The Blog Has Moved

I think I am starting to jump on the bandwagon driven by Sandy at Junkfood Science. It seems there are more and more articles coming out publicly that decry the problem of obesity in a way that goes beyond the science of the issue. It seems that there is a cultural war against obesity that is not simply a desire for healthy lifestyles, but instead a crusade in search of an infidel. That infidel seems to be the obese.

Two articles highlight this scary trend to me. The first is the well-publicized article from the New England Journal of Medicine in which a computer generated model showed a high association of obesity among close contacts of other obese people. From Medpage Today:

When individuals become obese, it dramatically increases the chance that their friends, siblings, and spouse will also gain weight, Nicholas A. Christakis, M.D., Ph.D., of Harvard, and James H. Fowler, Ph.D., of the University of California San Diego, reported in the July 26 issue of the New England Journal of Medicine.

Surprisingly, the researchers found, the greatest effect was not among those sharing the same genes or the same household, but among friends, even those living apart. What appears to be happening, the investigators said, is that obese persons change what they see as appropriate body size, and they come to think it is acceptable to be bigger, inasmuch as those among them are bigger, and this sensibility spreads. Other mechanisms might include food consumption, but the data did not permit a detailed examination of this factor, they said.

Now, I am not going to attack the science (as has been done in other blogs), except to say that the well-known scientific adage correlation does not imply causality needs to apply in these cases. In other words, if obese people tend to cluster in the population, it does not (as some headlines have implied) mean that obesity is “contagious,” or “viral.”

The scary part of this for me is that there is almost an unspoken implication that people should not make friends with the obese, or that the obese among us are the cause of the spread of obesity. While this is not explicitly stated, terms like “epidemic,” “contagious,” and “disease” seem to equate obesity with a plague or scourge on our society.

This is even more clearly implied in another article (thanks to Kevin for the article):

Doctors say they are now seeing children as young as six months old in their obesity clinics.

They are concerned some parents are supersizing meal portions for very young children and have lost sight of what “normal” weight looks like.

They told the BBC that in extreme cases overfeeding a young child should be seen as a form of abuse or neglect.

As a pediatrician, I find this to be an extremely distressing social phenomenon - but not as some may think. Children under two years of age generally eat what their body needs and stop eating. There are medical conditions that cause a pathological over-eating (Prader-Willi is the best known), but most children will stop eating when they are full. My view of a child when they come in at 6 months of age and are high in growth percentile is that this is their unique growth pattern. “This is the one time in your life that it is OK to be fat” is something I tell parents when they come in.

I find it very distressing that parents would want their 6 month old child to be thin. It seems inconceivable that a parent could overfeed a child to the degree that they would become obese. It is even more frightening that the authorities may even look at these types of cases as potential abuse or neglect. Here in Georgia, we have well-meaning health department nurses often telling moms that their baby is overweight. The problem is that the baby’s weight is in the 90th percentile, but so is their height. This is the appropriate weight for a child of this height.

It would take a huge discrepancy between height and weight for me to become alarmed, and I would dare say that I have yet to have a child under 12 months of age where I really worried about them being overweight. My main concern is them being underweight, not overweight.

For a society that idolizes leisure and physical pleasure, it is the ultimate in cultural hypocrisy for that same culture to go on a Jihad against obesity. Our society has achieved what has been dreamed about for the entire history of humanity: having enough food for everyone. Yes, this has come with a cost, and I do view the trend toward obesity as a real problem. The solution for the problem, however, is to not scandalize it and become mongers of shame. The solution is to look at the areas in which our society is pressuring us to eat more and go after them.  We need to see this as a problem in our society and not lay the blame at the feet of individuals.  Otherwise, are we really any different than the original crusaders?

This entry was posted on Tuesday, July 31st, 2007 at 8:13 am and is filed under Pediatrics, Medical. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.