Wednesday, May 12, 2010

Moving is Good. Destination is Important Too.

So, we now have an action plan from the First Ladies 'Lets Move' program. First blush; It would seem that Mrs. Obama and the Childhood Obesity Task Force have been listening. To whom? I couldn't say. However, the one thing that I did noticed while listining to the Press Conference is the distinct lack of the phrase 'weight loss'. 

There is a focus on nutrition in both schools and home which, in my opinion, is fine and well. Efforts to improve the quality and nutritional value of school breakfast / lunch programs, real and realistic efforts undertaken locally by nutritional / medical professionals and backed by the Fed Gov (Unlike those fronted by a certain Celebrity Chef who just plays one on TV) are more likely to improve HEALTH across the board for children. Most importantly for children with intermittent access.

There is also a lot of focus on food manufacturers and advertisers. Again, this would seem a necessary effort. Particularly in the advertising arena. I can remember when children's cartoons where silly entertainment and when they became nothing more than half-hour commercials for toys. It was almost inevitable that the food industry would get in on the act and equally inevitable that the whole thing would get out-of-control. There was / is FAR too much money to be made. Now, it would be the height of naiveté to believe that this doesn't effect children but does it mean we should start banning toys with kids Happy Meals? Ummm, No. We're doing pretty good so far. Lets not start back-sliding into EpiPanic rhetoric, K? 

One of the other things that this Action Plan seems to address is the Food Desert phenomena. Recognition that it DOES exist is an important first step and it, obviously, isn't something that's going to be easy to resolve. As that it is a recently recognized problem I wouldn't expect guaranteed, sure-fire, solutions. I'm not sure that putting a lot of the burden of insuring proper nutrition for ALL kids (which is pretty much how I'm viewing this entire program) on schools is going to work. There are strong, market driven, reasons why these deserts exist. The impetus to supply cheap, high-calorie, 'pseudo-food' in low income area's is akin to a gravitational effect and reversing or mitigating that is going to take something on the level of creating anti-gravity. First we've got to find out if it's even possible. Within the framework of a universe where Big Business is one of the driving forces behind it's physical laws, I'm not all that sure that it is. It's entirely possible that this might be one of those things that requires CULTURAL change before we see any positive movement. But that doesn't mean we shouldn't try.     

Exercise infrastructure / safety; How could this be anything but good? Insuring that kids have safe places to play and be active is a no-brainer as far as what should be happening. Why it isn't is a WHOLE 'nother question. Theories for that particular question run from 'blame-Nintendo/Xbox' to crack vial littered basketball courts and, again, answers to any of these problems won't come easy. Dealing with crime is a function of law enforcement. It's not like we've been ignoring it over the years but the world, it seems, has changed. Have Criminals become less discriminating? Willing to hurt, maim, kill anybody that gets in their way? Maybe. Maybe not. Are there more abnormal individuals out there targeting children than before? Yes. And no. Is the media instigating fear of the world outside our doors with sensationalist reporting. Yes. . . Unfortunately the options for passive, sedentary, entertainment are also much more pervasive than they've ever been in the history of humanity. I'd argue that not only is it possible to believe it's safer indoors but that staying inside, for kids at least, is the more attractive option.   
Again these are, primarily, attitudes that need to change. Take it from those of us in the fight for Fat / Size Acceptance; this ain't easy, but it can be done. 

Speaking of FA/SA, it would seem that the low whistle from those of us tired of being judged / penalized for the size of our bodies has been heard (Or, at least, one can hope). As one of the rallying cries of FA/SA states- 'Nothing about us, without us'. In my review of both the Mrs. Obama's speech and the task forces Q & A afterwards, not ONCE, was there mention of weight loss as a proxy for 'good health'. This is significant. 

Could it be that Michelle Obama and her Task Force have gotten, at least, PART of the message? Weight loss Good Health. A radical, oft decried, concept that can illicit completely irrational reactions from a LOT of different people. Reactions so ingrained they're almost predictable ('But being fat isn't healthy!1!1!). Perhaps FLOTUS and her Team have come to realize that if you want to seriously address the issue of HEALTH in regards to Fat People in this country, it might be a good idea to consult with the people who are, indeed, fat. Find out what we have found to work, what doesn't, isn't likely to, and what goals might be deemed more realistic than others. Experience, after all, is usually considered a fairly good teacher.    

