XXXL<\/p>\n
Why are we so fat?<\/p>\n
By\u00a0Elizabeth Kolbert<\/p>\n
July 13, 2009<\/p>\n
Human appetite is elastic: give us more and we\u2019ll eat more.Illustration by Zeloot<\/p>\n
One of the most comprehensive data sets available about Americans\u2014how tall they are, when they last visited a dentist, what sort of cereal they eat for breakfast, whether they have to pee during the night, and, if so, how often\u2014comes from a series of studies conducted by the federal Centers for Disease Control and Prevention. Participants are chosen at random, interviewed at length, and subjected to a battery of tests in special trailers that the C.D.C. hauls around the country. The studies, known as the National Health and Nutrition Examination Surveys, began during the Eisenhower Administration and have been carried out periodically ever since.<\/p>\n
In the early nineteen-nineties, a researcher at the C.D.C. named Katherine Flegal was reviewing the results of the survey then under way when she came across figures that seemed incredible. According to the first National Health study, which was done in the early nineteen-sixties, 24.3 per cent of American adults were overweight\u2014roughly defined as having a body-mass index greater than twenty-seven. (The metrics are slightly different for men and women; by the study\u2019s definition, a woman who is five feet tall would count as overweight if she was more than a hundred and forty pounds, and a man who is six feet tall if he weighed more than two hundred and four pounds.) By the time of the second survey, conducted in the early nineteen-seventies, the proportion of overweight adults had increased by three-quarters of a per cent, to twenty-five per cent, and, by the third survey, in the late seventies, it had edged up to 25.4 per cent. The results that Flegal found so surprising came from the fourth survey. During the nineteen-eighties, the American gut, instead of expanding very gradually, had ballooned: 33.3 per cent of adults now qualified as overweight. Flegal began asking around at professional meetings. Had other researchers noticed a change in Americans\u2019 waistlines? They had not. This left her feeling even more perplexed. She knew that errors could have sneaked into the data in a variety of ways, so she and her colleagues checked and rechecked the figures. There was no problem that they could identify. Finally, in 1994, they published their findings in the\u00a0Journal of the American Medical Association. In just ten years, they showed, Americans had collectively gained more than a billion pounds. \u201cIf this was about tuberculosis, it would be called an epidemic,\u201d another researcher wrote in an editorial accompanying the report.<\/p>\n
During the next decade, Americans kept right on gaining. Men are now on average seventeen pounds heavier than they were in the late seventies, and for women that figure is even higher: nineteen pounds. The proportion of overweight children, age six to eleven, has more than doubled, while the proportion of overweight adolescents, age twelve to nineteen, has more than tripled. (According to the standards of the United States military, forty per cent of young women and twenty-five per cent of young men weigh too much to enlist.) As the average person became heavier, the very heavy became heavier still; more than twelve million Americans now have a body-mass index greater than forty, which, for someone who is five feet nine, entails weighing more than two hundred and seventy pounds. Hospitals have had to buy special wheelchairs and operating tables to accommodate the obese, and revolving doors have had to be widened\u2014the typical door went from about ten feet to about twelve feet across. An Indiana company called Goliath Casket has begun offering triple-wide coffins with reinforced hinges that can hold up to eleven hundred pounds. It has been estimated that Americans\u2019 extra bulk costs the airlines a quarter of a billion dollars\u2019 worth of jet fuel annually.<\/p>\n
Such a broad social development seems to require an explanation on the same scale. Something big must have changed in America to cause so many people to gain so much weight so quickly. But what, exactly, is unclear\u2014a mystery batter-dipped in an enigma.<\/p>\n
