Of course, as a public health advocate I am in favor of bring more attention to the nation’s diet-related health crisis. However the HBO series distracts us with the usual scare tactics, dances around the hard political issues, and leaves the viewer with the misguided impression that if we all just worked harder in our own communities, we can fix this mess.

Fear the fat – more shaming and blaming

Numerous others have provided excellent explanations for why all the alarm sounding over obesity should be questioned from a scientific perspective. For example, see Deb Burgard and Linda Bacon, both leaders in the Health at Every Size movement, which aims to shift away from body size and fat-shaming toward health and compassion. Also, Marilyn Wann, in this excellent historical overview and critique disputes the CDC’s claim that Weight of the Nation is “an unprecedented public health campaign” but argues it’s rather a continuation of a decades-long painful episode.

But even without getting into a debate over data, the evidence that America’s fear of fat is harmful is clear. For example, scientific research shows that fat people have enough problems dealing with discrimination, bullying, and stigma, so shows like this make life even more difficult for them.

Indeed, the first two episodes were mostly about obese people suffering from one malady or another, interspersed with health expert talking heads scaring us with statistics and images of gross organs and surgeries. And not a peep about how thin people who don’t exercise or eat a healthy diet are at risk for chronic disease.

Individual stories of suffering were interwoven between the talking heads. For example, the bus driver who feared her husband didn’t love her anymore, or the woman who achieved weight loss (success!) through “small steps,” ensuring the focus remained on individuals and behavior change.

A few things they got right

Things did get a little better in segment three, which focused on children. Finally, an explanation of junk food marketing, with excellent quotes from folks like Kelly Brownell of the Rudd Center on Obesity and Food Policy, (“Powerful, pernicious, and predatory,” he called marketing to kids ) and Margo Wootan, of the Center for Science in the Public Interest (“marketing shapes kids’ choices, to foods that will kill them.”) Also good was footage of a Congressional hearing on junk food marketing, the only foray into actual policymaking in the entire program.

Several segments focused on important issues like agricultural policies and how our bodies are hard-wired to conserve fat, in a clear attempt to shift the conversation away from one all about personal responsibility. However, none of these segments dove deeply enough into the politics and overall the messages stayed safely in the realms of medicine, exercise, behavior change, and localized solutions.

Missed opportunities

We see numerous examples of junk food marketing to children, but far too little about the powerful lobbying by the food, advertising, and media industries and how that undermines policymaking. And it’s not like such information isn’t readily available.

During a segment showing Philadelphia Mayor Michael Nutter wandering his streets in search of healthy food, I thought, this would be a great place to talk about how the American Beverage Association lobbied to stop his soda tax proposal from going forward, even donating $10 million to Philly’s Children’s Hospital to ensure his silence. Not a chance.

Or, during the many scenes with New York City’s health commissioner Tom Farley, a mention could have been made of that city’s attempt to restrict food stamp spending on soft drinks, which also got heavy push-back from the soda industry. Nothing. This, despite the experts identifying soft drinks as enemy number one, along with other problems related to our food environment.

I was hopeful during one segment when the talking heads admitted that exercise and physical activity were really far less important than food intake when it comes to addressing obesity, a point I’ve made related to children. (Kudos for the  take-down the awful show, the Biggest Loser.)

But then the producers seemed to ignore their own experts by showing lazy kids playing video games and offering as the most tangible policy solutions more walking and biking trails. Indeed, the entire series ends with the mayor of Nashville leading his residents in a pied-piper walk to thinness.

Where are the policy solutions?

No clear policy solutions to prevent obesity were offered. Could soda taxes work? How about efforts to restrict toys with kid’s meals? Not even one lawyer to discuss litigation as a potential strategy to hold the food industry accountable for deceptive marketing practices? And what about the farm bill, which is up for renewal this year?

Nope, all too edgy, even for HBO.

Which is really not surprising given the entire project was produced in collaboration with the federal Department of Health and Human Services, which isn’t about to criticize the Obama Administration for its failure to lead on numerous food issues. Also featured prominently was the Congressional advisory body, the Institute of Medicine, which released a set of recommendations last week, which I described as déjà vu all over again.

Obesity distracts from food system change

Continuing to focus on obesity is problematic for numerous reasons. As this program painfully demonstrates, it’s too easy to place the blame on individuals, to make them the sole locus of change instead of fixing the systemic problems with our food system. Also, exercise is a powerful and safe distraction for policymakers.

Finally, obsessing over obesity is a great gift to the food industry because this is a problem food companies can supposedly help fix. They can market healthier foods! They can help fund playgrounds and exercise programs!

