New Year Brings (Ridiculous) Barrage on Weight Loss

Did you resolve to lose weight in 2013? According to an endless media parade, you have, or should have vowed to get in shape, or otherwise deal with your weight, eating or fitness.

I've been catching up on all the newspaper I've skipped while away several weeks, and notice that in every issue of the four different papers I peruse, there are at least two items about obesity, eating or dieting that I feel compelled to clip, given my work on a book in that area.  I find something objectionable about them all, because appearance/eating journalism features guilt, shame and failure as themes. No wonder newspapers are sunk.

Here's a piece in USA Today, "Critics pounce on Coca-Cola obesity campaign" from Tuesday, January 15. The Coca-Cola company makes a video trying to define its role in making people fat--after all, consumers pay to guzzle their products--and the anti-obesity establishment jumps all over it. The article's headline nods to the disdainful Michael Jacobson, executive director of Washington's Center for Science in the Public Interest, who says Coke's video "is a page out of Damage Control 101, which is try to pretend you're part of the solution rather than part of the problem."

If nobody bought Coke, the company would go under. Enough people are willing to pay for it to generate profits instead. Banning soda whether in Mayor Bloomberg's favorite 16-oz. cups or any other form, or shaming its imbibers is no solution for obesity, but nobody wants to hear it. At the end of the article, a Coca-Cola spokesman offers, "Obesity is complex, and it requires partnership and collaboration to help solve it. We have an important role to play in the effort to find solutions that work for everybody."

Barry Popkin of the University of North Carolina won't buy it, responding, "The Coca-Cola Company still remains one of the major causes of obesity in the USA and globally." So there.

On the very same page of that day's newspaper was an interview with "Manhattan socialite" Dara-Lynn Weiss, 41, whose new book explains why she put her obese 7-year-old on a diet. She wrote about it in the April issue of Vogue, to subsequent viral web vilification.  Now she's hyping her story further, and says little Bea, now 9, is a "healthy" weight. Bea bulked up by age 6, despite living in a home of thin people who shared healthy meals together, because she "was a child with an enormous appetite."



Dara-Lynn Weiss and Bea

What do I take from this? Just what the Coca-Cola spokesman says: Obesity is complex. Here was a little girl with skinny parents and a little brother "who doesn't want to eat sweets," whose natural physiological makeup gave her more appetite. Should she restrict her diet her whole life? Should her mom have enforced her weight loss? I don't know, but can you blame Bea's obesity on the Coca-Cola Company?

I can understand how difficult it is for a fat child. No mother wants to see her daughter suffer with something that can be addressed. On the other hand, few mothers would describe their efforts to slim their 7-year-old in Vogue Magazine.

That aside, the message remains: Fat, shape, obesity and dieting are enormous problems in America. Perhaps as much for their psychological impact as their physical manifestations. They're also huge sources of wealth for businesses large and small who deal with them.

Yet, being fat could be good for you. I found a slew of articles reporting on a new US government meta-review of 97 studies on longevity that found that overweight people had a 6%, and "Grade 1" obese a 5% lower risk of early death, than either higher-level obese or normal-weight people. The study's release was followed by a New York Times Op-Ed piece by Paul Campos, one of my favorite writers on the subject, who's made the same point repeatedly since his 2004 book, The Obesity Myth.

I'm also a fan of the lead author of the massive new study, Katherine M. Flegal of the CDC and National Institutes of Health, who discusses her process and findings in a three-and-a-half-minute video. Her team looked at 7,000 studies, eventually selecting 97 that met their criteria: body-mass index as the measure of girth, and broadly representative populations (not subsets, such as those suffering from a disease). Their many analyses yielded "strikingly consistent findings," across age, sex, smoking, gender and parts of the world (most studies were from North America). Being somewhat obese or overweight was simply not a hazard for dying; being overweight was a statistically significant advantage to longevity.

The obesity police? Watch out!

This is not a message that the obesity police want to hear. They immediately set to work tearing apart this unassailable, respectable analysis. Walter Willett of the Harvard School of Public Health erroneously said the study's flaw was "because the overweight and obese groups were compared to this mix of healthy and ill persons who have a very high risk of death, this led to the false conclusions that being overweight is beneficial and that grade 1 (moderate) obesity carries no extra risk." I wonder if he actually read the research, but he was emphatic in his review: "The paper is a pile of rubbish." With three million subjects studied, that's an awfully high pile.

