As Always, It's More Important To Look Good Than To Feel GoodS

Want to know how to make my head explode? Recommend a bunch of community initiatives I completely support — boosting walkability, bringing supermarkets to underserved neighborhoods, creating bike paths — and sell it all as a War on Childhood Obesity.

A new report from the Institute of Medicine does just that, calling on local governments to make it easier for their citizens to exercise and access fresh food (yay!) in hopes that it will prevent kids from getting fat (oh, did you have to?).

I can't say it any better than I already said it in response to a similar story out of Europe last year:

Free fruits and veggies for everyone! Local, organic produce for all my friends! While you're at it, bring back gym class and train future phys ed instructors to focus on encouraging the joy of movement instead of forcing everyone to move their bodies in exactly the same way, regardless of any pain (physical and/or emotional) it causes! Subsidize exercise facilities until they're affordable for everyone! Create more bike paths! Clean up local bodies of water so everyone can swim for free! Build cities on the scale of human bodies instead of cars, and keep the streets safe enough for everyone to walk around! Ban high fructose corn syrup! Keep fast food and soda and junk food corporations out of the schools! Raise the minimum wage and shorten working hours so people have more time to cook and be active! KNOCK YOURSELVES RIGHT THE FUCK OUT creating an environment that makes it easier for everyone to eat a variety of fresh foods and get plenty of exercise!

But don't tell me that's going to make everyone thin - and really, really don't tell me that making people thinner should be the main point of such a plan. It fucking infuriates me that with all of the many, many excellent reasons to do all the things I've just suggested, the only potential outcome that can muster the political will to enact any of it is weight loss. Fuck having a cleaner, safer, more fun environment that might lend itself to people generally feeling more energetic and vibrant (which might also lead to more productivity, for all the hardcore capitalists out there) - unless we can get rid of the fatties, it's wasted money.

And even if you're not as fat-friendly as I am, there's still the fact that these programs don't really make much of a difference in childhood obesity. As it turns out, losing weight and preventing weight gain are a lot more complicated than, as AP writer Lauran Neergaard infuriatingly puts it, "being more active and eating more fruits and vegetables instead of fatty fast food and treats." (Neergaard also trots out the "doctors worry that we're raising generations who no longer may outlive their parents" canard, despite U.S. life expectancy currently being at an all-time high.) The Shape Up Somerville program, a three-year intervention that took place in the Boston suburb between 2002 and 2005, is held up as a successful model of community fat-fighting. It's true that Shape Up Somerville did some awesome things for the community — it improved the quality of school food, creatively introduced joyful movement into classrooms, and made it easier and safer for kids to walk to school — but the evidence that it made a dent in childhood obesity is less than compelling:

On average, SUS reduced approximately one pound of weight gain over eight months for an eight-year-old child. This may seem small for an individual, but on a population level this reduction in weight gain, observed through a decrease in BMI z-score, would translate into large numbers of children moving out of the overweight category.

Note that that's one pound of projected weight gain, based on a guess about who was at risk for gaining how much weight. And remember that children grow in fits and starts, sometimes going from chubby to lanky in a very short period of time. And then ask yourself why a bunch of kids not gaining one pound could "translate into large numbers of children moving out of the overweight category." If you said "arbitrary fucking BMI cut-offs," you win a Lady's Brunch Burger! Meanwhile, the Shape Up Somerville program also did its best to shame and terrify children and their parents regarding things food and fat, even more than the rest of the world already did. All to prevent an average of one pound of hypothetical weight gain.

I know a lot of researchers believe that Health at Every Size, or health for its own damned sake, is too hard a sell; most people aren't nearly as interested in being healthier as they are in being thinner. But the reality is, eating a bit less and moving a bit more do not make fat people permanently thin, or prevent kids with fat genes from fulfilling their chubby little destinies. They can, however, make people feel a lot better, and reduce the incidence of "obesity-related" illnesses. Initiatives that make cities more pedestrian- and bike-friendly, gym class more fun, and school lunch less nauseating have a gazillion merits that have nothing to do with preventing weight gain — yet they'll be considered failures if they don't. I just don't even know what to say about the fact that making people's lives better is not a good enough reason to spend tax dollars on such improvements, but ridding the world of fat children is.

Report: Tips on creating fat-fighting communities [AP]
On Problems to Be Solved [Shapely Prose]
Shape Up Somerville [Friedman School of Nutrition Science Policy]
Health at Every Size [Linda Bacon]