Obesity Trends
Most Emory students who have taken a health or global health class have seen the CDC video of the staggering obesity trends in the US. If not, you must see it. 30 years ago, the highest rates of state-wide obesity were at 14 percent. Now, in the 2000’s, 14% is an incredibly low, unheard-of percentage of obesity. The rates of obesity currently exceed 30% for some states. Although debatable, obesity is considered an epidemic. When evaluating these CDC statistics, it’s easier to develop a stronger argument for obesity interventions in our country.
Hard Paternalism, Soft Paternalism, Maternalism
Holm asks “When can paternalism be justified?” The obesity rates in America have gotten out of hand. We are trying to combat the obesity trend with a larger focus on exercise and health (in grade schools, college, workplace, gyms, grocery stores, social media, etc.), remodeling the food pyramid, offering programs like weight watchers, etc. However, these are mostly voluntary interventions, and none of these interventions are coercive. As a country, it is difficult to impose mandatory interventions or any measures that represent the hard paternalism that Holm describes. On the other hand, we already use soft paternalism as a means to intervene in obese families; similar to the example of telling a smoker that if you smoke, you die, you can tell a mother that if you feed the child an unhealthy diet he will become obese and develop dangerous health problems. Furthermore, to soften the intervention and its accompanying statements, we can add maternalism to soft paternalism. For example, just like telling a mother that drinking alcohol during pregnancy can be potentially harmful, we can tell a parent that feeding their child an unhealthy diet can potentially harm the child, leading to preventable diseases like obesity and diabetes. Doctors use their social skills to talk to the parents of an overweight or obese child without sounding too offensive. Arguably, hard paternalism is too harsh, and maternalism may prove ineffective. Soft paternalism, whether or not used in combination with maternalism, is an effective way to introduce a need for intervention. This should most likely represent an intervention from a doctor (a pediatrician probably), or a different professional, such as a dietician.
Should Cost be a Factor?
Additionally, obesity contributes to America’s rising health costs. The CDC states that “in 2008 dollars, these [obesity] costs totaled about $147 billion.” Since then, obesity rates have not improved, and the cost has remained astonishingly high. Holm argues that we should not intervene with people’s lives and their comfortable lifestyles for the sake of money, but this is just the tip of the iceberg. The high costs associate with obesity are only a symptom of the problematic matter at hand. The statistics outlining obesity-related costs beg for attention- in this case, money can be used as a motivational factor for obesity interventions. Holm also states that “pure economic gain is usually not considered sufficient reason to claim that the common good is being promoted,” but this money comes from our tax dollars, and every person that pays taxes or utilizes the health system in the United States is affected by high healthcare prices. Although intervening would not result in economic gains, it will result in economic relief, since the strain of obesity on our healthcare system will loosen.
Conclusion
I agree that imposing interventions on obese children is paternalistic. However, if the kid is obese, the parents are probably obese, and their parents are probably obese too. The cycle of abuse has to stop somewhere. Intervening while a child is young can possibly break this vicious cycle. By employing well-phrased, maternalistic/ soft-paternalistic discussion, we can introduce interventions in a non-coercive way and possibly reverse some of the shocking trends we see in Obesity trends in the US.
Centers for Disease Control and Prevention. (2012). What Causes Overweight and Obesity? Retrieved from: http://www.cdc.gov/obesity/adult/causes/index.html
Holm, S. “Obesity Interventions and Ethics.” Arguing About Bioethics. Ed. Stephen Holland. London: Routledge, 2012. 392-97. Print.
I think this issue is a very important matter that the US needs to address more directly and effectively than it currently does. One of the major issues with obesity, is not the lack of knowledge, but the last of access to healthy food. First, it is expensive to eat healthy. For a family, who is making minimum wage, they will probably eat at Burger King instead of cooking a quinoaw burger. Let’s be real the amount of calories that fruits and vegetables buy is a lot less than processed foods buy for the same price. This causes families who are struggling financially to not afford to eat healthy. Even though they know the food is not healthy, they do not see the immediate effects of their unhealthy eating on their body, but they do see the effects of eating healthy on their bank account.
On the note about paternalism, I believe that we need a form of soft-hard paternalism. I would consider the not world famous movie, SuperSize ME, are perfect example of “soft-hard paternalism” This movie revolutionized the fast food industry and how people viewed their food. The movie is soft paternalism because a person needs to choose to watch it, but the message of the movie was hard paternalism. I think this media campaign against fast food was very effective and that we need to analyze effective methods of preventing obesity instead of sticking with the norm.
The obesity epidemic is a complicated issue because there is more to it than what appears on the surface. Sure, it seems the answer is simple: a healthy lifestyle = lower obesity rates. Many people now realize that there are adverse effects of a sedentary lifestyle and a poor diet. However, they may not be able to do anything about it. For example, some people live in food deserts, where the only thing surrounding them for miles is fast food restaurants. Some people have to work 3 or 4 jobs to support their family and only have the time and money to pick up fast food. Also, there is the obvious problem that some people just don’t know what constitutes a healthy lifestyle. The obesity problem is multifaceted and needs to be addressed from ALL sides of the problem in order to reduce obesity rates. Ironically, fatness was associated with abundance and the rich, but now it is associated with lower socioeconomic classes of society because they do not have access to gym memberships and a farmers market.
