Focus on fat puts thin at risk
Public health drives to decrease rates of obesity only increased anxiety over body image and distracted from real diseases, Manawatu fat and weight loss experts say.
Manawatu academics have lashed out at a policy briefing released yesterday by the New Zealand Medical Association titled Tackling Obesity, which recommends that obesity be recognised as a public health crisis in New Zealand and offers 10 measures aimed at doctors, health administrators and politcians.
The report states New Zealand is the fourth fattest country in the OECD with nearly two-thirds of adults either overweight or obese.
Massey University organisational sociologist Andrew Dickson, an expert in weight loss and obesity concerns, said focus on the term "obesity" was misplaced and led groups like the NZMA away from other important areas of concern, such as type II diabetes and cardiovascular disease.
The report reiterated existing arguments, and words like crisis and epidemic, that had been heard many times before, he said.
"Terminology like crisis is unhelpful and an engineered way to anxiety. They're constantly hammering these ideas so people become anxious about body size and practise peculiar ways of fixing that, which gives rise to the weight loss industry," Dickson said.
The focus should be on diseases like diabetes, gout, metabolic syndrome and cardiovascular disease, not the social expectations of how a person should look, Dickson said.
"I fail to see why obesity comes into that . . . by focusing on BMI (body mass index) instead of diseases they are drawing attention away from disease and running the risk of getting tied up in the body image and weight loss industry."
The title of the report, Tackling Obesity, carried a lot of stigma, Dickson said.
"Obesity is not a disease. Richie McCaw is obese . . . [the NZMA] is not interested in tackling Richie McCaw. That would be a mistake on many levels."
Labelling the issue as obesity was disadvantageous as underweight people also suffered from these diseases, he said.
Massey University lecturer and fat activist Cat Pause said it was a shame public health issues were often "wrapped around the throats of fat people".
"I don't think it has to be based around weight. People tend to hang problems on obesity, which I think is unnecessary. It's problematic because it reinforces the culture that shames fat people," she said.
"If the focus is on health and decreasing diabetes, heart disease and cancer then intentions are best focused around health choices and not just fat people. They're trying to get rid of a whole class of people."
Weight was a poor proxy for health because thin people were unhealthy, too, Pause said.
"A big part is the way we talk about it. Non-fat people don't listen because it's not targeted at them.
"[Doctors] assume fat people don't already know so they counsel them, but doctors are not counselling thin people, which is just as problematic. We don't know if they're not healthy and we just assume fat people aren't."
Pause said this often meant overweight or obese people didn't go to doctors because they felt ashamed.
Pause believed access to choices rather than education was the key.
"It's not like people don't know. Those people sitting at McDonald's eating already know it's not good for them."