The Obesity Epidemic

Posted: January 23, 2011 in Fitness

I’m not including a picture for this blog because we have all seen enough pictures of obese people stuffing their mouths full of double cheeseburgers to last us a lifetime.  I was even reticent to write a blog called “The Obesity Epidemic” because the phrase itself feels cliche and seems to point to nowhere.

But, I’m a little riled up after reading this month’s Scientific American’s feature article by David Freedman called, “How to Fix the Obesity Crisis“.  It’s not that it’s a bad article – it’s very good actually.  It takes a very scientific approach to obesity and examines all the root causes — the writer has certainly done his homework.  For instance, are you aware that nearly 1/3 of North Americans are obese?  Did you catch that?  One out of every three people is obese. Did you know that obesity is quickly taking over smoking’s esteemed position of causing premature death and disease?  Or that “almost everybody who tries to diet seems to fail in the long run—a review … found that as many as two thirds of dieters end up two years later weighing more than they did before their diet.” (Freedman, 2011).

Obesity is a big problem, no pun intended, so big that the USA’s National Institutes of Health have been spending more than 800 million on research studies a year.  And pharmaceutical companies are frantically working away on the pill that will magically melt all the fat away.  The article points to many possible sources of the problem: the social, biological, economical and even the marketing causes.

And though I found myself agreeing with many of his points, I kept thinking – he’s not stating the obvious.  My view, and I’ll be very frank here – is that obesity is caused by addiction to food combined with inactive living.  Not once did the word addiction come up in this article.  Nor did the word choice.  Perhaps the author omitted this purposefully, instead choosing to illustrate the greater complexities.  But I wonder if the overweight and obese people reading the article felt more hopeful after reading it or if they felt more defeated by the seemingly insurmountable perplexities surrounding the issue.

We cannot forget that we chose the way we’re living now – and everyday, collectively and individually, we choose to continue to move forward in this unsustainable direction.  We’ve been lulled into a kind of perpetual hunger for high fructose corn syrup and quick fixes and the only way out of this messy cultural diet is through education, choice, and careful planning.  It’s not easy to make a change – especially if the one you need to make is to drop half of your body weight and those in that situation will need a lot of support.  But no one else can do it for them.  Not the drug companies, not the grocery stores, and not the government.

We can make the issue as complex as we want, but it will always come down to energy (and the quality of it) going into the body and energy coming out of it.  The food we eat is increasingly more complex but we can still choose to eat simpler foods.  All the information is out there.

The short answer on how to fix the obesity crisis:

Exercise (moderate – high intensity) at least 90 minutes a week.
Eat 5 – 6 small meals of food everyday 2-3 hours apart (by food, I mean plants, nuts and animals).

The long answer:

We don’t know yet but we’ve set up a special government unit and are throwing a gazillion dollars on the problem.  We’ll have the answers possibly by 2025.

In health and simplicity,

Sandy

Ok – I couldn’t resist…

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Comments
  1. […] This post was mentioned on Twitter by Nelson Ko, Sandy Ibrahim. Sandy Ibrahim said: The Obesity Epidemic – my response to Scientific American: http://t.co/xZb9h5j […]

  2. Excellent post. “Addiction” is a loaded word, and experts debate endlessly about its applicability to obesity, and I find it not worth the trouble to try to work it in, no matter how you do it someone’s going to complain, and it ends up being a distraction. In the end, the word we use shouldn’t matter that much, clearly overweight folks are in some way compelled to take in more calories than they should (even if it’s just a very slight excess in some cases), whether or not we call it an addiction. We need to find reasonable ways to get people move from their current eating and low-activity habits to adopt lifelong habits of eating healthier foods and being more active, and people need education, encouragement, incentives, role models and support, among other things.

    • hitgirl says:

      David, thanks so much for your comment. I took a bold step in using the word “addiction” when referring to obesity and I accept your point that it holds such a stigma that it can be a distraction.

      But…

      What if focusing on the science and external causes for obesity is the real distraction. What if sugar and the other substances creeping into the North American diet are addictive and we need to see them that way? Just like nicotine, caffeine, heroin, etc. are known and accepted to be addictive substances – sugar needs to be viewed the same way.

