This article explores a theoretical legacy that underpins the ways in which many social scientists come to know and understand obesity. In attempting to distance itself from essentialist discourses, it is not surprising that this literature focuses on the discursive construction of fat bodies rather than the materiality or agency of bodily matter. Ironically, in developing arguments that only critique representations of obesity or fat bodies, social science scholars have maintained and reproduced a central dichotomy of Cartesian thinking (...) – that between social construction and biology. In this article I examine the limitations of social constructionist arguments in obesity/critical fat studies and the implications for ignoring materiality. Through bringing together the theoretical insights of material feminism and obesity science’s attention to maternal nutrition and the fetal origins hypothesis, this article moves beyond the current philosophical impasse, and repositions biological and social constructionist approaches to obesity not as mutually exclusive, but as one of constant interplay and connectedness. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Experiences of an Obese PatientChristine R. BrassIn the middle of an annual pelvic exam, the gynecologist said to me, “You should apply to be on ‘The Biggest Loser.’” I was too stunned and embarrassed to mutter anything more than a [End Page 88] comment that I didn’t think that, being quite introverted, I was a good candidate for a reality TV show. She argued with me about that. I (...) felt blindsided, intensely vulnerable, and dumbstruck—completely unable to respond—and later, when the shock wore off, incandescent with impotent rage.Four years later, I still don’t have words to adequately describe my outrage at this comment. It was only the second time I’d see this medical professional. The first time was the previous year, when she had been filling in for my regular doctor who was on maternity leave. At neither appointment did this physician ask me any questions about my lifestyle, whether or not I saw a primary care physician, or even if I had any concerns that day. She was very brisk, efficient and did not engage in conversation. Such a statement coming from a health care provider, who did not seek to understand or gather more information, surprised and dismayed me.Other incidents where physicians’ statements were not helpful:• Pediatrician: “Well, my wife has had great success with Weight Watchers.”—I was age 12, about 5’5 and weighted about 145 lbs. at that time. If you look at photos of me at the time, you would see I was not overweight.• Orthopedic Surgeon: “If you want her to look better, make her lose weight.”—This was directed to my mother. I was 19, weighed about 200 lbs., and in his office as per his directions to come back in seven years to see if the surgery he had done on my neck needed more attention.• Internist: “How did you get all those stretch marks?”—I was age 24, weighed approximately 220 lbs., and had lost and gained 50 or so pounds several times as a teenager and in college.• Gynecologist: “Lose weight and your periods will be regular.”—I was age 27, weighed 227 lbs. and my periods, which started at age 15, had never been regular.• Another Orthopedic Surgeon: “You don’t have to worry about osteoporosis; everything you do is a weight–bearing exercise.”—I was age 42 and weighed 300 lbs. This was after follow up surgery to remove pins from a broken ankle that had healed and I had asked about whether or not I should have a bone density test.Coming from a genetic heritage of predominately tall, large–boned people, I was tall and proportionally large compared to other girls my age until high school, when the others caught up. I was told I had to “watch my weight” by family members from my pre–teen years. Enforced dieting ensued, with little result because I wasn’t fat. I did not begin to be overweight until my junior and senior years of high school. I was 5’7” when I graduated from high school and weighed 187. By the time I graduated from college, I was no taller but 50 lbs. heavier. Now, nearing my 40th high school reunion, I am 120 lbs heavier than that. During the intervening years, I have done Weight Watchers®, TOPS®, medically–supervised programs (group and individual), and other popular diets, with periodic but temporary success, and hypnosis and aversion therapy, with no success at all.Over the years, I have been insulted, verbally abused, even bullied, because of my weight. I have been treated as though I am invisible, worthless, and stupid—a pariah. As a result, I have felt invisible, worthless, and stupid, even though I know I am none of those things. I have experienced and been treated for clinical depression. The descent into depression began in my late teen years, which was the time when I started gaining excess weight.In 2004, under medical supervision, I lost 70 lbs. over four–month period. I was delighted to finally lose a substantial amount of weight and feel physical lighter. My diabetes medications were significantly reduced, and... (shrink)

