Thursday, July 28, 2011

Child Obesity: Abuse Or Moral Panic

A number of articles were sent my way today about the phenomenon in the USA and Scotland - and probably in Canada - of charging parents with child abuse if they "allow" their children to become obese. I've discussed in previous posts here, here and here some of the social and nutritional roots of obesity in North America. But it's worth revisiting some of those points in the context of a discussion of child abuse.

The first thing to keep in mind is that child abuse, like other forms of abuse, is primarily defined in terms that apply to working class people. That is, forms of interpersonal violence that are generally outgrowths of the pressures of poverty, unstable and unhappy job situations, lack of access to extra-curricular resources like sports, community centres, childcare, etc. Of course it's bound up with the oppression of children, just like sexual assault and spousal abuse is tied up with the oppression of women. The people who suffer the most are always the least powerful in any relationship.

But the social response to child abuse or festering problems like obesity are reduced almost exclusively to one of moral panic. Kids are using the internet and are losing the ability to think or focus. Teen sex is the source of teen pregnancy (of course it is in a direct sort of way but not in an inevitable way). Obesity is the fault of neglectful parents who feed their kids badly.

I'm reminded of a news magazine special that I saw in university about a teenager who lived in a small town who made a suicide pact with his friend and then shot himself in the face with a shotgun. The one boy survived, though he was terribly deformed and damaged, forced to take pain killers for the rest of his life, eat through a tube, etc. He and his parents tried to sue a heavy metal band for playing violent devil music that tempted him.

Now, the filmmakers were clearly liberals and rightly made the point that it is absurd to suggest that listening to Iron Maiden would cause a teenager to commit suicide. But what they did instead was to put the focus on the parents. They were poor and the father had had a gambling problem. There was some suggestion of drinking and that their fundamentalist Christianity was hypocritical. It struck me at the time that they had wholly missed the point. This kid - who attempted suicide another time and succeeded - was a white trash trailer kid with no future, living in semi-rural America. The poverty and violence that went hand in hand with his family was his own future. He tried suicide when he was a heavy metal fan and he tried suicide when he was a born again Christian. Neither metal nor Christianity were the problem, nor his parents - it was the system.

Of course I don't mean to suggest that we have no personal responsibility. Rather, the parameters of our choices are seriously constrained and we are faced with the double burden of lacking the resources to be good parents and then suffering guilt - and imprisonment or the loss of custody - when we react in understandably human ways with anger, frustration, or exhaustion-induced neglect.

The same thing applies with obesity, except that there is the added burden that our whole notion of what constitutes nutrition is upside down and makes the problem worse. We are told that a healthy diet is one that is packed with whole grains, low fat and a moderate amount of protein. That - relatively recent - idea of a "healthy diet" is not disconnected from the fact that grains are the cheapest form of high energy density food that we have. And its prioritization as the go-to energy source, along with the demonization of meats and saturated fat, is in my mind a side effect of the end of the post-war boom in the 1970s and a shift towards austerity. We have literally made a virtue of a necessity.

Working class incomes stagnated and then declined, particularly in the USA, where a sustained war on union organization drove union density from about 1/3 of the workforce to less than 12% today - much lower in the private sector. In some regions of the US (and Alberta) unions are effectively non-existent. As living standards have fallen people look to cheaper food sources. Falling living standards are also expressed in longer working hours - American workers work over a month longer now than they did in the 1970s. This makes it more difficult to have a home cooked meal as workers turn to fast foods. As I've discussed recently, fast foods are not only loaded with carb heavy grains - rice, corn, wheat - they are also stuffed with flavour enhancers (generally various forms of sugar) and fillers like wood aka cellulose.

As I was walking down the street the other day I saw a sign for a sale on basmati rice at my local Bangladeshi dry goods store - 40lbs of rice for $30. At less than $1 per pound, that looks awfully attractive to someone on a tight budget compared to $4 or more per pound for pork chops and up to $11 per pound for New York striploin steaks. Ah, but don't worry, those high priced foods are bad for you, all those saturated fats and stuff. And too much protein, that's bad for your kidneys. The cheap shit, that's what you want to be eating. By that logic, food must be the only product under capitalism that gets better when it's cheaper.

The trouble with rice, corn and wheat is that they work too well. Your body absorbs and breaks down the carbs in these grains very quickly. The starches in them become sugar and enter the bloodstream for processing. But anything more than a very small amount of sugar - about 1 teaspoon in your total blood volume - is poison. As any diabetic can tell you, it will kill you if it isn't eliminated very quickly. Your body deals with it by producing a spike in insulin to distribute the sugar where it's needed in the body. But unless you're burning calories very quickly doing some very heavy cardio right after you eat, your muscles simply can't use up that much sugar. And so that cheap rice or that loaf of bread is shuttled to the other disposal facility in the body - your adipose tissue. It becomes fat.

This is different from if you consume protein or fat in excess of what your body needs. Protein is processed by your kidneys and you urinate it out. Or it is processed by your liver - using the metabolization of fat as the fuel source to power this process, and the protein is turned into the small amount of sugar that your body needs, primarily for your brain. The by-product of fat metabolism, on the other hand, is ketones which most of your tissue quite happily takes up in place of sugar. Heart muscle, for instance, works more efficiently using ketones for fuel. Even much of the brain is happy to use ketones. There is one type of cell that can't use ketones and which absolutely needs sugar to survive - cancer cells - but that's another story.

The overall point here is that sugar in both is simple and complex forms leads to obesity. There are other problems with grains as well - phyto toxins that cause auto-immune responses, leaky gut, etc. But for the purpose of our argument, the main issue here is the rise in childhood obesity and poor diet, the root of which is that a good diet is out of reach financially for most working people. It is literally four times more expensive to eat a diet that relies primarily on animal protein and fat as an energy source than one that relies upon grains and other carbs.

And it's worth repeating as well that obesity has little or nothing to do with activity level. Exercise does not make you thin. Our bodies are complex and sophisticated machines, nothing in them happens in a direct and linear way. What's more our bodies have evolved to be homeostatic - to maintain a steady state. Our temperature is always the same - unless we're ill. If the environment - severe heat or cold - causes our internal body temperature to move even a few degrees we can suffer brain damage, organ shutdown and death. Our body morphology is no different. If we "overeat" our body knows how to eliminate most excess as waste. It knows not to store too much fat. It wants to maintain a stable body weight and fat percentage. We have to work hard to overcome our bodies natural homeostatic mechanisms, which is why obesity leads to so many problems from inflammation to diabetes to arteriosclerosis.

Obviously physical activity is a good thing - it builds muscle strength, improves respiratory efficiency, increases flexibility, etc. But it has little or nothing to do with weight. It does however work the other way - obesity leads to less activity. Exercise becomes difficult and painful for those suffering from obesity.

What is the solution? The first solution is that the working class needs a big fat raise so that we can afford high quality meats, poultry and fish. Secondly, we need to revise our ideas about nutrition and revamp our system of food production in order to meet the real nutritional needs of the population. Ultimately that means redesigning cities and suburbs (like, get rid of them) to permit the integration of food production and high density residential living - which will also encourage walking, biking, and make public transit efficient and affordable. And it means opposing all attempts to blame working class parents for the obesity suffered by them and their children. It would be a good step, however, to outlaw the poison that is sold as food in the supermarkets - from twinkies to soda pop (5 teaspoons of sugar per can!). Processed food has exploded as a response to long term austerity and it should be abolished along with it.

Observations: Should Morbid Childhood Obesity Be Considered Child Abuse?

Wendy Mesley on CBC: Is Childhood Obesity Abuse
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