      I’m not talking about about personal weakness here – I’m talking about full-fledged addiction. As you stated obesity is fast becoming the number one PREVENTABLE cause of disease and early death and we should pull out all the stops to prevent it – even it risks raising the ire of those folks who aren’t warm to viewing themselves as addicts.

      Here in Canada, tobacco companies are required to put explicit warnings on each package of cigarettes warning the consumer of the health risks associated with their product. If our governments are as concerned with obesity as they claim to be, perhaps their money would better spent warning the consumer, again very explicitly, of the health risks they are taking when they consume 90% of what is being offered at a typical grocery store.

      Humans are predisposed to addiction. I remain firm in my view that we cannot fairly and honestly discuss obesity without referring to addiction as a possible cause.

      Thanks again for commenting. I’m honored you have taken the time.

      Sandy

      • Hi Sandy. Again, congratulations on a great blog and thoughtful posts. Putting aside for a moment the question of the use of the term addiction, let’s consider the question of whether the obesity epidemic is largely or even completely related to food cravings (and perhaps other problems) caused by sugar in particular, and perhaps by other substances such as other types of carbs, and fat. My take on this is that absolutely, some types of foods, eaten in certain quantities, have this sort of effect on some people. But I seriously doubt it’s anything approaching a complete explanation. I think it’s a factor for some people. I just spent 10 days traveling (mostly through India), and for a variety of reasons I didn’t have access to the sorts of balanced meals I like to eat, and instead I had to get almost all my calories from carbs (including a lot of sugar–just try getting tea or coffee that isn’t pre-loaded with it in some parts of India) and fat (including a fair amount of saturated fat from dairy). Fortunately I didn’t suffer from any travel-related gastric distress (well, a touch one evening), and ate heartily with a huge appetite (I adore the food in India) and no restraint. By many people’s claims, I should have been converted by this diet into a walking flab-accumulation machine. I actually lost two pounds. I got back last night, and immediately without any difficulty resumed my balanced diet. No addiction. No flab. This proves absolutely nothing, of course, but it’s the sort of thing I hear from people all the time–there are plenty of people whose appetites, cravings and fat-accumulation mechanisms seem undisturbed by taking in large percentages of their calories via simple cars including sugar, and/or via fat or other supposedly nightmarish foods. To be sure, it’s clear some people are affected in some way to some degree by these foods, and I think it’s a great idea for just about everyone to take it easy on simple carbs (especially sugar) and fats (especially saturated fats). But I strongly believe there’s a vast wealth of evidence that there are all sorts of reasons why people become obese, and while some are probably more important to most people than others, I don’t believe it’s helpful to point at one of them and say it’s the cause, and especially to say that addressing that one factor will be a universal solution. Yes, definitely, let’s all cut down on sugar. But don’t count on that by itself going a long way to get most of us to lose much excess fat. That’s my take!

  3. Anne-Marie says:

    Soon enough we’ll see the standards for overweight and obesity changing – just like the government of Canada decided to change the minimum amount of activity a person should perform per week – hey, if they’re not going to be active, we’ll just lower the standard; that way the general population will have less to shoot for. Heaven forbid we should assign accountability.

    • hitgirl says:

      Ann-Marie, check this out. http://bit.ly/gCwqhe More exercise is better!

      • Anne-Marie says:

        http://www.montrealgazette.com/health/exercise+guidelines+less+vague+exercise+society/4159803/story.html

        The old guidelines said 90 minutes per day for kids and 60 per day for adults – this included activities such as walking to school/work, taking stairs instead etc etc.

        Now it’s 60 per day for kids and 2.5 hours per week for adults.

        It would appear that 60 minutes of moderate exercise and 30 minutes of intense exercise per day for children was too confusing for the general public. Hmm – just how many of these kids are really getting even 45 minutes per day? It’s too scary to let them ride their bikes around like we used to as kids, walking to school unsupervised is a scary option, before and after school activities aren’t free or cheap, both parents have to work just to get by – there’s a serious doubt in my mind that most kids were even getting the 60 they’re proposing now. Why put a number on it? Why not just say – look, every day try to take the time to do an activity with your kid and that way you’ll both hit your target?
        Their assumption that John Q Public couldn’t figure out what the old guidelines meant is pretty insulting actually.
        On a sad side note – RIP Jack Lalanne – Godfather of healthy eating and exercise.

