Mental, Behavioral and Mental, Behavioral and Social Health Social Health

Implications ofImplications ofOverweight and/orOverweight and/or

ObesityObesity

Brandon Keppner, MAIOPExecutive Director

The DebateThe Debate• Obesity can carry scary consequences:

– Heart Disease– High Blood Pressure– Diabetes (Type 2)– High Cholesterol– Depression

• Anti-obesity efforts can also carry scary consequences:– Eating Disorders– Disordered Eating– Fat Prejudice– Weight Discrimination

By the numbers: By the numbers:

• One in three kids is obese.• Three quarters of obese kids grow into obese adults• 15 percent of children are overweight• 56 percent of women would rather be hit by a truck

than be fat• 67 percent of women would rather be stupid or mean

than fat• 81 percent of 10 year old girls have dieted at least

once• 9.3 percent of high school girls who have attempted

suicide stated that the mere belief that they’re fat is as important as actually being fat

What does being obese What does being obese look like in today’s world? look like in today’s world? Obese people are looked upon as being:

- Stupid- Lazy-Unmotivated-Undesirable-Unhappy-Unhealthy-Unsuccessful-Out-of-control- “Bad”

What does being thin look What does being thin look like in today’s world? like in today’s world? Thin people are looked upon as being:

- Happy- Healthy- Successful- Smart- Capable- In control- “Good”

SO, WHAT DO WE DO???SO, WHAT DO WE DO???

What’s currently being What’s currently being done about it…and why done about it…and why it may not be workingit may not be working• The “War” on Childhood Obesity• Weight Discrimination• Utilization of the Shame Cycle• Anti-obesity Ads• The books, the movies, the products, oh

my! • “Big Brother” Tactics• Taxing parents• Bariatric Surgery…for kids

The “War”The “War”

• Language matters! • Who is the good guy and who is the bad

guy?• What other wars is America waging? How

does the general public feel about these wars? How does this bode for those who are obese?

• Big focus on BMI as a measurement of health– Is this really the best measure of health?

The “War”The “War”

• History of the BMI– Not intended for its current use.– Financial gain of those that changed the standards in

1998.

Weight DiscriminationWeight Discrimination

• Prevalence of weight-based discrimination has increased 2/3 since the mid 90s (slate.com)

– Acceptable form of discrimination– People fear being fat!

• Stigma leads to Shame Cycle and continuous “bad” behaviors

• Bullying– Can have fatal ends– Encouraged at times as an effective “encouragement”

tool/change agent• Across the lifespan

– Obese people will make less, not be hired for jobs, and will not get medical screening at times because of their weight…and this is legal everywhere except for Michigan.

• Lack of support for positive change (making fun of fat people working out…)

The Shame Cycle The Shame Cycle

• Fear and shame are thought to be effective persuasion tools in this model

• Shame is easier than reinforcing positive change-less effort

• Major behavioral changes do not come out of shame

• Shame generates fear which leads us to the comforting behaviors we know

• Shame (along with humiliation and mortification) are very painful and isolating feelings and can lead to violence and suicide

Anti-obesity Ads Anti-obesity Ads

• Fear-based– Dying before parents?– Destined to a life being fat?– Having diabetes?

• Discounts medical conditions which can cause obesity and also discounts people who really do have larger builds/bigger bones

• Creates an anxious culture (which feeds into another cycle!)

• “Warning”? – What does THIS say?

The books, the movies, The books, the movies, the products, oh my! the products, oh my!

““Big Brother” TacticsBig Brother” Tactics

• Weighing kids’ lunch trays before and after meals

• Taking pictures of kids’ lunch trays before and after meals– Shame Cycle– Eating disorders– Discounts personal responsibility– Does it matter what they’re eating? What about

lunches from home?

• Report card grades on weight

Punishing the ParentsPunishing the Parents

• Parents are responsible for setting the standard for their kids

• What happens when they don’t know what the standard is?– Lose their children

• How does this affect a child who is already struggling with obesity?

– Are taxed (additional loss of income)• Significant correlation between poverty and obesity

Bariatric Surgery…for Bariatric Surgery…for kidskids

• Again, obesity does have real consequences associated with it, but we must also evaluate the effects that our intervention tactics might have:– Eating disorders in kids 12 and under have

doubled in past decade– Kids as young as 4(!) are needing treatment for

an eating disorder– Bariatric surgery in kids can cause vitamin

deficiency which can lead to irreversible brain damage and growth retardation

SO, WHAT DO WE DO???SO, WHAT DO WE DO???

Positive TacticsPositive Tactics• Take the judgment out of the picture.

– Good foods/bad foods– Good people/bad people

• Provide education on what a balanced diet looks like! Check it out.

• Encourage mindful movement.• Discourage dieting as a solution. • Be a positive example.

– “Fat Talk”

• Encourage a balanced lifestyle. • Look at the person, not the number!

THANK YOU! THANK YOU! Be kind to one another!