Well at least Trump is doing his job. He has so many Dems fired up and marching to and fro protesting this or that most are getting more exercise than they have in years......LOL
6
The problem of obesity, particularly in childhood, has been before us for decades. Michelle Obama spent 8 years trying to educate us. Yet now we have a counter movement against ‘body shaming’ that spreads propaganda that fat is beautiful, if that’s what you want to be. And we have a president whose diet of junk food is revolting and whose rear end could constitute a significant chunk of the border wall he craves. How did this happen!?
18
Get a dog.
8
I read somewhere that Rose Kennedy used to plan a menu for a week, and then repeat the same menu week after week for a long time before changing it up. I think this could be useful advice. It allows you to shop for a menu (always cheaper than random buying and less waste) and it lets you get into a rhythm so you are not always wondering what to have for dinner, coming up blank and then saying "what the hell" and ordering a pizza.
8
At 76, I'm about four pounds heavier than I was when I graduated from high school in 1960, with athletic letters in cross country, skiing, and track. "Personal responsibility" or "will power" won't keep one from gaining weight? They worked for me. Being self-employed, I covered our family's health insurance costs with a high-deductible major medical policy for over thirty-five years. I resent employer-provided health benefits to obese employees--much of the costs of these health plans are passed on to consumers, i.e., you and me. When I turned 65, I talked with an insurance representative about buying a supplemental policy to my Medicare coverage. Remembering an article I had read a few weeks before, stating that just over 50% of health care costs in this country are connected with tobacco use and being overweight, I asked the insurance representative if, as a non-tobacco user, I could get a discount on the insurance premium. Her response astounded me: "Oh, no! That would be discrimination!" "Duh," I thought, isn't that the point? And increased premiums for auto insurance for drunk driving, reckless driving, speeding tickets, etc. aren't "discrimination"? Time for some "discrimination" in health insurance, I feel.
22
Fresh food is more expensive than highly processed junk food. People don't have time to cook. People are working longer and don't have time to exercise. They don't have time to relax either. Recess periods have been eliminated or significantly curtailed in schools as has physical education. We're all expected to stay still for long periods of time which is not natural for us.
Each time a proposal is put forth to limit ads on junk food to children the food industry objects. Each time a locality tries to tax soda and fruit drinks there are objections. Portion sizes have increased tremendously in the last 20 years. So too have our appetites. We do tend to eat what is in front of us even if we wind up feeling overstuffed.
There are things we can do that help. When you eat out or purchase a large portion, don't wolf it down and don't always eat the whole thing in one sitting. Save some for later. Another thing to do is to eat more fresh fruit if that's possible. Drink water or milk. Skip the Gatorade. Don't bother with diet foods. Eat the real thing. That's more satisfying.
Exercise if you can. Walk into town instead of driving. Use an old fashioned push lawn mower. Stop the late night eating.
7
Add to your list: standing desks. A comprehensive study out of Texas A&M showed a delta of 6% over two years in BMI of kids sitting at school versus standing. Imagine the delta between sitting and standing over 12 years of schooling...These should be mandatory in public schools. It's such a simple and easy intervention for all kid.
4
As others have mentioned, physical activity does not prevent obesity when your diet is bad. I work on a large offshore drilling rig with a million stairs. People sweat all day performing physical tasks throughout their 12 hour shifts but many are overweight because the mess hall has too many unhealthy meal options available. There are healthy foods to eat, but over-steamed broccoli usually don’t look as appetizing as a cheeseburger and fries.
12
Despite the obesity epidemic, there are still parents who tell their children to finish what's on their plates. This is especially common among poor people, who are more likely to be religious and therefore more likely to punish their children.
Teaching children to finish their food is inflicting a curse on them which will follow them the rest of their lives.
8
Billions In Tax Dollars Subsidize The Junk Food Industry - Business ...
https://www.businessinsider.com/billions-in-tax-dollars-subsidize-the-ju......
Jul 25, 2012 - The sweet, fatty and calorie-rich Hostess Twinkies alone contain 14 ingredients made with highly subsidized processed ingredients, including corn syrup, high fructose corn syrup, corn starch and vegetable shortening.
4
The comments on activity and exercise as an approach to the problem is naïve at worse and narrow at best. The root of the problem is calories. The burn rate for even vigorous exercise, such as running or swimming, cannot make a dent in the caloric excess of the industrial diet.
20
Wrong. More calories consumed than calories burned WILL make you fat. Period. No "insulin", no "genetics". Works with dogs, cats and every animal on Earth, including the human animal.
1
This article gives a decent framework for starting to think about things. But that is about it. I feel the authors are a bit too rosy about the costs and logistics involved in it all - for example, ripping out and renovating kitchens and retraining staff is not "simple," especially when the school food program is looked as a break-even or a loss-making program. It will not be cheap in an era of constrained budgets. Getting a school to adopt a new menu is no easy feat - even if you change the menu, it does not follow that the new food will go down those gullets.
The language of "reversing" the obesity epidemic is also problematic. We aren't going to get the entire population to lose massive amounts of weight - research shows sustained weight loss is very difficult. The socio-political, economic, and health impacts of this massive weight gain, even if stopped in its tracks today, will be with us for generations.
3
Healthy diet starts at a very young age, conditioning your taste buds etc... my grandfather was a chef... my mother's diet was established through her father passed down to me...Years ago watching Charlie Rose "sad" he always asked his guest "any regrets" the fortune 500 CEO, answered I wish I had better nutrition and eating habits growing up, it had been incredibly hard to change his habits. My general lifetime diet has been the 100 year rule, if that food wasn't around 100 years ago, I DON'T EAT IT...
4
Obesity is the new norm. As I look around me I am astounded at its acceptance in oneself as well as those around us. I work in a high school and began to notice this norm several years ago. During my school years in the 1950’s and early 1960’s I remember just one obese girl. She stood out. Same for college years — very few at my public university. Farm policy shifted and I remember visiting the farm where my father grew up in Minnesota in 1973. The farms my grandfather had owned were now run by tenants and the manager proudly showed us the size of the corn and soy. Now corn had been always been a crop — one of several. Now the fast food/packaged food industry was dictating what was grown. Corn was once for eating and no one knew about soy beans in my grandfather’s day. HFCS and soy for processing. More profit in cheap food. And it is easy — why do you think the microwave is so exalted now? Quickly heat the processed food and get dinner done. Sit and eat in front of TV. And now the public ends up with higher medical costs because of industry profit. There is a vicious cycle and this is the first time I have read an opinion piece that finally links obesity to congressional policies. A national shame.
13
?
I used to feel sorry for most obese people but then I realized how many of them were Trumpkins, so things have changed.
6
Driving trips across America show exactly how this has happened. I have learned to stop at 7-11 for gas, because it has bananas, reasonably sized sandwiches, hard boiled eggs and cheese sticks. Not perfect food, but acceptable to me.
Unfortunately, in 7-11s, as in most other stores, overpriced and over sized junk foods occupy most shelves. Cold twelve ounce sodas are almost never available, except in smaller convenience stores in rural areas. In most stores, one must buy 20 ounces, far too large for me.
As in everything, follow the money, which flows from junk food sales to corporate marketeers, while consumers carry around the extra pounds. Not a fair exchange, but extraordinarily clever American merchandising has persuaded people to make this hellaciously bad deal. Of course, society's health care costs explode, but this doesn't come out of the pockets of the junk food marketeers.
Add to this the impossibly fractured schedules many familes labor under. Family meals, let alone nutritious ones, are a middle and upper class luxury.
What a mess!
7
How about #6, stop obsessing about "fat shaming".
1
Obese folks are now normal, its the 30% who need to eat more.
5
I am sure that Trump will jump at the chance to regulate "Big Food" to combat the epidemic of obesity. Trump is clinical obese except when he lies about his height. He loves fast food and diet coke. He thinks that government regulation is critical for serious matters like immigration but does not want Obamacare to cover pre-existing conditions. If you are clinically obese as a child, is that a pre-existing condition as an adult? Just wondering.
1
But I thought we’re supposed to accept everyone’s weight? The left confuses me
6
Reading some of these comments is starting to annoy me. No one can know anyone else's journey through life, their ups and downs, what made them who and what they are. How dare you judge others who don't look like you and, worse, find them wanting in some fundamental way? Here's a suggestion: focus on growing wise instead of just staring into a full length mirror.
14
@Cynthia--I think a lot of it has to do with the selfie-obsessed, narcissist society which has taken over--certainly in the United States. This plague was always bad but now it's gotten intolerable.
4
Well, when you take half my seat plus your own seat on an airplane or bus or train and I have to spend 4 hours with your arm brushing against the side of my breast, you bet I will not only judge you but will not give a hoot about your feelings and will ask to be moved to another seat.
14
This article states that the obesity epidemic has hit low-income families the hardest. Later on it is pointed out that the most desirable foods, fruits and vegetables, are also very expensive. This suggests that if fruits and vegetables were more affordable to low-income families and they took advantage of the new pricing, this would go some way to alleviating the obesity epidemic.
Perhaps what is needed is a change to the food stamp program such that when food stamps are used to purchase produce, the consumer gets a deep discount and the grocer gets a rebate from the government to make up the difference. Yes, this could require a tax increase but this program might result in an offsetting savings in governmental healthcare costs.
9
While it’s true that many get sick because they are fat I believe it’s also true that lots of people get fat because they get sick. There are many growing categories of disease that occur independent of weight and those diseases bring chronic use of potentially weight stimulating medications. For example, when I was young I didn’t know anyone else who suffered from asthma as I did. Now it’s rampant. The inhaled daily medication contains low doses of steroids, a substance associated with weight gain for many users. People are on this medication for life. I am and I find weight management more of a challenge than I believe it would be off the the medication. Autoimmune disease is another rapidly growing category. My daughter was a thin 8 year old when she was diagnosed with lupus. Now, after a sick childhood spent on steroids and other medications, weight management is a challenge. Depression is another category that is now more frequently diagnosed. Many gain weight on antidepressants. Antibiotics wipe out good bacteria in the gut and their use has been traced to weight issues. The list goes on, but my point is that we live in a far more chronically medicated society than previous generations and I believe that is an underestimated factor in why there are so many overweight people.
22
@Paulis--Absolutely correct. What I find ironic (and maddening) is when people castigate someone with bipolar or schizophrenia who is not taking antipsychotics, but when that person does end up taking these drugs and gains massive amounts of weight, those same patients are castigated for their weight gain.
14
I agree that school lunch improvements would be a great change. I am not currently overweight yet, but my weight has definitely been creeping up every year as I approach my 30s. I try to avoid fast food, but sometimes I just crave the kind of food my Texas schools gave us for lunch - chicken nuggets, fries (as the vegetable), chicken fried steak, pizza, chili dogs, sloppy joes, frito pie...I don't remember much in the way of vegetables and fruits, or healthy proteins. Even though my mom cooked healthy dinners for us, she trusted schools with most of our lunches. I wonder how much my current dietary desires are influenced by the school-provided food throughout those formative years.
4
I disagree with your assessment of responsibility in paragraph 12. Yes, we can blame individuals and expect personal responsibility. It may not be easy, but there is only one way that calories and sugar get into your body: you pick up your fork and shovel it in. Weight gain is not a mystery.
13
Your conclusion is superficial and simplistic. Clinical trials for weight management conclude that the relationship between food consumption and weight gain is impacted by many factors and poorly understood.
5
No. it is not. Many studies and Mother Nature herself have proven that if you eat more calories than you burn, you will get fat. My dog gains weight during winter time because he doesn't get his 3 mile-walks every day. He loses it all first few weeks of resuming the walks. Excuses, excuses, excuses.
4
But wait... isn't obesity just a culturally constructed myth perpetuated by the patriarchy to oppress women or something?
9
The role of social ‘media’ should also be examined. Hard to post to Facebook while one is riding a bike....
7
I was standing inside the ropes for ticket holders at Cinema Village. Inside the ropes there were no fat people at all. But just a few feet away a lot of fat people were walking by. Strange.
1
"With insulin now costing up to $900 a month, …"
Price of similar insulin prescription in Canada, England, France, Scandinavia is…?
10
I understand that obesity is a disease and that it is genetic. I get that the solution is not "personal responsibility". But what about the middle class, middle age person who is maybe 15-30 pounds overweight, but not obese and was not overweight in their youth. These folks, I think, CAN take matters into their own hands and make better choices and slim down. Europeans are not fat. Japanese are not fat. Chinese are not fat. The list goes on. Something is at play here other than "genetics".
13
We are a nation of addicts and that includes food addiction. Sadly unless the addict wants it, nothing and nobody will stop him from self-destructing using alcohol, opioids, heroin or food. Disease or not, there is an element of personal responsibility and personal agency.
5
Policy #1 should have been an outright ban on high-fructose corn syrup.
10
People did not evolve to withstand unlimited access to overly tasty food. There's probably no solution to this overeating crisis until somebody invented an effective appetite suppressant without side effects.
2
So long as the food industry spends billions of dollars lobbying for the health of their bottom line, and against the health of a nation, sensible suggestions such as those found here will wither on the printed page.
6
Addiction remains a business model of choice for businesses that feed the nation.
9
Tax soda.
Tax Junk food and processed food.
Call it an "obesity tax" and use it to fund really healthy lunches for children (not "ketchup is a vegetable")
When junk becomes too expensive people will start cooking.
There are ways to cook that are healthy, cheap, and time saving. Slow cookers, crock pots make it possible even if you have 2 jobs and little time. It doesn't have to be kale!
Also, how many people are having obesity- related orthopedic problems at relatively young ages? Walkers...hip replacements, electric wheelchairs?
It's not just diabetes.
10
Everyone’s so fat these days that I get called skinny! A hundred years ago - nay! A mere 50, I say - I would’ve been seen as completely average if not on the chunkier side. The average guy was probably 5’9” 140 lbs in 1900. Today? Maybe 5’10” and 200. That’s the new “normal.”
3
@alex
I remember the one -- and there was only one -- "fat girl" in my elementary school 45 years ago. Her name was Joni. She would be considered nearly svelte compared to the kids in any 4th grade today.
The 35-45-ish men in my neighborhood are all bald, soft, obese and lazy. They NEVER pick up a rake, broom, clipper, edger or scrub brush when they can fire up a fossil-fueled power tool to do the job instead.
I'm 10-15 years older than they are and I can hand-mow, edge, sweep and trim my entire front lawn & sidewalk (same size as theirs) in under 15 minutes. They move so slowly and are such bumblers with their tools that it takes them 2-3 times the same number of minutes.
Whatever happened to real men in the United States? The only muscular, competent and hard-working ones I ever see are the immigrant roofers, landscapers and road workers.
17
Agree on most points but there have been billions spent on obesity research and at the end of the day . . . Eat real food, at home and move more. Less funds need to be spent on more expensive research and more spent on outreach into communities showing low-income families how to prepare and enjoy vegetables, fruits and less processed foods. The secondary benefit includes families preparing food together instead of tossing chicken nuggets across the table on the rush to the TV!!
9
Why are cows and pigs fed corn? To fatten them up. And that's a major reason why American are obese. Corn sugar has addicted the United States and it is not healthy in such quantities that are put into processed foods. It's been pumped into products like sodas, bread and other baked goods, cereals, meats, including "cured" bacon. Big Food/Ag opposed nutritional labels just like Big Tobacco and use their throw-weight to by politicians. Caveat comedentis!
7
This obesity epidemics reflects a national unstable or unhappy mental status , just like the opioids crisis, the gun ownership glut, the increase populace control and submission to various religions ,out of control political manipulation of the lower classes and basic ignorance.
The cost to correct this humongous problem will be immense and probably not achievable.
We need a government whose main aim will be to correct this abomination, but Wall Street will always be in charge and will control the way we eat, we access healthcare and treatment services, we carry on our lives .
We are doomed , unless each single individual will take his destiny in his own hands , using common sense , self reliance and help from good willing people .
5
I have two pound hand weights next to my TV. Every time a commercial comes on I do a set of exercises to keep muscle mass which helps with weight control and leaves no room for snacking. Extra benefit, this blocks out the pharma ads, the food pitches and that guy with the incredible (over hyped) pillows. Use beneficial actions to block out stressful and obnoxious corporate intrusion.
7
Startling to read that we cannot expect persons to be responsible for their own obesity and the government must take action about diets. In the first place, it makes no sense that persons cannot take responsibility for their own health. In the second place, the American government does not have the ability to do much in health care because America does not have a universal health care plan which can be applied in a consistent manner.
Obesity is becoming a problem in other countries but other countries can mount a better campaign because they all have universal health care. One of the most effective places to start is with "fat kids". These kids must be in a program to help them by the time they are 5-6 years old. If nothing is done by adolescence the battle is lost. The simple medical fact is that fat kids grow up to become fat adults.
As others below have pointed out, the American government
4
Well, there's the trade-off. Ban smoking, making it unacceptable, and then everyone becomes obese.
Nobody smokes, anymore. By now, they are just all obese. And which condition creates the greater cost?
It is these Obese people. 39.8% according to the CDC. How many other people are overweight. Another 30%.?
Thank goodness we stamped out that "smoking." So that many, many more millions of people could die from obesity related diseases.
3
Let's focus on food. Overall Europeans generally are more thin than us. But they do not have more discretionary income. Why? One reason; Take a bottle of mayonnaise off a shelf in Europe and one here and read the labels. Guess what? More fat in ours, and in many products? More sugar!! - We do need a regulation regarding standard food staples that limit variance from same products in healthier countries as far as fat and sugar content. We should also encourage adults to switch to a plant based diet as much as possible - not strictly- but something achievable. And third, after we establish a single payer medicare type for all option, the premiums should be based on BMIs ( body mass index) for most US citizens -- if you meet the category for low risk obese ( starts at 30 for adults), medium risk for adults ( starts at 35 BMI) or morbidly obese (> 40 for adults) - your premium is higher( so 3 premium levels for the obese population overall) because you are going to cost the health care system more. So yes to a single payer all medicare docs are on your provider list you can't be rejected option - but higher dollar premium if your weight is in the obese or greater range( measured once every 6 months).
11
The professionalization of youth sports, complete with public schools telling kids NOT to play by limiting teams and cutting any kid who isn’t already in the top 10% for fitness, is literally killing us. Tell a kid one time that they are too runty or slow and they’ll head to the couch never to re-emerge. Slap a family with a $1500 fee for six months of elite sports and many of our poorest and most vulnerable children will never see the sports field regardless of capability. The current elite youth sports system is perverse and hurts our kids; we should not be spending public money for either fields or teams that do not welcome all children all the time.
15
I'm here on temporary assignment from Italy, living in central Michigan. Almost everyone here is really heavy or fat. Reasons?
1) There's a fast-filth food joint every hundred feet advertising their "special" with a beef patty, pulled-pork, bacon and special sauce (that's just one sandwich) for $3.00. Eat that garbage every day and you get fat.
2) There's something fundamentally wrong with the U.S. food system. All the high-fructose corn syrup, additives, genetic modifications and other "food science" garbage people buy in the stores is not healthy. Just look at what people put in their shopping carts. A lot of things are not food but are "formulations," manufactured for fast, easy consumption.
3) People are simply not as active as they should be. Our cities are built for cars not for walking or enjoying time outside. People snack all day at their desk jobs.
Sure, some people have special problems with their weight, but as a person who grew up in the 60's and 70's, it was rare to see overweight people. They were the exception, not the rule.
21
And a very all-American tendency to minimize the role of personal responsibility and personal agency. Once something is labeled "a disease" the toxic "there is nothing s/he can do about it" mindframe kicks and all you hear are excuses and the blaming of others for a self-inflicting "disease". Gluttony went from one of the seven deadly sins to a supposedly uncontrollable "disease".
9
What a missed opportunity this article is. There is a large and growing community in the US of people who are stopping obesity in it’s tracks, reversing diabetes, reducing hypertension, reducing cholesterol levels along with many other health benefits by following a whole foods plant based no oil diet. It is the start of a dietary revolution in this country and goes unmentioned in this article. So many people have yet to learn that there is a solution to break out of the death trap that is the “standard American diet” Shame on thes authors for such a superficial report.
6
Imagine how much money in health care would be saved if government put money into prevention by subsidizing fitness classes, cooking clubs, and the like.
8
Now the secret is out. Fat people are of poor health and cost a great deal, and one wonders what advice the authors would give to employers. Have the authors heard about wars and examined their human and health costs (There is a report in the Magazine to get you started)? There are so many things that cost so much, debunked medical treatments and wrongheaded economic advice among them, why pick on fat people?
1
Obesity is not limited to America. It doesn't take much global travel to see that it's present and probably increasing in many parts of the world. Perhaps understanding how other countries are addressing it can be helpful to us here at home.
3
Ludwig and Rogoff miss entirely the parameter of calorie expenditure and how it has decreased over the years. Do children walk to school these days, even if school is within a walking distance? Do children have physical education daily? Do they have daily recess, with active games? Do children go to summer camp with swimming and sports or do they attend academic programs and sit at computers? Finally, are children walking in malls with parents, or are they strolled reading iPads, even when they are clearly too big for the strollers? All these changes mark a significant decrease in calorie expenditure and create a pattern of inactivity, which will persist throughout life.
8
I joined a weight loss program and havs lost over 65 pounds so far, but still little more than halfway to a healthy BMI.
Some things I've learned along the way:
1. eating more whole foods changed my tastes; junk food, sugary food, and processed food doesn't taste as good as I thought it did 65 pounds ago.
2. The myth that eating more healthy food is expensive is nonsense. This new (for me) way of eating has actually saved me money. Buy veggies and fruit in bulk, still less per portion than meals from fast food restaurants, which used to be my main source of "sustenance." My credit card bill each month is smaller than before I started this program.
3. It's very painful and discouraging to move when you are obese. But once the weight started coming off, even though I was still obese, I had more energy and could build up to the point where I'm working out every day. But that inital state is overlooked by people who have never had a weight problem; it really is painful to be up and moving and it's a vicious carch 22. Workout clothes are more expensive too for plus sizes because we have to rely on specialty stores like Lane Bryant, yet we all have to start somewhere.
4. I would have started a lot sooner if my health insurance covered a variety of weight loss programs, instead of just the 1 the had a discount to but didn't work for me. Instead, I waited until I could afford to try it and even then, waited until there was a promotional price.
16
While this article covers many good things, it underestimates the current knowledge by functional medicine research that obesity epidemic is primarily caused by changes in factory farming, with less nutritious foods and greater toxins in those foods. This epidemic is not most fundamentally caused by a lack of personal will power but by an enabling of corporate greed.
5
A stunning and obvious example of our government mixing bad politics with bad nutrition: Under Battista, the U.S. received all our sugar from Cuba. Though he was a brutal dictator whose behavior was responsible for the revolution he was still an 'ally'. After his defeat America's main source of sugar was unavailable; the U.S. would not trade with a communist country. We used more and more corn sweetener. The government heavily subsidized production in those 'self reliant' conservative midwest farm states. As corn syrup became artificially cheap soft drink portions became bigger. The size of the bottles people buy is grotesque and the amount their children drink hideous. And it becomes addictive if you don't eat properly; you need constant intake. It's really beautiful: Your tax dollars are used to subsidize corn sweetener and agribusiness. Then they are used to help people who develop various nutritional problems like diabetes. Thankfully my Mom was ahead of the curve; I remember occasionally having a small coke containing only sugar, with plenty of ice. What a treat ! Never became a 'habit'. I'm 72, and work in construction supply. I drink coffee, water, and after work, a few beers. Many of the younger guys drink an artificially sweetened soft drink or trendy 'nutritional' drink. In an 8 hour shift, some drink a few 16 oz. bottles.
I warn them. Some listen.
9
Obesity to varying extent has become universal and worsening because it begins earlier on in life from addiction to processed fatty, salty and sugary foods as shown in the image to lack of significant daily physical activity. Sitting down and watching TV or starring at the smart phone for extended periods of time chugging sugary drinks or beer or alcoholic drinks could cause obesity and the effect of obesity are serious medical problems.
The massive economic costs which will keep rising is nothing compared to diet-related disease burden needing health care. Millions are now preferring to undergo invasive surgery to reduce food absorption rather than scream "keep me away from unhealthy food, it is killing me" Vaccines have been vital to lower incidence of several infectious diseases. Unfortunately, there are no easy solutions to prevent obesity.
Most Americans don't know that the budget of the Dept of Health and Human Services is the highest of any Depts. Higher than the Dept of Defense. Billions spent on biomedical research has not translated to better health for all. More is spent on health care per capita in the US than any other country and yet we have very serious health problems like obesity, drug and alcohol addiction, cancers, diabetes etc. Why is that?
Only a small minority of our country think of ideal health being wealth and invest time and money in their own health. It is hard to lose weight and it gets harder to lose weight as one gets older. So start early.
5
Over-eating is an addiction. It is a behavior that arises from depression. We need to deal with the root cause which is psychological. I don't see how we can disconnect the obesity epidemic from mental health problems and the failure of our health care system to provide effective, affordable mental health treatment.
7
We have been living under a poorly researched and possibly corrupted paradigm of what constitutes nutrition since within ten years after the end of WWII. We do not require carbohydrates to live - the molecular serum glucose they become when ingested, will eventually overwhelm our cell's ability to accept insulin - we become insulin resistant - commensurate with the excess levels of glucose typically coming from starches, processed foods, wheat, and all forms of sugars - our dietary food pyramid is upside down - and we have been lied to about dietary fat. Insulin resistance is at the heart of the obesity epidemic - and we have been aggravating this problem for decades - and will continue to do so as long as chronic illnesses are so profitable.
5
@James Yes, the body does require carbohydrates. It does not require processed sugar. You're confusing the two.
6
"It wouldn’t cost that much to invest in kitchens and train cafeteria workers so that schools could produce tasty meals from scratch..." This is simply not the reality. The equipment and training is minimal compared with the cost of buying healthy food daily for even small school populations. The small schools I previously worked for looked into this when a group of employees were dismayed at the low quality of what we served students. Taxing processed food and using that revenue to supplement fresh food sounds good, but many wealthy, educated families don't buy processed food, while it's a staple in poor, less educated families. So the tax would punish the very people you aim to help.
7
@e w
How can a turkey sandwich on wheat bread, a nut butter sandwich on wheat bread (bread being thin slices not huge rolls), a bowl of bean soup, a handful of carrot sticks and an apples be more expensive than the greasy fried/carby stuff kids are served now?
I have survived 50 years on very simple 400 calorie lunches and students could too; there is no need for "cooked" or "hot food" in school cafeterias. Sandwich, crudite, one piece of fruit is plenty. They will get used ot it.
8
Part of the difficulty is that any and all talk about obesity is regarded as impolite and it is under erasure. To speak about it - even very, very respectfully, as a health problem - is regarded as insulting and cruel, especially on the left. I get that the "body positive" movement is intended to give sufferers self-esteem. But I also know that you can't force people not to see obesity as a health problem. How can we ever deal with the vast emotional and psychological damage obesity does to individuals who suffer from it if we cannot even name it.
7
As an “older” resident of Victoria, where obesity is not the norm, I would like to pass along my observations.
Victoria has a very moderate climate where outdoor activities can be enjoyed year round. That definitely helps.
There are miles of public trails for bike riding, walking and running - abandoned rail beds were converted to public walk/run/ride areas. Apparently more people ride their bikes to work than any other place in North America... many major roads (not highways) have bike lanes painted green.
Food wise, sushi is available in all the grocery stores as “fast food”. Many schools do not have cafeterias, so school lunches tend to be healthier sandwiches and fruit etc.
But it is more than availability, I believe it is a culture and recognition that good health comes from a good diet, exercise, and of course, luck. We are lucky here, because healthcare is available at an affordable cost for everone (free for poverty level). Healthy living is a common topic of conversation.
Last year, my husband & I tried being vegetarians -we didn’t succeed, but did eliminate all meat from our diet. No counting calories, just fish, seafood, eggs, some cheese and lots of vegetables. Many meals are only vegetables. Less eating out. This has resulted in us losing almost 20 pounds each , and never being hungry -plus all the “numbers” are better on the medical tests!
15
Many industries are winners because of obesity. Big Food wins by providing and advertising a cheap, obesity-inducing diet. This makes room for a variety of entrepreneurs selling the latest diet fads and easy ways to lose weight. Obesity also creates the market for medical specialties and products such as insulin and amputations.
Making problems and cleaning them up creates more jobs and business opportunities than preventing the problems in the first place. Preventing the problems constitutes an attack on the jobs and businesses of those involved in making and cleaning them up. It involves government in picking winners and losers and telling or advising people how to live, and this is widely seen as overreach; advice on how to live, in a free enterprise economy, is acceptable and legitimate only from those who will make money if people take their advice. Those who give advice without making money from it are regarded with suspicion, because they have ulterior motives. They are up to something other than making money.
This understanding of things helps make us fat and assures that the contributions to obesity will continue.
1
Im 5'11'' 155lbs, wife is 5'6' 130 lbs, and although neither of us are really in all that great of shape, not a month goes by where we make a healthy eating choice and don't get a comment such as 'as if you two have anything to worry about'.
It always blows our mind that they don't see our bodies as a result of our actions.
20
Yep. The sheer willingness of the American public to disassociate personal choices and personal responsibility from healthy eating and healthy weight is astounding. I lost 65 pounds in 5 years: healthy eating and exercise. But when people asked me how I did it, they all seem to want me to tell them about some miracle pills as when I describe my daily routine and diet, all I hear are excuses, excuses and more excuses. And the dirty looks I get from obese people, especially women while they are ordering that donut while all I get is a black coffee are ridiculous.
11
Not only is the US government actually discouraging healthy eating habits in its own citizens (it is bad for business), it is actively exporting obesity. Note that one of the conditions the Trump administration has attached to the NAFTA negotiations is for the other countries to eliminate efforts that are successfully reducing the consumption of junk food in those countries. The administration also tried to block a UN resolution that discourages the use of infant formula, which is another cause of childhood obesity. For a few million or even a few hundred thousand bucks, this administration will overturn any effort for the good of the public.
It would be naive to expect this administration to enact policies for the benefit of its citizens, especially the underprivileged (mostly black and hispanic) ones, at the expense of big businesses.
19
Yeah but unless they have you tied up and are force-feeding you, you still have personal agency: an apple and water instead of a donut and a high sugar drink as a snack for example.
6
Three or four years ago I made exactly the same arguments to non-obese friends. Every day I see dozens of morbidly obese people, some with young children, I tried to explain to my friends why this was a disaster for both the individuals and our Medicare system. These were facts.
I was insulted and abused for being in favour of fat shaming, I felt afraid for the first time ever to express my opinions to people I considered friends. Facts were irrelevant to their assaults on my character.
But we shame smokers and drinkers and those who are inactive. The argument might be that being obese has no impact on others. But they are at the very least going to be a burden on tax payers and I worry about their children.
Just last week I read an article in which a woman of size complained about doctors fat shaming her by telling her she needed to lose weight.
It seems that if governments distributed information on healthy eating or the serious consequences of obesity they would be accused of fat shaming.
Working to control the obesity problem need not target the overweight and should not promote unrealistic body images. But right now I don’t see how it can be done.
11
"we can’t blame individuals and expect personal responsibility to solve the problem."
Why not?
My body is MY responsibility. I can ask for support and help (for example, education) but my poor health its MY problem.
Making the government responsible does not empower the needy.
14
Govt regulation is not the answer to the obesity crisis. Personal responsibility and discipline are. Obesity rates, are especially high amongst the poor and undereducated. One quick fix, as many of them are on food stamps, is to allow only the purchase of healthy non processed foods. For the more affluent create an obesity tax. We can’t sit still and let this scourge continue.
9
@Robert Haar If you limit food stamp purchases to non-processed foods there would be, literally, millions of people who could not afford to feed themselves or their families. Fresh foods cost more, a lot more. That point was pretty well covered in the article.
6
Healthy eating is NOT more expensive. Stop the myth. A piece of fruit and water is a heck of a lot cheaper than a cookie and a sugar-laded drink. It takes effort and thinking but it can be done if you do not want to die.
6
@Rosie Nonsense. Compare the cost of fresh foods to the cost of processed starches on a per calorie basis. The processed foods are much cheaper. Same goes for frozen foods and canned goods.
I find it astonishing to read commenters taking issue with the writers’ call for government intervention. As pointed out in the article the US government already intervenes by using our tax dollars to subsidize the production of foods with poor nutritional value. We have a health crisis in this nation and it is costing us in lives and dollars. If we are going to subsidize food production then let’s start with the food that keeps us healthy.
12
When thinking about the likely hood of those suggested steps outlined to help solve obesity coming to fruition, an old expression comes to mind: "fat chance".
If smoking was a difficult risk to manage, eating issues seem much more so, starting with the permeation into people's lives, the percentage of affected population and the conflicting stakeholders....or should the word be "steak holders"?
The huge, aging population of the obese, will form a tsunami of morbidity that will bankrupt the financial and medical resources of any health plan. It is difficult to be optimistic, but every effort must be made.
1
My sister died tragically at 47 from morbid obesity-related illness. I miss her terribly, and everyone who loved her wishes a policy could have saved her life. But the reality is too many citizens protest the idea of big government telling them what they should and should not eat. Moreover, this current administration has zero interest in establishing any of the policies outlined here.
5
It's very hard to get low-calorie, nutritious, really tasty food when eating out unless one is in a very high end restaurant. It is cheaper to feed a family at McD's or BKing than at home. French fries are cheap, filling and delicious. Fried foods are tasty and crunchy. And most of us love dessert.
Every try to get a vegetarian omelet at an amusement park? A ballpark? A sporting event? Every look for grilled fish with fresh veggies at a bar-b-q? Right.
Fresh, organic food is very expensive. Fresh food takes time to prepare. A healthy, varied diet is nice but not everyone understands how to make that happen. And, mostly, we sit.