I whole-heartedly agree that paternalism is necessary to help prevent the rise of obesity, especially in children. It may seem slightly immoral to say that hard paternalism may be the best option to preventing the rise in obesity, but I believe that soft paternalism may just not be enough. I believe that through education, the rates of obesity can decrease. But before families and individuals start to listen to the great amounts of educational information they are offered, I believe that they must be coerced into making the better choices. Obesity is a disease/ health issue that has begun to travel from generation to generation. The sizes of the mothers and fathers and grandparents are similar to the sizes of the children. There are a few situations where the child may be obese, but the parents are not. However, there will still be evidence that the parents may be unhealthy while the child is obese or overweight. Some parents may offer their children food not thinking of the harms that are possible, not thinking of the issues that can occur in the future of the child’s life, or simply trying to make their child happy. Some parents may not received any education regarding healthful foods and thus until society and health care professionals provide these families with education regarding healthy foods, then the parents cannot be blamed. However, I believe that there should be rules and regulations that can help to decrease the amount of unhealthful foods placed in front of obese individuals. I believe that these regulations are to be more focused on industries and companies rather than on families and parents.
I agree that the obesity rates in America are certainly out of hand. If there ever has been a justification for paternalism, it is when thousands of people are slowly killing themselves by their lifestyle and dietary choices. I believe that we as a society have the responsibility of stepping in in order to save our population as well as prevent tax payers from paying for others’ poor lifestyle choices. It would be extremely difficult to establish mandatory interventions in terms of obesity and I’m sure people would not react well. But according to Holm’s definition, we very much are using soft paternalism in cases such as the limitation on trans fats. I think soft paternalism is likely the way to go in order to improve the obesity epidemic and should be imposed on more situations. I disagree with Holm saying that we should not intervene with people’s lives for the sake of money. We are not merely disturbing their comfortable lifestyles, we are saving their lives and saving American’s billions of dollars in an economy that can not afford to spend this kind of money. I think a huge problem is posed in the way to effectively implement these interventions in a way that does not feel paternalistic to the population and thus does not make them feel as though their freedoms are being taken away. The back lash over a simple limit on soda size available for purchase was ridiculous. We as a society have to find a way to better present these soft paternalistic interventions in order to successfully combat obesity.
These graphs are powerful and show the reality of the obesity epidemic facing our country. I think intervention is justified and ethical because these graphs reveal the rise in death rates and arguably a decline in quality of life across the country. Most people do not realize that their life style choices and development of obesity risk factors can lead to a shortened life expectancy until its too late. In the case of children, they are easily influenced and vulnerable to make the same choices as their parents or guardians. Thus, sedentary behavior and poor food choices can easily become the norm, and a child develops obesity risk factors before they understand the impact of lifestyle choices in health. Therefore, interventions need to target the parents, parenting behaviors, and children. There could be downstream effects from targeting children. For example, anti-smoking campaigns targeted children to teach them the dangers and death related risk of smoking. They utilized this grim reality to help children talk to their parents about quitting smoking as seen in the article “I Want to Help My Parents Quit Smoking.” This intervention would educate the most vulnerable, young children, and hopefully help to reverse the trends seen on those graphs for both adults and children. Once again, autonomy and a feeling of freedom must be maintained as mentioned by Mckenzie in order for these interventions to resonate with the population and be accepted.
Source: http://www.uihealthcare.org/2column.aspx?id=22833
I really liked how you began your post because I just recently saw these trends in my predictive health class and was completely mind-blown at the rapid increase of obesity in this country. I agree with you perfectly in the sense that we already have these soft paternalistic interventions that are not making a huge difference in the way parents feed their children but I think they are definitely a big step. A big issue is that parents are not educated about nutrition and are unaware. I liked your comparisons how just like we tell mothers not to drink when they’re pregnant because it harms the baby, we should tell them not to feed them a poor diet either because then they run the risk of developing diseases in their later life. People need to be educated and become aware. Though I think that this knowledge is a responsibility of the individual, I think that the media also plays a huge role. The media needs to promote healthy eating as opposed to making meals at McDonalds and Burger King look absolutely delicious to most people.
The data you showed was quite shocking that it seems that the obesity problem is out of control. The government has implemented many soft paternalistic interventions, but the rate of obesity is still increasing. It makes us wonder if soft paternalistic interventions are workings or should we try hard paternalistic interventions. If government decides to use hard paternalism, those extreme obese people are going to be strongly influenced and that their lifestyles have to change entirely. However, I don’t think it’s possible for anyone to change one’s lifestyle. I believe like the government should not only educate the citizens but also provide direct supports for the severely obese people to doctors, because most people who are suffering from obesity are mainly lower income families. Therefore, the government should try to combine soft paternalism and supportive intervention to solve the obesity issue.
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