A book about a weighty topic
Think you look great? Well, look a little more closely in the mirror. Wherever you live you may be like a lot of Canadians. We think we’re in good shape, but about 11 million of us are overweight, and half a million of us are severely obese, according to XXL: Obesity and the Limits of Shame by Neil Seeman, Arts’92, and co-author Patrick Luciani.
Seeman says there’s a worldwide obesity epidemic, and it’s costing governments big money. Canada alone spends $200 billion yearly on health care, as much as 70 per cent of it on chronic illnesses, about 60 per cent of which are caused by obesity. “It’s by far the greatest driver of all chronic illness,” says Seeman.
He believes governments’ “shame-and-blame” approach to public health policy hasn’t worked over the last several decades. Seeman and Luciani suggest the solution to our weight woes lies with “Healthy Living Vouchers (HLVs).” Such vouchers, if funded by the government, would give everyone access to a variety of options aimed at weight loss and weight management that recognize people’s individual needs. HLVs could be used for such things as gym memberships, nutrition lessons, peer-to-peer counselling, or the purchase of Wii sports games and consoles or iPods equipped with pedometers for the techno crowd. “Healthy living would be decided upon between the patient and the provider,” the book suggests.
Now CEO of the U of T’s Health Strategy Innovation Cell and Senior Resident in health system innovation at the U of T’s Massey College, Seeman studied English literature and political science during his undergrad years at Queen’s. He became increasingly involved in the study of health care when he studied law at the U of T and public health at Harvard. Now the co-author of three other books and numerous research papers on health-related subjects, he’s also a member of the Canadian Obesity Network. While impressed with the advances in scientific work being done around obesity, Seeman became increasingly disillusioned with the failure of governments to make a change in the lives of the obese – thus the book.
XXL: Obesity and the Limits of Shame, which was one of Amazon Canada's top-selling books on healthcare delivery last summer, has drawn praise from both the political left and right, but surprisingly criticism from those in the middle. “People on the left champion prevention. People on the right champion data and outcomes and choice. Obesity is a weird kind of wedge issue,” Seeman says.
As well, there’s just a lot of plain old loathing out there for those who are overweight. This is something Seeman was unprepared for when his book was published. After one interview in the U.S., hatred filled the blogosphere. “My wife and I couldn’t even read them. They said obese people had it coming to them, that we shouldn’t do anything for them, not HLVs, not a fruit-and-veggies campaign – we should just let them rot. It was really hate-filled invective.”
Still Seeman is hopeful his book may make life better for the obese. “We don’t want to stigmatize, but rather to open up a dialogue around these issues. I make the analogy between that and depression. With depression we’re starting to come out of the shadows in terms of talking sensitively about it. I’m hoping that we’re going to move in that direction about obesity.”
On a personal note, Seeman lost more than 36 kgs (79 lbs) while writing the book. “In my case it was unscientific. I’d been going through some pretty depressive episodes as a result of a variety of factors in my life, and so I ate healthy food and exercised a lot. With me, sustaining the weight loss was the real challenge.”
His solution? He fell in love with boxing, and his training regimen caused him to lose weight and keep it off. Says Seeman, “It reinforced for me, that everyone’s path to sustained weight loss is individual.”