  4. Heidi says:

    Sandy, good post. It’s true that the words ‘addiction’ and ‘choice’ are very loaded in this context, but I support your view. Not everyone can be naturally skinny, but there is a big difference between having a genetic trait of large bones/heavy-set body and being obese.

    • hitgirl says:

      Thanks Heidi – it is a complicated issue. As David so clearly points out in his article, there are so many factors in our culture that are contributing to this epidemic, but I believe that education followed by personal responsibility and choice is ultimately the only way forward.

    • hitgirl says:

      Anne-Marie – yes RIP Jack Lalanne

  5. Heather says:

    chiming in… us folks in the substance use world use the word ‘addiction’ to describe one point on a diverse spectrum of people’s relationships to the things they put in their bodies. we use substances, including food, in a multitude of ways, and only some would identify with the term ‘addiction’ to describe that relationship.

    sandy mentioned that ‘all the information is out there.’ it may be out there, but it is not accessible to many. similarly, food choices are not always accessible. when we consider our global food industry, crap food is super accessible. it makes sense that if you’re living in poverty, for example, you might ‘choose’ to fill your kids’ bellies with KD rather than fresh veggies, lean meats, whole grains, etc.

    i tend to see most health and social problems as intimately interconnected with the dynamics of poverty, corporate capitalism, etc. our society does not make it easy for a lot of folks to make the ‘healthy choice.’ the more privileged you are, the more choices you have.

    that said, there’s a lot of privileged folks sitting around, watching t.v., sucking on starbucks beverages.

  6. hitgirl says:

    Heather – I appreciate your thoughtful comment. As you know, my husband works the front lines of addiction as an addictions pyschiatrist and when I decided to use the term, I did so after much discussion with him. I’m still hoping he’ll weigh in on this as well. Hint. Hint.

    I’m not entirely convinced that the information isn’t accessible to everyone – but I do agree that junk food and confusing advertising is overly accessible. IE – is Fruit Loops really part of a nutritious breakfast? Really?

    I’d be very interested to know more on the relationship between poverty and obesity. There’s the starting point perhaps.

  7. Heather says:

    i appreciate the opportunity to comment, and thanks for bringing this issue up!

    two links:

    “Poor and fat: The link between poverty and obesity in Canadian children”
    http://www.cbc.ca/health/story/2010/08/13/f-taylor-poverty-obesity-children.html

    And, from “A Poverty Reduction Plan for BC” (2008, link below)

    “BC faces a chronic hunger problem and significant food insecurity. According to the most recent Dietitians of Canada report on the cost of eating in BC, a family of four with one average income would spend 17 per cent of their income buying nutritious food for a month, while the same size family with one low-income earner would spend 31 per cent of their income on nutritious food. On income assistance, this same family would have to spend 42 per cent of their income to provide healthy food, leaving them unable to afford rent, let alone other basic living necessities. The result is that many low-income families go without adequate nutrition….

    …The consequences of hunger are dire and contribute to higher costs in BC’s health system — healthy eating prevents many diseases, and children who eat well have fewer behavioural problems. Without adequate income to buy nutritious food, low-income families tend to consume more energy-dense but nutrient-poor food choices, which contributes to the increasing rates of obesity.”

    http://www.policyalternatives.ca/sites/default/files/uploads/publications/BC_Office_Pubs/bc_2008/ccpa_bc_poverty_reduction_full.pdf

  8. hitgirl says:

    Heather – well that is very grim portrait indeed and quite compelling. I’ve already gone out on a limb here suggesting that addiction plays a role in obesity.

    I’m afraid I’m about to make myself even more unpopular by suggesting that healthy eating is an option for more than the privileged. Without getting into an argument of exactly how I can prove that let me simply state my opinion that perpetuating the popular view that healthy food is unaffordable further contributes to the problem.

    Healthy food choices are available to most North Americans – education on this would go much farther than saying it is simply out of reach. I would hazard a guess that few people who believe they can’t afford to eat better actually can’t.

