Government as Savior: Feed the Hungry, Slim the Obese

Pic from a 1949 'Life Magazine' article on obesity

It's ironic: the poorest Americans, the ones on government food stamps, tend to be the fattest. Which calls for another government program to get them slim.

Reading a fascinating series of articles in the Washington Post by Eli Saslow about poverty and obesity, I was struck by the underlying assumptions fueling many expensive, publicly-funded efforts to "save" the obese poor.

Everyone wants to spare people illness and pain. Everyone wants to enhance longevity and add to quality of life. No one wants to pay for medical services for poor people if their illnesses can be avoided. In fact, with the laughable state of Obamacare in its first roll-out weeks, it appears no one wants to pay for governmentally-required health plans.

But we're paying for a lot of health-oriented programs, anyway. One Post article describes ignorance and incapacity in nutritious food preparation of residents in Hidalgo County, Texas, near the Mexican border. Forty percent of the population there relies on federal programs to pay for comestibles, a percentage nearly the same as the area's 38% obesity rate. Local food stores don't offer many vegetables, but do a brisk business in Cheetos smothered in melted cheese. Is it greedy grocers who are pumping pounds onto hapless neighbors, or, could it be that if these outlets offered veggies, neighbors would still opt for Cheetos?

A slide show with the Washington Post series offers a rather disheartening, though honest answer. One photo shows a portly woman guffawing in a nutrition class when the teacher suggests serving smaller portions. "Yeah, well, try telling that to my husband!" she retorts.

In Chicago, where Mayor Rahm Emanuel boasts city efforts brought a 21% decline in "healthy food deserts" in the last two years, obesity remains high. Childhood obesity rates are notably higher than the national average; overall, 27% of Chicagoans are obese, 34% overweight, and 38% of "normal" BMI. Reporting on a study that made national projections, the Chicago ABC affiliate last year headlined, "Half of Illinoisans to be Obese by 2030."

A conundrum that health experts ponder is that food stamp recipients--whose need for sustenance is great enough for the government to step in--are disproportionately obese. As I frequently note, more and more non-gluttony causes of obesity are surfacing. Offering vegetables to the poor obese, even with education explaining how and why to cook them, can't affect most causes being discovered. It's condescending and silly to think that government-programs for classes, gyms and markets with produce can have much effect on the poor's collective girth.

That relates to the "government will provide" mentality inculcated in the public by Obama's Supplemental Nutrition Assistance Program (SNAP), the values-free new moniker for Food Stamps.

Under Obama-administration direction, taxpayer-funded "outreach" workers infiltrate low-income pockets to sign-up as many candidates as possible. One illuminating Washington Post article follows a recruiter as she approaches residents of a shabby central Florida trailer park, pursuing her quota of 150 seniors per month. Her method is to bring piles of free food to attract a crowd, and then lure them to enroll, using a set of SNAP-provided talking points crafted to silence listener's doubts.

If a prospect hesitates because of welfare stigma, the recruiter responds, "You worked hard and the taxes you paid helped create SNAP."

If a candidate's embarrassed, the recruiter soothes, "Everyone needs help now and then." If accepting denotes failure, the recruiter just normalizes the experience: "Lots of people, young and old, are having financial difficulties." The recruiter might add that with the step-up in loading people to the dole, fellow recipients likely live next door. In Florida, the setting for the story, food stamp enrollment soared in just the last 5 years from 1.45 million to 3.35 million beneficiaries.

The whole effort riles me, not only because of the increase in federal tax burden, but because stifling moral objections scoots a vulnerable population down the chute to permanent dependence. Of course, the presently-empowered political party gains supporters when more voters rely on them rather than on family, church or self-starting entrepreneurship. It's a smart move for Democrats to ease in as many new SNAP dependents as possible, because they form the voting bloc guaranteeing support for politicians who guard their entitlements. Challengers who would rein in government largess become the bad guys grabbing food away from the hungry.

Clever strategies cajole low-income elders with salesmanship and persuasion. The stigma of ripping stamps or paper slips from a coupon book is gone. Now, recipients swipe a cute little card called an EBT, for Electronic Benefits Transfer. Looks just like a credit card, but you never get the bill.

