Today, the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation released the 6th annual version of their study called "F as in Fat, 2009."
Their findings?
Well, simply put, too many Americans are too fat. The obesity epidemic is threatening our health care system and the productivity of our country as a whole.
I guess this isn't really a surprise, but a few facts that blew me away:
- Currently, two-thirds of American adults are either obese or overweight.
- In 1991, no state had an obesity rate above 20 percent. In 1980, the national average for adult obesity was 15 percent.
- Childhood obesity rates have more than tripled since 1980.
- 9 of the 10 states with the highest rates of obese and overweight children are also states that rank as having the highest rates in poverty. (Ok, we know there is a correlation between poverty and obesity but that fact sure drives the point home, eh?)
To me, this is an outrageous problem. I'm pissed. But, I'm not sure where to direct that outrage.
Natalie pointed out a recent story for me that serves as a great analogy for my outrage direction dilemma. Recently, a Baltimore mother was charged with neglect when authorities deemed her 14 year old son's weight had become a major concern. The kid weighed 555 pounds.
That level of obesity, like the level of obesity in America as a whole, is crazy. But, who is at fault?
The mother? Maybe, but the poor lady worked multiple low wage jobs and probably didn't know how to handle her son's problem. She says that she couldn't make the many appointments that social service officials tried to make her attend to get her son's weight under control. She couldn't afford the gas.
The son? I mean, 14 is old enough to know when to stop, right? But then I think that the poor guy probably wasn't having an easy time with his mom gone all the time working these jobs to try to make ends meet. Maybe he was eating as a comfort. Maybe no one ever taught him how to address loneliness or emotional difficulties in a healthy way.
What about social service officials? They claim they tried to intervene but that the mother wouldn't cooperate. But what I want to know is, how realistic were the demands they placed on her given her level of poverty and lack of free time?
In the end, the blame for this kid's obesity, like our nation's, could go a lot of places. The full version of F as in Fat 2009 study calls primarily on the US Government to step in and take control of America's weight problem but I'm not totally convinced. While legislative reform is important, it can also be very slow and in this case might seem a bit too Big Brother if administered incorrectly.
I am still a fan of quiet dinner table revolutions. I think we might be able to see more tangible, personal change that strengthens our communities if we step up as individuals to lead by example in our various spheres of influence.
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Some of the things you quote, while impressive looking, need backup before their import can be fully understood. for instance, childhood obesity tripled - does that mean it went from 1% to 3%, or does that mean 15% to 45%? Obviously, one case is more concerning than the other. Another: 2/3 of American adults are obese or overweight - your writing went on to say "2 out of every 3 adults in America have an obesity problem" - which is inaccurate. 2 out of 3 have a "weight" problem, but I, even at my high school competition gymnast weight, often qualify as overweight, despite no one in the medical field having ever indicated my weight is anything but healthy and proportional for my frame. The study is based on BMI, a tool notoriously unsuited for those who are extremely tall, extremely short, or extremely fit. The numbers also are based on self reporting via phone calls, so the selection bias of which people decide to answer the poll can really skew the results (especially if they choose to lie just for fun). Additionally, populations which are underreported in the poll get multiplied, meaning their demographic gets overgeneralized based on the few who did respond, potentially leaving out critical forms of diversity within the demographic.
ReplyDeleteAll that said, my husband (who works at a hospital downtown) was astonished to hear you say you found 2/3 to be a mind blowing number. Based on simple observation of the population around you, he would have expected you to find that unsurprising. But then, he sees people around the hospital, so his sample is also biased, frequently to populations that are more overweight than normal.
So, how to find a more concrete and less variable measure?
The study of fashion will tell you we're getting bigger. Looking at the diferences between a standard size 8 now and back in the WWII era is astonishing. Industry standards have changed dramatically in that time, because women always want to be "size X", not realizing the industry has changed what that means over the past 60 years. Sales records for men's clothing (conveniently sized off actual measurements) would give us a similar look at the male demographic. Sadly, these simple measures don't incorporate age factors. But, in general, yes, we're getting bigger.
(split due to length)
So what to do about it and who's responsible? Well, there have been a HUGE number of changes in our food supply during those 60 years since WWII. Our grandparents didn't all grow up with SPAM, but our boys from the war developed a taste for it. Much of the food processing has changed how what we eat affects our bodies. But if no one knew in advance what kinds of changes they would induce, do we hold them liable for these effects, and responsible for correcting it? Manufacturers were trying to provide easily prepared, shelf stable food products to allow Americans more time to spend doing other things, like work or leisure, depending on class. And *Americans wanted it*. So who is to blame or at fault? How do we educate on changing or fixing it when we're not even sure of which aspects of the American diet are "at fault"? It's a sticky question.
ReplyDeleteI think the best we can do is make nutrition information available in our public education system. I know health classes when I was growing up were always a joke as far as the kids were concerned. But if we can show them the kinds of diets that result in the sorts of body types they idolize in mass media, that might be one hook for the younger (and even adult) audience. But even in elementary school, appealing to their desire to be smarter, faster, better (because most small kids want to be good at stuff) and tying that into eating healthier foods would help ease their mindset into a receptive place for more detailed data in later years. But changing eating habits in the home if you're the only one who cares is tough, so it would most likely just serve as a groundwork for when they're older and in charge of their kitchen, and willing to change habits on their own.
Mandating minimal health requirements for food offered in public facilities like schools would also help. Government funds paying for farmers to grow healthier foods would encourage growth in that field, and those in the economically challenged sectors would have access to better foods than our current food deserts allow. The problem is convincing people to let their tax dollars pay for this. To convince the taxpayer base, you have to have a general change in public opinion, which is hard. People *like* junk food - our bodies love the instant gratification of it. Getting folk to voluntarily give it up, or even insist on it being reversed, is tough.
Stacey - I really appreciate your well thought out comment. You are very right that the statistics could be put in better perspective, and I do encourage anyone who is interested in more clarification to read the full report. Your insight about fashion sizes through the decades is a great addition. It reminds me of a quote I often hear "You know, Marylin Monroe was a size 10." Yes. A size 10 in the late 1940s and 1950s. Not the same as a size 10 now.
ReplyDeleteI also loved that you pointed out to me that the statistic about 2/3 of American's being obese or overweight is NOT surprising to everyone. The fact that it is surprising to me says a lot about where I come from and what my cultural upbringing is. Most of my life was spent in a rural/suburban town in Connecticut where people were relatively wealthy and, as one might expect, tended to be relatively fit. I grew up in a community that had access to healthy foods and lots of exercise options. The other chunk of my life was spent at Brown University, where most of the students had comfortable financial situations and were well educated. Obesity was not prevalent on this cute New England Ivy League campus. Now that I am living in Los Angeles and working and living in more low income neighborhoods, I am beginning to see why your husband might not blink and eye at the 2/3 figure...
I like your point about improving health classes and health education. I would like to see kids more actively engaged in planting, cultivating, and cooking healthy foods. I think providing a fun hands on learning experience with food is a very important part of the solution, especially considering the fact that cooking skills (or lack thereof) can be a major barrier in accessing nutritious foods for some Americans.