Obesity and personal responsibility

This is a post in response to a Facebook discussion, a view was expressed that parents were completely responsible if their kids become obese and someone asked for the other side of that debate, so I'm providing it :). Whilst I have read on the issue, I haven't done any additional research for this, it's just a lengthy Facebook post :).

A century ago, obesity was extremely rare in Australia, as were the obesity related conditions. Obviously that's not the case now. It could be that the modern parent isn't concerned about their child's health or safety but given the incredibly close levels of supervision applied to the modern child as compared to a century ago, my view is that claiming parental negligence is the primary cause of the obesity epidemic isn't backed up by the overall ways in which parents raise their children. I think modern parents are generally more concerned over their kids, if anything, rather than less concerned, compared to a century ago.

What's changed from a century ago? The onslaught of sugar, fat and highly processed foods. A century ago it was common for people to grow quite a bit of their own food and the food they ate was lightly processed. Food was generally cooked domestically, from the raw materials that had been grown or purchased by the adult, usually a woman, who worked domestically and not outside the home. They ate some fat but not a lot of sugar. The current diet is one hundred and eighty degrees away from that. People were also far less sedentary and that's surely played a role in the obesity epidemic. Interestingly, the diseases we associate with obesity are also associated with thin people who consume lots of sugar, so the point might be a little moot.

This modern diet is awash in sugar, which is being consumed in quantities unprecedented in human history and is the biggest dietary change from a century ago. High fat diets have been followed previously that didn't have as many negative outcomes as high sugar (not saying that a high fat diet is a brilliant idea - just that it's not an unprecedented part of a human diet).

Not only is the diet awash in sugar but it's incredibly cheap PLUS it's sold to us using the full force of the modern advertising industry. Sugar and highly processed foods are the dominant food culture in this country. So parents trying to get their kids to eat lots of whole foods are pushing against that culture on every level.There are no protections against sugar consumption, either on a price level or on an advertising level. It's as damaging as tobacco but completely free to peddle its wares.

The breakfast cereals that most people consume are incredibly bad for us yet have a very wholesome image, that's the power of that advertising. The amount of sugar in those products has consistently gone up over the decades, and the range of products that sugar is added to has also considerably expanded. When you're buying processed foods, it's very hard to dodge it.

Juices, which contain just as much sugar as Coke, even more, also have a wholesome reputation. Our bodies treat the sugar in juice the same way they treat the sugar in Coke so it's not there on health grounds! The idea that eating vitamins in pills is all useful as opposed to eating them in whole foods isn't particularly supported by the evidence either, but look at how many of us do it! I mention these things to make the point that pushing back against the dominant eating culture of the country is damned hard. Of course it's not impossible, but you need a lot going in your favour.

A whole foods diet is expensive in terms of money and time. Low income parents or time poor parents are going to struggle on both grounds, and they do. Highly processed foods such as confectionery, soft drinks, potato chips, ice creams are the most heavily and regularly discounted items in a supermarket and are constantly in your face. Worse, they're also superbly located at levels that your little children can reach. Fast foods are also quite cheap and they are fairly fast, as the name says. The combination is enticing. They are also advertised heavily in children's television programs.

A factor that I think is important is that the kids themselves push very hard to be given these bad foods and it's a constant struggle, I know Cassie's had her victories that she's won through her bloody minded persistence on the matter. Cassie's a pretty and charming child, the combination means that she gets offered more than her fair share of treats by shopkeepers and other strangers - due to that dominant culture, these treats are, without exception, high sugar and often high fat to boot! Combine that with the advertising and you have a little girl who thinks that sugar is a really good thing and a lot of fun!

The strength of the dominant culture leads to some scary compromises, McDonalds in schools with their vouchers, the menus in our school canteens despite years of claims that we are changing the rules to make them healthy, the National Heart Foundation giving the tick to numerous high sugar foods. I'm sure the people responsible for those decisions weren't thrilled with them, but they're getting pushed very hard.

The argument that we can just blame the individual for their decisions is one that has many corollaries, and I'm going to use one from my field, education. I have worked in many disadvantaged schools, I have taught children who've come from very poor homes, and from broken homes where there was a lot of violence and not a lot of educational opportunity being offered. Nevertheless, some of those children did fine at school, some of them have overcome all of those difficulties and earnt university degrees and other qualifications. Since some kids can overcome those problems, does that mean that we do not need to give more money and resources to poorer schools? That it's just up to the individual kid and there's no need for any systemic approach to educational disadvantage? It's the same argument, and I think that argument is just as empty in education as it is in public health.

The identical argument was made with regard to anti smoking measures, was consistently made every time a new measure was raised, and continues to be made throughout the 3rd World where the smoking epidemic has reached new heights. But individual choice wasn't enough to dent smoking rates significantly, it took a systemic approach from all levels of government to do it. Advertising bans, hefty price increases, age based restrictions and restrictions of when and where smoking is permitted have all combined to push smoking rates down. Obesity rates can't be pushed down by relying on individual parents to restrict the intake of their kids, a systemic approach has to be taken.

I'm going to close with some personal anecdotes. This is a subject close to my heart. I am morbidly obese.  My parents weren't although my father was certainly overweight. My grandparents weren't obese nor were my great grandparents. My three older brothers are all morbidly obese. My older sister isn't, she had a fat period in her youth and has fought a very determined war to eat whole foods consistently ever since. I use the term war because that's the sort of intensity she's had to strive with to maintain her slim appearance. It's not surprising that she has not been able to quit smoking in that period, a war on two fronts becomes too much to fight.

 Like Cassie, I learnt young that sugar was a great thing, and I found it to be strongly addictive. As a growing boy I avoided putting on weight but once I hit my 20's that changed. The sugary foods have done most of the damage. Three years ago, I managed to go 11 months consuming almost no sugar in processed foods. I lost weight easily for the first time, without feeling hungry. Previous diets had taken weight off for a while, but ended in an orgy of bingeing.

The problem was when I left the house. I could keep sugar out of the house, but once you leave it's fucking everywhere. Shopping at Woolworths? chocolate, ice cream, biscuits, sauces, breads, et bloody cetera. Birthday dinner in the family? Here, have some cake! Morning tea at school? Here, have some biscuits, have some cake. Go to the pub for trivia? Here, have a soft drink (I don't drink alcohol). It's just a constant fight to keep buying the right foods whilst surrounded by the pressures to buy the fucking poison.

I finally cracked on the day of Cassie's 2nd birthday party - there was just too much sugary crap in the house and I ate some. Being addicted to the bloody shit, that was the end of that. Subsequent efforts haven't lasted long and I've put all the weight back on and then some. My latest blood test says I'm currently diabetes free but I can't keep avoiding the major consequences forever. Indeed, the arthritic pain in the knee and the back pain are surely related to the block of flats those areas are keeping up. I'm not unaware of the facts here. But knowing the number of the train bearing down on you and getting out of its way are two different things.

I don't think it's impossible to lose weight or avoid the heavily processed shit, my sister's done it, as have many other people. But it is very hard. And it's very hard because we, as a society, are awash with sugar and highly processed foods which are continually presented as good things. I think that to blame the parents for their kids being obese and, by inference, to blame the obese for being obese, is to ignore the reality of the food consuming system that we live in. It's cheap and easy easy to eat sugar and highly processed foods in our society, expensive and difficult not to do so. I don't think we should be surprised that most of us choose the quick and easy path, even when we know it leads to the Dark Side.