Daniel Engber asks in the New York Times Sunday Magazine why the “reduce obesity” drumbeat doesn’t also spawn a “reduce shortness” drumbeat.
We’ve long known that stature can serve as a crude measure of public health. If everyone came from a perfect home, the average height across the population would be a function of our genes alone. (There would still be tall people and short people, but we would all have grown as much as we possibly could.) Anything less than an ideal standard of living, though, tends to stunt a child’s growth.
Daniel Engber also asserts that (in what seemed to me to be more radical a notion) notes that neither are about individuals but about populations. (Emphasis mine:)
Controlling our country’s height may be just as plausible — or implausible — as controlling its weight. It’s true that someone who is fat can lose weight on purpose, while a short adult can’t do anything to gain height. Yet instances of radical, lasting weight loss are exceedingly rare. Diet and exercise schemes tend to yield only minor effects over the long term. While lesser changes to your weight may be associated with modest health benefits, they won’t help all those obese adults to become slender. […]
Given how hard it can be to lose weight, a realistic war on obesity starts to look a lot like a war on shortness. In both cases, we’re dealing with a complex function of genetics, social class and poor health in childhood.
Early-life experiences play an important role in the development and consequences of body size. Exposure to malnutrition, infectious disease, chronic stress and poverty stunt a child’s development and seem to explain many of the long-term problems associated with short stature. Environmental factors may promote obesity, too: lack of breast-feeding, bad nutrition, chronic stress and poverty have all been associated with early weight gain and a higher risk of health problems down the road.
A danger here is to assume that anyone who’s fat or short had a bad childhood. As noted above, genetics will mean there’s still height and weight variance. With fatness, repeated dieting / weight cycling often leads to weight gain in the long term; I don’t think height has an analog to yo-yo’ing your weight up.
I do think it’s interesting that those who are shorter tend to graduate college less often, earn less, and are more likely to have heart disease, stroke, or diabetes — same as those who are fatter. Yet the US is all about individuals losing weight and ignores shortness. Perhaps a reason why is the US is so individualistic; anything individuals can do through self-improvement programs is lauded; height is mostly seen as something you’re stuck with.
The idea of the overall society working on improving children’s lives and health overall gets stuck in the details of “socialized” health care and parents’ rights in the US, but this could play well in some parts of Europe or Canada; I don’t have enough of a sense of other cultures (Australia?) to know about them.
What do you think?
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