Perhaps you can grouse that BMI isn't an accurate measure of overweight since it doesn't account for percentages of muscle, or location of fat, but when you talk about 97 high-quality studies of three million people, you've got enough information to say something important. The health establishment is so invested in its anti-obesity campaigns that it can't even acknowledge a bit of good news.

And the reason that establishment is so dismissive is the same cultural bias that prompted Dara-Lynn Weiss to print in a fashion magazine the dragon-mother tactics she used to whittle her 7-year-old ("I stopped letting her enjoy Pizza Fridays when she admitted to adding a corn salad as a side dish one week. I dressed down a Starbucks barista when he professed ignorance of the calorie content of the kids' hot chocolate...").

And that reason is our hatred of body fat. We associate a bulbous appearance with negative personality characteristics. Here's another article I clipped today, from the Wall Street Journal: "Want to be CEO? What's Your BMI?" "Executives with larger waistlines and higher body-mass-index readings tend to be perceived as less effective, both in performance and interpersonal relationships," according to a study by the Center for Creative Leadership, a non-profit group. "Excess weight can convey weakness or 'lack of control,'" adds New York image consultant Amanda Sanders.

A 2010 Australian study found that "obese people were rated less favorably, and as more disgusting, than all other social groups." Yale University researchers (2005) tried to improve anti-fat bias by combatting the perception that obesity is within an individual's control, and that "people get what they deserve and are responsible for their life situation." Interestingly, prejudice against the rotund has grown to a global phenomenon, with Arizona State University researchers reporting cross-cultural agreement with the statement, "fat people are lazy."

A generation ago, we might have considered it impolite to comment on others' sizes. I remember my mother admonishing that one's inner soul, or "the content of his character" is what counts, not how he looks on the outside. At the very least, we judge by behavior, right? No longer.

We despise fatness, and now in the guise of ending an epidemic, the obesity police have free rein to butt into our most personal decisions ("what size beverage do I want?"). It doesn't matter that health and BMI are for most people unlinked. Paul Campos can wisely repeat that "baselessly categorizing at least 130 million Americans--and hundreds of millions in the rest of the world--as people in need of 'treatment' for their 'conditon'" merely feeds big pharma and weight-loss industry coffers. He can insist that there's no health reason to push present ideals--but he won't change anything, because in our culture, fat is abhorrent.

I've spent a lot of  time researching causes of obesity, and they are many. Certainly not soft drinks, though glugging full-sugar sodas throughout the day adds calories, just as enjoying a morning latte does. Pure fruit juices count as "sugary drinks" equally, despite their enrichment with extra vitamins, since their calorie-counts are similar to Coke's (for example, 8 oz. of Florida's Natural orange juice is 110 calories; regular Coca-Cola has 96 for the same amount). What few people mention is that "normal" eaters, the ones in touch with their body's cues of hunger and satiation, feel full when they consume food or drink, and the more they consume, the less additional they want.

And that's my answer to the obesity issue, though certainly not a complete or perfect solution. Rather than listening to the prattle of pundits or exortations of experts, all of us can relax and strive to trust our bodies' messages. Even doing that, many people will be fat. I think of poor little Bea Weiss, whose mother watched in horror as she responded to her inner call for food. Dara-Lynn Weiss only wants the best for her daughter; she only wants her to grow up healthy and happy, and the only means she knows to facilitate that is to teach Bea very young to deny her desires and place a major emphasis on staying thin. "It's absolutely a problem every day that we are attentive to," Dara-Lynn Weiss tells Fox and Friends in an interview about her new book, The Heavy.

My hope is that medical science can learn more about the causes of obesity, and means to regulate them--and there's a lot to learn. Some obesity is caused by a cold virus. Some is the result of imbalanced hormones. Some is a medication side-effect. Some obesity is inherited, and some is the result of genetic changes caused by environmental factors. Stomach acids play a role; the amount of calories expended in breath impacts metabolism, too. If you ever watched the excellent BBC series "Why are Thin People Not Fat?" you know that a range of influences determines how calories are burned.

Exercise is not necessarily central among them. Some sedentary people eat whatever they want in any amount they choose and remain thin. They may not have finely-toned muscles, but they stay slender. What determines one person's desire for soft drinks versus another's preference for black coffee? Is the black coffee drinker more likely to be thin? Is a Cheetos-eater more likely to be fat? Not necessarily. We just don't know enough.

This is never the message of the articles I cull from the newspaper daily. I have folders on all sorts of interesting fat-related themes, including psychological influences on weight, what crusaders are doing to shrink the populace, and various substances certain loud voices dub deleterious (think sugar). I have files on childhood obesity (Bea!) and exercise and the food industry.