As long as agribusiness is in charge of Congress (and it is) you will not see things change, especially under the GOP. If we subsidized organic farms, had delicious plant based food in schools and ran a public education program about how to each fresh and healthy food at home, maybe (big maybe) things would change. As long as Americans eat burgers, fries and cola, and we drink alcohol, while we spend hours sitting at a car, a desk or on a couch, we won't lose weight.
Mark Bittman tried writing about the politics of food in this paper and then he was gone. Too bad. Without people like him campaigning for things to change where it counts -- in the government -- this problem isn't going away any time soon.
9
It is very hard but not impossible. If you do not want to die, you find a way. Bring your own food and when eating out make good choices and customize. Steamed instead of fried, fish instead of chicken, brown rice instead of fries and fruit instead of cheesecake. But first: you need to want it and it is not a diet, it is a lifestyle change. Excuses will kill you.
4
A major reason why obesity has gotten so bad is because people are eating more to combat depression. They are depressed because our hyper competitive society is making them depressed. High sugar, high fat foods make you feel good.
Add to this: (1) sedentary jobs; (2) automobiles, and; (3) large portions, and you have a recipe for disaster.
12
What? "We can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets"?
This is not the government's job; promoting the notion that shifting of personal responsibility to the government further erodes ..personal responsibility. Astonishing reporting.
7
Eliminate Coke, Pepsi and other sugary drinks from the diet and my guess is that the obesity problem is mostly solved.
4
Body image has changed. Overweight men and women no longer see themselves as such. In their eyes, they are normal and people whose weight is in their ideal weight range, are skinny or skeletal. Obesity is the new normal in the USA.
14
Mandates demanding clear and through nutritional information - good, teaching healthy lifestyle topics in schools - good, halting government support for production of unhealthy products - good, directly taxing specific foods to force dietary changes - very, very bad. As repeatedly demonstrated by numerous failed attempts at imposing soda taxes, people will not tolerate government mandating what they should eat. Democrats and republicans alike have aggressively turned against almost every politician or agency attempting to impose the government’s will directly upon their grocery bills. If you want voters to enthusiastically support urgently needed information and research, don’t you dare directly tax their coke and snickers bars.
3
Just returned from a trip to my hometown near Seattle with the kids. I spent the first 40 years of my life in the U.S. and return every year or so but nevertheless, experienced reverse culture-shock on the food selection, diet and food culture in the U.S. A stop into a typical American supermarket these days is simply overwhelming: huge facilities where easily 50% of the store is full of really unhealthy food. Out and about, the default drink sizes these days seem to start at the "Big Gulp" size range and go up from there. Who needs to drink 32 ounces of soda in a single sitting? Small has become large and large has become ridiculous. The portion sizes at restaurants are enough to feed a family of four... I think if I would live again in the U.S. I would have to become a strict vegetarian just to ensure a set of careful choices vs. the default. But if you grew up in this food culture and this is all you know, it's understandable that people think this is normal. No wonder obesity is so common.
23
@Kevin My wife and I (late 60s) always split the portion served in a restaurant offered as a single serving. We are not depriving ourselves and never feel "hungry". Look at over weight people walking the street, they frequently are eating or drinking something as they walk. It never used to be this way. We both are at high school weight. Clue: don't eat until you're full. Eat until you're not hungry and then stop and do something else. It's all about discipline.
6
Yes, I highly recommend this. The amount of food they serve at restaurants is so ridiculous that splitting a dish will not leave you hungry.at all. If anything, I wish resaturants would do "Restaurant Week" menus year round, not because of the price but because of the portion size.
1
I'm hoping to soon see an op-ed piece entitled "Two-Thirds of American Adults Are Paying Too Much for Food".
That's because the very first cost of overweight/obesity is at the supermarket. Think how much it costs to buy the amount of food that will maintain 50 pounds of additional weight. Now multiply that by millions of people (and additional weight -- 50 pounds is much less than the excess some people are carrying).
I remember watching a PBS piece on a family of four that was having trouble affording food. Two children, a mother who earned a salary, and a father who didn't. He seemed like a loving dad. Yet the undiscussed elephant in the room was his enormous weight. In feeding him enough to maintain that size, the children's meals were threatened, and their mother worried about finances.
He was almost literally taking food from his children's mouths. Multiply that by at least thousands of parents, and we need to get beyond shaking our heads.
8
It should be telling that in the US, with all the talk about the lack of access to health care, how much we are spending on health care, health insurance, no one is talking about the root cause of our health care mess. Estimates out there are that much of the cost of health care, in things like cancer, heart disease and diabetes, are cause by lifestyle and food, outside smoking, is one of the chief causes for exploding health budgets. Obesity leads to diabetes (despite the myths, sugar doesn't cause diabetes, Type II diabetes is caused by excess body fat blocking insulin reactivity), obesity also is a direct contributor to heart disease, stroke and many forms of cancer...yet the whole debate is over things like the cost of insurance, the cost of tests, the cost of medicines. If people ate a diet heavy in vegetables, if not vegetarian, you wouldn't need half the adult population taking statin drugs and blood pressure meds and needing insulin, the rate of cancers would plummet, but the government does little to nothing to promote healthy eating, and in fact through subsidies is directly contributing to the health crisis. The FDA and its dietary standards promotes the interests of agribusinesses, and its recommended standards are more political than science. The republicans, who only care about profits and big business, aren't going to promote healthy eating, and the Democrats do the same thing, while saying it is okay to be fat.
8
Exvercise is a very important part of weight management but by itself it stands no chance of compensating for a poor diet. Running a marathon to burn several thousand extra calories is not practical.
Primary requirement of every company is to turn a profit. Food producers are no different. Two methods for doing so is cheaper production costs and product addictiveness. Unless consummers immediately become ill, long term negative side effects do not affect producers.
it's a well known fact that sugar and corn are subsidized commodities and hence any food derived from them is cheaper than it should be and hence more likely to be consumed, especially knowing that sugar is addictive. Stopping the subsidy could make difference but politically it's very difficult to push through
it's also well known that processed food containing a combination of sugar, fat, and salt can not satiate appetite. A ban on having a combination of them could be more effective.
It would be interesting to see what would happen if food industry profits were taxed to pay for medical bills that results from diabities and high blood pressure.
4
The Times makes many excellent points, but they're dead wrong to say: "We can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets."
Certainly the government can and should do more to not only stop promoting poor eating habits but encourage better eating and make it more accessible, but the reality is that America's obesity problem won't be stopped until more Americans choose to change. It's already more expensive to guzzle soda with your meals than to drink water, so it's clearly not just about the money.
And frankly, the truth of the matter is that the average person simply enjoys fries and pizza more than cauliflower or a kale salad. We already know what we need to do, but most of us are unwilling to do it. Fad diets aren't the answer. Wholesale lifestyle changes are. It's not about losing weight to fit in a dress or trying to hit some magic number it's really about transforming our relationship with food.
Too many people rely on food as a reward when it should be seen as a fuel. Certainly it's OK to have a special meal once in a while to celebrate but by and large food should be functional part of our life and it's important to remember that food should serve us as we gain energy to accomplish our life goals. To many of us live for food instead of living on food.
11
Excellent article! But never gonna happen. Big food and big pharma make WAY too much cash, own WAY too many politicians to change the status quo...it’s up to we the people at an individual level to make the change.
8
Yes, we can expect personal responsibility to solve the problem. But we must educate students with solid, understandable facts about nutrition and not based on the special interests of *Big Food*. We must also make the nutrition information that is required on the food we purchase at the grocery lucid and not require a calculator. The labels should be color-coded according to their nutritional value similar to what the Canadiens are utilizing. The inconsistent message from the FDA and our schools makes nutrition difficult to understand and frustrating to implement.
Schoolbooks dealing with nutrition should be based on proven empirically based facts. For too long has our health been compromised by special interests and neglected the input of science. *The World of Science* was a widely disseminated school book for intermediate schools in the 60's. There is no mention of nutrition at all. The standard school lunch sandwich was made with highly refined white bread. (There is exactly one sentence regarding evolution.) We had made some progress in the rate of fiber in our diets since then, only to be hijacked by the government subsidized mass production of high fructose corn syrup. There is 39 grams of *added sugars* in a single serving of a popular soft drink. That's 78% of the recommended daily serving...It is no wonder that we have attained the level of obesity and the rate of diabetes that we are currently experiencing.
6
Dr.Jason Fung, Toronto nephrologist and diabetes expert, says our obesity epidemic is largely caused by highly processed carbohydrates.
His arguments are very persuasive to me and I have been following an every-other-day fasting regimen for the past year and a half and have been very pleased with the results.
Blood pressure is so much lower now andI have had to cut over half of my BP meds, my blood sugar is lower and I no longer take metformin.
Dr. Fung writings also show that "eat more and move less" is ineffective for the chronically obese, for people like me. I am no longer obese and I weigh less than I have since I was 30 -- almost 40 years ago. Back then the only way I kept my weight in check was by running 3 to 5 miles a day. Every other day fasting is far easier than that.
5
Startling to read that we cannot expect persons to be responsible for their own obesity and the government must take action about diets. In the first place, it makes no sense that persons cannot take responsibility for their own health. In the second place, the American government does not have the ability to do much in health care because America does not have a universal health care plan which can be applied in a consistent manner.
Obesity is becoming a problem in other countries but other countries can mount a better campaign because they all have universal health care. One of the most effective places to start is with "fat kids". These kids must be in a program to help them by the time they are 5-6 years old. If nothing is done by adolescence the battle is lost. The simple medical fact is that fat kids grow up to become fat adults.
As others below have pointed out, the American government has shown no interest in the health of citizens. The causes of obesity may be multifaceted but the real need now is to give medical and support help to fat kids so they can expect to live their lives without obesity compromising their health and well being.
3
@Pushkin
Obesity is hitting other countries and for the same reason it happened here, as the corporate food industry hits countries, you see the same issue. Places where the Mediterranean diet became famous for its health reasons, sees people becoming obese. China, with its traditional diet of rice and vegetables, now has a severe obesity problem. India, same thing....and what has happened? Companies like Nestle and the like have come into those countries, often with packaged versions of traditional fare that is made cheaply, full of fat and junk, and the inevitable happens. The heads of the big "food companies' are the equivalent to the tobacco companies, they are pushing poison while benefitting from it, and governments let them do this. Instead of doing what they should be doing, regulating food content,putting our real nutrition information not based in politics, and more importantly, subsidizing health food to be cheaper than junk food (known as incentivizing health), the government is subsidizing cheap corporate food which is killing their own people.
7
We could do lots of things to prevent obesity, like requiring all media to run public service ads that promote healthy behaviors. But that means social engineering, which is a deadly sin in the eyes of those beholden to free market capitalist forces. We know what to do; we choose not to. More to the point: those with the money and power choose not to.
1
Thanks to the authors and the Times for publishing this article. I think the emphasis on the economic costs and the costs to our personal quality of life as obesity takes its health toll as we age.
I liked the phrase "Big Food" because this is a tough issue to crack. Anyone who follows the nutrition issue knows that "Big Food" has been very effective at facilitating the consumption of convenience foods and drinks distributed in vending machines omnipresent in the American places of work and recreation.
It is big business and probably very challenging to rein in. You did not discuss the various forms of sweeteners that are built into our processed and convenience foods -- including healthy cereals and so-called healthy snack bars but these health foods contribute greatly to obesity.
I also am glad that you mentioned our sedentary lifestyles and decreasing opportunity for regular exercise. Couch potatoes, gaming and the omnipresent laptop and cell phone society has taken away too much from the play and exercise time of our children and their "fat" parents.
It is not easy, I am 81, weigh every morning, but realize that it is extremely difficult to avoid being obese. I haven't retired yet but I use a lot of my time commuting to work. In contrast, my wife, who was my high school sweetheart weighs the same as she did in HS and I added 50 pounds. The difference is she walks 2 miles a day and does a lot of squatting as she works around the house while I am commuting.
2
Start with this, it's simple and it works: 1) drink only water or coffee/tea with no sugar. 2) don't eat anything after 7 pm. 3) walk for 30 minutes each day, outside or inside.
14
We also need to focus on mental health, child protection, and general cultural change. Food is often used as a way for people to deal with trauma, especially sexual abuse. If we all focused on having a more human-focused society (instead of one driven by corporate profits), we could go a long way toward creating a healthier society.
Obesity isn't new. There have always been people whose bodies are programmed to weigh more. But we'd all benefit from having time and places to exercise, healthy food, and less stress.
5
It's disappointing the authors didn't mention the idea of small farms. They're right about Big Farming producing cheap food (think about that term for a moment -- *cheap* food) but it doesn't steer citizens towards promoting a small farm Agriculture Policy.
Pardon the pun but our Agriculture Policy is at the root of all our food problems. All the other ideas are great. But unless we get people back on the farms growing diverse crops for their communities, we're on the wrong path.
I highly recommend reading "The Omnivore’s Dilemma" by Michael Pollan.
8
@Don Brown
Michael Pollan did this 4 part series on food (I think it was on either Amazon or Netflix), and in one of the episodes he profiled how the big food companies worked. He showed in a lab in India of the food giant Nestle researchers and 'food scientists' creating imitations of traditional Indian food as packaged food, with the goal of producing food that tasted like traditional foods, but also with additives to make people want to eat more of it, and done with the cheapest ingredients possible. I guess in whatever programs these people trained ethics isn't taught, these 'scientists' are being paid to poison people (side note, India is facing an obesity epidemic, and worse, they don't have the medical care system to treat the effects).
4
I mostly agree with all this except for this statement: "we can't blame individuals and expect personal responsibility to solve the problem." Two paragraphs later, the authors contradict that statement with the study in JAMA they cited, which says people can lose weight and their genotype doesn't matter.
Regenerative Agriculture/Restoration Agriculture solve this and many other problems.
3
I am overweight and I'm sick of it. I am still perplexed by the health community's failure to develop appetite suppressant medications that are not stimulants. My physician has nothing to offer me because I am 71 and have high blood pressure. It is also very difficult to transition from processed foods to healthier options because such foods leave one with what I call "a high flavor threshold." It takes time to acclimate tastebuds to normal healthy food. I eat a largely vegetarian diet and can enjoy healthy food but it took a lot of work to get over ice cream, candy and salty snacks. Now I simply eat too much of a basically healthy menu. This is not a moral issue. There are fortunes to be made in safely suppressing the appetite!
9
I haven't read all of the comments, but we live in a country where our leader, the president, not just enjoys but prefers fast food, and his core supporters, according to demographics, do too. Instead of a White House with an organic garden, we have one where--if reports are correct--our chief watches TV at night with a burger accompaniment.
8
You lost me at "entitlement spending". Medicare is a repayment of taxed wages. Stop calling it - and social security, etc - "entitlements".
18
How about anyone who is able and wants government assistance must walk 30 minutes a day? Let’s ask something of people, instead of just taxpayers.
5
How about anyone who wants health insurance has to walk 30 minutes a day? Or maybe if you are in the obese range you can't get coverage for diabetes and high blood pressure issues? Why is it always people on assistance who need to prove that they're worthy? I'd much rather provide assistance to a family in need than subsidize the healthcare costs of a person who is obese with diabetes and high blood pressure, both of which are associated with obesity. ( we all provide such subsidies by paying higher and higher insurance premiums.)
5
It seems to me that the acceptance of obesity is certainly not helping it. The fashion industry, formerly a tormentor to anyone not super thin is certainly aiding America’s appetite by featuring more ads with models with plentiful derrières. Certainly almost anyone can have a large derrière but not a tiny waist too.
I grew up in the era of Twiggy and thankfully was built like her. But that wasn’t easily attainable unless by genetic predisposition.
Now, I look at teenagers and they are busy sipping their 400 calorie Starbucks while sitting and staring at their cell phones. They are on a whole, way fatter than previous generations were at that age.
Certainly, the standards set forth by “Vogue” and Madison Ave. led many of us feeling “less than”. And while body shaming isn’t the answer, embracing America’s increasingly wide berth may not be either.
14
A tangent.
The cost of obesity, as noted in the article, is something close to $300 billion. By some estimates, the cost of illegal immigration is close to $100 billion. Assuming these estimates are even directionally correct, which is a greater scourge facing America? The immigrants primarily come here to work. The obese are quickly headed towards, or already receiving, disability payments.
8
But illegal immigrants and their families cost a lot to the tax payer! I am a nurse who take care of a lot of them... emergency Medicaid. Charity care. Assistance programs of all kinds and they don’t work that hard for it.
1
“And as disposable income declines, so too does the ability to afford a nutritious diet". This is one of the biggest lies we keep hearing. This is not a matter of income but of intelligence. I grew up in almost incomparably bigger poverty (Eastern Europe) than our poor Americans are but there were no obese people around and our diet was quite nutritious (for that time period: the 1950s). It is safe to say that American obesity has 2 reasons: either poverty and lack of intellect or having too much money but being deficient intellectually.
19
@PaulN
Give it a rest, my wife came from Hungary, and you are comparing apples and oranges. In Eastern Europe thanks to the glories of the great Socialist worker paradises, people didn't have access to junk food, and what poor people had access to was relatively healthy food, grown locally, they ate things like locally produced bread, and they didn't have access to Soda (my wife didn't see soda until she got out of Hungary with her parents). The irony is that in countries like Hungary it was the well off people who had problems with weight, they were eating the traditional heavy diets laden with pork and potatoes and the like, and it was the well off who had trouble with obesity and heart disease and the like. I will add that if you take a look at eastern Europe today, they are seeing the same problem we see in the US with obesity, for much the same reasons, traditional diets have been replaced with cheap junk food, and even there things like fresh produce, bread and so forth have become relatively expensive. In a supermarket fruit and vegetables and bread should be the cheapest items there, but in most places today sugary drinks, bread loaded with sugar and fat, and processed/packaged foods are the food of the poor, while the well off shop at Whole Paycheck and buy basic foods at high prices.
3
@PaulN I agree. I think the idea that it is expensive to eat healthy is to a large degree a total fallacy. You do not need to buy "organic" to be healthy. Buy dried beans and rice in big sacks. Cabbage is nutritious and dirt cheap. Eggs are cheap if you get 'em at a big box and not Whole Foods. Carrots and many other vegetables, especially in season, don't cost much. Even chicken doesn't have to cost that much if you buy at Winco or whatever. Stay out of Whole Foods, and shop the periphery and be willing to eat rich and beans and you can be low income and healthy. I've done it!
8
It’s not just Eastern Europe. I have been living in Sicily for the last 7 months and many people here are at American levels of obesity. Forget the Mediterranean diet, it’s basically 100% carbohydrates. Sugar, bread, pasta and beer. Yesterday at the check out counter the obese lady in front of me had a shopping cart full of pasta, cookies and sugary sodas.
It’s not rocket science. Calories in and calories out.
2
The people of the world and Americans have been targeted by corporate algorithms to weaken their ability to say no to sugar fat and salt.
There is far to much attention given to food coming at you 24/7
3
Just do to fat people what you did to cigarette smokers. First, shame them and ostracize them socially. Of course, that's already happening but make it official: launch government and health organization ad campaigns to humiliate them like those anti-smoking ads did. Make the schools teach their children to go home and trash Mom's Twinkies and refuse to eat that mac-and-cheese and mashed potatoes supper she prepared. Then tax the bejeezus out of everything sweet and snacky. Add an obesity surcharge on their health insurance like smokers pay and sanction overt discrimination in hiring and promotions. If that doesn't take off the pounds, employers can give them a lose-or-lose proposition: Lose weight or lose your job. There's nothing like the threat of poverty to make kale and carrots look yummy.
11
@abigail49 Ha! That's so over-the-top.. I love it!
“…we can’t blame individuals and expect personal responsibility to solve the problem.”
“First, establish a federal commission to coordinate obesity policy…Second, adequately fund obesity research…Third, impose a tax on processed foods…Fourth, prioritize the quality of the nutrition…Fifth, ban junk food advertising...”
This article was clearly written by a soda tax Democrat. Any nanny state tax money will never go to the intended cause. It will go to the paychecks and pensions of unproductive government workers. This is America. Take responsibility for yourself.
1
Nary a word about personal responsibility or accountability. Let's just have more government and tax the "bad" processed food industry.
The vast majority of the obese got there by overeating and no exercise. The only non-culpable group are children. Obesity skyrocketed from 1970-2000 coincident with the advent and vast growth of government "nutrional support" programs. Remarkably, one can still purchase junk food with SNAP payments.
The excuse-mongering in this article is counterproductive. Once again, government has made the problem much worse and "progressives" just want more of the same.
P.S. Parents who allow their children to become obese should be jailed for neglect.
16
In addition to diet, exercise and genetics, exposures to heavy metals and chemicals impact metabolic functioning and can help fuel obesity.
4
It's true. About 10% of the population has 90% of the physical fitness.
At the gym in my community, a small number of people work out every day. Some of them may be a little chubby, but they are in pretty decent shape. There is another, slightly larger group that comes two or three times a week.
The other 90% of the people, who are free to use the gym, never show up. I hope they're at least out walking the paths.
3
When I was growing up in Ireland, I lived on the slopes of the Mourne Mountains, the mts that famously sweep down to the sea (literally where my home was).
Well, anyway, I only mention that because a very popular thing to do was to hike those mts from a young age, first with my grandfather, and later with my friends as it was an awesome thing to do.
NEVER did we think of carrying any kinds of snacks or drinks. If we were thirsty, we would take a rhodedendron tree leaf and use it to drink from the Glen River. We never thought it necessary that sustenance was needed for a 4/5 hour hike. Anyway, the highest mt, Slieve Donard, was less than 3K feet but a decent climb.
However, I see my grandchildren provided with snacks, sugary drinks for any kind of athletic endeavor.
I just wonder (unspoken) “is this really necessary?”
Could be I am wrong as they are healthy and not overweight.
11
Many years ago people who didn't look like they got enough to eat generally didn't. Before the boom of fast food and chain restaurants, most people cooked and ate at home. I don't remember knowing many overweight people and didn't know any morbidly obese. Times have definitely changed, with big, cheap food and advertising that should be against the law making a sea change in our diets and health. Now the poor are often overheat instead of too thin. Those cheap, unhealthy calories...
Eating at home, preparing healthy ingredients and letting the processed junk go could be a life changer. Revolutionary.
Thank you Drs. Ludwig and Rogoff for this column, we can't hear too much on the subject of real food and activity in terms of health and wellbeing.
4
@JessiePearl
I see you live in Tennessee (a beautiful state). I grew up in eastern KY, where there were many poor people. At that time (mid-50's to early 60's) poor people were often skinny. Even among the middle class and the few upper middle class who lived there, not many people were seriously fat.
1
I inherited my body type from my dad. Tall, fit and thin. My siblings inherited their body type from my mom and have struggled with weight issues every day of their lives. I used to stop somewhere for a quick bite before I came home so they wouldn't see me eating. Some of us will never know the battle many endure. it's not because of anything we can take credit for, it's merely good luck. We were born this way.
19
Among its recommended policies, the article fails to mention to paying people high enough wages by which they can afford healthy food and work only one job so they have time in their week for cooking fresh food at home and for adequate excercise as well as insuring access to affordable healthcare.
10
If forced to name only one factor for the huge increase in Obesity, I’ll go with Sugar. An abundance of added sugar in many, many “foods”. And many foods and drinks that are merely delivery devices for huge amounts of various sweetener. Want to really increase you odds of acquiring Diabetes ? Eat sugar. A lot of sugar. And I’m speaking as a lifelong sugar junkie. But not diabetic. Yet.
7
This article "The Toll of America's Obesity", was compulsive and appealing. From previous knowledge, I knew obesity was a major issue in America. After reading this article i was shocked, just over 30 years obesity tripled. I believe children are enclosed by junk foods, mostly because of manipulation and false information. Advertisements encourage American's to eat unhealthy, harmful foods. Children growing up with all those advertisements don't know any better and they start bad habits, for eating risky foods. I also consider that school lunches are an impact to obesity. The government should take charge and inspire everyone to eat healthier and have better diets. The earlier people take a stand, the less time there is for all people to develop health issues because of the foods we eat. Overall, I learned a lot of facts from this reading section and I encourage everyone to read "The Toll of America's Obesity."
3
I was the staff director of the Senate Select Commitee on Nutrition in the 1970s and led the committee's dinvestigation into diet and disease. In our freedom of choice society, we have some excellent examples of public health interventions that could be used to combat obesity. Seat belts and smoking come to mind. Either private funding or a small tax on sodas or health insurance could fund a creative PSA program. Focus on children. They will lead the way.
7
It is important to note that this article grossly mischaracterizes the findings in the (JAMA)[https://jamanetwork.com/journals/jama/fullarticle/2673150] study. The study finds that there is no significant difference in weight loss when participants adhere to a healthy low-fat diet vs a healthy low-carbohydrate diet. This article also sings the same old song about how bad processed foods are a factor in obesity (a truth) while totally ignoring the well research health impacts of high meat and diary diets. If we stop subsidizing meat and dairy and started subsidizing ethical farming Kale could become cheaper than chicken.
8
If school lunches were like what we have at my work (Apple) I’m not sure kids raised on bad food would much enjoy it. Sure it’d be immensely better (and expensive) but would it work? What I mean is healthy food is an acquired taste. Brown rice isn’t more appealing than white, otherwise the Japanese would be eating all brown.
And if the adults in the house don’t like veggies then forget having the kids eat them.
Still... I do agree the best policy would be to heavily tax processed food and subsidize healthy food, perhaps even provide healthy prepared food for cheap. I’m taking frozen or reheat-able meals that would be filling and tasty but still quite healthy.
3
Filling and tasty. Tasty and healthy. Healthy and filling. You can only have 2.
3
I'm no psychologist, but the human ego seems to almost outbeat its heart. This expresses itself in myriad ways: envy, greed, workaholism, alcoholism (my particular monkey), drug addiction, food addiction. The American addiction to food may be an expression of its Puritan roots, which forbid most of the problems above and leave only work and food. We try to find our way back to the garden, blind as we once were to our own nakedness. It doesn't help that the planet is overpopulated and, thanks to 40 years of GOP politics, there's no money to buy 'space' unless you're in the 1%. We really need, I think, to understand something about the 2nd law of thermodynamics: that our environment is bigger than us, that we tend toward it because of that. We must use the resources we have to build better, happier, more spacious environments, or our ego's will pull us in other directions, with sad outcomes. This we see in a country that keeps insisting that if its just tough enough, just hard-working enough, it can overcome the saddest environment. That's a myth: early European Americans expanded into a richly empowering environment, which due primarily to disease was robbed of its Native American presence. Now that its filled up and turning to trash, the only thing expanding is our waistlines.
2
This is a well-written, well-argued article in support of sensible policies that would reverse the incidence of obesity and its many social and economic costs.
The problem (or problems): human nature/biology (we like fats and sweets), and Republican ideology (they like the rich and hate government).
Only a fundamental, long-term change in political power from conservative/Republican to progressive/Democratic will allow us to change course.
Vote Democratic. Ride the Blue Wave. (Save the world)
2
It's the Republicans fault that we are fat and have fat kids? Talk about delusional. You can't blame everything on the opposite political party, considering they're pretty much the same, with only very minor differences.
As one of the few obese teenagers in high school in the 1970s I'm amazed when I see groups of young girls today - most are actually obese. I've been normal weight for 30 years - after trying and failing many times, I finally succeeded in losing 90 pounds. It takes a lot out of my life to maintain my weight, a lot of attention, a lot of adjustments, even a lot of loss - loss of spontaneity in terms of eating, which is a large part of modern culture. And friends and family don't always understand these accommodations. My point is, fixing the obesity epidemic is far from easy. Oh, and the funny thing is no one ever asks me how I've done it! Including doctors!
18
So how did you do it? I would honestly like to know. I recently lost 25 pounds myself, and I'd like to compare notes.
3
When pointing out the financial, economic, health and societal costs of obesity is decried as "fat shaming" by as many as are doing so in this comments area, we are pretty doomed.
My work takes me into contact with an endocrinolist, medical school faculty member at one of the nation's premier med schools and head of a huge lab studying obesity. He told me again just the other day that despite what people want to believe, it's not high fructose corn syrup, the "gut biome," or other pie in the sky reasons -- we are fatter now than 20, 30, 50 years ago because we eat more and move less.
He said you can eat 1,000 calories of broccoli or a 1,000 calories of Fritos, it matters not, and lose weight. Eat 2,000 calories a day and most are going to steadily gain.
Just look at the portion sizes of commercial food -- a McDonald's hamburger of the 1960s vs the gorgefests taht company peddles today. The size of the fries. The huges steaks and sandwiches sold at other restaurants. The bounty in the average Kroger. The 100-foot long snack aisles where a small bag of plain chips used to be a once-a-month treat (at least when I was growing up.) Our family of four could make a can of Pringles last a week when they first came out!
I collect vintage dinnerware -- the size of mid-century or earlier plates, cups and bowls -- even the stuff from the 70s and 80s -- is teeny compared to the jumbo eating and drinking vessels sold now. Contrast coffee cups then and now. It all adds up.
20
All these solutions and comments remain focused on either behavior change on the demand side. But I don’t think we as a society have fully considered the responsibility of the food industry in creating and sustaining this epidemic. It is simply in their best interest right now to make everyone obese because they depend on us consuming more. If we weren’t constantly bombarded with messages to eat more, we wouldn’t be buying and eating all this food, and lots of folks would go out of business. Until we shift our focus on consumer capitalism at all costs, there’ll always be a push to consume more than is healthy, which will continue to manifest in the form of our current obesity epidemic.
6
I am a nutrition professional who has studied obesity for 40 years. For the vast majority of people, the issue of weight gain comes down to calories in vs. calories out. In short, if one's caloric intake meets one's caloric expenditure, weight will be stable. But tweak this balance in either direction and see what happens. It's undeniable that the energy expenditure side has plummeted for most of us, while the energy intake side has skyrocketed. Don't forget, weight gain is cumulative. No one gains 10 pounds overnight. It's insidious and continuous.
This year, I visited Cuba, India, Israel, Iceland, Dubai, Denmark and Romania. I keenly observed what and where people eat/drink, and what's available in grocery stores, corner stores and restaurants. On the energy output side, I observe whether people are walking, biking, driving, taking public transit, etc.
Obesity and overweight is a worldwide problem. Physical activity alone cannot overcome the perils of a high calorie diet. The people of Cuba appear to be quite active, yet their diet is high in carbs, sugar, fat and alcohol. Most people I saw on the street were overweight.
I saw fewer overweight people in Denmark than anywhere else. In Copenhagen, the streets are full of bikes. Yes, people also take buses and trains, but they're walking/biking to the train.The SOCIAL NORM is to be physically active.
Many tourist towns in Romania had massive advertising for Coke or Pepsi EVERYWHERE.
NO easy answers--
16
When I look back at pictures of people alive in the first half of the 20th century (1920’s-1950’s) I am struck by how thin they all were compared to people today. And as other commenters have mentioned, kids were more active, riding bikes or walking to quiet neighborhood schools, playing outside and generally being more active. With a more urban existence with fewer open spaces, our modern car culture, busy lives with the reliance on the convenience of packaged or fast foods containing added sugar, salt and fat, no wonder we all struggle with living a healthy lifestyle. I think in particular, the food industry is a culprit and should subsidize the health care costs.
3
@Wendy Shray : Adults in early part of the last century also smoked. Smoking keeps the weight off most people.
3
As someone in my upper (cough, cough) 50's, I grew up a free range skinny kid allowed to explore outdoors all hours of the day and evening in the summer months and weekends year round. My lifelong love of the outdoors and outdoor activities continues to keep my weight in check. I start to feel uncomfortable when I put on weight and it is fairly easy for me to check my habits and get back on track. I also gave up soda probably 25 years ago. I just want to be able to move with ease. I bike, cross-county ski, and hike. I think lifestyle and what motivates a person to stay healthy is a big factor. Tackling this epidemic will require many approaches. Well wishes to all those out there trying to lose weight and live healthier lives!
12
The problem underlying the worldwide increase in obesity is that more and more people are living in high-density urban environments where regular physical activity is discouraged by the very nature of a city - lack of safe outdoor places to exercise and the indoor venues like gyms priced out of reach for many people. The solution to this problem is NOT dieting. All diets, many of which are brainchildren of the multi billion dollar weight loss industry rely on either extreme calorie restriction or eliminating entire categories of nutrients (like carbohydrates) from the dieter's regular food intake. Although people do lose weight on diets, they almost always gain it back. The reasons why this happens are complex - calorie restriction encourages metabolic slowdown which persists even when the diet is finished, people on diets often feel nutritionally deprived and tend to resume overeating with a vengeance when the diet is over (not to mention the fact that a dieter often lacks the physical energy to exercise, even when the opportunity presents itself).
Given that cities aren't going to go away any time soon, the solution is two-pronged and very simple. See that everyone has access to good, high-quality food like vegetables, fruit, lean meat, milk, eggs, cheese, and nuts and has enough cooking skill to turn these ingredients into satisfying meals. Encourage people to incorporate physical activity into their daily lives by walking more and driving less (or not at all).
2
Obesity is higher in the suburbs than in cities. I live in a city and can walk to stores and restaurants. My parents live in the suburbs in NJ and can barely walk anywhere. They can walk around their sub development but that is pretty much it. They drive everywhere. I am sure dangerous city areas make walking more difficult but the data shows that obesity rates are much lower in areas with greater housing density.
3
Saturday morning cartoons in the 1960's were interrupted with commercials for sugary cereals, candy, and other treats. I begged my mother to buy those snack box size cereals and loved opening a box of Lucky Charms. Fizzles in my glass was a favorite.
Dairy Queen was a summer treat we had weekly, along with Snowball cupcakes, Hershey Bars, and Good Humor ice cream from the trucks that drove down the street.
The difference of my childhood and today's could be that we were outside, playing, running, and riding bikes WITHOUT our parents watching us.
I left the house after school to play and came home for dinner 3 hours later. In the summer, I could be out all day except for a quick sandwich or a snack. Activity was pick up games, bikes, swimming, races we made up ourselves, and jumping rope.
