Thursday, March 13, 2008

The Obesity Police Are Coming

Lawmakers in Mississippi have proposed a bill that would revoke the business license of any restaurant that serves food to fat people, as measured by state health standards. Proponents of the paternalistic nanny-state are intent on transforming obesity into a public health issue. But obesity is a private health matter, of no legitimate concern to government.

Each individual has a right to life, which includes the right to eat as one sees fit. A rational judgment about what to eat takes into account many individual factors--nutritional needs, metabolism, genetics, medical history, and a doctor's advice--as well as the pleasure of eating and one's personal views on body shape. The fact that some people may irrationally maintain an unhealthy weight by overeating cannot justify government control over food intake.

Legitimate public health measures, such as quarantining persons with infectious diseases or outlawing disease-spreading cesspools, involve shielding innocent victims from physical force. But fat people do not emit physical forces that impede other people's freedom of action. Hence, government has no right to prevent or punish obesity.

Some say body weight is a proper subject of legislation because taxpayers bear the burden of treating obesity-related maladies. But the solution to escalating health-care costs is not to surrender control of our bodies but to question the prevailing view that government should be involved in paying for health care.

Obese individuals have the same right as anyone else to decide what to eat, and restaurant owners have a right to choose whom they will serve. The Mississippi legislative proposal is a particularly ugly, arrogant attempt to decree public ownership of human bodies. As such, it is an attack on everyone's freedom, and it should be denounced as such.


Fat kid = unfit parent?

The societal panic over childhood obesity, already entrenched in the medical system and evident in the furor over school lunches, is beginning to influence custody judgments and child-welfare authorities in their decisions about fitness to parent. An Ontario family court judgment involving the Children's Aid Society recently cited obesity as a reason for removing a child from the parental home, after determining the mother was contributing to her child's weight gain and was oblivious to the required medical regime.

The details of the case are covered by a publication ban, but the theme is echoed in another case, an epic nine-year custody battle that wrapped up in a Newmarket courtroom last month, much of which centred on the comparative merits of the battling parents in adhering to a diet plan for their obese twins. The children, who were toddlers when the custody dispute began and who were 10 when it was finally resolved in favour of the mother last month, have spent most of their lives in intensive hospital-based obesity programs.

The custody dispute between their parents, Robert and Lisa, pushed the limits of the extent to which childhood obesity could be considered a result of parental neglect, with evidence in the case using language that makes poor nutritional choices seem tantamount to child abuse. The father, Robert, for example, argued that it was "manifestly obvious that the health and very lives of the children were under imminent threat due to their mother's refusal to comply with prescribed nutritional regimes and not overfeed the children," according to the judgment in the case, released on Feb. 11.

The case even drew on the evidence of a renowned childhood obesity expert, Dr. Glenn Berall, chief of pediatrics at North York General Hospital, who described himself as an "advocate for the children" and who urged the court to place the children in the direct care of the parent who had demonstrated the ability to comply with a prescribed weight-management program and to restrict access to the parent who did not reasonably comply. Elliot Birnboim, the lawyer for the mother in the dispute, said this case was the first time the issue of childhood obesity was the primary issue put forth for determining custody.

Even adoption applications are being considered in this way. Last summer, a family court judge in Kansas City deemed Gary Stocklaufer "an unfit adoptive parent" because he was grossly overweight. Weighing more than 500 pounds, he was rejected for health reasons, but was awarded custody this year after undergoing gastric bypass surgery and losing about 200 pounds.

These far-reaching measures suggest the state may increasingly seek a role in the kitchens of the nation, a reflection of cultural attitudes that put obesity beyond mere medical concern and perhaps more in line of social scourge. A recent study found that Canadian childhood obesity rates rank fifth-highest of 34 developed countries. Rates have soared in the past 30 years, from 5% to 30%, with more children reporting ailments common in obese adults, such as joint degradation, Type 2 diabetes, hypertension and respiratory illnesses.

The morality of obesity has come up in the debate over the rise in the number of patients considered "super obese," and whether the medical system or the patient should bear the cost of oversized equipment. Charlene Elliott, an assistant professor at the University of Calgary who researches obesity, was not aware of these specific cases, but said it is interesting to consider "ways in which society's attitudes on obesity play out differently depending on whether the obese individual is an adult or a child."

"If you examine both the media and societal framing of obesity, you will observe a consistent shift in terms of responsibility depending on who is obese. Adults are considered to be responsible for their own bodies [and body size] whereas children are framed as vulnerable -- 'victims' of adult decisions and, therefore, not responsible for their size," she said.

She said this attitude is why, in the context of childhood obesity, there are "all sorts of social engineering remedies playing out," such as policies intended to make the environment more healthy for children, including the lobbying to extend the ban Quebec has on television advertising to children under the age of 13 to the rest of Canada, the banning of sugary sodas in elementary schools, and the mandatory 20 minutes of physical activity in schools.

"My take on this is that obesity should be treated no differently than other cases where conditions can lead to limited fitness to parent," said Dr. Arya Sharma, chairman for obesity research and management at the University of Alberta and scientific director of the Canadian Obesity Network. "Obesity is not a moral failing or necessarily always a lifestyle problem. One has to very specifically look at the causes of obesity -- these can be varied, ranging from genetics, mental-health problems, medications and other issues that may be difficult to control. [In the case of parenting] with the exception of extreme cases, where severe obesity may result in physical limitations to actually look after the kids, in itself increased body weight does not necessarily translate into inability to parent."

