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a big fat crisis
29 august 2016
Is maintaining a healthy weight a matter of willpower? If so, mine has been tested continuously for more than a decade. I was a skinny kid and a skinny 6'1" adult and for many years I never worried about either diet or exercise. Then I took a sedentary managerial job at the age of 41. A couple of years later I weighed 222 pounds. Nobody thought I was fat. But I had gone up from a 32" waist to a 36". It cost me serious effort to bend over and tie my shoes in the morning. I started walking up and down Manhattan Island, went back to slightly more active full-time teaching, and gave up ice cream (it makes me sick anyway). I lost 30 pounds. I've mostly kept them off in the long run (I weighed 194 this morning!), but every single day is like a battle against an arch-enemy within.
Deborah Cohen's Big Fat Crisis is dedicated to the idea that weight is not a matter of willpower. Eating is at the core of our beings: in the obvious sense, that if we don't we die; but also in the sense that we are hard-wired to overeat, our primate ancestors sometimes indeed not knowing where their next meal was coming from.
Much is made of the "food deserts" that constitute the American nutritional scene. Cohen isn't worried about food deserts so much as "food swamps," the supermarkets that display thousands of items in endless parades of novelty and seductiveness. She is especially critical of the contemporary tendency to pack high-fat, high-carb snacks at the ends of store aisles, and next to checkout registers. But even healthy fare is available in such abundance that the old association of gourmandism and adiposity lives again for 21st-century foodies.
I've always prided myself at being willing to try new foods. My mother ate about a dozen things in her life and I've eaten thousands. But of course this is not entirely because I'm more adventurous; it's because food options in 2010s America greatly outnumber those of the 1950s or even the 1980s. Food is more various, cheaper, more plentiful, and more conveniently packaged. This is OK, perhaps, when it comes to a new kind of fruit or vegetable, but not so much when a potato-chip brand introduces (as they just did in Texas) four new kinds of internationally-spiced chip flavors (which are really just different permutations of the chemicals they put on all their other chips). To try one of those chips I'll have to buy the whole bag, and times four flavors I could be a couple thousand calories worse off by the end of the week, just in the name of novelty. In this respect even a nutrition-conscious foodie may be at greater risk for fat than a picky eater, if the picky eater limits his intake of pizza and Kraft Dinner.
Cohen notes familiar problems: we're pressed for time, we eat away from home at establishments that manipulate us into eating larger portions (often by way of special combo deals that ease the transaction). We suck up the calories via a cookie here or there, a sugary soft drink, the candy that seems to pop up everywhere (Lord knows I'm guilty of throwing temptation in the way of my co-workers on that score). We don't get enough exercise. The pounds pile on.
The more someone tries to control herself by avoiding tempting food, the more the brain uses up the available sugar and the more difficult it is to continue to exercise self-control. (31)I see this vividly in the way I work. When grading papers or reading dissertations (though not, for some reason, when writing book reviews :) I experience a constant need for little bits of energy: candy or chips or something fat- and sugar-rich, celery isn't going to cut it. I think that when doing "my own writing," there's an intrinsic reward that compensates for the mental effort. I don't need constant sugar-fueling to do brain work, in other words (though you who read the results might wish I were taking a lot more performance-enhancing calories). But when the mental work is a mere task, done for pay and not for self-expression, dammit but I am going to eat cookies to keep going. I am notorious for self-medicating with chocolate chips during faculty meetings.
And there are always chocolate chips around. So awash is America in food that Cohen, an epidemiologist, sees obesity as primarily a matter of public health, not self-control or private morality.
Replacing the popular misconception that people can always control their diets with a more realistic picture of human limitations is the most important initial step we can take to stem obesity. (129).Cohen notes that we don't leave alcohol, tobacco, and other drugs totally to the marketplace; we realize that some people are addicted to them, and that it's easy to become addicted. Alcohol, tobacco, and those drugs that remain legal are regulated more or less strictly in the interests of public health and safety.
We can't restrict the sale of food or limit its consumption to those over 18. But Cohen argues that we should regulate restaurant portion size, display and promotion of junk foods, and various kinds of food marketing. Food advertising in the US now costs about $10 billion a year; even as cheap as food is, it would be even more affordable if food advertising were banned completely. Even Cohen doesn't suggest that, but she would like to see more negative advertising, messages that point out the dangers of fats and sugars, akin to those that point out the dangers of nicotine and other drugs.
It's a tough solution to get one's mind around. Nobody has to smoke, but everybody has to eat, and it seems unAmerican to mess with freedom when we're talking about a vital function. (Though we are pretty adamant about safe water supplies, and water is as vital as food.) Not many people are going to like surveillance-state suggestions like Cohen's idea that
an ID card or driver's license could encode our individual energy requirements so that when our cards are swiped with our orders, the restaurant will know exactly how much to serve us. (205)Wait, the cloud mind is going to know what we ate yesterday and this morning, or how many cookies we snarfed while grading papers this afternoon?
But strained as I find some of Cohen's solutions, the basic idea that fat isn't our fault is compelling. Not that we have no control, or that fat isn't bad for us, but that we've constructed a society that makes it really challenging to stay thin.
I get to books very late, since I read way too many and keep them sitting too long even if I buy them new. But A Big Fat Crisis has not dated much in the past two years and may be even more relevant in 2016. Though there is a detail or two that shows the 2014 context of Cohen's analysis. By way of establishing how powerful food marketing has become, "multiple studies," she says,
have been done to see how difficult it is to extinguish associations. If we see Bill Cosby with Jell-O in a few commercials, we may link the two together for months and maybe years to come. (101)And maybe Jell-O now wishes we could sever the link.
Cohen, Deborah A. A Big Fat Crisis: The hidden forces behind the obesity epidemic – and how we can end it. New York: Nation [Perseus], 2014. RA 645 .O23C64