If today's parents can roll back their constant presence and let their kids actually play in their neighborhood, is it possible things could change?
28
@mainesummers Ah, yes, when children were free to run around. I had the same privilege.
These days, half the neighbors would be calling out the Child Welfare authorities to chastise my mother for her lack of oversight, probably followed by the police for "felonious neglectfulness". No wonder that children are kept indoors, where there is little to do other than study one's iphone.
3
@mainesummers The essay in last week's NYT about the cultural opprobrium and downright criminalization of parents (mothers) who allow their children to be active and, gods forbid, sometimes alone popped immediately into my mind as I read this essay and comments.
Families and schools haven't limited children's physical activities because they want them to be obese, but because they face overwhelming and unmanageable social pressure to constantly mind them toward certain kinds of achievement and 'safety'.
There's no way to pull out the thread of 'healthy eating and exercise' and address it without addressing the overall social and economic inequity that the vast majority of American households face.
1
A much needed summary, but with some major flaws.
"Second, adequately fund obesity research into innovative approaches for prevention and treatment, beyond the conventional focus on eating less and moving more. "
Obesity research? Sorry, it's nothing more than calories in and calories out. The same thing as eating less and moving more.
Why would Americans want to give the savings from a successful campaign to combat obesity to the Republicans for more tax cuts? Education, infrastructure, basic scientific research, the safety net, and more are sorely in need of more funding. Republicans generally are the ones opposed to any regulation like a simple soda tax, and in favor of anything with the word "big" in front of it as in "Big Food" lobbyists.
Legumes are not expensive. Amazing how far a pound of (organic) beans and lentils can go. Animal proteins are not the answer with the attendant environmental degradation, antibiotic resistance, climate change, not to mention the cruelty. "Eternal Treblinka for the animals" per Isaac Bashevis Singer.
Tax these folks. We already do it for tobacco and alcohol. And tax the companies up the wazoo. Maybe even fine them out of existence. Their profits are a menace to society, and they're spreading their poison around the globe. Obesity is soaring not just in America, but everywhere on the planet.
3
Our children are surrounded by junk food but not only, most TV shows advertise healthy food as boring and »yucky » for a lack of a better term. Plus children’s books vilify healthy food.
Not to mention doctors who have absolutely no training on nutrition.
It takes parents to give good habits. Most of them are so worried their kids will become obese that they force them to play competitive sports. Driving them around to practice and giving them junk food as well as sugary drinks. My advice is to let the kids play outside, go for a bike ride with them, get off social media and cook every day.
4
When fat was demonized in the 80s everyone got fat. The problem then now and forever is sugar. Sugar is poison. Added sugar is a crime. Carbs are not mentioned. The old food pyramid was all wrong. If nature made it...eat it. If a corporation did...don't.
9
That we need more energetic efforts to fight obesity is hard to argue with. Except this article reinforces the stereotype that people are obese simply because they are weak-willed or stupid people who insist on eating too much or eating the wrong stuff.
I lost my brother to obesity. He certainly wasn’t weak-willed, and I lost count of how many people told me he was the smartest person they ever met. We were eleven months apart in age, and growing up we ate the same foods and in the same portions. We were the same height, yet he was always heavier than me, and by the time we were in high school he outweighed me by over 100 pounds. I never had any problems with weight, and he wound up dying in his late 50s from complications of obesity.
Unfeeling people advise the obese that, “Hey, you should go on a diet.” Diet? My brother tried every possible diet, trick, and fad. Yes, we need more help on a society-wide level on what we should all eat. But we also need creative approaches. A start would be developing a scientific understanding of why people like my brother are so prone to obesity. A ray of hope in the article is step two, which says we must “adequately fund obesity research into innovative approaches for prevention and treatment, beyond the conventional focus on eating less and moving more.” Hopefully as a society we’ll move forward in this fight. But it must include the search for innovative approaches. A little sympathy for the plight of the obese would also be nice.
16
Before I post my comment, I have to ask “is anyone else seeing duplicated/triplicated comments?”
Reading on an iPad mini: maybe that is the problem?
I follow Dr Fuhrman’s advice and have this posted on my fridge.
GOMBS
G - greens
O - onions
M - mushrooms
B - beans, berries
S - seeds,nuts.
I also like intermittent fasting. It is effective and healthy.
However, we are preaching to the choir.
I agree with most of the reasons/suggestions but at the end of the day, it is up to the overweight person to lose the weight. Obviously, it is not easy. It is nigh near impossible if they don’t have access to fresh produce nor the means to cook the healthy food.
2
1- A lot of paternalistic legislation (akin to seat belt laws) that make it expensive and annoying to be fat.
2- Anti-fat education from K-12 with rigorous Phys. Ed.
3- A re-introduction of fat shaming.
4- Strict limits on single fare airline seat weight requirements.
5- Ban soda sales in containers above 11 ounces.
6- Eliminate school bus service less than 2 miles for children 8 and above.
(I have some more draconian ideas but won't list them here. It's all basically tough love.)
15
@Crusader Rabbit - I'd love to read the full list!
I recall seeing in a documentary on families living in cheap motels what kind of food the government provides to the needy. Honestly, it is rather difficult to even call it "food." Junk is more like it. Equally distressing was to see the male parent lounging around eating potato chips while the female parent was out hustling for minimum wage.
I knew a guy years ago who was getting food from some government program. Will never forget the huge hunks of butter that reeked of gasoline.
Whoever said there's no such thing as a free lunch really meant it.
2
As with most things industry and capitalism are the problem. There is profit to be made in making people obese and keeping them obese. Look at all the junk available in the supermarket, it was all designed and marketed to make people constantly consume it. Once people are fat they need bigger everything - cars, clothes, furniture, etc. Then the healthcare industry and big pharma profits off of their ailments. This is combined with most jobs being sedentary and unnecessary in the first place.
6
Since all ingredients on food labels are measured in grams, the vast majority of Americans can't visualize how many teaspoons of sugar are for example 16 grams, a total that is often in just a small plain non-fat yogurt with nuts. Even supposedly healthy low fat plain yoghurt contains sugar. And then they should also count the many grams of sugar listed under different names, e.g. fructose, dextrose, etc.
The max consumption of sugars for children suggested by the AMA is 12 grams per day, while women should not have more than 17 and men 19.
Everyone should get a gram scale and adding all the teaspoons of sugars they consume per day with so-called sports and energy drinks, energy bars, white bread, ketchup and bottled again "low-fat" dressings, etc., etc., plus the piece of pie, and weigh the total of their daily sugar consumption, which averages about four handfuls sugar.
Heck, but seeing than mountain of sugar they might get a heart premature heart attack.
4
Diabetes 2 epidemic?? (here and in Mexico?) Blame CocaCola (Boycott CocaCola products!) Too bad Bloomberg did not succeed with his attempt to limit the size of soft drinks one could buy at restaurants and fast food outlets. (IMO he is a saint for making smoking a lot less fashionable than it once was.)
In Mexico it was impossible to buy bottled water and or diet sodas -- MUCH of the time. (I don't quite recall the coffee/tea situation but it was HOT.) Coke today: Metformin tomorrow? (Diabetes 2 happened to me at about age 60, and I always preferred diet soda and ate few French fries and was mostly OK weight.) BUT in addition to Metformin and keeping my weight below 26-27 BMI -- slightly overweight -- a 30 minute brisk walk daily is a MUST for keeping a level blood sugar. PS the disease has affected my vision... be careful and get tested... Testing is very important.
6
I'm so tired of the "fat acceptance" movement. I'm in my mid-60s and have never had a weight problem because I exercise moderately and don't eat junk food, except as an occasional treat. It pains me to go grocery shopping and see obese people riding the motorized shopping carts full of ice cream, fatty meats, sugary sodas, cookies, salty chips, and other calorie-rich, nutritionally harmful foods. I don't understand why Americans can't stop eating so poorly that they can't even walk around a store under their own power to buy their junk food.
36
@alterego
Exactly.
I was at a large amusement park recently and a super -obese 40-something couple each riding their own mobility cart were gorging on the junk food and sweets; for some reason we kept bumping into them amid the crowd of 10,000 and they had food in hand at every turn.
I realizze that is some sort of mental or emotional illness but they looked otherwise prosperous and stable. I have no problem shaming people like that for their gluttony. They are costing ALL of us.
5
Once more the role of soft drinks is overlooked. By knowledgeable people.
I'm not saying junk food doesn't contribute to the obesity problem. But even eating junk food, there's a limit set by a thing called satiety.
Drinks are something else. Thirst is probably your strongest biologic drive, stronger than sex. When you're thirsty, you'll drink the entire bottle of the soft drink, even if you don't want the 500+ calories. Has anybody actually looked at the lifetime diets of obese people?
1
I think it's becoming very clear that public obesity is a rather complex crisis that will absolutely never be banished, or even persistently abated, through lectures or education. There are socio-economic factors deeply woven into the problem. I really believe that this will only be resolved gradually and organically rather through education. "Fat' people always resent being told they're fat. And they absolutely (and understandably) detest the smarmy, self-righteous people (some commenting here) who brag about how fit they are.
On the bright side I see health consciousness becoming very much a part of youth culture. Whether or not it will get set aside as income and families grow, who can say.
I know that none of us want to face this potential not-so-distant-future solution but here it is: Climate Change. Worldwide agricultural yields are certain to suffer as the planet heats. That, combined with silly political tariffs, will make food more expensive. And so on...you see where this leads, don't you?
French fries and pizza! That explains a lot. Will anyone eat those fresh basil leaves in the center?
3
Obesity is a problem for me.
It is a problem for me because I have to incur costs for people who won't control their eating and who won't exercise.
If we are going to have a government "intervention," then why go after food? I like food. I can control what I eat and when I eat. I exercise, and always have.
Instead, go after people who have the narcissistic idea that they can eat whatever they want and as much of it as they want and not have health problems. Intervene with them. Stop enabling them by paying their medical costs.
Obese people are not victims. They are free agents who choose what they eat and how often they eat and how often they move their bodies. Respect that. Respect that by having them, not be, bear the financial costs.
12
@Dan I think you are on target on up to a point. But you shouldn't assume that your desire for food is the same as everyone else's and that your ability to regulate your behavior is the same as everyone else's. You don't have their brains and bodies. You don't know what it's like to be hungry constantly, or unable to stop eating once you start. Some, but not all obese people, actually are victims. I applaud your self-control, but I think you should talk to a few obese people before casting judgment on them.
4
Start paying people to keep their weight normal half of what we would be paying to care for their diabetes; you'll find a lot more healthy people.
6
For any and all who are interested in this topic, please watch "The Magic Pill" on Netflix. Eye opening on so many levels!
Also, all levels of health care providers must receive more nutrition education in school and beyond. Every time I care for a patient, I can usually insert some nutritional information into my interaction or education.
3
Legumes are not expensive. A one-pound bag is cheaper than a $3.99 bag of chips and has far more nutritional value.
14
Where is bariatric surgery in all this? It’s a safe and effective management tool with attractive side effects. (Unlike cosmetic surgery.)
1
@Bernard bariatric surgery has its place, but performing surgery on a significant portion of the population is neither practical or desirable. Plus despite the dramatic short term improvements a significant number of people gain the weight back after 5-10 years.
8
@Fege Research shows that significant weight regain occurs in only about 10 to 20% in long-term followup. (Karmali et al, Obesity Surgery 23:1922-1933) On average, more than half of excess weight remains lost after five years. (Lauti et al, Obes Surg 26:1326-1334) In brief, surgery sure beats being fat.
Folks should be held accountable for their life style choices.
Smokers pay higher insurance premiums than do non smokers.
Shouldn’t the same hold true for folks who are not predisposed to obesity?
11
@-tkf
Absolutely.
1
I know that portion size is just one of a multitude of reasons for this epidemic but it recently really hit home how NOT obvious this seems to be even to people who are quite well-educated about food and have the money to eat good quality food both at home and when they go out.
I spent last week with several well-off friends in Boston who are great cooks and know great places to eat. However, my husband and I were both shocked at the large portion sizes served at homes and out at nice restaurants. No one else batted an eye at the size of servings of meat, veg, breads, sweets, etc placed before us. We decided to write it off as American generosity and dug in but it was difficult to finish because we are not used to those portions. But I can see one getting accustomed to it.
Now it isn't as though Canada where I am isn't filled with plenty of fat people - we have problems too. But we haven't completely caught up with the normalization of large food servings (well, not in Montreal in equivalent "nice/upper scale" restaurants).
14
@JJ
I thoroughly agree with this. Again, as mentioned, it may not account for the totality of the problem or the solution, as obesity is clearly a multifaceted conundrum, but portion sizes in the US are totally out of control. I find that I have to order a "mini" bagel or muffin, or a "kids" scoop of ice cream, just to get a portion size that is remotely normal or comparable to what I was used to eating growing up (which was not even that long ago- the 1980s).
7
You note that, as a consequence of the fiscal pressures created by the poor health of the obese, "the less there is for discretionary spending (... highways, the environment and defense) and safety net services."
Not exactly.
There are ALWAYS dollars to throw at the military, and never a problem giving substantial tax breaks to the wealthy.
It's only those programs which impact the 99% that have trouble being funded.
7
At age 75 my weight ballooned up to 183 lbs. As per Atkins I cut out carbs and now I'm down to 171. 160 is my goal, and so far it's easy: no refined carbs, no sugars, lots of greens tomatoes, nuts and some protein, usually eggs. I am seldom hungry and heading toward my goal. Walking is also important.
10
We certainly CAN expect individuals to exert personal responsibility - the obese ate too many calories, and now they have to eat fewer. It is very much more difficult to lose weight than to gain it, but it can be done.
The government is also obese - eats too much money. Will it ever slim down?
8
Is easy to create flavorful, healthy meals on the cheap - dried beans, rice, greens, unsalted nuts, chicken, apples, and skim milk (to name just a few few items) can be procured incredibly inexpensively - virtually everywhere in the US - on a once per week grocery shopping trip..... I therefore don't buy the "healthy food is expensive" argument at all - sure, it _can_ be if you're after heirloom tomatoes, buffalo mozzarella, and fresh herbs; but it can also be inexpensive, healthy, and satisfying!
24
Try cooking for family when many are working irregular shifts and there is never enough money in the house.
5
@Anne - yeah, much better just to feed the family soda and frozen pizzas. We're all too busy to live decent lives anyway.
20 minutes is all the time it takes to cook a decent, healthy meal if you know how. And learning is no secret. Spend a few more minutes, double or triple the amount and you'll have meals for the next 2-3 days.
Get the family involved in the cooking and cleaning up as well. The burden of caring for others should be equally shared.
3
On days like that I whip out my crockpot. You can leave it on warm for hours while people grab servings whenever they want, and even the cheapest cuts of meat turn out pretty good. I’ve been enjoying discovering old recipes from around the world - it seems like in every culture there are traditional meals based on simple ingredients that can simmer undisturbed for long periods of time.
5
Under the guideline of "first, do no harm", start with removing subsidies. While this won't be easily politically, it's an easier sell then more government agencies and regulations.
6
This whole country is slowly becoming a "REAL" food desert. All in the name of profit. Address that and we might again be able to influence the foods people choose.
4
@Laura
What does profit have to do with people making responsible decisions to eat decently? Their are plenty of people who are not fat because they don't let themselves get fat.
2
Biology may account for obesity, but it doesn’t explain why 70% of adults are overweight today. Obesity was not common 50 years ago especially in children and teenagers. So what has changed? We have largely become a nation of non-cooks through no fault of our own. One reason is work schedules. In many families both parents are working. It is much easier to pick up a cooked meal or eat something frozen instead of shopping for ingredients at the supermarket and cooking from scratch. Recently I read that only 10% of young people like to cook. Traditionally, children learned to cook at home by watching. If parents are not cooking, children aren’t learning. Unfortunately, many schools have scrapped home economics classes in favor of more STEM and language arts classes due to the pressures of meeting academic testing goals. I believe cooking needs to be taught as a required, graded course in schools. Our children’s future health depends on it.
13
@Gale
I agree with your comments and you are correct that many young women starting families today do not have a basic knowledge of how to put a balanced meal together. They do not know what a protein is, what starches are and why we need salad and vegetables in our diet. I worked with young families in the military as a visiting nurse to provide education for meeting the needs of their infants and toddlers who sometimes had a pop tart for breakfast because the parent didn’t know better. We must educate children in grade school about healthy nutrition and proper care of our bodies. It is very challenging to motivate a patient who is obese with diabetes and associated health problems to change the way they have lived for years, to change their diet, eat less, get up and just walk or swim for exercise. They are victims of their own lifestyle and for many it is too late to change.
2
... and young men?
1
I picked up a pound of chicken, 2 pounds of potatoes, and a pound of string beans for less than 10 dollars at a super market in Newark, NJ.
For comparison, 2 packages of Oreos and one big mac will easily set you back 10 dollars.
I agree the government should regulate, but it's hard for me to take any argument seriously that refuses to acknowledge the impact of free will on a society.
43
"Seventy percent of American adults are at least overweight, and body weight is strongly influenced by biology; we can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets."
Sounds well and good. Modest governmental policies addressing the root causes of obesity, policies like banning junk food ads aimed at kids, making sure our kids are eating decent food at school, and more government research into prevention and treatment. Sounds reasonable.
BUT, according to a 9/9/16 article in the Denver Post, based on data from the CDC, "[t]here is a remarkable relationship between obesity and presidential preference. According to current polls, eight of the 10 leanest states favor Hillary Clinton, while all of the most obese ones favor Donald Trump. Using data from the 538 blog, the mean percentage of pro-Clinton voters in the lean states is 53.2 percent but only 34 percent in obese states."
We are facing a national health crises. And oddly, it seems one that both the left and the right can rally around. Does SNAP (Supplemental Nutrition Assistance Program) really mean SNAP when you can buy junk food with food stamps?
But in today's corporatist, hyper-individualistic environment, it seems almost impossible to address the issue effectively.
"Bread and circuses" has been replaced by "Junk food and social media." I fear for the future of our republic.
11
Physical inactivity is a primary cause of most chronic diseases.
Population levels of physical activity, inadequate to meet current guidelines can place a health burden on the U.S. population that results in higher health care expenditures.
Regular physical activity is associated with important health benefits, including reduced risk for premature death, cardiovascular disease, ischemic stroke, type 2 diabetes, colon and breast cancers, and depression.
A study of one million people has found that physical inactivity costs the global economy $67.5 billion a year in healthcare and productivity losses, but an hour a day of exercise could eliminate most of that.
Just 23% of US adults get enough exercise, CDC reports
Here we go again. Our lifestyles are not only contributing to sky high healthcare costs they are literally killing us. If it weren’t for prescription drugs to compensate the death toll would be a lot higher yet, let’s blame drug companies for OUR poor health.
There are many reasons people don’t exercise and a busy schedule is the most common reason. Whether the busy schedule is due to a job or kids or both, many people can’t imagine fitting exercise into a packed day. While some employers encourage their employees to exercise by providing on campus gyms or paying for health club membership most still don’t.
4
Dialysis is the only medical treatment that is covered by our government. It was a law passed in the heat of the moment by a bunch of congressmen who didn't understand the massive expense this would cause in the future. They stupidly thought the problem would disappear, instead it is a huge expense and growing.
Diabetics are in more immediate danger of dying on a daily basis than people on dialysis. Diabetics who don't watch their blood sugar are likely to end up with end-stage kidney disease. The drug companies that produce insulin have improved it tremendously, but the high price is not justified. People who can't afford the proper dose or the required number of blood test per day are at increased risk of future problems.
Congress should consider that diabetes is as much of an emergency as end-stage kidney disease and make sure everyone can afford all the required insulin and testing equipment. The damage done by improperly treated diabetes will dwarf the amount spent on kidney disease within a few years. This is an emergency which requires immediate action. Unfortunately, the people in areas where obesity is the highest, also voted for someone who promised to cut off their health care. We are all going to be paying the price in a few years.
12
I’m more surprised by the people who manage to stay healthy living in today’s modern culture. We’ve created a perfect storm, where people work frustrating, sedentary jobs with hour long commutes, constantly surrounded by cheap, addictive, yummy junk food. It would take incredible dedication and genetic good luck to possibly beat this rigged system, so congrats to those of you who manage. (I live off-grid on my mini-farm, where I work my bum off hours everyday and the fast food is so far away sloth generally beats gluttony.) As a society, we could make helpful improvements. We currently send billions in subsidies to Big Ag to keep a handful of commodity crops cheap and plentiful (not to forget Big Sugar) which encourages the processed food market and neglects most veggies and healthier grains. Instead we can use the funds to encourage independent growers using climate-change-fixing methods to increase the supply and drop the costs of high-quality produce. Seems like a win-win-win to me, but I’m not hopeful. The corn lobby can afford to buy up so many more politicians than the kale lobby.
31
Well put. We, too are off-gridders working out of a large (8.5 hectare) tropical research station in the Daintree area of Far North Queensland. Inactivity is pretty much impossible here.
2
I’m jealous, I hear you guys have an excellent growing climate! It is challenging, exhausting, but emotionally fulfilling work. I knew it was the right life for me one morning when I went to let out the chickens after a big rain, sunk into six inches of stinky muck, and thought yeah, this is still much better than going to staff meetings.
1
No mention of the role of the automobile in destroying just about everything that used to make humans more than consuming automatons? Alienation from nature and each other has taken a heavy toll.
28
No one's body violates laws of thermodynamics. If you're obese, input energy is exceeding output energy by quite a bit.
For obese people who think their obesity is a mystery or a genetic injustice: I highly recommend doing a serious and thorough daily calorie-intake log of everything you put in your mouth for a couple weeks. The resulting data can be a revelation, and help show where the problem is.
26
@rumplebuttskin Totally agree. The only way to know what you're eating is to track it. Weigh and measure and count every morsel. Research shows that most of us underestimate our food intake. Despite all the apps there are to keep track, it's a tedious proposition and people give up. But those who have successfully lost weight and kept it off track their intake (and weigh themselves regularly) (See: Rena Wing's research on the Weight Control Registry)
3
1) Instant gratification is why we have a fast food society as well as drug addicts.
2) Cheese is an integral component of almost all fast food - tacos, cheeseburgers, pizza, etc., as well as food served to children at home - casseroles, mac and cheese, salads even.
3) Sedentary children and adults. Watching a TV show while snacking on chips and such is instantly gratifying. Walking 30-60 minutes everyday takes a while to see results - delayed gratification.
13
I luv sugar, and thanks to expensive healthcare, I'm not dead ... yet.
/
I've diabetes 2 plus high blood pressure, and thanks to health insurance, there are medications, doctors, and hospitals for my my indulgences consequences.
And Medicare for me an elderly isn't a bad thing going on.
So, folks, I'm not ungrateful.
This candid confession is reality
Sugar, of course, should be banned.
There are multiple causes of cancers, and the s word is in all probability not an insignificant factor, we all should fear.
Sugar is imho probably the gateway to bad health, and imho that's probably
the reality that our culture can't reform.
In other words, death and disease imho is much about s.
7
As well described the article, the problems of obesity are myriad. Health and wealth are devoured by the ravages of obesity. As a physician I would agree we should try everything suggested, but the problem is not a simple one to fix. Urging a healthier diet sounds easy, but it is difficult to put into an effective practice.
Encouraging exercise would have benefits beyond weight loss and maintenance, as many of obesity-related illnesses are ameliorated with an increase in physical activity. I am also impressed with peer groups where obesity is the norm. how do we fix that?
Someone once said "eat smart, eat less, and move more. I am pretty good with the "moving" part, but eating smart and less is not easy.
Lets hope we can reverse this trend!
8
I worked as a medical social worker for a long time and obesity was commonly one of a long list of diagnoses for many folks, and along with that came a list of, at least, 20 plus medications.
These folks had tons of medical support (?) thrown at them, but no one seemed to ever help them with.... food. Physicians seem to ignore this part and there doesn't appear to be much medical consensus about dietary guidelines, at least ones that work, anyway. I believe that anti-imflammatory diets are healthiest for people and they lose weight and have much less pain; a few doctors seemed to be on board with this, but studies don't abound.
It was heartbreaking to see people who were too heavy to exercise without hurting themselves, blame themselves for not walking, when they literally couldn't. Or they thought they didn't have discipline with portion control. Some of the folks I knew didn't eat a lot, they just ate the wrong, very wrong foods routinely. Dieticians were rarely covered by insurance, maybe a quick consult after a new diagnosis of diabetes. And usually, when people are chronically ill they are poor and the cheap food they can afford is the food that makes them sicker.
11
Hard to eat correctly if you're poor and spend every waking moment working or commuting. When you lack energy and money, you go for something cheap and tasty. With so many single people and married couples that work, it just compounds the problem.
I'm sure that comes as a surprise to some Whole Foods shoppers who can't imagine not starting their day off with some Kale Oatmeal and a Soul Cycle class.
14
@LR Yeah, that's the common excuse...that poor folk don't have the 'luxury' to eat well. But as others have pointed out, there are plenty of cheap and tasty options that are also healthy.
Bag of chips vs banana?
Rice, beans and plaintain (cooked up ONE TIME, and in enough quantity, to provide 3-4 meals, with enough dried rice/beans leftover to cook more meals) vs 4 frozen dinners full of sodium?
glass of free tap water vs bottle of soda?
sandwich of canned tuna or PB & J vs sandwich with 'deli meats' full of chemicals?
Healthy does not automatically have to cost more or take significant time to prepare, and anyone who says that is simply looking for excuses.
18
Even Walmart has eggs buddy. I don’t get the poor excuse. Making eggs with toast and a banana is the exact same cost as a bowl of captain crunch and a pop tart. Life is about choices.
2
This social democrat agrees with most of your lofty ideas. But right now I do not want a government obesity commission! Even if we Democrats manage to retake both houses of Congress the executive branch will do everything it can not just to undermine useful progress but use the commission to make things worse, including by spreading counterfactual notions. Further cost savings from reducing obesity, apart from eliminating the cited counterproductive farm subsidies, would at best need years to show up. And when they did the idea that any political party resembling the current Republicans would support their being used for social safety net programs is malarky.
4
It’s strange to read, ‘obesity is strongly influenced by biology.’ Hispanic female here, I carry the FTO gene, which predisposes me to being overweight. I have been heavy and lean. I tend to get heavy when I eat more. My body gains rapidly and holds the weight tenaciously.
Thankfully doctors like Dr. Jason Fung and other researchers provide weight loss help free of charge online. I’ve lost weight and will continue to do so following his advice. I have also saved a great deal of money. It turns out that losing weight is free and simply requires me to stop eating. Fasting has been a life saver for me and provides a lifestyle that I can easily maintain. I don’t have to do anything, not even eat!
Three meals a day makes sense for farmers and factory workers. For the modern American who is primarily sedentary it makes no sense at all. I now eat five days a week instead of seven. I have more time to do other things and spend less money on food. This way, the food I do buy is of better quality.
Finally, I’m tired of the lie that it takes a lot of money to eat healthy. Beans, rice, corn,potatoes. That’s all one *really* needs to live. Don’t believe me? It’s been the food of choice for successful empires before us for millennia. Eating out is expensive. Fast food is expensive. Beans and grains are cheap.
Stop lying to people about how hard and expensive it is to be a healthy weight and maybe then we’ll see a change.
40
@Regina Valdez
The Aztecs grew and mostly subsisted on corn, beans and squash and frequently planted them together because when combined in the diet a person was able to get a complete protein, one that includes all of the essential amino acids necessary for a nutritionally complete protein. Not one of those vegetables contained all nine essential amino acids but combined they do. Essential amino acids are necessary for life.
8
@Regina Valdez
Actually, corn, beans, rice, potatoes are NOT sufficient nutritionally speaking. (One needs good old vitamins of which these mostly lack. -- Thus the fresh veggies, and vit. B. Fish, game, poultry -- not in huge amounts... but all the same.
How clever of you to make fasting work as a means of weight control. Ditto the article last week in The Times about how it is impt to consumer your calories in an 8-10 hour period... and then let the body do its thing (Cicadian rhythm.)
2
Good for you Regina! People tend to look for a quick fix or a pill or some magic potion to get control of their own bodies. You've done the hard work of first, finding out a diet and lifestyle that gets positive results and, second you've had the discipline to set your goals and implement them.
2
Of course the trend in the US food environment and lifestyle is to blame, unless you are going to pretend that the only thing that's changed over the last 50 years is that people have gotten increasingly gluttonous ... It's still possible to eat and stay healthy today of course, it simply takes more and more willpower and conscious effort to do so. I grew up in Europe and never thought about food as something I had to navigate, avoid for the most part, etc. I would just eat everything/everywhere. Turned out okay.
Also, I believe food culture and upbringing matters - just picking up basics of nutrition and how to prepare food when growing up. I am lucky enough to have had that. I suspect it is increasingly getting lost here, in this storm of junk food, snacks and unhealthy eating out options. I am not even talking cooking - just basic stuff. For instance before she met me my girlfriend here would only ever buy frozen processed food and heat it up in the microwave; she didn't even know how to boil vegetables.
Finally, I believe since being overweight/obese is the new normal, people don't even really understand that they are too fat any more.
8
@Alex
Alex, I'm curious, growing up in Europe, what was your food experience? Were most meals at home? Did you eat out much? Was junk food as available as it is in the states? Was fresh produce a daily part of the diet?
Thanks for bringing up the comparison. I've found the same to be true when comparing EU vs US food system and attitudes.
@Krystal
I grew up in Paris. Most meals were at home, we almost never ate out - only on special occasions. My mom would work a little less than my dad and so have time to prepare dinner almost every night with fresh food - an amazing, herculean effort, I now realize, and will probably never thank her enough for. Me and my sister would help out sometimes, and just became familiar with preparing food and cooking. Fast food like McDonalds was available, yes, but few and far between and actually a bit pricey. Typically when on the go it was cheaper and easier for me to buy a sandwich from a bakery. Obviously I also walked a lot everywhere.
So, I guess all things that are becoming rarer and rarer in America, as others have pointed out.
One of the problems is the taste of fresh fruits and veggies today. They have bred all the flavor out of them. When is the last time you had a good tomato unless you grow them yourself?
Another thing we can do is change the way we approach physical ed in the schools. Kids are taught tea sports almost exclusively and they are not practical over the long haul. We should be putting more emphasis on things that people can do easily by themselves or one other person. I'd like to see pilates, yoga, tennis, swimming and dance. Team sports are all well and good for kids who enjoy them and are good players, but most people can't spend their lives organizing enough people to play these sports.
We have another problem here in Mississippi. Very few fresh foods are grown here and there isn't much competition with grocery stores around here, so the prices are high. On top of the high price of food, there is a 7% sales tax on all groceries.
I don't agree that processed foods taste so good. Most of them are pretty disgusting, in my opinion.
Learn to shop and learn to cook. It's not that hard. Watch portion size both at home and restaurants.
19
Drs.,
You are surely bright, accomplished professionals within your respective fields. But the emphasis on biology is misplaced. How, exactly has human biology changed so much within the past 40 years, or even the past 20, to account for the dramatic increase in obesity? What is clear is that the abundance of cheap processed food has increased exactly in line with the increase in body mass. If these measures (i.e., weight increase vs. available calories) were plotted in a graph, the correlation coefficient would be 1.0. Fortunately, calorie counts are now available in many restaurants. Look at the people around you at the restaurant, note what they are eating and then count the calories. In just one meal, they are consuming over two thousand calories. In a day, maybe 5,000 or more. Given sedentary lifestyles, these calories are not being burned but accumulated. It is really that simple. Calories in, calories out. Always has been. And you know that.
6
@Marin
We don't know all of the mysteries of nutrition. It seems that a 12-14 hour fasting period daily allows people to burn all the calories that consumed over a longer period of time (8 hour fasting le'ts say) would result in weight gain. complicated.
4
Maybe the suburban lifestyle is a big part of the problem. I work in financial services and a vendor I deal with spends four days in her firms NYC office and one in their Nassau County satellite. She tells me her fit bit generally registers around two miles of walking on the NYC days and around 1/10 of a mile for Nassau County.
11
There are several interventions, government and otherwise, that could help this problem.
Ag policy is a big factor. Subsidies for crops like corn and beans create cheap sugar and cheap feed for meat animals. Sugar drinks, an acknowledged big contributor to obesity , are extremely cheap because of this. Anything with sugar should be expensive because it costs society so much, and farmers should not be given breaks for growing the poison. Ag policy should support small family farmers and people who are growing real food and keeping the soil and environment healthy. Right now most commodity farmers are on the gravy train in ag and many/most big agribusinesses are not good stewards of the soil.
In farmland we are also penalized by the poisons in the soil and air, and the bills for cleaning up the water.
Merchants who can benefit from SNAP sales should be required to offer real food for sale - fruits, vegs, beans, grains. Junk should not be on the list of items folks who need food assistance can purchase.
Keep junk machines out of school and incorporate more activity in the day, pre-k - 12. Feed real food at lunch, no matter how much whining for fries and pizza. Teach kids how to cook, and garden at school or other community places.
Insurance companies should support health initiatives through their policies instead of just supporting pharmaceutical health payments.
Walking and biking to work and school should be a priority for every community.
6
Humans have spent all of evolution trying not to starve to death, just like every other organism. Our lust for fats and sugars is as clever a design as our lust for sex. And then all of a sudden in the last few hundred years, we've perfected making fats and sugars so accessible that they are now the easiest to obtain of all foods. It's hard to know how to change course when you don't know what drives you.
103
This is an excellent observation rooted in science. The other half of this is that, until a couple hundred years ago, most people got lots of exercise through work - many more were engaged in farming, for example. Now we are office-dwellers who must consciously seek out physical activity.