In an astonishing reversal of right and wrong, recruiters claim that taking federal assistance is actually altruistic, because it brings money into the local economy and thereby creates jobs. Despite the appeal to civic responsibility, seniors are reticent to sign up, and only 38% of eligible Floridians have, a rate half that of other age groups. "That means about 300,000 people over 60 are not getting their benefits, and at least $381 million in available federal money isn’t coming into the state," spins the Post article. Mr. Low-Income Senior, it's your duty  to, well, snap it up.

The article describes the moral dilemma of one older Florida resident who prided himself throughout his life in being one of society's "makers" rather than "takers." He resists shifting to a new demoralizing status that confirms his failure, but the implication is that sooner or later, he will succumb.

While certainly some assistance to people in need is important, the search-and-SNAP effort brings two kinds of harm. First is replacing initiative with entitlement. And the second is the intrusion of public agencies' tentacles into the crevices of families' lives, all the way to their dinner plates. Cheetos smothered in melted cheese are awful as daily fare, but the issue isn't lack of broccoli, but the desire and energy to create vegetable-laden dishes--that children eschew anyway. Poor single parents, especially, are exhausted, and they'll never pay six dollars for salad when the Cheetos their kids crave cost just two. And once again, obesity can be driven by chemical, genetic or environmental causes that fruit and veggies can't cure.

 Government-as-savior's response is to do something. Subsidize greens for poor people. Install basketball hoops in every cul-de-sac. Send nutrition educators to every low-income home. Help these poor people!

Concerned legislators began throwing money at obesity ten, fifteen, twenty years ago, and even with Mrs. Obama's "Let's Move!" campaign, it seems obesity outruns it all. Mrs. Obama seems to see the futility in her efforts; last week she officially turned her focus from pummeling childhood obesity to encouraging college. Her new cause is a more constructive direction, because the college message says "you can make something of yourself." Much better than "we can make less of you."

Why Burger King's Healthy "Satisfries" Will Fail

Burger King announced they're going after "lapsed" customers who eschew their fat-infused French Fries by offering a new lower-fat, lower-calorie option made with a special new batter thick enough to repel cooking oil. Nice try, but it'll fail.

The new spuds are crinkle-cut, so staff won't confuse them with the sleek regular fries they still offer. Their name, "Satisfries," while  planting a positive association, is too cutesy; NPR repeatedly called them "Satisfies," missing the pun entirely.

BK's company website says they've got 40% less fat and 30% fewer calories than MacDonald's French fries, though only 20% less fat that the regular Burger King offering. A small serving of the slimmer fries is 270 calories, while the same size of their regular recipe is 340, a saving of 70 calories, but at a cost of an additional 30 cents.

I keep kosher, so I won't do a taste test to proclaim whether the less oily style trumps or slumps compared to the classic. But even if they taste the same, as claimed by the company, it won't matter. They're sure to bomb. Here's why:

If you're happy with the fries you usually get (customers of McDonald's love their greasy, thin fries; Burger King loyalists opt for thicker sticks), you might, under burden of conscience, try a healthier alternative. But not if you have to pay thirty cents more to do it.

How do I know Satisfries won't succeed? By observing the reception of mandates designed to improve school kids' diets. Michelle Obama spearheaded as part of her anti-childhood obesity program "Let's Move!" new standards for federally-subsidized school lunches. Turns out schools are dropping out from the program because kids won't eat the healthier offerings. One New York City student, Zachary Maxwell, 11, went "undercover" taking videos of each day's lunch tray, compiling them in a 20-minute class project he called "Yuck!" that has so far won six recognitions. "What would you rather eat?" he asks. "Five fresh Delicious apples, or a yummy crispy chicken sandwich?" He's quickly answered by a visual of the sandwich. "Exactly," he nods definitively.

Zach's secret films reveal day after day of day of brownish gray, tough-to-identify options (whole grain stuff tends to be monochrome) with a pile of cut fresh celery or carrots or an apple. Some school districts are finding that it's too expensive to buy all these veggies and fruits only to watch them spurned by kids who'd rather spend the afternoon hungry, or who sample the tastier components and dump the expensive stuff into the trash. By the way, our federal Department of Agriculture pays schools $2.93 for each of those trays, for kids who qualify for free lunches.

So far only 5% of participating schools have or are considering dropping out of the federal program--but it only started this year. Just wait until schools start tallying the waste and noticing dwindling desire for their fare.

Nutrition pundits love to blame "fast food" for the increase in American obesity that started in 1980 and continued until leveling off in 2000. But Burger King and its ilk serve up what people like, at a cost consumers are willing to pay. They're not nefarious, profit-greedy conspiracies who knowingly sacrifice the health of their market for extra coins, despite Michael Moss's accusations in Salt, Sugar, Fat. He told "CBS This Morning" that BK's new fries "might give people permission to overeat."

