The Great Debate

Why the surge in obesity?

Editor’s note: This post is republished from the author’s blog.

The Weight of the Nation is a four-part series on obesity in America by HBO Films and the Institute of Medicine, with assistance from the Centers for Disease Control (CDC) and the National Institutes of Health (NIH). It’s been showing on HBO and can be viewed online. Each of the four parts is well done and informative.

Obesity is defined as having a body mass index (BMI) of 30 or more. For a person 6 feet tall, that means a weight of more than 220 pounds. For someone 5’6″, the threshold is 185 pounds. People who are obese tend to earn less and are more likely to be depressed. They are at greater risk of diabetes, heart disease, stroke, and some types of cancer, and they tend to die younger. The CDC estimates the direct and indirect medical care costs of obesity to be $150 billion a year, about 1% of our GDP.

The chart below, which appears several times in The Weight of the Nation, shows the trend in obesity among American adults since 1960, the first year for which we have good data. The data are from the National Health and Nutrition Examination Survey (NHANES). They are collected from actual measurements of people’s height and weight, rather than from phone interviews, so they’re quite reliable. After holding constant at about 15% in the 1960s and 1970s, the adult obesity rate shot up beginning in the 1980s, reaching 35% in the mid-2000s.

What caused the surge in obesity? The standard explanation is too much eating and too little physical activity, and The Weight of the Nation sticks with this story. But it shouldn’t, because the evidence suggests one of these two hypothesized culprits has been far more important than the other.

Here is the trend in eating, measured as average calories in the food supply (adjusted for loss and spoilage) according to data from the Department of Agriculture. This chart too is from The Weight of the Nation. The timing of change matches that for obesity; the level is flat through the 1970s and then rises sharply beginning in the 1980s. An alternative series, measuring energy consumption per capita, goes back to 1950 (see figure 6, chart F here); it too shows little or no change until 1980, and then a sharp jump. The rise in food consumption correlates closely with the rise in obesity.

The diet wars

What would you do if she were your little girl? At age 7 and 4 ft. 4 in., she weighs 95 pounds – clinically obese according to her doctor. At school the other kids make fun of her. It’s a problem.

A little more than a year ago, that was Bea Weiss, an overeater who failed to self-regulate, in the words of her mother, Dara-Lynn Weiss. You may have read about Bea in recent days. Fat no more, she graces the pages of April Vogue, along with said mother, who cut back little Bea’s calorie intake until she hit 79 pounds. Then she wrote the Vogue story. And then she got a book contract.

I’m not sure which of these details sparked the outrage, but news of Bea’s diet, her mother’s chutzpah and the book deal lit up the Internet like the latest news of a Lindsay Lohan probation violation. Much of the anger, at least initially, was heaped on Dara-Lynn for having the audacity to put her child on a diet. She was accused of humiliating Bea, setting her on a path of lifetime eating disorders and taking out her own obsessive-compulsiveness about food on her daughter. Slate labeled Weiss “self-absorbed” and “fanatical.” Jezebel called the story “The Worst Vogue Article Ever.

Overweight? No pill will fix that


The following is a guest post by David Warner, a Philadelphia-based journalist and health writer. The opinions expressed are his own.

Would it not be wonderful if there were a pill for everything?

Have some kind of irritating bug? Pop an antibiotic, even if it’s a virus. Want to quit smoking? The heck with willpower, take something, wear a patch. Sex life on the wane? Men, swallow that little blue pill. Depressed? Can’t sleep? There are so many pills to choose from. Just watch all those late night commercials.

Overweight? There could be a pill for that as well. But you probably won’t be hearing any ad for it real soon. On Thursday, an advisory panel to the U.S. Food and Drug Administration rejected a Vivus’ drug approval bid for their new weight-loss drug called Qnexa, saying it was too experimental because there was not enough data to warrant approval. One FDA panelist said approving it would amount to a “huge public health” experiment. The FDA is expected to issue a final ruling on Qnexa by October 28.

A paradox of plenty – hunger in America

Bernd Debusmann–  Bernd Debusmann is a Reuters columnist. The opinions expressed are his own. –

Call it a paradox of plenty. In the world’s wealthiest country, home to more obese people than anywhere else on earth, almost 50 million Americans struggled to feed themselves and their children in 2008. That’s one in six of the population. Millions went hungry, at least some of the time. Things are bound to get worse.

This the bleak picture drawn from an annual survey on “household food security” compiled by the U.S. Department of Agriculture (USDA) and released in mid-November. It showed the highest level of food insecurity since the government started the survey, in 1995, and provided a graphic illustration of the effect of sharply rising unemployment.