Thank you for so compassionately addressing this issue. So often those who don't suffer from this disease don't understand it is multi-faceted and a very complex co-mingling of biological, sociological, economic, and cultural factors. Previously, it was common for people to judge cancer and alcoholism the way we now judge obesity and its related illnesses - exclusively as a punishment for lack of will-power. While there is frequently a behavioral component to the disease, people without the same biological and other contributing factors in their lives will engage in similar behaviors without similar consequences. Such people are quick to judge an illness - and the people who have it - out of their own ignorance to understanding the fundamentals of the disease.
We are all responsible for our individual health and well-being, but by turning a blind- and judgmental-eye to overwhelming structural factors affecting people's ability to avoid becoming overweight we are engaging in the same kind of misplaced criticism that allowed people to suffer and die for generations from diseases like alcoholism and cancer that were much more preventable once we started to address the underlying elements leading to them. We have a moral and economic imperative to do the same for obesity and its related diseases.
7
In the middle of the article, on my phone, an ad for potato chips; a prime example of the most pernicious type of food product excacerbbating this epidemic. Why? I don't buy them. Related to the content? I hope not NYT digital ad gurus.
7
All of the ads that I see are for bicycles.
Economic stress & obesity go hand in hand. The competition to survive in a Capitalist society causes alcoholism & obesity both additive drugs.
5
@Joe Blow In reality, capitalism has done far more to eradicate poverty than any other economic system ever invented.
I’m old and maybe 10 pounds overweight
What’s astonishing is all the young people who are fat.
I wouldn’t be caught dead being 1 pound overweight when I was a young chap. Today the young folks are just horribly fat. Like they’ve totally given up. And the cause is simple. Way too much junk food going in the mouth and no exercise whatsoever.
17
A word on the 'cost' of nutrition -- I have been vegan for years, but switched to a mostly raw food diet 3 months ago, and I have saved actually saved money.
5
No one has mentioned that children are not allowed "to go out and play" because of the fear of something happening to them (i.e. predators, pedophiles) as well as being on phones and computers all of the time.
18
Interesting that the word "beyond" is used . . ."beyond the human suffering . . ." Ordinarily I would take the connotation of "beyond" to be "more significantly". And this is the way health issues related to obesity are generally framed today. Even in medical journals.
What is the economic cost?
It shows what we value. But "beyond" that it shows how a complex human issue can be reduced to the lowest common "denominator" which is the denomination of dollars.
Banning junk food ads directed at children? How about banning their slobs of parents who lounge around on the sofa with a huge sack of chips literally tucked under their double-chins like feed bags? How about relegating junk food to a special back corner of the market? Well I guess that wouldn't work since just about everything in the supermarket is poisonous garbage. Even markets like Whole Foods have long aisles of sweet drinks and chips facing each other, large "bakeries" right by the front door and, disgustingly, open bowls of salty chips or broken bits of cookies where the carts are for people to grab a dirty handful of and stuff their faces with just as they hit the vegetable section.
Junk food is high profit food. Fresh, unprocessed food is low profit margin and requires special handling, refrigerated transport, etc.
There is no suffering "beyond" the human suffering of this situation.. The financial "suffering" is nonsense. It's a boon to many industries keeping them rich and powerful.
3
Unfortunately, not a single one of the 5 policy proposals has a chance of becoming reality in today's federal government. Please rerun this article in a few years.
6
I would rather be fat then eat Kale.
4
@Jake
That's like the farmer who fed his dogs turnips. Asked how he got his dogs to eat turnips since dogs don't eat turnips the farmer replied, " They didn't either, at first."
1
@Jake
But you don't have to eat kale to be thin.
@Jake
Ha ha! Fortunately, those are not your only two choices.
Nutrition research and education can always use more funding. Better understanding of the underlying genetics and biochemistry of metabolism and obesity could lead to an era of more widespread personalized nutrition that helps each person know his or her metabolic phenotype and then select from specially formulated commercially available foods that maximize satiety and minimize fat storage. People chow anyone?
Revolutionary
Poorly regulated policies on the marketing of dangerous foods is the direct result of money influencing politics.
The obscenely expensive healthcare in the USA is the direct result of money influencing politics.
Both are an enormous problem for the majority of the population all would agree - esp. tragic is how these same political perversions hit the poorest members of society - the same ones most vulnerable to obesity, the poorest members of society.
Money in politics = No Confidence in Govt = Democracy Fails
Weigh the costs...of lying to public for too long.
This is the single best issue for governments to exercise enlightened policies for the people by pushing-back at the corporations and drawing a line in the sand for human values and human dignity.
Human Rights, Democracy and Socialism are a sham if they cannot support the wisdom of life-giving public policy.
Governments may let the corporations destroy the planet's ecosystems - but when it comes to knowingly destroying the healthy lives of citizens due to cowardice and bribes - it stops sooner than later.
This is the tip of the spear, this is last line in the sand, families expect their children to be nourished - not targeted by advertisers.
This is the tip of the spear - healthcare and nutrition.
Governments could not pick a more popular issue to stand up to Big Data Corp.
- Fact is, they should have done it long ago.
4
Actually, I have marveled at all the ways the new obesity has likely pumped up our economy. Now you can buy bigger cars, clothing and furniture. Examining tables in medical offices and chairs in restaurants are larger, people need more medical supplies such as diabetes products, walkers, wheelchairs and those scooters very large people use in grocery and other big box (!) stores. If people weigh just 20% more, airplanes carry much heavier loads and use more fuel. There are certain women's clothing retailers who have sized their clothing in huge sizes without ever marketing them for "larger" people. Etc. I appreciate the Times running this article; it is painfully apparent, when one is in the midst of a waddling crowd of Americans that our population is very sick, and no one is talking about it.
168
@marywho
The medical and biological research communities are certainly talking about the obesity epidemic! But it’s very difficult to intervene and change behaviors that have become an ingrained part of our culture. When both mom and dad are working full-time to try to make ends meet and have few hours left in the day to make dinner from scratch, accessible, fast high-fat and -carb foods are perceived as convenient necessities. Add them to a sedentary lifestyle with lots of additional inactive time spent in the car, and you have the perfect recipe for diabetes and metabolic syndrome. I’m amazed at how clueless most Americans are about the effects of these patterns on their health. This pattern is possibly the most important threat to Americans since the cigarette was invented..
The airline industry is the exception. The seating space just keeps getting smaller and getting stuck between two "large" people on a plane has become the norm!
@marywho Imagine the pain of not being able to have any dialogue in my culture (blacks) because talking about it is taboo because there are so many who are obese. A person risks a physical altercation if he/she point out the problem. The relatives are all enablers, saying such things as "Give that girl some mo food if she want it." And that girl is a woman too big to even get up to get the food for herself.
America is not alone, it is all across Africa and Brazil. I am seeing more than a small amount here in SE Asia. I have read that it is also epidemic in the SF Bay area. So sad but some of us have accepted that we can't cause good changes so we accept the anger that is thrown at us for walking away. Which is what I now to, can't fight losing battles.
Obesity in America is a serious health problem. One of the many causes is a poor diet, often based in junk foods, as noted here. Poorer people tend to consume more junk food because its cheaper, and the advertising juggernaut for junk food drives its popularity. Result? More sickness and ill health. If America wants to address its obesity problem and move toward a healthier society, it needs to make a commitment do so. That means - among other things - closing the income gap between the rich and the poor and ensuring all stakeholders - including Big Pharma - are similarly committed to that goal of societal health.
2
During the past six months, I have taken my wife to the Emergency Department of a local hospital about six times. My observations were that there were that a very high percentage of people using the facility were severely obese. Glad that NYT is reporting on this and making what should be bipartisan.
2
"Diet" is the wrong four-letter word. Want to improve eating habits and outcomes? WALK.
5
While cheap calories abound, I don’t think all the blame falls on food. We have become a completely sedentary society. If you drive to a desk job, drive to lunch, drive home, then spend the rest of the evening in front of a screen, you will struggle to burn even low calorie diets. Even worse, most people’s idea of exercise is getting in a car and driving to a smelly indoor gym.
Get outside! Go for an evening walk and get to know your neighbors. Get a bike and explore! Use your lunch at work to walk around, even if it’s around a parking lot. You’ll feel better and the pounds will come off.
5
Why no mention of animal products? They contribute greatly to the obesity epidemic.
3
If it's about biology, so we cannot blame individuals or expect personal responsibility to solve the problem, then why was obesity rare 50 years ago? Biology hasn't changed.
Dry legumes are the cheapest, and probably healthiest, food there is. It's not hard to boil them. Poor people used to live on beans, and weren't fat. The problem may be that most people, including most of the "poor", have too much money and can afford to buy junk food.
9
Ah, there's the answer! The poor have too much money. Is there any societal issue for which you don't imagine the solution is less money for the poor?
5
Just one sentence on the most important solution to the obesity epidemic -- "Third, impose a tax on processed foods, and use the proceeds to subsidize whole foods"?
We need a tax, paid by both producers and consumers, proportionate to the amount of added sugars and fats in all foods. "Foods" that are nearly 100% sugar (candy, soda) would be taxed at 100% of the established rate.
If this was the law in America you better believe it would change eating behavior for the better, overnight. And if not, at least there'd be money for the medical care that will be needed by obese diabetics.
4
@nothin2hide There are plenty of ways to fight the "epidemic" of obesity, increasing sales tax on junk food is not one of them. A tax increase on junk food is going to immediately be labeled as regressive, i.e. unfair to the populations that apparently have no other choice for food besides junk food. A better suggestion would be banning the use of SNAP dollars on things like junk food, soda and candy.
It's depressing to see a list of the common-sense things the government should do and then break out of that haze and recall that this is a government that's afraid breast feeding will harm the processed baby formula industry.
273
First of all,you need to get rid of capitalism.
Food processors and packagers sell their products because people buy them. They package foods for convenience in America's active lifestyle and so the mother can have a full time job. (This is going to sound sexist but try to be objective.) It's a lot of work preparing meals (3x) for a family. It's even a profession for some. How can one feed a family and work a full time job? It's difficult, so people want quick ways to prepare foods and the manufacturers oblige, but it has to be food that most people will eat, that tastes good or it will be wasted. It has to be packaged for distribution and to delay natural spoilage, so they use preservatives. They employ scientific methods to create flavors the the masses will consume in great quantities, to make a profit. They advertise to people who will eat their product. (Spam! I love it!)
Secondly, it is necessary to get rid of capitalism in schools. School boards want money so they sell junk food to the kids in vending machines and they sell chocolate milk in the cafeterias, and what ever else kids will eat in quantity, that is also packaged for distribution and to avoid spoilage.
Thirdly, get rid of capitalism in medicine because the medical industry wants to make money from our ailments. It's big business. Diabetes is a cash cow in America.
2
@Aristotle Gluteus Maximus Getting rid of capitalism would definitely fix the obesity issue. Tens of millions would starve. At least that is what history shows us. We would also fix the environment as very few could afford to pollute. Interesting idea. Fix society through forced poverty.
2
@John
My other suggestion would have been to instigate another world war of comparable size to WW2. During that war the American public was put on rations, kind of like socialism lite, no one called it that.
Drs. Ludwig and Rogoff`s sensible recommendations are just what are needed to try to halt the epidemic, But they WILL NOT be implemented by politicians beholden to Big Food including Big Agriculture, who will not stand to be cast as villians in this drama. The sugar and fast carbohydrate pushers will fight with incredible fury and determination to keep their enormous and lucrative business.
6
Maybe having a access to a non- fragmented seamless healthcare system whereby your (same each time) trusted general nurse practitioner or doctor can give you “the look” over his or her glasses at least once or twice a year after weighing you and then putting you on a diet and exercise program would help? We don’t have that in the U.S. for many Americans especially the poor.
3
@Tim Shaw--Have you ever seen overweight doctors and nurses? I have seen lots of both (especially nurses). So you think the answer would be to give the patient a "look"? How about setting a good example first as a "health" practitioner?
Amen! I could not agree more with everything you said here. This should be a top priority of our country's public health policy, and it gets next to no attention. Between big food manufacturers trying to slowly poison us with food and big pharma creating the drugs that allow us to band-aid the problem, all backed by our misguided politicians, what could possibly go wrong??
5
The burden on caregivers both professional and personal for elderly and obese people in the final stages of life must be tremendous. If my dad was heavy, I don't think we could have cared for him at home until his passing.
3
I will be seeing my next patient in 18 minutes. I will see 11 patients this afternoon and 6 of them have BMIs over 30.
Pray tell, what am I supposed to do with this?
Let's all cure obesity!! And the opioid thing. And the ennui of modern life and every little other thing. Then spend maybe 4 hours tonight typing up the morning and afternoon jokes.
What an absurd joke, doctors.
2
All this talk of diets. So little mention of GET MOVING.
1
While I agree that research proves conclusively the necessity of exercise to good health, I think it has also suggested that it ultimately has much less impact on weight.
8
"Liberty" strikes again. People will eat themselves to death just to prove to those pointy-headed experts that non one can tell them what to do. They would never consider the "liberty" of those who pay the taxes and premiums that fund their care, or the staggering environmental damage caused by the highly-subsidized, monocrop, big ag practices that produce the unhealthy, typical American diet which they consume.
10
In my opinion, it's the culture of our country which is toxic. We are more of a nation of spectators than doers. Just count how many disengaged people you see every day staring at their phones instead of what is happening around them. People would rather look at a screen than the living, breathing humans around them.
107
How about a National Fasting Day to raise awareness that what each person puts into his mouth affects all of us as a community.
5
You are what you eat. As the data clearly illustrates Americans do not eat right. You can "diet" from now until the day you have a heart attack from eating meat and processed foods. Dieting won't keep the weight off. It will require Americans to change their diet.
Eating a salad covered with cheese, ham, and commercial dressings does nothing. Load up on the greens, lose the ham, substitute nutritional yeast for cheese, and make your own dressing. Treat sugar as the toxic substance that it is.
It is tough to eat right. Being obese is tougher. You can do it. Make up your mind and do it. Good luck and God Bless.
2
Before reading the comments on this article I wrote down these things: 1. personal anecdotes, 2. tax obesity, 3. self-righteousness, 4. losing weight is easy, 5. 'quality' food is cheap, 6. no more fat positivity! Now that I've read the comments I'm not disappointed: all items checked off. I'll spare you my personal anecdotes. What I can say is that solving obesity is not simple and compassion does not cause obesity.
14
@raftriver
Finally, a sane comment!
2
as long as we have a country that cares more about profits than people, food companies diet 'experts' and doctors will get rich.
5
It's all quite revolting really.
Families no longer have meals together. Everyone eats on the run. No one cooks.
Many Americans think fast-food is...food. Our produce comes to us in a truck driven half-way across the country and was grown using pesticides and modified seeds.
Our store shelves are full of packaged foods and frozen dinners. Entire supermarket aisles are dedicated to 'soda'.
People are too lazy to walk to the market with a shopping cart, so instead they start up their gas-guzzling SUVs, make a pitstop at Dunkin Donuts for an overly-sweetened iced coffee, then drive another three blocks just to do food shopping in the neighborhood.
Many Americans 'insist' on having TVs in their bedrooms, and slouch in bed for hours, gorging on mindless drivel. They then wonder why they are overweight, and/or why their spine/neck always feels to 'out of whack'.
People are glued to their phones. People are driving 2-ton vehicle, riding bicycles, crossing streets, but not paying attention.
It's too much trouble to bring a tiny, foldable shopping bag to the market, so instead we produce and then toss aside billions of plastic bags, which end up in our shrubs, trees, parks and oceans, littering the landscape and killing wildlife and fish.
Climate change is apparently a 'hoax', while temperatures and fires rage all across the globe.
Social media rules, and has created platforms for those with the loudest voices and the smallest minds to have the most 'influence'.
20
I don’t see a lot of obesity in NYC.
The obese people there always seem to be from elsewhere in the U. S. , never from the City or overseas.
Probably has to do with walking and education.
5
Walking. My family of four lived in NYC, where I once estimated my young children walked 2 miles a day just getting to/from school and I 4 going to drop them off and pick them up. Then, we moved to Houston and all immediately gained weight till we found extra physical activities, also moved to a walkable neighborhood.
12
As long as Republicans are in power, there's slim hope of any of the suggestions in this column seeing the light of day. That's because anything concerning public health requires a public policy that (gasp!) interferes in our God-given, all-American right to "individual freedom," and Republicans won't hear of it.
In the end, our weight is driven by three things: Habits (probably the biggest force, but also the hardest to break), public opinion (what others think of us, which is what we think about most often), and the law (which only works when it's carefully calibrated to match what's already exists or is at least calibrated to what's ascending in public opinion).
Two almost insurmountable problems not mentioned in this column are deeply psychological. The first is that public opinion today embraces being fat as a "choice," and shaming or discriminating in any way against someone because of his or her weight is not permitted. Second, the more we're surrounded by obese people, the more all of us see obesity as the normal way for a body to look.
Our destiny, it would seem, is to end up like the jolly fat people, several hundred years in the future, in the wonderful movie WALL-E. No longer able to walk or even stand up, they can only lie horizontally on their backs, smiling happily as they glide here and there on little mechanical sleds.
1
When I was in elementary school in Baltimore County, our school had a kitchen and staff and they prepared hot lunches every day. My mother worked there as an assistant and we received real food for lunch. We also received a pint of milk each day. Of course this was a long time ago (1950s).
In today's rushed world where people spend more time on their smart phones than they do planning and preparing nutritious meals, the obesity epidemic is not surprising. Too many of us spend too much time sitting or lying and not enough time exercising - even doing small exercises in the office can relieve stress.
I saw my first McDonald's in 1957 in Albuquerque. A hamburger cost 15 cents; a cheeseburger 20. Fries were a dime. These were so tempting because they were fast and cheap, and yet when I worked in a supermarket after school, I was able to bring home fresh fruits, veggies, and meat at reduced prices when the sell-by date had expired.
There was another serious temptation that is still with us today: sugar-ladened soft drinks. As kids we drank Kool-aid because our parents did not want to buy bottled soft drinks. There was sugar enough in that beverage.
Advertising for fast foods and bottled soft drinks really took off in the Fifties and has never let up. Market psychologists spend countless hours researching our habits in order to recommend ways for food companies to cater to them. It's all about making us feel "comfortable" and "secure". We are paying for this big time.
7
Just back from short stay in Amish country of PA. We ate at two of the all-you-can-day buffets that are popular thereabouts. If any researchers want to see and/or talk to obese Americans a visit to these eateries will provide ample opportunity. Kind of upsetting to know that there are so many at-risk people about. Gluttony is the coin of that realm. Such an easy deadly sin, too.
2
@Kerryman Those people who eat in titanic quantities either suffer from depression and have assosciated food with pleasure (dopamine in the limbic system), or lack the ability to produce leptin (the "I'm full, stop eating" hormone) receptors. The second group is more dangerous. They only know they are full when the stomach is full, stretched beyond capacity and hurting. As a response, their stomach grows so it does not become overwhelmed in the next time. And the cycle worsens.
5
Big government to the rescue. No, once again the solution from the Left will only serve as an additional tax on the folks that are the least able to pay for it.
4
I've never seen pizza & fries served in the same meal. Where do they do that?
2
We can help alleviate the problem by calling obesity what it is- a pathology and not a life-choice.
The recent emphasis on curbing so-called “fat shaming” is a farce.
4
Being human and having to be mindful of what "fuel" we CHOOSE is difficult. I have Celiac's which FORCES me to make qualified decisions on 1) where I can eat, and then once I'm there, 2) what I can eat. I will ask questions, and if the server/waitperson is unsure about a meal's gluten-content, I'll get a barebones salad. The key for me is to ACKNOWLEDGE that gluten will 100% sicken me pretty much immediately, and eventually could kill me. Cause and effect.
Perhaps we need to restate the problem -So it's not that being too fat or obese may make you sad, or uncomfortable, or unhealthy, but maybe that being too fat or obese WILL make you sick, and can eventually kill you.
Being diagnosed as Celiac made me very sad, and unhappy as now I have to be vigilant about my food, but it's worth it not to suffer the horrible effects of gluten-consumption, painful, and perhaps embarrassing - a great combination to keep me on course. With this vein of thought, I'm glad the ramifications of accidental or mindful wheat consumption are so terrible, that it's "easy" for me to make the right choice.
I have spent MANY a family dinner, work lunch or dinner, or cocktail reception, eating something boring and other times NOTHING AT ALL, while others enjoy scrumptious buffets of multiple options. I'd rather be bored or hungry for a little bit, than sick.
3
....And, the portions. I went to Mickey D’s the other day and I was amazed at the food that young woman put on the tray! Plus, to get a cup of ice water...she gave me some minuscule cup with a few ice cubes...told me i had to pay for a bigger cup. I had forgotten how awful Mickey D’s is...
1
Big Food, Big Pharma, Big Insurance and Big Medicine collectively make billions of dollars annually from the obesity epidemic. Since their lobbyists own Congress, no way will any changes be made that risk killing the golden goose, especially when Congress gets a piece of the action and can borrow a $trillion/year to pay for it all.
10
@James They only make money because people want and buy their products. The advertise because it’s what people want. If people genuinely wanted to be healthy then that is what would be advertised and sold. Businesses don’t choose what people want. They give them what they want.
1
Take the stairs. Walk places. Use a push mower. Shovel your snow. Drink water instead of sugary drinks. Eat three meals a day, and stop eating when you're full. Americans lived like this for generations even before "fitness" was a thing, it's not hard. Americans' refusal to take responsibility for their own obesity is really an amazing sight to behold. And their illogical defensiveness on this subject is off the charts.
194
@Jim Your point works on most people, but not on the balloons you see at all you can eat buffets. Those people who eat in titanic quantities either suffer from depression and have assosciated food with pleasure (dopamine in the limbic system), or lack the ability to produce leptin (the "I'm full, stop eating" hormone) receptors. The second group is more dangerous. They only know they are full when the stomach is full, stretched beyond capacity and hurting. As a response, their stomach grows so it does not become overwhelmed in the next time. And the cycle worsens.
4
@Jim
Thanks Jim, I agree with you but the biochemistry is a little more nuanced. High fructose corn syrup actually interrupts the satiety hormones that inform our bodies when enough is enough, plays havoc with blood sugar, and transforms into fat much faster than any other kind of sugar (especially in the liver) so it adds to the challenge for people consuming it. The companies selling this stuff and the complicit FDA need to take responsibility too. As you implied it is not mysterious or difficult to see what is happening and truly worrisome that people and our so-called food industry are so willfully ignorant or worse.
4
Reply to PA’s @Jim. My body seems to prove it is people with your opinion that cause the obesity epidemic. I do all the things you advocate, have 3 dates for breakfast, 2 eggs and bread for lunch, and whatever is cheap at the local pub for supper. I have a good size lawn and a push mower. I have a large circular driveway and shovel the snow unless it is more than 12” deep (we get a dozen storms per year). I don’t walk to the stores as it is 5 miles to groceries and 50 miles to a Home Depot. I’m up and working in my shop 6 hours a day. I’ve been watching calories for 65 years, since I was 10. I was a ski patroller for 20 years, use to run or canoe 5+ miles every day. Throughout my live I’ve been obese. Over the decades I read hundreds of notes and articles claiming I need to do the things I am already doing and I will lose weight.
There are also articles that say the bacterium in our gut controls our weight. Why do people with favorable gut bacteria always preach self-control?
3
In today’s NY Times there is anarticle advancing large sizes for women. Supposedly it is stigmatizing to segregate “plus” sizes from normal sizes! There should be “pride” for one’s body even if that body is taxing one’s heart, causing Type 2 Diabetes and stressing one’s joints. Talk about encouraging and trying to make obesity mainstream! Also, don’t knock eating less and moving more. They work!
3
One only needs to look at all the contradictory articles on obesity that get published in the NYT, and the even more contradictory comments where everyone has their pet hypothesis: the traditional energy in/energy out calorie cult, the vegans, the low-carbers, the intermittent fasters, the paleo crowd, the sugar-phobes, nobody cooks, exercises, or eat family meals anymore, food is too cheap/abundant, breakfast is bad/good, chemicals in the environment, and our sociopolitical structure, and I'm still sure I've left a few out. Every single one has some evidence for, as well as plenty of evidence against.
There is only one rational, scientific conclusion: we really don't know with any scientific certainty what causes obesity, and we sure as heck don't know how to cure it. (Cue the people who will proclaim "Sure we do, because I lost weight doing blah blah blah...", all N=1 evidence that can never be shown to work clinically for more than a small sliver of obese people and for short periods of time.)
Until the field of obesity science can find the humility to admit that, there will never be any progress toward actually solving this problem.
7
@Tom I don't think anyone is suggesting there is one explanation, or that that explanation will necessarily be the same, for everyone who's overweight.
But can anyone deny that too much sugar is not a good thing? That a sedentary lifestyle is not good? Can we also not agree that there are far more overweight Americans, than in the past? So the question becomes: what has changed, in between the time most Americans were fit and body-proportionate, to now? Well, we all have many hypothesis on that, now don't we?
5
@Lisa - Clearly, you must be reading another thread because this one is chock full of comments saying exactly that. And the experts aren't much better.
I agree there is an obesity epidemic, and never suggested there wasn't. I agree sugar is part of the problem, but note that there are still many who are skeptical, and it's only in recent years that the 'nutritional establishment' generally acknowledged that, instead focusing on fat as the problem.
My point is simply this: we, from the 'experts' down to the laypeople, clearly don't know as much as we'd like to think we do about obesity, if we did there wouldn't be this muddle of conflicting hypotheses. And that's the point in science where you have to start putting all of your assumptions up to scrutiny, otherwise nothing moves forward.
I totally agree. Tax the sugar, so that the children won't grow up addicted to it. While we're at it, tax the tea, and the stamps, and let's go ahead and have someone quartered up in our homes telling us how to eat. I can SO get behind this.
What ?
The author says "....we can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets."
Oh sorry judge, it's not my fault. I shot the kids in the school. But it wasn't my responsibility. I haven't seen any guidance from the government to encourage me to preserve life, not take it.
Can't blame the individual, eh ? I haven't seen any evidence that with every box of Krispy Kreme donuts or 18 gallon bottle of Coke, comes a gun-toting enforcer obligating the person to eat and drink it all.
So, about these policy changes then ? What will the government to do what exactly ? You think that policy changes will ever happen, given current circumstances to do with another, equally serious issue of gun control ?
What ever happened to personal responsibility ?
When the heck did you Americans (or just the author of this article) lose all common sense ? The author goes far to take the blame away from the individual. I can only imagine why.
2
Sugar is the next tobacco industry.
3
@Kelly Next? There is evidence that the tobacco industry took their cues in the 30s and 40s from Big Sugar!!
https://tobacco.ucsf.edu/sugar-industry-suppressed-evidence-health-risks...
2
I can’t remember in which movie, but I definitely recall Humphrey Bogart rather cruelly describing Sidney Greenstreet by saying “Ya can’t miss him — he must weigh 300 pounds”.
Well, today you could miss him. In fact he’d probably melt right into the crowd.
6
Don’t take more food than fits on the plate.
3
@Ed
In retirement I have found time to wander flea markets. Looking at old patterns of china is fun. It is obvious that plates used to be MUCH smaller. Most restaurants use plates that were called platters when I was a kid. So your advice would be even better if you used your grandma's plates.
12
People whose children are obese are guilty of child abuse. Pure and simple. They are raising children who will be plagued with health problems and psychological problems.
And no, it's not genetic. Years ago, people weren't obese in this country: it's overeating, and eating the wrong things. Just because an industry forces something on a population, doesn't mean you can't resist. Plenty of people have stopped smoking. As a culture, we can reject this too.
I remember two very fat little girls in the playground, year ago. I watched them over a number of days. Their mother didn't give them one cookie each, she gave them the whole bag, and they walked around eating all the cookies in the bag. There it is.
9
@Concerned Mother
Well said.
"Nobody has time to cook! We're too busy!" say the people as they drive 15 minutes to the restaurant, wait 10 minutes to be seated, wait 5 minutes to place their order, wait 15 more minutes for the meals, then wait for the check before they drive 15 more minutes back to their house.
17
The authors write: "Second, adequately fund obesity research into innovative approaches for prevention and treatment, beyond the conventional focus on eating less and moving more." That information is available now: Eat a plant based whole foods diet. My husband and I both lost weight, by practicing portion conrol and making healthier choices as vegetarians. Now that we've switched to whole foods plant based eating, our weights have drifted down even further. If we can do it, why can't others similarly situated to us do it? Check out https://nutritionfacts.org, https://www.forksoverknives.com, https://www.pcrm.org. https://www.chiphealth.com. It's not rocket science. That said, I agree with the other recommendations suggested. Especially to change our currently perverse system of incentives for food production, and to increase the availability of healthy foods in "food desserts."
4
Ludwig and Rogoff write "we can’t blame individuals and expect personal responsibility to solve the problem." I am so glad to hear that. All the junk food I've eaten over the last 10 years was beyond my individual control. Eating properly is not only not my personal responsibility, but also won't solve the problem of my obesity. On the one hand, this is the kind of writing that shows how far the once mighty NYT has fallen. On the other hand, thank you! Great stuff! Time for breakfast.
2
Junk food is a cheap and available drug. Until we come to terms with that fact, nothing will change.
12
Maybe we should cut diabetes funding from the Affordable Care Act. That seems like the next Trump Executive Order.
"These policies would ... even promote a modicum of political comity."
The problem is that you would need *to begin with* a significant level of political comity to pass such an ambitious and beneficial raft of policies. That comity in no way exists at present, and it probably never has.
Your policy prescriptions seem sound, but they presume that our government cares about people and seeks to improve their lives. However, the entire GOP reason-for-being since Reagan has been to destroy government. Less government, theoretically, means lower taxes, which in turn, erroneously, means less white money going to dark people. (Although in truth it is predominantly whites who use government relief programs, the GOP "alternative-facts" brigade will never concede that reality.)
You are living in a dream world. Congress will always do what its donors demand. Its paymasters, such as "Big Ag" or "Big Food," finance the re-election contests of those who do their bidding. Constituents, actual persons residing in a legislator's district or state, are only rubes to be conned anew every two or six years. Whether they are healthy or obese is of no concern to those who purport to represent them in Congress.
2
If you have traveled around the USA with your eyes open you have seen how truly unhealthy, both physically and mentally, this nation has become. Go to a gas station in France and see the variety of fresh and well made food items there are. Good luck finding fresh vegetables, or high-quality meats and cheeses while traveling outside of major cities in the US. Here, we happily consume garbage...bad food, bad entertainment...but people do have the power to make better choices for themselves and their families.
5
The US doesn't need Russia or ISIS to get wiped out. It will happen eventually just with fast food.
Who would have thought that the biggest enemy sits on the plate in front of you, presented by the corporate food industry.
2
...and the Republicans MOCKED...MOCKED...and MOCKED (repeatedly) Michelle Obama's well-sourced efforts to enable schools to supply healthier lunches to their students.
We get the government we deserve, I'm afraid.
30
So the authors’ solution is to essentially have the government ration the public’s food by limiting its choices through supply and advertising regulations. These authors should never write a paper again. This ain’t Russia nor China.
@Pilot It's worth noting that the federal government facilitated this situation in the 70s and beyond by heavily subsidizing farms and companies that produce the ingredients (soy, corn, etc) that probably started this epidemic by offering subsidies that drive the cost of fattening foods down to unrealistic levels. Using the power of the government to reverse that would seem like a good use of their reach and authority.
13
I have often wondered if the obesity crisis is much like the opioid crisis - a mental health issue. Many people self-medicate with food just like with other substances. Our entire society just seems miserable.
14
@JoAnne I think you may be onto something. I think in general, the US has collectively lost its soul. Extended families now live separated. Job security has gone out the window for a large % of the population. Global warming. Our healthcare system is one hot mess. National infrastructure maintenance/improvement has been forgotten about. The level of our public education is abhorrent. If you want higher education, you can expect to pay for that for the rest of your life. Corporate greed continues, while workers get no raises or raises that are an insult. Trump. The incessant bad news from all over the globe, brought to us 24/7. Most people preparing to retire have little to no pensions. No one makes eye contact or engages with those around them, but instead is glued to their glowing devices. People 'stuff their faces' with snacks, cookies, ice cream, as they sit planted in front of their 64" flat screen TV binge-watching Real Housewives from their beds. Local politicians are beholden to real estate developers and rubber stamp project after project, decimating neighborhoods and cities all across the US. The NRA owns our congressmen/women.
The US spends more on war than the next seven countries combined. The US and its For- Profit Prison System has the Highest Incarceration Rate. In The World. And the majority of those in our prisons have a Mental Illness.
We are so, so lost.
4
@Lisa - Thank you for your response. I agree with all. I recently visited Canada - everyone seemed much more relaxed and happy. I am sure universal healthcare contributes to that. Kind and helpful people, cleaner air, public transit, more music, outdoor cafes, etc. Would move in a minute if it was practical.
The biggest difference i've noted between being a child in the 60s and being a child now is the quantity of "snacks" one has throughout the day. We used to be hungry at mealtime, sometimes very hungry. I understand that we don't want children to feel hungry, but look what has happened. Feeling hungry doesn't mean you'll die, if you have a meal coming up in an hour or two. I think we need to get rid of this idea of feed on demand.
29
@Hope
I agree. I did Nature Trail walks with children and parents, and the parents could not stop shoving food into their children.
I finally started 1/2 h walks by asking kids what kind of animals did they think they might see? And what do those animals eat?
Then I said they do not each "our" food, so put it away please, we will have snack or lunch AFTER the hike.
Children understood, parents were just outraged.
3
@Hope
That's true. When I grew up (50's and 60's), we (i.e., my 5 siblings and I) were allowed to have snacks at certain times of the day, and my mother controlled the content of the snacks. which sometimes included cookies or toast, but usually involved raw carrots or fruit. In the summer, we were allowed to raid the garden for cherry tomatoes or raw peas whenever we wanted.
2
@Ivy
This is true, but it's not just kids, it's adults too. I can't count the number of meetings I have attended where people apparently thought they would perish without donuts or pastries of some sort. If people get together for a half hour, apparently they have to have something to eat at the same time (even though most of them had breakfast a couple hours ago, and will have lunch within 2 hours).
