We celebrated World Health Day last month. The Centers for Disease Control and Prevention (CDC,) one of the official U.S. sponsors of World Health Day, says it decided to make this year’s theme “Move for Health,” which seems to be its polite way of telling us to haul our fat carcasses out of the Barcalounger and get some exercise.
The CDC probably felt it had to do something. A recent report from the surgeon general tells us what we already knew if we’d spent any time at a shopping mall: as a nation, we’re pushing maximum density. Headlines called it “an epidemic of obesity,” and the report certainly threw around some epidemic-sized numbers. Sixty-one percent of adults are overweight or obese, and the number of obese children has tripled in the last 20 years. Underneath the eye-popping statistics was an even scarier assertion: All that extra padding is costing us a lot of money.
$117 billion, to be exact, is the surgeon general’s estimate for the cost of healthcare and lost wages from obesity-related illness. And that doesn’t include any money spent at The Forgotten Woman or Jenny Craig.
In the face of this, declaring April 7 “Move for Health Day” seems hardly adequate.
But when it comes to weight loss, our public efforts mirror our private ones. Which is to say that we’re happy to do the easy things: advertising campaigns and feel-good gestures like World Health Day. Unfortunately, the easy gestures aren’t much more effective than the magic weight-loss pills or electric abdominizer gizmos gathering dust in our closets. After all, if advertising could make people embark on a fitness regime, surely the steady barrage of emaciated models in every commercial or print ad would have done the trick. Yet when it comes to the harder, more effective choices, such as raising the cost of food, or ancillary goods like healthcare, our will fails us. We bypass the obvious in search of a painless solution.
Lawyers and activists, flush from the tobacco victories, think they have found one: Sue the companies who sell us the junk we overeat. They talk about recovering the costs of obesity-associated diseases. But the real hope is that by going after the companies, they can force changes in price and marketing that will, in turn, force us to stop eating so much junk food. Corporations, after all, are much easier to regulate than the fractious individuals targeted by most public health campaigns.
There are a lot of reasons why the new legal strategy is unlikely to work. Fast food isn’t as easy to pinpoint as a killer as tobacco, and legal experts can point to an additional array of factors that will make finding corporate scapegoats for obesity far more challenging than bringing Philip Morris to heel. There are a host of legal issues, they say, that will make it difficult to even get such cases heard in front of a judge. And aside from legal strategems, successfully suing the likes of McDonald’s and KFC will require a dramatic shift in the way the public thinks about overeating — taking the focus off the individual’s responsibility for what he eats, and placing it on those corporations.
But we may be seeing the beginnings of that shift in two recent books: “Fast Food Nation,” by Eric Schlosser, and “Food Politics” by Marion Nestle. Both have advanced the argument that the way food companies manufacture and market their products makes them bear serious responsibility for our current crisis. And now George Washington University Law Professor John Banzhaf, a veteran of the tobacco battles, has publicly declared that he thinks it possible to sue companies like McDonald’s for misleading advertising, for failure to warn about the health dangers of their products and, if public opinion swings his way, for, well, making us fat.
If Banzhaf is right, we should all be nervous. Because if such cases do make it to court, they could be devastating. The economic costs alone are potentially staggering, and not just to the companies involved; the increased liability risk to all companies would almost certainly mean rising insurance premiums and interest rates, lowered profit margins and stifled innovation for fear of litigation. Not to mention the cost to our sense of justice. If you can’t be held responsible for what you put in your mouth, what are you responsible for?
Dr. Diana Berger, a public health expert specializing in obesity, notes that there are two obvious ways to make a difference in what people eat, both of which will require legislation or litigation to enact. The first is closing the information gap: letting people know about the 1,200 calories before they order their meal. And the second is what any economist could have told you: Raise the price. We turn to fast food, after all, not because it’s good, but because it’s fast and cheap.
But trying to make such a change legislatively is tough. In California, where they’ll try anything, a state legislator has introduced a bill to put a 2-cent tax on every can of soda. Now, imagine yourself in the 7-Eleven, your hand hovering between the bottled water and the carbonated sugar syrup, paralyzed by indecision. Suddenly you notice that the can of soda is 2 cents more. Decision made. You grab that bottle of spring water and march it triumphantly to the register.
You get my point: The proposed tax is too small to do much good. Oh, sure, there will be someone who doesn’t have the extra coins on the day the “give a penny, take a penny” jar is out of service. But when 61 percent of a nation as rich as ours is overweight, adding 2 cents to the price of a soda is like rearranging the deck chairs on the Titanic.
Stronger measures are bound to meet stiff opposition. Every measure designed to tax that 61 percent into giving up their high-calorie treats will catch the almost 40 percent who aren’t overweight in its dragnet — which by my calculations makes almost 100 percent of voters eager to get rid of the politicians who made them pay extra for their Big Mac attack.
