Foresight, Tackling Obesities: Future Choices is the name of a project commissioned by Sir David King KB ScD FRS, Chief Scientific Advisor to HM Government, who was then Head of the Government Office for Science. King commissioned the report because he was concerned about what he thought was the rise of obesity and its cost implications for the UK. The report has become the government's go-to resource in terms of developing anti-obesity policy and has sprouted an Independent Expert Advisory Group.
I wanted to have a look at Foresight again because I'm working on a paper about the war on obesity as a metaphorical conflict, and I'm struck by the repetition of the expression "tackling obesities" in the report. It makes me think of wrestling with an invisible foe, like something Captain Kirk might wrassle with on an old episode of Star Trek. This must be how the report's authors and advisors see fat people, a nebulous enemy that needs taking down by them, and not so far off from the supposed enemies of the war on terror. Obesities is pretentious too, but not as pretentious as 'obesogenic,' which this project may have coined.
I also wanted to revisit it because I noticed recently that two Health At Every Size proponents were using the Obesity System Map fairly uncritically. I think this map is baloney, and that Foresight is no friend to HAES, so I wanted to have a look at the report again and try and see it from their points of view. Could it be a useful tool?
There are more problems with this report than I have time to write about today, but I want to mention a couple of things.
The report is wrong, and wrong in the most amazing ways, because it starts from a popular position that is simplistic, and also wrong. Remember the parable about building a house on firm foundations? This house is built on sand.
King commissioned the report with the explicit belief that obesity is a problem and the implicit assumption that fat people could not also be healthy. I don't think obesity is the problem, I think social attitudes towards fat people go a long way in affecting people's health. I think my health as a fat person is threatened by a health service that tries to withhold treatment from me until I lose weight, or tries to coerce me into profitable but unhealthy weight loss regimens; or the stress and social repercussions of being stigmatised or discriminated against, and the internalised self-hatred this can engender. I think my health is more threatened by these things than by the wobble of my belly, and that the cost to the nation of obesity-related health problems is really about what hatred costs the nation. I also know that the size of one's body does not necessarily correlate with the health of one's habits.
Foresight is fixated on energy balance (calories in + calories expended = body size), a polite, 'scientific' way of blaming fatness on gluttony and sloth, even though they also make confusingly inconsistent genetic claims for fatness. They build fantastically complicated Obesity Systems Maps around this assumption. If this was a project about how to make people eat less and exercise more then it would be more successful, I have no problem with proposals to increase the availability of good quality food, or opportunities to ride my bike. Unfortunately the project is built on the assumption that fatness is synonymous with an energy balance that's out of whack and that therefore fat people must be prevented from existing and eradicated because they cost too much. Rather than working with fat people in a compassionate and respectful way, this is a project that seeks to further disempower, punish, scapegoat and marginalise fat people for daring to exist, instead of using state resources to manage the social systems and structures that contribute to poor health in the first place.
Foresight, Tackling Obesities: Future Choices fascinates me because it says more about state power and its manifestations, values and beliefs than it does about me and my life as a fat person.
The report claims scientific purity a number of times and seems oblivious to the idea that science is also a product of ideology, or might be influenced by such worldly entities as, perhaps, corporate sponsorship by the diet industry. It astounds me that the report can claim to be objective when the list of reviewers and advisors includes professors, Knights, a Lord and a Dame, so firmly is this work entrenched in the values of the establishment and the upper class. This class background is particularly problematic given that a large chunk of the report is concerned with the question of What To Do About Poor Fat People? As is so often the case in obesity research, the notion of nothing about us without us is irrelevant, fat people are absent and abstracted. The battle cry of the war on obesity is that it is a war against obesity, not "the obese" (a term which also abstracts and dehumanises us!), but how does one make the distinction?
In Foresight, Tackling Obesities: Future Choices, the modern world is characterised as a no-good place fast heading for chaos where fatness is linked with climate change. The past is a better place where there were allegedly fewer fat people. Progess is suspicious, the authors decry investment in a potential magic bullet treatment for getting rid of obesity, the way to get rid of fatness lies in solid, puritanical and moralistic endeavours such as taking personal responsibility for the problem, enacting self-surveillance and doing hard work over a lifetime. Whose values are these?
There's a sense of
By the way, if you want to have a look at any of these reports, they are massively funded so you can order a range of high production value booklets, CDs, posters and other assorted crap from the project's website and they will be sped to you by courier immediately! For free! I'm not making this up. I could paper my walls with this lovely, thick, heavy, glossy stuff if I had a mind to.