Dear Ms. Okon,
I would like to begin this letter by acknowledging the hard work you and your organisation, The American Obesity Foundation (AOF), have been doing for many years now, aiming to prevent obesity and its subsequent diseases all over the United States. This is by no means an easy job, I understand, as it is no secret that obesity levels in the western world, particularly in the US, are steadily rising at an alarming rate. According to the World Health Organisation, in 2016, 39% of the adult population across the globe were overweight, with 13% of the population being classified as obese (Anon., 2021). These figures are nothing short of shocking, hence why I find your work to combat the issue of obesity and obesity-related health problems admirable, and understand that to do so is an uphill battle. To tackle such a deep-rooted and widespread issue, several approaches must be taken and AOF does an excellent job with regards to many of these, educating the people of North America and advocating for a healthier lifestyle.
I do, however, believe that there is more to battling obesity than education alone. Reading through the foundation’s website and looking at all the work you do there, it struck me that there appears to be an over-emphasis on educating communities about the dangers of an unhealthy lifestyle and promoting healthy eating through spreading knowledge, but not enough of a social approach to solving the issue. The foundation’s website clearly states the goals and actions of the AOF, from your ‘Health-Is-Wealth Behavioural’ goal, which aims to promote integration of decision-making techniques, crisis-management, and other skills in order to advocate for healthy eating and living, to the Mobile Clinic which frequently tours at-risk neighbourhoods in order to spread the message of healthy eating, inform citizens about the importance of eating fresh foods, as well as screen for figures like body-mass index (American Obesity Foundation, 2016). Both of these programs are essential to fighting the obesity epidemic sweeping the nation, however they are also both based on the assumption that these communities are only lacking knowledge when it comes to leading a healthy lifestyle. The same could be said for the AOF’s ‘Houses of Faith Obesity Prevention Program’, working with religious and faith-oriented families in order to teach them the value of healthy eating, or the Community Wellness Coaches, who, though trained in the cultural sensitivities for certain groups, still only aim to educate populations about the dangers of obesity and unhealthy lifestyles.
These services are, to some extent, necessary; knowledge is a powerful tool for fighting epidemics, and many people could more health education, however this is not the primary issue when it comes to obesity. The issue of unhealthy eating in the US is less to do with people being misinformed about what behaviours are good for them and more the result of entire communities not having access to the resources required to life a healthy lifestyle, be that as a result of poverty or simply having no healthy food available to them, living in what have been dubbed ‘food deserts’ (Garth, 2020). Moreover, other factors like growing inequality in certain areas, as well as shifts in quality of food being produced and sold globally, and even presence of toxic chemicals (obesogens) increase risk of obesity at different stages of life (Baillie-Hamilton, 2002). Several studies have been carried out by nutrition specialists and anthropologists throughout Europe, Australia, and the USA especially that conclude that racial and socio-economic inequalities severely impact obesity rates amongst both children and adults, and that these are the groups which must be targeted in order to prevent the issue (Madden, 2013; Walsh & Cullinan, 2015). These studies show that this is therefore not an issue of education alone, but one of means and abilities. In her 2020 short article, Garth makes much the same point about health inequalities in Los Angeles specifically, which is perhaps more pertinent to the work of the American Obesity Foundation; she highlights the ignorance of policymakers in banning fast-food restaurants in an attempt to prevent obesity, as opposed to increasing the availability of fresh food stores in Black and Latinx areas, ensuring that the inherent racial and social issues underlying America’s obesity problems are never addressed (Garth, 2020). In much the same way, focusing on education alone ignores these contributing factors. One can know all the secrets to living a healthy life, can entirely comprehend the importance of eating fresh fruit and vegetables every day, but if these things are not available or unaffordable to them, then this education is, to phrase it strongly, pointless.
