Should people be held responsible for being obese or can that only be the case if we have a "nanny" state?

The obesity prevention campaign needlessly shines a light on personal appearance versus health. Fat people are ridiculed, overlooked, and caricatured in our society.  Public health has taken the stance that "it is the environment, stupid" that explains food choices.  A good strategy, but is it enough.

An article in the March 2010 issue of Health Affairs (all obesity cover-to-cover) contends that collective responsibilty (advocacy for healthier foods/places) must kick-in first, before we blame the individual.  

I think the issue goes well beyond collective responsibility.  It will be hard to rally support for policy if we do not change our attitude about size being liked to health. It is not that simple. 


Anyone out there willing to tangle with me on this point?


ARTICLE-Personal Responsibility & Obesity-Health Affairs March ...









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With or without a nanny state, obesity prevention needs a makeover. I do not work in public health, but as an everyday person, I think the stress placed on looks in general versus being healthy is doing more harm than good. The answer is fitness measured by being able to walk 3 miles in 30 minutes without having someone call 911 to revive you; and what your blood pressure & lipid lab results say about your health.

The information going to the general public is incorrect. I see super obese women at my gym, and they look so self-conscious and no one ever talks to them. Doctors are giving the wrong message-join a gym and start dieting. We need to hear more about health in all sizes. The idea is to enjoy being able to move your body with ease and enjoy healthy meals. Dr. Linda Bacon has demonstrated that we can be healthy at every size.
Click on the link for her point of view." target="_b...

Science of health at every size" target="_...
Thanks for the reference to my work. But I did want to alert you that the link you provided is to a wonderful organization called ASDAH. I did not write those principles. It's great that you are bringing attention to them - ASDAH has done a lot to educate people on these topics. I you are interested in seeing any of the work I've done, a better link is to the website of my book, called Health at Every Size: The Surprising Truth About Your Weight ( There are also a lot of general resources about HAES on my personal website, including links to my research on the topic: Lastly, you can learn about a lot of other community resources here: www.HAESCommunity.Org.
Changing attitudes about the causes of obesity is not going to catch on anytime soon. When leading public health figures like Sir Liam Donaldson, former director of health for the UK, talk about obesity as character deficit, the environmental cause chorus is singing into the wind. What he said should be done was all about individuals.
Turning public opionion around is going to take at least 10-15 years. Make that time shorter, we have to get a group of really prominent physicians to be much more vocal on prevention. The AMA view is the only one heard by Congress. They have not put on as big an effort about prevention as they have about Medicare. Yes, a few people testify for community health versus individual responsibility, but the medical lobby out shouts & outspends everyone.
Here is an article from The Guardian that makes sloth (one of the seven deadly sins --so now the obese are sinners) the cause of obesity.
Gee...thanks for the links. I never expected to "meet" someone who is responsible for a theory. Social networks can be very powerful tools for learning on the fly. Thank you again.
There is no way I am going to tangle with you- I am with you entirely.

While the environment we have created allows for too many people to be unhealthy and obese- linking the two as one and the same is incredibly dangerous. Our emphasis should be on fitness and chronic disease prevention, whatever package that comes in. There is an awful lot of evidence to suggest that size and health aren't nearly as closely linked as previously thought, as well as the fact that 95% of diets fail. What? 95% of diets fail (by "fail" I mean that 95% of people gain back weight lost within 3-5 years) and yet we still tell people to do it?

Instead, lets create an environment where healthy food choices are easy, exercise is fun and how you look doing either is irrelevant.

Check out this Health at Every Size study:
Thank you for the link. I also checked out several of the articles that popped up in the box on the right referring to related articles. It seems that there is not much of a conversation taking place between the policy camp & the clinical care camp in public health. The emphasis on a segment of the population, without understanding the underlying clincial aspects of the health problem, cuts out a more nuanced understanding that can help a policy gain support.
Also, there are real people behind the numbers whose stories can be used to make the case for change. But if you label people, putting them on the defensive, you get what we see now-a backlash for blaming overweight/obese people for increasing healthcare costs. Yes, the data point in that direction, but a simplistic presentation misleads thinking about the issue.
This Message Comes Via Linda Bacon (merely posted by me)

Hi all. I'm floored to see the welcoming and friendly response to my presence (on-list and private). Thanks. I probably won't be participating much in your discussions - got a bit too much on my plate now - but I did want to thank you. I suspect that one reason many of you are familiar with my work is because I'm all about building community. So I hope it's okay if I throw in a few more resources here that you may find supportive. Please, check out the (free) HAES Community Resources ( to learn about stuff being done to transform the paradigm to supporting people in body-appreciation and making good health choices and to register your support/make your role known. Also, some of you may know that I have a popular press book out called Health at Every Size: The Surprising Truth About Your Weight ( I am very excited to report that a second edition will be released in less than a month, updated with the latest research and many other fun additions, including a lot of tools to help build community. I will be making many of these additions available for free on my website when the book is released. Feel free to check it out in a month - or head over to the website now to join my mailing list and get an alert. While I may not participate in ongoing discussions here, please check in with me if there's stuff you'd like me to comment on. Congrats on the great community you've developed here. And a special hello to my buddy, Joanna Silber - let's follow up off-line.
All best,


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