11 June 2014 13:05

The cover of our new book, Childhood Obesity: Ethical and Policy Issues, shows a playful picture by Christopher Boffoli – ‘Red Velvet Cupcake Boys’ from his recent book, Big Appetites. Two children play in the snow – or rather, the frosted icing on top of a cupcake. Why choose a humorous image when the topic’s so serious?

The first thing to say is that Boffoli’s work is not simply playful. ‘I’m also making a statement about North America’s bounty as well as our overuse of resources,’ he has said. Books and media offer a glut of glossy culinary images. At the same time, we consume huge amounts of processed foods that bear no resemblance to those pictures nor, indeed, to any raw ingredient. Thoughtless consumption, the degradation of daily foodstuffs, the unsustainability of food systems, how our sense of reality is distorted by idealised, aspirational images – these are important issues that bear on the rise of obesity and the ways that we perceive it.

Truth be told, however, this coincidence between Boffoli’s underlying concerns and ours was not the main reason we chose this cover image. Above all, we wanted to avoid the clichés that dominate in the media.

When obesity features in the news, editors reach for a small stock of images. There’s the headless fat person, usually doing nothing more active than eating or, at best, walking along the street. There are pictures of food – either cartoon healthy (an apple) or cartoon unhealthy (brightly coloured cereals or sweets or sodas). Or we’re shown an instrument for measuring body size. To really clinch the clichés, the images are sometimes combined – a tape measure wrapped around a piece of fruit, callipers measuring a fold of fat spilling over the waistband.

These images aren’t just clichés, though – they’re misleading and even stigmatising. Pictures of fat bodies, robbed even of the dignity of an individual face, are worst of all. They perpetuate vicious stereotypes of laziness, gluttony, and even stupidity – as if obese people were just space- and food-consuming objects, not people who contribute to society and struggle and love and make mistakes like everyone else. In the book, we argue that the simplest and most urgent thing that should be done about childhood obesity is to end the stigma and bullying which fatter people continually experience – not least, by virtue of dehumanising depictions in the media.

Other images focus on the wrong thing. Pictures of bathroom scales or tape-measures or callipers invite us to fixate on body size. Part of the difficulty in thinking about childhood obesity is that obesity isn’t really the basic issue. Obesity is something that’s easy to measure and even easier to notice, partly because our societies are so prejudiced against fat. But increased obesity rates are part of a larger picture of lifestyle-related diseases. Levels of physical fitness and activity have decreased; most people’s diets involve more calorie-dense, over-processed foods; the incidence of metabolic syndrome, the precursor of diabetes and cardio-vascular problems, is increasing. We see these problems in many children (and adults) who are not overweight or obese.

It’s not just about food, either. Whether we think of ‘five a day’ or junk food, obesity is not only to do with what people eat or how much. We still hear the old line that obesity is caused by ‘excess’ calories in over calories out. But this truism just isn’t true. How the body converts energy to fat, how hormones regulate appetite and metabolism, how some chemicals (so-called ‘obesogens’) disrupt metabolic pathways – all of these things are immensely complicated. At the extreme, a person’s vital organs may be effectively starving, even as she or he gains in fat. In this case, ‘overeating’ is a symptom, even a desperate remedy – not a cause. Food is certainly part of the obesity story, but there’s still much to learn here.

Of course, our image is partly about food – a giant cupcake with a sugary topping. But it’s an image that celebrates the pleasures of food. After all, food is one of the great joys in human life. This sometimes gets forgotten when we think about food as something that improves or damages health. Indeed, some authors argue that looking at food in health terms is actually bad for health – we trust labels rather than taste buds, we think in terms of nutrients rather than love of food and the sociability and cultural meanings it can express.

Not least, our cover image celebrates children’s play, even as it notes the risks that might be involved. (For such small figures, there’s a long way to fall!) Again, we don’t want to suggest that play is just a means to increase physical activity and improve health. Play is valuable in its own right – part of children exploring the world on their own terms. Speaking about the model figures in his photographs, Boffoli has commented, ‘Especially as a child, in a world in which adults make every decision, the world of play was very liberating.’ While we have reason to worry about obesity and other risks, we should also worry about how restricted children’s lives have become. Ever-heightening safety concerns rob many children of freedom. This has probably contributed to increasing obesity rates. More broadly, if we see childhood as a condition to be supervised by adults every step of the way, then we deprive children of the joys and challenges belonging to their time of life, and chances to develop independence and personal responsibility.

So, a playful image, not just for one serious topic, but for a whole series of them. The standard obesity images may be serious, but they simplify and even stigmatise. Boffoli’s photograph reminds us not just of calories and physical activity, but of the good things in life and childhood. Yes, there are reasons to worry about obesity, and the less visible health problems that surround it. But we should remember other priorities as well. When we worry about children’s health and safety, we need to keep these in mind too.

What do you think? Share your comments with us below.

Dr Garrath Williams teaches on our BA Philosophy and LLM/MA Bioethics and Medical Law programmes.

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