RSS Feed MenuLast week, news of rising obesity rates made big headlines. “Obesity Rates Keep Rising, Troubling Health Officials,” declared The New York Times.
According to the widely reported study, 27 percent of American adults in the U.S. are obese. The findings are drawn from a telephone survey of 400,000 adults who answered questions about their own height and weight.
Telephone surveys are far from perfect, and it should be noted that the result is different from another CDC-backed survey – the National Health and Nutrition Examination Survey (NHANES). In that survey, which combines both interviews and physical exams, 34 percent of U.S. adults are found to be obese.
Obesity is a major problem. Whether or not it’s a growing problem is debatable (NHANES data suggests we may have hit a plateau) but with roughly 3 in 10 adults tipping the scales, so to speak, obesity is something that must be addressed. First Lady Michelle Obama, as I’ve noted before, has done much good work in this area. Shortly before the survey results were released, she put the pen to paper again.
One of the hot topics at the city level is how to address food deserts. Inner-city America is rich in crime, poverty, and fast food. The dearth of vegetables and fresh fruits – what experts term the food desert – partly explains rising rates of obesity, particularly among minority communities. Three million Chicago residents and half of Detroit’s population reside in food deserts.
First Lady Michelle Obama, in her high-profile campaign against childhood obesity, has specifically targeted food deserts; many cities – including Chicago and New York – are attempting to address the problem. See, for example, Time’s excellent article on Farmers Best Market in Chicago.
Though generally favored and championed by the left, these efforts are worthwhile. As an aside, I’m particularly impressed with Baltimore’s efforts (a topic for another day).
But the full magnitude of the problem is important to remember.
Last year, the Department of Agriculture released a thoughtful report on the topic, “Access to Affordable and Nutricious Food: Measuring and Understanding Food Deserts and Their Consequences.”
The authors write: “Of all households in the United States, 2.3 million, or 2.2%, live more than a mile from a supermarket and do not have access to a vehicle. An additional 3.4 million households, or 3.2% of all households, live between one-half to 1 mile and do not have access to a vehicle.”
Urban initiatives may irrigate food deserts, but that will probably help only a sliver of the population.
What’s to be done? Professor Tomas Philipson and Judge Richard Posner suggest a robust role for the private sector in terms of medical innovation – an idea that is touted by the right. (Though, for the record, Philipson and Posner do see a legitimate government initiative: subsidies for medical research in order to foster medical innovation.) They argue:
Another form of technological change—medical innovation—may be the most promising solution to the obesity problem, and here the government may serve a useful role by subsidizing basic research. Medical R&D has proved effective in disease control when behavioral change proved costly. Consider the replacement of quarantines by vaccines or of low-cholesterol diets by drugs, or drug treatments for HIV, which have changed the disease from a death sentence to a chronic condition, at least in wealthy populations.
Philipson and Posner see hope in recent pharmaceuticals, like Onexa (which is up for FDA approval).
And while it would be great to believe that we’re just a pill away from an obesity fix, the reality is that both left and right seem to be prescribing thin solutions for a major problem.
abk1985 // Aug 13, 2010 at 3:04 pm
Watusie: That is not what empty calories are. Empty calories are calories that have little or no nutritional value. If I fed you 2000 empty calories a day, you would be full. But you would be liable for pellagra, or scurvy or something like that. If I fed you 2000 “full” calories you would have well balanced diet.
“Are you going to agree that it would be good government policy to intervene vis a vis the food industry,”
And what exactly do you have in mind in terms of government policy? Branding? Labels? Do you want to ban commercials for McDonald’s or Kellogg’s Corn Flakes? Be specific, please. Speaking for myself, I don’t care what the government does, as long as I can get some of the really good grease when I feel like it.
Watusie // Aug 13, 2010 at 3:59 pm
abk. Everything I’ve ever read saiys empty calories leave you hungry. If you’ve got a different definition, okie dokie.
As I just wrote in the comment you are responding to, I don’t know what the solution might be. But then again, 40 years ago I would not have imagined all of the anti-smoking measures that would eventually come into effect, either. The question is – does the right acknowledge that this is a legitimate sphere for government action?
ktward // Aug 13, 2010 at 4:29 pm
Another form of technological change—medical innovation—may be the most promising solution to the obesity problem …
The cause of our national obesity problem is ultimately a complex mix of societal, physiological and nutritional dysfunctions. To suggest that we solve the problem by throwing a pill at it is like suggesting that a can of Lysol will take care of air pollution.
