A Philosopher's Blog

The Fattening

Posted in Business, Medicine/Health by Michael LaBossiere on May 28, 2012
An obese topless man on a motorcycle. Original...

(Photo credit: Wikipedia)

For much of history humans struggled to acquire enough food. In much of the West, especially the United States, there is a new struggle involving food. This is the battle against the fattening. While the exact figures vary from study to study and estimate to estimate, it seems reasonable to accept that about 68% of adult Americans are overweight and about 34% are obese. While many parts of the world are still faced with food shortages, it is estimated that about 10% of men and 14% of women are overweight.

Given the advances in agriculture and improvements in distribution, it is hardly surprising that people have better access to even more food than before. However, the relatively recent surge in obesity in the United States does raise some questions about the cause(s).

One obvious causal factor is that a considerable percentage of food is high calorie (generally processed). As such, people are getting more calories per bite than before, which can easily contribute to weight gain. While people do need energy, much of the available food is calorie dense while being nutrient low (or empty). This creates situations in which people can be obese and also malnourished. As might be imagined, this is rather bad. A solution that people can apply themselves is to make better food choices: select high nutrient and lower calorie foods over those that are high calorie and low nutrient. Trying to avoid processed foods and junk foods as much as possible is a good idea.

A second obvious factor is that food portions are larger than in the past. People, Americans especially, tend to link volume with value. That is, getting more is good-even when it is more than a person needs. ‘”Super size” nicely sums up this volume problem. People typically get more than they need, they tend to eat it all anyway and thus they themselves become super-sized. The personal solution is to avoid super-sizing. True, you will get less for your money, but there will also be less of you-which is trading one value (money) for another.

A third obvious factor is technology. People in the United States spend a great deal of time watching television, playing video games, surfing the web and so on. These activities do not burn many calories and tend to encourage idle snacking. The personal solution is to cut back on these activities and to resist the idle snacking.

A fourth obvious factor is the dominance of fast food and convenience stores. These places make it easy to simply grab food quickly. The problem is, of course, that these places tend to provide high calorie and low nutrient foods. While there has been some push to get these places to improve food quality, the obvious solution is to not get your food at such places.  For example, I make my own lunches for work and thus avoid the junk (and also save money). If you must get your food from such places, then select the best available option-which probably won’t be that great.

A somewhat less obvious factor is politics. Certain high calorie foods (like corn which yields the ubiquitous high calorie corn syrup) are heavily subsidized by the state which is why such foods (or foods containing them) tend to be cheaper than more nutritious fare.  As might be imagined, people will tend to buy what is cheaper. That said, it is possible to get nutritious food that is not extremely expensive. However, solving this will require shifting the subsidies so that healthier food is being subsidized. Or, as true free-market and small government folks might argue, food subsidies should be eliminated. This would bring food prices for the good foods more in line with the now cheaper foods, but would do so by increasing prices.

Another somewhat less obvious factor is based on economic class. Poorer areas of the United States tend to have a significant density of fast food places and convenience stores while lacking full grocery stores. Individuals can, of course, take the extra time and effort to travel to the grocery store. However, this is not always a practical option for many folks (such as people who do not own a vehicle). When I was in graduate school, I did not own a car and I can testify to the challenge of carrying groceries even for just a few miles. There have been some calls to see to it that better food is available in such food deserts. However, the obvious problem is that businesses go where they will make money (or they fail) and hence there is not much incentive to open such a store in such places. The state could, of course, step in an provide incentives to such businesses. This could actually make good economic sense. After all, what is spent in tax money to help the businesses could be offset by the savings in later medical expenses and the fact that local jobs would be created would be a plus.

A final factor is that people seem to be less inclined to be active, although there are some notable exceptions. Part of this is, obviously enough, the impact of technology. Social changes are also probably a factor, such as the tendency to drive even when something is within reasonable walking distance. Individuals can, of course, solve this problem themselves-get up and do something (other than eating).

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32 Responses

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  1. Nick said, on May 28, 2012 at 7:51 am

    I think at least one more factor should be considered here: why some people are more likely to be obese than others (when both are overeating the same amount, proportionally).

