Fully wrapping our heads around the very complicated relationships we all have with food in the 21st century is, understandably, just as complicated. And even people at the frontlines of what many think of as “healthy eating” can misfire or misunderstand the broader contexts that contribute to eating behaviors by missing the larger systemic inequalities at play.
On Friday, in an interview with the The New York Times, Whole Foods founder John Mackey gave an interview sharing his thoughts on American nutrition, eating behaviors and COVID-19 comorbidities — and, unfortunately, his comments contribute to damaging, pervasive myths rooted in the toxic intersections of classism, racism and fatphobia.
“Some people have been moving in the right direction, and the majority of people in the wrong direction. We can see that through the way people eat today versus the way they ate 50 or 60 years ago. Statistically, we definitely moved in the wrong direction,” Mackey told The Times. “The whole world is getting fat, it’s just that Americans are at the leading edge of that. We’re getting fat, and we’re getting sicker, by the way. I mean, there’s a very high correlation between obesity and [COVID-19] deaths. And one of the reasons the United States has had more of a problem with Covid is simply that the comorbidities like diabetes, heart disease, high blood pressure, they’re just higher in the U.S.”
He went on to focus on how he believes eating behaviors in 2020 fundamentally comes down to consumer choices (and market supplying that demand) and “ignorance”: “In some sense, we’re all food addicts. We love things that are rich, that are sweet. We love ice cream. We love popcorn. We love French fried potatoes. And the market is providing people what they want. I don’t think there’s an access problem. I think there’s a market demand problem. People have got to become wiser about their food choices. And if people want different foods, the market will provide it. Whole Foods has opened up stores in inner cities. We’ve opened up stores in poor areas. And we see the choices. It’s less about access and more about people making poor choices, mostly due to ignorance. It’s like a being an alcoholic. People are just not conscious of the fact that they have food addictions and need to do anything about it.”
It’s a lot to unpack, but these often-repeated tropes are deeply damaging and reductive to understanding the real face of inequity in the United States and how food retailers and industry voices further contribute to the crisis. In reality, issues with nutrition in the U.S. are matters of access — where disproportionately people of color and indigenous people are put in a position where they are less likely to be able to feed their families the ways they would like.
What is food insecurity — and what are food deserts, swamps and mirages?
“Food insecurity is a lack of consistent, dependable, culturally appropriate food for healthful, active living,” as Lindsay Ganong, MS, RDN, and Alison Harmon, PhD, RD wrote in Today’s Dietitian. “A food desert is defined as the general unavailability of healthful food in socially disadvantaged and/or economically depressed geographic areas. Food deserts are associated with poverty. In the United States, people of color and indigenous peoples are particularly at risk of a lack of access to healthful foods and disproportionately live in food deserts.”
So there are food insecure households and environments like food deserts that leave communities without healthful food they can afford. There are also “food swamps,” which are areas with increased concentration of foods of low nutrient density an “food mirages,” where areas appear like they have “adequate full-service grocery stores that have a variety of foods, but in which the components of a healthful diet are unaffordable or the grocery store may be culturally or socially unacceptable to some neighborhood residents.” The latter especially can be a common issue in lower-income areas that are being gentrified as high-end grocery stores open.
As the CUNY Urban Food Policy Institute notes “much of the gentrification literature has focused on residential displacement, but those able to remain in a gentrified neighborhood often face higher rents – and higher food prices. Paying more for rent reduces the amount of household income available for food, making buying healthy food more difficult and increasing food insecurity… As existing businesses market to new residents, changes to their products and prices may exclude longstanding residents. Supermarkets are not all equally affordable; different grocers charge different prices and offer different types of products. Food deserts can turn into food mirages, neighborhoods with the appearance of adequate food access that obscures the social exclusion faced by residents who find the new retail to be too expensive, uninviting, or culturally inappropriate. Grocery shopping may burden low-income households with higher food prices or the cost of time and transportation to shop elsewhere.”
These are difficult ideas to explain to people who have never lived in food insecurity, poverty or even lived paycheck to paycheck. But, ultimately, the “choices” that are discussed and critiqued (particularly those of lower income people that are so often scrutinized) are false ones.
And then there’s the easily-accepted fatphobia in the room…
While access to nutritious foods remains one systemic socioeconomic problem in this equation, there’s also a matter of the easy and casual fatphobic attitudes that contribute to negative, dehumanizing narratives about people living in fat bodies (that they are failing morally, that they are hedonistic, lazy or uninterested in their health).
The “we’re fat and making bad decisions” line is something disordered eating advocates are constantly trying to swat away — because it reinforces all the dangerous, harmful narratives about food and bodies that lead to eating disorders, negative body image and mental health outcomes and lead to cruel treatment of fat people (which brings adverse health outcomes of its own).
As Karen Manias MBChB, Ph.D. writes in Psychology Today: “Bodyweight is determined by a complex interplay of genetic, metabolic, environmental, and behavioral factors… Our set weight is essentially written into our genetics, and there are many other things that influence the size of people’s bodies that also influence their health. Societal problems like poverty, racism, and sexism could contribute to body size and shape whilst simultaneously contributing to adverse health outcomes. As with so many other areas in medicine, correlation does not imply causation and we need to recognize that weight reduction is not guaranteed to improve health or wellbeing.”
While there are connections between some people being overweight and coming from food insecure backgrounds and having conditions like diabetes, heart disease, high blood pressure, it is again reductive to say that these factors are all due to choices (a la that correlation/causation fallacy) — and not matters of economic and social inequality (ex: structural racism, a lack of access to preventative healthcare or weight bias-free healthcare or the resources (time, energy, funds, etc.) to engage in less sedentary lifestyles).
As for obesity and COVID-19 outcomes in the pandemic, there’s additional information that pokes holes in the matter-of-fact delivery stats alleging obese people are more likely to experience complications from the virus.
As Wired reported earlier in the year, the earliest studies connecting obesity and worse COVID-19 outcomes were based off Body Mass Index (BMI)— which has long been critiqued as a problematic metric for understanding health and weight in diverse human bodies. They also note that these early reported cases used to make these hypotheses “don’t control for known individual health risks that may be associated with worse outcomes for this virus, including asthma and other chronic respiratory conditions, cancer, and immunosuppressive medication use.”
Instead, these studies do what medical communities and supposedly concerned parties regularly do in conversations about bodies and health: overlook the numerous other systemic factors at play and claim it’s all about fat people’s “bad” choices.
Before you go, check out our favorite inspiring quotes for having positive attitudes about food and bodies: