What should we do about obesity?

No. However, the experience of my country, the United States, over the past few decades is that there has been a big push in the schools and the media for a “balanced diet” and the “active lifestyle.” At the same time, people have gotten heavier, not lighter. I do not see obesity being prevented. I do see a tremendous number of teenagers in the United States who are having psychiatric problems connected to body image, in part because they are being pushed into a diet and exercise regimen that almost always fails.

The phrase “prevents obesity” implies that we are dealing with children. First, I should point out that all three of our kids are in the average weight range, in case anyone thinks that what I will write next is just sour grapes.

Now, on to a little case study. Our ten year old boy is a very fussy eater who lives on french toast, french fries, chicken nuggets, hot dogs, and spaghetti. He’ll eat grapes, but not much else in the line of fruits and vegetables. You can say that we should starve him out of this high-carb diet, but that is easier said than done, and I question the psychological implications. I was just talking with my father in law about this, and he said that one of his brothers (still living, fairly healthy and thin) was also a terrible eater, only wanting jelly sandwiches. Although his parents were tough disciplinarians even by depression-era standards, this particular kid could just not be forced to eat what he did not want to eat. Ours is the same way. As for exercise, this is even harder to force than food. Those who think this stuff is easy cannot have such strong-willed kids. Gentle encouragement gets you nowhere, and harsh measures probably would do nothing except to convince the child to anticipate the worst.

Another story. My daughter, 16, went to visit relatives in London this summer accompanied by a heavy female friend. The friend was already self-conscious of her weigh, espcially because she is from a family where everyone else is thin, and she faces the usual pressure to slim down. My daughter reports than everywhere she went, her relatives were praising her because she had slimmed down a bit since the last time they had seen her. To make a long story short, my daughter’s friend was mortified, and had a terrible time during what should have been the great adventure of her young life. Such unhappiness, and not actual obesity prevention, is the real effect of America’s obsession with fat. Now the girl’s mother is putting her daughter on a diet, although, ironically, she is a nurse in the building (Hospital of the University of Pennsylvania) in which it was first shown (look up publications by Albert J. Stunkard) that, long-term, diets do not work. Yes, weight loss surgery may work. But I suppose the girl is young for that, plus the mother has told us of us patients she has seen who had serious complications from the surgery.

Especially since I am new here, I should own up to my general approach to internet posting. It is to find something everyone agrees on and try to shoot it down. Of course, sometimes the conventional wisdom is right. Not usually, but sometimes.

And thanks for the kind words concerning my last post.

No, it’s far from as simple as that. But if you show me a person who leads an inactive lifestyle, I’ll show you a person who either is fat or is going to be fat unless they make a lifestyle change. That doesn’t mean that every fat person got there just by being lazy, though.

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And this is part of the reason for my belief in the need for education. There are a lot of choices, and planning a diet is not incredibly simple. But you’ve done your research, and that’s good.

btw, as far as vegetarian options go, you might want to check out [url=“http://my.webmd.com/medcast_channel_toc/3068”]the Ornish diet**. Flatly put, it looks good.

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Yep, and it’s a damn shame. I really do feel for the people who are too poor to eat well, and I wish there was something I could do to help. But the people I have in mind are the regular McDonald’s customers. You got enough money to eat that crap, you got enough money to eat well.

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The government advocates an hour of activity per day for weight management. This can include things like taking the stairs instead of the elevator, parking further away and walking into work, and the like. Heck, you can even buy a jumprope and work out with that–I’d be impressed at anyone who can keep up a good pace for ten minutes.

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The information is free if you know where to look for it. But I agree that it should be more readily available.

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I agree with everything you say here.

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Yes, but for a lot of people, those issues just aren’t that pressing. There is a very large group of people out there who could lose weight easily (at least compared to people with the hardships you describe), and they’re just not trying. For them, it really is a matter of willpower.

This is the group I spoke of, and I realize that I should’ve made that more clear.

We seem to be using a term differently here. When I say diet, I mean “what you eat”. When you say diet, you seem to mean “an eating plan designed to bring about weight loss as rapidly as possible”.

[QUOTE]
*Originally posted by SteveEisenberg *
**No. However, the experience of my country, the United States, over the past few decades is that there has been a big push in the schools and the media for a “balanced diet” and the “active lifestyle.” At the same time, people have gotten heavier, not lighter.

While there has been a big push, who’s to say it’s been successful? Apparently not, judging by our ballooning waistline.

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Right, which is why we need better education on diets and exercise regimes that do work.

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In Great Debates especially, but across this whole board, if you’re responding to a particular poster, you should address only what they said. If you want to transition to some more general discourse, you should make a point that you realize what they didn’t say. Just FYI.

Hopefully someone will do a five year followup on these kids.

There are many diet and/or exercise regimens which achieve weight control for a year or two. The problem is that these programs put people on a multi-year yo-yo, with weight sometimes ratcheting up a bit each time. While many individuals will express satisfaction with a program that works for two years and then fails, I doubt that being on such a yo-yo is good for them in the long run, physically or psychologically.

Another point. I don’t blame the dance program for this, but I am struck by the CBS news report of a middle school child losing fifteen pounds in two weeks. This is a red flag indicative of an eating disorder.

The school where I teach has about 110 middle schoolers and 125 high schoolers. There are five cola machines on the campus. During break, the student government sells chips, candy bars, and ice cream. More than one parent has told me of their reservations concerning this, and I agree with them. If it were up to me, I’d have the cola machines removed and allow the student government to sell only fruit or other healthy food. It won’t happen anytime soon because even though our administration agrees, there’s too much money wrapped up in the concessions - money that pays for supplies for the poor students, money that helps the juniors throw prom, money that buys uniforms and field trips and books.

The guy running the cafeteria does his best. There really isn’t too much fried stuff, but there is hardly a balance of vegetables versus cheap starch. He’s supposed to feed 400 students (including the elementary school) a day on an average of $2 per student. I’m amazed he does as well as he does.

If you want the schools to supply better food to the kids, you have to replace the money provided by the cola and candy companies and supply even more to get the lunches up to some sort of nutritional standard.

And Dance Dance Revolution is a nice thought as well.

Thanks phouka for that post. That’s exactly the kind of problem I’m talking about. It really ticks me off to see soda machines in schools and to know how dependent schools are on this source of revenue.

SteveE, my kid isn’t much younger than your fussy eater and he also has some strange eating habits. I don’t worry too much about what he eats, as I don’t believe in forcing kids to eat stuff. But I do think that most kids can be encouraged to exercise: and of course by that I don’t mean that they should be made to do 50 push-ups. If kid’s television intake, especially during the week is limited, they can pack in quite a lot of physical activity. It doesn’t matter whether it’s playing in the park, taking a walk, shooting hoops, karate class, skipping rope, soccer practice, dancing with the radio playing–just as long as it isn’t sitting in front of the tube (or computer) with a bag of chips in hand. It’s this snacking/sitting habit that seems to have changed most in American eating habits, combined with the extra stress on fast food. In any case, even if a kid is particularly unkeen on exercise, every minute away from television is a gain for the child’s mind (or so I believe).

I also think you have a point about obsessive concern with weight. That is, girls especially are made to feel dreadful if they don’t conform to a standard of thinness that isn’t natural for many people. I think it’s fair to make a distinction between dieting because of an obsession of thinness, and diet in the sense intended by ultrafilter.

The government has extensive programs to educate people about nutrition and exercise. Why should it do anything else? Why is everyone so intense on doing something about fat people? My quality of life is fine thank you very much. Of my great-grandmothers who died non-accidental deaths, 2 were fat and one thin. They all died at age 89. The two fat ones were far more active in later years and had demonstrably better quality of life than the thin one and needed far less medical care than the thin one. My grandmothers are both overweight, one has been obese her entire adult life. They both are in their late 70s and last I heard worked part time. The obese one still has active physical jobs. Obese as I am, I am very likely to live to a ripe old age because genes count more towards life expectancy than does fat. My quality of life is much higher when I don’t try to lose weight. I am active and before I got pregnant, I had more energy than anyone else I knew. And spare me any talk about attractiveness, my lovers think I look just fine.

