Obesity in America

May 22, 2012

By Rick Wilking

Almost 2 years ago I started work on a photo documentary simply titled “Obesity in America.”  It’s a simple title but with complex subject matter.

Getting the access, the various permissions from individuals and institutions and working through the convoluted American HIPPA (Health Insurance Portability and Accountability Act) that protects patient privacy to extremes was quite a challenge. But trying to tell a story with this many layers and permutations was even tougher.

It was a hot topic back in 2010 when I started, with obesity-related stories moving frequently on the Reuters wire but with few images to go with them. I set out to change that and decided to work the project in multiple chapters.

Since I last blogged about the documentary, I have shot several more chapters and learned a lot more about how complicated this topic is.

After the early chapters in 2010 on “fat acceptance” and on an obese woman getting a gastric bypass, I’ve done work on:

–       Local hospitals fighting youth obesity

–       Morbidly obese people auditioning for The Biggest Loser TV show

–       The Biggest Loser Boot Camp in Utah

–       A clinical study on infants born from obese mothers

–       How schools are working with very young and obese children to eat better and exercise

–       A teenager having a controversial lap band procedure and her mother who had gastric bypass at nearly the same time

–       And most recently, free Zumba classes for low-income people

What I have learned along the way is there is no easy fix. Simply telling people to eat less and exercise more is not the solution in and of itself. There can be complex genetics involved, psychiatric implications and much more to address.

Then there are the societal influences like the “super sizing” of fast food offerings. There are the “food deserts” in the inner city where supermarkets selling healthy food are completely absent. Convenience stores selling cheap hot dogs and chips are the sources for dinner for many. And there are traditions like bringing giant cakes to school for parties celebrating every kid’s birthday.

Possibly the most rewarding work has come in covering Jazmine Raygoza and her mother Veronica who both had bariatric surgery. I’ve been covering them consistently from the days before Jazmine’s surgery, through her procedure, and post-surgery life with gym workouts, learning exercises with other bariatric patients and just hanging out with friends watching her get thinner. Since she is in her last year of high school I’ve shot her at prom, her graduation. I will be shooting the final set of pictures at her one year mark on June 20, 2012. By then, between Jazmine and her mother, they will have lost nearly 200 pounds. That’s a lot of weight they won’t be carrying around anymore – hopefully forever.

As for me, I did well in the gym and lost 20 pounds myself. But don’t look to see me in a photo documentary any time soon!


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Thanks for the sensitive portrayal of a serious problem which is causing immense human suffering.

The author did a good job of listing a survey of the reasons people are obese. I wanted to comment on one new line of research that wasn’t included. Scientists are now taking a look at the biological state of the body AFTER weight loss.

Subjects who lose weight by dieting and exercise do not regain the same physiology that they had before they became obese. They report feeling far more hungry and preoccupied with food than before they lost the weight.
While researchers have known for decades that the body undergoes various metabolic and hormonal changes while it’s losing weight, an Australian team detected something new. A full year after significant weight loss, men and women in a study remained in what could be described as a biologically altered state. Their still-plump bodies were acting as if they were starving and were working overtime to regain the pounds they lost. For instance, a gastric hormone called ghrelin, often dubbed the “hunger hormone,” was about 20 percent higher than at the start of the study. Another hormone associated with suppressing hunger, peptide YY, was also abnormally low. Levels of leptin, a hormone that suppresses hunger and increases metabolism, also remained lower than expected. A cocktail of other hormones associated with hunger and metabolism all remained significantly changed compared to pre-dieting levels. It was almost as if weight loss had put their bodies into a unique metabolic state, a sort of post-dieting syndrome that set them apart from people who hadn’t tried to lose weight in the first place.

The lead researcher, Joseph Proietto puts it this way:
“What we see here is a coordinated defense mechanism with multiple components all directed toward making us put on weight. This, I think, explains the high failure rate in obesity treatment.”

For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more. While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. This translates into a sobering reality: once we become fat, most of us, despite our best efforts, will probably stay fat.

Posted by BajaArizona | Report as abusive

A Case of Low Metabbylism:

Posted by hkrieger | Report as abusive

If one were to travel to Wisconsin, or even live here, the enormous amount of obese persons, (very young to oldsters), would shock anyone. On top of the Tavern League and various breweries encouraging drinking, the huge meal portions served in restaurants does not lessen the epidemic. Even some theatres are installing wider seats! Buffet restaurants attract those already overweight with unlimited trips and endless hours of commandeering a table. There should be a buffet cut-off point,(as bartenders), or a specific menu for the obese, since this has become a national health crises. Also, the SNAP,(FoodShare Program), should prohibit the purchase of “junk” food, and limit purchases to only fruits, vegetables, meats, dairy, and juices. What is truly incomprehensible is how the obese continue to overeat, and seem oblivious to their own and family’s toxic food choices and gross physical appearance. If there is a medical and/or genetic component, these can readily be addressed by low-income clinics. Perhaps, even the ubiquitious health clubs might promote low-income or no-charge programs, in concert with physicians, to attract the non-exercisers. Nationwide city contests like the successful televison show, “The Biggest Loser,” with good prizes,would bring about a major obesity reduction.

Posted by orionciara | Report as abusive