    An experiment was conducted in the 50’s by Ethan Allen Sims at Vermont State Prison (Sims 1974, 1976, Sims et al 1973, Sims and Horton 1968) in which 20 to 30 males volunteered to gain 30 pounds. Each member more than doubled their calorie intake and ceased exercising, gaining a few pounds in first couple weeks. But not all volunteers actually reached their goal of gaining 30 pounds. One member in particular was unable to reach his goal despite eating 10,000 calories a day.

    In Sims studies and in reproductions since (Brooks 1981, Galgani et al 2008), there are very real differences in how easily people can gain weight. There are several theories as to why: (1) differences in metabolic efficiency, (2) some people have genes allowing for adaptive thermometabolism, which turns excess calories into heat and not fat, (3) and some people who have been infected with a virus that results in a body producing more and larger fat cells (Wingham 2006, Dhurandhar 2002) are, on average, fatter than those who have not been infected. It is also worth noting that in each of the reproductions of overeating studies, some subjects simply cannot stomach their daily calorie goal (even when they are allowed to fulfill it with enjoyable foods like chocolate and other sweets).

    Further, there is plenty of evidence that once one reaches a certain point (lets say, obesity), it is very unlikely, even with various types of surgery, that they will ever lose their excess weight and maintain it (Kraschnewski et al 2010). When someone has been obese/overweight for many years, and then they lose hundreds of pounds, they will have almost perpetual hunger pains despite even when they do not need more calories. It is as if the body has become accustomed to being a certain weight and once it falls well below that weight, it begins working back towards the customary weight.

    Finally, there is plenty of statistics showing that certain pre-natal and early childhood environments correlate with obesity later in life (Nader et al 2006, Whitaker 1998). So, it might also be that some people will cultivate behaviors and habits (maybe even beliefs) that predispose them to obesity more than others. So while McDonalds might be providing the means, our early home life might be providing the motivation/behavior.

    I mention this because in a few of your posts about obesity, I get the feeling you take obesity to be almost purely self-inflicted—I am totally open to this being a misreading. I suppose that at least part of that sentiment is true. After all, someone has to continue overeating. But, it seems that extended periods of overeating do not produce the same results in all people. It also seems that once someone is obese, they might never escape obesity—this implies that we might need some creative ways to approach the issue.

    I’m off to go run the Bolder Boulder 10K. Cheers!

    Nick
    http://www.critiquemythinking.com

    Sources:

    Dhurandhar, N.V. Journal of Nutrition, 2002; vol: 132 pp: 3155-3160.

    Galgani J, Ravussin E (2008). Energy metabolism, fuel selection and body weight regulation. International Journal of Obesity, London. 32 Suppl 7: S109-S119.

    J L Kraschnewski, J Boan, J Esposito, N E Sherwood, E B Lehman, D K Kephart, C N Sciamanna. Long-term weight loss maintenance in the United States. International Journal of Obesity, 2010; DOI: 10.1038/ijo.2010.94

    Philip R. Nader, MDa, Marion O’Brien, PhDb, Renate Houts, PhDc, Robert Bradley, PhDd, Jay Belsky, PhDe, Robert Crosnoe, PhDf, Sarah Friedman, PhDg, Zuguo Mei, MDh, Elizabeth J. Susman, PhD (2006). “Identifying Risk for Obesity in Early Childhood” in Pediatrics. Vol. 118 No. 3 September 1, 2006
    pp. e594 -e601 (doi: 10.1542/peds.2005-2801)

    Sarah L. Brooks, (1981) “The fat of the land”, Nutrition & Food Science, Vol. 81 Iss: 2, pp.10 – 11.

    Sims EA, Danforth E Jr, Horton ES, Bray GA, Glennon JA, Salans LB: Endocrine and metabolic effects of experimental obesity in man. Recent Prog Horm Res 1973, 29: 457-496.

    Whigham, L.D. American Journal of Physiology: Regulatory, Integrative, and Comparative Physiology, January 2006; vol: 290 pp: R190-R194.

    Whitaker RC, Dietz WH (1998). “Role of the prenatal environment in the development of obesity” in May. 132(5):768-76.