Which brings us to litigation. When the tobacco suits were first brought, critics charged that the legal reasoning behind them could be applied to almost any product that was bad for you, like, say, fast food. At the time, the plaintiff’s attorneys said that this was ridiculous, a bit of grandstanding from tobacco industry apologists. Now that an anti-tobacco lawyer is training his sights on fast food, however, it seems that the slippery slope really is steep — and dangerous. All the legal experts I talked to agreed on one thing: After tobacco overturned years of legal precedent, you can’t say any lawsuit is impossible.
“After all,” said David Leebron, dean of Columbia Law School and a specialist in torts, “the great mystery of the tobacco suits is why they settled. The law seemed to be on the side of the companies.” He points to public opinion and government intervention as major forces in the capitulation. As state governments began changing their laws to make it easier to sue, and state attorneys general got involved in the suits, the companies’ risks began to rise dramatically, even as the public’s opinion of them declined.
Companies manage risk by weighing the probability of a given event, such as an earthquake or a windfall profit or, yes, a lawsuit, against the money to be gained or lost. Such calculations tend to break down, however, when a single event is both unpredictable and catastrophic; that’s why frightened insurance companies stopped offering terrorism coverage in the wake of 9/11. That’s also why tobacco companies seem to have decided to settle. With lawsuits piling up and no end in sight, they had to face the risk that, even though the law was on their side, a jury might return a verdict that would bankrupt them. This cataclysmic possibility made even an expensive settlement attractive. If such suits could be brought against the food industry, they could follow a similar course.
So the question is: Can such suits get a toehold?
Banzhaf is cautiously optimistic. He describes four different kinds of suits that could be brought, ranging from easy to difficult. The first and easiest kind is for false advertising or labeling. In fact, such suits are already being brought, notably against the makers of Pirate’s Booty brand snacks, for allegedly misrepresenting the fat and calories in their product. Another, slightly more challenging type is suing for misleading advertising; sue the manufacturer of, say, Fruity Nutrition Puffs for implying that their sugar-kibble is healthy. More difficult still are suits for “failure to warn”: sue McDonald’s for not telling you the calorie and fat content of that super-sized Big Mac meal they’re trying to sell you. (The answer, by the way, if you order a diet soda and no dessert, is 1,200 calories and 63 grams of fat. No wonder we’re gaining weight.)
But it is the fourth category of lawsuits that presents the possibility of making radical changes in the food industry, and thus radical changes in the way we eat: suing the companies to recover the costs of our national fat problem. Such suits would be very difficult to bring. But they’re also the most likely to actually make a dent in our waistlines.
Litigation lets public health advocates sidestep the messy process of attempting to regulate bad behavior and forces companies to make the changes in marketing and price that Dr. Berger suggests will change our habits.
If, that is, courts will allow the suits to be brought.
Eric Schlosser, who is certainly no fan of fast food companies, questions whether lawsuits are the answer. “It wouldn’t be my first choice,” says Schlosser; moreover, he doesn’t think it’s necessary. “Fast food companies could actually change their behavior rather easily. Tobacco companies can’t really change what they sell — it’s addictive, and dangerous. Fast food companies could just change the recipe to grilling instead of deep-frying and have a profound impact on the healthiness of what they’re selling.”
Litigation faces some hefty obstacles, as well. One of the biggest problems with class-action suits is that they increasingly rely on juries to make decisions where they’re simply not qualified to judge. As the O.J. Simpson trial demonstrated, juries confronted with complex evidence they don’t understand often just tune out. “What the juries see are dueling experts,” says Professor Leebron. “It’s very hard for a lay person to determine what the right answer is. The problems are extremely complex, and jurors often don’t have the background to evaluate competing claims.”
Unable to judge on the merits, juries often resort to emotion. This is why professor Aaron Twerski, a product liability specialist at Brooklyn Law School, thinks the tobacco suits succeeded: “A lot of what happened in tobacco is that the lawyers were able to demonize the defendants, because the consequences of using their products were so horrendous.”
Our legal system depends on judges to restrain those appeals to emotion, by refusing to certify class actions that don’t meet minimum legal standards, or by overturning outsized verdicts on appeal. This is where most legal observers expect food industry suits to fall down.
It will also be very tough even to establish sufficient causation to file such a suit. Berger says that obesity is only 60 percent environmental; the other 40 percent seems to be genetic, which places a heavy burden of proof on anyone suing McDonald’s. Moreover, tobacco is overwhelmingly linked to lung cancer; the health effects of excess weight are broader, but harder to trace to a single cause. Then there’s the “empty chair” problem: the difficulty of suing one party when other, responsible parties aren’t in the courtroom. Tobacco litigation was helped by the extreme brand loyalty of smokers, which meant only one company to put in the dock. Unless trial lawyers discover a hitherto unsuspected band of strip-mall dwellers who subsist only on Kentucky Fried Chicken, anyone suing a food company for their weight problem is going to face an empty chair that metaphorically seats thousands, from the owner of the donut shop down the block to the neighbor who brings over those divine homemade brownies.
