Tuesday, June 19, 2007

Only the Finest Propaganda will Solve Childhood Obesity

Yes, life sometimes gets in the way of my blog posts; rather than keep you waiting for a fully referenced article I was hoping to post as follow up to the new recommendations to address childhood obesity, issued jointly from the AMA, CDC and HHRS, I'm going to keep this short and point first to a massive, 400+ page, document - Preventing Childhood Obesity: Health in the Balance - published in 2005 by the Food & Nutrition Board (FNB) of the Institute of Medicine (IOM) that painstakingly reviewed the evidence published regarding childhood obesity.

When you take some time to read it, you'll notice some critically important statements thoughout:

"Empirical data is lacking..."

"...problem exists, causes less clear..."

"...little clarity about the relative importance of possible causitive factors..."

"...a robust evidence base is not yet available."

"In reviewing the available evidence to inform this report, there was an abundance of scientific studies on the causes and correlates of obesity, but few studies testing potential solutions with diverse and complex social and environmental contexts, and no proven effective population-based solutions."

But that's okay, let's press forward without hard data; the latest AMA recommendations seem to have ignored the above lack of data and even ignored that the IOM document specifically states that within their publication there is "limited literature upon which to base these recommendations..." and chose instead to concentrate on "...parallel evidence from other public health issues..." to side-step empirical data and move forward to modify public opinion anyway.

"Now that the nation has begun to realize the significant health, psychological and societal costs of an unhealthy weight, it is time to re-examine its way of thinking and revise the social norms that are now accepted."

"In the absence of precise understanding of the eitology of the problem, it may be useful to look at the lessons learned from other public health campaigns and to try and determine if these lessons have any relevance for the prevention of childhood obesity."

Their playbook to resolve childhood obesity? Lessons learned from tobacco control, seat belt enforcement, underage drinking, childhood vaccination, and regulation of speed limits; with the most notable precedent examples throughout the section on Lessons Learned from Public Health Efforts and their Relevance to Preventing Childhood Obesity being the stunning success of tobacco control initiatives, that now leave smoking, in the minds of the majority of society, "nearly considered, if not deviant behavior, at least one in private;" and they note the magnitude of the change in public perception of smoking over the years of gradual change, from a time when smoking was viewed as a private matter, to now when smoking is viewed as a moral failing and deviant behavior.

They note, "Culture is not a static set of values and practices," and that programs to prevent and reverse obesity need to balance "the role of coersion versus the individual."


How they fail to see the under-current of shame and moralizing a behavior like smoking is scary. We're going to now do this with children, kids who happen to weigh too much for their age and height? Have we lost our minds?

Oh, it just gets better though.

The 'best practices' to be employed in a national campaign to address childhood obesity:
  • Community-wide campaigns
  • School-based initiatives
  • Mass media strategies
  • Laws and regulations
  • Provider reminder systems
  • Reduce costs to patients
  • Home visits

The list includes elements of both formal planned interventions and recognized cultural and social factors. Detailed too are the necessary elements to convince the population at large there is a problem that requires drastic measures:

  • A persuasive science base documenting a socially and scientifically credible threat
  • A supportive partnership with the media
  • Strategic leadership and a prominent champion
  • A diverse constituency of highly effective advocates
  • Enabling and reinforcing laws, regulations and policies

Notice above, the critically important factors are not solid evidence, but persuation, packaging the message for the media to propogate to the public, repeat the message through advocates and champions, and regulating laws and policies to conform to the pursuasive messages.

That's not science, that's carefully orchestrated propaganda.

"Propaganda is the deliberate, systematic attempt to shape perceptions, manipulate cognitions, and direct behavior to achieve a response that furthers the desired intent of the propagandist." Source: Garth S. Jowett and Victoria O'Donnell, Propaganda And Persuasion, 4th edition, 2006

This is what public health experts intend to do to our children.

In stunning clarity, the document provides insights into what we can expect in the coming years:

"Tough choices will have to be made at all levels of society. There will be trade-offs in convenience, in cost, in what's 'easy', in pushing oneself and one's organization, in choosing between priorities, in devising new laws and regulations, and in setting limits on individuals and industries."

The second document I'd like to direct your attention to is from the US Preventative Task Force, published in 2006, Screening and Interventions for Overweight in Children and Adolescents: Recommendation Statement.

It states, "There is insufficient evidence to ascertain the magnitude of the potential harms of screening or prevention and treatment interventions. The USPSTF was, therefore, unable to determine the balance between potential benefits and harms for the routine screening of children and adolescents for overweight."

Now, in 2007 - with no new science and still no compelling evidence, no empirical data, absolutely nothing more than "hope" this will work, the AMA, CDC, and HHRS is jumping in with both feet, and expects all of us to do the same; expects we'll all get on board, full steam ahead with little more than our fear that if we do nothing, our kids are going to die prematurely; anything is better than nothing.