Though weight-loss books will doubtless always be more popular, what might be called weight-gain books, which attempt to account for our corpulence, are an expanding genre. In \u201cThe Evolution of Obesity\u201d (Johns Hopkins; $40), Michael L. Power and Jay Schulkin take a frankly Darwinian approach. They argue that we are fat for the same reason that we are capable of studying our backsides in the mirror. \u201cIn many ways we can blame the obesity epidemic on our brains,\u201d they write.<\/p>\n
Brains are calorically demanding organs. Our distant ancestors had small ones.\u00a0Australopithecus afarensis, for example, who lived some three million years ago, had a cranial capacity of about four hundred cubic centimetres, which is roughly the same as a chimpanzee\u2019s. Modern humans have a cranial capacity of about thirteen hundred cubic centimetres. How, as their brains got bigger, did our forebears keep them running? According to what\u2019s known as the Expensive Tissue Hypothesis, early humans compensated for the energy used in their heads by cutting back on the energy used in their guts; as man\u2019s cranium grew, his digestive tract shrank. This forced him to obtain more energy-dense foods than his fellow-primates were subsisting on, which put a premium on adding further brain power. The result of this self-reinforcing process was a strong taste for foods that are high in calories and easy to digest; just as it is natural for gorillas to love leaves, it is natural for people to love funnel cakes.<\/p>\n
Although no one really knows what life was like in the Pleistocene, it seems reasonable to assume that early humans lived, as it were, hand to mouth. In good times, they needed to stockpile food for use in hard times, but the only place they had to store it was on themselves. Body fat is energy-rich and at the same time lightweight: when the water is taken out, a gram of fat contains 9.4 kilocalories, compared with 4.3 kilocalories for a gram of protein, and when the water is left in, as it is on the human belly, a gram of fat still contains 9.1 kilocalories, while a gram of protein has just 1.2. As a consequence, a person with a genetic knack for storing fat would have had a competitive advantage. Power and Schulkin are both researchers at the American College of Obstetricians and Gynecologists, and they argue that this advantage would have been especially strong for women. Human infants are unusually portly; among mammals, only hooded seals have a higher percentage of body fat at birth. (Presumably, babies need the extra reserves to fuel their oversized brains.) Tellingly, humans, unlike most other animals, have no set season of fertility. Instead, ovulation is tied to a woman\u2019s fat stores: those who are very thin simply fail to menstruate.<\/p>\n
Of course, for early humans putting on too many pounds would have been a significant disadvantage; it\u2019s hard to chase down a mastodon or track through a forest if you\u2019re tubby. Thus, there would appear to be a Darwinian argument against obesity as well. Power and Schulkin get around this problem by noting that, as a practical matter, opportunities for eating too much were limited. Austerity was the rule for hunter-gatherer societies, and that didn\u2019t change when people started to form farming communities, some ten thousand years ago. In fact, human remains from many parts of the world show that early agriculturalists were\u00a0less\u00a0well fed than their Paleolithic forebears; their skeletons are several inches shorter and often show signs of nutrition-related diseases, like anemia. Genes that controlled weight gain wouldn\u2019t have been selected for because they simply weren\u2019t needed.<\/p>\n
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In America today, by contrast, obtaining calories is very nearly effortless; as Power and Schulkin observe, with a few dollars it\u2019s possible to go to the grocery store and purchase enough sugar or vegetable oil to fulfill the average person\u2019s energy requirements for a week. The result is what\u2019s known as the \u201cmismatch paradigm.\u201d The human body is \u201cmismatched\u201d to the human situation. \u201cWe evolved on the savannahs of Africa,\u201d Power and Schulkin write. \u201cWe now live in Candyland.\u201d<\/p>\n
The evolutionary account of obesity is a powerful one\u2014indeed, almost too powerful. If, as Power and Schulkin contend, humans are genetically programmed to put on weight whenever they encounter plenty, it would seem that by this point virtually everyone in America should be fat. Meanwhile, several million years of hominid evolution can\u2019t explain why it is just in the past few decades that waistlines have expanded.<\/p>\n