But aside from awaiting research, what can Americans do? Learn to turn inward. To thine own body sensations be true. Separate psychological, media and presence-of-food influences from real hunger, and when eating, focus on physical reactions. This is a learnable way to live, natural and effortless for a swath of the population. It's just too bad all this publicity about obesity and sloth has everyone so unfairly and wrongly uptight.

Fat Fashion Models Defined: 36.2-inch hips

Dutch fashion model Anandon Marchildon won her lawsuit against a modeling agency who dismissed her, saying her 36.25-inch derriere was two centimeters larger than they say it had been before, making her unsuitable for work.  The case really wasn't about her expanded girth but about whether the company, which had taken over another agency, was obligated to retain the other agency's contracts.  After two years of litigation, during which time Ms. Marchildon took up work as a cabinet-maker, Netherlands courts decided yes, the new agency should have kept her.

The case, however, elicits ire because it raises the question, "Who you callin' FAT?"  The five-foot-eleven-inch 25-year-old, as winner of the fourth round of Holland's Next Top Model, had been guaranteed a three-year, $98,000 contract, but was axed after she'd earned only about $13,000, when the Modelmasters agency was bought out by another, Elite Model Management.

According to an email exchange made public, she'd tried to work with the new agency over several months to diet down her hip size. She apparently succeeded in June, 2010, according to the Associated Press, but by September she and Elite had "parted ways." Just to demonstrate her talents, Ms. Marchildon did a one-time Sloggi lingerie modeling gig, and a company spokeswoman said "It's too crazy for words that a model who's her size would be written off as too fat."

Rising to her new status as crusader, Marchildon responded to her court victory saying, "I'm proud to be a good role model, that's how I see it, for young girls. If you can't be a model for high fashion, you're still beautiful."

Absolutely. But in her shape, Ms. Marchildon offers a nearly-impossible ideal for most.  Certainly she is far from fat, but given that about 30% of American adolescents are overweight or obese, her figure in the Sloggi ads can't count as encouraging. In fact, it could well be disheartening: If her hips are too wide, most women have no hope at all.

I can't resist reference to my current book project, Eat What You Want. Researchers are stymied in finding a real cause for the 20-year jump in obesity rates (that has leveled in the past decade), and until they can sort out why some get fat and others don't, the most sane approach is to eat only when hungry, enjoy one's food but stop eating when satisfied. Cyclical dieting means ongoing stress and usually a higher "normal" weight; even reasonable eaters (and research has shown little difference in consumption between the overweight and those of "healthy" BMI) now seem to be heftier than in generations past.

So indignation over Ms. Marchildon's extra inch means little for the millions who are far from a model's silhouette.  A serious question is whether a chunky norm should be accepted and even lauded, since "overweight," according to Paul Campos, is associated with best overall health; only extreme obesity, as extreme thinness, brings real risks.

And, there's also the question, equally legitimate, about whether an agency can require those it represents to maintain a standard relevant to its business.  I wouldn't be so quick to tell modeling agencies how to cater to their clients, especially if the models they represent agree to their rules when they sign up.  At the same time, I do think that particular occupation leads women--and our culture--toward destructive behaviors, self-hatred and emphasis on the superficial.  But can we restrict or outlaw all the negatives in society?

Bottom line--no pun intended--is that Ms. Marchildon put herself forward into a competitive business well-known for its insistence on thinness. She competed on TV for her entry into that contorted world, and then, when it turned against her, she railed at its injustice. I don't blame her for seeking legal means to the prize she thought she'd won.  But I don't think it's time to claim a triumph for larger women everywhere, as this story is slanted. More significant triumphs occur every time teens look in the mirror and see their potentials instead of their sizes.

Veggies in "Healthy Food Deserts" Won't Cure Obesity

Hand-wringers in universities and government care-for-you offices have rearranged urban geography to stop the obes-ifying of America's children--by deeming certain neighborhoods "healthy food deserts." That's deserts, like the Sahara, not desserts, like what kids are actually eating.

They say that communities lacking large supermarkets, but boasting a plethora of convenience and corner stores, prevent residents from consuming the veggies and fruits that would keep them svelte.  Time and cash-strapped neighbors feed their families the fried chicken, corn dogs, chips and soda these mini-marts sell--but the experts insist that if the same stores featured cucumbers and apples front-and-center instead, parents would opt for the healthy choice.  And they, as well as their children, would be thinner.