And if you get those cases to court, you immediately have to face the issue of how to allocate responsibility between the individual and the thousands of companies from which they’ve purchased food over their lifetimes. No, it won’t be easy.
Nor will the suits pull the kind of political weight that the tobacco cases did. Remember, one of the major factors in the tobacco settlements was the state governments and attorneys general. But smokers are only 25 percent of the population; the overweight and obese not only constitute a majority, but also have a vocal advocate in the fat acceptance movement. Furthermore, almost every American eats something that would become more expensive as the result of any settlement. Attorneys general are political creatures; even with the prospect of a juicy monetary award, it would be a challenge to get them to sign on.
But even with all these persuasive arguments, legal scholars still aren’t sure that obesity lawsuits are an empty threat. Judicial culture, says Twerski, has been shifting away from strictly enforcing the standards that could keep such cases out of court and toward letting the jury decide — juries that, as already noted, have difficulty making decisions on the legal and scientific merits. Now with the public health establishment pushing us to view obesity as a disease rather than a choice, we’re moving ever closer toward an environment where such suits could become a reality.
Which means we should start worrying now. Never mind the question of whether fast food is good or bad for you. Never mind the fear that we’ll litigate some of life’s basic pleasures out of existence.
Let’s talk money.
The kinds of risk assessments that forced the tobacco companies to settle, even though the law seemed to be on their side, are performed every day by companies all across the country. Those risk assessments are a big part of the decisions they make about whether to invest in new technologies, make new products or build new plants — the innovations that improve the quality of life for everyone. Clearly, if those companies are considering investing in, oh, an atomic death ray, we want them to be restrained by thoughts of liability. But if liability is expanded too far, such thoughts can do more damage than good.
If a company can be sued because someone took a perfectly legal product and, through overuse, harmed themselves and cost the taxpayers money — well, would you risk making a new product if your customer’s misuse could bankrupt you? Would you want to sell any product that was even moderately likely to be misused? It’s tempting to dismiss such fears by saying that the economy won’t crash because we missed out on the next Mrs. Field’s cookies — but what about the next automobile, or the next aspirin? As the tobacco suits have shown, any precedent set here will extend far beyond this industry.
So while some may be tempted to root for Banzhaf — and others to dismiss him as a latter-day Don Quixote — ultimately we can do neither. We have to seek less drastic ways to address obesity. And we have to take a long, hard look at both the legal and the legislative system, and ask how, and why, these suits might succeed. Otherwise, someday someone’s long-shot lawsuit could send us all to the poorhouse.
If Benjamin Franklin was writing his famous letter to Jean-Baptiste Leroy today, his famous aphorism might read: “In this world nothing can be said to be certain, except death, taxes and the obesity crisis.” It seems no matter the year or the season, that crisis inexorably continues, with experts now saying 42 percent of Americans will be obese by 2030. And whether you are one of the 42 percent or not, that trend is going to affect you, because it is expected to cost the country roughly half a trillion (yes, trillion) in additional healthcare costs.
And yet, as relentless as the obesity crisis appears to be, its expansion doesn’t have to be a foregone conclusion. That’s because, unlike a naturally occurring epidemic, it’s almost completely human created — a reality that allows for the possibility of a human-directed reversal.
What does such a reversal require in practice? First and foremost, awareness, and thanks to everything from Michelle Obama’s fitness campaign to HBO’s new documentary “The Weight of a Nation,” that prerequisite is finally starting to be met. But then what? As GI Joe said, “knowing is half the battle” — but it’s only half. Once more of us are aware of the emergency at hand, what will be the most reliable way to address the problem?
In an instant gratification culture obsessed with extreme makeovers and get-thin-quick diet schemes, it’s easy to feel confused about a path forward. But a tranche of new science, data and public policy proposals that cut through the fog of misinformation suggests that path is there — if we’re willing to take it. Here are five of the most promising ways forward.
1. Tax Junk Food
Over the last four decades, we went from spending $3 billion a year on fast food to $110 billion a year on fast food. At the same time, there’s been an explosion in the amount of chemically enhanced, calorie-packed processed foods Americans eat at home, at work and in the school cafeteria. Not surprisingly, in predictable cause-and-effect fashion, this has all happened as obesity became a public health epidemic.
The response from some policymakers has been to champion junk-food taxes, initiatives whose supreme press-release-worthiness can make them seem a bit gimmicky, but whose merits are nonetheless rooted in substance. Indeed, a bevy of new studies show that such levies, when structured properly, can disincentivize junk food consumption on a large scale.