For many, obesity is, in large part, a result of extreme malnourishment: too much high calorie, cheap and easily accessible crap food, and too little fresh nutrition-dense food. We require nutritious food not solely to manage our weight (not all nutrient-dense food is low calorie), but to remain healthy. Not that I’m against stop-gap supplements, but there isn’t a pill on the planet that can serve as a substitute for the real thing. Popping a C tablet is not remotely the same thing as eating an orange.
Medical R&D has proved effective in disease control when behavioral change proved costly. Consider the replacement of quarantines by vaccines or of low-cholesterol diets by drugs, or drug treatments for HIV, which have changed the disease from a death sentence to a chronic condition, at least in wealthy populations.
In the case of obesity, behavioral change is *essential*. Costly or not, there is no substitute for it, although meds can augment the weight-loss process. The comparative analogy offered by the article’s author is profoundly absurd: we developed vaccines & meds not because we couldn’t effectively quarantine patients or otherwise control their behavior, but because patients were either horribly afflicted or died as a result of the disease.
As to the weight-loss meds currently gearing up for FDA approval: in every case, this class of meds is meant to be used only under strict physician supervision accompanied by — Yep! — behavioral mods in both diet and exercise. As well, potential side-effects are a huge issue … FDA rejected Qnexa:
But the drug has side effects, both known and theoretical. It may cause birth defects, it may increase suicide risk, it can cause a condition called metabolic acidosis that speeds bone loss, it increases risk of kidney stones, and may have other serious effects.
“It is difficult if not impossible to weigh these issues as the clinical trials went on only for a year, and patients will use this drug for lifetime,” (panel chair Kenneth) Burman said. “It is impossible to extrapolate the trial data to the wider population.”
abk1985 // Aug 13, 2010 at 4:32 pm
Watusie: I am going offline and hope to be gone for a few days: I have to put my money where my mouth is and try to jazz my system with some cardio.
To your question, I consider myself a paleoconservative with strong libertarian sympathies. However, conservatism is not completely a live and let live philosophy. Just because it allows laissez faire in commerce, as libertarianism allows laissez faire in conduct, does not mean that there are not preferences.
Conservatives recognize the division of the human family into groups, however the got there. Nowadays the dominant grouping principle is nation states. Nation states are more likely to be successful — like any individual human being — if they boast certain attributes, such as health, good education, pleasant appearance, physical strength and endurance, good manners, good mental habits, and so forth.
Hence conservatives would be in favor of anything that improves our national qualities or virtues.
I do think the government has a legitimate state interest in immigration control, increasing the native birth rate, decreasing sex out of marriage, reducing the promiscuity and sexuality of our dominant culture, improving the health, strength, and virtue of Americans, and, yes, reducing obesity.
The problem is how to do it.
From the POV of being a smoker, I don’t think any of the measures against smoking that I can think of have been objectionable, with one exception: the fact that I can’t go into a bar and have a drink and a smoke. However, since I only did that maybe 2-3 times a year, it’s no big loss.
I’m not sure how you can get people to eat less and exercise more. I know a 2o something obese woman who was teased about her weight. She promptly went out to exercise and strained a muscle and then spent the next two weeks playing Farmville and noshing McNuggets to get over it. Most of the women in my town but luckily not my spouse are obese. They spend a lot of time watching TV, or are on Facebook, and they drag themselves down to the van to get in line at Mickey D’s once or twice a day.
Question is: What to do? I favor any strategy but not prohibition. I am pretty much an absolutist on free speech and freedom of action, even action deleterious to the self. Maybe someone has some specific ideas.
LFC // Aug 13, 2010 at 5:21 pm
Fascinating conversation. This is one of those instances where the comments are more interesting than the initial post.
DSP, you said “I would like know which social problems you non-limited government types believe should not be solved by government.” For me, this would be one of them outside of nutrition and exercise programs, especially for kids. The points made by others on ending government subsidies for corn, sugar, beef, etc. are also very good.