This speculative chain of thinking led the "do something" activists--progressively-bent feds, local governments, university researchers and foundations-- to attack the problem the only way they know how: by throwing money at it.  Pres. Obama's stimulus package--our tax dollars at work, through the Centers for Disease Control bureaucracy-- has awarded thirty communities $230 million in grants to prevent childhood obesity.  Local United Way offices have funded "healthy corner store initiatives," like $50,000 to three stores in Franklinville, Ohio, and an unspecified amount in Seattle to upgrade the healthy-food stock and displays in 22 convenience stores in the Delridge neighborhood.  In addition, the W. K. Kellogg Foundation in Battle Creek, Michigan, funded nine sites nationally, including $500,000 to Seattle's King County. In Pennsylvania, $30 million of state grants over three years was triple-matched by $90 million more in grants and loans from The Food Trust, used for 78 grocery outlets in poor neighborhoods.

But the front-page lead article in this week's Sunday Seattle Times paper, combined with its Sunday magazine cover story (funded as a grant project by a California endowment through the University of Southern California) exposes how ineffectual throwing money at fat-causing behaviors really is (even as the feature lamely offers sidebars advising parents on curbing kids' expansion).

The article says that here in my state of Washington, the feds and foundations tossed mega-bucks ($15.5 million from stimulus funds alone) at the "food desert" problem without results. It describes how food-access advocates finally convinced the Delridge "Super 24" corner store to revamp its stock, adding refrigerated cases with an assortment of fruits and veggies. A KOMO TV news story features United Way rep Lauren McGowan pointing to the new cases effusing, "you've got lettuce and limes and lemons and cucumbers, and stuff that families can go home and make a salad, make a fresh meal for their family!"

The news video laments that small convenience stores don't take food stamps, suggesting illogically that this forces homeless customers like Jose Lopez to buy junk food instead: "Oh, I like to have these fruits..." Mr. Lopez, holding a freshly-purchased large coffee says, pointing to a basket of apples, oranges and bananas by the cash register.  He's cut off mid sentence by reporter Elisa Jaffe who finishes, "but they don't take your food stamps."  Lopez shrugs. "They don't."

It's wonderful that kindly community members want their poorer brethren to eat well. But the brethren themselves don't choose to. Bhim Singh, the Delridge store's owner, was lauded in December, 2009 when his new refrigeration units and "healthy choice!" signs touting nutritious items went up. This week's newspaper article, however, provides an update:  "We would spend $200 on vegetables and make only $10," he admits.  He's back to stocking only the longer-shelf life produce he carried before the hoopla, like potatoes and onions.  His clientele, it's clear, keeps him afloat with their fried-food-and soda purchases.

"Officials say they have learned valuable lessons," says the Seattle Times story. "Maybe they didn't spend enough time selling the idea.  In any case, they've budgeted another $1.8 million in hopes of enlisting at least 25 stores."  Don't bore them with facts.

The research considered most definitive on the question of access to healthy food was conducted by the US Department of Agriculture, published in June, 2009.  In it, a national questionnaire (which, when examined, is a pretty poor measure of food access) found that 81 percent of respondents "always had the kinds of food they want to eat."  Sixteen percent had enough, but not "always the kind of food they want to eat." Of that 16%, five percent said they didn't "always have the kinds of food they want to eat" because "it was too hard to get to the store, or the kinds of foods they wanted were not available."  Elderly or infirm people, and those who didn't have the money for food--even if it were easily available--made up more than half of those people--leaving less than 3% of respondents overall who don't "always" have what they want because "the kinds of foods they want are not available."

This calls for another government grant.

Now, nowhere in the study does it ask exactly what are the kinds of foods that respondents wanted.  Might be hallal food, or kosher food.  Might be gluten-free, or sugar-free foods. Might be gourmet cheeses or craft beers.  And of course the questionnaire asked if their desired foods were "always" available. If your market runs out of your brand of cereal or the kind of milk you like, then you aren't "always" able to get what you want.

There's an assumption that people in low-income areas crave fresh fruits and vegetables, but that a nefarious capitalistic force thwarts their innate healthy-food proclivities.

There are indeed market forces at work, and what they do is push shop-keepers to provide their local clientele what that clientele wants--or risk going under.  It's an insult to suggest that poor people don't know the difference between healthy and junk food.  Anyone with a television hears the news stories about Michele Obama's "Let's Move!" program, and watches reports like the video of the Delridge Super 24's new offerings. In 2007 alone, the USDA spent $697 million in classroom education, and every child in school over the last 20 years has, usually by government mandate, learned about good nutrition--but it does no good.  Ask the convenience-store patron buying grease-fried chicken wings about his purchase, and he knows darn well it's less beneficial than the apples he ignored near the cash register.

