Obama admin stepping up its anti-obesity rhetoric

[firecat]

Where I'm coming from: I am an Obama supporter in most ways. I support health care reform in the US and want everyone to have affordable access to health care. I am concerned about some of the rhetoric of health care reform right now.

I would welcome your suggestions about fat-activist communities to send this message to.

The Obama administration's first forays into health reform focused on eating habits and exercise, without mentioning weight per se. But that seems to be changing. Over on http://healthreform.gov/ there are now a number of articles claiming that it is possible to "prevent" obesity, diabetes, and heart disease.

In one article there are claims such as "85 percent of the money spent on health care goes toward people with at least one chronic condition." The article also promotes the claim "Scientists say this generation of American children may not live as long as their parents did," which was literally mapped out on the back of a napkin and is based on the now-debunked "fat kills 400,000 people a year" statistic. http://healthreform.gov/forums/secretaryscorner.html

The first bullet point in the "Closing the Gap" article about disparities in health care availability among ethnic minorities is: "Obesity is debilitating and is often a catalyst to chronic disease. Seven out of 10 African Americans ages 18 to 64 are obese or overweight, and African Americans are 15% more likely to suffer from obesity than Whites." http://healthreform.gov/reports/healthdisparities/index.html (Lack of access to health care is a huge problem, and it's vital to bring health care access to under-served groups. But I don't think that sticking more African Americans on diets is the best first priority.)

One of the major items linked from the first page of healthreform.gov is an op-ed from the CEO of Safeway, which includes such claims as: "70% of all health-care costs are the direct result of behavior." "74% of all costs are confined to four chronic conditions (cardiovascular disease, cancer, diabetes and obesity)." "80% of cardiovascular disease and diabetes is preventable... more than 90% of obesity is preventable." http://healthreform.gov/forums/whatpeoplearesaying.html#rewarding_healthy_behavior

I think the fat activist communities need to address the Obama administration's overfocus on "obesity."

• We need to explain that weighing more than the government approved BMI is not a health condition. If fat people incur more medical costs than thin people (which I'm not convinced is true), it's partly because so many of us are either (a) ignored with "go away and lose weight" when we go to doctors with real conditions, until those conditions become drastic (see the First Do No Harm blog for some tragic and infuriating examples), or (b) treated as if we are at death's door, just because we weigh more, and subjected to unnecessary tests and "treatments".
• We need to explain that weight and diabetes are largely genetic and debunk silly statistical claims such as "90% of obesity is preventable."
• We need to explain that weight is not a behavior.
• We need to explain that blaming people with chronic health conditions for the high cost of health care in the US is not a good strategy for lowering health care costs or improving health care access for women and ethnic minorities.

(I would welcome being convinced that this is just a bunch of hot air and not a hammer about to come down on the backs of fat people. But I am worried.)

Note: I am not going to allow debates on the benefits of weight loss or the possibility of achieving permanent weight loss in this journal entry.

Comments

[amadi]

When I heard Obama stepping up the anti-fat rhetoric, my heart fell. This administration has been so full of fail on my other "personal" issue -- LGBT rights -- that to have them starting on the "fat people are costing us money" and to trot out all the debunked crap about people losing weight to not get diabetes from his own mouth just really set me off. I already rampaged a bit about the DOMA nonsense, I'm wondering, though, what lists I'll end up on if I send a second angry missive through whitehouse.gov in the span of a week.

[firecat]

debunked crap

This is what really disturbs me. My impression was that Obama has knowledgeable advisors. But if his administration is still prattling about the urban legend that this generation will live shorter lives than its parents? That makes me question the other information coming out of his administration, which I don't know enough about to judge for myself.

I am mad about the LGBT fail too, but I'm afraid I expected it.

[amadi]

My guess is that they're taking points from the CDC and the Public Health Corps and they're both firmly in the "OMGFat Kills!" camp, clinging to medical science that's five years out of date. And yes, that's really, very disturbing.

And you know what's most bothersome is that none of this "lawyer takes bad talking points from statisticians with no medical knowledge" is even necessary. There are so many better illustrations of the shortcomings of our current insurance system (or lack thereof) I don't know who he thinks he's winning points with by beating the "gotta lose weight" drum.

[aquaeri]

The problem with the medical science is not even that it's five years out of date, if it's the same paper firecat linked back then. The text of the paper (which I think had the 400,000 number) was in direct conflict with the data in the same paper - that's the first time I saw a survival curve at which the best survival was at BMI 25 and the authors never mentioned that! Because it didn't match the conclusions they wanted to draw.