Although the obesity epidemic appears to have affected all segments of the U.S. population, its impact on children with special health care needs has received little attention. “Children with special health care needs” is a term used in the U.S. to describe children who come to the attention of health care providers and policy makers because they need different services and supports than other children. Government, at both the federal and state levels, has long felt a particular responsibility for (...) safeguarding the health of children with special needs. The definition “children with special health care needs,” in fact, was developed by a work group established by the U.S. Maternal and Child Health Bureau to assist states in their efforts to develop community systems of services for children with complex medical and behavioral conditions. (shrink)

BackgroundThe increased risk of developing attention-deficit hyperactivity disorder (ADHD) in extremely preterm infants is well-documented. Better understanding of perinatal risk factors, particularly those that are modifiable, can inform prevention efforts.MethodsWe examined data from the Extremely Low Gestational Age Newborns (ELGAN) Study. Participants were screened for ADHD at age 10 with the Child Symptom Inventory-4 (N = 734) and assessed at age 15 with a structured diagnostic interview (MINI-KID) to evaluate for the diagnosis of ADHD (N = 575). We studied associations (...) of pre-pregnancy maternal body mass index (BMI), pregestational and/or gestational diabetes, maternal smoking during pregnancy (MSDP), and hypertensive disorders of pregnancy (HDP) with 10-year and 15-year ADHD outcomes. Relative risks were calculated using Poisson regression models with robust error variance, adjusted for maternal age, maternal educational status, use of food stamps, public insurance status, marital status at birth, and family history of ADHD. We defined ADHD as a positive screen on the CSI-4 at age 10 and/or meeting DSM-5 criteria at age 15 on the MINI-KID. We evaluated the robustness of the associations to broadening or restricting the definition of ADHD. We limited the analysis to individuals with IQ ≥ 70 to decrease confounding by cognitive functioning. We evaluated interactions between maternal BMI and diabetes status. We assessed for mediation of risk increase by alterations in inflammatory or neurotrophic protein levels in the first week of life.ResultsElevated maternal BMI and maternal diabetes were each associated with a 55–65% increase in risk of ADHD, with evidence of both additive and multiplicative interactions between the two exposures. MSDP and HDP were not associated with the risk of ADHD outcomes. There was some evidence for association of ADHD outcomes with high levels of inflammatory proteins or moderate levels of neurotrophic proteins, but there was no evidence that these mediated the risk associated with maternal BMI or diabetes.ConclusionContrary to previous population-based studies, MSDP and HDP did not predict ADHD outcomes in this extremely preterm cohort, but elevated maternal pre-pregnancy BMI, maternal diabetes, and perinatal inflammatory markers were associated with increased risk of ADHD at age 10 and/or 15, with positive interaction between pre-pregnancy BMI and maternal diabetes. (shrink)

In this article, we use qualitative methodology to explore how 15 low‐income women of diverse sociocultural location construct and experience health and weight gain during pregnancy, as well as how they position themselves in relation to messages pertaining to weight gain, femininity and motherhood that they encounter in their lives. Discussing the findings through a feminist poststructuralist lens, we conclude that the participants are complex, fragmented subjects, interpellated by multiple and at times conflicting subject positions. While the discourse of (...) class='Hi'>maternal responsibility (i.e. managing personal behaviours for the baby's health) is very much in evidence in their narratives, embodied experiences of pregnancy, lived experiences of financial constraints and religious beliefs provided some with an alternative discourse and resistant subject position. Participants also had mixed emotions about weight gain; they recognized the need to gain weight in order to have a healthy pregnancy, but weight gain was also not welcome as participants reproduced the dominant discourse of obesity and the discourse of ‘feminine’ bodily norms. Based on our results, we advocate for change to recent clinical guidelines and social discourses around pregnancy and weight gain, as well as for policies that provide pregnant women with a range of health‐promoting resources. (shrink)