That being said, there are still problems with this program. It seems to leave a lot of the usual stigmatization of weight out of it's practices but still manages to be antagonistic in it's intent. And this is probably due to it's focus on 'fighting obesity' rather than on the overall health of ALL children.  There's no such thing as a program that's gotten everything perfectly right, straight out of the gate. However, imagine for a moment, what could be achieved if the focus were really on health. Cardiovascular fitness, flexibility and strength, balanced and varied nutrition. Imagine if more fat kids turned out to be living healthier while more underweight kids and more normal-appearing-UNhealthy kids became more healthy as well. As fewer of ANY of those types of kids become likely to show signs of the body warping image or psychological issues that run rampant in their parents now.       
I mean, I'm not seeing a down-side here. So. . .  When do we get around to dropping this 'obesity' nonsense and start concentrating on real Health? Are we still listening? 

Muzak Therapy:
Dire Striaghts / Once Upon A Time In The West

Monday, May 3, 2010

Big Questions? Big Science! . . . More Questions.

A funny thing happened on the way to the Doctor.

              He said; 'The Patients are revolting!!
              I said;     'In know. Fewer and fewer seem to think you guys actually  
                              know what your doing. It's almost like their ready 
                              to take up arms or something.'
              He said; 'No, no. I mean, they're revolting. I really don't like them 
                              very much.'
              I said;    'Oh. . . Well, hope you can work that out then.'

One might think the members of the Medical Science Community would know the potential harm that comes from shooting one's self in the foot, but. . . 

Science, or one of it's basic tenants, is supposed to be non-biased integrity. The pursuit of fact has long been the doctrine of, really, any kind of science in it's quest for the incontrovertible 'truths' about that which has, previously, been unknown. Unfortunately, we humans love our biases. especially when they make us look good.

This particular article focuses on medical science and it's relationship to pharmacological research. However, one might argue that there has been a certain amount of. . . Scientific obfuscation in matters pertaining, obesity and the frenzy of 'crisis' news that surrounds it.

We've seen this before. Checking our friendly media providers we find a new 'death scare' health report about the 'dangers' of obesity almost every month (Ok, well that last one is a ringer but you get the idea).
We are virtually inundated with so much information pointing toward the shear lethality of fat, one almost wonders how there could possibly be ANY fat people walking around anywhere. Or, perhaps, there's less to all of this than we're being led to believe. Less fact and perhaps too much agenda. 

One might wonder; What would be the purpose of disseminating all this bad information? What would be the purpose? Well, like fat itself, the answer to that can get a little complicated. As the HuffPo article on medical research suggests, Medicine has traditional momentum to account for some of it's entrenched attitudes. However, in the case of obesity, we've also got a 40 - 60 billion dollar diet industry, a media machine capable of shaping societal perception, Insurance concerns who's bottom-line interests revolve around paying out as few claims and disqualifying as many people as possible, and WLS? If the revenue generated by that particular medical specialty is a fraction of what the diet industry pulls in, we are talking about a lot of money. As it turns out, money is a pretty good motivator.  But this phenomena in the scientific community is not just powered by greed and industry specific interest. There are also powerful social / cultural components facilitating and often directing this mis/disinformation. In a society where it's quite simply acceptable to hate fat people, how can it not? Now layer on a general ignorance of how / why people become fat, why it's nearly impossible for some to lose weight (Umm because some of us are supposed to be fat? Just a guess.), and add irrational beliefs about how individual bodies should work or how they should look and you get a toxic environment in which, even incorruptible Science, is not immune to influence. As a caveat, the last Presidential Administrations attitudes about what science is and what it should say, didn't help any. Still the question of why researchers and those who do the Big Science thing might be compromising their own integrity, really isn't the most significant one. 

It seems that some of the most important questions in all of this often go unaddressed: What is this doing to the reliability, the reputation, the dependability, of Science and, by extension, medicine in general? How will this willingness to 'sell out' fat people for a quick buck, for an entrenched bias, or for a perceived 'societal good' while ignoring inconvenient truths or passing off junk science as cannon, effect what we 'know' in the future? Obviously these would be questions that could potentially effect, not just fat people, but everyone. However, we'll need to get over our general dislike of a certain class of people before we can even address them. For those skipping ahead, that would be; Fat People. Not impossible but as history has shown, often not a very easy thing to do. If we don't want the Scientific Process to become short-hand for 'just another rumor mill', perhaps we should get started.  

Muzak Therapy:
Cars / Bye Bye Love