In one University of North Carolina study, ABC News reports that “Patients got significantly less of their calories from soda or pizza when there was a 10 percent increase in the price of either.” In another study of college-age adults, “researchers found that the students generally bought fewer lunchtime calories when sugary, high-fat fare came with a tax of 25 percent or more.” In yet another study, this one from the University of Buffalo, it was much the same result: Higher taxes meant more healthy consumer choices.
New York Times food columnist Mark Bittman has noted that while taxes alone won’t solve the obesity crisis, they are an important part of a multifaceted attack on the problem — and they will also raise much-needed public revenues at a time of crushing deficits:
A study by Y. Claire Wang, an assistant professor at Columbia’s Mailman School of Public Health, predicted that a penny tax per ounce on sugar-sweetened beverages in New York State would save $3 billion in health care costs over the course of a decade, prevent something like 37,000 cases of diabetes and bring in $1 billion annually. Another study shows that a two-cent tax per ounce in Illinois would reduce obesity in youth by 18 percent, save nearly $350 million and bring in over $800 million taxes annually. Scaled nationally, as it should be, the projected benefits are even more impressive; one study suggests that a national penny-per-ounce tax on sugar-sweetened beverages would generate at least $13 billion a year in income while cutting consumption by 24 percent…A 20 percent increase in the price of sugary drinks nationally could result in about a 20 percent decrease in consumption, which in the next decade could prevent 1.5 million Americans from becoming obese and 400,000 cases of diabetes, saving about $30 billion.
Put it all together, and junk food taxes should be about as close to a no-brainer as you’ll find in the public policy arena.
2. Stop Subsidizing Junk Food
There’s no scientific reason junk food should cost less than whole grains, fruits and vegetables. After all, the former are the product of a mechanized process relying on an entire industrial system, while the later can be grown directly out of the ground by almost anyone.
Yet, junk food consistently beats natural foods in the price competition. Why? It’s all about the subsidies.
As a the U.S. Public Interest Research Group’s “Apples to Twinkies” report shows, your taxpayer dollars subsidize junk food and artificially deflate the cost of that junk food so that it undersells everything else. “Between 1995 and 2010, $16.9 billion in tax dollars subsidized four common food additives—corn syrup, high fructose corn syrup, corn starch, and soy oils.” At the same time, PIRG points out that “taxpayers spent only $262 million subsidizing apples, which is the only significant federal subsidy of fresh fruits or vegetables.” To put those numbers into real-world terms, “if these agricultural subsidies went directly to consumers to allow them to purchase food, each of America’s 144 million taxpayers would be given $7.36 to spend on junk food and 11 cents with which to buy apples each year — enough to buy 19 Twinkies but less than a quarter of one Red Delicious apple apiece.”
While studies show that changing this subsidy structure would be no cure-all for obesity, there’s no evidence to suggest that keeping it in place does anything but make the obesity crisis worse — and there is evidence that changing the subsidies would make things better. This isn’t surprising; it’s basic economics.
Think about it: If subsidies for commodity crops that create junk food were redirected into subsidies for natural foods, it would radically change the market incentives for healthful eating. Sans the subsidies, industrial food corporations would no longer be able to price processed foods at artificially lower prices than their natural competitors. Instead, healthful foods would have the price advantage — and, quite likely, bigger market share.
3. Ban Junk Food in Schools
The Obama administration has been trying to reduce the amount of obesogenic foods in school cafeterias, under the theory that stopping obesity-inducing eating habits at an early age might stop the obesity crisis in its tracks. It’s been an uphill fight. According to the Associated Press in February, “Junk food remains plentiful at the nation’s elementary schools,” with “nearly half of public and private schools surveyed sold sweet or salty snack foods in vending machines or other places.”
Nonetheless, new data proves the administration’s efforts, in conjunction with local school districts, are indeed worthwhile. As the New York Times recently reported:
Five years after California started cracking down on junk food in school cafeterias, a new report shows that high school students there consume fewer calories and less fat and sugar at school than students in other states…The study found that California high school students consumed on average nearly 160 calories fewer per day than students in other states, the equivalent of cutting out a small bag of potato chips. That difference came largely from reduced calorie consumption at school, and there was no evidence that students were compensating for their limited access to junk food at school by eating more at home…
To study the effect of this policy, the researchers examined data from the Centers for Disease Control and Prevention on the eating habits of high school students in California, comparing it with data on students from 14 states that did not have nutrition standards for vending machine snacks and other foods sold outside of school lunches and other meal plans…California students had the lowest daily intake of calories, fat and, especially, added sugars.
In light of this, it’s hard to imagine anyone still defending the American school system’s role as glorified junk food machines.
