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Karl’s adventures in Newfoundland: Time for a healthy debate?

in Gadfly by

A few weeks ago, the media tempest in a teacup around here was all about a Norwegian travel writer who had visited and called “everybody” fat. At first I thought he had fallen in with resident cyclists.

Sadly, no.

As it turns out, he wasn’t talking about “everybody” either. “Famed Norwegian author Karl Ove Knausgaard goes to Jungle Jim’s restaurant in St. Anthony, calls everyone there except the waiter fat” must lack the punchiness the National Post was after.

Anyway, the sweeping headline got the hits, for clearly far more people read the piece in the Post and similar accounts by CBC and The Telegram than Knausgaard’s own piece in the New York Times. That’s if they read anything at all. It didn’t take long before the dogs in the street knew that the only thing Knausgaard could find to say about his visit here is that Newfoundlanders are fat. Well, maybe also that he had some misadventures with a clogged toilet and had misplaced his driver’s license.

Oh yes. And also he smokes. How dare he describe anyone as fat when he smokes? Not only that. He also went to Detroit, and everyone knows that Americans are much fatter than we are, so why didn’t he remark on their fatness? How could anyone be so rude?

I am only slightly exaggerating one cluster of responses to the Cole’s Notes version of the NYT article. A spin-off industry involved gleeful Facebook reposts of a Slate piece describing Knausgaard as “the world’s worst travel writer.”

World’s worst tourism writer, perhaps

Now that the dust has settled, we might ask ourselves whether a grown up country throws a tantrum whenever visitors fail to summarize their experiences in Newfoundland with: “I can’t believe how friendly everyone was.”

Perhaps I’m a weak critic, but I actually liked Knausgaard’s approach. I found his description of north-most Newfoundland—the Times asked him to follow the trail of Norwegian migrants to North America, starting with L’Anse aux Meadows—evocative: “In front of me lay a world so beautiful and so cruel that it numbed my senses.”

Likewise, I was compelled by his reflections on how Detroit’s poverty manifests as the detritus of wealth, and on the strange problem of the local in the United States, a country built on an ideology of individualism and a materiality of mass-production and interchangeable labour. Mind you, I suppose not all Americans would see these observations as fodder for a tourism brochure.

Getting back to our local, if one set of reactions was affronted, another can be summarized as, “the truth hurts.” The provincial government got in on this act, with Clyde Jackman, minister for wellness, noting that the province tops the charts when it comes to “being overweight.”

Both Jackman and local medical researchers cite the negative health correlates of carrying significant extra weight, which some put on a par with cigarette smoking. These include, among others, high blood pressure, type 2 diabetes and osteoarthritis. In consequence, the government is designing programs aimed at “get[ting] people to take responsibility for their health.”

On the other side of the debate, scholars in the newish academic field of fat studies would probably tell me off for using the phrase “extra weight.”

Fat studies, according to a recent call for conference papers, “confronts and critiques cultural constraints against notions of ‘fatness’ and ‘the fat body’; explores fat bodies as they live in, are shaped by, and remake the world; and creates paradigms for the development of fat acceptance or celebration within mass culture.” Submitters are urged to “rethink using words like ‘obesity’ and ‘overweight’ … unless they are used ironically, within quotes, or accompanied by a political analysis.”

I haven’t got the expertise to adjudicate this debate. The fat studies scholars are surely correct that reading anyone’s health directly from their weight is facile. Worse, an obsession with weight can be seriously damaging, in ways ranging from mental distress to bizarre diets and harmful drugs.

And you don’t need to be a Fat Studies scholar to sense that shaming people for being fat is a terrible public health strategy.

But is government’s approach, aimed at getting people to take responsibility for their own health all that different? Isn’t it just a nicer way of saying “this is really your own fault”?

Collective alternatives to fat-shaming and fat-blaming

A sensible article in the International Journal of Epidemiology offers a helpful perspective. First, based on US American data, it suggests that the obesity epidemic may be more of a moral panic than a material crisis, partly because the actual weight gain for the majority of people is around 3 to 5 kg – not that much, but enough to nudge a lot of people’s BMI into the “overweight” category.

More importantly, the authors argue that weight loss in itself is no guarantee of improved health. However, behavioural modifications often prescribed for weight loss — notably eating better and exercising more — produce health benefits even for people who gain body fat during the intervention. In short, the focus should be on health, not weight as such.

This means we might be better off targeting those social conditions associated with increased obesity that we know will likely negatively affect anyone’s health — thin or fat — rather than obesity itself.

What are these? Too little exercise and too much of the wrong kind of food are frequently cited as key contributors. But what can governments do to change that? As Minister Jackman said, they “can’t force people to be healthy.”

Just say yes to exercise?

While the province does recognize that there’s more to it than lecturing people about their five servings a day, too many public health interventions focus on education and awareness. Really, how many Newfoundlanders and Labradorians don’t already know about the benefits of eating more fruits and vegetables and getting more exercise?

Indeed, all levels of government could do more to make eating well and exercising more of a default than an act of will.

They could start by holding accountable industries that profit off of health-damaging products and practices. These are “harm industries,” to use anthropologists Peter Benson and Stuart Kirsch’s term, for “enterprises that are predicated on practices that are destructive or harmful to people and the environment: harm is part and parcel of their normal functioning.”

 Indeed, all levels of government…could start by holding accountable industries that profit off of health-damaging products and practices.

Tobacco is an obvious example, and Benson and Kirsch document in detail both the harms caused and the dirty tricks Big Tobacco used to neutralize or contain its critics. Ultimately, the critics won some battles, and government proved willing to impose taxes on tobacco at a rate that must have seemed unthinkable in the 1970s. Ditto for regulations on tobacco marketing.

Why not take a similar approach to “Big Sugar” and the rest of the processed and fast food industry? Its profits rest not only on engineered food cravings that encourage harmful eating, but also on environmental degradation, land grabs, and exploitive labour practices at every stage of the commodity chain. Perhaps some of the revenues from increased taxation could be spent on ensuring healthier foods were better accessible to all, a measure that has enormous potential for saving health dollars and lives.

As for exercise, public recreation facilities are an obvious social good. Government should also follow the lead of Calgary teacher Kyle Stewart and do whatever it can to facilitate “incidental activity,” primarily through provision for active transportation: biking, walking, skateboarding and the like (combined with public transport) instead of driving.

I’ve written before about the benefits of increased bicycle and foot traffic. I won’t rehearse them here, except to note that they extend well beyond the obvious fitness, health and environmental benefits to include support for local businesses—and not just bike shops—safer roads for everyone, and just plain enjoyment. Every excuse that we hear about the unsuitability of this place for biking—from the winter to hills and narrow streets—is countered by other places that face up to the same challenges.

Exercise and diet are self-evident areas for a collective response to the problems associated with obesity, as opposed to an individualistic one, where particular people are seen as problems to be targeted.

But there is one more factor, and it is much less intuitively obvious

In The Spirit Level Richard Wilkinson and Kate Pickett argue that, in richer nations increased inequality (not just individual income or a country’s total wealth) correlates with greater levels of obesity at a societal level. And levels of income inequality in this province are high and increasing, despite the “boom” of the 2000s.

It’s just possible that one of the most effective and efficient public health interventions any government could make is to introduce a guaranteed income.

Ultimately, even if people don’t drop pounds — if the Fat Studies scholars are right, fatness is fine anyway — wouldn’t it be good to live in a place where nutritious food was easy to come by, physical activity was part of the fabric of daily life, and wealth was better shared? What do we have to lose?

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