While availability matters, in our bounteously blessed nation, the real determinant of what people eat is what people themselves put in their mouths.

Are Burger King's Satisfries more an effort to quell the food-police (who, I'd guess, seldom eat in their establishments) than the result of consumer-driven demand?  Authorities brainwash the public to feel guilty about eating what they really like, basically teaching us not to listen to our bodies because erudite-types know best. Rather than swallowing the advice whole, frugal and determined customers will politely laud the new choice, and then  save money--ordering exactly what they want.

Punishing Smokers and the Obese--what?

Heidi Klum: Role model for the obese?

I just read an Associated Press story in my local paper with the headline, "Do penalties for smokers and the obese make sense?" It proposes either punishing folks whose conditions are likely to require greater health care expenditures or letting "these health sinners die prematurely."
In other words, there are only two options for smokers, whose annual health-care costs are "about $96 billion," and the obese, ($147 billion): Death before they otherwise would go--perhaps saving the system old-age-related health care costs--or taxes and restrictions designed to curb smoking or eating, to offset the extra services they'll likely need while alive the usual length of time.

Does this sound crazy to you?

The most glaring and offensive assumption is that smoking is a choice that is equivalent to a choice to be obese.

The big argument in the article is whether penalties are unfair to the poor, who tend to be both smokers and obese. A secondary argument is about whether it's fair that other people sharing a health carrier should be forced to absorb the expenses of your smoking or obesity. Sorry, those are not the relevant questions, and certainly shouldn't be posed as if these two divergent health problems are comparable.



Daniel Callahan: shame fatties

Quoted is bioethicist Daniel Callahan, senior research scholar at The Hastings Center, New York. He got in trouble last week for a paper in which he suggests that the obese, already "lost," aren't going to be helped, but overweight folk don't really realize how badly-off they are, and need "nudging" by policy and practice toward eating less and having some self-control. His paper got press under the term "fat-shaming," though that isn't exactly what he advocates. He describes how social pressure got him to quit smoking, and thinks that when the brains of the bulging understand how they're harming their bods with excess weight, they'll gain motivation to slim.

Does he have any evidence that fat people are unaware they're chunking up? Does he think our society, that confronts everyone purchasing food in a check-out line with magazine covers of impossibly thin movie stars, offers little pressure to be healthy, fit and slender?

Here we have an individual who truly has little understanding of the complexities of the obesity issue, yet suggests we ask the portly, "Fair or not, do you know that many people look down upon those excessively overweight or obese, often in fact discriminating against them and making fun of them or calling them lazy and lacking in self-control?"

The central mistake in both Dr. Callahan's paper and the Associated Press piece is the belief that the smoking and obesity problems are parallel, subject to the same causes and cures. The causes of both, implicitly, are exactly the taunts Dr. Callahan points out to those of size: laziness, lack of will-power and self-control.

That such a paper could be called scholarly and get published is astonishing; that newspapers would carry such assertions and suggestions is appalling.

You can teach a smoker to completely stop smoking--but never an eater to completely stop eating. Smokers have a range of physical and emotional reasons for smoking; science is constantly revealing new causes for overweight and obesity, many of them out of individuals' control.

A few days ago, Nicholas D. Kristof wrote in the New York Times about the impact of en-utero and at-birth influences on offsprings' obesity. He described research in which genetically identical mice fed and exercised the same were of greatly differing sizes--depending on whether they were exposed to an endocrine-disrupting chemical at birth. A single exposure determined whether they spent life obese or normal-sized. Kristof used the information to argue against endocrine-disruptors, such as the plastic additive BPA, in the environment.



'Flabby' and normal mouse differ only by at-birth endocrine disruptors

I wonder how he feels about dieting, then. If the "flabby" mouse ate and exercised the same as his thin brother, yet was programmed to be obese in a way he could never change, why ever argue for eating less and exercising more? For these mice, is a calorie a calorie, or does the calorie do something different depending on warped or healthy chromosomes?

Could you shame an endocrine-disruptor-exposed obese person into losing weight? How about someone with obesity as a souvenir of the Adeno 36 virus, also shown to change both people and animals from svelte to swollen after exposure? Can you "nudge" into skinniness someone whose hormones have gone wacky? Or those experiencing obesity as a side-effect of needed medication for another condition?