4. Stop Glorifying Unhealthy Eating Habits
In his endorsement of the campaign to legalize gay marriage, Vice President Joe Biden said that “when things really began to change is when the social culture changes … I think Will & Grace probably did more to educate the American public than almost anybody’s ever done so far.” It was an acknowledgment that televisual images often play as big a role in our society as ironclad policies — and the same truism relates to the obesity crisis.
Today, our political culture regularly equates unhealthy eating habits to Americanness and authenticity. As evidence, recall that the party nomination fights have become a kind of televised eating contest, with candidates trying to one-up their competitors with photo ops stuffing corn dogs and cheesesteaks.
The committee now has a White House petition calling on the president to stop undermining his wife’s crusade against obesity and end such photo ops. It’s the least the administration can do.
5. Start Broadening Our Understanding of Obesity
Conventional wisdom holds that a calorie is a calorie, and that if Americans simply take in fewer calories and use more via exercise, obesity can be stopped. But journalist Gary Taubes reports that science now suggests that this formula may be fundamentally flawed — that obesity is a product of specific kinds of calories from sucrose and fructose:
There is an alternative theory, one that has also been around for decades but that the establishment has largely ignored. This theory implicates specific foods—refined sugars and grains—because of their effect on the hormone insulin, which regulates fat accumulation. If this hormonal-defect hypothesis is true, not all calories are created equal…
Sucrose and high-fructose corn syrup have a unique chemical composition, a near 50-50 combination of two different carbohydrates: glucose and fructose. And while glucose is metabolized by virtually every cell in the body, the fructose is metabolized mostly by liver cells. From there, the chain of metabolic events has been worked out by biochemists over 50 years: some of the fructose is converted into fat, the fat accumulates in the liver cells, which become resistant to the action of insulin, and so more insulin is secreted to compensate. The end results are elevated levels of insulin, which is the hallmark of type 2 diabetes, and the steady accumulation of fat in our fat tissue—a few tens of calories worth per day, leading to pounds per year, and obesity over the course of a few decades.
He goes on to note that “back in the 1980s, the FDA gave sugar a free pass based on the idea that the evidence wasn’t conclusive” — but that now, the evidence can’t be ignored.
This isn’t to say that the theories about sugar are 100 percent correct; it is only to point out that if we are going to reduce our consumption of junk food in order to stop the obesity epidemic, we need a better understanding of exactly what junk food is. That means broadening our understanding of obesity’s roots and rejecting the reductionism that says simply that “a calorie is a calorie.”
With the economy still struggling and the debates over how to fix the problem more intense than ever, one word still evokes bipartisan consensus: exports. “I want us to sell stuff,” said President Obama, summing up the bipartisan sentiment.
That nebulous word “stuff” is significant. It asks us to see all exports as the same and to refrain from making nuanced value judgments about what exactly we’re shipping overseas. In this coldblooded view, a job-creating export is a job-creating export, and that’s as far as any conversation should go.
At first glance, such reductionism seems logical, rational, even boringly uncontroversial. But two recent news items highlight how in a globalized economy, there are troubling consequences that come from the particular kind of export economy we’re building.
The first bit of news came from the Washington Post, which this week reported that “the Obama administration is crafting a proposal that could make it easier to export firearms and other weapons.” Though the Homeland Security and Justice Departments say the new rules could make it easier for terrorist and drug cartels to further arm themselves, the White House is nonetheless citing the “stuff” theory of exports to ignore the objections.
This is part of a larger pattern since President Obama took office. During Obama’s first year in the White House, he began to gut the Pentagon’s approval process for arms exports, weakening controls on what could and could not be sold. Later, diplomatic cables uncovered by WikiLeaks showed, as Fortune magazine put it, “American officials act(ing) as de facto pitchmen for U.S.-made weapons.”
The result is that America has become the true “Lord of War,” as the arms dealer motto goes. We are the leading arms supplier to the developing world and we are responsible for the majority of all weapons sales across the globe. Yes, we are so committed to selling instruments of death to the rest of the planet that military industries have almost tripled their share of the U.S. economy in just a decade.
The second bit of news came from the Institute for Agriculture and Trade Policy, whose new study shows that America is exporting our obesity crisis to Mexico. Coupling health statistics with U.S. export data since the North American Free Trade Agreement tore down Mexico’s agriculture trade barriers, researchers found that the Mexican market was flooded by American agribusinesses’ taxpayer subsidized commodities (corn, soybeans) and their processed derivatives. According to the report, that quickly wiped out Mexico’s local food economy, leaving its food system exactly “like the industrialized food system of the United States — characterized by the overabundance of obesogenic foods.” Not surprisingly, Mexican obesity rates have consequently skyrocketed.
Taken together, these export booms represent what could be called America’s new Guns and Butter economy. We are so desperate to export any “stuff” we can, we are now fattening up the world and arming it for permanent bloodshed.