Eric Finkelstein is a health economist at a research institute in North Carolina. In \u201cThe Fattening of America\u201d (Wiley; $26.95), written with Laurie Zuckerman, he argues that Americans started to put on pounds in the eighties because it made financial sense for them to do so. Relative to other goods and services, food has got cheaper in the past few decades, and fattening foods, in particular, have become a bargain. Between 1983 and 2005, the real cost of fats and oils declined by sixteen per cent. During the same period, the real cost of soft drinks dropped by more than twenty per cent.<\/p>\n
\u201cFor most people, an ice cold Coca-Cola used to be a treat reserved for special occasions,\u201d Finkelstein observes. Today, soft drinks account for about seven per cent of all the calories ingested in the United States, making them \u201cthe number one food consumed in the American diet.\u201d If, instead of sweetened beverages, the average American drank water, Finkelstein calculates, he or she would weigh fifteen pounds less.<\/p>\n
The correlation between cost and consumption is pretty compelling; as Finkelstein notes, there\u2019s no more basic tenet of economics than that price matters. But, like evolution, economics alone doesn\u2019t seem adequate to the obesity problem. If it\u2019s cheap to consume too many calories\u2019 worth of ice cream or Coca-Cola, it\u2019s even cheaper to consume fewer.<\/p>\n
In \u201cThe End of Overeating\u201d (Rodale; $25.95), David A. Kessler, a former commissioner of the Food and Drug Administration, takes a somewhat darker view of the situation. It\u2019s not that sweet and oily foods have become less expensive; it\u2019s that they\u2019ve been re\u00ebngineered while we weren\u2019t looking. Kessler spends a lot of time meeting with (often anonymous) consultants who describe how they are trying to fashion products that offer what\u2019s become known in the food industry as \u201ceatertainment.\u201d Fat, sugar, and salt turn out to be the crucial elements in this quest: different \u201ceatertaining\u201d items mix these ingredients in different but invariably highly caloric combinations. A food scientist for Frito-Lay relates how the company is seeking to create \u201ca lot of fun in your mouth\u201d with products like Nacho Cheese Doritos, which meld \u201cthree different cheese notes\u201d with lots of salt and oil. Another product-development expert talks about how she is trying to \u201cunlock the code of craveability,\u201d and a third about the effort to \u201ccram as much hedonics as you can in one dish.\u201d<\/p>\n
Kessler invents his own term\u2014\u201cconditioned hypereating\u201d\u2014to describe how people respond to these laboratory-designed concoctions. Foods like Cinnabons and Starbucks\u2019 Strawberries & Cr\u00e8me Frappuccinos are, he maintains, like drugs: \u201cConditioned hypereating works the same way as other \u2018stimulus response\u2019 disorders in which reward is involved, such as compulsive gambling and substance abuse.\u201d For Kessler, the analogy is not merely rhetorical: research on rats, he maintains, proves that the animals\u2019 brains react to sweet, fatty foods the same way that addicts\u2019 respond to cocaine. A reformed overeater himself\u2014\u201cI have owned suits in every size,\u201d he writes\u2014Kessler advises his readers to eschew dieting in favor of a program that he calls Food Rehab. The principles of Food Rehab owe a lot to those of drug rehab, except that it is not, as Kessler acknowledges, advisable to swear off eating altogether. \u201cThe substitute for rewarding food is often other rewarding food,\u201d he writes, though what could compensate for the loss of Nacho Cheese Doritos he never really explains.<\/p>\n
In the early nineteen-sixties, a man named David Wallerstein was running a chain of movie theatres in the Midwest and wondering how to boost popcorn sales. Wallerstein had already tried matin\u00e9e pricing and two-for-one specials, but to no avail. According to Greg Critser, the author of \u201cFat Land\u201d (2003), one night the answer came to him: jumbo-sized boxes. Once Wallerstein introduced the bigger boxes, popcorn sales at his theatres soared, and so did those of another high-margin item, soda.<\/p>\n
VIDEO FROM THE NEW YORKER<\/p>\n
What Popcorn and Vaping Have in Common<\/p>\n