The Associated Press story talks about the success of rules limiting smoking in public places, and cites NY Mayor Bloomberg's ban of sugary drinks in 16-ounce or larger cups as another policy to address a health problem. I've never seen anyone harmed by second-hand soda, and there's scant evidence that selling16 versus 20-ounce fountain drinks makes for smaller bodies. New York government is meddling in restaurant commerce with a kindly intent but with the erroneous assumption that like smoking, obesity can be extinguished through laws better able to help people than they, themselves, can.

Another striking and shockingly erroneous parallel appearing in news media, by the way, is between smoking and gun ownership, seen as similarly dangerous. If we can legislate limitation of smoking, and thereby save lives, we can legislate limitation of gun ownership, again saving lives. The comparison fails, however, in that the vast majority of gun owners are responsible, law-abiding citizens whose weapons could stop a crazy person's rampage, thus saving, rather than taking, lives. Current campaigning to eliminate gun ownership (gift cards for guns turned in; creating hurdles to gun ownership; limiting size of ammunition clips), especially as portrayed by the New York Times' "expose" this weekend on what the paper considers the gun industry's efforts to capture children as future customers, contains the same misguided underpinning: Big businesses want profit despite causing harm, and government needs to step in to protect people from their own deleterious decisions in patronizing them.

The Associated Press story does acknowledge a difference between second-hand smoke and first-hand-to-mouth imbibing: "When you eat yourself to death, you're pretty much just harming yourself," University of Illinois professor Jay Olshansky concedes. The Affordable Care Act allows a surcharge for smokers, but none for the overweight or obese, however. New studies showing that overweight and mild obesity correlate with greatest longevity don't do much for the argument that smoking and obesity are equal evils.

And that's my point: The thickening of America is a unique issue, and, if these longevity studies are correct, doesn't have to be, in all cases, a problem. I think our culture has thoroughly shamed people whose bodies are wider than ideal, and the number of diet books and slimming industries, feeding $20 billion annually into our economy, testifies to the extent Americans care about their weight, health and appearance. Don't tell me our nation needs "nudging" or penalties or restrictions to motivate us toward healthy size. Don't even suggest that people are unaware of their shapes or even the healthfulness of their diets. They know, and a plethora of forces acts on their food decisions and ultimately, whether they are fat or thin.

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.

Anti-Obesity Ads Rile Some--But Empower Most

Some people are irate that a new series of short TV ads by Blue Cross in Minnesota, aimed at getting parents to think about the food-related example they're setting, implies Moms and Dads are to blame for their kids' overweight. They say a parent's ephiphany about his influence amounts to "shaming" them. I disagree.

One of the controversial ads, below, notes how children mimic their parents. A second ad in a fast-food restaurant (called "Eating Out") shows a dad bringing his heavily-laden tray to the table, catching his son and friend bragging about the amounts their fathers can consume. The underlying assumption is, of course, that obesity is an epidemic and scourge that will lead to all sorts of health problems for children, and that its cause is too much unhealthy food, provided by parents. That may be erroneous, but the theme of the ads is "today is the day:" Now, rather than later, is the time to improve.

I'm writing a book on the obesity issue, and my work leads me to conclude that the nation's expanding girth cannot be attributed to junk food. I've found there are dozens of possible causes for the rise in obesity rates that started in 1980 and leveled off in 2000. It's unlikely that, as in the following ad, people's shopping carts overflow only with cookies, chips, sugary cereals and soda pop (and nothing fresh).

 But no one can debate the notion that parents are powerful models for their children, and good parents want their children to emulate healthful behaviors. I say there's nothing wrong with reminding parents that their actions shape their children.

Being a "good example" is a worthy goal in every aspect of life. Considering the idea--and its immediacy--can relate to myriad spheres. Moms can ask themselves if they're modeling for daughters desirable ways to talk to a spouse; fathers might wonder if they're conveying to their sons what a husband should be. Everyone can watch their interactions with others to be sure they're kindly--e.g. Are phone conversations polite?

No parent on earth thinks junk food only is a healthy diet, though I've nothing against junk food, as long as a person chooses it in response to his own body's signals--in which case it's likely to be but a small part of an overall picture. Well-meaning authorities' pronouncements or emotional issues can interfere with the natural connection to one's physical nutritional needs; we're programmed to be omnivores. Unfortunately, our culture tells us to disregard that in favor of some program or rules devised by an expert.