In fact, that's the exact scenario on the KOMO TV video about the Delridge store.  It opens as heavy-set Joseph Munnerlyn is selecting his purchases. Caught in the act buying junk, he explains, "I'm hungry, I'm trying to get something fast and quick, so I..." A voice-over then interjects that he's "a connoisseur of corner-store meals." Voice up. "Oh, I love it all," Mr. Munnerlyn intones with affection, waving his hand by the fried offerings in a heat-lamp-warmed glass case. "The wings, I mean come on! The breasts, the burritos, the Jo-jos...!" (Jo-jos are breaded and fried potato wedges.)



Bhim Singh owns "Super 24" store

 He gives a sly smile. "I know it's not healthy, but at the same time..." He lifts up an apple from the basket of fruit in front of him at the register. "...It's hard for me to pick up an apple when I've only got two bucks and I've got to feed myself for the rest of the day."  The unchallenged assumption there is that he gets more satisfying food for his money buying Jo-jos than a Jonathan.  It's not his fault.

When it looked at healthy food access by social variables, that Department of Agriculture national study about Americans' access to food found some astonishing conclusions--about supermarkets, typically stocked with a wide assortment of produce-- that the reform-corner-stores crowd might want to consider, such as:

"Overall, median distance to the nearest supermarket is 0.85 miles. Median distance for low-income individuals is about 0.1 of a mile less than for those with higher income, and a greater share of low-income individuals (61.8 percent) have high or medium access to supermarkets than those with higher income (56.1 percent).

"Overall, ethnic and racial minorities have better access to supermarkets than Whites. Median distance to the nearest supermarket for non-White individuals is 0.63 miles, compared with 0.96 miles on average for Whites.

"Similarly, a smaller percentage of non-Whites (26.6 percent) have low access to supermarkets than do Whites (48.2 percent)."

Given failure to influence purchases when corner stores feature fresh fruits and vegetables, and the fact that poor people and minorities have better access nationally to supermarkets than the financially better off and whites, why are anti-obesity experts so gung-ho on watering so-called "healthy food deserts" with tax money and foundation donations?

Because they're desperately searching for do-able solutions to a problem whose cause has still to be defined, and which has foiled all efforts to solve.

It's really not as if gluttony, sloth, inactivity and even childhood obesity are novel foes. According to CDC statistics, the steep increase in childhood obesity began in 1980 and after reaching an alarming peak a few years ago, has leveled off.  Throughout those years, and particularly since 1990, attention at all levels has focused on the issue.  It's just that these problems have proven resistant to even the most expensive and valiant efforts to overcome them.

For decades, millions of dollars have poured into nutritional education.  At the same time that carbonated soft drink consumption declines (every year for the past six!) organic food options burgeon, gaining by 20% every year in the last decade.  Health food stores, once a niche market, have gone mainstream; a case in point--the Whole Foods supermarket chain, begun in 1980 in Austin, now boasts more than 300 outlets.

Still, the mantra throughout professional obesity-world literature is that the problem requires still more investment of public funds. A 2007 book by the Food and Nutrition Board, Progress in Preventing Childhood Obesity: How Do We Measure Up? notes that "Government, industry, communities, schools, and families are responding to the childhood obesity epidemic by implementing a variety of policies, programs, and other interventions," but decides "the current level of investment by the public and private sectors still does not match the extent of the problem."

Of course, its main finding is that we just don't know if all the spending and talking and teaching and fruit-and-veggie-touting is making a difference, phrasing this conclusion in admirably academic terms: "Current data and evidence are inadequate for a comprehensive assessment of the progress that has been made in preventing childhood obesity across the United States."  Ahem.

Obesity in children--and adults--is a far more complex phenomenon than well-meaning agencies and pundits are willing to admit.  And because its causes are not yet understood, creating innumerable boards and bureaucracies to eradicate it (and make food deserts bloom) have failed. To be sure, some money must go toward innovative medical research to tease out the true sources of obesity--and whether the future generation is as doomed by it as alarmists insist.

I suspect that genetics and environmental influences (A virus, like the Adenovirus 36? An "obeso-genic" substance or situation that, like carcinogens, throws cells out of whack?) will prove contributors to the problem, and that unfair stereotypes that suggest all fat people are ignorant, have no self-control and need patronizing interventions will be squashed like the unsold tomatoes at Super 24 in Delridge, Washington.