Two conundrums puzzle COVID‐19 investigators: 1) morbidity and mortality is rare among infants and young children and 2) rates of morbidity and mortality exhibit large variances across nations, locales, and even within cities. It is found that the higher the rate of pneumococcal vaccination in a nation (or city) the lower the COVID‐19 morbidity and mortality. Vaccination rates with Bacillus Calmette–Guerin, poliovirus, and other vaccines do not correlate with COVID‐19 risks, nor do COVID‐19 case or death rates correlate with number (...) of people in the population with diabetes, obesity, or adults over 65. Infant protection may be due to maternal antibodies and antiviral proteins in milk such as lactoferrin that are known to protect against coronavirus infections. Subsequent protection might then be conferred (and correlate with) rates of Haemophilus influenzae type B (Hib) (universal in infants) and pneumococcal vaccination, the latter varying widely by geography among infants, at‐risk adults, and the elderly. Also see the video abstract here https://youtu.be/GODBYRbPL00. (shrink)

In this article, I focus on two problematic aspects of British health-promotion campaigns regarding feeding children, particularly regarding breastfeeding and obesity. The first of these is that health-promotion campaigns around “lifestyle” issues dehumanize mothers with their imagery or text, stemming from the ongoing undervaluing and objectification of mothers and women. Public health-promotion instrumentalizes mothers as necessary components in achieving its aims, while at the same time undermining their agency as persons and interlocutors by tying “mother” to particular images. This (...) has a double effect: first, it excludes mothers who do not fit the campaign picture of a mother; second, it encloses those who do fit the picture into an objectified image of motherhood that is defined by and subject to the dominant white, heteropatriarchal gaze. The second problem is that campaigns place unjustified demands on mothers, which stem from a misinterpretation of the maternal duty to benefit. I argue that nutrition-related health concerns regarding children are improperly framed as individual failures of maternal duty, rather than as failures of a system to function correctly. These arguments ultimately support shifting the focus of responsibility for issues around childhood nutrition away from mothers and back toward policymakers. (shrink)