    I would like to point out that my opinion stems from my vocation as a trainer. What I do for a living is to support people into taking accountability and responsibility for their health and ultimately, their lives.

    I work with a privileged group and whenever I hear reasons for why a certain problem is beyond their control, I raise my eyebrows a little. I recognize that some people are just in survival mode and any food at all is a gift. My question is if 1/3 of North Americans are obese – are these same people also impoverished? And are there any examples of people living in poverty who have found a way to eat healthy. Maybe I’m asking for the hope here.

    Thanks to Nelson Ko – who has contributed his thoughts on FB:
    “Eating healthy, being healthy is not a question the underprivileged have the deciding on. Sadly, survival is their goal. Options are limited. processed foods are generally less healthy but cheaper than fresh, unprocessed food. A sad fact. That part of the equation (the other part being fit) is weighted against them.”

  9. Anne-Marie says:

    Sandy, some of us weren’t always privileged. There was a time when I went to the grocery store with a calculator and crossed fingers (and many times those crossed fingers didn’t do the trick). There weren’t many – if any – pennies left a few days before payday. Sometimes I had to opt for the food bank – and baby could I stretch out one of their jars of peanut butter! I found china town to be a treasure trove of very very inexpensive veggies and fruits – they beat out the grocery stores hands down any day of the week – by a LARGE margin. Yes, there were times I fed my son oatmeal for dinner – BUT – he got large flake, long cook dense oatmeal, with raisins or apples or some kind of other fruit thrown in. You do the best you can with what you have AND with what you know. Yes, mr noodles or instant no name oatmeal was a damned cheap alternative – but I also knew that A; He’d be hungry in 10 minutes and B: those kinds of sodium levels are lethal. So really feeding him the mr noodles or instant oatmeal wasn’t an option. Besides, when you really look at it that enormous bag of large flake or steel cut oatmeal is cheaper than the processed boxed stuff if you break it down to cost per serving.
    I certainly couldn’t buy a large variety of fruits and veggies – I heard a lot of “Apples, carrots, celery and boiled eggs for lunch AGAIN??” Lentils were cheap and an excellent option as well. Organic was completely out of the question (SIXTEEN dollars for an organic muskmelon at Safeway!!) But I still managed to steer clear of pop, slurpees, chips, mcdonalds etc.
    I am in NO way saying that it is easy to eat healthy when it’s hard just to keep a roof over your head and certainly there are many in even more dire straights. There are over 125,000 children in BC living below the poverty level right now – that’s just atrocious.
    Truly, what we’re looking at here is what you are talking about – that portion of the populace who think that dinner at MacDo 3 times a week cause you’re in a hurry is OK. Eating at the computer, in front of the tv, in the car is OK, because we’re in a hurry. Packaged prepared foods are ok, because we’re pressed for time.
    Take the time to eat like you’re in your grandparent’s house. No eating outside of the kitchen or dining room. The family eats together – a meal that has been prepared with care because it IS for the family to share – taking the time to thoroughly chew, discuss the day, recognizing they’re full in plenty of time to avoid overeating because they’re having family time, talking, taking turns listening and eating. Absolutely it’s hard to find the time to manage that – but even if you make a rule to try to accomplish it 3 times a week and work your way up from there, you’re on the right track.

    • hitgirl says:

      Thanks Anne-Marie – I was hoping to hear from a perspective like yours on this. Thanks to everyone for a lively and engaging discussion. It may not be easy to engage in a discussion like this – but without thoughtful and honest discourse there can be no progress. I appreciate all the comments, experience, perspectives, and opinions.

      Sandy

  10. Jess says:

    I’m new to the HIT to FIT program but it has already taught me an important lesson which I believe is pertient to this discussion.

    You do what you can. No more. No less. And be proud when giving your full effort. And most important of all, recognize that true effort is unique to you and so changes face often because we are, afterall, incredibly unique individuals navigating complex circumstances that change and so change us.

    By respecting our unique circumstances we become aware of them, and, I believe we should aim to do this on a daily, or even moment-by-moment basis if possible rather than trying to live up to a static/unchanging national standard or ideology of effort that in no way approximates the diversity of circumstances and experiences.