    234th National Meeting of the American Chemical Society, Boston, Aug. 19-23, 2007.

    News release, American Chemical Society. Atkinson, R.L. International Journal of Obesity, March 2005; vol 29: pp 281-286.

    • magus71 said, on May 28, 2012 at 1:54 pm

      Nick,

      I done quite a bit of research on the subject, and the new fad seems to be that calories don’t matter. I even saw some Google search results that stated: There’s absolutely no evidence to support the calorie theory at all.”

      Quite absurd.

      If someone tries eating zero calories for a week, I’m sure they’d see some validity in the calorie theory. I challenge any average build male to restrict the intake of calories to 1500 and not lose weight. I’ve done calorie measurements on myself, and the predictive formula came within about 50 calories for the day. As for the dude who ate 10,000 calories a day with no exercise and didn’t gain weight, I call for some common sense here. That’s about 18 Big Macs a day. I challenge 99% of the population to replicate this themselves. In fact, scientific rigor calls for replication of results.

      One of the worst things we can tell most folks is that they can’t control their weight by how much they eat. Sounds like a recipe for learned helplessness to me.

      Clarence Bass, a man in his 70s and one of the leading authorities on leanness, says that he controlled his weight by changing calorie intake day by day. He could sense himself getting plumper and would take out as little as a single piece of toast a day, and over the time the caloric deficit resulted in loss of body fat.

      http://www.cbass.com

      Here’s my advice to all who want to lose weight:

      1) Change your mind set. You can’t eat everything all the time.

      2) Three square meals a day. Balanced meal with voluminous fruits; meat and fat are fine. Yes, even butter. No seconds, though.

      3) 100-150 grams of carbs, a day, preferably non-grain carbs.

      4) Only have a dessert after supper and on weekends.

      5) Skipping a meal won’t kill you.

      6) Following these guidelines you probably won’t have to count calories.

      • Michael LaBossiere said, on May 28, 2012 at 5:31 pm

        Quite right-calories matter. They are not all that matters, but the biology of fat building is rather well established.

  2. T. J. Babson said, on May 28, 2012 at 10:10 am

    I think a lot of people think they are heating a healthy diet but still can’t lose weight. The problem is that “healthy whole grains” are not especially healthy. Whole wheat, for example, has a higher glycemic index than table sugar.

    The Dietary Reference intake for carbohydrates is 130 g/day.

    https://en.wikipedia.org/wiki/Recommended_Dietary_Allowance

    Just one bagel has half of one’s carbs for the day.

    We have got to get people to drastically reduce their carbohydrate intake.

  3. T. J. Babson said, on May 28, 2012 at 11:15 am

    “I mention this because in a few of your posts about obesity, I get the feeling you take obesity to be almost purely self-inflicted—I am totally open to this being a misreading.”

    Nick, since Mike doesn’t believe that these people are capable of getting ID cards in order to vote, I can hardly believe he thinks they are competent to decide what to eat.

    I can easily imagine a dystopian novel in which obese people are really livestock tended by the Nanny State.

    • Michael LaBossiere said, on May 28, 2012 at 5:27 pm

      That is a basic philosophical question: how free are we in the metaphysical sense? In other words, how much of what we seem to chose is really choice and not determined?

      I work from the assumption of at least a degree of free will, on the basis this is the only reasonable assumption from which to begin a discussion-I could be wrong about that, though. As such, I would say that people are largely free to make their life choices and hence obesity would be largely a matter of choice.

      However, I would be a fool to simply ignore factors such as physiology, economics, and so so. That is, I also do accept that there are factors that push people towards or away from certain choices. For example, when I was in graduate school I would have liked to have chosen high quality foods to eat. However, my pay was just enough to cover a cheap apartment and enough basic food stuff (99 cent rice puff cereal, for example) to survive. So I ate stuff that was not so great because that was all I could afford. As another example, exercise is tough and takes time-so many people are unable to stick with it.

      I do think people are competent enough to get ID cards, but there are obstacles that can deter them (cost, time, etc.).

      Actually, the idea of people being raised as cattle is not uncommon in sci-fi.