Government should continue to provide education, where desirable provide facilities for exercise like public parks and community centers and encourage people to look after their health. It should not try punishing those who are fat. I do not understand why so many people want to.

While I do understand why some folks (muself included) get distressed when they see really heavy kids I don’t think “we” should do anything about it other than make resources available and monitor children’s health as we would for any other possible abuse or neglect.

If being a fatty is so bad then it’s going to be self correcting at best and NOY(or my)B at worst. I’d much rather have happy friends than the responsibility of correcting other people’s eating disorders or assuming people even have disorders. Hell we could come to another ice age and envy that extray layer of heat and calories, or the CHUDS could start chasing you and make you thankful for someone heavier than you to throw to them (j/k: There is no conclusive proof that CHUDs prefer slow or large food).

IMHO, it has to do with the human instinct to bigotry. Fat people and conservative Christians are the only groups left which it is socially acceptable to dislike.

I suspect this will be an unpopular post, and have one question for anyone who responds. Please show me solid evidence that being fat is either more preventable or, over a time frame of at least five years, more cureable, than homosexuality, by other than surgical means. Saying that everyone believes it does not count as evidence. And saying that one has been to place X or seen photos from time Y, and everyone was thin, does not qualify either, because, truth is, it could not be true unless there was mass starvation.

Actually there are many similarities between obesity and homosexuality. Both may or may not be unhealthy, physically and emotionally. Both are under conscious control of the individual involved, in the short run, but probably not in the long run. Both are somewhat more common than they used to be. And both involve commonplace fears (might I be just a little fat or a little gay?) which people hate to admit to themselves.

JShore wrote:

I think it is precisely on-topic, and I think you’ve drawn a distinction without a difference.

The politicians in business and those in government are partners. Look at the tobacco companies, for instance. Some people compare the War on Americans I Mean Obesity with the War on Americans I Mean Tobacco.

The tobacco executives were punished by their government partners by forcing the victims to pay a fine. I guess that’ll show those rascals.

The fast food industry will be treated the same way. The punishment for their fraud will be that we pay five times as much for Big Frigging Macs.

I’ll let others respond to your homosexuality comments, but as to this idea that a healthy weight in society can only occur where there is starvation, I think that is just wrong. People have posted about their experience in Japan and Europe where obesity is much less common. If you believe that to be untrue I will try to google up some numbers for you. I don’t think people in Japan are starving.

I think he meant “true” in the philosophical sense.

Libertarian: *" The tobacco executives were punished by their government partners by forcing the victims to pay a fine. I guess that’ll show those rascals.

The fast food industry will be treated the same way. The punishment for their fraud will be that we pay five times as much for Big Frigging Macs."*

Lib (if I may),

  1. Pay a fine? Weren’t these jury trials? Certainly the most recent wopping mega-bucks in damages to a tobacco plaintiff was chosen by a jury of my/your/the plaintiff’s peers.

  2. Most lawyers I’ve spoken to feel pretty certain that the fast food case will not hold up; the circumstances are too different. So it’s probable, or so I’m told, your Big Mac attacks can be sated on the cheap for a little while longer ;).

  3. I agree (as you said earlier) that “politicians in business and those in government are partners.” That is, our democracy is need in reform, to be sure. But I still believe that government is directly accountable to us in a way that business–esp. big business–certainly is not. We do elect most of these people; whereas our market-based freedom to choose is often constrained if non-existent (e.g., HMOs). It’s precisely when people feel powerless to impact corporate “control” over their lives that they turn both to government regulation (without which corporations couldn’t survive in the first place - so there’s a give and take there), and to the courts. In either case, though, it reflects the will of the (at any rate some) people. The democratic mechanism is no more perfect than the market mechanism and on a case by case basis they can be compared. But it isn’t collusion between politicians and some corporate elite that produces health and safety standards or settlements. It is people wishing to retain control over their by recourse these modern institutional means.