Learning how to be healthy begins at home. And yes, it is about what and how much you eat. I used to jog 40 minutes a day and still was 50 lbs overweight. I gave up all alcohol, which completely curbed my appetite and improved my judgement, started doing planks and push ups at home and lost 50 lbs over a year. No 'diets' or gyms necessary. At 45 I am in the best shape of my life. I did this for me, but also for my son (6 yrs), because I want to set the right example for him. He has never had processed foods or sugary foods at home, other than home baked goodies, which he loves. He doesn't like the taste of potato chips, greasy pizza or any fast food or candy (except real chocolate) because he has never eaten it on a regular basis. He forgets about his Halloween candy the day after and doesn't care about it at all. I have never prohibited it, just not encouraged it or made it readily available. We exercise together as much as possible and eat small portions (enough). He is lean and healthy, sleeps great and is active, has no cravings at all for any foods, and gets to eat ice cream (1 scoop) for dessert whenever he wants. It's all about portion control, not eating processed foods, and cutting out the excess. Any habit can be broken after 3 weeks, you just have to stick it out. And it is worth it. Teaching kids how to be healthy is critical and parents must set the example.
19
@EWG And one more thing: no sugary drinks. Do not drink your calories! What a waste, most juices included. My son has always had just water and occasionally milk (also breast fed for first 2 years). He has never wanted or asked for soda or sugary juices, because I don't drink them either or have them in the house. Even on his own, in camp, class or at birthday parties, he chooses water every time. That is basic education and healthy habits, and it works.
@EWG
Sounds great -you are doing a good job, and your son is very fortunate.
Sometimes I think that as a country our relationship with size and weight is as fraught as the one we have with race. On the front digital page today we have this artical discussing the epidemic/pandamic of obesity and the cost to society, and then we have the article on how clothing sizes make people feel bad because they are random and nothing more than floating indicators of thin privilege (or some such jargon). At the same time Netflix is being petitioned to not air a show where the protagonist gets fat-shamed because in this era of body positivity, no one should be made to feel bad about their bodies.
Various media messages add dimension to the discussion of obesity but also are drowning out real science about the cascade of problems that comes with being overweight.
We need to be more vigilant about separating frustrations with vanity sizing in clothing from the fact that the average American woman wears larger than a size 12, and likely considered obese or morbidly obese on the BMI scale. No one should be shamed for being overweight, but we must not fail to address obesity because it makes someone feel bad about themselves.
6
@Gail O'Connor
Actually, fat "shaming" needs to be done, but without being mean spirited. Fat "consequences."
Plant Based Diet. Cook at home, chew your food well, walk around your neighborhood. Eliminate sugar as much as possible. Read about healthy lifestyles, ask questions, be curious, choose a healthcare provider who looks healthy. You can do it!
3
What about the role of stress in weight gain? Give people an opportunity to make a decent living without having to work multiple jobs and the obesity rate would go down. There’s a lot of untreated chronic pain, mental health issues, and chronic illness out there that makes it hard for folks to avoid self-medicating with food. It’s not all a matter of individual self-control. People have only so much willpower to expend in the course of a day.
12
I wish schools would take PE (physical education) for all more seriously. Too often, coaches and parents focus on star athletes in some sick, vicarious fantasy and/or the fantasy of having college paid for or a career in pro sports for the athletic kid. By all means, take each kid as far as they want to go and their talents will take them, but get serious about having all children introduced to physical activity they might like and do all their lives. Too often, all the focus is just on sports stars, with so many more kids shut out of even playing the sport they like by elementary school and then there are PE classes that the coaches use as an excuse to read the paper while the most unfit, awkward kids, the ones most in need of coaching, sit in the bleachers and look at their phones.
I think every kid should have a serious PE experience throughout their schooling. Everybody doesn’t have to be on the varsity team but I think, in any sport, schools should have as many teams at all levels as there is interest. And the variety of options should be expanded. Don’t like competitive sports? Have a hiking club, a gym workout club, yoga, martial arts, fencing, swimming, agility train with their dogs, whatever tickles their fancy and gets them moving. Kids should be required to pick something to do every semester or quarter. And teach them real nutrition information too.
7
Few of us have the time to cook from scratch, and fewer still know how. Thus, we are beholden to the food industry who have made long term storage and addictive palatability a fine science. Neither of these translates to easy availability of healthy food. Add to this a government that awards subsidies to farmers growing grains, but not fresh fruits and vegetables, so that the cost of the healthiest foods is prohibitive. The bottom line (no pun intended) is that people have to get and stay married, someone has to stay home and cook, budgets have to be adjusted accordingly, farmers have to be supported for growing low-calorie, nutrient-dense food. We have to change the way we live, if we want to live long and healthy lives, physically and mentally. And, we have to stop accepting that obesity is normal.
3
@sandhillgarden
I prepare meals from scratch nightly upon returning from work, making double portions that allow me to reheat the leftovers for lunch at work. Washing and peeling vegetables takes ten minutes, tops. It is possible to cook something decent in under half an hour. As far as time considerations, it is also possible to prepare such meals in advance during the weekend before storing them in the freezer. All a question of willpower and organisation.
16
@sandhillgarden I don’t believe that people have a lack of options. If you look at statistics, lower income people are the largest users of several expensive though unhealthy habits. Lower income individuals smoke more even though cigarettes are more expensive than ever. They tend to eat out a lot even though eating at home is more affordable. There are fresh food stands and markets everywhere. It’s teally just a choice.
5
@sandhillgarden
I can cook a simple, healthy meal in 20 minutes. I know how and I'm no one special. All it takes to learn is a bit of interest.
Anyone one whose finances are so tight that they have to watch their budget closely for food is being highly irresponsible if they spend a single dollar on junk food. Ever $2 spent on Coke could have been spent on apples.
9
I would go so far as to make continuing medical coverage for the obese dependent upon continuing weight loss. Each month you don't lose weight -- you get no treatment.
Yes, that can lead to early demise. But if one is insistent upon killing oneself with gluttony -- I don't want to delay the inevitable by depleting my very limited financial resources paying for your care.
Before you start criticizing me as lacking understanding: Been there, took care of the problem. Went from 237 lb and watching sports all weekend when I was 38 to 178 and running 30 miles a week by age 43.
Now 80, and planning yet more hiking in Shenandoah this fall. In spite of major cancer surgery a year ago.
Nike: "Just Do It."
9
@Texas Liberal
You seem to equate obesity with gluttony, one of the seven deadly sins. For some of us, the craving for food has a physical, biological origin. It's not something we wish for, no more than having restless leg syndrome. More research is needed into the physiology of hunger and craving. These are not sins in the biblical sense. They are treatable, though this may cost a lot of money. Not all of us can pass through a metamorphosis and become a healthy runner. One's ability to change eating and exercise habits depends upon many environmental factors, not the least of which is the access to a safe outdoor place in which to walk and exercise without fear of being shot. So, good for you that you have lived so long and are healthy. For others, the crisis with food, overweight, diabetes, and other physical ailments is a real mountain to climb.
6
@Texas Liberal--I'm sure you have this all figured out, but what happens if the "obese dependent" is on medication which hampers/prevents weight loss? In other words, they have to take medication to treat their pre-existing illness, i.e, it's the medication which is making them "overweight."
I have composed a list for your education because you seem to be clueless about this: steroids--which are used to treat illnesses such as Multiple sclerosis, lupus, etc.; anti-convulsants to treat seizures or bipolar illness; anti-depressants; thyroid medication (not to mention thyroid illness which can cause obesity and weight problems); cancer drugs can also put weight on some people.
You seem to have lost a lot of empathy along with your weight.
3
Portland, Oregon and it's reverence for craft beer is contributing to obesity here. In my neighborhood there are about 20 bars within walking distance. Some are small boutique places serving as outlets for the brewery in the back. People drink their fool heads off. 3-4 12 ounce beers...all artisnal, sweet, sour, tart, notes of this that and the other thing...combined with a a big huge pile of salty locally grown fries, hand rolled, overstuffed burritos and multi layered burgers...meat, cheese, bacon, meat, cheese bacon...Then we have the Happy Hour on Steroids...half price drinks...and half price food. People just stuff themselves after work. There is empirical evidence that men's weight, age 20-40 has increased 30% in the 10 years. Men's bellies routinely hang over their belt buckles..s and women can barely fit into their fashion forward yoga pants...diabetes is coming.
13
In the Bay Area too. As an experiment, I stopped drinking entirely from mid-May until the end of June. I didn't otherwise change my eating habits or fitness routine. I lost maybe only 4 pounds, but my body fat percentage decreased significantly. It seems like my whole metabolism changed.
4
@Harley Leiber
According to one study in Switzerland, alcohol slows down our metabolism by 30%. This should provide some pause for reflection before downing those artisanal suds.
Went to a concert this summer and the sea of overweight/obese people drinking copious quantities of beer was very depressing. Don't they know what they are doing?? Of course, try to say anything, and people think you are being a buttinsky. Or impinging on their freedom.
Worst, still, is the U.S.'s exportation of packaged foods to Latin America. The Times did an excellent article on this in a December 2017 entitled: A Nasty, Nafta-Related Surprise: Mexico's Soaring Obesity.
Such a troubling issue. It's the children I feel the worst for.
https://www.nytimes.com/2017/12/11/health/obesity-mexico-nafta.html
5
The US is devouring itself from within. Parents should not need pediatricians to tell them their children are dangerously obese. Don't expect anything good from our junk food President who needs a golf cart to go a few yards. And who keeps his farm base raising meat instead of promoting a plant based diet better for people, for the planet. Not happening.
9
So how do you make all this advice not sound so elitist?
1
We are digging our graves with our mouths...
5
Michelle Obama encouraged people to eat more plants and move more. For this she was met with arguments about “freedom” and cries of the “nanny state.” I live in a red state and work with lots of fat white Trump supporters. I give up. Let them eat their processed fried foods while watching Fox News. Their health is none of my concern.
50
@E
Except that your hard-earned wages will be taxed to pay for their care.
4
I saw a sign at a protest: “High cholesterol is our only hope.” :)
6
@Kosher Dill, not really because there won’t be healthcare anymore ;)
Put an scale in all the schools with a red blinking light that shouts YOU ARE FAT when the Body Mass Index is over 25
2
@Manuel: People, including kids, already know when they're over-weight. And public shaming serves no purpose. In fact, shaming people will often make it more emotionally difficult for them to seek help.
13
I was a chubby kid. I knew it, and sometimes got picked on. But mum suffered from mental illness and many times unable to get out of bed she would hand us some money to go get hot chips (fries) for lunch or dinner (sometimes both). It wasn’t until i had moved out of home, and learned about nutrition that I was able to take control. But as a kid I had none to little control. So your idea doesn’t just lack logic (how is a child going to change family eating routines and habits?), but it is cruel and lacks compassion for an individual already struggling.
20
Something happened to Americans after the 1970s. Just take a look at any concert scene or game show audience video from an earlier time period in the United States. I personally believe that much of America's obesity crisis lies with an overall tolerance and indifference towards personal appearance, a virtually zero sense of style. Everything in America is geared towards utilitarianism, including diet and apparel. So content yourself with easy to prepare meals with unsubtle tastes when slipping into those XXL clothes which are now the new norm. Americans are quite content with morbid obesity, with the minuscule exception of a few scattered gym buffs.
8
@AE
Right. Of my parents' generation (would be in 80s if alive) to their death, all men and women could tuck shirts into pants or jeans and belt them.
Of my generation (50s) it's a tossup.
Of the 30-somethings I interact with in my neighborhood (which has a Kroger, two Whole-Foods type stores, a local upscale chain, a big-box regional chain and various other food stores literally within two miles) all but one of the men are obese, wear huge loose shorts with huge shirts hanging out over their guts, and use power equipment to do even the smallest task. They'll stand there and wave a gasoline leaf blower forth and back to blow a handful of grass clippings rather than reach down for them or grab a broom. It boggles the mind.
I work in a university town and the obesity among 19-25-year-olds is not quite as universal but also stunning. Of the pink-collar and health care workers at the teaching hospital, most are significantly overweight if not outright obese. And that's with financial rewards and other incentives for healthy eating and living.
5
@Kosher Dill
A very thorough and realistic demographic assessment. I just don't think that the majority of overweight people are perturbed enough anymore by the aesthetic side of things. It's almost as if folks have become totally body unconscious. Of course, there is no need to tilt towards fashion house shallowness and the other extreme of anorexia. It seems as though any desire to please or -- gasp ! -- seduce a third party has completely evaporated in American society today. No need to dress modestly in today's social scene....
@AE
People smoked more in the 70' and 80's. Smoking curbs appetite. Smoking serves as a reward (the way food does now).
7
I hope Dr. Ludwig knows his way around an Excel spreadsheet. https://www.nytimes.com/2013/04/19/opinion/krugman-the-excel-depression....
This again? Everyone's tired of politics so let's start calling fat people names again? If you don't like looking at people who aren't stick-thin, look at something else. Perhaps you could distract yourself with all those thoughts about how perfect you are? I'm so sick of the obesity canard. What someone else does with their body is not one little bit of your business. (And with that I'm sure twenty people will trot out the "but insurance premiums! but taxes! but public safety! but all these other things!" arguments...please save it.) No processed-foods tax, no sugar tax, no taxes on anything that you think those poor people, those lazy people, those fat pigs spend hours shoveling into their mouths. So tired of all the judgment. (And--surprise!!--I'm not fat.)
5
@Tabby Brown-Thomas
Whose business? Dr. Ludwig's (the author of this opinion piece who sees the increase in obese children and adults, that results in human suffering?
2
@Tabby Brown-Thomas
Do you think it will be my business to have my wages confiscated via taxation to pay for the diabetes, alzheimer's, liver failure, kidney failure, amputations, knee replacements and other care that these fat people will need? I have a stake in how obese others are, and so do you.
3
@ Tabby Brown=Thomas
"What someone else does with their body is not one little bit of your business".
I wholeheartedly agree with this comment when it comes to women's choices and same sex marriage.
Obesity though is one of the reasons that the US has to spend more than three times as much per person on healthcare compared to all other OECD nations.
Of all OECD countries the US also has the highest rate of obesity plus inequality, which resulted in a shorter life expectancy that in the rest of the countries.
And many of these nations have already forbidden the marketing to children of sodas, energy-drinks, energy bars, etc. that are loaded with three times the sugar that a child should consume per day in order not to get early onset diabetes.
7
How dare you fat-shame our people of size? Apparently you haven't heard the news: morbid obesity is just another lifestyle choice made by people exercising their free will and autonomy, and they -- dare I say we -- will not allow you to marginalize them further with your scientific and medical evidence. The othering of those of size is damaging, hurtful, bigoted, and a paternalistic imposing of "standards of size" on a population whose positionality has rarely been listened to with the respect and care that it deserves.
2
The author's 5 step program seems rational enough - but totally unrealistic.
The US population like in no other country is deeply suspicious of government and government intervention.
Remember death panels! Remember the Affordable Care debate! Forbidding lead in paint took over fifty years nationally| and so on ... A model how to solve this problem may follow the Tobacco approach - through the judicial system.
1
If I ran things I'd say to every overweight adult in America that you have two years to get to the "recommended" healthy weight. If you show-up for medical care overweight after the two year grace period you'd (1.) receive less medical care and/or (2.) pay more for your coverage. The cost of treating obesity-related diabetes in America will bankrupt the nation alone. Same goes for cigarette smokers. Two years to quit. Show-up for federally funded healthcare with nicotine in your blood and you'll receive less care and/or pay more.
3
When I was a child and my parents took us to the grocery store they taught us how to shop. My Dad taught me to count the number of ingredients in processed foods and to avoid foods that were heavily processed. I was taught how to pick produce and at home I learned how to make basic meals.
Those skills came in handy during the years when I struggled to make a living and raise a family.
We now have entire generations of people who aren't taught how to shop for food and cook it properly and we're paying the price for it.
16
Most of the data shows snapshots… health issues among individuals at specific BMIs. In general, people add pounds as they age. Today’s overweight seniors were probably normal-weight young people. Today, with so many overweight and obese young people, it’s reasonable to imagine that seniors 30, 40, 50 years from now will likely be morbidly obese… if they’re even still alive.
Do we know the impact of being overweight over the majority of one’s lifespan? Health impacts of obesity times years of being obese can’t be assessed in snapshots. When that data become available, the picture is likely to be far worse than what we’re seeing now due to long-term impacts of health issues.
Fat shaming aside… no matter how hard it is to lose weight when we’re young; it usually gets harder. And the long-term health impacts multiply because of the long-term exposure to health issues. We need to stop pretending that weight issues are about vanity and self image. Emergency tough love is certainly called for!
7
Love America? Stay thin and fit.
6
One way to attack the added sugar problem is to address corn subsidies. I don't want corn farmers to go out of business, but high fructose corn syrup has no place in a healthy diet. What if farmers instead grew corn for use in compostable containers? To insure that the corn is used that way, the subsidy would be paid to the producers of the containers, rather than the farmers. Better for health, better for the environment.
12
@svk58 - I like this idea a lot. Another product made from corn is ethanol, which lowers our use of fossil fuels and creates jobs and income for rural regions. Gets a lot of bad press, but overall bioethanol is a good thing and diverts what would otherwise be converted to more sugar.
1
@JoeM
Ethanol can be made cheaply from sugar cane grown in really poor land. Corn is expensive to raise...and IMO should be used as a food crop only. (Fresh corn on the cob this year is 75- 80 cents per!!) During WWII there were Victory Gardens.... Frank Lloyd Wright suggested green roofs on city high rises. (Insurance companies want no one on the roof.) London has garden plots all over. In NYC the few gardens are chained shut. Community might solve the problem ,, if one could find it. PS we throw out tons of fresh good daily -- rather than lower prices and stock less. (Only Trader Joe's seems to have empty shelves ... perhaps Aldi's.
The garbage economy throws it away that starves its citizens.
What, really, is the point of publishing Opinion pieces like this in the New York Times?
It seems that what it's really intended to do is provide a forum for the finger-wagging, science-denying warriors for personal responsibility yet another opportunity to tell us all how THEY limit their daily intake to either nothing but meat or nothing but vegetables, exercise tirelessly and are really sick and tired of paying the bill for lazy, stupid fatties.
Really -- read the comments and see if at least half of them don't fall into that category.
It's easy to castigate the fat -- no one loves them, we all KNOW what made them get fat. You can't reason with anti-fat crusaders. You're never going to get them to acknowledge reality -- that body weight is not completely within our ability to control, that being fat is not a mental disorder, that if fat people would just put down the fork and take a walk once in a while, they'd be thin.
Please stop giving them a platform for their hate by publishing stories like this. Adding fuel to the fire of anti-fat people fury by toting up the cost doesn't really help anyone.
11
When smoking was finally taken seriously as causing a whole host of illnesses, warnings started to appear on cigarette packs, in doctor's offices, and cigarette ads were pulled from all media. Sports events stopped taking cigarette company sponsorships and eventually smoking bans were put into place in restaurants and other places. The key though was that the information was actively promoted in pretty graphic ways. They used to run ads of ex-smokers talking through a hole in their throats or sucking on an oxygen mask because of COPD. Doctors and pharmaceuticals got on board with helping people quit smoking. The same thing has to happen with obesity. Being fat is not the worst part of obesity and that information needs to get out. Unfortunately, what we see on TV reality shows are the worst cases which gives false reassurance to someone who is 25, 30 even 50 pounds overweight because they aren't as bad. The message has to be delivered over and over until it gets through to at least enough people that it makes a difference. Not the before and after picture of someone who has lost weight, but how about Surgeon General ads of someone with Type 2 diabetes saying that losing weight meant they could stop medication, or someone dying from Stage 4 liver disease saying that eating a healthy diet means you don't die from the complications of cirrhosis caused by fatty liver. Does the US still have a Surgeon General?
9
There is a profound difference between the BMI of the average
person on the street here in Malmö, Sweden, and that of a person on the street in Los Angeles, NewYork or Chicago.
Why ? I think one clear difference is the weight put on making
your own meal here ( from raw products) and the ban on certain
oils ( for frying..) in restaurants: one can actually smell the difference !
But the biggest difference might be the emphasis on sports in school. F.ex. its a stated goal that all children must learn to swim
at least 150 meters ( actually all citizens...)
People here walk and bike a LOT ! One reason is that the infrastructure is mature. Its not that the weather or geography
is more accomodating here ; on the contrary.
Could this be part of the explantion ?
19
@Jon Fuglsang
People in Europe definitely walk more in Europe than the U.S. But my own unscientific observations in dozens of trips a year to Europe and Africa is that people all over have been getting larger and larger (not as much as in US airports). I rarely saw obesity outside the U.S. but in the past ten years it has increased a lot. I truly believe it is something about the food supply. Processed foods are a far greater part of diets in Africa over the past decade (and Kentucky Fried Chicken).
2
Thank you for a most illuminating update of the ravages of Obesity. Of course, this is not new, as the 'fast food' industry has been able to gouge our health for the profit that it entails. Akin to a carbon tax to dissuade polluters and protect the environment, the 'sugar mafia' must be stopped from pushing sodas (and the like), and switching to nutritionally- sound good-tasting food; the industry that bases it's business in 'poisoning us' must be made to pay a heavy tax, hopefully to change their habits or, even better, be part of a solution to prevent disease and premature death. Too bad the F.D.A. is toothless and/or looking the other way, a dereliction of duty leading to obesity and it's results (hypertension, cardiac disease, diabetes, cancer and Alzheimer's). Akin to teaching 'civics' in school, and participate in politics so to minimize the assault of demagogues and charlatans 'a la Trump' to screw us all, nutrition and physical activity (now optional only, a shame) must be taught since elementary school...while providing the right foodstuff at school, so a healthy habit is created not only in students but extensive to their families as well. If you look at the social injustice for a persistent inequality in this 'rich' country, the current discrimination in Housing, Health and Education is many times more expensive than providing a more decent and equitable share of the economic pie. And Trump's conversion of this democracy into a pluto-kleptocracy doesn't help a bit.
5
it might also help to enroll new parents in a program that outlines and encourages feeding children in a healthy way and making sure they have exercise. follow up every six months or year as children's nutritional needs and appetites expand. we spend so much on trying to make sure children and mothers are healthy through pregnancy, and then drop it all once a child is born. encourage parents to limit time in front of televisions, in use of electronic devices, etc. nothing will turn the clock back, but certainly we can do a better job going forward.
3
There seems to be a misconception that obese people can't monetarily afford to lose weight, but this is honestly false. The number one cause of obesity is simply eating too much; Eating less saves money. The second leading cause of obesity is eating too much sugar (actually drinking it); Switch to water for all drinks and save money. And there are better processed foods and worse ones. Cut out the Swanson Hungry Man dinner and replace it with frozen fish fillets and a side of cheap rice. Maybe with half a $1 can of green beans. You don't need to eat expensive fresh organic produce from Whole Foods to eat ok. And physical activity is free.
9
@Jim - I agree with some of what you are saying but a better meal than the frozen fish and cheap rice would be vegetable soup and some whole grain bread.
3
The secret to keeping your weight down is activity. You can eat a lot if you have an active lifestyle. I work 8-10 hours a day at a desk (but I stand and walk around a lot). I never take an elevator if there are stairs, I get 10-15,000 steps in every day (or more) and I do some kind of physical activity every day. It's not that difficult if you make it part of a lifestyle. I weigh less now than I did at 18 and I am middle age. I have no health issues. And surprisingly I have bad eating habits (lots of junk food) but I rarely eat sugar. And I eat small portions. There is a way if there is will.
3
Name a malady, and somewhere there is a utopian progressive with a government plan to solve it. And, of course, that plan promises massive resource savings and other benefits is we can simply order everyone to live and behave as the progressives would direct us. Why are progressives so controlling and absolutely opposed to individual liberty? More importantly, why is it that every time we implement one of these miraculous progressive plans, the underlying problem never gets solved, government grows and our taxes increase? Save us from the know-it-alls!
2
@AR Clayboy - like those liberals that insisted we wear seatbelts, or banned advertising of cigarettes to kids? The trouble with your approach is that it doesn’t work! I am not for an all powerful government by any means, but in some cases a top down approach is better that the alternative. I believe there is a role for government in the case of obesity, just as there is a need for individuals, and parents in particular, to take responsibility.
13
@AR Clayboy
Do you have any helpful suggestions, or.....?
3
@AR Why are you including politics in this debate and particularly the progressive? As you started the debate yourself the countries will less obese people are mostly European countries (Japan should also included), most of them very progressive on social issues. Once again being progressive does not mean loss of individual liberty (you need to better understand the english language!), on the contrary progressive means accepting the evolution of society based on reality contrary to conservative ideas which does not accept evolution and debate of ideas. Anyway obesity can be fought thru education and fighting poverty and ignorance.
6
How wonderful to see Mr Rogoff acknowledging the need to eliminate food deserts, but the idea of more tax cuts for repubs when what we need is support to get low income families in higher cost areas, for there to be more exercise options for inner city kids, and for low income people to have reasonable commutes so they have time as well as opportunity to exercise.
1
It's not so bad. People are making millions of dollars off obesity. We've created an industry and we're exporting it. There are American fast food restaurants all over the world now.
3
My husband and I were watching an documentary about the 1970's. It was striking that almost everyone was thin. I don't know what has happened to our food supply, our national pastimes, or our knowledge of healthy eating and healthy exercising but something has gone horribly wrong. Why are so many people obese? I do put significant blame on the food industry which has worked to make the American public addicted to a combination of sugar, fat, and salt. I am almost 70. I remember the 70's. Food was not a marketable commodity then. We ate because we needed to eat. We did not see huge images of food about to be eaten on television. It is time to return to some sane, non-profit driven food rules. Good article.
34
@Realist I love this quote: "Food was not a marketable commodity then. We ate because we needed to eat."
2
This article is just the same ol', same ol'. And that's fine, I guess. There's the "usual" value in the points made.
But let's take a look at the addictive nature of some foods ... namely SUGAR. It's a highly, highly addictive substance.
And let's take a look at the addictive processes around eating. We eat to relieve extreme boredom in the workplace, to "stuff" emotions we can't or won't deal with, to "fit in" with other people, to relieve all manner of frustrations we face in daily living, to help us forget this cracking up, burning up world we're now living in, to relieve enduring loneliness.
Everything in this article could be enacted, and it still would not touch the addictive nature of foods and of processes around eating.
5
@P H - your point about the addictive nature of some foods is valid. But WHY is the problem so much worse NOW than in the past? The nature of the foods hasn't changed. It's a question that is very much worth exploring.
4
@J Jencks - The nature of foods has changed a lot. Check out how many foods have high fructose corn syrup in them.
@DR - True. The nature of foods has changed, in a respect. We're using more of some types of foods we didn't use in the past.
Of course, if we actually did our own cooking, there wouldn't be much high fructose corn syrup in our meals. After all, who keeps it in their kitchens? Clearly, the problem in that respect is with our dependence on prepared foods.
But sugar in general, the example used by P H, has been plentiful and cheap for several generations. So, why is it that this generation has so much more of a problem with "addictive" eating? Other's have commented on that as well. One woman commented how when she was a child you didn't see all this focus on food as something special, worthy of lots of advertising, sports sponsorships, etc. Food was just something one ate because one needed to.
A huge, huge part of this problem is the consumption of processed and pre-made foods. There are a variety of ways to flavor these foods but typically a heavy dose of sodium and fat are the cheapest options. Yes, it is more expensive and takes more planning to eat healthy foods, but it isn't impossible.
Items like greens and carrots, dry beans (especially in bulk), whole grains like quinoa bulgar or brown rice (again in bulk), are not expensive and are very nutrient rich. Yes, you have to cook them and plan, because they take time, but the rewards are delicious food that is good for you.
Unfortunately, we are currently subsidizing future health problems by permitting highly processed foods, highly refined sugars, and high sodium processed foods to be a huge part of of our supplemental food programs.
I do understand that these items represent a convenience and are sometimes the only thing available in urban "food deserts", but we need to figure out a way (whether it is as described in the article or not) to place healthier foods within reach of more of our people.
Also, having worked in commercial kitchens for years, there is a learning curve that is significant. Providing some education about sanitation, prep, cooking, and storage would be very helpful. You can't take advantage of things like dry beans if you don't know how to cook them properly.
At the end of day, foods that are prepared at home are much more cost effective, healthier, and actually less expensive!
12
Ours is an era of declining personal responsibility and self-discipline.
The obesity epidemic is but one manifestation of this cultural decadence. Yes, decadence.
28
@R. R. Let's not forget that over the last 50 years consumers have seen a variety and volume of processed foods with added salt and sugar that have never before been witnessed in human history. It's awfully hard to give someone 10,000 choices of what to eat and then claim they're irresponsible when they don't choose one of the 8 that are actually healthy.
Perhaps a cap-and-trade system for added sugar and salt in the American diet?
6
@Mark
Only self-discipline will change personal behavior.
If you want to blame this or that, you will get fatter.
@R. R. Lol to that nonsense. Decadence is me, and the people in the same economic & social circles I occupy, eating $20 organic barley & beet salads with turmeric dressing. Decadence is having the time to go run for an hour before work or afford a gym membership and pilates classes.
3
I fully agree with starting our kids early with healthy eating and exercise, less food advertisement, and a healthy farm bill -- all excellent starts!
But I wonder how much our dependence on cars to move around is exacerbating the obesity problem as we age? Perhaps better urban planning, with less asphalt for cars and parking lots, more green areas and pedestrian-friendly local markets, and more emphasis on walking, biking, and taking public transportation to places, would be beneficial for our bodies as well as for our environment.
10
@Steve WE have to stop using pesticides, hormones and antibiotics !!!!! People can't afford organics... We eat food full of estrogen and generally don't have normal natural smell and taste. We eat chemicals.... It is American greed to get more money from everything.
3
"Seventy percent of American adults are at least overweight, and body weight is strongly influenced by biology; we can’t blame individuals and expect personal responsibility to solve the problem."
Sorry but we CAN blame individuals. Even low-income people can eat an apple a day and take 30 mins 3 times a week to do some light exercise.
10
@Minnie Yes, and let's provide neighborhoods for them to live in so they can walk without fear for their safety.
3
@Minnie - If all it took was eating an apple a day and 90 minutes of exercise a week, no one would be obese. It's easy to cast blame if you can actually believe it's that simple or easy.
5
The "System" is rigged. The foods that are mass marketed contain manipulated foods (GMOs) along with addictive sugars (corn syrup, etc) that make you crave more. Those who are interested in what real food is may want to check out the Weston Price Foundation. To heal myself, I saw a nutritionist who put me on the GAPS diet. Very low sugar no grains - mostly meat and vegetables with a little bit of fruit and I feel so much better. We are what we eat.
5
@TLUF- the GMO issue is a red herring and distracts from the real issues at hand. I agree that sugar is a huge problem, but bristle when people try to tell me that all natural sucrose is somehow healthier than HFCS - it is not.
3
@JoeM, on the contrary, I believe GMOs are part of the problem. Glyphosate is everywhere in the food system. I've read that it contributes to weight gain
@TLUF - glyphosate is another non-issue. Before glyphosate there was atrazine and 2,4-D etc. Do some research and try to determine exactly how much glyphosate remains in food - the amounts are really, really low Andy well below toxic levels. Blaming trace chemicals in food distracts from the real issue of overconsumption. Don’t fall for the Big Lie that trace contaminants are the bulk of the problem. The only trace contaminant you need worry about is all natural, GMO-free E. coli and other food pathogens.
"We can’t blame individuals and expect personal responsibility to solve the problem."
"People can lose meaningful amounts of weight and lower their risk of heart disease by limiting sugar, refined grains and processed foods."
Those two statements appear to be a bit contradictory.
If people can lose weight by changing their diets it would seem that personal responsibility can indeed be quite helpful.
22
With regard to diet:
When I was 25, and a medical intern, I gained 14 pounds - 150 to 165, The hospital gave us starched canvas uniforms and I was too big for my britches. Over the next three months I lost the 15 pounds by eating less (easy because I had very little money and where I could east was limited by my work), My physical activity did not increase for the reason already given.
The plus side of this is that my stomach (a smooth muscle organ) shrank as well as my waist. After I had lost the weight I found that I could not comfortably eat as much as formerly.
It is probably better to exercise as well, but recently during a post-operative period I lost another 6 pounds because I had no appetite.
I am currently in my 9th decade.
11
I appreciate the earnest call to action regarding the personal, community and national implications of increasing obesity. As a rural family physician, I have seen the toll it has taken on many of my patients and our health system.
I also agree strongly with the need for our broader community, culture and nation to come together to honestly face these challenges. For the past three years I have lived and worked as a physician in Ethiopia. While not known for its obesity, there is an emerging epidemic even in low income countries of obesity, diabetes and hypertension as those with means begin to adopt a western diet with soda, more processed foods and a less high-fiber diet. Personal choice is strongly affected by the food options available.
We often blame individuals for choices they make that contribute to their obesity. I suspect most obesity results from the environment we have created around us. Specifically, it is an environment with abundant access to relatively cheap, high-calorie foods with very little disincentive with less physical activity. Combine that with good taste, no immediate consequences and intense advertising and it would be remarkable if we didn't have such emerging obesity. We need to take steps, tangible steps, to recognize and address the influence of psychology, commercial and marketing interests, and our changing culture that catalyzes this unhealthy transformation. I applaud the authors for their strong call to action.
21
Our children attended school in Japan for three years. The meals were delicious, made from scratch, nutritious - and very low in empty calories.
It would not be at all difficult for U.S. schools to do better by our children. All that's needed is some imaginative thinking outside the box based on other models, and really giving it their all. Unfortunately, in my experience (and I am a long-time teacher), I see precious little of this willingness in U.S. school systems.