A decade later, Wallerstein had retired from the movie business and was serving on McDonald\u2019s board of directors when the chain confronted a similar problem. Customers were purchasing a burger and perhaps a soft drink or a bag of fries, and then leaving. How could they be persuaded to buy more? Wallerstein\u2019s suggestion\u2014a bigger bag of fries\u2014was greeted skeptically by the company\u2019s founder, Ray Kroc. Kroc pointed out that if people wanted more fries they could always order a second bag.<\/p>\n
\u201cBut Ray,\u201d Wallerstein is reputed to have said, \u201cthey don\u2019t want to eat two bags\u2014they don\u2019t want to look like a glutton.\u201d Eventually, Kroc let himself be convinced; the rest, as they say, is supersizing.<\/p>\n
The elasticity of the human appetite is the subject of Brian Wansink\u2019s \u201cMindless Eating\u201d (2006). Wansink is the director of Cornell University\u2019s Food and Brand Lab, and he has performed all sorts of experiments to test how much people will eat under varying circumstances. These have convinced him that people are\u2014to put it politely\u2014rather dim. They have no idea how much they want to eat or, once they have eaten, how much they\u2019ve consumed. Instead, they rely on external cues, like portion size, to tell them when to stop. The result is that as French-fry bags get bigger, so, too, do French-fry eaters.<\/p>\n
Consider the movie-matin\u00e9e experiment. Some years ago, Wansink and his graduate students handed out buckets of popcorn to Saturday-afternoon filmgoers in Chicago. The popcorn had been prepared almost a week earlier, and then allowed to become hopelessly, squeakily stale. Some patrons got medium-sized buckets of stale popcorn and some got large ones. (A few, forgetting that the snack had been free, demanded their money back.) After the film, Wansink weighed the remaining kernels. He found that people who\u2019d been given bigger buckets had eaten, on average, fifty-three per cent more.<\/p>\n
In another experiment, Wansink invited participants to cook dinner for themselves with ingredients that he provided. One group got big boxes of pasta and big bottles of sauce, a second smaller boxes and smaller bottles. The first group prepared twenty-three per cent more, and downed it all. In yet another experiment, Wansink rigged up bowls that could be refilled, via a hidden tube. When he served soup out of the trick bowls, people, he writes, \u201cate and ate and ate.\u201d On average, they consumed seventy-three per cent more than those who were served from regular bowls. \u201cGive them a lot and they eat a lot,\u201d he writes.<\/p>\n
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Before McDonald\u2019s discovered the power of re-portioning, it offered just a small bag of French fries, which contained two hundred calories. Today, a small order of fries has two hundred and thirty calories, and a large order five hundred. (Add fifteen calories for each package of ketchup.) Similarly, a McDonald\u2019s soda used to be eight ounces. Today, a small soda is sixteen ounces (a hundred and fifty calories), and a large soda is thirty-two ounces (three hundred calories). Perhaps owing to the influence of fast-food culture, up-sizing has by now spread to all sorts of other venues. In a 2002 study, Marion Nestle, a nutrition professor at New York University, and Lisa Young, an adjunct there, examined the offerings, past and present, at American supermarkets. They found that during the nineteen-eighties the amount of food that was counted as a single serving increased rapidly. A similar jump showed up in cookbooks; when the researchers compared dessert recipes in old and new editions of volumes like \u201cThe Joy of Cooking,\u201d they discovered that, even in cases where the recipes themselves had remained unchanged, the predicted number of servings had shrunk. According to the federally supported National Heart, Lung, and Blood Institute, the bagels that Americans eat have in the past twenty years swelled from a hundred and forty to three hundred and fifty calories each. If, as Wansink argues, people are relying on external cues to determine their consumption, then the new, bigger bagel is sneaking in an additional two hundred and ten calories. For someone who is in the habit of eating a bagel a day, these extra calories translate into a weight gain of more than a pound a month.<\/p>\n