Except that anything is may wind up destroying our children in the long-term.

But hey, they won't be fat, right?

The direction we're now heading in stubbornly and without evidence, reminds me of something Aldous Huxley said in a speech at the California Medical School in San Francisco, 1961:

"There will be in the next generation or so a pharmacological method of making people love their servitude and producing dictatorship without tears, so to speak, producing a kind of painless concentration camp for entire societies so that people will in fact have their liberties taken away from them but will rather enjoy it ... [through] brainwashing enhanced by pharmacological methods."

In the 1953 publication of The Impact of Science on Society, Bertrand Russel penned the following:

"Scientific societies are as yet in their infancy. . . . It is to be expected that advances in physiology and psychology will give governments much more control over individual mentality than they now have even in totalitarian countries. Fitche laid it down that education should aim at destroying free will, so that, after pupils have left school, they shall be incapable, throughout the rest of their lives, of thinking or acting otherwise than as their schoolmasters would have wished." "Diet, injections, and injunctions will combine, from a very early age, to produce the sort of character and the sort of beliefs that the authorities consider desirable, and any serious criticism of the powers that be will become psychologically impossible."


  1. Anonymous12:00 PM

    My, oh, my. What a terrifying set of circumstances we're all faced with. This was a great, well-written and thought out posting. I just wish it wasn't so true. What's on the horizon is awfully frightening. So glad you posted again!

  2. Anonymous2:41 PM

    Page 92 of that monstrousity says that one small chocolate chip cookie is the equivalent of walking briskly for ten minutes. Calories in, calories out, right? One peach has about the same calories as a small cookie so,
    one small cookie = ten minutes walking, one peach = ten minutes walking and therefor, one small cookie = one peach, right?

  3. one small cookie = ten minutes walking, one peach = ten minutes walking and therefor, one small cookie = one peach, right?

    Hey now ::wink:: looks like you've got it exactly!

  4. Anonymous8:53 AM

    All the brainwashing and propaganda in the world won't change the effects of the low fat/high carb diet! Kids will be brainwashed AND fat.

  5. Anonymous5:13 AM

    People don't tend to sit there and eat a whole box of peachies though do they? Cookies also tend to be empty calories, unlike fruit.

  6. The food pyramid propaganda has failed. Now we might get the foold pyramid shoved down our throats by law. Give me liberty (and low carb) or give me death.

  7. Anonymous10:46 PM

    To the previous anonymous: Fruit still contains sugar, and I suspect the main reason (aside from messiness) that more people don't gorge out on fruit is that it has a built-in self-correcting mechanism: frequent trips to the potty. But fructose in large amounts is not good for anybody, and the vitamins you can get from fruit can also be found in vegetables.

    Re: smoking: I would hope smokers get shamed and blamed into making their behavior more private--that is, not blowing smoke in the faces of people who have chosen not to use this particular drug. People don't seem to realize that smoking a cigarette is not like taking a drink or popping a pill. When you do either of the latter it is self-contained and affects no one else around you. When you smoke you spread your drug to everyone within breathing distance. It is long past time we started discouraging smokers from forcing their drug use on others. It's not at all the same as making a child feel guilty for not meeting the height/weight requirements.

    That said, this looks like an awesome blog. Keep up the good work. :)

  8. God, I hope Canada stays far, far away from this and anything like it. Scary.

    Of course we all know that being overweight is a moral failing, and the remedy is just eating less and exercising more. *sarcasm alert*

  9. You know, there is a lot of discussion around childhood obestiy, clearly a surfeit of talk, when what we really need is some good, old fashioned common sense. Enough talk. Feed our children fruits and vegetables and whole grains and take away desserts masquerading as food, such as cereal, and chemicals pretending to be meals, such as processed foods. Then, suddenly, the problem will disappear.


  10. Anonymous11:38 AM

    People don't tend to sit there and eat a whole box of peachies though do they?

    They're kind of large and full of water but I could easily put away four or five back when I still ate fruit regularly. Eat one, crave another and another and another... I didn't even realize what I was doing. My whole family is like that.

  11. Anonymous8:45 AM

    I fully admit I could sit and eat a whole tray of peachies, strawberries, bananas etc etc. Yes it is all sugar, but there are other things in there too, good things. But you cannot say that of cookies, fries, processed meals stripped all anything that needs digesting and chemical filled 'low fat' deserts. The UK has seen a rise in malnutrition recently especially in overweight kids eating nutritionally void high fat junk food. I think when you see this kind of thing happening getting even a slightly healthier choice is more important than fine tuning which comes later. Some people thing veggies = fries.