Meat is an important source of nutrients for human health and wellbeing. However, because meat intake is reportedly linked to diseases such as obesity, cancer, cardiovascular diseases and other health problems, more and more people are reducing meat consumption in the developed world. Yet in developing countries, maternal and childhood malnutrition continue to bedevil people due to a lack of or inadequate consumption of meat and other foods rich in protein. In this paper, we undertook an exploratory study (...) of the influence of attitudes toward animal welfare on meat consumption among Ghanaians. After controlling for other covariates of meat consumption, we found that people who express concern about animal welfare are significantly less likely to consume meat in Ghana. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Global Health Careers:Serving the Navajo CommunityMaricruz Merino, Jonathan Iralu, and Sonya ShinGallup Indian Medical Center (GIMC) sits on a hilltop in Gallup, New Mexico, a town of 20,000 in the four corners region of the Southwestern United States. From its third story windows one can see the red cliffs of the nearby Navajo Nation, a 27,000 square mile reservation that reaches into Arizona, northern New Mexico, and the southern (...) edges of Utah. It is a vast, rural landscape that houses more than 350,000 Navajos. For many on the reservation, healthcare is provided by Indian Health Service hospitals such as GIMC."Are you going to stay?" is a common question for new doctors at GIMC. The Navajo know that their geographic location, while beautiful and attractive to many young providers, will also be the reason they leave. It is hard for doctors to be away from their own homelands. Aging parents get sick, [End Page 86] educational opportunities arise, and children who need to be near extended family are born. But to the Navajo, the story of an individual provider is not so important or memorable. All they know is that providers come and go."Are you here to experiment on us?" is yet another question. Years of exploitation and efforts to destroy traditional ways and language have made many Navajo wary of healthcare providers, no matter how genuine their intentions. Many are so fearful of the hospital—they regard it as "the place to go die."Yet despite this initial suspicion, the Navajo are welcoming people at heart, and tend to develop relationships of trust with their providers. Parents will begin to talk about their grief over a son that has committed suicide or a daughter who died from alcoholic cirrhosis. The elderly will tell you how they care for their five orphaned grandchildren while they can barely take care of their own diabetes. A carpenter tells you he has not worked in a year and feels worthless. An HIV-positive woman will tell you she has been sleeping in a dry river bed because she has no place to go. It quickly becomes apparent that as a physician you will be treating patients with enormous social challenges in addition to complex medical conditions.The origins of the Federal Government's involvement in the healthcare of American Indians and Alaskan Natives (AI/ANs) in the 19th century arose out of both legal obligation and concern for self- preservation. Health services were promised to AI/ ANs in exchange for land, settlements, and agreements. In addition, infectious diseases endemic on reservations as a consequence of crowding and abject poverty, including smallpox and tuberculosis, were seen as a major public health concern. The responsibility of Native American health was first granted to the War Department, then to the Bureau of Indian Affairs, and finally to the Public Health Service in 1955 under the heading of the IHS, or Indian Health Service (U.S. Commission on Civil Rights, 2004; National Library of Medicine, 1994).Since then, the IHS has had many successes. Vaccination rates have gone up, and rates of pneumonia and tuberculosis have gone down significantly. Maternal and infant mortality have declined, and life expectancy has increased (Indian Health Services, 1999). Nonetheless, these improvements remain overshadowed by glaring health disparities among AI/ANs across a broad spectrum of diseases, both communicable and non-communicable, acute and chronic. Native Americans experience higher rates of obesity, diabetes, and cardiovascular disease than the general United States population. They are also more likely to die from alcohol-related causes and in accidents. Life expectancy remains more than five years less than that of the general U.S. population (U.S. Commission on Civil Rights, 2004; U.S. Department of Health and Human Services, 2000).Underlying these health indicators is the continued impoverished status of most AI/ANs. In Navajo, almost half of the population lives below the poverty line. According to the Navajo Nation, the current unemployment rate is 42% (Navajo Nation Department of Economic Development, 2011). Many Navajo on the reservation do not have running water or electricity. They heat with wood, which they chop and haul themselves—regardless... (shrink)

The contribution of inherited non‐genetic factors to complex diseases is of great current interest. The ways in which mothers and fathers can affect their offspring's health clearly differ as a result of the intimate interactions between mother and offspring during pre‐ and postnatal life. There is, however, potential for some overlap in mechanisms, particularly epigenetic mechanisms. A small number of epidemiological studies and animal models have investigated the non‐genetic contribution of the parents to offspring health. Discovering new mechanisms of disease (...) inheritance is technically difficult, especially in genetically, socially and environmentally heterogeneous human populations. Therefore, rigorous experimental design, appropriate sample numbers and the use of high‐throughput technologies are necessary to provide convincing evidence. Based on recent examples from the literature, here we propose several ways to improve human studies that aim to identify the underlying mechanisms of transgenerational inheritance of metabolic disease. (shrink)

Health research has shown that overweight and obesity in children and adults are becoming significant public health problems in the developing world. Evidence suggests that this phenomenon is more marked in urban than rural areas and may be associated with modernization. However, the underlying reasons for this nutrition transition remain unclear. Dietary shifts, often in conjunction with income and time constraints in urban environments, may entail a greater reliance on more convenient sugar and fat-dense food. Also, the necessity of (...) labor-intensive agricultural work to meet rural subsistence needs is supplanted in urban environments by sedentary work. This paper extends the application of human behavioral ecology theory into the realm of international development and policy by applying Kaplan’s embodied capital theory to explore differences in food habits and nutritional status of Indo-Fijian children within the context of urbanization. Urban high-embodied-capital women demonstrate higher rates of wage-earning employment than urban low-embodied-capital or rural women. Findings indicate that urban high-embodied-capital households spend significantly more on food purchases, purchase a greater proportion of processed foods, and have children with higher body mass indexes (BMI) than do urban low-embodied-capital or rural households. This suggests that urban high-embodied-capital mothers, who tend to be employed, may be making trade-offs between income and food choices. (shrink)