Seeking to short-circuit any objections to this trend, President Obama has said simply that “we’re at a moment where necessity has tempered the old debates” over exports and economic policy. In terms of history, he’s not wrong — during the previous century, America witnessed fevered fights over what constitutes a moral farm policy, and in the 1930s the U.S. Senate’s Nye Committee held almost 100 hearings into “greedy munitions interests” that were unduly influencing public policy. Sadly, Obama is correct – those debates have been silenced.
But should they be? Should we simply say that any exports — no matter their moral, ethical, environmental or health implications — are inherently good? Does “necessity” really mean that “stuff” for stuff’s sake must be the basis of our export economy?
Washington and profit-at-all-cost industries certainly say yes — but that doesn’t mean it’s the right answer.
January sucks. Every magazine cover is festooned with the image of a celebrity in a bikini, promising you the secrets of a BETTER BODY for the new year. Your friends are all going on juice fasts. And the answer to “Feel like going for a bike ride today?” is “Maybe sometime when it’s not 11 degrees out.”
So here’s a crazy idea. This time, let’s not use the beginning of the year as an excuse to hate on our bodies. Let’s not swear to get a tinier butt by Memorial Day, or even Labor Day. No 21-day “action plans.” No master cleanse. Nothing, in fact, that sounds like an enema from a dominatrix. Instead, let’s do something radical. Let’s do something small.
In just the time it takes to realize that “Work It” is the worst thing that ever happened to television, you could change your life. Thirty minutes a day. That’s the minimum amount of physical activity the CDC recommends to stay fit. Yet approximately 30 percent of Americans get no weekly activity at all. Zero. Not even candy-ass pastimes like gardening. And many more of us aren’t exactly wearing out the gym membership cards. Right now, the only thing moving at a fast pace in our country is the obesity rate – 30 percent and climbing.
In an already over-saturated life full of work and family and errands and commuting, it’s often grueling to find 30 minutes to do anything at all. There are days when carving out a window of opportunity to grab a shower feels like a big deal. But I promise, a half-hour is not a lot of time. Treated seriously and honored consistently, it’ll do a lot more for your health and well-being than that spinning class across town you go to once a month. And don’t you deserve as much loving attention as you’d give your car or your iPad?
Here’s what you need. Sneakers. A mix of cardio and strength training. An understanding that you can’t fool your body by not making an effort. A casual saunter on the treadmill while tweeting isn’t going to do jack. You know that lady in the Apple Siri ad, the one who wants to be reminded to call Chris while she’s going for a run? Yeah, don’t be her. No talking on the phone. No checking the weather. And no excuses. Thirty minutes to put in real work, whatever work feels like for your fitness level. (Here’s the inevitable reminder that this isn’t medical advice, and you should talk to your doctor about a plan that’s realistic for you.) Here’s the payoff. Research says that you can build bone density and ease the symptoms of arthritis, high blood pressure and even depression. If this stuff came in a pill, it’d be hotter than Viagra and Effexor put together.
Like a lot of people, I spend most of my days on my butt. Yet I have a beautiful heartbeat. When I see my doctor for my weekly health monitoring, he smiles appreciatively as he presses the stethoscope to my sternum, praising my “slow, steady, runner’s rate.” And last summer, shortly before my lung surgery, the respiratory technician was similarly complimentary. “Look at that pulmonary function,” he said encouragingly as I puffed into a tube. “I can always spot the yoga people.”
Now here’s what you need to know about me. I was always chosen last in gym class. I can’t open a jar of pickles without assistance. I don’t train for marathons. I will never be on the cover of a magazine, Valerie Bertinelli-style, flaunting my abs. I have a body that’s over 40 and has birthed two children, and looks it. And many days, I don’t want to get out of bed. But I put in three and a half hours of exercise a week – mostly running, mixed with the use of a pair of five-pound dumbbells and a yoga app on my phone. I breathe hard. I stretch muscles. I resist gravity. Then I’m back on my butt, possibly holding a beer. That’s it.
Good health should not be reserved for the perky sporty types. Screw the jocks. Almost everybody, of every age and fitness level, can afford a half-hour a day. You can. Why am I telling you this? Because when the surgeon had to cut some cancer out of my lung last August, I was pretty happy I could breathe unassisted afterward. And because I hope that if you’re ever in a similar situation, you are likewise prepared.
This year, it’s not about fitting into those jeans that linger accusatorily in the back of the closet. It’s not about the scale. It’s about getting in touch with what we humans were meant to do – move around. It’s about taking the stairs. It’s about being able to play with your kids. It’s about those sweet, sweet endorphins. And it’s about knowing that though we’re all different, we’re all capable of greater wellness. Is it hard sometimes? Does it get boring at times, day in and day out? Sure. Is it achievable, and is it worth it? Always. But don’t listen to me. Listen to my beautiful heartbeat. Now get out there and thump along. And tell me about your progress — I’ll be right alongside, cheering you on.