      I’m not a fan on the Nanny State or the Nanny Corporation. However, I do think that the state should act so as to make better choices easier. For example, if the agriculture lobby is too strong to beat, then we should at least have our tax dollars making healthy foods cheaper than the less healthy choices.

      • magus71 said, on May 28, 2012 at 5:54 pm

        I really disagree that eating healthy is more expensive than unhealthy. A carton of eggs, a container of oatmeal, an apple–dirt cheap. I’ve read media reports saying I’m wrong because some fruits and vegetables don’t receive government subsidies. Regardless, I always control what I put in my mouth and how much I move.

        In the Army I have more access to food than at any other time in my life. It’s about the only thing the Army doesn’t try to deprive me of. Still I’m lighter than I was 10 years ago. I do PT 5 days a week and sometimes I skip lunch because I get so busy.

        You talk about the cheap food you had to buy in college. You didn’t get fat though, right? There are fat people in college, too. Personal decision in the land of plenty is a deciding factor. And as usual, I’m not letting the poor off the hook so easy because I was one of them for a long time.

  4. FRE said, on May 28, 2012 at 2:37 pm

    Some people attribute obesity to genetics. Probably genetics is a factor in some cases, but genetics has not changed in quite some time and therefore cannot account for the increase in obesity.

    One factor which is given insufficient attention is a change in perceptions. It is now possible for people to be 30 pounds overweight and not realize it since people who are 30 pounds overweight no longer compare unfavorably with the average person. Parents have to be told that their children are overweight because, as a result of changed perceptions, they cannot see it themselves. To them, a certain amount of flab around the waist seems normal.

    Also, at one time, being overweight was once considered very unattractive, but except in extreme cases, that no longer seems to be true.

    Part of the blame for obesity has been placed on the scarcity of physical education classes in schools. However, when I was in school over half a century ago, the physical education classes would have been useless to improve fitness. All we did was play games, and generally the most adept at playing games got most of the very minimal exercise. We rarely did anything that required a sustained effort and there were no strength-building exercises. Class periods were less than one hour so because of the time required to change to our gym clothes then afterward take a shower and get dressed, most of the class period was was unavailable for physical activity. So, although well-designed physical education classes could help, the increase in obesity cannot be blamed on a reduction in physical education classes.

    When people fail to get sufficient exercise and have poor diets, the consequences do not become apparent for some time. Also, the consequences become apparent only very gradually. That makes it difficult to motivate people to get sufficient exercise and stick to heathFUL diets. And, if they do decide to reverse the damage they have done to themselves, it takes a long time to see results, so they are inclined to give up too soon. They expect to lose 50 or more pounds in just a few weeks, and that is impossible. It appears that once people have become obese, their metabolism changes thereby making it exceedingly difficult to lose the excess weight. It is easier to prevent obesity than to reverse it.

    I myself have never been overweight and have generally maintained a high level of physical fitness through aerobic exercise and working out in gymnasia. And, because the majority of people are now well above their ideal weight and I am not, being fit makes me conspicuous whereas 30 year ago being fit did not make me conspicuous. I hope that my example might encourage others to control their weight and become more fit, but I’m not sure that it does.

    • Michael LaBossiere said, on May 28, 2012 at 5:33 pm

      Quite right about the perception-people who are just overweight seem fine in comparison with people who are obese.

      As you note, gym class would not do a great deal to fight obesity. But it does still make sense for the kids to be at least somewhat active. In my case, I got into sports and those did really burn calories. As might be imagined, I think all kids should be active in sports.

  5. FRE said, on May 28, 2012 at 2:47 pm

    An additional factor that I failed to include is that walking is now often impossible. At one time, most kids walked or biked to school. Now, because of poor city planning, most kids have to ride to school; they have no choice. Walking may not burn a lot of calories, but over time, it adds up.

    Many people live in neighborhoods where they are totally dependent on motorized transportation, again because of poor city planning. Some neighborhoods are actually miles away from the nearest sidewalk. Recently, when I walked about two miles to get some place, people were amazed that I would walk that far. Actually, walking two miles is not very much and, unless people have serious disabilities, they should be able to walk several times that distance without difficulty.