Cet article a pour objectif de montrer l’importance de la réception de la théologie politique de J.B. Metz auprès de certains théologiens soucieux de la dimension politique de la foi chrétienne. L’étude présente les réactions immédiates au projet théologique de Metz pour ensuite se focaliser sur des théologiens contemporains. Premièrement, on trouve J. Milbank, qui apprécie la pensée de Metz en la confrontant à son programme de Radical Orthodoxy. Deuxièmement, on rencontre H.-J. Gagey et J.-L. Souletie, qui évaluent la force (...) politique de la théologie de Metz. Enfin, on découvre la façon dont L. Boeve reprend de façon personnelle certains aspects de la pensée du théologien allemand. Pour terminer, l’article propose une réflexion synthétique et critique sur cette réception, avec le souci de montrer la pertinence de la théologie politique de Metz et sa capacité à stimuler la réflexion sur le rapport foi et société. (shrink)

Kant's contribution to modern Protestant theology is as unmistakable as it is controversial. The authors of this volume are investigating a new perspective on the work of theology and the effects of Kant's philosophy of religion concentrated on biblical hermeneutics and dogmatic theology.

In den Publikationen der Synthetischen Biologie und in Darstellungen dieser neuen Biotechnologie finden sich häufig Begriffe des Herstellens, Konstruierens, Erschaffens und Kreierens. Im folgenden Beitrag wird dieses Begriffsfeld auf der Basis von technikphilosophischen und kunsttheoretischen Ansätzen systematisiert. Es wird erstens untersucht, inwiefern sich die verschiedenen Forschungsrichtungen in der Synthetischen Biologie mit diesem Begriffsinstrumentarium angemessen beschreiben lassen; zweitens wird analysiert, welche ethischen Fragestellungen mit den unterschiedlichen Begriffen des Herstellens und Erschaffens im Fall der Synthetischen Biologie verbunden sind.

Obesity has generated significant worries amongst health policy makers and has obtained increased attention in health care. Obesity is unanimously defined as a disease in the health care and health policy literature. However, there are pragmatic and not principled reasons for this. This warrants an analysis of obesity according to standard conceptions of disease in the literature of philosophy of medicine. According to theories and definitions of disease referring to internal processes, obesity is not a disease. (...) Obesity undoubtedly can result in disease, making it a risk factor for disease, but not a disease per se. According to several social conceptions of disease, however, obesity clearly is a disease. Obesity can conflict with aesthetic, moral, or other social norms. Making obesity a “social disease” may very well be a wise health policy, assuring and improving population health, especially if we address the social determinants of obesity, such as the food supply and marketing system. However, applying biomedical solutions to social problems may also have severe side effects. It can result in medicalization and enhance stigmatization and discrimination of persons based on appearance or behavior. Approaching social problems with biomedical means may also serve commercial and professionals’ interests more than the health and welfare of individuals; it may make quick fix medical solutions halt more sustainable structural solutions. This urges health insurers, health care professionals, and health policy makers to be cautious. Especially if we want to help and respect persons that we classify and treat as obese. (shrink)

In this paper, we aim at rethinking the concept of obesity in a way that better captures the connection between underlying medical aspects, on the one hand, and an individual’s developmental history, on the other. Our proposal rests on the idea that obesity is not to be understood as a phenotypic trait or character; rather, obesity represents one of the many possible states of a more complex phenotypic trait that we call ‘energy metabolism.’ We argue that this (...) apparently simple conceptual shift can help solve important theoretical misconceptions regarding the genetics, epigenetics, and development of obesity. In addition, we show that our proposal can be fruitfully paired with the concept of developmental channeling of a trait, which connects to the study of the plasticity and canalization of complex traits. Finally, we discuss the potential impact of our approach on the assessment, treatment, and social narratives of obesity. (shrink)

