The Puzzle of Obesity.

More news on the obesity front: the U.S. Preventative Service Task Force has concluded that pediatric obesity programs can prove successful. Five years ago, they concluded otherwise. The change of heart was due to the success of pediatric obesity programs. The success was attributed to "intensive behavior programs." Those programs, however are "costly, hard to find and hard to follow." Task force chairman Dr. Ned Colonge stated that "this is a recommendation that says there are things that work." Gyms, exercise, and diet have been eclipsed by "behavior modification." One can expect that it will be only a matter of time before there is pressure to extend health care insurance to cover those behavior programs.

Implicit in the term "behavior modification" is the idea that obese children are unable or unwilling to lose weight by themselves or with the help of their parents and families. This idea is underscored by the increasing tendency to treat obesity as a predominantly medical condition. While obesity certainly has medical ramifications, it has only recently become a medical issue to be treated. In the report is the curious omission of the fact that most children neither buy their own groceries nor cook their own meals. Every obese child has a sponsor.

Triumphantly, Cologne goes on to state that the report, published in the journal Pediatrics, means "insurers will no longer be able to say that they won't provide coverage because treatment works." Which also means that, under national health care, neither will the government. This will certainly be a relief to those unwilling to do what it takes to lose weight but prefer to seek medical treatment for their condition. Insurance will soon cover it.

It is less and less common for obesity to be seen as an issue of character, motivation, and self control. Instead, the inability to forgo that second piece of pie or spur oneself to take a walk in the park is rapidly becoming a psychological condition requiring therapy and treatment. Once again, government studies and scientific reports are supplanting common sense. Says Dr. Cologne, "you don't have to throw your arms up and say you can't do anything...there are things that work." It is as if avoiding weight gain and losing weight have been medical mysteries that science has only recently begun to solve. Undoubtedly, the medical and psychological approach to obesity has its appeal to the overweight. It serves to remove from them the responsibility for their own predicament. In other words, being obese is increasingly being seen as no longer the fault of the obese person. Nor is it necessarily a situation that can be improved by the person on their own. It is becoming a medical condition that requires treatment.

The scientific approach has its appeal to the scientific and medical communities as well. It represents a new frontier; a new facet of human behavior to be brought under the dominion of science. For many, human behavior is a puzzle to be solved. Once it is solved, it can then be understood. Once it is understood, it can be manipulated. The scientific analyses and reports issued concerning obesity rarely pay more than lip service to self discipline and common sense. Obese people know they are obese. They know why they are obese and they know what they have to do to lose weight. It is not a mystery. Where the new studies differ from common sense is that they uniformly give short shrift to human motivation by obscuring it amidst scientific data and technical jargon. Watching TV or playing video games does not make people obese. Eating too much and not exercising do.

Clockwork Orange was a book written many years ago attempting to point out the errors and dangers of an overly scientific approach to human nature. In the book, a violent and sociopathic character, after committing a string of horrors, was not imprisoned, he was "treated". His violence was not seen as due to his character and lack of conscience, but rather due to his flawed psychological make up. The solution was to readjust him. In the end, the "adjustment" failed to stick, and Alex returned to his violent and cruel ways because that is who he was: that was his nature. The point of the story was that people are not clocks: they are not things to be adjusted, manipulated, and corrected.

Neither is society a clock. The scientific approach to human behavior is becoming more and more fashionable. But society is not something to be adjusted, manipulated, or corrected. Neither are the obese. While people may be enticed or discouraged, it is ultimately up to them to evaluate their motivation and decide whether to change their behavior and habits. Government will never succeed in stopping someone from going back for seconds or make them take a walk in the park. Only the person them self can do that. But that does not mean that the government won't try by seeking to "modify" their behavior.