My research suggests that most overweight and obese individuals are not to blame for their sizes (there are many hypotheses about cause, including a cold virus, environmental toxins, genetic and hormonal changes). It's cruel and harsh that our society confers diminshed respect on its larger members, often denying them recognition or even common courtesies because of unfair disdain.  Embarrassing or shaming are unacceptable approaches to anyone--but these ads really don't do that.

Instead, they offer empowerment. Some people just don't consider the effects of what they're doing, and they could.  The mom whose shopping cart is filled only with junk food is probably a fantasy, and how many kids get in verbal war about whose dad can eat more? But that's not the point of these messages. They let parents pause to consider their role as teacher in their everyday behavior, and take it a step further by urging adults to improve now.

By the way, taking responsibility is a theme in the health-promoting Blue Cross ad series. Nobody's complaining about the one that chides people for their own lack of discipline, using a parody of the song "Tomorrow" from the play "Annie" (below). I don't see much difference between taking responsibility for one's own unhealthy choices (smoking, being sedentary, pigging out) and a parent taking responsibility for the food environment of his children at home. I do not think parents should force any food choices on children, but at the same time, a parent realizing where she can make positive differences in her family's lives today is motivating and uplifting.

NY Big-Soda Ban: Symptom of "The Do-Something Disease"

Mayor Bloomberg announces large-soda ban, May 30 (NYTimes photo)

Everybody's got an opinion about New York Mayor Michael Bloomberg's proposed ban (in restaurants, movie theaters, stadiums, arenas and mobile food carts) on sweetened drinks larger than 16 oz.  The American Beverage Association quickly responded with full-page ads in the New York Times, claiming that "beverage calories and added sugars have decreased for more than a decade, while the CDC reports obesity rates continue to climb."

Actually, obesity rates have leveled off since 2000, remaining about the same overall for the past 12 years. However, between 1980 and 2000, adult obesity rates skyrocketed, from about 13% up to 32%, after staying comparatively flat since 1960, when data was first collected. In the same period, the percentage of obese children aged 6-11 swelled from 7% to 20%; teens aged 11-19 from 5% to 18%.

What happened between 1980 and 2000 to cause ballooning obesity? And what happened after 2000 to halt its rise? And why is everyone so upset about it now? 

Could it have something to do with last year's "hate-the-1%" reaction to the recession? Corporations have again become the enemy, the latest in an "us-versus-them" feeling of victimhood as unemployment and a real estate slump drags on, and President Obama laughably insists "the private sector is fine."

In this climate, there's a new receptiveness to explanations of our corpulence that point fat fingers to entities we consider "the powerful." The loudest pundits posit that an explosion of cheap junk food, especially high-fructose corn syrup-sweetened drinks, fattened a gluttonous public victimized by the advertising of greedy corporations marketing their high-profit foodstuffs. Dual-income parents, with no time or energy to cook, but with need for quick and easy dinners, grabbed super-sized buckets and carry-out bags from ubiquitous drive-throughs. They did this for twenty years, scarfing down more and more--enough to push girth figures higher every year for two decades, and keep rates at a distended level for twelve years since.

Warnings about our nation's burgeoning bulk are nothing new; they've proliferated since the late 1970s, when a National Institutes of Health report recommended 23 pages of policies to address obesity, including "that any national health insurance program...recognize obesity as a disease and include within its benefits coverage for the treatment of it." In 1980, the Department of Health and Human Services proposed objectives: Within ten years, no more than 10% of men and 17% of women should be obese, half of America's overweight should start a "weight-loss regimen," and 90% of the populace should understand that reducing requires fewer calories consumed and/or increased physical activity.

 
With obesity rates leaping, in 1999 Surgeon General David Sacher launched "Toward a National Action Plan on Overweight and Obesity: The Surgeon General's Initiative," and in 2001 Health and Human Services Secretary Tommy Thompson declared, "Overweight and obesity are among the most pressing new health challenges we face today." As a result, the 2001 "Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity" urged a wide range of measures, including mandatory p.e., healthy school meals, obesity education, and campaigning against sedentary activities like watching TV--similar to remedies put forward today. More goals were set in the "Healthy People 2010" effort, including a population of 60% healthy weight BMI, with fewer than 15% of adults, and 5% of children and adolescents obese.