    Improved city planning would make it possible for people to incorporate walking and bicycle riding into their daily routines.

    • Michael LaBossiere said, on May 28, 2012 at 5:36 pm

      Good points. As a runner, I really notice how pedestrian accessible places are and I have noticed that many cities do little to allow people to safely walk or bike places. When I was at OSU, I biked to class or ran. When I tried the same thing here in Tallahassee, I quickly found that biking was not a good choice. There was no bike trail and the bike lanes and sidewalks end well before my university.

      Like you, I have gotten some interesting comments over the years about walking places.

      • FRE said, on May 28, 2012 at 7:00 pm

        When I lived in Minneapolis (1957 – 1978), they put in bike trails but I didn’t like them; it was impossible to ride at a reasonable speed. When I called the city, I was told that they were designed for 7.5 mph! I can’t imagine riding that slowly unless there is an unusually strong headwind. More recently, they have put in much better designed bike trails. I learned to ride a bicycle when I was five and never stopped riding, even when it was considered inappropriate for anyone over 16 to ride a bicycle; bicycles were considered toys for children. When I got a license for my bicycle, I had to indicate whether it was a boy’s or girl’s bicycle. In about 1962 I actually heard a child say, “Look, mommy! There’s a grown man riding a bicycle!” Someone once asked me, “Didn’t I see you riding a bicycle on Hennepin Avenue while wearing shorts?” When I told him that it was possible because I often did that, he replied, “Don’t you feel out of place riding a bicycle and wearing shorts at your age?” At least it finally became socially acceptable for men to wear shorts and ride a bicycle.

        In about 1962, when I started working out with weights in a gym, people really thought that I was eccentric. As a result of doing it, I sometimes overheard comments at the beach.

        I also started running before it became popular, or even socially acceptable. People constantly kept demanding that I explain why I did it. They couldn’t imagine how it was possible for a person to run 10 miles.

        Perhaps those of us who have chosen to be physically fit can serve as a positive example for others. Maybe it will have an effect.

      • magus71 said, on May 29, 2012 at 7:52 pm

        Yep. Even in the Army people are amazed when I ride my mountain bike to work. I’d do it every day if weather allowed. I walk every time I get the chance. Walking is a simple path to health.

  6. T. J. Babson said, on May 28, 2012 at 6:23 pm

    Even dogs are getting fat. I think it is probably due to cereal-based dog food. Does anybody think a dog would get fat on a purely meat-based diet?

    • FRE said, on May 28, 2012 at 7:03 pm

      I thought that it was because people stopped taking their dogs for a walk.

    • magus71 said, on May 28, 2012 at 7:12 pm

      No, they wouldn’t. However I will say that it also has something to do with people’s ability to say no to anything cute. I have this conversation with my wife all the time about the kids. My view is somewhere in line with Buddha’s as far as kids go: It’s not about how much they have but about how low you can keep their expectations. Thing is, no matter how many toys we buy them, they always want more toys.

      Same thing with dogs. A dog will eat itself to death if you keep his dish full. People just keep cramming the food to the dog and he just keeps eating. My dog ate dry dog food when i was a kid. It was common knowledge that you limited how much he had access to and you walked him every day. As humans, we have brains that enable us to stop eating when we think we’re getting fat. There’s a lot of bad info out there, but I think folk knowledge could go a long way. Our grandparents knew that starches made us fatter faster than meat and eating between meals was a bad idea.

      Growing up with my grandparents, I remember talk that picking up children too often would spoil them. Now we worry that kids will be traumatized if we don’t do everything we ask. Apparently they run the show. Most kids have dessert with every meal. And juice to boot–nature’s soda.

      • Michael LaBossiere said, on May 28, 2012 at 7:53 pm

        One part of the problem is that a significant proportion of foods are very calorie dense while being nutritionally almost empty. Soda is a good example of this. One cause of this is that corn syrup is very cheap because of government subsidies. So, manufacturers use it because it is so cheap. It is amazing where that stuff shows up.

        As you would say, most people would really benefit from a fitness program.