    What I’m trying to say is…I believe people, all people, are giving a pretty good effort as it is; the only problem is, many of those people aren’t giving themselves the credit where it is due. This is understandable, considering that there is a clear ideology, a standard if you will, surrounding what is thought of as ‘effort’ and ‘success’ as it pertains to health.

    If we were to recognize and respect the great spectrum of effort not only as it changes in our own lives, not only would be feel immensely better for our sense of accomplishment, we would also be more sensitive to (i.e. recognize and respect) the spectrum of effort in other peoples lives.

    We should give ourselves and others way more credit where it is due!

  11. hitgirl says:

    Thank you Jess – I feel like you might be touching a bit on societal expectations and projections of image and perfection. Well, that’s a whole other can o’ worms isn’t it?

    One thing has become abundantly clear to me with this discussion – and that is that nothing is clear.

    Over lunch today, my husband and I discussed how it really is all about food. Where we are as a society and as a planet today is because of decisions we made around food production, food choice and consumption. What concerns me greatly now is that what is being masqueraded as food – IS NOT FOOD – and hence we have obese people suffering from malnutrition.

    Where do you think we’re going to go from here?

    S

  12. Michael Tension says:

    That burger looks awesome.

  13. Jess says:

    Yeah, I agree with you that societal expectations are a whole different can of worms! The crazy thing is, it appears that someone could bring up any ‘ol environmental, biological or cultural issue and it would fit into this discussion somehow. 😛 LIke you said, nothing is clear and I agree with you there. This is such a broad issue!

    I just wanted to add something that I learned in my anthropology graduate seminar last week and it relates to Freedman’s section of the article pertaining to ‘behavioural interventions or modifications’. As you will recall in the article it mentions the techniques, successes and shortfalls associated with a number of behavioural modification approaches such as those associated with Weight Watchers, The Zone Diet, and others which in some way or another try to monitor and control calorie intake and expendature. Well there was one behavioural modification that wasn’t mentioned and it is a pretty simple one and that is: cooking.

    Okay so hear me out on this (we are still ripping apart the guys theory in class but I’ll try my best here), so a guy by the name of Dr. Richard Wrangham recently shook the whole anthropological community with a theory that suggests that, overwhelmingly (i.e. more than tools, language etc.), human evolutionary success can be attributed to COOKING. The basis for his theory explains that cooking greatly increases the amount of calories one gets from foods because it denatures proteins, gelatinazes starches and (usually) softens food texture, all of which allows enzymes to get at foods and so break them down for absorbtion into the body. So the exact same piece of food uncooked will not be broken down the same as the same piece of food that is cooked. This can thus, an aspect calorie intake and expendature greatly, even if we are talking about the same food!

    INterestingly (and still according to Wrangham), every culture cooks and even more interesting is that captive primate studies show that our closest relatives will always choose cooked food over uncooked foods! Now, Wrangham doesn’t suggest we all switch to Raw Foodism which he suggests is only attainable by privledged, modern and urban eatters since raw fodism in underprivedled cultures end up causing amenorrhoea in the women, but he does suggest that it has had, and continues to have a MAJOR influence on our evolution (both biologically and culturally)

    I’d just like to say that I’m not against Raw foodism or anything, nor am I 100% on board with Wrangham’s claims. I just wanted to share the whole cooking / calorie idea with y’all. Oh and I think I just completely sidetracked this whole discussion once again – sorry Sandy!

    PS: the book by Dr. Richard Wrangham (Biological Anthropologist, Harvard) is written for public audiences and is called “Catching Fire: How Cooking made us Human”

    • Jess says:

      Mmm.. I just realized that cooking versus eatting foods raw may be blantantly obvious point for some but I perhaps cooking and the extra calories it brings is more subtle and thus sneaky than we think?

  14. hitgirl says:

    A few things.

    David – thanks once again for responding. It’s so wonderful of you to engage in this discussion. I wholeheartedly agree that taking on dogmatic approach on this issue will get us nowhere. Thanks to your article and these responses, my views on the matter have been somewhat compromised. 🙂 I am willing to throw out my biases and look at this with fresh eyes.