But instead of heeding health leaders, the citizenry remained fat--with a third of adults and 15% of youngsters obese, and another third overweight. If chubbies can't help themselves, our benevolent legislators must save them--and so "The Do-Something Disease" becomes contagious. First Lady Michelle Obama adopted childhood obesity as her pet cause, and her "Let's Move!" campaign, with its tax-funded programs, sent tentacles of government urgency into communities. (Now a new study shows that "black girls are less sensitive to the effects of physical activity" than white girls, casting a peculiar twist on the plan.)

Mayor Bloomberg has succumbed to "The Do-Something Disease" with his limit on sweetened-drink cup size in New York. Conservatives cry "nanny state," and the public nixed the size-cap 64-36% in a Reuters/Ipsos poll. But many, including mayoral daughter Georgina Bloomberg, suggest other government-imposed means to shrink the national waistline, such as "lowering the cost of healthy food," or taxing a wider array of junk foods by at least 10%.
Recently, Disney pledged to healthify its theme-park foods, and spurn advertising from sweet and junky products on its kid-centric TV channels. At a news conference, Disney's CEO was flanked by the First Lady herself, who called the corporation's new nutritional guidelines "a game-changer for the health of our children."

Just a few thoughts: There were fast-foods, working moms, ubiquitous Coke promotion, and sedentary TV before the obesity rate escalation began in 1980. And health officials wrung their hands about overly-solid citizens before the obesity increase ceased in 2000. Given that medical experts can't even say for sure what fueled the BMI boom, where's the evidence well-meaning interventions will work?

Unless we're willing to ban all convenience or fast foods (throwing millions out of jobs, by the way), individual choice reigns. If tasty, cheap baked goods sit cheek-and-jowl on the grocery shelf with produce, well, have you ever seen anyone actually buy one of the bananas sitting in the little basket recently placed at your supermarket check-out? You can lead a shopper to apples, but you can't make him eat.

A New York Times article describing residents' pessimism about the Bloomberg soda plan interviewed people imbibing soft drinks; the ones sipping sizes larger than 16 ounces were all sharing.  It's presently cheaper to buy a bigger cup of soda than two smaller ones; so the new ban could bring some a financial penalty.

Even the foremost expert on the psychological effect of portion sizes has his fears. Brian Wansink of Cornell University, author of Mindless Eating: Why We Eat More than we Think, says “I’m really afraid it will be an epic failure,” so that “people won’t have any faith that anything else will work.” Not that they should have any faith that anything else will work, because many researchers believe the rise in obesity is caused by factors outside of human control.

Sudies support that obesity could be caused by (pick your favorite) the evolving FTO gene, environmental influences on the hormones ghrelin and leptin, an Adeno 36 virus, lack of brown adipose tissue related to the COX-2 enzyme, metabolic sensitivity, or environmental chemicals like bisphenol A, pesticides and ptalates--none of them resulting from simple overeating or low physical activity. Realistically, it's highly unlikely that smaller soda cups in some venues will have an impact.

But it's the message that counts, isn't it? "The Do-Something Disease" is about making laws to protect soda-slurpers from both corporate greed (soda is a high-margin item) and themselves.

Fans of 7-Eleven stores can still get their Gulps, which, the chain claims, "are genetically engineered to quench even the most diabolical thirst." Convenience stores are excluded from the cup-size ban, so help yourself to the 20-oz. Gulp, 30-oz. Big Gulp, 40-oz. Super Big Gulp and 50-oz. (down from 60 for ease of carrying) Double Gulp, all of which cost less than $1.85. You can even mix their flavors to your carbonated delight.

Of course, under the Bloomberg restrictions, fruit juices, which confer as many calories as soft drinks, may continue to be sold in any cup size. Also, you can order as many 16-oz. fountain drinks or refills as you like. So the disease to cure first might be the "Do-Something," because the "obesity epidemic" isn't understood, and may not even be a matter of choice.

"The reason we have government in the first place," intones a talking head early in the HBO four-part TV series The Weight of the Nation, which aired last week, "is to solve collectively problems we can't solve individually." In this case, for government to absolve the rest of us of weakness by tackling the conglomerates who stack our comestibles with extra calories and lure us to spend sedentary hours in front of our computers and TVs. We're fat individually, but government will "collectively" fix it.