The aim of my letter is not, as it may seem, to brazenly criticise you and the work of the AOF. I simply wish to advocate for a more efficient and society-oriented approach to preventing obesity and its related diseases. Whilst educating people remains an important part of the process, it is not the only thing that needs to be done, and not the part of the problem which requires the most change. To truly tackle the issue that is the rising obesity rates in the USA, I firmly believe that organisations such as yours should address the deeper issues in society; aim to look at the racial divides in communities and how this is reflected in the food options available; analyse the socio-economic status of people in areas with disproportionately high rates of obesity and assess whether or not there is anything to be done about this. Health issues are not simply a matter of nutrition and biology, but are rooted in much more systemic issues with solutions that, on the surface, appear to have little to do with food and fitness. But if a charity such as the AOF were to use their funds to collaborate with policymakers, big corporations, and social scientists in order to understand these patterns and consequently make a difference, perhaps adding more affordable healthy food options to ‘food desert’ neighbourhoods, or doing more to understand cultural differences which lead to food issues. Language, for example, can play an important role in both education and progressing communities in order to improve health (Yates-Doerr, 2014). Incorporating anthropologists and other social scientists into the organisation may help further communication and thus improve obesity prevention.
Furthermore, AOF should now pay more attention to socioeconomic status and health disparities, and aim to provide financial aid and work advice to families without the money to afford the healthy lifetyles they are taught to live. I understand, of course, that AOF works with the Supplemental Nutrition Assistance Progam (SNAP), aiming to supplement the food budgets of needy families, however this in itself is not exactly solving the issue either; organisations like SNAP ensure that people have enough to eat and follow nutritional guidelines at as low a cost as possible, meaning they actually have been shown to encourage eating habits that contribute to chronic disease levels amongst impoverished groups (Dickinson, 2020). By discontinuing your work with SNAP and working with supermarkets or delivery companies, for example, in order to make a wider range of healthier foods available, the foundation could accomplish a much more significant change in obesity levels in the USA, tackling the problems that cause obesity and its related health issues. Working with private companies in this way as opposed to federal organisations may also allow for more flexible decisions when it comes to spending, and therefore avoid using low quality food in order to save money. In doing this, there is a chance that we could begin to see generational progress as well, as communities move forward and healthy food becomes both more accessible and more affordable through the efforts of charities like yours.
Allow me to emphasise once again that the aim of this letter is not to criticise the American Obesity Foundation. Educating the public about making healthier choices is a vital and necessary part of obesity prevention, this is an undeniable fact. What I am proposing, however, is that the time has come for the foundation to do more. Education, whilst important, targets the victims, the individuals who are more susceptible to obesity and obesity-related diseases, treating the problem as though they are the only ones with the power to change it, when in fact this is a much deeper issue. To truly prevent obesity and improve health in communities, charities such as the AOF must aim to achieve social change, to tackle the racial and economic issues in countries such as the US. This is a big task, and impossible to achieve quickly, but through cooperation with local governments, supermarkets both big and small, and other organisations in the food and development industries, there is a chance that a foundation like yours could make huge steps in the fight against obesity, hopefully changing habits and social structures, one vulnerable community at a time.
I hope you take these points into consideration, and I look forward to watching the AOF develop and progress in the future!
Anon., 2021. World Health Organisation. [Online]
Available at: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight#:~:text=Facts%20about%20overweight%20and%20obesity&text=In%202016%2C%2039%25%20of%20adults,tripled%20between%201975%20and%202016.
[Accessed 17 February 2022].
Baillie-Hamilton, P.F., 2002. Chemical toxins: a hypothesis to explain the global obesity epidemic. The Journal of Alternative & Complementary Medicine, 8(2), pp.185-192
Dickinson, M., 2020. Fiscal Violence in the United States’ Food Safety Net. American Anthropologist, 122(3), pp. 649-650.
Foundation, A. O., 2016. Programs, Services & Initiatives. [Online]
Available at: https://americanobesityfdn.org/programs-services-initiatives/
[Accessed 17 February 2022].
Garth, H., 2020. The Violence of Racial Capitalism and SouthLos Angeles’s Obesity ‘Epidemic.’. American Anthropologist, 122(3), pp. 653-654.
Madden, D., 2013. The socioeconomic gradient of obesity in Ireland. Economic and Social Review, 44, pp. 181-196.
Walsh, B. & Cullinan, J., 2015. Decomposing socioeconomic inequalities in childhood obesity: Evidence from Ireland. Economics & Human Biology, Volume 16, pp. 60-72.
Yates-Doerr, E., 2014. Obesity science and health translations in Guatemala: engagement in practice. Anthropology Now, 6(1), pp. 3-14.