Is childhood obesity child abuse? Child services officials in Cleveland seem to think so. They recently removed an 8-year-old boy from his mother and placed him in foster care — because the child tips the scales at over 200 pounds. Department of Children and Family Services spokeswoman Mary Louise Madigan told the Cleveland Plain Dealer that the boy’s condition constituted “a form of medical neglect.”
“This child’s problem was so severe that we had to take custody,” Madigan said, adding that her office had worked with the boy’s mother for over a year before removing him. The boy first caught the attention of child services when his mother brought him to the hospital last year with breathing issues. He was diagnosed with sleep apnea, and now uses a machine to assist his breathing while he sleeps.
Was the boy’s mother, in fact, neglectful? That’s something the state still appears to be determining. The boy’s mother told the Plain Dealer that “They are trying to make it seem like I am unfit, like I don’t love my child. Of course I love him. Of course I want him to lose weight. It’s a lifestyle change, and they are trying to make it seem like I am not embracing that. It is very hard, but I am trying.”
But how do you undo deeply ingrained patterns, combined with a damming family history? Both of the boy’s parents are overweight. (His teenage brother is not.) For her part, the mother says she enrolled the boy in a local Healthy Kids, Healthy Weight program at a local hospital. She got him a bike. She says she tried to talk to him about what foods to eat. And for a while, he lost weight. Then he gained it back — and then the county intervened. He was taken from his school last month, and now his mother sees him once a week for two hours. Reps for the county say he has, in the past few weeks, lost “a few pounds.”
Was his removal an overreaction or a necessary intervention? In a July piece for JAMA, the Journal of the American Medical Association, Lindsey Murtagh of the Harvard School of Public Health and David S. Ludwig of the Children’s Hospital in Boston recommended “State Intervention in Life-Threatening Childhood Obesity.” In the article, they noted, “Improper feeding practices, causing undernourishment and failure to thrive, have long been addressed through the child abuse and neglect framework.” If we consider it a social responsibility to step in when a child is being starved, should the same imperative apply if he’s overfed? Aren’t both forms of malnourishment?
Deprivation, however, has a very different connotation. The notion of being harmed by having too much has generally been too unusual to consider seriously. Now, however, 20 percent of American children between the ages of 6 and 11 are obese — and approximately 2 million of them are extremely obese.
Public defender Sam Amata said Monday the removal of the Cleveland boy would be challenged on the grounds that he was never “in imminent danger.” It should, however, be uncontroversial to say that a 200-pound child – well over triple the average third-grader’s weight — is a child whose health is severely at risk. He needs help, and so does his family. Not diets, not restrictions, but help. Help shopping. Help cooking. Help embracing physical activity.
Yes, parents are responsible for their children. And extreme obesity may be a sign of deeper, more severe issues at home. But it is nonetheless seriously disgusting to see children wrenched from their parents when, at the highest levels, we are represented by a government that has made it abundantly clear it would prefer to pander to the interests of the frozen food industry than reform childhood nutrition. One in which presidential candidates mock children’s health initiatives as “nannying.” Even the authors of that provocative JAMA story recommended governmental “investments in the social infrastructure and policies to improve diet and promote physical activity among children.” It takes a village to raise a child without a body-mass index number in the danger level.
Imagine if you were a little boy, perhaps without the best body image, and you knew that seeing your mom was contingent upon losing weight. Now imagine the over 12 percent of third-graders in Ohio who are severely obese and may now be facing a similar fate. Whatever you think of parental accountability for childhood obesity, ask yourself this: If one child can be removed, what happens to the rest? Who’s going to decide which parents of obese kids are neglectful? And who will take care of their health when neither their government nor their families seem to know how?
I was channel surfing mindlessly, avoiding some household chore, when I landed on a cable talk show discussing child abuse. The guests were talking about horrible things: parents who starve children, beat them or sexually abuse them. Parents who let their children get fat. This last one, one woman leveled, was the same as any other form of abuse and deserved the same unequivocal response: Remove the kids from the parents.
I had happened upon yet another media debate in response to the controversial JAMA article that came out a few weeks ago. This study looked at whether intervention was ever warranted when parents allow their children to become dangerously obese. The study itself was balanced in its approach, but the talking-head response was anything but. This particular pundit — shoulder-shrugging with a clear look of disgust on her face — talked about taking fat kids away from their parents as if it were nothing more than trading in a car. I had to turn the TV off, my stomach in knots.
I wondered what this woman would say if she met my own parents. Would she blame them for the way I turned out? For that matter: Should I?
