't have looked that much different from what she has proposed now - when you really get into the vision of the Let's Move! campaign, it is focused upon societal level actions for societal level problems: reinstating physical education in schools, making neighborhoods safe for the engagement in physical activity, making certain all neighborhoods have access to affordable, fresh vegetables...these are health and food justice issues!

But what would have happened if Michelle Obama had unveiled a plan that stated her goal was to guarantee equal access to the predictors of health?  Particularly in the climate of the 2008 election?  I imagine that if the initiatives listed on that website were framed as issues of equality or social justice they would very quickly have been labelled as "socialism" - after all, there wasn't much in that time period that wasn't being labeled socialism.

Is that what the people who marketed Let's Move! were thinking? I have no idea - in many ways this is nothing more than a thought exercise.  But that doesn't make the result of the scenario any less important.  Because, truth to tell, programs that tend to social welfare and social justice in this day and age are woefully under-funded.  They are increasingly unpopular.

This is the temptation and the danger of obesity epidemic rhetoric - and this is what we must learn to wrangle with if we want to change the discourse; If you can build into your social justice program - any social justice program - an element that will combat the obesity epidemic you have access to funds.  Desperately needed funds.

But here is the rub.  In accessing and using those funds, you are buying into the discourse. And that means all these great health and social justice ideas are wrapped up in ideas about personal responsibility and the pathology of the fat body.  That is why you can't have a discussion about obesity epidemic, or fat without also having a discussion about gendered, raced, and classed bodies.  All of our discussions about obesity epidemic are inherently political, and inherently about which bodies are fit and which ones not -and how we tell.





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