The Obesity Epidemic Is Confusing

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In writing programs, students are taught a Latin phrase: in medias res

It means into the middle of things. Teachers typically introduce the phrase to teach students to start in the middle of the action, to focus on the conflict, and to advance the story. As short stories don’t offer much in terms of room and time, the writer should start somewhere interesting.
Lately, I’m reminded of the phrase whenever I try to make sense of complex issues. The world of media is a confusing and busy place to explore. When I try to wrap my head around any one topic, I have the overwhelming understanding that I am truly in the middle of things. And people are yelling at me. From every angle. Screaming scary words. 

I’m tired of hearing about the obesity epidemic. Now, I know it’s a problem. What bothers me is the complexity of the issue, coupled with the crisis-control stance that the media takes. Because the media lives and dies on the attention span of its audience, it’s become a convention to engage audiences with scare tactics and, frankly, depressing content. As far as news media is concerned, threats of disastrous epidemics and mentions of fearful things make people show up. But it can be overwhelming for the audience. When’s the last time you watched a local news broadcast and wanted to go outside and play?

Accordingly, American obesity has been exposed in a multitude of ways. For example, the military is now starting to consider obesity a potential security risk, as 27% of American males between 17 and 24 are too heavy to meet enlistment standards. Essentially they're calling us too fat to fight. It's clear we need to do something, at least to stop the snarky Brits from making fun of us. We’re so out of shape that our pets are fat

But, wait. Surely there are ways to battle obesity! Simple, universal methods!
  • Hmm, maybe we should work on limiting our calorie intake. If we eat fewer calories than we burn, we’ll lose weight. Seems simple, right? But it’s not that clear cut. A recent study found that a diet high in saturated fat and refined sugar actually causes changes to the brain, making it more difficult to lose weight. Also, some early research in calorie restriction—albeit on depressed-looking rhesus monkeys—hints that quality of diet is as important as calorie restriction. (So diet sodas can’t work miracles after all.)
  • Well, what about encouraging people to cook at home? For years, a major argument about American weight gain has stemmed on the increased consumption of packaged and prepared food. Basically, since we’re not eating enough at home, we’re getting fatter. However, evidence hints that more people eat at home than we think. In fact, a recent study reported seventy-eight percent of families cook and eat dinner at home five or more nights a week. Four of the dinners are made from scratch, two are made in part from packaged foods like boxed side dishes, and one is a fast food dinner. Spoiler alert: the lower the family’s income, the more they cook from scratch. 
  • Okay, let’s try better access to fresh food. This is a noble thought, but access is a matter of scale and logistics. Cities are growing, but we lack understanding of how to source fresh food to urban inhabitants. For example, researchers have found heightened levels of lead in the eggs of chickens kept in New York City. To make it more difficult, low prices for accessible, hyper-flavored food are tough to ignore. I followed a city bus the other day emblazoned with ads for Checker’s burgers priced at a dollar apiece. My drive-time radio stations have been covering Five Guys’ crowning as America’s favorite burger chain. (Note: a standard Five Guys’ burger has 400 calories from fat, 43 grams of total fat, and 19.5 grams of saturated fat.) My news aggregator tells me Nutella is going on a 12-city “breakfast tour” to encourage kids to eat chocolate-hazelnut spread at breakfast, and Taco Bell is on the upswing after the debut of its Doritos Locos tacos. How can traditional, fresh food compete? (In a cosmic irony, it also turns out obese kids are less sensitive to taste than other kids. Sigh...)
Information is power. But the application of information, beyond its mere conveyance, is the key to change. When exposed to a plethora of options and information, one response is paralysis. Think about the toothpaste aisle in a pharmacy. How do you choose a tube of toothpaste? Faced with too many options, choice becomes difficult, and can even come down to whim. (“That one’s forty cents off! I can finally leave this place!”)

Here's my point: We know that obesity is a problem, but what’s the first step to combat it? 

It’s a trick question. There is no one step, but rather a matter of building systems that are easy for people to understand and follow. When I was a kid—here’s where I puff a pipe and put my hand in my robe pocket—I didn’t know much about eating. What I did know was the food pyramid, which was stapled to classroom billboards and taught in class. It was simple, straightforward, and memorable. It was packaged so I could act on it. Simply put, if you make it easier for me to understand and apply the information, you’ll have a better chance that I do both. 

That is not to say that people aren’t trying. In fact, there have been some interesting strides to simplify the issue and present practical options. Last year, the USDA changed the food pyramid to a plate, so it’s even easier to understand. (I’m hoping they clean up their website, which is busy and confusing.) More recently, Greatist posted this helpful infographic to help people understand calories. A number of sites are offering lists of items to buy at the store. Personally, I’d like to see more priced shopping lists, like this one.

Shouting "epidemic" does little besides make noise. You can't scare people into meaningful action. In the case of obesity, if the media wants any change, it would be better suited to helping their audiences take actionable steps. Cut through the noise, show people a clear path, and hopefully they’ll find their way. 

As a healthcare professional, what do you make of the issue? What do you tell your patients? Do you have any ideas how to better combat obesity? Please post your comments below.

Image by Stuart Miles /

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  • George Jacob
    George Jacob
    Thanks for your comments! I'm happy to know there are people working at the ground level to combat this issue. You've listed some great ideas and practices here.