Mr. Birnboim, the lawyer in the Newmarket custody dispute, said the ruling was significant because it swept aside "the prejudices about obesity" to try to consider the overall condition of the children. According to the judgment, the parents "have been in almost continuous litigation concerning the diet, health and residence" of their twins. When the children were just two years old, Dr. Berall determined the boy was morbidly obese and his sister overweight, and set them on a prescribed course that included twice-weekly weigh-ins. At one point in the long-running custody battle, he told the court "consistently, with rare exceptions, the children lost weight under the care of their father and consistently gained weight, with rare exceptions, under the care of their mother."

Robert, the father, put forth a custody plan that gave him "sole responsibility for the children's health care, for the primary reason that he could enhance and direct the children's ongoing weight-management program," the judgment said.

The mother, Lisa, argued against the father gaining full custody, saying that his approach to parenting was "his continuous attendances with the children on numerous medical reviews, weigh-ins and the administering of blood tests; combined with his continuous negative references to others and directly to the children that they are overweight, not normal and are ill and in danger of developing certain conditions or diseases."

In the end, the court determined that primary custody should go to the mother, where the children seemed most happy and well-adjusted, while conceding "the weight-management of the children was a problem that needed addressing." "There's no question that obesity has been a hot issue," Mr. Birnboim said. "Not to downplay the health issue, but we've got to push aside some of the prejudices we have about obesity. It doesn't preempt having a happy, well-adjusted child."



Just some problems with the "Obesity" war:

1). It tries to impose behavior change on everybody -- when most of those targeted are not obese and hence have no reason to change their behaviour. It is a form of punishing the innocent and the guilty alike. (It is also typical of Leftist thinking: Scorning the individual and capable of dealing with large groups only).

2). The longevity research all leads to the conclusion that it is people of MIDDLING weight who live longest -- not slim people. So the "epidemic" of obesity is in fact largely an "epidemic" of living longer.

3). It is total calorie intake that makes you fat -- not where you get your calories. Policies that attack only the source of the calories (e.g. "junk food") without addressing total calorie intake are hence pissing into the wind. People involuntarily deprived of their preferred calorie intake from one source are highly likely to seek and find their calories elsewhere.

4). So-called junk food is perfectly nutritious. A big Mac meal comprises meat, bread, salad and potatoes -- which is a mainstream Western diet. If that is bad then we are all in big trouble.

5). Food warriors demonize salt and fat. But we need a daily salt intake to counter salt-loss through perspiration and the research shows that people on salt-restricted diets die SOONER. And Eskimos eat huge amounts of fat with no apparent ill-effects. And the average home-cooked roast dinner has LOTS of fat. Will we ban roast dinners?

6). The foods restricted are often no more calorific than those permitted -- such as milk and fruit-juice drinks.

7). Tendency to weight is mostly genetic and is therefore not readily susceptible to voluntary behaviour change.

8). And when are we going to ban cheese? Cheese is a concentrated calorie bomb and has lots of that wicked animal fat in it too. Wouldn't we all be better off without it? And what about butter and margarine? They are just about pure fat. Surely they should be treated as contraband in kids' lunchboxes! [/sarcasm].

9). And how odd it is that we never hear of the huge American study which showed that women who eat lots of veggies have an INCREASED risk of stomach cancer? So the official recommendation to eat five lots of veggies every day might just be creating lots of cancer for the future! It's as plausible (i.e. not very) as all the other dietary "wisdom" we read about fat etc.

10). And will "this generation of Western children be the first in history to lead shorter lives than their parents did"? This is another anti-fat scare that emanates from a much-cited editorial in a prominent medical journal that said so. Yet this editorial offered no statistical basis for its opinion -- an opinion that flies directly in the face of the available evidence.

Even statistical correlations far stronger than anything found in medical research may disappear if more data is used. A remarkable example from Sociology:
"The modern literature on hate crimes began with a remarkable 1933 book by Arthur Raper titled The Tragedy of Lynching. Raper assembled data on the number of lynchings each year in the South and on the price of an acre's yield of cotton. He calculated the correlation coefficient between the two series at -0.532. In other words, when the economy was doing well, the number of lynchings was lower.... In 2001, Donald Green, Laurence McFalls, and Jennifer Smith published a paper that demolished the alleged connection between economic conditions and lynchings in Raper's data. Raper had the misfortune of stopping his analysis in 1929. After the Great Depression hit, the price of cotton plummeted and economic conditions deteriorated, yet lynchings continued to fall. The correlation disappeared altogether when more years of data were added."
So we must be sure to base our conclusions on ALL the data. But in medical research, data selectivity and the "overlooking" of discordant research findings is epidemic.

"What we should be doing is monitoring children from birth so we can detect any deviations from the norm at an early stage and action can be taken". Who said that? Joe Stalin? Adolf Hitler? Orwell's "Big Brother"? The Spanish Inquisition? Generalissimo Francisco Franco Bahamonde? None of those. It was Dr Colin Waine, chairman of Britain's National Obesity Forum. What a fine fellow!


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