This may sound a bit cold, but one area not mentioned was the left-wing protection of people who are fat. They talk about comments being cruel and how people should be proud of their bodies no matter what. They defend peoples’ “right” to be able to physically fit wherever they go. I’m sorry, but if you’re body screams that you eat thousands of calories too many and don’t exercise, you have no right to be proud of it. It is simply the highly visible result your failure to take care of yourself.
Rabiner // Aug 13, 2010 at 5:29 pm
abk1985:
“Question is: What to do? I favor any strategy but not prohibition. I am pretty much an absolutist on free speech and freedom of action, even action deleterious to the self. Maybe someone has some specific ideas.”
This is where taxation can be used to dictate consumer behavior. Taxation worked for cigarettes. It’s worked on gasoline. It’s worked in a number of instances that reduces consumption of a commodity. Why don’t we tax foods with added sugar or other foods that are purely empty calories? It would either change consumer behavior or would bring in revenues to the state to help offset the costs of that behavior or most likely both.
easton // Aug 13, 2010 at 5:37 pm
I do think the government has a legitimate state interest in immigration control, increasing the native birth rate
Not sure how increasing the native birth rate is superior to importing the best and brightest from around the world, with most coming already already educated up to a very high level.
Certainly we are a fat and lazy country, but having lived in Asia I can honestly state you can live well and have a balanced and delicious diet. Our diet in the US is a disaster, no question about that.
easton // Aug 13, 2010 at 5:43 pm
And one thing I do not understand is if I were so fat why do these people not take radical steps. I moved to China, I lost 30 pounds without any effort whatsoever and kept if off for years, it has only been since I moved to Mexico (where I live is truly a nutrition desert) that I put a lot of it back on, but I know when I do eventually move back to the states I will go back on an Asian diet.
ktward // Aug 13, 2010 at 6:59 pm
abk1985 asks, really, the only question that matters: What to do?
1. First and foremost, the most proactive effort is non-stop PR. Public awareness.
We eventually caught on that smoking was all kinds of bad for us: parents stopped smoking for their kids’ sake both in terms of health and modeling; the Surgeon General spoke out; schools taught the evils of smoking in health class. On an on. But that decades-long PR campaign was Gov-funded and directed, and it would not have happened if it had been left to the whims of the private sector.
So, rather than slam Michele Obama with petty partisan criticisms (if you’re so inclined), consider her efforts as part of the necessary PR. Build on her message, rather than tear it to shreds.
2. Gov regulation.
I hear knee-jerking as I type, but some sweet regs are already in place and completely reasonable. Case in point: nutrition labels. You don’t believe food manufacturers put all that valuable info on their packaging out of the philanthropic goodness of their hearts, do you? It didn’t happen until Gov. regulation, via the FDA, required it. Consequently, consumers are now able to make truly informed choices, not choices based on Keebler’s elven marketing.
(This is a shining example of how the free-market is at its best when smart gov regulations are in place: Keebler reformulates according to the demands of a better-informed market; new companies more immediately and culturally attuned to meet well-informed consumer demand become successful; MickeyD’s offers apples as an alternative to fries in their Happy Meals.)
More options for beneficial Gov. intervention (IMHO, significantly more effective & inarguably healthier long-term than R & D funding of diet pills and, for all we know, cheaper to boot) :
- Education: science-based, nutritional mandates for lunch programs; recess/PE mandates, and funding for districts that cannot meet requirements. (School Boards have slashed PE programs every year in the attempt to meet their super-strapped budgets and comply with grossly under-funded NCLB mandates.)
- Tax breaks, or some other mechanism, to incentivize ‘food desert’ grocery retailers to provide a mandated percentage of fresh food/produce commensurate with their own State or Regional average.
- Tax credit or other incentive toward the purchase of exercise equipment or gym membership.
- Funding to community Park Districts for program outreach, either diet or exercise-related. (This is especially important for kid programs: many of our kids simply cannot, today, just go outside and play street hockey with the neighborhood rugrats.)
- Big Ag/Farm subsidies: time to pull the plug on what has become perverse funding of Big Ag, and re-distribute to our farm-to-table food farmers as originally intended.