Instead of talking body size, (don’t thin people get sick?) let’s garner the political power we need to focus squarely on fixing the food system, which is admittedly more complex than calories in, calories out but is also more compassionate. As Deb Burgard explains, the fat blame game is just too easy:

Blaming fatness keeps us from addressing the root causes of our problems and is clearly unfair to fat people. Many powerful people understand this but find it expedient to frame a problem in terms of fat in order to bring attention to it. They don’t think people will just attend to the real issue unless they whip up the fat panic. … I say, have the courage to make your argument about the real issues and stop doing it on the backs of fat people.

This will take a political movement that can’t be brought to you by cable television.

An edited version of this article appeared at Grist.

Why Philadelphia? Could a proposal to place a tax on soft drinks have anything to do with it? Here’s how the Philadelphia Inquirer explains it:

When City Council was considering a soda tax last spring, doctors from the Children’s Hospital of Philadelphia testified about the dangers of sugar-sweetened drinks. On Wednesday, the hospital announced that it would expand its obesity program with the help of $10 million from the very industry that produces them.

What a coincidence. Maybe not. The paper continues:

The industry first made the offer last spring, when City Council members were debating Mayor Nutter’s proposed 2-cent tax on every ounce of sugar-sweetened beverages sold in the city. The tax was projected to bring in $20 million for obesity-prevention measures and more money for the general fund. The idea fizzled in May without going to a vote.

Can’t imagine why. At least industry followed through on its bribe. The paper also notes: “The three-year grant is the inaugural gift from the Foundation for a Healthy America, a nonprofit created by the American Beverage Association.”

The American Beverage Association, which represents powerful companies such as Coca-Cola and PepsiCo, has lobbied for years against such commonsense policies as getting soda out of schools. Now the policy debate has shifted to soda taxes, an issue that industry finds more threatening than any other. Ongoing sales of Coke and Pepsi rely almost entirely on the products’ cheapness. Companies hate any government meddling in their competitive price points.

So here’s the game plan: create a front group – the Foundation for a Healthy America (how touching) – and funnel corporate money into it. Out the other ends comes tax-deductible grants to anybody who gets in industry’s way. There’s a name for this: it’s called buying silence. And guess who championed it? Back in 2006, I interviewed Richard Daynard, law professor at Northeastern University School of Law and veteran of the tobacco wars. Here’s an excerpt worth revisiting:

Another tactic we are seeing from the food industry is philanthropy. For example, we have PepsiCo and Coca-Cola funding educational programs in schools. What parallels do you see here with tobacco companies?

It’s very interesting. Phillip Morris was a very active philanthropist. They particularly gave money to minority organizations, and basically bought silence. [Meaning that in exchange for donations, recipient groups would not speak critically of industry.] There have been a number of articles written about how the tobacco companies bought silence, particularly from black organizations. They also would advertise very heavily in minority media; one of the few national companies to do it. It resulted in the black organizations and the black media basically not getting the word out that they were among the principal victims of this industry. They also advertised in early feminist publications, such as Ms. Magazine when that was the leading feminist magazine. So they bought Gloria Steinem’s silence. They bought a lot of peoples’ silence by buying ads.

Sound familiar? A $10 million donation may be a lot of money for a children’s hospital, and some good will likely result from the funds. But it’s a drop in the bucket for the soft drink industry, a small cost of doing business and a worthy investment. Especially because the proposed beverage tax was projected to bring in $77 million in just one year, with $20 million specifically allocated to obesity prevention programs. And with no strings attached. Somehow I doubt we will see any research coming out of Children’s Hospital of Philadelphia that could ruffle the feathers of the beverage lobby.

Mayor Nutter has said he won’t introduce the soda tax again this year, big surprise. Congratulations Coca-Cola and PepsiCo, you may now take your rightful place alongside Philip Morris and R.J. Reynolds in the Corporate Hall of Shame.

And the timing of the ad campaign seems awfully suspicious, as Ad Age notes:

While the school initiative was in place well before the industry was put on the defensive against the proposed taxes, the promotion of the program is certainly well-timed. New York Gov. David Paterson has called for a one-cent-per-ounce tax on sugar-sweetened beverages, while Philadelphia Mayor Michael Nutter last week proposed a two-cent-per-ounce tax on sugary beverages.

The soft drink industry certainly knows how to deflect attention and confuse the issues. Calling their latest “initiative” (is anyone else sick and tired of hearing that word?), “Clear on Calories,” Big Soda seems to think that placing calorie numbers on the front of beverage containers and vending machines equals good nutrition and “has painted the voluntary commitment as an answer to First Lady Michelle Obama’s call to eradicate childhood obesity.” Funny, I don’t remember seeing anything about soda calorie labels in the First Lady’s program.

The ever-ready with a quote PR guy Kevin Keane, of the American Beverage Association (i.e., lobbying trade group) explains: “These are the fiercest rivals you’re going to get. But our companies felt [the campaign] was the strongest way to convey what they’d done and that they’d done it together.” How warm and fuzzy. Of course, these same companies have been lobbying together for years to undermine school nutrition policy, so this teamwork is really nothing new.