The series offers the usual suggestions for individuals to modify their diets and activity levels in order to reduce. But as Cindy, of Bogalusa, Louisiana says in the first episode, "It's not easy to take weight off! And that's been liposuction, patches, peels, fad diets, countin' carbs, countin' calories--I've tried it all." Which would mean she failed even when following what the show offers in its very conventional list of resources. After all these years of media advice, at least one of the 1980 obesity-fighting goals has been reached: 90% of adults are well aware--incessantly informed-- that calories and exercise affect their size.

It's tough to await the research necessary to really address the causes of the twenty-year swell in America's girth, but effective cures for obesity require it. In the meantime, silly laws like restricting soft drink cup sizes won't make much difference, except to assuage lawmakers' cravings to do something--anything--about the fat of the land.

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.

All that Fast Food in Tonga is making them Fat

Writing a book about fat and dieting means when I see a related news story, I read it.  I'm a contrarian when it comes to the idea that an "obesity epidemic" in the US is the fault of eeeevil Big Food corporations who sneak extra sugars and fats into our food and force us to buy it.  My research convinces me that obesity isn't foisted on us, or grew because we're spoiled and lazy and victims of too many Cheetos flung in our faces. It's a much more complex phenomenon.

So I was amused to find a scolding Reuters piece distilling four Lancet articles about the state of the globe's obesity.  Oh, we Americans are fat.  Depending on who you believe, a quarter to a third of us are obese.  And the world, too, is going to health hell in a breadbasket, warn researchers from Columbia University, as Reuters reports: "Due to overeating and insufficient exercise, obesity is now a growing problem everywhere and experts are warning about its ripple effects on health and health care spending."

A quarter of Brits, Canadians and New Zealanders are obese. Mexico boasts 30%, Chile and Ireland 22%. Iceland and Luxembourg 20%.  Seventy-five percent of black women in South Africa are obese.

Then there's the South Seas island of Tonga, where ninety percent of the population is obese.  Must be all that fast food.  Must be the Cheetos and eeevil Big Food Corporations.  We in America are exerting pressure, and threatening legislation, to force food-makers to make products healthy.  Must Tongans more urgently do the same?

An interesting article in The Guardian explains Tongan's source of flab:  they like to eat fatty meat.  Roast pig is a great treat. Corned beef is an everyday staple. They eat the taro root and yams they grow there.  And they value heft as beauty.

I don't know obesity trends in Tonga, but are we to believe that its citizens have only recently fattened into obesity, just as we in America are almost daily alarmed by new studies warning that we're inflating and soon to bust?

Except that it's not true.  Women's obesity rates in America stopped swelling a decade ago.  While at significantly higher rates than 1980, when the stats climbed after little change since records were kept, obesity figures have even dropped slightly since the overall peak six years ago.

Also, US obesity rates have risen in tandem with an increases in life expectancy.  Correlation does not imply causation, but isn't that an interesting co-incidence?  Paul Campos, in The Obesity Myth, discusses the lack of evidence that rising body weights can be blamed for disease.  In fact, being overweight is associated with longest life and best health outcomes.

That's why the headline "Half of Americans to be Obese by 2030" makes me chuckle, though I'm sure it makes many well-meaning folk gag.  First off, we're not on a trajectory to balloon endlessly. And secondly, the admonition that our horrendous food options and choices are for sure the cause of obesity (along with the eeeevil computer that keeps us sedentary) is simplistic and unproven, and after all these years of mandatory health education, ineffective in changing the fat of the land.

Kids Like Candy, and Breast Milk is Sweet--Is Sugar the Enemy in Obesity?

The New York Times today had a story about a vigilante group of Philadelphia parents in "bright-colored safety vests and walkie-talkies" gathered to admonish children entering a convenience store on their way to school against buying junk food.  They think they're going to keep these kids from becoming obese.

All I can say is, "good luck."

You can food-pyramid kids to death (in my generation it was a square), trying to educate them to eat nutritionally, but they're going to like sweets.  And even if they avoid sugar, we really don't know if any of these efforts would reduce the swelling child obesity rate.

The underlying assumption is that kids gorging on contraband is fattening them up, but apparently there's scant research data to support this.  "Specific causes for the increase in prevalence of childhood obesity are not clear and establishing causality is difficult since longitudinal research in this area is limited," admits a report on childhood obesity from the US Department of Health and Human Services.  It continues, "Several studies have been published that attempt to link children’s diets with the onset of obesity. However, none have been able to show a causal link between diet and obesity."