40
@Angela A Little willingness by American society not just the school systems which are stymied by budget shortfalls and legal requirements. Jamie Oliver, a well known British chef, tried to change how American and British kids eat. It was astounding how many parents were against the idea. It is remarkable how much people will push back against their own best interests if they feel "big government" is telling them what to do.
18
The aim of the U.S. school-lunch program is not student nutrition. It exists to manage farm surpluses by feeding them to America's schoolchildren. That's why it's administered by USDA and not, say, Education or HHS.
4
Although America’s problem with obesity spans all socio-economic groups, many inner cities have “food deserts,” where you can’t find a full-sized grocery store with fresh fruits and vegetables. Local residents who often lack transportation have only convenience stores available, and therefore eat a diet of relatively expensive frozen pizza, sugary cereal and other processed unhealthy food. A concerted effort has to be made to get choices into every neighborhood and to teach parents and their kids how good food can be made affordable and easy,
5
@J. The vast majority of people have far more opinions than you give them credit for. In the vast majority of urban environments there are fresh food stands or markets in close proximity to most neighborhoods. The problem isn’t what people have available, but what people choose as a preference or for convenience. Processed foods are cheap, easy, and taste good. Fresh foods including vegetables and meats take time to prepare and require the users attention and skill in order for the food to taste good. Most people choose the easy, tasty option. It’s really just that simple.
7
@John "i n the vast majority of urban environments there are fresh food stands or markets in close proximity to most neighborhoods." That is simply not true in poor urban areas.
@John can you cite a source or share a website with a map of where these fresh food stands are located?
This is really an affluence issue. People have more choices than ever before. Food companies advertise and sell what people buy. People across all income classes have easy, affordable food options of all types. There are special occasion foods now but there are really no longer foods that have to be reserved for special occasions. It wasn’t that long ago that certain foods were only available at certain times of the year and it was a special treat to receive those items. Now we can and do have almost anything we want, whenever we want it.
6
@John - There are probably close to a dozen shows on TV centered around baking cakes. Cakes! Who the heck eats cake more than twice a year at the occasional birthday party?
4
I love these articles. I see this again and again. When there is an ongoing discussion of some serious problem--global warming or other ecological catastrophes, gun violence, income inequality--someone weighs in with the clinching point: beyond the human suffering, this problem has economic costs! Well, in that case, we'd better do something.
The course of this line of thought shows what our society's true values are. Human suffering is a negligible concern. Harm to the economy? Now we're getting serious.
15
@Robert F I take your point in general, but I think you're doing a disservice to Dr. Ludwig, who has been tireless in his attempts to educate the public about the harms of sugar and the need to change the infrastructure that supports poor nutrition in this country. His concern has been both scientific and humanist. Can you blame him for trying every tactic available and reaching for the money issue when other arguments fall on deaf ears in the governmental bodies that can make a difference?
3
There's no secret to a healthy lifestyle.
When it comes to food, for normal daily fare:
1. Avoid sugar. You'll be amazed at how much is added to thinks you wouldn't think of as sweet, like ketchup.
2. Avoid white flour.
3. Eat a couple of pieces of fresh fruit daily.
4. Eat as much fresh and lightly cooked vegetables as you want.
5. Eat a moderate amount of whole grains.
6. Eat only the best quality unprocessed meats/chicken/fish and in moderate amounts.
Other things to do:
1. Find an exercise activity you enjoy and engage in it several times a week.
2. Get enough sleep.
3. Avoid emotional stress from work and family.
Being at a healthy weight is EASY. But once people are obese, getting back to a healthy weight is really hard. We desperately need to teach our children, at home and at school, healthy living habits, so that they don't get obese in the first place. As I wrote in another comment, many parents are total failures in this respect.
29
@J Jencks We also need to require airports, malls, stadiums and other places where communities to gather to offer healthy, affordable options too; especially where people are a "captive audience" like airports.
4
@Kathy - I agree, though I think most of us don't spend the majority of our time in those places and it's our daily food habits that are doing us in.
I was in the local mall 2 weeks back, feeling a bit peckish. I checked out the food court, that was of considerable size, and could not find a single thing to eat that appealed to me. It all looked heavy, oily, overly sweet, etc. Not a sign of a piece of fresh fruit, or a salad bar.
I have a feeling that kind of food has the highest profit margin and is easiest for business to handle. So that's what they serve, then spend billions on advertising it. They don't "respond to consumer demand". They create the demand through what they choose to advertise. Then WHAT they advertise is whatever gives them the highest profit margin.
I don’t know. You’d think that in a capitalist, famously market-oriented country like the US, if there were demand for healthy options at shopping malls and airports, some enterprising company would move to meet it. Surely the same goes for so-called food deserts. I mean, it’s not like there’s some food commissar in Washington deciding what to produce and sell. Supply follows to demand.
2
Great writing by Ludwig and Rogoff on a difficult issue. Just a cursory tour through supermarkets and shopping malls reveals the obesity problem. And one can look at one's own family and friends.
Achieving good, individual health should be a motivator to eradicate obesity, but if that doesn't move people, the economic argument is sobering. It's just that GDP is such an abstract measurement that people can't apply an imagined decrease in the cost burden of national obesity to themselves. It's become a luxury that we support.
Part of the problem is that we are such a heterogeneous culture that Big Food can penetrate our ranks with a lowest common denominator food offering. Some people do eat healthy, but obviously most are lured to bad diets. It's hard to get the message of health out to the public. With a poorly educated public, the task is formidable.
This means that we need a national healthy food program. There is controversy over government programs; Republicans don't like paying for them except for the undetermined cost of an open-ended "Space Force" and a wall with Mexico.
But a *responsible* congress would look to lower cost burdens on the American public. Achieving health is the moral equivalent of war. And we already have the resources here; it's a matter of directing them to the right targets.
For those who are worried about impairing the processed food business, it's killing us.
4
Try enacting any of the good recommendations Drs. Ludwig and Rogoff propose in this essay, and all the agencies of government will be inundated with calls, emails, petitions, personal visits, threats to cut off political donations, pledges to run candidates against incumbents in the next election, and more. If the economic impact of obesity is between 4 and 8 percent of GDP, here's another factor that has an impact: how much of the economy is devoted to snack foods and sugar? How much advertising revenue goes to market those foods? How will a federal commission to coordinate obesity policy outweigh (forgive the pun) the obese Big Food industry? And research into obesity? We can't even get Congress to allow research into a much more egregious problem of gun violence! When at least 4-8% of the nation's GDP -- and the millions of jobs that are a constituent part of it -- are dependent on Big Food and the political machinations that work against reform, we will likely never see any of these good proposals come to fruition.
11
@Ockham9 - We succeeded in getting control of the tobacco industry. The parallels are obvious. It's a matter of concerted, long term pressure, from citizens who use the power of their vote.
8
Hear !Hear!!!
@J Jencks You are comparing apples and oranges. No one needs tobacco to live.
One issue I seldom see addressed in obesity-related articles (which tend to focus on the myth of "food deserts" and the evils of sugary beverages) is the obesity attributable to alcohol.
Off the top of my head I can think of several friends and family members who eat fairly moderately but who consume many calories each week in beer, wine or spirits & mixers. Many of them are self-medicating for anxiety, depression, pain or just the angst of the modern lifestyle.
I don't know what the solution is, but the present medical model's aversion to prescribing sleeping pills, temporary anxiety relievers such as Xanax, doesn't help. Also if more pain/stress relief therapies were accessible, from physical therapy to massage to yoga, people might choose them instead.
16
@Kosher Dill I don't think you know what the word "aversion" means.
2
@Kosher Dill So you don't know any slim people who are "self-medicating for anxiety, depression, pain or angst"?
Is it OK to be an alcoholic as long as you don't consume enough food to become fat?
2
And how well I remember an interview with a Big Pharma guy about twenty years ago now. His final comment: "Of course diabetes is a terrible thing, and we're doing what we can to fight it. For us in the industry, if you're not in insulin, you're not in the game." Yes, the game.
9
A tax on processed food will end up being a regressive tax. A "healthy" option, say a can of black beans, is readily available and cheaper than many of its unhealthy alternatives, like pizza, chips, etc. Similarly, there are healthy options at most fast food places, but they'll rarely be the best-selling item. The thing is, people like processed food because it tastes better than healthy food. And when you're poor a tasty snack is one of the few opportunities for pleasure in life. Processed food is also often easier to prepare than healthy food. If you're coming back from a job and have an hour to eat and spend with your family before you have to go to your second job, what are you going to do, prepare a delightful vegetable and chicken breast stir fry with sides of quinoa and asparagus or are you going to order some pizza? The problem with ivory tower thinkers is that their solutions aren't rooted in reality.
46
@Gary - "The problem with ivory tower thinkers is that their solutions aren't rooted in reality."
What solutions do you recommend?
"people like processed food because it tastes better than healthy food."
If as much money was spent advertising black beans on TV as is spent on advertising pizza and soda, I wonder if people would suddenly start liking them more? If those processed foods really DO taste so much better, then why does the industry feel the need to pump so much advertising into them when people already prefer them over black beans?
I believe that most people who watch TV regularly will believe they prefer the items that they see advertised over the ones that aren't advertised. There's a word for it. "Teaching". There's another word for it. "Manipulation"... and another, "Propaganda"
6
@Gary
I could stir-fry some chicken, steam some veggies, add potatoes or rice--in less time to order pizza.
Maybe spend some time cooking with kids and talking to them.
What people and kids REALLY need is a minimum wage that enables them ONE job, like used to be.
@Gary Even when I was low income and climbing up the ivory tower, I managed to avoid ordering pizza. Too expensive! I would buy cans of beans, cheese, veggies and corn tortillas and make burritos. Or sometimes just have rice and beans. Also lots of spaghetti with jars of sauce with steamed brocoli on the side. Oatmeal for breakfast. It cooks while you are getting dressed. Not exactly the chicken breast/quinoa diet, but convenient and healthier and cheaper than ordering pizza and buying foods that are even more processed. Many more people can eat this way than do.
1
All this seems to be the case. In the 25 years I have been in Seattle I would judge that the average Seattlelite has gained a pound per year - I myself have remained lean and mean but for one year where I indulged in the wonderful food available in the International - i.e. Asian - District. At the Plaza Cafe, the cafeteria of the University of Washington Hospital ,I have seen many a case of a hugely overweight patient wheeled to the foodline who then adds to his or her weight by loading up.
1
@michael roloff I visited a relative at her office at U of Washington Hospital a few years ago and ate at the cafeteria. It was truly awful. Unlike most hospital cafeterias, there were almost no healthy options. I was talking to her recently and asked if the cafeteria had gotten any healthier. She said "Nope." By contrast when another family member was at the hospital at the U of Wisconsin, the entire cafeteria was set up so that the healthy options took center stage and the unhealthy ones were hidden in the back.
2
I live in an upscale, tree-lined suburb that dates back to the 1930s and 40s, crime free, walkable to the quaint downtown, all sorts of activities, a recreation center, three schools, an arts complex. In our city no household is further than 10-minute walk from a public park with play equipment, sports nets etc.
Of the seven young families (parents in mid-30s to early 40s, kids from baby to about 13-14) ringing my house, six of them are obese. Not just plump, obese, from mom and dad to the little kids. One family is slim, does all sorts of activities like kayaking and rock climbing and plays outdoors even on cold winter days.
The rest of them -- not disadvantaged people but engineers, nurses, doctors, teachers with good dual-income households -- are fat. Not a single one of the men can tuck in a shirt. The women are huge and go around in pull-on leggings and loose tops -- these are young, pre-menopausal women. The pizza delivery vehicles are constantly on the street. The families buy equipment like bikes, tennis raquets etc., which are used for a few days and then rot in the garage. None of them do their own yard work or any outdoor activity such as flower or vegetable gardening. Little kids are paunchy and the teens are downright obese.
It's not just the demands of work because these people have plenty of time to sit on front porches, to cook out ongrills, etc. -- just a bone-deep aversion to activity and a self-indulgence in their food and beverage choices.
106
@Kosher Dill
Ouch !
the key to being thin is to eat well, run, and to own (and use) these three things:
1) a snowboard
2) a manual car
3) an australian shepherd (or a boston terrier)
6
@richguy And where do you find a minivan with a standard transmission?
@richguy I would add to that 4. a lawnmower (push, but self-propelled is okay)
1
@NotNormal
the bros at the Dogpound gym in NYC imitate that by pushing around 90lbs of weight on a sled type thing.
It's not just socio-economic. I live in a prosperous neighborhood, in a prosperous city in a prosperous part of the country. There are obese people all around me.
Much of the obesity problem lands squarely on the shoulders of parents, who raise their children to crave sugar.
Anecdote: Just this morning I was at the grocer. In the cereal aisle a woman was buying one of those sets of small cereal boxes, with her son of around 10 years old. I got the impression they were buying for a sleep-over.
She pulled the set off the shelf and showed it to him. It contained the usual array of cereals from less sweet, like rice crispies, to the extreme sugar frosted cocoa pops.
He said it would be good. The MOTHER said "no", that several of the cereals "weren't sweet enough and some might not like them". He said HE liked them, pointing at the rice crispies, the least sweet in the set.
Finally she gave in and bought them.
I've heard similar things many times. Parents are TEACHING their children to prefer the sweeter products. These are educated, well to do, people.
It infuriates me.
23
As a hospital based diabetes educator, I am amazed at the lack of understanding the typical American adult possesses.
There needs to be a greater emphasis on middle school and high school nutrition education, as a beginning remedial push.
In addition, I believe every college degree "must" include as a prerequisite to graduation, one completed course in nutrition. In other words, if you graduated college, you also should have a rudimentary understanding of food composition, daily protein, calorie and vitamin requirements, product label reading, etc. A college degree should prepare you for success in life, and simultaneously prepare you from needless suffering.
A major problem in the obesity epidemic is simple systemic and nationwide ignorance of food science.
13
@GP, we are INUNDATED with nutrition education. My goodness, I remember the 4 basic food groups from 50 years ago. Then there were 7, then there were micro-nutrients. Just read the comments here - people who are obsessed with diet and nutrition and read everything - and can't come to any agreement. And I have lost respect for the whole field of "nutrition science." Not the endeavor, but the fact people dare to say they've found THE ANSWER, and, oh, it's just so simple. I have to note that Gary Taubes's NUSI institute has basically gone belly up due to an inability to produce study results that back up his low-carb claims. I am NOT taking any "expert" advice. Not until they stop fighting about carbs vs. fats.
3
@GP - I have great respect for your profession and appreciate your comment.
But I would like to add that it goes beyond formal education in nutrition. Children need to be taught, but more than taught, they need to imbibe habits of healthy living. This can only happen when both their home environments and their school environments supports those habits.
Children need to be raised appreciating and enjoying the flavors of healthy food.
Yes, at an appropriate age they need formal education in nutrition as well.
And just as importantly, from the earliest school years they need to be give really good physical education that focuses on non-competitive activities that build the body, its strength and its coordination. Team sports have their place. But many of them, such as football and baseball, are inefficient in terms of physical development. Just look at how the pros train. They don't expect to get and stay in shape by playing football and baseball games. No. They swim. They jog. They run. They dance. That's a big part of their training and it should be with children too.
If we are raised with these habits we will enjoy and engage in them throughout our lives.
2
@GP It used to be done in high school (which everyone attends, unlike college). It was called Home Economics.
1
Cut out sugars and starches.
Look away from the electronics for a long while.
Plan infrastructure for more sidewalks and bike able streets.
Make cities and suburbs more people friendly.
Not auto oriented.
Go out and play.
G'luck all.
Life is short.
Go plant some trees.
8
@Dobby's sock At the age of 73, I've spent the summer with the trees I got heeled in last October. Transplanting and watering watering watering. All exercise.
3
In the '90s I worked with a group of guys who, due to the nature of their strenuous work and risk of serious injury, were afforded an hour of physical exercise each day. A few swivel-chaired administrators were offended that we were given time to do that while they were not. Being a bureaucracy, and being unable to 'discriminate', it was then decided that they, too, should be allowed to take an hour out of their work day to exercise as they thought best.
The result of this was unsurprising to us. We watched as a few overweight women sauntered about our running track, a few smoking, taking time to rest. They weren't burning enough calories to offset their morning donut. For that, the government paid them an hour's wages every day.
You cannot take a horse to water and make it drink.
At 61, I have pins in my spine, webbing holding my stomach muscles together, a herniated disc, and several degenerated discs from dozens of hard falls. I can no longer play tennis, ski, play soccer, or even run, but I can still walk a hill faster than the average fit human. It's all about effort. If people are not willing to put in effort they will complain about genetics, or complain about getting out of breath, or have bad knees, a bad back, a headache. I've even heard people say they do not like to sweat. Well okay, then, so don't eat as much!
Good grief! It's no wonder America has an obesity epidemic. The excuses for not doing something seem to have become ingrained into the American psyche.
22
@James Devlin I could not agree with you more with all that you have said! If people put 1/100th the time into exercise that they do into their electronic devices, maybe we would get somewhere. But sadly, don't hold your breath.
Bravo to you for your efforts and continued good health to you!!
5
@James Devlin I live in one of the most prosperous areas in the country and yet the anger that a few bike lanes (and removal of parking spaces) creates is astounding. Anyone that wants to create more walkable communities is branded an entitled elitest. It's exhausting and demoralizing to watch Americans dig in their heels and destroy themselves. Sigh.
5
Where I live we have an abundance of healthy and fresh food available - if you have the resources to buy it. Food costs have soared and the organics are too expensive for many families. I can't imagine affordability isn't also a factor driving food choices.
11
@Ann Try dry beans. Healthy food for poor people.
1
@Ann - Any family that claims that healthy food costs too much, then proceeds to spend money on sugar soda and white bread, is simply being irresponsible. That stuff is not food and every penny spent on it is wasted.
2
Getting corporations to make changes that would improve public health is about as likely to occur in the food industry as in the gun industry. Good luck with that.
13
1) Losing weight is NOT easy. Removing the judgment and being encouragers whether at home, school or in a place of employment would go a long way to assisting in the struggle
2) Healthy food options are always more expensive and less ubiquitous. Perhaps giving incentives to companies to offer more affordable healthy options can promote healthy choices
3) Places of employment can incorporate break times specifically for employees to get some exercise or include benefits that have gym membership discounts. Or organize more activities like signing up for a corporate 5k (team building AND the added bonus of exercise). Even standing desks at office spaces can help with the forced sedentary lifestyle our capitalist society thrives on
It takes a village to change this tide. Our country to should adopt a framework that positively motivates each other, unlike the current divisive climate.
I am speaking as someone who once upon a time lost over 70 pounds and kept it off for six years until I had my baby this past February. Trying to get back on the running wagon. Never give up!
17
@sunzari
1. Yes, losing weight is easy. Eat less; move more.
2. Healthier foods are not more expensive. The salad-with-chicken breast and a banana I pack for lunch everyday costs less than $2. Add in my stacks (oranges, pears, almonds) and you're still under $3.50 per day, which is a third of what my (obese) coworkers spend on their daily Chipotle. Additionally, eating fewer calories is far cheaper than eating excess calories, 100% of the time.
At 45 I'm in the best shape of my life despite sitting at a desk for 8 hours per day. This isn't a magical accident; it's because I choose fitness every day.
10
2) Healthy food options are always more expensive and less ubiquitous.
Only if you don't cook. The most important habit to pick up and stick with is cooking, not running.
17
@Michael-in-Vegas No. Losing weight is not always easy. If it was, obesity would not be a problem. Congratulations on "choosing" fitness every day. Others with various physical and mental conditions don't always have that choice.
A pint of blueberries can often cost more than a fast food value meal. Anything that could be done to change this imbalance would be a positive step towards encouraging better eating habits. My grocery bill always goes up when I diet. This is a problem I can afford, but many are not so fortunate.
32
@Junctionite
Those who "diet" have already failed. Chose a way of eating that is sustainable and meets your goals. Personally, I eat whatever I want on the weekends and restrict calories during the week. After 10 years of this, I've maintained my weight, and look and feel great.
Also, of course blueberries are expensive; they're seasonal. There are many fruits and vegetables that are always cheap and plentiful.
5
If you insist on eating a small list of fresh "superfoods" without regard to season, then yes, you will pay more. Eat only what's in season, and you will pay less. Today, for example, I will score some blueberries at Aldi (from your neighbor, Canada) at $1.39 a pint, and those will probably be the last fresh blueberries I buy until next spring.
5
you are fortunate you have an Aldis. I assume you do not have to dri e 80 miles one way to your grocery. monthly shoppers do not always find the bargains.
2
At my local grocery store (not Whole Foods) in a decently affluent New England suburb, if you want to grind the check-out line to a halt, load up your cart with a bunch of veggies. The store staff cannot distinguish between types of vegetables, like peppers (don't even try to buy a Poblano pepper, if they're even in stock) and often have no clue what things like a fennel bulb are. Because the veg doesn't scan in, the staff have to stop and search for the PLU codes from a sheet of paper. I actually had a woman in line behind me quizzing me on what I do with all those "exotic" vegetables! I was kind about it and tried to really talk up how delicious, flavorful, and healthy my vegetarian meals are. She was genuinely interested; but people, vegetables are not exotic! This pales in comparison to the week my family stayed in Cape May, NJ. At most of the grocery stores in the non-touristy parts of the area, vegetables truly were exotic!
18
@LE Richardson Try going to a Walmart grocery store if you want to lose all faith in the future of healthy foods.
3
You mean I can’t eat as many non-GMO, pesticide-free, all natural, no gluten, sea salt laden burgers as I want?
Consumer advocacy groups and so called critics of the food industry have a lot to answer for as well and seem to obsess on issues that are well down the list, if they are risks at all.
The primary issue is excessive caloric intake and lack of physical activity. Food quality is not unimportant, but until we reduce the quantity we consume, the problem will continue...
8
@JoeM - Do you understand how powerful the food lobby is? They spend mightily to resist any changes that would affect their bottom line despite proven negative health effects of their products (think added sugar in breakfast cereals). As was stated in the article, children younger than about 8 years old are susceptible to the relentless advertising of sugar- or even more insidious, fructose-enriched "foods" which have proven negative health effects. I agree that overall caloric intake matters, but the macronutrient composition (i.e, quality) matters too!
5
@Peter - I think you missed my point entirely. Yes, I do understand how powerful the food industry is, which Is why it is so incredibly frustrating that so called consumer advocates buy into the Big Lie that it is primarily a food quality issue. Of course macronutrients are important, but it is not the primary issue here. If all Americans ate a Mediterranean diet, we would be healthier - but I bet we wouldn’t still eat twice as much as those in Southerrn Europe...
@JoeM Unfortunately the food industry has greatly changed even "healthy" foods and not for the better. Today's vegetables are bred for appearance and shelf longevity not nutrition or even taste. Meat today is full of hormones and fat so that the animal can be slaughtered and sold as soon as possible. The so called natural foods of today wouldn't be recognizable to our great grandparetns.
3
Social and family life in lower socioeconomics communities that suffer from high obesity rates often revolves around high calorie meals and celebratory/holiday foods. That’s personal choice and personal responsibility, but it’s really hard to be the only person who won’t eat the food offered, especially if that’s all there is. And that environment makes those choices seem perfectly fine because everyone else @the event is also 50lbs overweight. A tough underlying part of these problems.
12
@jkk Do you know how much it costs to buy fresh produce? Do you know how hard it is to find in urban settings? Do you think it's easy to prepare a healthy, nutritious meal for your family while you're working 2 or 3 jobs? Sure. Being poor and unable to afford Whole Foods or uneducated about the latest research on healthy eating is definitely a personal choice. Right behind keeping the lights on, keeping the kids in school and keeping your minimum wage job.
17
@jkk
Even on East Coast back after West and HI it was difficult.
TOO much meat, way Too early, way too much fat.
Just tried to show up and eat a tiny bit of each, except salad and fruit--still hassled.
I was fit but underweight via two teenagers and about 1/3 my SIL and 1/4 my brother.
I was being polite as possible by trying to eat more, at least SOME, LIKE you're are fat as heck, I don't tell you that.
Never did, but people couldn't get their heads around annoying thin people is just as bad. NOBODY ever mentions this!
In the last couple years there has been a ton of disappointing public policy, so it was especially disappointing when Cook county repealed its "sugar drink" tax.
It was my favorite new local legislation since banning smoking in bars.
Not only did it tax an externality, discouraged bad behavior, but I think it educated people who genuinely do not understand what healthy choices are. It can be shocking to look at the sugar content of not just pop, but iced teas, gatorades, and fruit drinks. If you aren't looking for it, you can drink a ton of sugar when thinking you are making a healthy choice.
Unfortunately, Cook county's neighbors didn't follow suite, and a large part of the population bought into the argument that the law taxed even non sugared drinks (because high fructose cornsyrup isn't sugar).
Hopefully we see the law come back nation wide. As someone who is always trying to drop those 5-10 pounds, cutting down on the sugar I drink has helped.
9
OK, poor choice of diet and obesity create costs, but the GDP would be demonstrably lower if we all ate as well as some nutritionists, doctors, and other experts would suggest. Entire industries that contribute to the GDP could be wiped out: Fast food, soft drinks, meat producers, sugar producers, candy makers, and so on. All these entities create lots of jobs. And then there are all the jobs in health services, medical treatment delivery, and medical research that would not be needed if diets were drastically improved, too.
So it's all a great futile cycle which help keeps the economy churning along. Be careful what you wish for everybody else, but you yourself can choose what you put into your own body.
1
@Jim But we all--ALL--bear the costs for a system that subsidizes poor health choices. We bear those costs through our insurance premiums and through our taxes.
3
@Jim It's not that easy. A lot of obese people develop the problem as children. It's not reasonable to hold children responsible for bad food choices.
Also, your comment disregards the fact that careful food choices are a tiny part of the problem for someone who is already fat. It's not just a matter of learning to eat and move like a thin person, you have to learn to focus obsessively on your intake and exercise, not just temporarily, but for life (see metabolic studies on Biggest Loser contestants--thin people who used to be fat burn substantially fewer calories than people who have always been thin).
Unlike a thin person, a fat one has to be constantly vigilant, because her body perceives her weight loss as a period of starvation. It now believes she is living in a place where she can starve so extremely that she will drop 100 pounds, so it deploys all kinds of hormones to get her to sit still and eat--regain the weight--so she'll survive next time it happens. There are tricks to fight your body on this, but someone has to teach people those tricks. Preferably, someone who isn't a snake oil salesman trying to sell treatments, surgeries, regimens and packaged food, as pretty much ALL weight loss program purveyors are in the US. Few medical doctors really understand the science of obesity and those that do don't know the tricks to combat the body's love of its own fat.
So I'm with Dr. Ludwig. We need regulations and national programs to fix this thing.
9
@Jim - I sincerely don't mean offense, but your comment reminds me of a well-known scene in the movie Idiocracy where people are finally convinced to stop irrigating crops with sports drinks. The immediate result is an economic crash because so many people worked for the sports drink company. This CANNOT be the logic we use to chart our future.
3
What is maddening about this is that busy, hard-working Americans most often do not even have the option to make the healthy choice. Anyone who travels knows this all too well. Our interstates are lined with fast food and fast-casual places that offer nothing but variations on the same meat-bread-cheese-potato-sugar theme. American airports are similarly stacked with the same fast food chains cranking out the same stuff. It is nearly impossible, or hit-and-miss at best, to find a place selling fresh, nutritious, vegetable-based food at a non-extortionate price. Even potentially healthy items such as salads and vegetable sandwiches are stuffed with cheese, sugary toppings and salt. I would support a law that requires public places like airports, shopping malls and train stations to have at least one healthy food establishment that sells only fresh, nutritious food items. How can we make the healthy choice if the choice doesn't even exist?
67
@Ed Actually, most fast food places DO have healthy options. Just not a lot. Micky D has salads and breakfast burritos, both low cal healthy food. Taco Bell has several excellent options. You just have to make decisions to eat healthily.
8
@Ed I agree with Ernest. There are healthy options, generally within a mile of most Interstate exchanges, even in cities of smaller populations. And with the internet, they,re not that hard to find. For instance, on a recent trip, a quick google search of "restaurants twin falls idaho" pointed out a healthy Thai place. It only takes a few extra minutes.
4
I travel a lot for work. I was gone about 20 weeks out of the last year. Eating healthy is not hard or expensive, but it takes planning. I would plan out meals to take and pack with me, regardless of whether I was driving or flying. The relatively short time I spent planning and cooking my meals probably ended up being less time than I would have spent getting to restaurants, getting my food, and eating, and boy was it ever cheaper.
4
Fine ideas and suggestions and they might work to lower the obesity rate in America.
Good luck conquering the profit-above-all-else food industry which starts with toxic farmers and ends with consumers who think the problems are 'other peoples'.
12
And many of these big processed food companies are expanding their reach to many other countries who now have more obesity, diabetes, and heart disease issues than they have ever had before. Do these companies need to be held accountable? Yes.
9
Unfortunately, many times, I kayak alone, hike alone, bike alone, paddle board alone, swim and dive alone --- my lifelong friends have grown too large and do not have the capacity for mildly strenous outdoor activities. And, I cannot keep up with the frequent feasting they enjoy.
62
@cecz - It has been pretty conclusively shown that obesity can be a social contagion. Obese people eat large quantities and more frequently, and there is usually social pressure to join them in the feast when you are spending social time with them. Bottom line; If you spend a lot of time with obese people, you drastically increase your chances of becoming obese. I know people who essentially eat a second dinner around 9-10 at night before they go to bed. I know people who will go out for drinks, and cap the night off with huge platters of wings and nachos at 1AM. All I can think when I see it is "Really? How can you guys possibly still be hungry?" I'm not even tempted to partake, and I easily turn them down without a second thought. But some people succumb to the peer pressure, which never ends well.
7
This article continues to spread the lie that fresh produce is more expensive that processed foods. It is simply not true. Today at any store including Wal Mart, green beans, peaches, nectarines, and plums are $.99 per pound. Bananas are $ .59 per pound. One dozen eggs are $1.50. Chicken breast $1.99 per pound. What the government should do is limit foods that can be purchased through the food stamp program. That is the most direct way to influence what kinds of food people bring into their homes. It's not hard to eat and be healthy but it takes some effort on the part of the individual families.
64
@Melissa M. Well, good for you and Saginaw. If you were to get out and around more, you might see that these great prices are NOT available "At any store". Where I live, apples are $2.49/lb. Apples! And, as the article notes, in lots of places, "fresh produce" is not even available.
28
Apples aren’t in season now, that’s why the prices aren’t as low as stone fruit. Eating seasonal produce doesn’t have to be expensive. You’re in New Mexico, so apples have to be trucked quite a distance.
4
@Melissa M. It's harder than you would ever think. I had a work trip to a small town in Mississippi, and my colleague and I drove there from Atlanta. We wanted to stop and pick up a quick breakfast before we headed to our meeting, and we could NOT find a single grocery store. We ended up at some weird dollar store type place, and he had to content himself with a orange soft drink and prepackaged sugary donuts. All he wanted was some milk and fresh fruit. Could not find it at all.
3
Obesity is a very complicated and serious problem.
Most people overeat because of stress. We celebrate by going to a party or meal and eat as much as possible. When we are lonely or depressed, we eat to satisfy our emotional hunger.
In countries with much physical labor and few cars people are thin. Athletes who stop exercising gain weight.
3500 calories equals 1 pound of fat. Running or walking burns 100 cal/mile- Running 35 miles/week burns 1 lb of fat. Loosing a pound a week is 50 pounds a year. Marathoners need 4000-6000 cal/day. Sedentary people 1800-2000.
Fat people do poorly in romance, usually marrying beneath their class. and make less money too.
You can identify social class often by a person's weight. The poor have more stress in their lives.
15
An earlier version of this article showed children at a swimming pool at an 'obesity camp.' I don't recall seeing any of the kids actually in the pool getting exercise. Soon after that I read the article on three parks on the East River Waterfront. One photo shows a bunch of thin children gleefully dancing in a water park.
It was obvious which children were happier. And healthier.
The question is: what factors are responsible for the difference in these two groups? That's what needs to be addressed and fixed.
3
@D. Epp - You conclude from a moment in time photograph that the "obesity camp" kids never entered the pool or swam?
If you saw a picture of the astronauts at Cape Kennedy, would you conclude that they never landed on the moon?
2
Big Ag is to blame for many of these problems. Farms which do not use their government subsidies lose them the next year. This has served to push massive farms (hardly the wholesome kind seen serenely pictured on the packages) to grow inordinate amounts of corn as well as soy. What to do with it to keep the government's bucks coming? First of all make high fructose corn syrup and cram it into everything from pickle relish to cereal to frozen ready-to-eat meals which are not conventionally sweet. And I won't even get into soy oil and its link to breast cancer.
10
Americans need to stop saying that our national obesity problem is caused by genetics. There are several of these comments below, and I must say that any such case is the exception to the rule. We did not have this problem a generation ago, and the overall genetic makeup of a population does not change in a generation. This is a problem caused by poor diet and inactivity. Period. Any real solution must first acknowledge this as the root of the problem. This article addresses this reality, and should be heeded. The only debate at this point is how to best fix the diet and activity of Americans.
66
@Jim
Genetics can change in a single generation in response to the environment, actually its the epigenetics that are responsible for gene expression.
This was discovered when a normally well fed population in the Netherlands experienced famine during WWII, which caused lifelong problems for the studied group related to changes in gene expression.
Audrey Hepburn was one victim and experienced life long eating disorders which contributed to her chronic (fashionably) underweight condition. She had a BMI of 14 at the end of the war and 17 thereafter.
3
Has anyone noticed the expanding grocery isles full of frozen prepared food? It appears premade processed meals must be a profitable industry. It has to be otherwise it wouldn’t be such an expanding industry. I’m curious how many consumers use these “services” instead of making their own fresh meals? What about all the different options food companies offer such as the “Blue Box” ? Frozen or fresh delivered options must be a costly service. Higher incomes can afford the healthier options. Lower incomes can also buy fast meal products just more preservatives added. But, just how healthy are these products? What are the advertising messages used for these products?
