July 21st, 2009

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Food, Fat People, and Society

My partner Doug pointed me at this interesting article discussing why Americans are getting fatter:

Why are we so fat?
In the early nineteen-nineties, a researcher at the C.D.C. named Katherine Flegal was reviewing the results of the survey then under way when she came across figures that seemed incredible. According to the first National Health study, which was done in the early nineteen-sixties, 24.3 per cent of American adults were overweight—roughly defined as having a body-mass index greater than twenty-seven. (The metrics are slightly different for men and women; by the study’s definition, a woman who is five feet tall would count as overweight if she was more than a hundred and forty pounds, and a man who is six feet tall if he weighed more than two hundred and four pounds.) By the time of the second survey, conducted in the early nineteen-seventies, the proportion of overweight adults had increased by three-quarters of a per cent, to twenty-five per cent, and, by the third survey, in the late seventies, it had edged up to 25.4 per cent. The results that Flegal found so surprising came from the fourth survey. During the nineteen-eighties, the American gut, instead of expanding very gradually, had ballooned: 33.3 per cent of adults now qualified as overweight. Flegal began asking around at professional meetings. Had other researchers noticed a change in Americans’ waistlines? They had not. This left her feeling even more perplexed. She knew that errors could have sneaked into the data in a variety of ways, so she and her colleagues checked and rechecked the figures. There was no problem that they could identify. Finally, in 1994, they published their findings in the Journal of the American Medical Association. In just ten years, they showed, Americans had collectively gained more than a billion pounds. “If this was about tuberculosis, it would be called an epidemic,” another researcher wrote in an editorial accompanying the report.


The article mentions various theories but doesn't really tie them all together. Americans are gaining weight rapidly due to a confluence of factors, including but not limited to:
1) Human evolution inclines people to like high-calorie foods. This used to be an asset in a food-poor environment but is turning deadly in a food-rich environment.
2) Some populations have a genetic predisposition to pack on fat, others less so.
3) Food quality isn't great right now, and people forget that if you eat empty calories, they aren't very satisfying and you wind up wanting more.
4) Portion sizes are growing, and people do tend to eat more if the portion is bigger.
5) Lifestyle pressure puts most people in sedentary jobs. They spend so much time working, little time or energy is left for physical activity. Technological advances mean less activity at work, such as using a scanner and printer on the desk instead of walking down the hall to a copy machine. Many people live in places with little opportunity for outdoor activity: lack of sidewalks, dangerous cities, etc.
6) Many drugs cause weight gain as a side effect, especially certain psychoactive drugs that are becoming extremely popular. More and more people are on drugs long-term and that adds up.
7) Companies are rewarded for making products that sell, not for making safe nourishing food. Consequently they focus on making as much money as possible by selling as much food as possible; if it fails to nourish people, or if it destroys their health, the companies only care if it's so traceable they can be sued (which costs them money). If it's endemic, they do not have to pay the price so they are free to harm people.

So basically, American culture makes it hard to do the right thing and easy to do the wrong thing. It's possible to eat a healthy diet and get enough exercise, but you have to go quite a bit out of your way to do that. Most people won't, and many simply don't have the resources even if they wanted to. Browbeating people will do absolutely nothing to solve this problem. The only way to fix it is to undo the damage we've done; that would take work and cost money, so people don't want to do it. All we have to do, and the only thing that will work, is to make it easy to do the right thing and hard to do the wrong thing.

Another consideration that the article muddied up one side and down the other is the issue over how society treats fat people. It is true that too much fat is hard on the body; statistically, heavier people are more likely to run into health problems and certain problems are exacerbated by weight gain. It is not true that being fat necessarily makes a person unhealthy; there are plenty of fat people who are healthy. It is also true that being too skinny is hard on the body, and America also manages to have severe problems in this direction. Eating disorders are widespread and growing. It doesn't help that the guidelines are often badly skewed in one direction or another, distorting perceptions of what a healthy weight range really is. And none of this addresses how people treat each other: fat people (or even non-scrawny people who are called fat or perceived as being fat) are often picked on, harassed, discriminated against, overcharged, or otherwise mistreated simply because of their size. That is unacceptable. Fat people are still people. It is not right to abuse someone just because you don't like the way they look, or live. Condemning an entire group is wrong. Condemning an individual is rude and risky -- you have no way of knowing whether someone is fat due to overeating, due to genetics or disease, due to prescriptions, or any other combination of factors.

Take responsibility for your own life and body. Do the best you can with what you have. Don't beat up on yourself if it's not perfect; don't pick on other people if they're not perfect. If you are displeased by your society's values or actions, do something about it. If you want to make a widespread social change, first analyze the problem using the best data you can find. Do not be distracted by emotions. Identify as many causes and variables as you can. Set aside the ones that can't readily be influenced. Then work on changing the ones that can be influenced. Don't stand by and watch society continue to do something stupid just because everybody's doing it. Fix what you can, and usually after a decade or few other folks will catch on.