Review of Weight of the Nation, Part 4: Challenges

On Wednesday May 9, 2012, I attended a screening of the upcoming HBO four-part series Weight of the Nation. During the screening the audience was only shown Part 4: Challenges.  I went to the screening knowing I would be angry, however I attempted to have an open-mind. I left feeling both impressed and disappointed. 

I was glad to see an acknowledgement of the complexity of the health issues facing America. The episode reviewed the largely subsidized corn and soy industry and made references to food deserts in low income areas. A lifespan disparity of 20 years within a 10 miles radius between affluent and poor neighborhoods was informative and disturbing.

The lack of safe and appropriate playgrounds, sidewalks, and areas to bicycle were also emphasized.  A corner food market/liquor store in a low income area was visited to exemplify the food choices for the people living in the community. A small bag of potatoes chips was 25 cents while a banana and an apple were one dollar and 25 cents all together.  

This particular community did not have access to a supermarket.  The corner food market/liquor store was their only affordable access to food.  However, within this review of social, governmental, and economic factors there continued to be a complete lack of regard for body size diversity and fat acceptance. 

As I watched the screening I fidgeted in the small, hard, uncomfortable chairs as once again “obesity” was identified as a problem and the cause of chronic illnesses.

Obesity was being used beyond its’ actual definition. Obesity is typically defined by BMI standards (30 or greater) and is commonly used to describe a particular appearance related to body size and type. 

BMI is used as a statistical measure and should not be used as an individual health assessment. Additionally, obesity is not a word that should be used to describe social, economical, or nutritional problems.

Obesity was still partly targeted for the major health and economic problems facing America today. However, coming back down to reality, obesity is a word from an archaic categorical system that describes a group of people with a BMI of 30 or greater.  Unfortunately, the people within this category have now become the scapegoat and consequently the perceived problem. 

I found it ironic that the campaign against smoking was related to the fight against obesity. The message was along the lines of “we did it before, we can do it again.” The film ignores a crucial difference between smoking and obesity.

Smoking is the cause of health problems, obesity is sometimes a symptom of health problems. The fight against smoking was not led by the tagline “to win we need to whiten our teeth,” or “to win we need to gain the weight lost by the appetite suppression of smoking.”  

The campaign was about a behavior, it was anti-smoking. Why is it that the current fight for health is so narrow and misguided?  We call it anti-obesity or really anti-larger body types.  If it is really about health shouldn’t we be looking at the issue through a different lens all together?  Let’s have a campaign for health promotion!

At the beginning of part four, various large body types are displayed as if on an assembly line with a white background.  During this introduction the possibility that some of these individuals are healthy is never broached.

As the audience is shown one large person after another, the camera cuts to an interview with each person as they review their list of health problems. Not one person is presented as being both large and healthy.

Additionally, there is a complete lack of diversity of body types. For example no one on the assembly line would be considered thin or of average weight by the outside observer. The only message to walk-away with from this introduction is obesity equals illness and early death, while thinness equals healthy. 

As a therapist who specializes in eating disorder treatment I was gravely saddened by this message.  Weight-loss is horrifically glorified in the film’s tagline “to win we have to lose.”

We know that the majority of eating disorders are partly influenced and developed through body dissatisfaction and dieting.  In the episode a young boy is playing in a parking lot while his mother sadly watches.  

The boy tells the woman interviewing him that he would like a park to play in. He whispered his reason for justifying a park in his neighborhood while he stood half-way behind his mom.  

His reason: “you know...I am fat.”  Is this the message we really want to be sending? You should play to lose weight and avoid gaining weight? Weight-loss would make the multi-billion dollar dieting industry happy, but does it really make Americans happy?

Although I know a big part of the reason this series is missing ideas from the Health at Every Size movement is due to profit for some I am still shocked and disappointed that an opportunity to spread awareness was passed up by all those involved in the Weight of the Nation series: Institute of Medicine (IOM), Centers for Disease Control and Prevention (CDC), the National Institute of Health (NIH) and Kaiser Permanente.  

As I have not seen the other episodes yet, I am not sure what they will specifically review, however if anyone next week happens to only view the “challenges” episode they will walk away with more awareness of the social and governmental factors related to the health problems of America, but also a strengthened belief that obesity is wrong and inherently bad.

For additional responses to the Weight of Nation series, Deb Burgard provides an exceptional review of critical thinking skills to arm yourself with as you watch the program next week. She also provides facts to dispel the myths and false information that the episode “challenges” continues to propagate.