Being too busy to cook and loosing out on valuable family time.
I would be very interested in seeing data from cities that relies on public transportation systems. I wonder if communities that have commuter transport systems with people needing to walk short distances to their destinations, have less obesity? On my travels watching people in San Francisco, Seattle, Washington DC, and New York City, there appeared to be a lot more physical mobility. Many commuters carried bikes onto the trains. But when expanding public transportation is put on the ballot, the auto and car insurance industries sends in their lobbyist to squash the idea.
As a nation we need to become more educated on the powers of advertising and how industries are influencing our lifestyles and the end results lead to high obesity rates.
10
"Seventy percent of American adults are at least overweight, and body weight is strongly influenced by biology; we can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets."
Hm. If its all down to "biology," and therefore "personal responsibility" (ie eating healthy food, not too much, being active) won't solve the problem, then why should the government "pass a suite of policy changes to encourage healthy diets?" I thought it's all down to biology, huh?
This article's a joke.
I happened read this while eating a slice of pizza. After a 1 hour workout! I work out everyday to keep my heart and muscles strong, my mental health in check, and it allows me to treat myself now and then while staying slim. You can actually have it all.
10
"It wouldn’t cost that much to invest in kitchens and train cafeteria workers so that schools could produce tasty meals from scratch with fresh vegetables and fruits, beans, minimally processed grains and healthful proteins."
Ok, Dr. Rogoff, economist, just how much would it cost? Perhaps $5/day/per student, above consumables? About 51 million students attend public primary and secondary schools X $5/day = $45,900,000/yr nationwide. Then we begin to pay for the supplies.
2
@Heckler An ounce of prevention is worth a pound of cure?
In many foreign countries, e.g., France, healthy school meals cooked from scratch and served family style is the norm. Children lean to eat "grown up" meals (not pizza and chicken nuggets!) using silverware and employing table manners at an early age. How we treat school children in the U.S. is a national embarrassment.
3
How about an obligatory advertisement shown once an hour or once a day or once a week or once a month, or after every 10 or 100 or even 1000 commercials:
Your health may be severely undermined by products advertised on TV.
The frequency of the obligatory advertisement could also be varied depending on its effect, and could be tuned with the overall BMI index of the public.
This may seem like a desperate action, but in fact, the situation is desperate.
7
Watching documentary about the civil rights era, I noticed that 99% of the young people pictured on the marches looked to be their right weight or on the thin side.
And many of them were from the south, where the diet is infamously filled with fattening foods.
I don't know what to make of this.
Was food less convenient, and therefore less available, causing fewer calories to be consumed?
Or was it all "whole" food?
OR did the 1950's - 60's lifestyle demand more activity?
Answers to these questions could make a big difference in fighting this scourge.
23
@RW
Their was just less food and sugary drinks freely available. You could find them if you want but they just weren't part of your daily diet.
No Big Gulp drinks, XL Candy Bars, Family Size Potato Chip bags. When you ate out, portions were smaller and it was rather expensive so in reality you really just didn't eat out that much.
7
I watch a lot of historic stuff (YouTube is great!), and I have also noticed this.
I also often get the impression that in the past, regular people seemed to move more easily, less wooden. Only people in power tried to avoid excessive movements.
5
@RW Similarly, when reviewing my high school yearbook from the late 1980s everyone was very skinny, and I mean everyone! We didn't obsess about food or diets so I don't know what made the difference between now and then. I do know that I had to eat whatever mom put on the plate every night for dinner whether I liked it or not! And we had a huge garden and I had a lot of chores to do around the house every week. We also had mandatory physical education twice a week in the school.
3
Having largely a motor vehicle based society has a lot to do with it too. No sidewalks or safe biking ways. Nobody thinks about walking anywhere. We jump into our cars for every little thing.
27
This is absolutely maddening to me, honestly. There is a bike path running most of the length of our train line in my city that would get me straight to work, and yet, I have no safe way of actually getting to it by bike. Some planning that was.
2
@Lee - And in urban areas that do have lanes and sidewalks, there is an obsession among Millennials with motorized point-to-point rideshare services. Why walk 15 minutes when instead you can scoop up a motorized scooter off the ground, and then dump it on someone's front step when you reach your destination?
An overlooked part of the obesity problem is the design of our cities, which favors the automobile over the individual. Even for those who would like to get more exercise, the suburban, car-centric lifestyle makes it difficult to work it into the natural course of the day. If you have the time, resources, and commitment to go to the gym regularly, you may be able to balance your intake of food. If not..... The influx of people from parts of the world where subsistence-level living is the norm is another big factor. In such places, the ability to retain weight is an advantage. A sudden change to a place of abundant food supply--much of it calorie dense junk food--immediately puts these people at a severe disadvantage, through no fault of their own.
10
@CPC But so many of the food substitutes poor obese people eat cost money but are very detrimental to their health. Sweetened water in various forms and salty snacks (chips, etc) are major contributors of American obesity. I understand these toxic substances are hughly addictive, but any family eliminating them from their food budget would have more funds to buy real food.
No. 1 should be training doctors to prescribe plant based diets to their customers.
All the research required has already been accomplished to stop the obesity epidemic. What is required is putting fast food restaurants and sugar factories out of business.
13
Unless Americans have researched and educated themselves on how to read an ingredient list and understand fat to carbohydrate ratios, along with how calories are burned, they are eating at least ten times the nutrition they need per meal and per drink.
Sugar, salt, fats of all kinds, and added proteins riddle our food supply. If you've ever looked at what's in sandwich meat, other than preservatives and spices, then you should have noticed that all kinds of other things are added. Why would a meat need protein from dairy or soy provenance? Why all the salt? Sugar?
Most people think the obese eat junk food out of vice. For a person who can't afford the higher cost of fresh foods at a supermarket, processed foods are what fits the budget, between the coupons, rewards programs and sales.
Before Trump, the trend was for employers to encourage employees to better take care of their health. After Trump, with healthcare costs having gone through the roof and regulations having been rolled back, I fear these trends will go out of control.
Good eating habits and nutrition are things we all need to learn. Doctors, during well visits, should talk to their patients about where they shop for food and what they buy to eat, and encourage them to stay away from processed and partially-processed foods.
--
Things Trump Did While You Weren’t Looking
https://www.rimaregas.com/2018/08/07/greed-malfeasance-never-sleep-blog4...
13
No food bans or prohibitions, that solves nothing.
2
The costs of obesity are minuscule compared to the cost of Republican tax policies resulting in decreased revenue, health care policies that increases costs, and wasteful military spending.
11
The solution to this problem can be found by reading The Obesity Code by Dr. Jason Fung. Our country has lost its way in this area (as in so many others) largely because of corporations who deliberately sell highly processed addictive food and government policy that abets them. The answer to obesity and diabetes is 1) not eating any processed foods, 2) not eating sugar and watching the amount of fruit eaten and 3) intermittent fasting. Instead, we're in this hamster wheel of eat less--exercise more which over time does not work for most people. Take a look at the government's My Plate. Too much processed food and sugar. I was borderline obese. My doctor recommended The Obesity Code. I am losing weight and feeling great, and not exercising any more than I did previously.
12
Thin people don't eat pizza and fries at home. They might have some in public to blend in with people, but at home they eat good food. Next time you visit a thin person's home, look in his or her fridge, It won't be pizza. It'll be kefir and broiled chicken.
I don't drink when I'm alone. I have a drink to be social. What I eat at home alone is different from what I eat with people.
20
@Counter Measures
The powerful side effect of many antidepressants and antipsychotics is weight gain. It's important to be aware of that effect, and if a child is taking them, to adjust their diet accordingly. I've seen a kid put on 70 pounds from taking Abilify, for example.
14
@Trista-YES! Thank you for being that voice of reason in a sea of people who think obesity is only a matter of "calories in and calories out."
Medications do make it difficult/almost impossible for weight loss.
2
A horrifying idea to consider upon viewing a toddler that by early adulthood the child will be obese. We also need a national campaign that makes it "cool and hip" to raise one's child to develop a taste for real food, rather that all of these garbage "kid foods". I remember a brief period in my eldest daughter's elementary experience when as she took out her lunch and none of the kids knew what she was eating (they can't identify real vegetables/non-packaged foods) and they announced they "felt sorry" for her, which of course at the time bothered my daughter. Many parents can't fathom the idea that anyone criticize their child, so they cave to peer pressure and pack the lunchables, go-gurts, and all of the other frankenfoods kids eat. (This is the problem with cell phone use as well.) Now she is entering the 8th grade and has a larger worldview and has thanked me on more than one occasion for starting her down a healthy path as these foods taste good for her, and the junk does't and she watched as teens concerned about skin, weight, emotional problems, etc, attempt to change a lifetime of habits surrounding food. Not an easy thing to do.
24
@Lynnae
Similar experience here. My daughter stopped being the weird one when it was noted that she had fewer problems with her skin and hair than many of the no-veggie kids in high school. She looked healthy because she ate healthful food. It is also true that she tended to have fewer mood swings and dark days. I won't claim that a solid diet was all that was going on, but it clearly didn't hurt.
3
@Lynnae, the CEO of Oscar Meyer confessed he would NEVER feed his own children 'Lunchables'.
4
Many interesting and valid points, but you utterly lost me when you dropped this gem:
"...we can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets."
That idea is so fundamentally toxic to what America has historically and fundamentally stood for, i.e., personal responsibility.
And lets be completely and transparently honest: nearly every single aspect of the American Government is installed, financed, controlled and micro-managed by corporate interests. How can we rationally expect our government to do the right thing regarding its individual citizens?
We cannot.
147
@lowereastside
Sadly I agree with you, but the problem is that personal responsibility requires that a person have choices in what they do. The fact that obesity is strongly correlated to income levels tells the tale, it takes significant money to eat well and healthily, sadly, in the US. I saw a documentary on You Tube about Japan, and one of the things they highlighted was convenience stores (like 7/11 here) or vending machines had a few unhealthy things in them, but most of the stuff they sold was relatively healthy, in the US it is the exact opposite. Sadly, in large part thanks to the government policies, the starchy, laden with fat and sugar, chemically enhanced to make the person eat more, is very cheap, while whole foods are expensive. If obesity were about people being lazy or glutenous it should be hitting people with higher income levels as well, the fact that it hits the poorer people the most says a lot.
1
@lowereastside, thank you for your common sense answer. I have been fighting my battle with weight and related health issues for my entire adult life. The only way I've been able to keep weight off is by eliminating flour and refined sugar.
1
Totally agree. Can’t believe that statement!!Lack of personal responsibility and accountability is the root cause of most of society’s problems...
Who do you think the tax on processed foods will hurt the most? Yes, the low income folks. Inflation of portion size in all restaurant food (not just fast food) is a contributing issue since people eat out so much more now than they did in the past. Also we walked or rode bikes to school, afterschool sports, etc. and played outdoors - our parents did not chauffeur us everywhere back in the olden days of the 60's and 70's.
10
@Marti Mart well, now you can get arrested for leaving your child to play alone in a playground for a bit or letting them walk to school alone, so...
We also need to remember that food types are addictive and heavy children exhibit neurological signs of addiction just as an alcoholic or opiate addicted person would show. Research and policy needs to identify the addictive qualities of food types and we as a society should respond to that!
2
@Reader "Research and policy needs to identify the addictive qualities of food types..."
...and then what? Make food taste awful so people will eat less? The Food Industrial Complex has already figured out how to make food seem addictive and they're making boatloads of money. Since tasty, unhealthy food is not likely to disappear any time soon, we either have to make it more expensive (via taxation) or regulate it like we regulate other vices like tobacco and alcohol.
3
It's kind of interesting (read: upsetting) to read all these comments about how the obese eat pizza and don't exercise, which I, myself, am obese despite years of dieting to lose weight only to regain it. I don't eat pizza. I don't eat out at all, actually. I eat a lot of vegetables. And I exercise, strenuously, at least 8 hours a week. Which, I might mention is far more than any of my thin pizza and McDonalds-eating friends do.
People sure do have some bizarre (and not data-based) ideas around weight and diet. I'm sure I'll get some hateful comments just for admitting to being fat. But I know it is not for lack of trying, it's something else. I'd be lying if I said I knew exactly what. Unlike all of these godlike commentators, I think the issue is actually quite complex and cannot be understood by one simplistic statement.
225
@rockstarkate
define "strenuous." I try to run 30 miles a week at 7mph. To me, at 48, that's strenuous. To a 23 yr old, it might not be. Most people I meet who say that run a lot mean 15 miles a week at 6mph.
Today, I'll lift for an hour. I'll do 14 sets for chest, 5 sets of free bar squats, 4-5 sets of weighted incline crunches, 4 sets of calf raises, 4 sets of hamstring curls, and 4 sets of deadlifts. That's 60 mins, because I rest 60-90 seconds between sets. I'm drenched with seat by the end (if it's over 80 degrees).
4
@richguy No, I'm not going to explain myself to you, because you'll never think what I do is "enough" anyway, so what would be the point? And I'm not going to respond for any of you who give me suggestions like I'm not a grown adult who can research and try things and has done for my whole life. With great "success" temporarily too. We all have access to the same internet, and trust me, most fat people know every possible diet and every possible exercise routine one can try, and many of us have tried them.
There's no reason I would bother with strangers on the internet who don't know my life history. I simply wanted to add a comment that pushed back against the idea that all fat people "eat too much McDonalds".
2
@rockstarkate
Don't claim to work out hard, if you do not work out hard, because it misleads other people who are trying to lose weight. You claim that exercise hasn't helped you. I'm just trying to find out how much truth there is to that claim. The claim is based on how we define "strenuous exercise." Your claim is that strenuous exercise is wasted effort (in terms of weight loss). I'm defending strenuous exercise. It's not personal. I don't know you. Your post basically said that exercise is useless. So, I asked how much exercise you do (to justify your claim).
3
Taxing certain foods is never the answer. Most food taxes are done simply for revenue and not for anyone's health.
What people need is easier and cheaper choices in good food.
Did you ever notice that the worst foods for people are often the cheapest?
7
@Joe "What people need is easier and cheaper choices in good food." And how do you expect this will happen? Out of the kindness of Big Business's heart? A sin tax on junk food used to subsidize "good food" is one way to do it.
1
@Joe Why is taxing sugary food and drink never the answer? It seems to work for cigarettes, at least in NYC.
1
Hard to sometimes understand. In my case a group of high school classmates have formed a routine get together to keep in touch. We go way back graduated from High School in 1956. When we meet we often comment we can recall any fat classmates. From grade school right on up through high school and few today are considered over weight. As for being considered over weight my take is few can ever hit the right weight on BMI charts. They seem designed for one frame size fits all . As for diet most of us are of German heritage and you can guess what we ate, washed down with beer. Seems so logical fructose allowed in most foods, with an over abundance of salt to make everything taste good is the issue.When a kid is out of a parents sight a bunch of lettuce doesn't compare to a big mac and a coke.
4
Good points but can we add video game lethargy and marijuana addictions to this litany of sugar and diet issues with tax increases? The list of so many bad choices are long and time is too short. As much as I like to read I think balance and variety is the key.
10
Charlie,
You may want to rethink your cannabis stance.
You are wrong.
Investigators at San Diego State University and Cornell reviewed twelve years of data from the US Centers for Disease Control's Behavioral Risk Factor Surveillance System to examine the effects of medical marijuana laws on body weight, physical wellness, and exercise.
They reported, "[T]he enforcement of MMLs (medical marijuana laws) is associated with a 2% to 6% decline in the probability of obesity. ... Our estimates suggest that MMLs induce a $58 to $115 per-person annual reduction in obesity-related medical costs."
For those age 35 or older, authors determined that the passage of medical cannabis laws is "associated with an increase in physical wellness and frequent exercise consistent with the hypothesis of some medicinal use of marijuana." For younger adults, researchers theorized that obesity declines are the result of less alcohol use.
The findings are consistent with prior studies finding that those with a history of cannabis use possess lower body mass index and reduced rates of obesity compared to non-users.
journals.plos.org/plosone/article?id=10.1371/journal.pone.0144270
https://academic.oup.com/aje/article/174/8/929/155851
https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3267
3
@Charlie, why don't we legalize marijuana first (in all 50 states) before talking about taxing it.
2
And yet the Times run articles promoting the Body Positivity movement, which advancing the myth that one can be "healthy any size", and concerns over the scourge of obesity are merely bigotry and "fat shaming".
What we're experiencing is an epidemic of a debilitating, life-shortening disease. Certainly, government policies and subsidies that make bad food very cheap, and good food difficult and expensive to obtain in many areas, are partly to blame.
15
@Fred - No one believes that a fat person can be as fit as a thin person. But given that most fat people will never be thin, don't you think it's a good idea to encourage them to be as fit as possible, given their weight?
3
I have a friend whose obesity is a result of untreated childhood trauma. She is now in her late 60s and has lived a very restricted and isolated life. The human toll has been awful. She has been miserable and our society has lost most of her potential. The financial toll of her illness became clear when she was hospitalized for a hernia. I had outpatient hernia surgery around the same time and was in the hospital for a total of five hours. My friend was hospitalized for six weeks because of complications related to her weight. This is only one episode in one person's life but it helped me to understand how urgently this problem needs to be solved. It's a humanitarian and a fiscal emergency.
71
Portland, OR, school breakfasts typically contain the equivalent of 15 teaspoons of sugar, in between natural sugar (as in apple juice) and added sugar (as in Craisins and pastries.) Seems like a lot.
14
"Children under age 8 are psychologically defenseless against these advertisement" Are they buying the food or their parents? These advertisements have been around since the sixties and they were spouting this line then too. Hello Parents " You are in charge." "
60
The article is spot on! There is another somewhat related toll! The increase of all these pharmecutical advertisements in the media, especially TV, is making many of us nauseous,and probably increasing the anxiety level of middle age and older adults! And the side effects of some of these drugs! Ironically, very few if any of these medicines, treat obesity!
8
Repubs who deny climate change and only support tax cuts for the wealthy would laugh at these suggestions.
16
In an otherwise interesting and important article we see this: "...we can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets." To me this sounds like the talk of a couple policy mavens. While the correct policies would be good, in a fight with stakes as high as this, we need to bring all the tools to bear, including personal responsibility.
36
How can we depend on personal responsibility when the causes of obesity are so complex? If eat less and move more worked, the problem would be much less severe than it is currently. The latest science suggests that our gut microbiome (bacteria and other organisms that control digestion and immunity) is very important in determining what foods can trigger an individual's obesity. But frankly determining what the microbiome needs to release weight is still being studied. So what works for you might not work for me and vice versa. For some people, eating what would cause most to lose weight might have the opposite effect on them For these people it really isn't their fault.
6
"Obesity rates in the United States continue to worsen. So, too, does economic inequality. Are these trends related? "
Well doh! it's elementary my Dear Watson. When poor families can buy a giant pizza or supersize themselves for far less money than buying and actually cooking a decent meal then yes! No amount of education will change that it comes down to money.
41
Synthetically scented laundry detergents, fabric softeners, dryer sheets, air fresheners (spray, in-car and electronic) and scented candles are depleting the “happy” hormone serotonin when you inhale them with every breath, causing cortisol and adrenaline to surge into the system and put you in a constant state of fight/flight … so you can respond to a very real toxic threat. But since you’re wearing or sleeping in it and taking in the off-gassing with every breath, you can’t fight or flee. The result is chronic cortisol overload, i.e. Cushing Syndrome. Serotonin released as you eat blocks receptors on the dopamine-producing cells that give you your appetite, thereby reducing the desire to eat and making you feel full. But when serotonin is in a state of depletion, dopamine release continues, the body is unable to shut off its appetite, and the result is chronic increased appetite and weight gain – think ‘comfort; food. What can the medical community do to help? Question overweight patients about their personal laundry and air freshener product use and habits, and prescribe a Fragrance Free lifestyle for them and their children to combat the effect these products can have on their physical and mental health. Because, contrary to what fragrance and laundry product companies want us to believe — we, our homes, bathrooms, cars and clothes don’t smell bad. So go Free, get happy, and watch the weight slowly melt away and the obesity rate begin to go down.
10
@David Rockwell is this a joke? So now perfumes and laundry detergent cause weight gain? I know Americans are prone to magical thinking but this is the tops. I wear perfume every day because I like it. I am thinner than most people in my age and gender group. Just eat less and you’ll be fine. And don’t eat scented candles or dryer sheets, even though this may be a shortcut to weight loss.
I once saw a TED talk from an Army Lieutenant General who talked about how obesity is a national security issue. While serving for decades, training new recruits, and conducting studies, he saw the increase in obesity among incoming recruits. Many of these recruits were unable to pass the basic physical tests, and were suffering from injuries due to their weight. Not only does the obesity epidemic greatly decrease the number of possible recruits into the branches of our military, the costs of the injuries sustained is enormous. These are just a couple of the reasons why he said the obesity epidemic in this country is a national security issue. I urge you all to watch his TED talk on YouTube.
60
Would rather have my child die of a heart attack at 60 then from a roadside bomb at 19, but I appreciate the General’s concern.
2
"First, establish a federal commission to coordinate obesity policy, which is now fragmented among numerous federal, state and local agencies. This commission would serve as a counterweight to the corrosive political influence and manipulative marketing practices of “Big Food” manufacturers."
There is no way that this is going to happen, especially under a Republican Congress beholden to corporations. Congress is a forum for legalized bribery by corporations, and members will do whatever corporations want them to do, so long as their re-election is assured.
23
It's impossible to make fresh vegetables and fruits come off as tasty to children because the ones available on the market today are almost entirely tasteless.
I'm completely fresh-veggie-oriented and the only time I can get genuinely tasty produce is abroad in certain countries, or when in the California Bay Area.
Even as an adult with self-discipline its painful to eat healthy here.
38
@LF, wow! I've experienced just the opposite: vegetables these days taste better than when I was growing up. I just ate some corn on the cob (cooked in the microwave in the husk, 4 min for 2 ears) that tasted fabulous plain, without any dressing or seasoning! So many delicious recipes online, shelves of cookbooks in book stores. Many of the recipes are easy, simple, and fast. I find it amazing!
3
@LF, Much of it is tasteless, mushy or cardboard. Lately cantaloupes are disgusting taste. The produce section is horrible and expensive. A toxic stew of nasty flavors. Ever eat food in Europe? It tastes better and is less expensive.
2
Obesity in the U.S. is an intractable problem that is spreading around the world, even in developing countries. It is a reflection of contemporary life: over-reliance on technology, a food industry that knows how to entice with salt, fat, and sugar, and no exercise, except for periodic visits to the gym. The solutions suggested by the authors are meager indeed, and not very creative. But then why would establishment authors want to tell the truth--that nothing short of societal transformation will end obesity?
10
How about a new initiative to continue Michele Obama's "Let's Move" program? This could be an opportunity for Melania Trump and Michele Obama to join forces.
27
@C.L.S., weight is more a matter of diet than of moving. The "Let's Move More" campaign was supported by (started by?) Coca Cola, to absolve their products of any role in weight gain. My favorite adage: "Get Fit in the Gym; Get Thin in the Kitchen." True for me, my husband, and many more whom I know.
3
Regulation is all well and good, but the data points to another solution; one completely ignored in this typical liberal Nanny-State proposal from the authors.
As noted, obesity rates in America started to take off in the 1970s. That's conspicuously the same point at which wage growth parted company from productivity growth, leading to stagnant incomes for most Americans and massive inequality, as more and more of the benefits of the American economy flowed to fewer and fewer. In the 50s and 60s, when wage growth closely tracked productivity growth, obesity rates were flat. Surely there are other factors, other changes over the years, but how much income one has or reasonably expects at one's disposal is an ineluctable fundamental in decision making.
On limited incomes with dim future prospects, food, especially indulgent, cheap pleasure food, is about the only enjoyment most Americans and their families have to look forward to. Try as you will, you are not going to lecture or regulate them out of consuming them. Restore to average Americans incomes and income growth to afford and anticipate better prospects in life, and they will chose not to pacify themselves and their children with unhealthy junk.
Don't build up the Nanny State. Dismantle the Robber Baron State.
111
Perhaps it is related to types of employment rather than the wages paid for said labor. Over time we have eased toward a service and knowledge economy versus a strong mix of those along with physical labor: farming, industrial manufacturing, assembly line work and so on.
6
Perhaps. But anyone who has tried to lose weight through exercise alone would be skeptical. And reaching for ways in which we might have more cheaply healthy poor people while still systematically robbing workers of any share of productivity growth is a rather morally dubious and likely quixotic quest. That direction is the one in which the Liberal Nanny-State and the Conservative Robber Barron State are two sides of the same two-party coin.
@RRI--the onset of the obesity epidemic can be traced to the USDA's 1977 introduction of the "Food Pyramid," which emphasized grains over produce and protein--and the consequent "low-fat" diet craze. Fats in many foods were replaced by sugar and grain-derived texture additives--people were taught that dietary fat was the enemy and that fat-free foods were okay to eat in quantity. (Not to mention that a food could be called "fat-free" if a "serving" contained <0.5gm of fat). Most of those foods of course could not believably be consumed in such small serving sizes--relatively small packages contained multiple "servings," and nobody could limit themselves to just one "serving."
We now know that many fats (especially Omega-3) are vital to health, and that added sugar, refined grains, white potatoes & rice pack on the pounds and raise both triglycerides and blood glucose.
1
A whole food, plant based diet (WFPB) would solve all of this. But few people want to listen. The answers are already here and have been for a very long time. Please check out Dr. T. Colin Campbell,
Dr. Michael Greger, Dr. John McDougall, Dr. Neal Barnard, Dr. Caldwell B.Esselstyn. They have been promoting for decades the diet that will reverse (yes, reverse) this epidemic. Stop listening to so called "experts" that have nothing to back them up. REAL research is behind the truth. And I am certain that the truth is not being promoted by the cattle industry, the pork industry, the poultry industry, the dairy industry, the egg industry, the oil industry or the sugar industry. Please do your own research and beware who funds that "research".
20
I love how the biggest democrat and progressive voices move quickly into "personal" responsibility whenever we talk about fat people.
Perhaps, this would help you guys empathize with your republican colleagues?
4
I can't help but laugh at the vicious Obama-haters castigating Michelle Obama for having the unmitigated gall to suggest that we eat more healthfully...of all the NERVE!
140
I thought it was interesting that in the same article about the toll of American obesity, the Times ran popup recipes for "corn casserole" "beef strogonoff"and "pecan crusted salmon. " It makes it harder to take a vital article like this--as seriously as one would like to.
16
When we moved to Florida my wife and I had to find new doctors. All had requested that we bring whatever medications we take to the first office visit. I went in with my four and my wife, who is older but healthier than I, went in empty handed. When the doctor asked her how she could be in her seventies and not be on any medication, she answered "My diet is my medicine".
153
Very few people actually cook meals anymore. People eat on the go. They eat as restaurants. Or they just microwave something. In the 1970s, schools stopped teaching girls how to cook because it was sexist. As a result, few people under 50 ever cook a whole meal. It used to be a woman’s job to clean and cook, now it’s nobodies job. We’ve even had to allow people using food stamps to buy fast food because young people are clueless in the kitchen.
Also, the past 40 years has seen a huge increase in the percentage of people with cars. People used to walk to work or the store, now they drive. If you walk a mile to the grocery store, you get some exercise, but you also buy less because you have to carry it home.
Gym memberships and orthorexic eating cannot mitigate overeating caused by anxious times and work and leisure that involves staring at a screen.
34
I have struggled. There may be a genetic propensity, but weight can be managed. It takes discipline. Hardest thing in the world to maintain, but it can be done.
This article is absurd for mentioning "income disparity" and how it hits lower income people more. Yes, a wealthy person has more money to spend on everything, even medications. The solution for the poorer people who cannot afford the diabetes drugs is.... lose the weight. This is something almost entirely within their control.
11
@Ny Surgeon, of course it is about income disparity. It's easy to shake your finger at a poor person for eating $1 slices vs. paying $3 for a tomato at Whole Foods. It's about calorie density and the ability to reach satiety for as little money as possible. Food security is definitely an issue for lower income communities and, calorie-for-calorie, the unhealthy choice consistently provides the most value for the money.
4
@Ny Surgeon I don't consume processed junk and I don't throw anything away. I'll bet my food budget is way less than most poor people's.
1
@Ed
Once again, choice. The same way people excuse crime because the crook was poor, you demean the fact that most of the impoverished people in this country are not criminals. Likewise, people find a way to control calories and eat healthy. If one is gaining weight, they reduce whatever it is that they are eating, IF they care.
The poor have it rough. Most could probably escape its clutches... if they work hard and want to.
Interesting how there is no mention of any correlation between the decline in the number of smokers and the increase in the numbers of obesity. The fanatics and the government will never admit that in pushing people to stop smoking they drove many to sate their feelings of boredom, insecurity and anxiety with cheap food that provides immediate satisfaction.
21
@alocksley
That's true! My ex-husband was a heavy smoker and always skinny. When he quit about ten years ago he started putting on weight, eating desserts (instead of just having a cigarette), and he is now 60 pounds overweight and can't seem to lose it. Also, being retired and not having to fit into business clothes anymore relaxes the restraints.
I'd love to eat more organic and healthy but on a limited budget I have to go for the less desirable selections. Has anyone checked out the prices of regular fresh, inorganically grown produce lately at your local market? One orange or a pear costs about a buck and some change. Onions and potatoes have increased greatly. I bought 2 sweet potatoes for around 2.50 today. Forget about the Farmer's Market where an apple can run you 1.50 or a pint of berries for 6 or 7. It's expensive to eat well in this country. And no, not everyone has the time (or land) to garden. Especially if you're working 3 jobs just to get by.
Our commercially raised meats and dairy are full of poison(s) too. There could be a correlation with heavy pesticide laden chemicals in our bodies that leads to obesity as well. Along with toxic air, water and soil. Not to forget stress factors.
50
@Lee Organic foods are indeed more expensive, but not as expensive as decades of medical care to treat chronic diet-related health problems. The problem is our policymakers are in the pockets of BOTH big Ag and big Pharma.
6
@Lee How much for a pound of beans?
@Lee
It doesn’t cost more to eat less. An organic donut is not going to help you lose weight.
Articles of this nature are hard to disagree with, I think. As regards #2-
"Second, adequately fund obesity research into innovative approaches for prevention and treatment, beyond the conventional focus on eating less and moving more."
I wonder what the authors have in mind by" innovative approaches"? I hope not the increased use of stomach - altering procedures and other extraordinary medical interventions.
Also, I notice that several contributors have already taken up the issue of personal responsibility. I think that point of view does not adequately consider the effects of lack of availability of better foods, of the impact of ads on kids, of the the costs of better eating if you are poor or of the increasingly sedentary life of children.
As an overweight child who eventually lost over 50 pounds I certainly acknowledge the role I had to play in losing the weight. But I also know that I had a lot of support and social advantages in doing so.
I agree that controlling advertising and shaping government policy as regards agriculture are important steps to help make this easier for people. As would be structuring environments to promote walking, bike riding and play.
In other words, we need to recognize that the outcome we desire- healthier people who do not burden the medical system as they do now- will be easier to attain when we structure our policies to promote that goal. Simply relying, solely, on the efforts of individuals will likely not be enough.
12
One of the reasons obesity is so prevalent is because it is so accepted, so normalized, so around us that we think it normal.
If you look at any photo of a 1950s American crowd and compare it to today, you will see that we look now like a black clad convention of cows. This isn't fat shaming, it's just a fact.
I doubt any government policy can stop this. What we need are financial incentives to induce people to be thinner. We could pay all women under 200 lbs, and men under 225, $400 a month to maintain that weight. That would provide them with the motivation to stay thinner. Nobody would want to give up their income to be grossly, morbidly obese.
54
So true! Side note: The actresses did not have artificially plumped-up lips, either. Very noticeable differences.
2
@Harding Dawson - Walk around obese for a week and you'll see whether it's accepted and normalized.
3
@Harding Dawson This is ludicrous. Why would you pay me to not get obese? Don't you get it that for most of us who are not fat, the biggest motivator is not money, but the mirror? I did gain a bunch of weight in my 40's and lost it over the next few years. It was personal vanity and pride--and living in a world where overweight is not the norm that caused me to lose that extra weight and keep it off. The sad thing is that during the time I was overweight I never heard a peep from my doctor about that excess weight.
1
The major problem is humans, like all animals, have the instinct to find the food that is most readily available and maximize caloric input and minimize caloric output. The food that is most readily available to eat is provided by a food industry. If we don't like what we buy we won't buy it again. The food industry needs to make "food" we will keep buying. This results in lack of nutrition, excessive energy, food which becomes toxic to us, do to the large amounts consumed, an altered gut biome which effects our metabolism and a repeated biologic message to gain and maintain weight to survive. It is not hard to be healthy but our modern life makes it too easy to be unhealthy.
18
It appears that Ronald McDonald is as much a villain as the Marlboro Man.
27
Let's not forget Tony the Tiger and the polar bear who pushes Coca-Cola.
Not really. My clothes have never smelled like a Big Mac after being around those who partake.
3
Long-term fat guy here who recently lost 100+ pounds after 50 years.
What changed? I figured it out. Track every single bite that goes in your mouth. I munched so much I never remembered what I ate, plus I had little idea as to the calorie content of food. Cut to 1500 cal/day (for me). No sugar. No white carbohydrates at all - potatoes, wheat products, rice. Lots of vegetables. Virtually nothing processed. Lean meats. Basically, start cooking again. You eat less to lose weight, you exercise for cardio health. When you think a MacDonalds cheeseburger equals an hour of running, you see it's not exercise that makes you thinner.
I look at these tubby kids and I could probably write down their daily diet - sugary cereals and snacks, fruit juice that is "healthy". Probably were allowed to turn their noses up at every healthy food offered to them.
They don't need their parents to send them to fat camp - they need training for their parents on how to feed kids (and deal with whining).
