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The World Health Organization, justifiably regarded as a top authority on matters of public health and health policy, just released a final report from its Commission on Ending Childhood Obesity. It includes a whole slew of guidelines, but one that's grabbing headlines is backing for a tax on free sugars — those specifically in sweetened beverages like soft drinks and soda — reinforcing the global trend in that direction.
Several countries have instituted sugar taxes, as have some U.S. cities, and many are congratulating themselves over their brave blow against fat children, while others publish bombastic editorials about the need to make soft drinks and soda more expensive via the so-called "sin tax."
Fat kids are in for more shaming than they ever were before, making growing up fat extremely dangerous — but not because of their body weight. In just one example, a gross campaign in Georgia plopped a bunch of fat kids on billboards with stigmatizing labels in 2011. In response, fat activist Marilyn Wann started Stand4Kids, a collection of fat-positive affirmations featuring happy fat adults. These kinds of shaming campaigns and constant media fluttering about a "childhood obesity epidemic" serve to legitimize the shaming and harassment of fat children, reinforcing a "it's for their own good" argument.
Given that the subject of weight and health has been covered amply (haha) and ad nauseum here before, I don't want to derail this entire conversation with the subject, but in a nutshell: Fat is not a predictor of health, claims that the obesity rate has "jumped" should be viewed with a dump truck full of salt considering that the guidelines keep shifting, and the prejudice against fat people has nothing to do with concerns for their health and everything to do with social attitudes about fat bodies and the idea that fat people are gross and should hide at home. In other words, I reject the notion that people in general should lose weight in order to be healthy, and I do not support widespread public health interventions designed to promote weight loss.
Moreover, weight is not a simple calories in/calories out equation, as scientists were actually surprised to learn. The amount of post-prandial glucose in the blood (a big predictor of type two diabetes risk, with diabetes being closely associated with fat in the scientific and public eye) is not as closely linked to what people eat as weight loss proponents claim — in fact, the body is a microbiome, and every body really is a special snowflake that responds differently to food. Thus, general weight loss recommendations aren't even applicable to everyone, even if people think that being fat is always universally a bad thing (which it isn't, health-wise or morally).
These recommendations, which are part of the good food/bad food dichotomy that demonizes sugar (and various other foods depending on what is in or out of vogue), are joining the chorus of fat-shaming aimed at children. It's counterproductive — if the goal is to reduce weight on the grounds of claims that higher body weight makes people unhealthy, at any rate — and it's emotionally damaging. People who consistently encounter fat-shaming in childhood aren't exactly being set up for a lifetime of healthy relationships with food, or their bodies.
Fat shaming comes at a high cost for fat children
In fact, dieting as a child or adolescent tends to contribute to the development of eating disorders, which can have life-long emotional and physical health consequences. Perhaps unsurprisingly, young girls — especially fat girls — are experiencing a growth in disordered eating in response to weight shaming and teasing, but children of all genders are experiencing a radical uptick in eating disorders, showing that this isn't just a result of an oppressive sexist beauty culture and pressures on young girls and women.
Lest ye leap into the fray with the perfectly valid criticism that correlation is not causation, a fundamental of science, researchers have noted a direct connection between school health programs targeting fat children and eating disorders. Orthorexia, the dogged and frantic pursuit of "healthy" and "pure" foods, is on the rise. While it's not a formal clinical diagnosis (yet), this quest for "health" is driven by in-school education programs that paint fat as the enemy and suggest that it's critical to get less fat at all costs.
The costs of fat-shaming children can be seen on the wall: Diabetes is less common in children than eating disorders. Diabetes is used as one of the most common scapegoats in the pursuit of making fat children feel terrible about themselves. Eating disorders caused by being hounded by fat shamers are more common than a health condition that actually doesn't necessarily have anything to do at all with fat — there are different forms of diabetes, genetic factors can play a huge role, and so can some lifestyle factors.