So what\u2019s wrong with putting on an extra pound, or ten pounds, or, for that matter, a hundred and ten? According to the contributors to \u201cThe Fat Studies Reader\u201d (forthcoming from New York University; $27), nothing. The movement known variously as \u201csize acceptance,\u201d \u201cfat acceptance,\u201d \u201cfat liberation,\u201d and \u201cfat power\u201d has been around for more than four decades; in 1967, at a \u201cfat-in\u201d staged in Central Park, participants vilified Twiggy, burned diet books, and handed out candy. More recently, fat studies has emerged as a field of scholarly inquiry; four years ago, the Popular Culture Association\/American Cultural Association added a fat-studies component to its national conferences, and in 2006 Smith College hosted a three-day seminar titled \u201cFat and the Academy.\u201d<\/p>\n
Among the founding principles of the discipline is that weight is not a dietary issue but a political one. \u201cFat studies is a radical field, in the sense that it goes to the root of weight-related belief systems,\u201d Marilyn Wann, who describes herself as five feet four and two hundred and eighty-five pounds, writes in her foreword to the \u201cReader.\u201d Kathleen LeBesco, a communications professor at Marymount Manhattan College and another contributor, has put it this way:<\/p>\n
Fat people are widely represented in popular culture and in interpersonal interactions as revolting\u2014they are agents of abhorrence and disgust. But if we think about \u201crevolting\u201d in a different way . . . in terms of overthrowing authority, rebelling, protesting, and rejecting, then corpulence carries a whole new weight as a subversive cultural practice.<\/p>\n
According to the authors of \u201cThe Fat Studies Reader,\u201d the real problem isn\u2019t the sudden surge in obesity in this country but the surge in stories about obesity. Weight, by their account, is, like race or sex or bone structure, a biological trait over which individuals have no\u2014or, in the case of fat, very limited\u2014control. A \u201csocietal fat phobia,\u201d Natalie Boero, a sociology professor at San Jose State University, writes, \u201cin part explains why the \u2018obesity epidemic\u2019 is only now beginning to be critically deconstructed.\u201d<\/p>\n
Undeniably, the fat\u2014the authors of \u201cThe Reader\u201d are adamant advocates for the \u201cf\u201d word\u2014are subject to prejudice and even cruelty. A 2008 report by the Rudd Center for Food Policy and Obesity, at Yale, noted that teachers consistently hold lower expectations of overweight children, and that three out of five of the heaviest kids have been teased at school. The same people who are repelled by racist or misogynistic humor seem to feel that it is perfectly acceptable to make fat jokes.<\/p>\n
But, just because size bias exists it doesn\u2019t follow that putting on weight is a subversive act. In contrast to the field\u2019s claims about itself, fat studies ends up taking some remarkably conservative positions. It effectively allies itself with McDonald\u2019s and the rest of the processed-food industry, while opposing the sorts of groups that advocate better school-lunch programs and more public parks. To claim that some people are just meant to be fat is not quite the same as arguing that some people are just meant to be poor, but it comes uncomfortably close.<\/p>\n
As its title suggests, \u201cGlobesity\u201d (Earthscan; $34.95) takes an international approach to the problem of weight gain. The book\u2019s authors\u2014Francis Delpeuch, Bernard Maire, Emmanuel Monnier, and Michelle Holdsworth\u2014observe that, while Americans were the first to fatten up, they no longer lead the pack. \u201cLike it or not, we have no choice but to face up to the numbers: current data reveal that in Cyprus, the Czech Republic, Finland, Germany, Greece, Malta, and Slovakia, the proportion of overweight adults is actually higher than in the U.S.,\u201d they write. In Asia, Africa, and South America, too, obesity is on the rise. Although nearly a billion of the world\u2019s most impoverished citizens still suffer from too few calories, Delpeuch and his colleagues note that it\u2019s those living just above the poverty level who appear to be gaining weight most rapidly. It may seem to go without saying that being fat is better than starving, but even this truism, the authors argue, is no longer entirely true: in the new world order, it is possible to be overweight and malnourished at the same time. \u201cPeople on modest incomes suddenly find a cheap, calorie-packed diet within their grasp and make the most of it as soon as they can,\u201d they write. \u201cUnfortunately this means sacrificing many elements that are nutritionally more valuable.\u201d<\/p>\n