New anti‐obesity medications (AOMs) have received widespread acclaim in medical journals and the media, but they also raise critical ethical, public health, and public policy concerns that have largely been ignored. AOMs are very costly, need to be taken by a patient in perpetuity (since significant rebound weight gain otherwise occurs), and threaten to shift resources and focus away from other crucial efforts at obesity treatment and prevention. Many people may feel less motivated to exercise or reduce their (...) caloric consumption, if they assume that obesity is now medically treatable. Policy‐makers may similarly come to feel that the solution to the obesity pandemic is simply to prescribe medications and that prevention efforts are far less necessary. These drugs raise concerns about justice (since AOMs will disproportionately benefit the wealthy), medicalization, and marketing. Policy‐makers, clinicians, and others need to engage in multipronged educational and policy efforts to address these challenges. (shrink)

Widespread obesity poses a serious challenge to health outcomes in the developed world and is a growing problem in the developing world. There has been a raft of proposals to combat the challenge of obesity, including restrictions on the nature of food advertising, the content of prepared meals, and the size of sodas; taxes on saturated fat and on calories; and mandated “healthy-options” on restaurant menus. Many of these interventions seem to have a greater impact on rates of (...) obesity than does simply providing information about health risks and healthier lifestyles. The more interventionist policy options have, however, been implemented only slowly, in large part because of criticisms that they are unjustified infringements on the liberty of consumers. Food industry groups, free-market think tanks, and the popular press regard measures that incentivize or penalize particular food and lifestyle choices as unjustifiable state regulation of purely self-regarding behavior. To counteract the liberty-oriented position, those who favor a more interventionist role for the state have recently argued for labeling obesity as a public health emergency. By labeling obesity as a public health emergency, policy-makers could override concerns about individual liberty in order to pursue more interventionist policies designed to guide consumer choices toward healthier lifestyles. In this paper, we argue that, contrary to initial appearances, obesity possesses some of the morally relevant features of public health emergencies, though we do not argue that it actually constitutes one. (shrink)

Partly in response to rising rates of obesity, many governments have published healthy eating advice. Focusing on health advice related to the consumption of animal products (APs), I argue that the individualistic paradigm that prevails must be replaced by a radically new approach that emphasizes the duty of all human beings to restrict their negative “Global Health Impacts” (GHIs). If they take human rights seriously, many governments from nations with relatively large negative GHIs—including the Australian example provided here—must develop (...) strategies to reduce their citizens’ negative GHIs. As the negative GHIs associated with the consumption of many APs are excessive, it is my view that many governments ought to adopt a qualified ban on the consumption of APs. (shrink)

Obesity is often considered a public health crisis in rich countries that might be alleviated by preventive regulations such as a sugar tax or limiting the density of fast food outlets. This paper evaluates these regulations from the point of view of equity. Obesity is in many countries correlated with socioeconomic status and some believe that preventive regulations would reduce inequity. The puzzle is this: how could policies that reduce the options of the badly off be more equitable? (...) Suppose we distinguish: (1) the badly off have poor options from (2) the badly off are poor at choosing between their options (ie, have a choosing problem). If obesity is due to a poverty of options, it would be perverse to reduce them further. Some people in public health say that preventive regulations do not reduce options but, I shall argue, they are largely wrong. So the equity case for regulations depends on the worst off having a choosing problem. It also depends on their having a choosing problem that makes their choices against their interests. Perhaps they do. I ask, briefly, what the evidence has to say about whether the badly off choose against their interests. The evidence is thin but implies that introducing preventive regulations for the sake of equity would be at least premature. (shrink)

