Thank you to Anonymous blog reader KX for submitting the following two-part essay for my consideration. Amitai Etzioni on Obesity Public Policy Part One and Part Two. Do not be intimidated, my gentle readers. In PDF form, part one, before notes, is only three-and-a-half pages and part two is two-and-a-half.
I read the essay(s) before reading the author’s bio (silly, ignorant me), but as I read I could tell that he’s an outsider to our issue. He clearly doesn’t understand or divide out the players the way we might, or as I have. He has absorbed our issue as any intelligent, disinterested person might and then proposed public policy recommendations in keeping with his particular theory and area of expertise.
Amitai Etzioni is a respected public policy scholar who has been a senior advisor to the white house and held university professorships at some of this country’s most prestigious institutions (Columbia, Harvard, George Washington). He’s been president of the American Sociological Association and the International Society for the Advancement of Socio-Economics. In 1990, he founded the Communitarian Network, a not-for-profit organization dedicated to “shoring up the moral, social and political foundations of society.” (The group also calls itself nonpartisan, but Etzioni’s jabs at Libertarianism would seem to betray that claim.) He’s the author of more than 30 books, none on obesity from what I can tell.
In other words, he is the “guru” of a respected theory/platform, “responsive communitarianism,” and in this two-part essay, he applies his theory to obesity public policy. It is worth a look from us, because it is most certainly getting a look from powers that can influence our lives.
The first half of part one is very hard reading. He lays a foundation of assumptions: Fat is BAAAAD! Fat is expensive. Fat kills. His sources are ones that we in the fray have refuted or countered with alternative sources many times over.
Then he seems to double back. Beginning with his Criterion II and continuing in III, he notes that even though fat is bad, interventions that focus on lifestyle changes don’t work. Moreover, public health campaigns that push lifestyle changes fuel discrimination, stigmatization and may prompt eating disorders and result in other psychological consequences. They also hurt poor people more than the rich. Way to go, man! In part Two, we will learn how we might refocus public policy along a “Responsive Communitarian” line.
It turns out that Responsive Communitarianism would lead us to have our public policies promote exercise. While I might agree with that, his justification is tortured. He claims that exercise is more effective at reducing BMI than diet or diet combined with exercise, and uses a lame study as support – exercisers maintained a five-and-a-half-pound loss, whereas people who combined diet and exercise only maintained a four-and-a-half-pound loss. Yeesh. Beyond that he states the obvious benefits of exercise.
He then says a “communitarian” approach would focus on children. (Ack! Danger! Most of us know this kind of focus, combined with careless language, could lead to a bully problem for fat kids.) Better food and PE in the schools would be in order and in keeping with his theory, as would other social reforms. In the end, however, an obesity public policy might just be too expensive. Etzioni concludes:
Obesity is a serious health problem, but a rather intractable one. It requires costly interventions that will generate little gain as long as the focus is on reducing caloric intake through encouraging individuals to change their eating habits. Much more focus should be given to (a) caloric expenditure (exercise); (b) on parenting and children, as opposed to adult lifestyle changes; and (c) on societal rather than on personal factors. In addition, much more attention should be paid to the adverse side effects of dieting. Finally, the merit of making obesity reduction a high-ranking public health drive should be weighed against the value of other campaigns.
Those last two sentences give me heart. An intelligent outsider can see something that has been obvious to those of us dealing with the issue, but has eluded many “experts.” Most of the rest of the essay(s) read(s) as same-old-same-old to me.