3. Personal responsibility. (Got your attention?)
Admittedly, this is extraordinarily difficult to measure or mandate, but it’s absolutely part of the solution. However, given the growing severity of this particularly chronic health crisis that affects every single one of us on some level, without a comprehensively implemented 1 and 2, 3 is simply a wishful afterthought rather than a reasonable and justifiable expectation.
anniemargret // Aug 13, 2010 at 9:09 pm
Bad food is cheap. Nutritious whole unprocessed foods are expensive. The average individual in the US is exhausted . They are up at 6:30 AM and have to get their kids on the bus, and then rush to work themselves. They come home at 5:30 or 6PM. Their kids are hungry, Dad is just coming in the door . They take the easy way out and eat something fast….and not nutritious.
Lordy…. everyone needs to get off the high horse. Of course we should all be eating better and exercising more. Our society is fast-paced and we are a nation of workaholics. A German friend of mine who visited once said Americans work too much and don’t relax. We don’t savor our food anymore, we gulp in down. Europeans know how to enjoy their food, don’t overeat, walk and bike more, and relax more .
This problem is also society-related. The fact that we are bombarded by cheap food and sodas in the media doesn’t help . No one cooks anymore. I still cook for my husband and myself, since my kids are all grown and out. It takes time to cook whole nutritious foods. The average family is straining for time.
This is a big factor which must be weighed in with all the other arguments posted above. Also if you all haven’t read Michael Pollan’s wonderful books on food and the food industry, do! Especially his “IN Defense of Food” in which he excoriates America’s favorite past-time…demonizing the latest food or looking for the ‘miracle food.’
anniemargret // Aug 13, 2010 at 10:11 pm
Also, there is one point that I don’t believe anyone yet has made…. the one size fits all solution to every body in America. Ridiculous. First of all, women’s bodies are far more complex hormonally than men’s. Ask any women and they will tell you that when their husbands want to reduce, all they do is cut out some calories…and voila!….they lose weight. The woman can do the exact same thing, but her body resists.
Secondly, there isn’t such a thing as a diet that will work for everyone . Reduced fat or low-cal diets are great for folks who have 15-25 lbs to lose. It rarely works for the person who must lose 50-65 lbs. Just reducing calories, even with exercise (and new stats show that exercise does NOT reduce weight – it helps with muscle tone and strengthening, but actually factors in little with weight loss unless you are working out strenulously everyday), does not work for most people.
Eating lots of fruit can be a tremendous weight inducer for many women who suffer from metabolic syndrome – or resistance. For these folks, eliminating all sugar from the diet (including fruit or very limited fruit), and all starches is the only way they lose weight. Ever see those glamorous actresses or models on TV or in the movies? They eat very, very little, and/or eat protein dense foods, ‘good fats’ and almost no starch or sugar.
There is NO easy magic solution for the average American. Each person must find a way…and for some – they need assistance. We offer assistance to the smoker, the drinker, the gambler – all addictions. Some people are becoming exercise addicts – to the detriment of relationships .
Anyone can be addicted to anything at any time, and food is no exception. This is a very complex issue that is seldom just about eating less and exercising more . If it were that easy, we wouldn’t be having a problem!
Madeline // Aug 14, 2010 at 3:48 pm
Three million Chicago residents and half of Detroit’s population reside in food deserts.
Since Chicago has fewer than three million residents total, I’m doubting that this statistic is true.
Rabiner // Aug 14, 2010 at 5:56 pm
“Since Chicago has fewer than three million residents total, I’m doubting that this statistic is true.”
The greater Chicago area probably has more than 3 million. Just like Los Angeles may not have 15 million but the metropolitan area does.
sinz54 // Aug 15, 2010 at 11:48 am
Watusie: I would love to know what you “limited government” types have to say on this issue.
End Government farm subsidies.
And that would eliminate the market distortions that have made corn products (like corn syrup) so much more profitable than fresh fruits and vegetables.
And this is where we conservatives part company with mainstream Republicans (as well as Democrats), who keep showering farmers and agribusiness with subsidies in exchange for their votes and campaign contributions.
sinz54 // Aug 15, 2010 at 11:59 am
anniemargaret:
The biggest contributors to obesity in the suburbs are the automobile and the school bus, which have virtually eliminated walking in favor of door-to-door transportation.
