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Getting Our Arms around Obesity



“I’m fat. You’re fat. We’re all fat. Let’s eat.”

The pale blue sky wisps with clouds, and the temperature in Santa Fe is climbing toward 60 degrees. How odd to be writing here in such lovely circumstances when the South and the Northeast are struggling with emergency conditions in ice and snow. However, what I am writing about is also an emergency situation, but one rather hidden in the moment.

I am referring to the obesity epidemic, and although I note articles on the subject, a talk I attended Wednesday evening put it in high relief. It was sponsored by the Santa Fe Institute, which brings in experts from all over the country to present research on complex problems. The speaker was Ross Hammond, Ph.D., senior fellow and director at the Center on Social Dynamics and Policy, Brookings Institution. He is involved with many issues besides just obesity.

Hammond ripped through a complex series of slides providing data on the obesity epidemic, and as he talked, I had a growing sense of unreality about the magnitude of the problem. At the same time, I have to say that I have never seen a young man in a professorial situation who seemed more brilliant, energetic, or confident. He is slender and dark-haired with faintly exotic good looks, and as I watched, it dawned on me: He is an alien, and he has come here to help us.

I’m joking, I think, but as I listened it seemed that we would, in fact, need extra-planetary support.

When Obesity Was a Sign of Wealth  (Charles Mellin, 1600-1649)

When Obesity Was a Sign of Wealth (Charles Mellin, 1600-1649)

I have to say that I have often been impatient with and thus callous about this problem, and I got my comeuppance that night. It is infinitely more complex than I had ever imagined, and the systems Hammond is developing to deal with all its facets are themselves are so complicated that it is hard to imagine society being able to implement them.

But to summarize the breadth of the problem, obesity has doubled in the United States since 1970 and now affects one in every three people. (Amazingly enough, the rate in New Mexico is 60%. I see many signs of this.) In all, about 200 million people are obese, and there has been an enormous increase in extreme obesity. About 30% of children are obese, and herein likes the scariest aspect of the problem. It is estimated that one in three of them will develop diabetes, and their lives will be much shorter and less healthy than their parents.

The cost of the side effects of obesity, including heart disease, hypertension, stroke, liver and gallbladder disease, sleep apnea, osteoarthritis, and gynecological problems, threaten to overwhelm our health care system, costing even now something like $147 billion a year. And there are other costs we don’t think about. For example, hospital beds need to be redesigned as well as theater and airplane seating. The extra  jet fuel required to fly the overweight has risen to an estimated $1.2 billion, and the cost of automobile gas to $2.7 billion.

As Hammond went on and on with the figures and maps of the spread of the problem internationally, I began to imagine humans like seeds worldwide swelling and swelling to sprout chaos and ultimately self-extinction. I have a lot of imagination, but what could turn this around?

Hammond repeatedly made the point that there are no simple answers, no one-solution-fits-all, no magic bullet, and interventions can sometimes prove disastrous. (The ads for liver-damaging dieting supplements come to mind, as do serious complications from bariatric surgery.)  The computer models Hammond is working on require incredible levels of coordination–among parents, schools, local governments, the healthcare system, agriculture, corporations producing food and food delivery systems, grocery stores, restaurants and the fast food industry, advertisers, the exercise and athletic industry, and people designing communities.

Hammond provided an example of one small community that took this on and made some gains, but how can a city of millions even begin to address this problem? Funny how we have so long been on the alert for a viral and bacterial epidemic when fat is the growing peril.

I did some research here and there surrounding the talk, and a sense of the bizarre kept intruding. Take for example research recently reported in The New York Times on grizzly bears to try to discover the mechanism that enables them to manage their hibernating obesity without harm. The thought is that the mechanism could be activated in humans. The scientists had better hurry, I thought, since with the progression of warming, there soon won’t be any hibernating bears.

Elsewhere I ran into information about the tremendous amount of energy the human brain uses. Are we not using ours enough? Are all the computerized aids in research, mathematics, grammar, spelling, navigation, and the like making us overweight as well as less intelligent? Obesity is, in fact, associated with a shrinking brain and dementia. What is the order of things? Did under-use of the brain cause weight gain or is obesity reducing brain potential?

As the list of unwelcome side effects goes on and on, it looks as though any alert obese person (as opposed to someone simply overweight) would immediately go into high mode to trim up. (See the note at the end of this post to find out where you rank in Body Mass Index.) However, Hammond suggested that the primary problem may be perception. It boils down to an attitude kind of like this: “I’m fat. You’re fat. We’re all fat. Let’s eat.” If everyone is obese, and we seem to be moving that way, people are blinded to the problem by a sense of community. And TV ads more and more often star obese people who seem to reassure viewers that this is normal, that it’s all right.

As I said, I emerged from Dr. Hammond’s talk feeling kind of overwhelmed by the magnitude and complexity of the problem facing humanity. I am wondering, however, if the remedy is waiting in the wings. If the advance of climate change radically disrupts agriculture and our food supply, the challenge of simply surviving may trump the complex causes for obesity. Nature has its own ways of restoring balance, and it may soon put us all on a very severe diet. How ironic it would be if the ones at normal weight are the first to starve. Better start beefing up a bit. No, better put the difference in long-term storage.

(You can calculate your Body Mass Index (BMI) by going to the link:  http://www.nhlbi.nih.gov/guidelines/obesity/BMI/bmicalc.htm)






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