    Jess, Anne-Marie, Heather, Heidi, and Nelson- thank you for your thoughtful contributions to this discussion. I love what you all have had to say and love the way you said it.

    There are many people who have been following this discussion who haven’t chimed in online but who have been engaging with me on it in real life. A few interesting ideas have come out of that – one being a healthy eating regional cookbook based on a monthly budget. I think that’s a really cool idea. I’d also love to have the gym host a viewing of Food, Inc and keep the dialogue going.

    Clearly there are many different aspects to this issue. For those of us called to create change – I think we need to examine where our circle of influence is and where our true passions lie. From there it is incumbent upon us to educate ourselves as best we can and take action as best we can – and hopefully have an awesome time doing it.

    David – a good piece of writing causes the reader to think. A great piece causes the reader to act. Please know that in a small city on a little island in a cold country a few people have been roused enough by your article to take action.

    Sandy

  15. Deb Furlong says:

    As one of the 1 in 3, There is a lot of characteristics of an addiction in food. Both are self suppressions behaviors. What it really is, is a chain of choices, one decision takes you down one path, you can always step in another detection but if you relax your focus, you easily find yourself on that familar path

    • hitgirl says:

      Thanks Deb – appreciate your perspective a great deal. Addiction, habit, choices. Why did God give us such a big brain coupled with the difficulty to control ourselves?

  16. Sue says:

    I come from a family that has a middle-class income and are not survival-driven. All of us have at some time had weight issues, but have managed them differently. My brother and I, born with close to the same genetic raw material (we are not twins), have gone in different directions with the same upbringing which is very interesting! He is obese and has been since his late teens. I had a brief period where I was overweight but I now have a healthy body weight. My mother is also obese and has struggled with her weight most of her life, and my father has only recently brought his weight under control. When I look at our choices, here are some of the differences I see: my mother and brother have always tried to control their weight through food choices. My brother’s diet is full of highly processed foods and very large portions so his version of “diet” is to eat low-fat cheese in large portions instead of very large, and he plays team sports which involve a fair amount of standing around in the name of “exercise.” My mother jumps onto a different low-carb diet bandwagon every year but still consumes alcohol and bacon like it was water. (Not in the same serving, yet). My dad has finally addressed his weight issues after a major aortic surgery and concentrated rehab program involving a major dietary change and structured exercise program. I tried dieting on Weight Watchers for 2 months and said “screw this” and took up rowing. For the past 7 years I have found that my exercise habits are the largest predictor and dictator of my body health. When I exercise more, I am more inclined to eat healthy foods.

    So… the point of all this was to say that food and food choices play a huge role, of course, but we must acknowledge the fact that 90 minutes of exercise a week is sadly, pathetically insufficient to allow our bodies to operate healthily. Lack of activity is bad for our physical and mental health. For everyone I hear who’s adopted a new diet plan only to find they put all the weight back on 3 months afterwards, I ask them: what changes did you make to your physical activities, and have you kept those changes?

    Exercise is not limited to those people who have the means. Walking is free, last time I checked. If you want to achieve a healthy body weight, image and mental health, get off the couch and go outside!!

    • hitgirl says:

      Hi Sue – thanks for chiming in! It’s funny you should say that “90 minutes of exercise a week is sadly, pathetically insufficient to allow our bodies to operate healthily”, Funny – because the main message of my business is the opposite. Three 30 minute workouts/week absolutely maintains a sufficient level of fitness. BUT and it’s a big but (not mine though – ’cause I work out 3X/week) it depends on what and how you approach those 90 minutes. Heck – 10 minutes of vigorous exercise/day is sufficient if you’re really givin’ er’. It depends on where you are starting from and what you are doing in those sessions. The biggest hindrance I encounter as a trainer is that people think exercise is too hard, will take too long and is generally just not accessible. I say forget about the minutes. Do 30 pushups tomorrow morning. Do it again the next morning. The next morning do 35. Hell – do 1. Park your car at the far end of the parking lot then sprint to the grocery store. Take your dog for a walk and balance on the curb the whole time. We make too big a deal of “exercise”. YES! “Get off the couch and go outside!” Eat real food. Honor your health. Enjoy your life.

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