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Listen carefully. You can almost hear it. The sound of zippers tearing, buttons popping, Spandex expanding. America is getting fatter by the day. We may soon see our beloved Stars and Stripes replaced by a yellow flag declaring "Extra Wide Load."
Americans as a whole have gained about 12 pounds in the past decade. According to the old definition of obesity, whereby you had to be 20 percent overweight, a third of all Americans are obese. But on the basis of new medical evidence that anything over your ideal weight is unhealthy, almost three-fourths of American adults are too fat.
It’s "a 25 percent increase in six years," says former surgeon general C. Everett Koop. "We just can’t afford to go on like that. If I had stayed on longer [in office], I would have launched the same assault on obesity that I did on smoking."
It is my belief, after two years of researching this topic for my new book, The Fat of the Land, that yes, Americans must attack obesity in the same way we did smoking, when the number of smokers was cut in half.
Obesity is a terrible problem and, unlike other epidemics, such as a flu epidemic, it won’t go away on its own.
Some would have us believe that there is nothing wrong with being fat, that people just find it distasteful and therefore assume it’s unhealthy. Actually, doctors believe fat is unhealthy because a multitude of studies for decades has shown it to be so.
"We know," Koop says, "that excessive weight fosters everything from diabetes and heart disease to breast cancer, colorectal cancer and osteoarthritis."
A recent University of Wisconsin study found a direct correlation between extra weight and increased breast cancer in women. Another study, at Brigham and Women’s Hospital in Boston, found that women 44 pounds overweight had 2.5 times the chance of developing common strokes. Obese people are less likely to survive surgery. They are more likely to develop cataracts, arthritis, gallstones.
According to the World Health Organization, 300,000 Americans die prematurely each year because of obesity. Among lifestyle-related illnesses, only cigarette smoking (an estimated 400,000 deaths) has a higher toll. But smoking deaths are declining, while obesity deaths will continue to climb as long as obesity does. Meanwhile, adolescent obesity has jumped 40 percent in a little over a decade.
Americans are the fattest people in the industrial world (see box above). We eat too much. We get too little exercise. We never run out of excuses for both. To name a few:
Portion sizes have exploded; muffins now are many times larger than just a few years ago. The original Coca-Cola bottles meant for individual consumption contained 6.5 ounces. In Europe, they’re still around
Long before waistlines began to balloon, we began to build a society that promotes values that themselves promote obesity.
"This population-wide problem" of obesity, says Northwestern University’s Jeremiah Stamler, M.D., "is best comprehended as a societal problem."
"The root of the problem," according to the respected Institute of Medicine, "must lie in the powerful social and cultural forces that promote an energy-rich diet and a sedentary lifestyle."
One of these forces, in my view, is the victimization fad, in which everything wrong in our lives is the fault of someone or something else. I’m not to blame for being obese; I must have a slow metabolism. It’s the restaurant’s fault I ate a portion big enough for the "star" of the Jurassic Park sequel. Nobody’s arguing it should be illegal to be so enormous that, like chef Paul Prudhomme, you can’t get around without an electric scooter. But neither should it be seen as a choice on par with picking a Ford over a Chevy.
Moderation and setting limits could work. "If social and cultural forces can promote obesity, these same forces should be able to control it," concludes the Institute of Medicine.
This doesn’t mean "oppressing" fat people. Rather, it means combating that which pushes us in the direction of fatness. On top of the barrage of health warnings and limitations on tobacco advertising, our society made smoking uncouth, nasty, inconvenient. "Thank you for not smoking" became a common demand. No one took away the right to smoke; society took away the right not to be embarrassed about it.
But America isn’t fighting obesity. It’s adjusting to the problem — indeed, institutionalizing it. A generation ago, physical education was almost universally mandatory. But by 1995, only 25 percent of high school students had mandatory phys ed.
It used to be that no food maker in its right mind would use a fat person to advertise its products. Now Wendy’s runs ads about a "Big Eaters Club" in which everyone is obese — and nobody cares.
Manufacturers are doing everything possible to make being fat as easy as possible. From subways to stadiums, seats are becoming bigger to accommodate bigger bottoms. Clothing makers change their sizes to flatter buyers, and sales of euphemistically labeled "women’s" clothes are growing twice as fast as sales of other apparel. The newest trend: stores catering to obese kids, such as the "Pretty Plus" line at Sears. Generation X is fast becoming Generation X-Large.
Society could learn to sneer at calf-sized steaks, sodas that could float a battleship and chocolate syrup ads that say "just pour it on" because, though it has 50 calories per tablespoon, "it’s virtually fat-free."
Saying obesity is a societal problem in no way gets individuals off the hook. Yes, we live in a nation that is a conveyor belt to fatness. But some of us have gotten off, and all of us have an obligation to try, not just for own sake but to save the lives of our children and other family members.
Like smoking, drug abuse and violence, obesity is a socially contagious disease. The more you have, the more you get. Even taking genes into account, fat parents are more likely to have fat children. Research shows that if you improve your eating and exercise habits and lose weight, there’s an excellent chance other members of your family will, too.
Health and safety campaigns often fail, but they can succeed if efforts persist year after year.
For example, seat-belt use steadily rose even before many states made it the law; the number of smokers has dropped by half; illegal use of hard drugs and hard liquor has dropped among adults. Americans have significantly lowered their cholesterol intake.
Obesity may be the toughest beast to slay. But after all, if we can put a man on the moon, surely we can get through doorways without greasing down our sides.
In researching his book, Fumento pored over thousands of articles in medical journals to find what works and doesn’t. His top 10 conclusions:
"We must attack obesity in the same way we did smoking."
NAAFA members hold rally during 15-minute break between breakfast and lunch.
"For millions, this approach will be a great disservice."
"It’s true that overweight and obese individuals can benefit from improvements in their diet and exercise patterns," says Michael Steelman, president of the American Society of Bariatric Physicians. (Bariatrics is the study of obesity.)
"However, Fumento’s view seems simplistic and denies a plethora of medical evidence. For people with minor weight problems his suggestions may be fine, but for millions of obese individuals this approach will be a great disservice. Very few obese individuals are able to reduce to their ’ideal’ weight. Obese people need to be directed toward improving their health, not pushed toward a mythical ideal weight."
"To encourage stigma against fat people is size-ist," says Sally Smith, executive director of the National Association to Advance Fat Acceptance (NAAFA).
"We have to separate weight loss from health issues. What message does it send that no matter what changes I make in my lifestyle, if it doesn’t result in weight loss, I’ll drop dead? I just turned 39. I’m fine." - Cesar G. Soriano