You know, Libertarian, you sometimes sound like Foucault ;).

To some others: again, I think we can recognize that obese people are subject to all kinds of prejudice, and that weight has begin an obsession in an unhelpful way, while still recognizing that there is more that we as a society can do to help individuals en masse, esp. kids, eat more healthily and exercise more regularly.

Aargh -sorry for all those typos. “It is people wishing to retain control over their lives by recourse to theose modern institutional means.”

“weight has become an obsession in an unhelpful way”

I am a lousy proofreader as you can see!

Mandelstam,

My point about the “fine” is that the executives were allowed to pass payment of it along to their victims. What kind of “fine” is that?

Judge: “Mr. Mandelstam, I fine you $100. Take five twenties from the guy you bilked, and go pay the bailiff.”

I would like to get it clear: If people (people being used in this sense as ‘people who aren’t you’), for whatever reason, take in more calories then they expend, why is it our business?

I am obese. If I really wanted not to be, I’d not eat for a day or two, since the eat-fruit-and-salad-and-walk-everywhere hasn’t done much for me. I keep up the EFaSaWE plan, though, because I have no real desire to gain more weight, either.

And, is it not common knowledge that if you intake more calories then you expend, that you will gain weight?

Robert It is our business if, and only if, it costs us money. If obesity is controllable, i.e. a matter of choice, and obesity costs society money, is it unreasonable to ask those who choose to be obese to pay for their decision?

On a separate issue, there is a suggestion here that schools etc. are not only not doing enough to prevent obesity, but may be a leading contributor to the problem. Perhaps, it is argued, with a few small changes and some additional money we could prevent a large number of children from becoming obese in the first place.

It does seem fairly obvious, to me, that obesity is a direct result of one taking in more calories than one puts out.

Why should obesity cost “society” money? Why not just stop making people pay for other people’s bad judgment?

Well, if obesity leads to health problems, and health problems lead to higher health care costs and higher health care costs lead to higher health care insurance premiums, then obesity costs society money. Maybe this is a gross over simplification of the system, but I think it is an assumption we are all working under.

Rhum, I agree that there are social costs attached to widespread obesity. Lib, people (en masse) are already paying for other people’s bad judgment. The health costs of obesity are absorbed by all of us as a society. It can’t but be otherwise. Whether we’re talking about private health insurance (the costs of which, AFAIK, don’t vary according to weight) or people who rely on publicly available forms of healthcare, the health of the truly obese (and I think that not all “overweight” people are obese in a medical sense) is likely to be worse on average, and therefore to incur additional cost.

All of that said, I don’t love the “it costs us money, therefore we should do something about it” justification for social action in this case. There are many reasons why but I have to go to work, so I’ll be brief. I don’t think that human costs can be reduced to quantifications. There are human reasons why we should care. For the same reason, I certainly don’t think that the answer is to penalize the obese in some monetary fashion. The obese are already penalized by social prejudice.

robert, I don’t think that any policy formulated to help Americans to eat more healthily would be directed at you. It is more likely to be directed at parents in their parental role (as feeders of children) and at school-age children. It is very hard to change habits and body patterns that have developed over the course of the lifetime. If you are happy as you are then rest assured that I, at least, am happy to know it and don’t regard you as a “problem” for me or society to solve.

The fact that schools can play a central role here is, I think, a very good thing. It means that there’s no necessary need to fear big government “control.” Schools and local governing bodies are relatively responsive to what people think. The organizing of a food co-op for low cost fresh vegetables, community events to promote nutritional knowledge, the elimination of soda/snacks from schools (along with a way to compensate schools for lost revenues), the promotion of exercise, local campaigns against excessive TV watching, public support for healthy school meals–these are all things that can make people feel more in control of their lives rather than less.