I finally watched Fed Up now that it’s on Netflix and here are some of my thoughts.
First of all, it’s about time a documentary took the food industry to task for their immoral lobbying practices. I do agree with the way the film compared food advertising and lobbying to tobacco advertising and lobbying. It’s deplorable. It was depressing to look at Michelle Obama’s “Let’s Move” campaign and see how it buckled under pressure from the food lobbies and reduced itself to an education/awareness/PR campaign instead of a multi-faceted public health initiative working at the individual, community, and policy-making levels. I believe policy reform is crucial; without it, any attempt to improve the state of nutrition in this country will fail.
I was also struck by the way the film gets at the issue of culture and environment – and how much change has happened to our culture and environment in the past 30 years. As a child of the 80’s, it’s interesting to learn more about the historical context of the “obesity epidemic.” I didn’t realize that I was growing up right in the midst of this new(ish) phenomenon. I think it’s human nature to assume that the culture and environment we grow up in just is. We tend to assume that things have always been the way they are.
It blew my mind to imagine a world pre-fitness culture where Americans didn’t all belong to gyms or own workout clothes or think of exercise as positive, healthy, and normal. It’s also interesting to re-examine some of my personal memories (for example, the debate about bringing Coca Cola vending machines into my middle and high school in exchange for a new scoreboard and who-knows-what-else) within the larger context of these sweeping changes that were happening across the country at that moment in time.
It’s strange to realize how different the culture and environment looks compared to what I experienced as a kid in the 80s and 90s. Now we have Crossfit bros and “fitspo” on Instagram and Pinterest. We have artificially flavored water-type beverages for sale as health drinks. We have energy drinks. We have Grub Hub and Foodler. Today we jump on weirdly specific food trends as though they could fix everything, like greek yogurt, acai berry, coconut water, kombucha, and coconut oil. At the same time, we lose our shit over KFC Double Down chicken sandwiches, Taco Bell Doritos Locos Tacos, and Cronuts. I never would have thought that fast food companies would ever be allowed into school cafeterias, and yet they have been. We must remember that this culture and this environment is something that can be molded and changed according to our values and goals, not something that “just is.”
I really appreciated that the filmmakers made a point to explicitly take the blame for obesity off of fat people. Although we can each try to improve our own health as we see fit, individual behavior change is not the solution to obesity in America. I was glad they touched on the psychology of addiction and the way environmental cues prime our brains to eat in harmful ways. I was glad that they talked about how dieting doesn’t work because it’s nearly impossible to do successfully in a long-term, sustainable way. I was glad they explained how being thin does not necessarily mean someone is healthy.
My only real gripe with this film was the disappointing way it talked about the role of exercise. While I appreciated that they showed a fat person who exercised regularly (fat people can be active too!), I had trouble with the way her failure to lose weight was equated with a failure to be “healthy.”
Some really promising studies have shown that exercise can improve health measures and reduce the burden of disease regardless of whether or not a person loses weight. So while I think it is valuable to point out that “calories in, calories out” is inaccurate, and while it is important to know that exercise does not necessarily result in weight loss, I am disappointed that they did not talk about the ways that exercise can improve a person’s mental and physical health and lower their risk for diseases often associated with obesity. Basically, the film made it sound like exercise was pointless because you’ll still be fat. This is patently false.
You can improve your health and quality of life by exercising, even if you stay fat. You can also improve your health and quality of life by eating better, even if you stay fat. This is the basic premise of the Health At Every Size approach. We need to avoid making people feel like they are doomed to be unhealthy and sick if they cannot lose weight – this can only result in worse outcomes for everyone.
This is all very similar to a recent article “You can’t ‘outrun’ obesity: Study says exercise doesn’t help weight loss.” I quote the brilliant Ragen Chastain:
What’s super messed up is that these doctors are aware that movement reduces the risk of developing heart disease, dementia, some cancers, and type 2 diabetes (the exact reasons that we’re given for losing weight,) and instead of saying “Hey, this seems like more evidence to suggest that maybe we should be more focused on evidence-based health interventions and less focused on manipulating people’s body size,” they are trying to downplay the actual health benefits because the evidence-based health intervention that they’ve found doesn’t make people’s bodies smaller…
The problem here is that we’ve become so obsessed with trying to get everyone into the same height weight ratio that we’ve taken our eye off the ball of giving people options and information that will support their actual health.
Most studies about weight and health don’t take behavior into account, which is weird because those that do take behavior into account find that behaviors, and not body size, are the best predictor of future health. To be clear, health is complicated, multi-dimensional, not entirely within our control, not guaranteed under any circumstances, not an obligation or a barometer of worthiness.
A final thought is that I wish that the filmmakers had found a way to talk about the negative consequences of fat stigma for individuals and society in more of an intentional way. I understand this was probably outside their scope, but it is an important piece of the story.
Overall, I am glad this film was made and I think it could be a useful tool in creating change. We must remember that social change requires a multi-faceted approach. In Public Health we call this the Socio-Ecological Model.
This model states that we need to make change at each of these different levels – including and especially the policy level. It also teaches that different strategies are warranted at each level. The Fed Up film did a great job talking about the kind of change that needs to happen at the policy level, which I think was the goal of the film. But when it comes to the individual level, it’s important to understand that being overweight does not doom a person to poor health always and forever. If the statistics in Fed Up are correct and approximately 95% of Americans will be overweight or obese by 2035, it is so, so important to give people hope.
As I said before and Fed Up clearly demonstrates, policy reform is absolutely crucial. But another piece of our overall strategy for change must be focused on helping individuals navigate the world they live in. By reducing stigma and focusing on the benefits of exercise and healthful eating for their own sake, we can help people live healthy, happy and productive lives – even if they stay fat.