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Obesity is health issue, rather than image issue

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Esther Cepeda
September 8, 2011
— Half the United States will be obese by 2030 unless government interventions—making healthy foods cheaper, junk food more expensive, and regulating the marketing of unhealthy foods—are put in place, according to a report in the Lancet, a British medical journal.

At the news conference for the report’s release, one of the authors, Harvard professor Steven Gortmaker, said, “Governments certainly need to lead obesity prevention, but so far few have shown any leadership. If we have no measures and don’t set any targets, we’re not going to make a lot of progress.”


I couldn’t agree more. I’m a huge supporter of government providing the incentive for healthy behaviors. But before such measures can be effective, people first have to start giving a damn about the childhood and adult obesity epidemic in this country.


For the last 10 years, I’ve seen little reaction to a steady stream of jaw-dropping statistics concerning obesity and obesity-related illness. Skyrocketing state-by-state percentage increases, warnings that obesity is becoming a national security threat because weight is disqualifying people from the armed services, and countless scientific reports on the medical, sociological and multibillion-dollar economic toll of this epidemic have done little to inspire much more than outrage over government “meddling” in America’s weight problem.


What does get people’s attention? Try “Maggie Goes on a Diet.” The book, written by Paul M. Kramer, has yet to be released but has already stirred up a controversy on social media websites because it targets female readers as young as 8 with a message that, I think, is actually intended to give solace and encouragement to girls dealing with obesity.


The description on Amazon.com reads: “This book is about a 14-year-old girl who goes on a diet and is transformed from being extremely overweight and insecure to a normal sized girl who becomes the school soccer star. Through time, exercise and hard work, Maggie becomes more and more confident and develops a positive self-image.”


Theoretically there’s nothing to take issue with here—a third of American children are overweight or obese. This in turn limits mobility and access to physical activities such as team sports and destroys self-esteem. It takes time and lots of hard work in the form of perseverance, calorie restriction and exercise to lose weight healthfully. And the success of such a difficult challenge can undoubtedly spur confidence in anyone who has prevailed in transforming him- or herself into a fit person.


The problem is that the cover—on which an overweight girl with a small-sized pink dress stares longingly into a mirror image of a thin girl—reinforces the well-accepted attitude that obesity is primarily an image issue rather than a health issue.


This false collective belief keeps people from taking a killer disease seriously and instead characterizes attempts to combat a legitimate medical crisis as more evidence that society pressures women, men and children to be an “ideal” size or shape.


This is grist for the mill of those who preach that everyone is special and beautiful regardless of what they look like. Unfortunately, focusing on self-acceptance and self-esteem completely overshadows the fact that anyone, skinny or overweight, can be beautiful, special and very sick at the same time.


Once people start talking about obesity in terms of whether anyone should be expected to be thin like those on TV, in magazines, and movies, there’s little appetite for rerouting the conversation to whether society should accept succumbing to a 100 percent preventable disease.


Without major changes in public attitudes about obesity—plus revolutions in how food is marketed, and increased public awareness about how to eat and stay active to maintain a healthy weight—one-third of all children born in the year 2000 will develop Type 2 diabetes during their lifetimes. Many others will face obesity-related problems such as heart disease, high blood pressure, cancer and asthma.


Sure, it’s easier to be outraged about a male author’s attitudes toward a fictional 14-year-old’s self-image issues than it is to ponder public health policy. But if you’d rather debate appearances, you might consider that nothing is harder to look at than a child who can’t walk down the block without being completely winded, a teen who has to prick his fingers every other day to measure his blood sugar, or an adult who must live a shortened life span on drugs to control her heart rhythm or blood pressure.


Esther Cepeda is a columnist for the Washington Post Writers Group. Her email address is estherjcepeda@washpost.com.

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