Nevertheless, the report gives us graphs and pie (!) charts illustrating changes in kids' diets over the years.  For example, children in 1977 used to drink 1.5 times as much milk as any other drink.  By 1996, they drank twice as much sugar-sweetened beverages as any other drink. Between those years, of course, we were bombarded with anti-cholesterol information, and school milk cartons downsized, down-fatted and up-priced.  And also, those convenient, inexpensive "sugar-sweetened" boxed juices became very popular for sack lunches.

There are 100 calories in a Minute Maid box of enriched vitamins and calcium orange juice, 100 calories in a Minute Maid pouch of "Coolers" (sweetened) fruit punch.  There are 100 calories in a cup (8 oz.) of 1% low fat milk, and 120 in a cup of 2% low fat milk.  Which makes kids more obese?

But there's little to suggest that eating sweet things, per se, is the cause of obesity.  We know that children like sweet tastes, though.  If you've ever sampled breast milk (okay, I tasted a few drops of my own while nursing) you know it's surprisingly sweet.  And it's loaded with fat--whole cow's milk is just 3% fat, but mother's milk, according to the first definitive study, is 5% fat in the first few months, and keeps getting richer--to a whopping 17.5% fat for moms nursing 1-3 years.  The researchers speculated that these intense amounts of cholesterol at an early age accustom the body to it, and actually protect against future heart problems.

Could it be that young kids love sweets because they're naturally programmed to prefer mother's milk?

The Health and Human Services report then goes on to suggest that sitting is the culprit in kid obesity.  After all, now children park in front of computer screens playing video games and doing Facebook.  But the government report doesn't address new media--first, they admit they haven't got trend figures on children's physical activity.  The best they've got is a one-shot study suggesting adolescents get less exercise than recommended.  Then they resort to saying kids spend a quarter of their waking hours watching TV.  That's bad--but this isn't any different than kids spent two decades ago, as I reported in a book on childhood co-authored with my husband.

The most convincing arguments regarding elevating obesity rates in children relate to genetic causes.  Fat parents usually produce fat offspring, and I don't believe it's only due to learned sloth. Certain people have family dispositions to obesity, as a CDC research-overview report puns:  "These investigations suggest that a sizable portion of the weight variation in adults is due to genetic factors."

Also, obesity statistics vary by racial groups, with black and Hispanic Americans experiencing significantly higher rates of obesity than other groups (51% and 21% more respectively, according to the CDC).  New census data show that the US Hispanic population has increased 46.3% in the last decade, from 35.3 million people in 2000 to 50.5 million in the 2010 census.   States which have increased Hispanic populations exhibit growths in obesity rates, and those with highest African-American populations also show highest obesity rates.

Another non-volitional explanation for increases in childhood obesity, perhaps related to familial connections, is that an obesity virus alters the way people process calories.  Studies have found a greater likelihood of the adenovirus AD36 marker in the blood of obese children and adults.  The virus, of the type that produces the common cold, was isolated just at the time that obesity rates took a steep climb.  Animal studies on the virus found some shocking results: "Chickens, mice, rats and monkeys infected with the virus all get fat even though the animals don’t eat more or exercise less than they did before they were infected."

Today's article describing the Philadelphia parents' protective vigils at mom-and-pop stores was perplexing on several levels.  Apparently, the kids have school breakfasts awaiting them, but prefer to stop at the corner store for candy.  The article's highlighted student, Tatyana Gray, comes from a caring home, where her mom keeps a basket of fruit on the dining table.  Tatyana eschews the fruit for morning cereal, and then "stops for a snack on the way to school."   Her school, William D. Kelly, "has expelled soda and sweet snacks," and the nurse "pushes water" instead of fruit juice.  The first-graders sing "Old MacDonald" with vegetarian lyrics: "and on his farm, he had some carrots," while skipping around a gym.

Still, the corner store lures these health-educated kids.  "Ha, ha, ha!" one child teased a parent as she emerged with "the usual fare."  "I bought everything!" another "bragged."  "After several weeks of parent intervention," the article notes, "more children were skipping the corner stores, showing progress against the pull of sweet snacks."

I wouldn't count on it.  Kids like sweets, and for some reason, sweet fruits aren't good enough.  Michelle Obama's campaign to fight childhood obesity is benign and might even benefit some people--certainly fresh foods and movement are worth touting.  But I think we have to look beyond the "sugar is bad, exercise is good" obesity antidote and realize the problem has yet to be defined, much less solved by a bunch of well-meaning parents in florescent vests standing guard at the corner store.