Diabetes Self-Management Blog

It was all the rage two or three weeks ago. Bioethicist Daniel Callahan, senior research scholar and president emeritus of The Hastings Center, had determined that fat people needed to be shamed into losing weight. After all, it worked for smokers.

In a blog entry I wrote about it, I noted that I tried to access the original article he wrote for The Hastings Center, “Obesity: Chasing an Elusive Epidemic,” but was unsuccessful. So I quoted from an article in The Huffington Post.

I should have known better. I should have looked harder for the original article and not written anything without reading it.

A reader named Katherine sent a copy of the original article to Web Editor Diane Fennell, who forwarded it to me. In Katherine’s e-mail, she noted she had read a newspaper article about Callahan’s paper “which made this article sound absolutely dreadful. However, after reading it, I came away with a different attitude. How the article was portrayed…and how it really reads are totally different…”

I agree.

Yes, Callahan did mention shaming, but he also pointed out early in the article that obesity has many causes, writing, “The causes of obesity include age (the body’s metabolism slows with age); gender differences (more common in women); genetics (obesity tends to run in families); illness (hypothyroidism); cultural acceptance or indifference (poverty, race); sedentary habits (long commutes, sitting at a desk or work bench all day, watching TV, lack of exercise); poor diet (few fruits and vegetables, processed foods, overly large food portions at home and in restaurants, sugared beverages); and, too often neglected, all the luxuries we possess — automatic garage door openers, can openers, food blenders and mixers, escalators, elevators, golf carts, automobiles, and so on.”

Yes, he gets it — and realizes that obesity can be caused by more than too many calories and too little activity.

And it wasn’t exactly shaming he advocates. Instead it’s more of a “nudge,” utilized early in the process, when people first begin to pack on some weight. It’s easier to lose a little rather than a lot, he says, and notes that it’s probably too late for people who are older and very overweight.

Also, while he does say that shaming worked for smoking cessation, smoking and weight are two different animals.

“Three reasons are common,” he writes. “(I)t is wrong to stigmatize people because of their health conditions; wrong to think it will work well, or at all, with obesity; and coun-terproductive with the obese because of evidence that it worsens rather than improves their condition. Ethically speaking, the social pressures on smokers focused on their behavior, not on them as persons. Stigmatizing the obese, by contrast, goes after their character and selfhood, it is said, not just their behavior. Stigmatization in their case also leads demonstrably to outright discrimination, in health care, education, and the job market more generally.”

As part of a larger effort to prevent obesity, Callahan advocates a three-part strategy to address the problem in the realm of government and business: government action and regulation (for example, using taxes to raise the price of unhealthy foods and subsidizing the cost of healthful foods to make them more affordable); calling for private companies to be more public about the steps they’re taking to make foods more healthful; and calling for employers to do more in terms of wellness programs and financial incentives.

As an aside, I got kind of tickled at what Callahan wrote about private companies needing to be being more transparent about steps they were taking, particularly when it came to Darden Restaurants, which is the parent company of a number of chains including Red Lobster, Olive Garden, and LongHorn Steakhouse. Darden plans to reduce sodium by 20% over the next decade but, says a spokesperson, “we are going to be making changes silently and slowly” and adds that their clients won’t even know it’s happening.

So, no, Callahan doesn’t advocate having people point fingers at the overweight and chant, “fatty, fatty!” He understands that there are many underlying reasons for overweight and obesity, and notes that it’s more productive to nudge people into maintaining their weight before the numbers on the scales zoom into the stratosphere.

I would add that environmental changes need to be made, as well. Don’t bring food into the house that isn’t healthful, except on rare occasions. Use smaller dishes. I have a set of dishes from my husband’s family. You’d be amazed at how small the sizes are compared to today’s dinnerware.

And a note for myself: Jan, go back to your newspaper reporting days, when you never would have relied on secondary sources. This goes back to when I was 16 years old and thought I would be a band director when I grew up. We were at band camp when one of the boys dove into the swimming pool and injured his spine. The newspaper story that followed was full of incorrect information. After all, I was there: I was the one who pulled my friend off the bottom of the pool and got him to the side where he could be lifted out and revived.

It was a slap of reality: News reports aren’t always correct. Today, they can be very biased. Sensationalism is frequently at the forefront. When I was in the “business,” we presented the facts on both sides and left it to the reader to interpret what happened. Kind of a Joe Friday’s “just the facts, ma’am.” (He was a sergeant in a 1950’s television series called Dragnet — which you can watch on Hulu.com — and, yes, I’m showing my age!)

I apologize to you, and to Daniel Callahan. And, with thanks to Katherine, I promise — no more secondary sources.

POST A COMMENT       
  

We are currently experiencing technical difficulties with our commenting system. Thank you for your patience as we work to resolve them.


Weight Loss
Is Weight-Loss Surgery for You? Pros and Cons (11/24/14)
Is Weight-Loss Surgery for You? (11/17/14)
Can Grapefruit Juice Prevent Weight Gain, Increase Insulin Sensitivity? (10/16/14)
Whittle That Middle: A Trimmer Waistline Improves Your Health (09/22/14)

 

 

Disclaimer of Medical Advice: You understand that the blog posts and comments to such blog posts (whether posted by us, our agents or bloggers, or by users) do not constitute medical advice or recommendation of any kind, and you should not rely on any information contained in such posts or comments to replace consultations with your qualified health care professionals to meet your individual needs. The opinions and other information contained in the blog posts and comments do not reflect the opinions or positions of the Site Proprietor.