Fat people who experience discrimination on the basis of their size tend to gain more weight — fat shaming, in other words, really doesn't work at all. Studies focusing on weight stigma in young girls came to similar conclusions, noting that these bold public health campaigns coming to the rescue of fat children everywhere are actually doing just the opposite.
Oddly enough, it would appear that being told you and your body are disgusting tends to have the effect of dehumanizing you. How dehumanized? Kids who think they're fat are more at risk of suicide. And fat people of all ages are at risk of sometimes fatal medical discrimination — almost every fat person can tell a story of going to the doctor for something completely unrelated to weight, only to be told to lose weight, or, worse yet, to be told to "come back when you're lost weight," only to develop serious medical complications.
The war on sugary drinks
Multiple meta-analyses of research on the subject claim that increased free sugar intake, specifically in sweetened drinks, increases body weight. Meanwhile, proponents of sin taxes suggest that, given the success of increased taxation on tobacco, increasing the cost of sweetened drinks via taxation would reduce their consumption. But these claims are more complicated than their proponents like to let on.
Literature reviews of research on free sugars and weight gain include very stringent acceptance requirements to find studies that will provide the most accurate results — they don't include cohort studies that only extend for a brief period of time, for example, or studies in which subjects were encouraged to undertake other measures designed to promote weight loss, such as caloric restriction and exercise. However, there are some factors that cannot be controlled, and these are genetic and environmental — if one accepts that fat in children is bad, which again I do not, these factors would need to be addressed as well.
While genetics isn't a sole determining factor, it's clear that there is a linkage between genetic heritage and weight regardless as to what someone eats. People with certain genes have to work much harder to lose weight and keep it off than others, at times endangering themselves with aggressively restrictive diets and excessive exercise programs. Those same genetics can contribute to the development of health conditions associated with weight gain, ensuring that almost from the start, people are holding a one-way ticket to Fatlandia.
The real kicker is environmental, though, because fat isn't just about what you eat or how much you exercise. It's about where you live, what kinds of foods are available to you, and even things like your educational attainment level. Low-income people aren't fat because their families stuff them full of "junk food" — or at least, if that's a factor for some people who gain weight on a diet high in saturated fats, sugars, and starches, it's not the only one. They're also more likely to live in areas with environmental pollutants that can disrupt the metabolism and endocrine system. They're more likely to live in areas where it is impractical or unsafe to exercise, and where exercise programs through schools may be more limited. They're more likely to live in areas where health care is limited, and underlying health care conditions that contribute to weight gain go unidentified — instead, they're just shamed for being fat.
Class has a huge influence on opportunities. Better-educated people have a better chance at class mobility and are more likely to get out of unhealthy communities, while those born into wealth start out several rungs up the ladder and tend to stay there. Unsurprisingly, their children tend to benefit from their wealthy environment, obtaining access to health care and other needs.
Those sugary drinks may be linked with weight gain — though researchers in metadata analyses themselves acknowledge that results are conflicting — but they aren't the only factor. Sin taxes tend to penalize people, putting even more stress on low-income communities. Tobacco sales have certainly declined as a result of higher taxes as well as public health interventions, but notably, tobacco is actually provably dangerous to the health of the consumer. Furthermore, tobacco causes proximal health problems in the form of secondhand smoke.
In this sense, regulating tobacco is like regulating guns: The owners wreak havoc on the people around them. Commonsense regulation protects members of the public from harm, because these things aren't about individual choices, but rather public good.
Being fat might cause people emotional distress as they are forced to look at fat people and acknowledge them as human beings, but that's not a health problem, that's just a "being a decent human being" problem, which fat people can't be held responsible for.
Taxes aggressively attacking sweetened drinks may contribute to overall weight loss (but not necessarily across all individuals or communities) in regions where they're implemented, but they come with a high associated cost. Many fat haters believe that being dead is better than being fat, and their war on fat people illustrates how seriously they take that maxim: They'll shame children even if it increases their risk of suicide or eating disorders, all for the sake of ensuring that they're thin.
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