It is a sign of the times that one of the most talked-about reality-TV shows of the season centers on a woman who desires to lose weight. Lots of weight. The show’s star, Ruby Gettinger, now tips the scales at around 500 pounds, having once climbed to 700. She has adult-onset diabetes, thyroid problems, and an enlarged heart. But Miss Gettinger aims to weigh a mere 145 pounds by the time Ruby wraps; she has already lost 100 pounds through a combination of diet and exercise—and therapy, since 700-pound or even 400-pound people are rarely happy. She lives in Georgia—which is telling, because the South, for various reasons, is the epicenter of obese America. Just as tellingly, when she hits her ideal weight, she will likely go to Los Angeles.
Miss Gettinger is not alone. Though, admittedly, not many people weigh as much as she does, fully a quarter of all Americans are clinically obese. In no state are fewer than 15 percent of residents badly overweight. In 30 states, the figure is 25 percent. In Alabama, Mississippi, and Tennessee, 30 percent of adults have a body mass index of 30 or greater, that index being a measure of weight against height, so that a 150-pound person five-and-a-half feet tall would have a BMI of about 24, considered normal—with 30 considered obese.
Now, the causes of obesity are complex. Some of it has to do with the dumb luck of genetics. Some of it has to do with the healthy functioning of the hypothalamus, which keeps track of how much food energy we have used and how much we need, and which is apt to go haywire once tricked by one cheeseburger too many; humans are notorious for ignoring the signals the hypothalamus sends, for which reason, it seems, we eat by the clock instead of by when we are truly hungry. And some of it has to do with chronic stress, a problem in postindustrial and developing countries alike; in time of psychological burden, our bodies instruct eat, and so we do.
There are other reasons. One is a product of our economic and social organization: Most Americans who work do so at sufficient distance from home to require motorized transportation, and thus do not benefit from walking. Strapped for time, most exercise less than the recommended half-hour a day. In the truck-farm economy of yore, leanness was our natural condition; now that our lives are spent indoors, tethered to desk, phone, and keyboard, the ounces and pounds are ever harder to shake off. This is true of every country in which knowledge work and commuting figure heavily in the economy—not just the United States, but these days every nation in Western Europe and, increasingly, those of East Asia, where girth was once the exclusive province of deities and dictators.
Obesity has a class component, an ethnic component, a geographic component. It targets the poor, who are likely to spend their food money on heavily processed, high-fat food that seems to deliver bang for the buck, even if the calories are “empty”—a bag of cheese puffs, say, instead of a bag of carrots. According to the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, an illuminating if necessarily alarming compendium of data, obesity prevalence is lowest among college graduates (at 22.1 percent) while highest among those with less than a high-school diploma (at 30 percent). It is higher by several percentage points among blacks than whites. It is highest in the South (27.3 percent) and Midwest (26.5 percent), where Jell-O is considered a vegetable, and lowest in the West (23.1), particularly Colorado, where body consciousness is more pronounced than anywhere else in America, even California.
Obesity, as Miss Gettinger’s therapist rightly recognizes, has a psychological component as well. Those who overeat often have no idea of how they behave in the face of food, but scientists do. In one recent study coordinated by Cornell University, the center of some of the best food-related research in the country, 213 diners were placed in the Petri dish of several all-you-can-eat Chinese restaurants in various parts of the country. Those diners who were obese tended to sit facing the buffet, as if to make sure it wasn’t going to disappear, and to sit an average of 16 feet closer to it than did their normal-weight peers. Yet, on being told of their behavior, none of those obese diners was aware of having made any choices on where he sat and how he ate. Blame it on some feast-and-famine ancestral memory from the distant past, or on some need to exercise as much control as possible over one’s environment; the point is, as one researcher remarked, there is an obvious correlation between too much convenience and too many calories. Given our collective preference for the path of least resistance, the weight consequences are small wonder—as is the enduring popularity of all-you-can-eat Chinese buffets, awful as most of them are.
Finally, and here I risk seeming unkind, there is the infantilism factor in the prevalence of obesity, by which I mean this: When I was young, a couple of generations ago, such fattening things as soda pop and candy bars were firmly tucked away in the great semantic domain marked “treat.” They were not for everyday use, but instead the stuff of leisure and reward: Come Saturday, way back in the days of the Johnson administration, and I would be rewarded with a quarter with which to go to a double-feature matinee, complete with a small bag of popcorn, a small beverage, and a small piece of chocolate of some sort. I place due emphasis on two keywords here, small and reward, concepts that seem to have been lost in our time, when so many of us seem to think that it is part of our birthright to drink many times daily from great tubs of high-fructose soda and eat supersized portions of heavily processed foods—to say nothing of being entertained our every waking hour, courtesy of a popular culture designed, as the literary critic Morse Peckham once observed, to keep us from becoming aware of what is happening to us.