Is there an obesity crisis? Postmodernists like Michael Gard argue that there is not while epidemiologists argue that there is and it is growing. In this paper, I argue that such polarized positions are not a sign of healthy dialectic, but a sign of an increasingly fragmented and reductionist obesity research field. As a further example, I draw on long term seemingly unresolvable disputes within nutrition brought about through reductionist approaches. I argue that there is an obesity (...) crisis, that it is linked to other major global crises and that to meaningfully address it will require greater unity within the obesity research field. I therefore put forward the post-reductionist general concept of semiotic corruption developed by process philosopher, Arran Gare and drawn from the emerging post-reductionist field of biosemiotics, as a potential unifying concept for the field. In doing this I explore the history and nature of biosemiotics and its links to other holistic traditions which all seek to mend the gross philosophical errors committed by those such as Descartes who ruptured the relationship between living and non-living processes. I then discuss some implications of this holistic approach for better understanding obesity as semiotic corruption, particularly focusing on the concepts of embodied, anticipatory systems and the need for a new ethics of health which understands and augments the real complexity and irreducibility of life. (shrink)

Obesity may be the most difficult and elusive public health problem this country has ever encountered. Unlike the classical infectious diseases and plagues that killed millions in the past, it is not caused by deadly viruses or bacteria of a kind amenable to vaccines for prevention, nor are there many promising medical treatments so far. While diabetes, heart disease, and kidney failure can be caused by obesity, it is easier to treat those conditions than one of their causes. (...) I call obesity elusive partly because of the disturbingly low success rate in treating it, but also because it requires changing the patterns, woven deeply into our social fabric, of food and beverage commerce, personal eating habits, and sedentary lifestyles. It also raises the most basic ethical and policy questions: how far can government and business go in trying to change behavior that harms health, what are the limits of market freedom for industry, and how do we look upon our bodies and judge those of others?. (shrink)

At no time in recent decades has more attention been paid to ethical issues in pregnancy. Particularly riveting—and alarming, to many—was the passage of Senate Bill 8, a Texas law banning abortion...

The obesity epidemic is not only impairing the health of millions of Americans but also giving rise to billions of added dollars in health care spending. Climbing rates of obesity over the past decades are one of the predominant determinants behind the surging progression of health care expenses in the United States. Moreover, the less fit and less productive U.S. workforce has gradually eroded the nation’s industrial competitiveness. Since the early 1970s, adult obesity rates have doubled and (...) childhood obesity rates have more than tripled, while health expenditures have risen two percentage points faster than the Gross Domestic Product, burgeoning from 8.8 percent in 1980 to a projected 17.9 percent in 2011. Studies analyze that greater than a quarter of America’s health care expenses are attributed to obesity. The stunning growth in obesity has been imputed for 20 to 30 percent of the increase in health care costs since the late 1970s. If the proportion of obese population had stayed unchanged, then health care expenditures in America would be approximately 10 percent less on a per capita average than they are today. (shrink)

In this editorial, we argue that midwives should focus on climate change, a link which has been underexplored.

KNUTSEN IR, TERRAGNI L and FOSS C. Nursing Inquiry 2011; 18: 348–358 Morbidly obese patients and lifestyle change: constructing ethical selvesIn contemporary societies, bodily size is an important part of individuals’ self‐representation. As the number of persons clinically diagnosed as morbidly obese increases, programmes are developed to make people reduce weight by changing their lifestyle, and for some, by bariatric surgery. This article presents findings from interviews with 12 participants undergoing a prerequisite course prior to bariatric surgery that is intended (...) both as a preparation for further (surgical) treatment and as a tool to empower individuals regarding lifestyle changes. In this study, we investigate how power operates by looking at how the participants position themselves throughout the course. Findings reveal how participants construct their ability to act in line with norms of lifestyle change. They do this by positioning themselves as both included group members and as ‘morally’ acceptable individuals. Despite some resistance, the participants tend to glide into the role of ‘good patients’ acting in compliance with the aims of the course in their hope and striving for new positions as ‘normal‐sized’. The intention in the course is to empower individuals towards lifestyle changes. The findings provide a basis to question whether these kinds of courses create new forms of compliance and dependency. (shrink)

