This week in the media I saw a collection of articles praising Chile for taking extreme measures in the “war on obesity”. Since 2016, the Chilean Government has implemented a whole pile of legislation, including:
https://www.nytimes.com/2018/02/07/health/obesity-…
A compulsory labeling system on processed foods, which displays ‘warnings’ in the shape of scary looking black stop signs on items deemed to be high in sugar, salt, calories or saturated fat.
Cartoon characters have been banned from the packaging of sugary foods.
Kinder Surprises have been banned (?!).
“Junk food” such as ice cream, chocolate, and chips were banned from sale in school cafeterias.
Advertising of ‘junk foods’ was banned for large portions of the day on television.
Advertising of infant formula was banned.
An 18% tax was introduced on high sugar beverages.
So – have these measures worked? Did they win the ‘war?’
Nope. To quote the article:
“Obesity rates in Chile have yet to fall, and experts say it could take years to significantly modify the way people eat.”
So, 2 years into these extreme measures, and obviously people are paying attention to those labels (40% of consumers report that the labels are influencing what they buy) – but still no corresponding magical weight loss?? After 2 YEARS! I’m sorry, but if it hasn’t happened by now you know what….it isn’t likely to happen!
There’s no doubt that these policies will definitely have an impact – but NOT in a great way!! The biggest impact so far is that Chileans are now EXTREMELY conscious of how ‘healthy’ their foods are. Especially the kids:
“They’ll say ‘Mom, this has so many logos. I can’t bring them to school. My teacher won’t allow it.”
While the ‘obesity experts’ cite the population’s increased vigilance about their food choices as a ‘win’, as an eating disorders psychologist I am very alarmed about the long-term impact of raising food anxiety on the entire country’s relationship with food. Calling foods ‘good’ and ‘bad’ has a whole range of disastrous consequences, such as:
Increasing fears of the ‘bad’ food.
Increased cravings for ‘bad’ food.
Hidden eating, experiencing a sense of shame when eating ‘bad’ foods.
Loss of connection with hunger, fullness, and satisfaction signals.
Increased risk of binge eating and other eating disorders.
Making people feel guilty, fearful, and more preoccupied with food does not support a healthy relationship with food. Far from doing anything to reduce people’s weight, it is MUCH more likely that the scene is being set for the whole of Chile developing cravings for the so-called ‘bad’ food!
We saw impacts like this in the United States after they introduced policy changes aimed at increasing ‘healthy choices’ in school cafeterias. Instead of the expected smooth transition to embracing ‘healthy choices’, a black market was born – students started to smuggle in and trade salt, pepper, and sugar in an effort to make their meals taste better. Since the policy changes were introduced, participation in school meals has dropped considerably. Many parents reported picking up their kids and taking them to fast food restaurants instead of eating the ‘healthy’ food! http://freebeacon.com/issues/kids-create-salt-blac…
Policing people’s food choices doesn’t lead to compliance – instead, it leads to people rebelling against the police state!
The people in charge in Chile seriously believe that the nationwide ‘obesity crisis’ is purely down to the food choices people are making. This narrow view ignores the plethora of evidence that genetic, epigenetic, and socioeconomic factors have a much stronger impact on body weight than actual food choices. It is not a coincidence that in the 1980’s in Chile, malnutrition was a major health issue. We could view the country’s increase in body weight as a normal response to a suddenly bountiful food supply, rather than a moral failing!
Enacting policies like this in order to eradicate fat bodies is implicitly shaming. How would it feel to be a larger person living in Chile since 2016? I’m certain that larger people in Chile are feeling judged, ashamed, and afraid to eat the dreaded ‘black label’ foods. But of course, no-one is asking them how these changes make people feel – because in the ‘war on obesity’, collateral damage is never considered.
If the policies were implemented with the aim of supporting better nourishment for the entire population (not just the aim of shrinking the larger people), whilst still likely to increase food guilt, and food rebellion, the policies at LEAST wouldn’t also shame larger people. But the fact that everything is being done with the explicit aim of the ‘war on obesity’ means that the Chilean government is greatly increasing levels of prejudice, shame, and stigma to a group who are already marginalized and judged on a daily basis.
When we declare ‘war’ on body size and introduce dis-empowering legislation which reinforces food guilt and body policing, we’re entering into an unwinnable war. And the casualties are larger people.
Why do we have to declare war in the first place? Why can’t we look around the world to places where PEACE was declared against a perceived ‘health crisis?’ What happens there?
In Portugal in 2000, they had a huge problem with drug addiction. 1% of the population was addicted to drugs. For years they had followed the status quo and waged a ‘war’ against drug use, with harsh criminal penalties, but these measures did nothing to reduce rates of drug addiction:
http://www.cbc.ca/news/canada/british-columbia/por…
So they came up with a truly radical solution: in 2001 they decriminalized ALL drugs and poured the money previously devoted to the ‘war’ into public health programs which encouraged harm minimization, social connection, community, and compassion. Here are some examples of the measures the introduced:
Addicts were encouraged back into the workforce through government subsidies. Employees were told that if they hired an addict and kept them on for a year, the government would pay half of their wages.
Counselling and support systems for drug users were made widely available.
Free needles and health checks.
How effective have these interventions been?
“In 1999, Portugal had the highest rate of drug-related AIDS in the European Union; since then, H.I.V. diagnoses attributed to injections have fallen by more than 90 percent and Portugal is no longer at the high end in Europe.”
Now that’s a pretty impressive outcome!!
Dr. Joao Goulao, head of Portugal’s Service for Intervention in Addictive Behaviour and Tendencies (can you see here that even the name of the service is not stigmatizing?), says that the main reason for the program’s success wasn’t decriminalization itself – it was de-stigmatization:
“The big impact is that drug use and drug addiction is no longer a taboo.”
These measures are inclusionary: rather than treating drug addicts like second-class citizens who needed to be eradicated, drug users were viewed as human beings who deserved dignified health care. Rather than continue to fight an unwinnable war, the Portuguese government called a truce, and it was only then that meaningful changes happened.
Going against the status quo and declaring peace when the rest of the world is at war takes guts. Portugal was at first criticised around the world for taking a ‘soft stance’ on drugs, but since the results came in they have changed their tune!
“The World Health Organization and American Public Health Association have both praised decriminalization and a public health focus, as has the Global Commission on Drug Policy.”
We really need to stop the ‘war on obesity.’ We need to see that it is not ‘working’ to reduce ANYONE’S body size, instead, we’re seeing increased levels of stigmatization and terrible treatment of people in larger bodies. We’re also seeing huge increases in disordered relationships with food and eating disorders.
In the ‘war on obesity,’ let’s be more like Portugal than Chile. Let’s make policies based on INCLUSION rather than exclusion. Let’s de-criminalize foods and focus on the much bigger picture: reducing inequality, reducing poverty, improving food quality for ALL of us, regardless of size. Let’s stop the conversation about obesity altogether, and focus on embracing body diversity, respect for difference, and dignity in health care.