        • FRE said, on May 28, 2012 at 8:24 pm

          Sodium also shows up in many places where you wouldn’t expect it. Not that Na creates obesity, but it does, at least in many people, lead to hypertension which is also a health hazard. Just try to find tomato juice, breakfast cereal, and other things without added Na. You can, but not at all stores and it can require some searching time. Also, sometimes the variety without added Na costs more!

          As I see it, people can always add salt if they really want to, but cannot remove it. Therefore, it would make more sense to leave the Na out and on the label, print, “Salt to taste.” Why should that be a problem?

          • Michael LaBossiere said, on May 29, 2012 at 12:53 pm

            The salt lobby is rather powerful. One thing that seriously impacts our food is the fact the large corporations have significant political influence which they tend to use to impact subsidies, “scientific” studies, and so on. As such, what we eat and what “science” tells us about it is generally influenced by what is perceived as profitable.

            That said, it doesn’t take a MD to know that too much sugar or salt (or anything) tends to be bad.

            • FRE said, on May 29, 2012 at 1:10 pm

              It would help if more people complained to store managers about the difficulty of buying healthFUL items. I do complain, but it takes more than one person to affect store policies.

        • magus71 said, on May 28, 2012 at 8:54 pm

          Soda’s horrible. First thing anyone should get rid of in their diet unless they regularly imbibe plutonium.

          • Michael LaBossiere said, on May 29, 2012 at 12:54 pm

            I’m glad I was able to give that up. I think what actually saved me was when fructose was used instead of sugar. To me, the fructose sweetener makes soda taste wrong. Also having a low income in grad school helped-water became my standard beverage then.

            • FRE said, on May 29, 2012 at 1:11 pm

              You can drink club soda without added sodium. Basically, it’s just carbonated water and, consumed in reasonable quantities, should be harmless. On the other hand, the price is outrageous.

  7. PushDumpFatButton said, on May 29, 2012 at 4:24 pm

    Reblogged this on Push Dump Fat Button.

  8. nick.a.byrd@me.com said, on January 9, 2013 at 9:36 am

    More data on DNA playing role in obesity (above and beyond fast food intake): http://www.cell.com/cell-metabolism/retrieve/pii/S1550413112004986

    The basic thrust is that obesity seems to have both environmental AND genetic causes.

    • biomass2 said, on April 17, 2013 at 8:38 pm

      More and more frequently now , we discover that we’re born with our strengths and weaknesses and our propensities . Some carry a much heavier burden than others. If you have won the DNA Toss , you’ll begin with a mighty lead, and you’ll probably cross the finish line at or near the front. Of course, bombs might explode. That could change things.

  9. Nick said, on April 17, 2013 at 1:26 pm

    The following link is an essay by Gary Taubes published in BMJ in April 2013 about the fact that we know very little about the causes of obesity: http://db.tt/D57OR7lu

    • Michael LaBossiere said, on April 17, 2013 at 8:08 pm

      I’ll go with the usual formula of calories in > calories expended. However, you are right to note that the full analysis of obesity is not complete and the causal chains involved in particular cases of obesity can be rather complicated and diverse.

  10. FRE said, on April 17, 2013 at 10:17 pm

    One thing we haven’t mentioned is the types of bacteria in the digestive system. There have been studies which showed that the types of bacteria in our digestive systems can affect us in many ways including our propensity to gain weight, have ulcers, colitis, gas, etc.

    Some years ago I hypothesized that bacteria in the digestive system affected us. I had been having considerable trouble with excessive gas, to the point that I feared becoming a social pariah. Then, after taking a trip to Fiji, the problem went away. The only thing I could figure that could have caused the change was a change in intestinal flora. That was before the Internet and I had no way to research my suspicions, but now it appears that I was correct.

    It has even been determined that infants born via Cesarean have more digestive problems than infants born naturally. It has been hypothesized that natural childbirth endows infants with beneficial bacteria which aid digestion.

    It seems strange that until recently, there was no widespread suspicion that the mix of intestine flora was of any importance in spite of clear evidence that it did matter. It has been known for decades that some antibiotics cause gastric disturbances that can persist for weeks after there are no more antibiotics in the body. That should have been a clue that the matter should be studied, but it was not.


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