Let me back up a bit. I’m fat and have been since I was a toddler. Not “trapped in my trailer” fat, or “have to use an extra-wide electric wheelchair at the grocery store” fat, but medically, technically, morbidly obese. I confess that whenever I hear that term — morbidly obese — I giggle, because I picture chubby Goths with back nail polish and dog collars. That is not to say I do not take it seriously, because I do. It is the first thing I think about when I wake up in the morning, the last thing on my mind when I go to bed at night. And I will never be a member of the “fat acceptance movement,” because I don’t accept it. I have been fighting my weight for over 35 years.
But I don’t believe I deserve to be hated, and hate is what I feel every single day as a fat woman. I feel it in the stares from strangers’ children, and when someone screams “fat ass” as I walk my dogs. I feel it when I get a flawless performance review, but my boss asks if I have considered weight loss surgery — as if that has something to do with my professional skills. I feel it in the constant stream of media images about what women should look like, in the tired fat jokes from comedians (come on, stop phoning it in — get creative!), and in the constant articles about the doom that is The Obesity Epidemic. Fat people are taxing the healthcare system, they make other people uncomfortable on planes and trains, they use more fossil fuels because it takes more gas to haul their big butts around thus causing global warming, and they suck up the world’s food resources while others starve.
And yet, I understand: These arguments aren’t without merit, and it is after all human nature that some people express their points with meanness and derision. I don’t take it personally.
But even at my most open-minded, I could not bear the debate that erupted in response to the JAMA article (and the derisive online comments). While the study, by Dr. David Ludwig and Lindsey Murtagh, did suggest that obese children — in some extreme circumstances — should be taken away from their parents, coverage of the article focused on the most sensational elements of the argument. It resulted in a cascade of hate on cable news and morning shows that was packaged as concern for children, like that disgusted-looking pundit who made me sick to my stomach.
Did my parents make me fat? Probably. They fed my siblings and me meals of bologna on white bread, hot dogs and potato chips. They let us have four of those Oreo-knock-off cookies-that-don’t-quite-taste-right in a sitting, rather than one or two. They used fast food as a reward and eating in general as a form of entertainment. If I was upset, I might be offered a tasty snack as a pick-me-up. Even if nothing got done all day, not the dishes, not the vacuuming, not mowing the lawn, by god dinner would get done and there wouldn’t be any leftovers to pack up and put away. I suppose to some people it is a portrait of failed parenting.
But my parents are also a success story. They were teen parents. They had me — the eldest — at age 16. It was not a mistake but a planned pregnancy. My mother grew up in a household where she faced daily abuse at the hands of people she trusted. There were challenging finances and in a family with eight children, food could sometimes be scarce. My father grew up in a slightly more stable financial situation, but where violence was the primary outlet for anger, or disappointment, as well as for discipline of children. When these two wounded, but hopeful souls met they made a forever pact in heart-shaped doodles on their class notebooks. They crafted an escape plan: Create their own family where they would make different rules. That is just what they did.
And they did it all on their own. My dad worked two jobs while finishing high school. My mom went back to night school after I was born. Dad worked double night shifts and Mom cut coupons and raised the kids while balancing work at McDonald’s. They never got welfare. They never received food stamps. They modeled hard work and commitment and most of all, love. They are still married — still go out on date nights and still laugh and look longingly in each other’s eyes — almost 40 years later.
Doctors did warn them about the children’s weight, and these problems were not ignored. My mom worried. She ached for me when I came home crying after schoolmates teased me all day long. She was my biggest cheerleader when, in the fifth grade, I became the youngest member of the local Weight Watchers group to reach the 50-pound weight loss mark. She saved money we didn’t have to buy weight-loss shakes and exercise equipment. She went without sleep sewing cute clothes that actually fit well, unlike the pricey crap in the husky department. Dad did his best when he wasn’t working.
But once the fat is on, it is hard to get it off. When you get it off, it comes back with a vengeance. My parents could never quite bridge the gap between what was recommended and what we could afford, between what they went without and what they would never allow us to miss. And who’s to say what part their parenting played in all this, really — which part was simple genetics and which part of was the learned behavior of emotional eating; which part overindulgence and which part the negative side effects of yo-yo dieting; which part was uncooperative children and which part plain lack of knowledge and time. To think of that pundit giving such a disgusted look to my parents, crushes me. They tried so hard. They, in fact, did way more than so many. From troubled beginnings, they created a family where the cycle of violence was broken, where their children had access to more education and opportunity than they had. Did they make mistakes with food? Yes. But there was nobody better to raise my siblings and me than the two people who sacrificed so much to make sure we grew up happier and healthier than they had.
That’s the real point here: We are healthier for their efforts. No matter our size.
Stacey R. Hall lives and works in southwest Ohio, where she regularly walks her dogs, despite the rude yelling, and works with her siblings to educate the next generation on healthy eating, exercise and the importance of family.
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