Food, obesity, restaurants…
Elizabeth Kolbert in the New Yorker:
According to the first National Health study, which was done in the early nineteen-sixties, 24.3 per cent of American adults were overweight—roughly defined as having a body-mass index greater than twenty-seven. (The metrics are slightly different for men and women; by the study’s 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’ 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 Journal of the American Medical Association. In just ten years, they showed, Americans had collectively gained more than a billion pounds. “If this was about tuberculosis, it would be called an epidemic,” another researcher wrote in an editorial accompanying the report.
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—the 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’ extra bulk costs the airlines a quarter of a billion dollars’ worth of jet fuel annually.
Obesity was more common among women than men. Black women had the greatest rate of obesity with 39.2 percent, followed by black men with 31.6 percent. The rate for Hispanic women was 29.4 percent, with Hispanic men at 27.8 percent. White men were at 25.4 percent, and white women at 21.8 percent.
Higher obesity rates for blacks were found in all Census regions and in most states, with significantly higher rates for blacks in 21 states. The highest obesity rate for blacks, 45.1 percent, was found in Maine. The highest rate for Hispanics, 36.7 percent, was in Tennessee; and the highest rate for whites, 30.2 percent, was in West Virginia. The highest rates for all three groups were found in the South and Midwest.
Frances Kissling in Salon on how the above relates to Obama’s new pick for surgeon general:
From her photos, it appears that Dr. Benjamin will need a generous size 18 military uniform. The anti-fat brigade has been arguing in various online comments sections about her BMI and whether or not the term obese applies. These chattering masses wonder if a country plagued by obesity should have an above average-weight woman speaking to public health.
For me the answer is a resounding yes. This country is full of above-average weight women and children struggling for dignity as well as to lose weight. Achieving either of these is not easy. (Never mind that none of these criticisms have mentioned any actual health concerns Benjamin might or might not have, instead presuming “obesity” as a catch-all for bad health.) Having a confident, big-bodied and big-spirited woman as America’s family doctor could do more to improve their health than skinny HHS secretary Kathleen Sebelius. It’s good to know that even doctors struggle with their weight — and lead full and active lives in spite of adversity.
But not one of these assholes said a god damned thing when Obama nominated former Iowa Governor Tom Vilsack to head the Department of Agriculture, despite his oversight over: the food pyramid; agricultural subsidies that go heavily to grains and hardly at all to fruits and vegetables; the school lunch program, food stamps, WIC programs and the lists of foodstuffs that comprise what the poor are able to eat; and the Center for Nutrition Policy and Promotion. Nobody piped up when he nominated non-skinny former Congressman Ray LaHood to head the Department of Transportation, who has since become the face of an agency that provides oversight over the roads that make sure most Americans need do little more than walk from their buildings to cars and back again. And goodness knows none of these concern-trolling assholes had a word to say when Larry Summers was appointed to lead the National Economic Council, whose remit includes agriculture, health care, Social Security and labor issues. Google any of their names and the acronym BMI and you’re more likely to read about the airline than weight — and any of the stories about weight aren’t about theirs.
I ‘ve scoured the Intertubes pretty thoroughly this evening, and I can find no evidence of any mention of this point by anybody other than a stray anonymous comment on a newspaper website. But now that you mention it… it’s not completely crazy. Would the president choose a visible smoker as SG? The post has few responsibilities, it is almost purely symbolic. So, if obesity is indeed a serious public health challenge, an “epidemic” as the First Lady among others strongly argues, wouldn’t it make sense to select for the most visible public health job somebody who has overcome this problem – rather than failed to do so?
Bring back Sanjay Gupta!
Now on to the subject of restaurants. Matthew Yglesias:
(my [Matt Y] photo)I was walking downtown the other day and saw this sandwichboard outside a Potbelly’s. The idea was, basically, that people ought to be eating larger sandwiches for lunch. Messing around with their nutritional information calculator, I see that if you order a regular-sized meatball sandwich and an oreo milkshake from Potbelly’s you’ll be taking in over 1,400 calories at lunchtime. So it’s not clear that a larger portion size is what’s really needed here. And, as a general principle, it’s very hard to believe on the merits that what Americans need to be doing is eating more food.
But there’s a very profound problem of evolutionary psychology here. For the vast majority of human existence people were engaged in much more daily physical activity than is the typical member of a contemporary rich society and it was impossible to be certain that food would be available in the future. Consequently, people are largely designed with the instinct to err on the side of eating more food rather than less. Especially if the food is tasty. These days, of course, we’re in a very different situation. Nobody starves to death in the contemporary United States, but lots of people have problems related to poor dietary habits.
Peter Suderman in Reason:
As someone who enjoys Potbelly but has on more than one occasion decided to head for Subway instead in order to get a bigger sandwich, I think this misses the point. Painfully bad made-up marketing buzzwords aside, what if you’re just extra hungry? Sometimes a six-inch sub isn’t enough — and my uncomplicated desire for a couple of extra meatballs shouldn’t be the domain of our nation’s policy makers.
Onto a different restaurant. Ezra Klein:
This is why the obesity crisis is such a tough issue: Calories are delicious. The Cheesecake Factory isn’t doing anything wrong, either ethically or culinarily. Human beings are wired to prefer abundance, salt, fat, sugar, and value. The Cheesecake Factory is giving people the whole package. Changing people’s eating habits so that type two diabetes don’t become the new chubby would be easy if the food was actually repulsive or the value was bad or it was all, in some other way, a trick. But it’s not. The food is enjoyable. The value is incredible. The cost is long-term, and remembering that we might get diabetes down the road is pretty hard when eons of evolutionary wiring are telling us to eat this stuff now now now now it’s right here now now!
People go to the Cheesecake Factory because they like being there, not because they’re being deceived. The only catch is that they really don’t know how bad the food is for them. Study after study shows we wildly underestimate caloric load of our foods, and we underestimate by more as the meal becomes larger. It’s not clear that nutritional information on menus would actually change eating habits. But it would at least give people a place to start. Diners know what they like. They know how much money they’ll have to pay to purchase it. No reason they shouldn’t also know what it’s going to cost their waistline.
Tom Philpott in Grist disagrees with Ezra
Beyond that, one of the things that has long occurred to me about restaurant dining is that, because every customer must be served the same portion size (within allowances for human error) they’re naturally going to provide huge amounts of food. If you serve a 275 pound man an amount of food that would be appropriate for a 125 pound woman, he’s going to still be hungry at the end of his meal and therefore a dissatisfied customer. Because the marginal cost of additional food (especially pasta, potatoes, and the like) is negligible, it’s just good business to pile it on. Naturally, everyone else will be given too much to eat and all but the most disciplined will overeat.
Two obvious ways health conscious diners can adjust are to resolve to take half the food home with them — better yet, get a “doggy bag” before starting eating and divide it right away — or to share food. My wife and I will often order an appetizer and a single entree if we’re out and not returning immediately home. Otherwise, I’m happy to have extra food for the next day’s lunch.