Why should those of us who are not obese care about those who are? Well, for one thing, those who are obese—and especially those who develop obesity-related illnesses such as type II diabetes in adulthood—burden an already overtaxed healthcare system. Put another way, in the end, those who consume more calories consume more healthcare services. The costs tend to be averaged out in higher healthcare costs for everyone, since insurers have proved reluctant to charge higher premiums to cover lifestyle-related illnesses (that is, those having to do with behavior such as smoking, excessive drinking, overeating, and the like). If it is true that governments have taken a nanny stance about such things as smoking indoors and railing drunkenly on the sidewalk, they have shied from the more complex underlying issues lest they be perceived as discriminatory, for which reason a lean, steadily exercising, morally blameless person will pay the same premium as one who lives on fat, carbohydrates, and booze, soothing though that diet may seem.
Given the distaste with which most Americans regard the nanny state, efforts to reduce the obesity epidemic will have to dance around many sensitivities—cultural, psychological, ethnic, ethical, economic, geographic. One of the most interesting efforts has come from that most sensitive of areas, Berkeley, California, courtesy of Alice Waters, the celebrated chef, author, and owner of Berkeley’s renowned Chez Panisse, a restaurant that uses only fresh, organic ingredients purchased from local growers. Inspired by a Bay Area program in which prisoners were allowed to establish gardens at local jails—which also sowed ideas of responsibility and yielded a marked decline in recidivism—Waters lobbied the administration of a Berkeley middle school to allow her to tear up an old blacktop and establish what she called The Edible Schoolyard. The one-acre organic garden produces a wide range of vegetables throughout the year, thanks to the Bay Area’s generally clement weather. But what is more important, the school’s students are active in growing that food, harvesting it, and preparing and cooking it, teaching them valuable skills and lessons that will remain with them for the rest of their lives. Waters observes, for instance, that children tend to be suspicious of and avoid many kinds of vegetables, especially those that are unfamiliar to them. (How many kids these days know what a turnip is, for instance?) But if they have grown the plant and their teachers have helped them research its history and culture, the chances are much better that they will eat it without hesitation—good news for those who know the benefits of a diversified diet.
The Edible Schoolyard program, now about ten years old, is costly on the face, since a healthy diet is inherently more expensive than one made up of mass-produced starches, sugars, and fats. It is sure to realize savings in terms of healthcare costs over a lifetime, however, by turning children away from junk food and toward healthy produce. There are other virtues, too. For one, in a time when few families eat even a single meal together each day, growing and preparing food allows children what is now a rare privilege: sitting down and dining in company, one of the hallmarks of civilization. For another, the benefits that would accrue to small-scale agriculture are many: As Waters notes, if schoolchildren—20 percent of the population—were fed organic, locally grown foods, then growers would have a huge new market as “people again grew up learning how to cook affordable, wholesome, and delicious food.”
The Edible Schoolyard program may take a long while to reach every corner of the country. In the meantime, the present ailing economy will likely induce most school districts—and, indeed, most consumers—to make poor food choices in the interest of maximizing their food dollar. Our exceedingly strange system of agricultural subsidies supports just those poor choices, favoring producers of such things as processed grain, corn syrup, and livestock while discouraging producers of fresh produce and fruits, such that the more “energy dense” a food is—the more laden with sugars and fats, that is—the cheaper it will be per calorie on the supermarket shelf. It is possible, at least in the short term, for an adult American to get his required calories for under a dollar per day, consuming a diet of, say, prepared cereal or canned chili, whereas a diet that delivers the same calories in a more healthful and various form can cost orders of magnitude more. As one report notes, for instance, the sugar in fresh raspberries costs nearly 100 times more than refined cane sugar.
Ending misplaced subsidies should be a goal of policy-makers. Making fresh foods more affordable should be a goal of local growers and consumers, and here I harbor a long-standing Voltairean dream in which Americans finally recognize the wisdom of the Jeffersonian agrarian ideal and plant food gardens everywhere that it is feasible to do so, Victory Gardens to declare war against those who would do us harm with bad food trucked in at great distances courtesy of imported fuel. Along the way, restoration of the notion of gluttony as a sin might be in order, too. Combine that with a little more exercise, sitting farther away from the buffet, and choosing a glass of water over a trough of pop, and there may be hope for our groaning, huffing compatriots as they fight the endless battle of the bulge. Stay tuned. €