The belief that obese people ought to lose weight and keep it off is widespread, and has a profound negative impact on the lives of the obese. I argue in this paper that most obese people have no such obligation, even if obesity is bad, and caused by calorie input exceeding output. Obese people do not have an obligation to achieve long-term weight loss if this is impossible for them, is worse than the alternative, or requires such an enormous (...) effort in relation to what stands to be gained that this option is supererogatory rather than obligatory. It is highly plausible that most obese people fall into one of these three groups. Politicians may still have obligations to fight obesity, but they ought to do so through progressive politics rather than blaming and shaming. (shrink)

Obesity is one of the most significant public health challenges and becomes a public health problem. Consumption of fast-food, which have high energy densities and glycemic loads, and expose customers to excessive portion size, is frequently associated with weight gain, therefore, it is hypothesized that relative availability of fast-food is a risk for obesity.

It is important to identify the developmental antecedents of externalizing behavioral problems in early childhood. The current study examined the main effects of maternal personality and its interactive effects with child temperamental reactivity in predicting child externalizing behavioral problems, indicated by impulsivity and aggression. This study was composed of 70 children (Mage= 17.6 months, SD = 3.73) and their mothers. The results showed that maternal agreeableness was negatively associated with child impulsivity. Child temperamental reactivity moderated the effect of (...) maternal conscientiousness on child impulsivity in support of the differential susceptibility model. Specifically, for highly reactive children, maternal conscientiousness was negatively associated with child impulsivity whereas this association was nonsignificant for low reactive children. Child reactivity also moderated the contribution of maternal neuroticism to child impulsivity. That is, maternal neuroticism was negatively associated with impulsivity, only for highly reactive children. (shrink)

This chapter examines the case for health care policies aimed at holding obese individuals responsible for their weight and for obesity-related health issues. In particular, it considers the merits of two arguments for policies that would seek to make obese individuals bear some of the higher health care costs associated with being that way. On the fairness argument, it is claimed that such policies would serve the interests of fairness by holding obese individuals to account for irresponsible lifestyle choices (...) that are linked to their higher weight and its associated health risks. On the public health promotion argument, it is claimed that adopting such policies could produce impressive public health benefits: encouraging people to make healthier lifestyle choices, reducing obesity rates, and reducing obesity-related health care spending. Both arguments face serious objections. Contrary to the fairness argument, policies aimed at holding obese individuals responsible for their weight or for related health problems would neither treat people as they deserve to be treated nor make the distribution of health care resources fairer. And contrary to the public health promotion argument, those policies would not produce better health outcomes for society at large. Indeed, they would tend to do just the opposite. Reflection on the shortcomings of those arguments reveals that their conclusion is false: society should not adopt policies aimed at holding obese individuals responsible for their weight or for obesity-related health problems. (shrink)

In ____Maternal Ethics and Other Slave Moralities__ which includes the first extended philosophical discussion of the works of Frederick Douglass, Cynthia Willett puts forward a novel theory of ethical subjectivity that is aimed to counter prevailing pathologies of sexist, racist Eurocentric culture. Weaving together accounts of the self drawn from African-American and European philosophies, psychoanalysis, slave narratives and sociology, Willett interrogates what Hegel locates as the core of the self: the desire for.

Sara Ruddick's Maternal Thinking represents a great contribution to moral philosophy-in particular, by bringing women's "private" virtues into the public sphere. However, there remain problems in the analysis which need to be addressed: How can one possibly generalize about the practice of mothering from one, necessarily limited, perspective, given the facts of cultural diversity? Is Ruddick's normative account of mothering congruent with the reflective judgments of others? Is her account of the transformation of parochial mothering into feminist peace work (...) viable? After exploring these three questions, this reviewer calls, with Ruddick, for the telling of more maternal stories, from different cultural, racial and economic perspectives. (shrink)