The authors of \u201cGlobesity\u201d are, for the most part, nutrition researchers, and, in contrast to the contributors to \u201cThe Fat Studies Reader,\u201d they see obesity as a disaster, both for the individuals who suffer from it and for the health-care systems they are likely to enter. Type 2 diabetes, coronary disease, hypertension, various kinds of cancers\u2014including colorectal and endometrial\u2014gallstones, and osteoarthritis are just some of the conditions that have been linked to excess weight. (Last month, the\u00a0Times\u00a0reported that gout, once considered a disease of royalty, is, as the population gets fatter, making a comeback among the middle class.) It has been estimated that the extra pounds carried by Americans add ninety billion dollars a year to the country\u2019s medical spending. No credible estimates exist for global costs, but, Delpeuch and his co-authors write, \u201cObesity is inescapably confirming itself as one of the biggest drains\u201d on national health-care budgets.<\/p>\n
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Whether anything will be done\u2014or even can be done\u2014to stem the global tide of obesity is, at this point, an open question. The World Health Organization has come up with more than three dozen actions that governments could take to encourage better eating and fitness; these include imposing a \u201cfat tax\u201d on caloric snacks, improving health education, regulating food and beverage advertising, limiting the foods available in public facilities, and insuring access to sidewalks and bike paths.<\/p>\n
But, as anyone who has ever gone on a diet knows, weight that was easy to gain is hard to lose. If anything, this is even more true on a societal level. Those politicians who could take the recommended actions tend, the authors of \u201cGlobesity\u201d point out, to be in thrall to the very interest groups that are profiting from the status quo. (It\u2019s probably no coincidence that, in a period when the rest of the world has come to look more like Americans, U.S. corporations have been making significant investments\u2014some fifty-five billion dollars a year\u2014in food-processing and distribution facilities abroad.) \u201cTo conquer obesity will thus require a complete new awareness, the re-education of the great mass of consumers, and this seems a distant prospect,\u201d they write.<\/p>\n
In the end, it\u2019s hard to argue with such fatalism. The problem goes even beyond the corporate interests that have brought us \u201ceatertaining\u201d foods, Value Meals, and oceans of high-fructose corn syrup. Collecting the maximum number of calories with the least amount of effort is, after all, the dream of every creature, including those too primitive to dream. With the BK\u2122 Quad Stacker\u2014four beef patties, four pieces of bacon, and four slices of cheese for $4.99\u2014man edges close to realizing this ambition. And that\u2019s without the fries. \u2666<\/p>\n
Published in the print edition of the\u00a0July 20, 2009, issue.<\/p>\n
Elizabeth Kolbert\u00a0has been a staff writer at The New Yorker since 1999. She is the author of \u201cThe Sixth Extinction: An Unnatural History,\u201d which won the Pulitzer Prize for nonfiction in 2015.<\/p>\n","protected":false},"excerpt":{"rendered":"
XXXL Why are we so fat? By\u00a0Elizabeth Kolbert July 13, 2009 Human appetite is elastic: give us more and we\u2019ll eat more.Illustration by Zeloot One of the most comprehensive data sets available about Americans\u2014how tall they are, when they last visited a dentist, what sort of cereal they eat for breakfast, whether they have to […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[10],"class_list":["post-91620","post","type-post","status-publish","format-standard","hentry","category-research-paper-writing","tag-writing"],"_links":{"self":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/91620","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/comments?post=91620"}],"version-history":[{"count":0,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/posts\/91620\/revisions"}],"wp:attachment":[{"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/media?parent=91620"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/categories?post=91620"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/papersspot.com\/blog\/wp-json\/wp\/v2\/tags?post=91620"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}