    Deborah B, I'm glad you were compelled to comment. I was examining the issue from how it's been covered by the media, which often does more to confuse its audience than help it. As long as there are good and savvy healthcare workers like you, the public has a fighting chance. Keep fighting the good fight.
  • Cheryl L
    Cheryl L
    As a psychologist (who is also overweight - more so since returning to the US after 4 yrs living in South Africa - I think there is too much genetic modification of our foods here, leading to problems digesting the foods we eat here properly), I generally advise my clients to eat less "white carbs (e.g. white bread, pasta, white rice), and fewer carbs in general.  Latest research indicates that fats are less of a problem than carbs to causing weight gain.  Sugar is also poison, and very addictive (I struggle with staying away from these myself!).  Lots of fresh fruits and vegetables, and lean protein are advised - but my clients in the adult home I work in have limited access to the healthiest foods.
  • Tanya N
    Tanya N
    I have worked exclusively for individuals and families with diabetes for 18 years; the last 3 years with children/parents and early as 2 years old. I developed a way to work with them using food models-initially laying out all foods eaten/times consumed in a day. Then, contrasting  combinations aside of the eaten meals- that would produce better blood glucose levels, and also be within the family's ability to secure, enjoy and allow many children to become independent. This method is a pragmatic, simple method to understanding and empowerment.
  • Tedana W
    Tedana W
    everything you said I deeply agree with all of it . as a retired physician, I plan to go to school at RIT next year to earn a degree in nutrition.
  • Deborah B
    Deborah B
    As a health care professional for the past 22+ years, I agree that you cannot scare people into meaningful action that has a lasting effect and result.  You might be able to scare them for the moment and see a temporary change in behavior that yields a temporary, positive result.  However, "quick fixes" just don't work effectively since they are likely rooted in fear, hype, or the latest fad.  After a while, the fear begins to "wear off" and the old, typical behavior (i.e., compulsive overeating, lack of significant body movement to burn the consumed calories, etc.) gets re-triggered, thus ensuing a relapse.  It can take many days or months to "carve out" new neurological pathways in the brain to truly develop new behavior that is healthier.  Regarding your last sentence in your last paragraph (right before the, "As a healthcare professional,  what do you make of this issue?"), I really like how you write, "Cut through the noise, show people a clear path, and hopefully they'll find their way."   As a holisitic psychologist, I do work with people to "cut through"  their noise within (the voices of doubt, belittling comments, projected fear, over concern regarding "what if's").Also, I believe that I "show people a clear path" and help them to determine multiple options in order to empower them with both choice and responsibility.  The last part of that same sentence (i.e., "and hopefully they'll find their way") is what enticed me to write these comments to you.  As a practitioner, I strive to do more than relying on, "hopefully they'll find their way".    I have a large "bag of tricks" that I go through as needed while working with the client who has issues with money.  I use various therapy modalities that are readily accepted by the client which I believe reduces the "hopefully" part within his or her own childhood.  Let me know if I can be of service to you at at later time.  Thank you.Peace and many positive memories and ideas.
  • Kammi D
    Kammi D
  •  Ami G
    Ami G
    A good start is by determining a proper activity level and integrating it into the school day. We make our kids sit too much at desks, computers, doing home work with little physical activity.  Offering healthy whole foods in appropriate amounts and getting rid of the high fat high carb items with lots of sugar that are often served now.  My kids take healthy foods they eat at home to school and kids often comment on the lunch so my kids feel bad and don't eat much.  Then they eat when they get home...the same food.  They like the food but are afraid they don't fit in when they eat healthy. If more kids ate healthy  it would be easier. If they didn't have a choice at school but to eat healthy, if they buy lunch, then more kids may get used to the good food and accept it. Now the kids are so used to junk that good food is foreign.
  • Rudolph R
    Rudolph R
    Well it's all about the person/people that love themselves.So once you start back to loving your self, then you are able to make a change.change starts within!As a master trainer,it is my job to help you motivate yourself and keep you on a healthy diet and workout program.85% of losing weight is what you put into your body!Then the other 15% is the workout program!I want to start a program dealing with household family and teach them about their health and how important it is!It is not a game we are killing ourselves slowly!Wake up America We need each other!So help me help us!.
  • George Jacob
    George Jacob
    I'm not contending that obesity isn't a problem: it clearly is a national issue. Michael W's comment about La. school buses and caskets makes that point well.

    Michael R., generalization is what I mean to convey. I think the media has a tendency to generalize the problem and its solutions, and that doesn't bode well for solving the problem. I'm not a healthcare professional or fitness trainer, so I'm not in any position to prescribe courses of action. I just think it's a shame there aren't more accessible, realistic resources to help people fight obesity. For example, what types of protein should I buy? How much would it cost me? Can I do it for a reasonable expense, compared to what I'm buying now? What types of vegetables are best to eat, and where can I get them locally? How often should I eat, and what? What are the financial effects of switching to such a diet? Will it save me money on health expenses in the long run?
  • Michael R
    Michael R
    Unfortunately, there is too much generalization in this article.  Losing weight and staying healthy does have a very simple formula: only eat nutrient rich foods and maintain persistent and consistent self control.  Almost all foods that are high in nutrients are low to medium in calories.  By focusing on a palm sized portion of protein and filling up on vegetables, it's really hard not to lean up.  Also, the fiber in the vegetables facilitates weight loss and helps to clean out your gunked up arteries from all of those years of eating fast food.  Exercise comes into play, but studies show that real weight loss comes from adjusting your food intake.  The exercise helps with shaping and toning the muscle that is eventually exposed.
    Think we DON'T have a child obesity problem? Ask the State of Louisiana. They found out that they needed to order more school buses. Why? Because they found out they could, no longer, sit 3 students to a seat...only 2! Want more evidence? Casket makers have found that they are getting 40% more requests from funeral home for..."over-sized" caskets.Gives new meaning to SuperSize me, huh?

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