177
You got it, Man!
1
Mtnman1963,
Sounds like the Keto diet.
Well done. Congrats.
1
Congratulations on your weigh-loss achievement! Weigh to go !!
1
Articles like these should be shoved in the face of every single "fat activist" in the country. Being obese is not like having brown skin or blue eyes. It is not "natural". It's a terrible condition, almost closer to alcoholism because it's also mental, not just physical. Like another user below me said, eating so much junk is often a coping mechanism to deal with emotional issues. Just like alcohol.
92
Your suggestions are far too sensible to ever be implemented. The Trump administration went after Ecuador for promoting breast-feeding at the UN, and the Obama administration tried to bully the EU over food safety standards, which led to the collapse of the TTIP negotiations.
Let's face it, NO US-administration will EVER go after big Agro or the processed food industry. And as long as poor Americans live stressful lives, and work longer hours than everywhere else in the developed world, they will go for the convenience and sweet relief of processed food and cheap take out.
American obesity rates are the result of deeply rooted social and political forces that are beyond the power of the US government to change.
28
@Kassandra This. Thank you for saying it so plainly and honestly.
Several good suggestions here.
However: the man at the top of government is overweight, averse to exercise, and is known to indulge in fast food - fried chicken, burgers.
What are the chances anyone in this government will push policies such as these?
62
@D. Epp He's more than just overweight. He has to lie about both his height and his weight in order to stay out of the obese category. (And no, he doesn't have any muscle to use as an excuse.) He also seems to be getting fatter by the day in the White House.
2
Your data on the relative prevalence of type 2 to type 1 diabetes is outdated and inaccurate. Many adult diabetes cases are of autoimmune etiology, probably well over 20 percent and perhaps higher. This is now well understood and can be shown via autoantibodies and insulin deficiency. Diet is critical for these patients, but it is not the cause of their diabetes. A lot of these are mislabeled due to the later age of onset. It's also worth mentioning that risk of type 2 diabetes variesfactors.- by 5-fold or more - based on family and ethnic history, among other factors. The NYT itself featured this in an infographic a while back.
16
At some point our thinking may evolve from blaming the victim to understanding that obesity is an inherited disease. Many thin people have bad diets but they are thin so it doesn't show. When a thin person gains some weight, they cut out donuts or a second glass of wine and lose it quickly, leading them to think, hey, I did it, why can't really fat people do it? The self-righteousness of some people knows no bounds. As I say, thinking has to evolve about this. And individuals who are fortunate enough not to have weight issues should stop acting holier-than-thou. It is like gloating you don't have cancer or lupus or some other terrible disease. Obese people need compassion not lecturing. That merely adds insult to injury.
55
@Asher B I agree about the need for compassion, but the reality is obesity was much less common even twenty years ago. I don't come from one of those naturally thin backgrounds but back in the day the elders in my family were typically maybe twenty pounds overweight, not fifty or sixty. It wasn't because they were naturally less overweight. It was because they realized the importance of eating healthy food and doing exercise. We didn't have a lot of money but my mother stressed buying veggies and fruits over junk food. I never had a sweetened cereal until I was an adult--and then it tasted terrible to me.
9
I’m one of those naturally trim people, but I certainly never feel or act holier than thou. I realize I’m lucky. And by the way, when you are a slender female, a fair amount of resentment gets leveled at you by other women at times. I was even periodically accused of having an eating disorder in my 20s.
2
@Asher B. Please read the following. The “inherited” mantra only goes so far.
https://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/ge...
We still don’t know why some people get so darn fat. Until we do all of these are half measures at best. Getting big gov involved for half measures is a very bad idea in this political environment. We need people to admit that when it comes to themselves, if they can’t get themselves into shape there is no possibility of making America great....talk about military unpreparedness.
I suspect significantly under-researched microbiome disturbances are the real problem....
When children under 5 are heavy we need to educate their parents.
5
another unmentioned cost: shortage of fit young people for our military (this is true whether considering current voluntary recruits, or whether a draft might ever be called in the future).
9
"we can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets."
What is this? No really, what am I supposed to make of this? That something so personal as the choice of what you consume is not your responsibility is so baffling a concept as to be deserving of Orwell's classic dictum; “[t]here are some ideas so absurd that only an intellectual could believe them.”
41
What if all this American obesity is caused not so much by rich diet, as by heritage from certain ethnic groups, such as central European Germans?? What will we do then, while we are starving ourselves with all that lettuce and kale?? Genetic heritage from certain groups is extremely widespread after all these generations.
2
@Joyce Boles Go to Germany and you will see some heavy people, more than in, say, France. But the percentage of people who are obese is nothing like the percentage of Americans who are heavy. And when you go to places like the American South or Midwest, you will see that almost all of the people are overweight. Even a lot of children in those areas are seriously overweight. You don't see that in Germany.
2
@Joyce Boles Do you really believe that the genetic makeup of "central European Germans" has changed in just a couple of generations after migrating to the Americas? How many pictures dated 1950-1970 of "central European Germans" showed obese people?
How do you explain that even today, "central European Germans" still living in "central European Germany" are not as obese as their American counterparts?
Full disclosure: I am a "central European German" who was once overweight, and then decided no longer to be, and have been weighing in at BMI < 20 for the last 15 years.
1
People are NOT healthy at every size, despite what certain factions within the social justice warrior movement will tell you.
Men and women alike have a duty to their families and country to stay fit. Tons of boys from the heartland are beginning to be turned away from military duty due to being so overweight that their hips are breaking under pressure from basic.
It's really all a matter of temperance and a basic understanding of nutrition and caloric intake.
Good source: https://liamrosen.com/fitness.html
12
"Beyond the human suffering" is the animal suffering & the planet suffering (the things that produce the food being eaten). Every time I see an overweight person I think, "don't you care about the needless suffering you're causing because you can't control your eating habits?" Not to mention the impact of all the medicine that is then required to control their blood pressure, etc. What about all of the extra waste they produce? And the extra garbage from the additional packaging, etc.? And when the stats say that 40% of food goes in our trash, their 40% is likely higher than most. Again, what about the animals, the planet, your family (who may not see you grow old), don't you care about something other than yourself? None of these things are enough to make you change your habits? Really?
8
@BeTheChange I have lost 50 pounds and I'm on my way to lose 150 more. This won't be the first time I've lost weight, although if I succeed it will be the most weight I've lost. If it was as easy as thinking about those things, I'd have lost the weight long ago. It isn't that easy. I no longer eat animals (not the first time I've done this either) and try to avoid packaging whenever possible. Most of the food I see in the trash comes from thin folks who don't want to overeat or who actually get full from meals, something that just never happens to some of us.
I'm aware that being obese is not healthy. I don't like it. I've tried to get help many, many times starting at the age of 12 (I'm 59 now). I've been up. I've been down. But it is never, ever easy and it is certainly not because I don't care about animals, the planet and my family. I'm going to continue losing weight, but it is not because of folks like you who only complicate the problem. There are much better ways of helping folks.
20
@BeTheChange
Boy, that's harsh. Have a little compassion for your fellow human beings. Nobody wants to lose weight more than they do, and they care deeply. In fact, internalizing the intolerance and contempt of people like you worsens their sense of guilt and self-contempt, makinf it all the harder to lose weight and live positively. As a thin person, I'm grateful for the problems I don't have, but I try never to judge people, even in my own mind, because it makes me ugly on the inside, even if I'm pretty on the outside. And it hurts those who don't need the self-recrimination. Just a ceontemptuous look or snide remark does a lot of damage.
2
There needs to be a cultural shift as well. Most Americans believe that eating healthy is a penance, while MacDonalds meals are a guilty pleasure. Anybody with an educated palate knows it is the opposite. Good food is delicious. Once you are used to eating vegetables and fruits daily, you’ll never go back to processed junk or the huge quantities of meat Americans consume as a matter of fact. Yesterday we went out for a business lunch with an obscenely overweight guest. He was not poor by any means. But he ordered a steak to my salad and ate twice as much of everything as I did. Biology? I don’t think so.
25
@Mor
I eat aged strip steak two or three times a week. I have six-pack abs. I do not drink (much), eat sugar, eat white flour, eat fried foods. Beef is not the culprit. I don't eat truckloads of greens (kale, collards, arugula, beet greens).
1
@richguy
Oops. I mean I DO eat truckloads of greens.
A thoughtful article with idealistic measures. The most difficult aspect to implementation is actually getting fresh food on the table. I know, I am a stay at home mom who frets about my family eating well and that takes a lot of effort and a lot of time. Cutting vegetables, seasoning them, preparing them differently to appeal to children and adults, it's a lot of thinking and cooking. No salads, while healthy, they are hardly child friendly, and for vegetarians, pretty much leave folks awfully hungry quite quickly.
So, to convert America, you need to change work timings to account for home made dinners. You need to change the psychology of an entire nation on how to spend free time at home. The convenience of processed foods and their rewards are immediate. To change, one must be acutely aware of long term gains. Take a look at the cooking shows today. They hardly focus on health. It's all about speed cooking, strange ingredients or tremendous amounts of junk foods. And the healthy eaters? They resort to crazy power bars with really questionable biochemistry behind them.
America as is, makes a lot of money for a lot of industries and the medical community. A healthy community is hardly good news for the economy. But, this conversation is a very good start.
12
@Meena, I had a wonderful waitress who years ago, told my 5 year old daughter that salad was a finger food: pick up a piece, dip it into the dressing, and eat. Worked like a charm. She still likes salads today -- though she did graduate to a fork.
2
Obesity is linked to low vitamin d levels. As a start, how about changing the standard of care - a checkup could include bloodwork and a dna test so people can determine if its diet or mutation that is forcing them to overeat in order to get the nutrients they need. Secondly, how about forcing schools to let students go outside for recess. Its ridiculous to sit inside and watch movies all winter.
9
Thanks for these details and common sense policy suggestions. The root cause of our diet problem is corporate control of the food chain, especially subsidized meat, starchy grains, and sugar. Eliminating their subsidies and incentivizing healthy foods would cause major changes.
30
The fallout( spike in obesity) began when public schools dropped physical education ( and the arts) from curriculums. I have been some what of a regular exerciser since elementary school. I keep it simple - push ups, sit ups , and jogging / brisk walking three miles in 50 minutes or less 5 times a week. Keep the body moving or face atrophy. I am also hopeful that my example has been noticed and internalize by my children.
20
@HenryC PE was pure torture for me and there was not one bit of "education" in physical education. It was part of my schooling all the way through my first semester of college.
PE, with the exception of two years in High School, was a one size fits all class. It sure didn't fit me. It was a place for bullying, teasing, fighting and watching the fittest of the bunch be praised and the ones beneath that to be ridiculed. If PE is going to help with obesity, it needs to be changed. Drastically.
20
@Jeffrey I have to agree. I am 60, and was physically fit and slender, still am. However, PE class was often like Lord of the Flies, and I felt bad for the fat kids - they were picked on without mercy. Many gym teachers were nuts, and oftentimes were the worst teachers and that is they they were placed. Dodge ball was one game where the demons can out and it was savage - even amongst the girls!
Aside from those who are obese due to reasons beyond their control (biological, medical, etc) the average person needs to exercise discipline about their health. I know this is easier said than done. Our society is designed to encourage sloth - people drive everywhere, look for the closest parking space, love fast food, etc. But it is on the individual to do what is right for our health - the blame is on all of us, not just junk food peddlers, TV commercials, etc.
22
I graduated college in 1965 at the age of 20. Back then I never saw a fat (obese) person. The men and women were for the most part, slim and trim. Of course McDonalds was practically nonexistent, Half a supermarket aisle consisted of soda and potato chips.
Today, half the people (including teenagers)I see are overweight (obese). We know what the supermarket aisles look like, so no further description is necessary. Five flavors of Coca-Cola in in pint bottles and Utz Yuengling-flavored potato chips.
Everybody sits at a desk and works in "marketing."
143
@george eliot You know, somebody always says back then they never saw an obese person.
But they were there. I have photographic proof of several family members and people in the neighboring communities.
10
@Kate, yes, there were overweight people 50 years ago. But they were few and far between. The question is: Why are there so many now? The food has changed. It's not really food, it's junk: highly processed, with lots of refined grains, sugar, salt, and fat or oils. And that includes prepared "convenience foods" as well. And then there are the sugar drinks -- a 12 ounce can of Coke contains 39 grams of sugar, 9 1/3 teaspoons. Who would sit down to eat 9 1/3 teaspoons of sugar?
@george eliot - I'd like to show you pictures of my parents.
And my grandparents.
And my great-grandparents.
Not a thin person in the bunch.
1
Agree to all five proposals, but there must be a sixth one - public education on exercise. The clinical trials data have been there for doctors but not made known to the public: Walking 5000 steps a day prevented diabetes in patients with glucose intolerance as efficiently as taking metformin. 5000 steps are ~2.5 miles, not easy for the most of us, but every step counts. We should all set a goal of reaching 5000 steps a day, not only for the good of ourselves but also for the good of our eonomy.
30
I like "personal responsibility" but too often it is used as a substitute for "you're on your own". No society can be healthy in any sense when everyone is on their own. We should provide universal healthcare coverage so kids and adults get one on one counseling from medical professionals to help them achieve and maintain healthy weight and deal with obesity-related conditions. We should richly fund education everywhere so people have the factual knowledge, comprehension and reasoning abilities to make good life decisions, including understanding and using nutritional and health information, and are able to resist clever advertising for junk and convenience foods. A half literate and sickly population does not bode well for dealing with the obesity epidemic, and that's where we've allowed the US to go today, in favor of funding lavish lifestyle for the thin and healthy 1% who benefit from this upside-down system of rewarding pushing those things that harm instead of help people.
88
@greenmatters As someone who has seen pictures of Donald Trump, I certainly wouldn't characterize all the 1-percenters as thin and healthy...
A significant change could be made quickly - though politicians will not want to give up Big Food money to make it a reality: treat soda (and/or high fructose corn syrup) like cigarettes. No advertisements. 100% tax (at least) on every can/package. A political war was waged on tobacco companies when it became clear that cigarettes led to lung cancer, and that lung cancer was a significant cost to the states. This is no different, except in its scale...children were not smoking 5 packs a day back then, but they are consuming the equivalent amount of poison today and it's "normal".
56
@Bill McCumber
No difference?????
I don't remember my parents giving me a pack of smokes with breakfast everyday.
This problem can be easily addressed by sending what economists refer to as a “price signal.” Imposing a 50% tax on sugary foods and drinks would go a long way towards addressing this epidemic. There is no need to deny companies freedom of speech. As the old saying goes, people react to incentives, everything else is just commentary.
Of course, this type of price signal is unlikely to happen due to the enormous amount of money involved for stakeholders like farmers, the medical industry, and the fast food industry. There is zero political capital to be gained by enacting this type of legislation. Bad incentives all around but a very laudable goal.
I wonder if the California legislature has the backbone to take the lead on this? Probably not but definitely worth a try.
35
@Joe - this was tried in Chicago and it failed miserably - the tax was rescinded.
3
@Jk - true... people just about rioted at having to pay a heavy tax on their 2 liter bottles of soda... it was viewed as, why do I have to pay more for my necessity, not maybe I should cut back...
I figured out about 10 years ago, soda (diet or regular) are just plain bad for you... now I just drink water or seltzer water in the fun flavors you can get. It gets the job done to hydrate you, and doesn't add a ton of chemicals to your system.
The biggest "cost imposed on the economy" is the growing population. The authors might have as well advocated a reduction in the number of people, if a healthy economy is something they worship.
3
As a school nurse, I like the proposals for the lunch program, and for a ban on advertising aimed at children. But we need to get the kids more active. We need to get back to two recesses a day for elementary school children, and more than one physical education class per week for all grades. Many school districts cut back in these areas, thinking that more time spent on academics would increase test scores. Well, it didn't. Let's try getting the kids more active now.
372
@Bbrown
School recesses won't save the problem for children whose parents allow them to make poor food choices and drink sodas instead of water or a little milk.
Americans of all ages continue to be seduced by advertising for sodas, sweetened drinks all kinds that too many drink instead of water. Bloomberg tried hard in NYC to put a tax on oversized sodas to no avail. Coke, Pepsi, and a myriad of other sources, and perhaps the soda drinkers themselves, would have none of it. If you're addicted, you may not even think about the damage to your health. We finally woke up to the dangers of smoking.. maybe, maybe...
Schools all over the country sell sodas and candy bars. Even educators, apparently,like the money they make from their vending machines. Many individuals, however, buck the trend. THEY WANT TO BE HEALTHY.
@Bbrown could not agree more. Getting kids physically active is key-- and cultivating this throughout their lives. Despite not having gym class in high school, I was lucky that I swam/ran competitively from a young age through college. It helped me by-pass the freshman 20 and today-- at 56-- I continue to swim run (and bike!) and am within 5 pounds of what I weighed in college.
... The amount of activity kids do can never result in enough calorie expenditure. The surest way to manage weight is to control consumption of calories. So making them more "active" wouldn't be of much help, since calorie expenditure from exercise never tops baseline calorie expenditure.
1
One of the largest causes of Obesity revolves around unfulfilled lives - unhappy people find comfort in sweet products. You see it everywhere
Make yourselves a little happier every day and you'll find food becomes a necessity not a reason for living.
I've done it.
39
@JBT will do. just as soon as NYState legalizes pot.
6
@JBT - stop conflating body size with mental illness. There are plenty of depressed thin people, too.
2
I am sorry, while there is definitely a corrolation between socio economic status and obesity, it’s not the reason. It is false to say high quality protein s expensive. You can get chicken breast at 2$ a Pound and chopped turkey meat for 3$ a pound. Look for the sales and use your freezer. Education would help.
54
@alan
You can't get chicken breast for $2 a pound where I live. It's more like $6 a pound. I am lucky that I can afford to pay these prices.
It's hard for working people to find the time to shop around for food at the lowest prices and prepare the food. I spend my entire Sunday doing just that. I have cleaning people, so I don't have to clean. People living on a tight budget don't have time to bargain shop and still have a life.
5
@Abby I am not sure where you live but if the only chickenbreast around you is 6$A pound then I don’t know what to say. I work, clean house (don’t have $to pay others for that) and do most of the cooking for the four of us. It takes five min to make turkey burgers, five to make egg whites (cheap per serving)and 30 min to bake chicken breasts. All cheap and quick. Yes more expensive to eat at a fast food place nd linger to wait many times. Sorry, it’s about education.
@alan
You raise a good point about education — life skills education like home economics classes have fallen by the wayside in an era of mandated testing. So a whole generation only cooks if taught by parents, or self-taught. Many people don’t know the rudiments of basic nutrition, meal planning, shopping and cooking, and rely on takeout or frozen prepared foods from the grocery store which might be loaded with salt or sugar, and are pricier per serving than food you cook yourself from scratch. People are also exhausted from long work hours and they don’t want the bother.
It takes a lot of effort to retrain a family to adopt better habits. I have a daughter who essentially refuses (she is heading off to college soon, but previously would happily spend her earned babysitting money on takeout and junk food rather than cook anything for herself) and a younger son who is interested in learning how to cook. Neither is obese but I hope for their lifelong health that they learn how to cook for themselves!
Taxing groceries seems retrograde. It’s certainly true that food consuming a smaller portion of the family budget is a contributing factor. But making food more expensive so poor people are forced to eat less seems Dickensian. Starve the poor so they will look leaner and more attractive when people drive by in their Teslas.
The emphasis on processed foods is odd because the 1950s were peak years for canned food, sugary breakfast cereals, soft drinks and TV dinners. Fresh produce came back in style in the 1970s, just when the obesity epidemic began.
The idea of increasing taxes and building a new government agency seems exciting to Liberals, but just when we got big government out of the bedroom, it’s taking over the kitchen.
9
@Rick
Seems like the sin tax strategy worked to reduce tobacco use, though.
5
There are several issues that need to be emphasized re this opinion piece about an epidemic that should not be. The first is the ever-increasing necessity for parents to work long, exhausting hours. Our economic paradigm now requires both parents or the single parent to work while raising their children. Hence, a high-salt, high-saturated/trans fat, high-cholesterol diet, whether it be from fast-food chain or frozen/pre-prepared meals. Because of limited time, we send our kids to school either without breakfast or give them sugary cereals, Pop Tarts, etc. Lunch, dinner, and "snacks" are anyone's guess.
Next is education. How much would it cost us taxpayers to make sure that our teachers incorporate the basic science of good nutrition? Just imagine how much our children would learn...a little biology, a little chemistry, and basic physiology along with anatomy. All this while learning how to take care of themselves
Last and most important is prevention. Just think of not only a healthier body but also a healthier mind with less depression and higher self-esteem. It is doable.
94
@Kathy Lollock that's not true. I know many families in which only one parent works. One friend of mine has 6 children and homeschools them. And while money is tight, they are not homeless and the children are not starving.
1
@K That depends a lot on what the one person's job is, where you live, and how sure the dependent spouse it that she/he won't be dumped at will by the other spouse with no career to fall back on.
@Kathy Lollock You make a good point - here in NYC it's relatively easy to find fast, casual chains that are healthy, but the reality for most of the country is that they have neither the time nor energy to consistently prepare their own meals nor healthy, affordable pre-made or takeout options.
This is an excellent article hi-lighting a very important issue that is impacting most western countries. I agree with all of the author's recommendations, particularly as it relates to banning advertising of all processed foods that is directed towards children. I also really like the idea putting a tax on all processed foods with a redirection of those funds towards making healthy food education (and options) more available to all, particularly targeted towards the lower socio-economic classes. However, the unfortunate reality is that most U.S. politicians are beholden to "Big Food" and their lobbyists. Inertia on this file is their greatest weapon. Nothing will get done and in 20 years, 50% of all Americans will be obese. Book it.
43
Will someone explain to me how the maps that link on the "show" in this sentence:
"County-level maps show striking correspondence between areas with the highest obesity rates and those with the greatest increases in mortality"
show anything of the sort.
All I see is mortality data and only against the mean, not in absolute terms. I think using the mean here is meaningless. And the comparison is 20 years old.
2
@m.pipik
You are correct that the maps don't say anything about obesity. But there are maps at the CDC website that show the obesity rates over time in the US. Those maps do show the regional differences in obesity. It does roughly correlate with the maps here related to life expectancy.
5
It would be nice if there were more public pools, indoor gyms and other athletic facilities available to more people for low cost. Where I live there is none, no pools, nothing. No Y's, boy/girl's club either. And the new bike path is on the upscale side of town, where most people ride for pleasure. Whereas on the other side of the tracks, people are riding their bikes down dangerous roads, all year round, wearing their supermarket and fast food restaurant uniforms. Giving the general population more places to exercise and get healthier is a start. And the earlier we get kids learning to be active the better for them later in their lives. Build it and they will come. General physical finess should be a national public health priority.
242
@Lee
I agree with your post. I live in Boston, where there are neighborhood community centers where you can join for $75 per year for the whole family. The hours aren’t extensive, but there are usually swimming pools and a gym where you can take basic fitness classes. Same with the Y, which charges on a sliding scale. Teens can also join for $5. These facilities are probably scarcer outside of cities, but this is an important resource for families to get some exercise.
10
We live in a society that is focused on instant gratification, with no person accountability. Losing weight is not hard, but no one want to be personal responsible for doing it. You do not need a gym membership, you can walk 45 minutes every day. But our society is focused on fast food and we have multi generations that believe it is good for you. How do you change the behavior? A good step is for health insurance companies that get more involved and requiring members to either loose the weight, for face much higher premium.
26
@David Lewenz As someone who's recently lost a substantial amount of weight, I can tell you that obesity is absolutely not an issue of "instant gratification, with no personal accountability." Losing the weight was extremely hard, and keeping it off is harder, despite the fact that I can count on one hand the number of times I eat fast food in a year, and despite the fact that I run, on average, 20 miles per week. Losing weight requires access to healthy foods, safe places to exercise, and support from loved ones. And because there's a strong correlation between obesity and income, your idea of adding penalties to insurance premiums would ultimately exclude the very people that need help.
Also? It's "lose," not "loose."
245
@David Lewenz Someone working 2 jobs can't (or can't bear to) walk 45 minutes a day. The same can be said of cooking healthy foods- admittedly, careful shopping and planning will yield cheap and nutritious meals, but have some compassion for the working poor with very little left-over energy. This is where the socio-economic scourge of obesity shows itself.
Solutions need to include a focus on food, but developing an economy that helps ALL citizens live a decent and healthy life would be ideal. I won't hold my breath, though.
31
@David Lewenz The science is now clear that obesity is not a disease of insufficient exercise. It is a hormonal disease of hyperinsulinemia caused by eating refined carbohydrates and eating too frequently. Recommending gym memberships and brisk daily walks to combat this disease is exactly the kind of dangerous propaganda that the Big Sugar industry promotes. ("drink coke then go for a run!") People have gotten ill by following the government nutrition guidelines, and now you want to punish them for following your failed advice? Since when does punishing victims help the situation?
13
Thank you for this excellent and timely article. One thing I'd add: eating disorders.
Many chronically obese people are eating disordered. They use food--and compulsive binge eating in particular--to cope with emotional issues. Binge eating disorder is now formally recognized as a psychiatric condition and may well be epidemic. When the obesity is triggered not merely by poor food choices, the problem calls for psychological intervention.
The authors' recommendations for government to get more involved in prevention and promotion of healthy dietary habits are spot-on. We also need for the medical profession to be more aware that at least some of these chronically overweight children (as well aa adults) are using food to help them cope with abuse and other dysfunctional family problems.
69
@steve, As long as we ascribe all of our problems to the mental disorder du jour, nobody is going to get real about getting to the root of the problem. So if chronic obesity is due to some kind of compulsive disorder, why are Americans, who are a melting pot of genes and ethnicities, uniquely afflicted? Sure, eating disorders do exist, but the vast majority of cases of morbid obesity in America is secondary to lifestyle and the vicious cycle of lifestyle-related illnesses and immobility. The market is simply rigged in favor of the Big Food industrial complex, which rewards the consumption of cheap, processed, calorie-dense foods that are engineered to deliver optimal salt/sugar/fat ratios to trigger sensations of pleasure. Until we dis-incentivize this, Americans will continue to gorge.
12
@steve Obesity is not, at its core, a psychiatric condition. It is a hormonal disease of hyperinsulinemia caused by eating refined carbohydrates and eating too frequently. One of the ways this disease functions is that because insulin is high all the time, the body is in permanent food-storage mode. It can never burn the body fat it has stored. The result is that physiologically your cells are starving and this causes unbelievably strong food cravings. If you stop eating carbohydrates and allow your insulin levels to drop, your body has access to stored energy and the cravings go away. No binge eating any more. Really. Its that simple. I have experienced this first hand.
29
@LeeAnn Thank you for describing a Ketogenetic (Keto) diet. Many more people are enthusiastically embracing it simply because it works. Google it! Reddit has one of the best Keto information resources available.
"More research is needed" is the mantra of academia. We don't need more research to know that:
Too many people are choosing the wrong foods;
Animal-based foods (eating cows, pigs, chickens, fish, cow's milk and cheese, and eggs) are the principal cause of many preventable diseases, that the federal government subsidizes and thereby promotes these industries (especially animal 'agriculture,' an oxymoron);
There is no financial incentive in our "health care" system for people to choose to eat healthfully or be healthy;
The disease industry--doctors, hospitals, pharmaceutical companies, and their partners in academic medicine, led by Harvard Medical School--are thriving as unsustainable demand for disease care continues to mount, while most doctors have no training in nutrition or healthy lifestyle.
The solution would require a paradigm shift at many levels--societal, governmental, industry, and consumers. In our current political environment, this is impossible.
104
@JCX - You sound pretty sure of yourself, but switching to a diet consisting almost entirely of eggs, cows, pigs, chickens, fish and cheese saved my life - emotionally and physically. I'm in my 50's now, at a normal weight, and I've never felt better.
It's sugar that's the culprit here (including processed carbs of all sorts), along with the fact that a typical work schedule can make it difficult if not impossible to get in regular exercise and that a typical work day consists of sitting at a desk for 8 hours (the tedium of which makes sugary snacks all the more appealing as a way to artifically boost energy).
51
@Kristin, actually, both animal products and processed foods are culprits in obesity and ill health. And a whole foods plant based diet is more sustainable and better for the environment than eating animal products. (Not to mention better for the animals and workers, and for decreasing development of antibiotic resistant resistance -- more than 23,000 Americans die each year of antibiotic resistant infections.)
@Kristin I am pretty sure, and I'm very qualified to render this assessment--not that this matters in the internet world where everybody is a self-proclaimed expert. Your anecdotal story (whataboutism) is part of the problem, not a solution. By the way, the same animal-based diet is also consuming more fresh water than any other source on the planet; contributes massively to global warming; and is grossly inhumane. If the US were to convert all the animal feed crops (corn, soy, hay, etc.) to human food, we would have enough to feed the over-populated world many times over. All of this information is widely available and scientifically established.
Thanks for this important essay. I see small children who are obese and I want to cry for them. Through no fault of their own, they are condemned to a lifetime of struggle with their weight, and all the associated social and physical problems.
While the First Amendment extends only slightly lower protection to commercial speech (advertising) than to political speech, I've long thought that advertising aimed at addicting children to unhealthy foods should enjoy no more constitutional protection than that which would aim to addict them to cigarettes, liquor, or meth, i.e., none.
47
@John - Exactly, I agree. The NYT ran an article earlier this year on how the country of Chile has effectively banned or greatly limited past advertising practices directly associated with the spiraling obesity epidemic there.
Feb 12, 2018 - Published in NYT
"In Sweeping War on Obesity, Chile Slays Tony the Tiger"
...New regulations, which corporate interests delayed for almost a decade, require explicit labeling and limit the marketing of sugary foods to children.
In my opinion, the costs for governments to not take action and let this scenario runs it's course, is that it would erode all public support for the governments that fail to support the people's will - and not the lawyers & lobbyists .
2
One additional measure would be adding calorie, sugar and starch data to restaurant and take out menus. It used to be true, I think, that Times recipes included a calorie count. I realize it is possible to get a calorie count from NYT Cooking but how many of us take that extra step. When I buy coffee at Starbucks, the calorie count has saved me from many a coffee cake or doughnut I really don't need. So NYT put your influence where you are editorially. Add nutritional information to your recipes.
115
@Rima Blair Restaurants in NY already have calorie counts, don't they? And besides, it's not calories that should be counted, but carbohydrates.
2
@Rima Blair I've read in the past that this doesn't make much difference but I know that I have found it helpful. Portions often have much more calories that I would expect.
4
@Rima Blair; Have you ever encountered a coffee cake or doughnut that wasn't excessively high in sugar, fat, salt and calories? Why do you need a label to validate what you should already know?
2
I agree with many of the points made here, but a sales tax on processed foods is a regressive tax that will hurt lower income communities the hardest. Processed foods are calorie dense, require little time to prepare, are widely available, and have a long shelf life. For hungry families, taxing such goods is not the solution -- it only adds a further burden to an already limited grocery budget. Local and federal governments should seek alternate sources of revenue to subsidize healthy foods.
91
@Edward
We could start with a tax on soft drinks.
4
@Edward, but then you are then assuming that, all things being equal in price, lower income families will make the healthy choice. Much has been reported about the "food deserts" in low-income communities, but nobody has ever complained about the taste of cheap, unhealthy food like fried chicken, french fries and pizza.
1
@Edward yes, you're right that ' Processed foods are calorie dense.' However, please note that they are expensive, usually produced and contained in a manner that is bad for the environment, and are NOT nutrient dense. The focus should be on nutrition, not calories. Because processed/prepared foods are largely not necessary, taxing them is fair game.
1
Combating obesity and weight related health issues should be a national priority. It is not too far fetched to talk in terms of this being a national security issue. Hundred of millions of dollars that could be spent on infrastructure, education, the national debt, etc.-investments that strengthen us as a nation are instead spent on health care and related costs that are totally preventable and pay no “dividends” to our country.
33
@HK
Although I agree with you sentiment, this country is suffering from a number of issues that are a national priority: the Mental Health epidemic, the Gun Death epidemic, the Opioid epedmic, just to name a few.
To Make America Great Again is going to take more than yelling a silly slogan and wearing a hat or a tshirt. It is going to take: teaching critical thinking skills, personal responsibility, an investment in human beings as valuable members of our communities and polity (not corporations as human beings), and realizing that complaining about immigrants and brown people is not going to bring back jobs that technology is taking away daily.
12
"we can’t blame individuals and expect personal responsibility to solve the problem. Instead, we need the government to pass a suite of policy changes to encourage healthy diets"
Encouraging governmental support for healthy living is essential. However personal responsibility is also essential. Increasingly we live in an age where everything is blamed on outside sources. The narrative shift by the government and society must not rely solely upon acceptance of things beyond our control, but how to overcome them, rather than rely upon the government to do it for us. That is a dangerous path.
178
@Dustin, this is exactly my point. People didn't use to be fat, so blaming it on genes is not exactly accurate. It's astounding to watch tv shows from the 50's and 60's and see how lean and fit everyone on the street was! The very fact that so many people are now fat encourages people to think of it as the new normal.
6
@Dustin Well, Dustin, nice idea but it isn't working judging by my own observations across several states of the obesity of Americans.
Government policy including nutritious school lunches and adequate recesses and physical education can go a long way to encouraging better health practices.
Fast food restaurants should be taxed with the money earmarked for subsidizing healthy food in grocery stores.
All restaurants should reduce their portion sizes.
Two meals per day are all that are needed for sedentary lifestyles.
Open spaces should abound in all urban areas.
Since obesity is rampant in rural areas as well, even more so, because there are few if any gyms or Yoga classes or the existence of an "exercise culture" in small towns, rural population obesity needs to be addressed.
3
@marywho
I can send you pictures of my fat great-grandparents from the 1920s and 1930s to disprove your theory.
It is not a matter of dispute that weight is regulated by genetics. Claiming the opposite is like being a climate change denier.