NY Times Reporter's File on Obesity: Could you BE more pessimistic?!

Dear Laura,

I received your email re: NYTimes.com: Reporter's File: Obesity. Per your comments concerning the content of said "file", I have responded below in an itemized fashion.

(I would like to note that I am NOT a medical professional, nor a professional of any kind (besides being on the Board of the North American Jackass Association, NAJA). Therefore, my comments are purely my own opinion and do not reflect the established opinion of the Western medical community. However, I would like to note that I have read widely on the subject of obesity in the United States because it is a curious problem and besides, everyone and their mom seems to have their own idea about why the U.S. is so fat, so why shouldn't I?!)

1. Let's start at the beginning, shall we? On the issue of genetics, Reporter's File says:

Diet and exercise do matter, they now know, but these environmental influences alone do not determine an individual’s weight. Body composition also is dictated by DNA and monitored by the brain. Bypassing these physical systems is not just a matter of willpower.

You already knew this. People look different and have different body types and are able to consume different foods to different effects. Some people are going to have an easier time gaining weight that losing it just as others will stay thin forever.

Is this an excuse for obese people? Should we all just get over the fatness because it's genetic?! It might sound like that at first, but I don't think it is. There are several factors at play here, and none of them reign supreme in determining weight. Genes, diet, exercise and willpower are all important parts of the equation here. They are clearly not EQUAL parts of the equation, but they are contributing factors nonetheless.

The article also completely seems to miss the influence of other factors like stress and sleep deprivation, not to mention the higher prevalence of obesity among people with low SES. Maybe those things are considered "weaker" or maybe just more boring. It's hard to say.

2. On the issue of diet, Reporter's File says:

The nation’s poor diet has long been the scapegoat... The recent rise in obesity may have more to do with our increasingly sedentary lifestyles than with the quality of our diets.

It seems there is evidence that we Americans have been eating a lot of crap for quite awhile now, but I would argue that the definition of "crap" has deteriorated to an even lower level of crappiness.

Case in point: The article points to the fact that in 1966, McDonald's had already sold about 2 billion hamburgers. What they don't say is that in 1966, people were washing down those hamburgers with a 10 ounce can of Coke, or more likely, a 6.5 ounce bottle. Today, it's more likely that people are eating Big Macs (not introduced until 1968) which weigh in at 540 calories, a large fries (500 calories) and drinking a 32 ounce Coke (310 calories). Can you do that math? It's 1350 calories. I SERIOUSLY doubt that a meal at McDonald's in 1966 was 1350 calories. Yes, we sit around on our asses a lot more, but there is no doubt in my mind that we are consuming a lot more calories to go along with it.

(Which is to offer no explicit comment on the increasing size of individual soda quantities. A year ago, a Pepsi spokesperson explained the reasoning behind the introduction of 26- and 16-oz bottles into convenience stores: "[It] is about giving consumers more choices, and if that leads to more frequent transactions and greater volume, it's also a win for our customers, our bottlers and us.")

3. On the issue of exercise, Reporter's File says:

The leisurely after-dinner walk may be pleasant, and it may be better than another night parked in front of the television. But modest exercise of this sort may not do much to reduce weight, evidence suggests.

The key word here is "modest." A meandering 20 minute walk will hardly get your heart pumping. Unless, of course, you are extremely overweight and you just ate the McDonald's Big Mac, fries and Coke for dinner and also the walk is uphill. This sort of modest exercise *might* help you maintain your weight so you don't gain any more, but it's not going to reduce weight.

The Reporter's File fails to mention exactly what type of exercise can aid weight loss, so it seems like exercise is worthless. Obviously that is not the case. Have you seen The Biggest Loser? Have you noted how hard they work out? So hard! And how long? Hours! A huge amount of effort is expended to lose all of that weight. And once they get to their "goal weight", whatever that may be, it's going to be more hard work to maintain that weight. This effort does not fall under the "modest" exercise category. It's hard f-ing work, but exercise can help.

However, for the average person, I think that if you only exercise to lose weight, you are going to be disappointed. It takes more than 30 minutes of cardio twice a week to see significant weight loss. Fortunately, the benefits of exercise are far-reaching! Exercising affects your muscles and bones--from your legs and arms to your heart and lungs--is incredibly important to your physical and mental health. The Reporter's File mentions nothing about this (since it has nothing to do with obesity) but it's useful to note that exercising isn't just about weight loss.

4. On the issue of the body's/brain's determination, Reporter File says:

Scientists now believe that each individual has a genetically determined weight range spanning perhaps 30 pounds.

I really don't know anything about this. It's the genetic thing again. Obviously, this 30 pound span is not a hard and fast rule. If that's true, then how does a person grow to be 40, 60, 100 pounds overweight?

I don't want to get touchy-feely, but if this "30ish pound span" idea is correct, there is clearly a pretty big disconnect between what we think our bodies want and what they actually need. People must be seriously ignoring the subtle signs they receive from their body in order to gain so much weight. Does your body really want a Big Mac or is your brain just mesmerized by the fluffy bun, the sizzling patty and the glistening cheese? (Yes, sometimes cheese glistens with delicious cheese sweat.)

5. On the issue of maternal diet and pregnancy, Reporter's File says:

According to several animal studies, conditions during pregnancy, including the mother’s diet, may determine how fat the offspring are as adults. Human studies have shown that women who eat little in pregnancy, surprisingly, more often have children who grow into fat adults. More than a dozen studies have found that children are more likely to be fat if their mothers smoke during pregnancy.

I believe this. This research is fairly new it seems, but it's pretty compelling and scary as hell. The Reporter's File was updated August 2007, and already there have been some new updates in the role of the maternal diet. In January, researchers found that a high-fat diet can lead to fatty liver disease in newborns, which sounds like a fantastic way to start a new life.

Overall, on the first read the Reporter's File comes across as hopelessly pessimistic. But after I read it a second, third, fourth time, there really isn't any content that you haven't heard before. The difference is that you usually hear bits of this information accompanied by tips and tactics to combat the somewhat depressing information. But the File lays the bad news on thick and without relief.

But that's the point. The title is "For the Overweight, Bad Advice by the Spoonful," not "I'm Going to Tell You a lot of Bad News, and Then Make You Feel Better About It." The facts are that it's hard to lose weight and there are a lot of factors stacked against the obese.

A little awhile ago I posted a quote from an editorial in the American Journal of Public Health. Essentially, people are starting to recognize that the epidemic of obesity (and yes, I'd call it an epidemic if 66% of Americans are overweight or obese, according to the File) is not just a personal problem shared by of millions of individuals. It's systemic. The way We eat, the way We teach our children, the way We do business, etc. is quickly becoming one giant, intertwined mess of misinformation.

The File makes it seem like there is no hope for the obese Individual, and maybe there isn't a lot. But I think there is hope for the obese Society, if we start making some difficult changes in the way we live our lives.

Love,
Chloe