When I lived in New York City, I used the subways. But the nearest subway station was some 5 blocks from my home. Then when I got off the subway, it was another 5 block walk to my school. And some of the bigger subway stations are huge; changing trains at Times Square involves another long walk from one subway line to the others. You got at least some exercise that way.
Now, I see kids being dropped off by school bus. The school bus stops at one kid’s home, and he gets off the bus. Then the school bus travels a half a block to the next home, and another kid gets off there. And so on. Each kid gets deposited right at his doorway, as the school bus ties up traffic behind it for half a mile. What’s the matter, a kid can’t walk a few blocks to his home?
And I see shoppers in their automobiles at shopping malls, cruising around and around till they find an available parking space right next to the store. What’s the matter, they can’t park at the far end of the parking lot and walk over to the store?
anniemargret // Aug 15, 2010 at 4:49 pm
sinz54: I grew up as well in NYC. Where did you grow up? Manhattan? I grew up in northeast Bronx, and we walked to the bus or train, about a 5-6 block walk. Then took that and walked again.
Yes. Our entire country is overly dependent on the car and we are paying for it in more ways than one. Also, our children no longer have ‘recess’….. in some cases, there are no more classes in PE either.
Throw in exhausted parents both working all day and then having to cart their kids to soccer and little league games, etc…and you’ve got the menu for a bad eating pattern for the whole family. As a person growing up in an Italian household, believe me, I learned to cook at the age of 5. I still try to cook from scratch whenever I can because I hate all the chemicals in foods.
But those on this blog that see this problem as simply an act of will power are ignoring the other issues that play into this big time…. expense/hormones/car dependency, etc…
sinz54 // Aug 15, 2010 at 6:41 pm
anniemargaret:
As a kid, I lived in the Bronx. Then my family moved to Brooklyn.
In both places, the nearest subway station was quite a hike from home. And btw, the supermarket was maybe four blocks from home: We brought a shopping cart to the supermarket, loaded it up with groceries, and pushed it home, walking all the way.
The automobile, with its effortless door-to-door travel, has removed the need for suburban Americans to walk anywhere anymore. No wonder they’re all getting soft and fat.
anniemargret // Aug 15, 2010 at 7:55 pm
Gosh ….you and I are probably one time neighbors. My Dad worked in Brooklyn for 36 years. We are poles apart politically, but sometimes we can agree…to disagree!
Yes, I remember the shopping carts and riding bikes with groceries in the basket. With all our conveniences today, sometimes things were much better in the ‘old days.’
I would prefer we do more in mass transit and get off the car dependence…
Madeline // Aug 15, 2010 at 11:28 pm
“Since Chicago has fewer than three million residents total, I’m doubting that this statistic is true.”
The greater Chicago area probably has more than 3 million. Just like Los Angeles may not have 15 million but the metropolitan area does.
The Chicago metropolitan area has 11 million people. But the statistic in this post is still in error.
From David Gratzer’s post:
Three million Chicago residents and half of Detroit’s population reside in food deserts.
From the linked Time article:
Experts have declared roughly half of Detroit (pop. 916,000) a food desert and estimate that nearly 633,000 of Chicago’s 3 million residents live in neighborhoods either lacking or far away from conventional supermarkets like Jewel, Pathmark and Winn-Dixie.
sinz54 // Aug 16, 2010 at 9:08 am
anniemargaret:
Unlike you, I and my family lived in the West Bronx.
But compared to the size of this nation, that still made us neighbors. We could have met with just a short crosstown bus ride.
anniemargret // Aug 16, 2010 at 1:57 pm
sinz… I have great memories of my middle class upbringing in the Bronx. I bet you do too. West Bronx? I lived for awhile off Kingsbridge Rd when I was first married, and spent a lot of time in Van Cortlandt park and Riverdale.
My own neck of the woods was near Albert Einstein Medical Center near Eastchester Rd . Went to school (CUNY) Hunter College, Bronx campus, where Natalie Wood filmed Herman Wouk’s ‘Majorie Morningstar” and down the street from Bronx High School of Science where Bobby Darin went to school.
Yep…. it always seems I run into somebody somewhere somehow with similar memories. Did you ever read Robert Klein’s “The Amorous Busboy of Decatur Avenue? Funny! Brought back a lot of memories as a kid in 50s NYC. Highly recommend.