Some time back, the U.S. Preventative Service Task Force 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 prepare 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 or do what it takes to raise children who are not obese 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 addressed 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. Sitting on the sofa and watching TV 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 people themselves
can do that. But that does not mean that the government won't try by
seeking to "modify" their behavior.
Behavior modification is not a new concept. Indeed it is an ancient concept. For thousands of years parents, elders, and kin have sought to instill desirable behavior among their youths. While what precisely constitutes "desirable behavior" can and does vary from culture to culture, the concept is the same. What has changed is now behavior is a subject scientifically scrutinized, analyzed, and objectified. Sure, there were bad apples in the old days. There always have been and there always will be. Removing child development from the subjective sphere of family and kin and placing it in the objective sphere of psychology and sociology has yielded poor results. Society does not raise children. Family and peers do. Schools and government can train children. They can indoctrinate children. But the cannot raise them. Many progressive, both on the left and on the right, will disagree. To them I will only point to how quickly society has degenerated over the last 50 years despite their earnest attempts to raise a generation of responsible adults and good citizens who think and behave in a socially desirable way
Children are not a social group that needs to be studied and manipulated. They are a collection of individuals in need of rearing. The First Lady and others might think the nation can and should do more to affect how children are raised. It does take a village to raise a child. But neither an education system nor a government is a village. That is where the error lay. That is where the fundamental flaw in progressive thinking lay. Society and government are two very different things. Government is a product of society, not its source. A government does not create people. A people create a government.
Behavior modifications programs can and do work but only if people are truly willing to commit themselves to them. Just as alcohol and drug addiction programs can succeed, they also fail at an alarming rate. They are not magic. They only work in the presence of determination and commitment. We can neither expect nor create a determination to control diet and a commitment to fitness on the part of people, let alone children. All the governmental enticement and all the penalties and punishment in the world will not change that. Some children strive for academic achievement. Some don't. Some children strive for athletic achievement. Some don't. Some children have goals. Some don't. You can encourage the desire for achievement but you cannot create it. That is just how it is. That is how it always will be.
