During the recent swine flu pandemic scare, many observers noted we would be doing a lot more toward improving public health if instead of wigging out on the swine flu we spent the same energy addressing the obesity epidemic. I found the comparison between the two epidemics thought provoking. The problem with the obesity epidemic is that we know more people are getting fatter than ever, but do we really treat it like it is a public health issue?
If someone ends up with swine flu, do we blame her for not washing her hands enough? Or for going to flu-infested areas? No; we usually don’t blame people for diseases (unless it’s lung cancer, and even then we don’t say it out loud). But the Obesity Epidemic is different. Why? Because you don’t catch obesity from sneezing (at least we don’t think so, but there might be an obesity virus). It might be caused by hanging around the wrong people (because people need more reasons to ostracize the obese).
But we definitely know one reason why people become obese: they eat more than their body uses. Follow any article or comment thread, and sooner or later there’s some jerk who brings up that obvious fact, with the implication (if not outright statement) that obesity is a personal failure, and the cause of the disease is a lack of willpower, laziness, gluttony, fill-in-your-favorite vice.
So if obesity is caused by individuals lacking willpower, how can it be an epidemic? We can either believe that we are going to nutritional hell in a handbasket because people are weaker and more ignorant today than they were twenty years ago, or we have to believe that there really is something more to obesity that makes it a little less a matter of individual willpower and a little more about how our society has changed.
We’ve been tinkering around the edges of this kind of thinking when we try things like banning soft drinks in school or limiting fast food restaurants, but this kind of action strikes many (including me) as faintly ludicrous. Don’t want it? Don’t drink it! Don’t prevent other people from getting those drinks just because you’re fat.
My thinking on the wisdom of limiting access has changed by reading The End of Overeating. Taking Control of the Insatiable American Appetite by David A. Kessler, MD. A former commissioner of the FDA, he was also the dean of the medical schools at Yale and the University of California, San Francisco. Despite all of this expertise, he too has had problems controlling his weight, so it’s clear it’s not being stupid or misinformed that is causing his problem.
His approach is to look at the marketing forces that figuratively pushes food on people (and I mean “pushing” in the drug-using sense). Food is deliberately made irresistible and habit-forming, a trap for those who are prone to it. Although there are larger forces that are making sensible eating difficult, he promotes the solution to the conditioned hypereating pushed by these companies to not be banning such foods, but to take steps to make eating a conscious activity.
Naturally, there’s a lot more to it than that… If you don’t want to wait for my future posts on it I’d recommend getting and devouring (figuratively) this book.
