Why are we so fat?
Marc Ambinder’s article on the roots of American obesity is worth reading.
Will
Will writes from Washington, D.C. (well, Arlington, Virginia). You can reach him at willblogcorrespondence at gmail dot com.
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“The people most vulnerable to obesity, however, do not have access to healthy food…”
Meh. A bag of lentils at the store costs maybe 50 cents. It’s enough to feed a person for a few days. Can of cheap tuna costs maybe 40 cents. Doritos are really expensive.
Know what’s cheaper than a bag of Doritos, and has fewer calories? Half a bag of Doritos.
People have plenty of access to healthy food.Report
@Sam M,
I have to agree with this. When I was a grad student and so poor that I couldn’t even afford beer, I’d roast a chicken every Sunday for dinner. A loaf of bread, a jar of mayonnaise, and some lettuce made it into a week of lunches, too. Then on Saturday I’d make chicken stock and have soup. I’d freeze the rest of the stock and start another week. Not difficult, not expensive, not time-consuming. All you really need is one day a week at home (to make the stock), plus a little presence of mind.Report
@Jason Kuznicki, Eh, I don’t know. I’ve lived in a few lousy cities where there simply weren’t grocery stores. Getting groceries meant driving 45 minutes away, which was ridiculous and not possible if you didn’t have a car, because the buses didn’t go that far; or you had to try to figure out where in the world is the health food section of 7-11. I ate a lot of microwaveable fried chicken and ramen noodles and could tell it wasn’t good because my heart would be pounding when I went to sleep! So, anyway, it’s sometimes not so much an issue of money as much as physical access.Report
@Rufus, I grew up in poverty (in rural WI), and while we did not eat All-Natural & All-Organic, mom knew how to shop for food and prepare it on a very tight budget, while running a day care center out of the home (with anywhere from 3-5 kids underfoot). And we lived miles outside of town (although I can see how urban dwellers with a lack of public transit or POVs or walkable grocery stores are in a bad spot)
It’s mostly about giving people the knowledge to shop for and prepare food, and hoping they have the will to make the effort to do it. Providing access is secondary. If people don’t know what to shop for, a good grocery store will just stock junk food and frozen meals because that is what moves.Report
Sam is right, beans, rice, lentils, etc. are all very cheap and easy to get. What people lack is not access to healthy food, but knowledge of how to prepare it.Report
@Madrocketscientist,
Maybe they also lack the will to prepare it.Report
Now, ordinarily, I’m not a big fan of calling arguments that call for the working class to make smarter choices paternalistic, or condescending, etc. However, I am deeply uncomfortable with the notion that because a bunch of us college educated types have the means and know-how to prepare cheaper, healthy food, that it is equally easy for people living under actual poverty. For one thing, I think whether healthy food is in fact cheaper or more expensive is a very complicated question. It is often cheaper to feed a family of four at McDonald’s than it is to try to prepare a dish for four with a meat portion. Now I know a lot of people would say, “then don’t eat meat,” but come on. Like it or not, many, many people in this culture think that meat at lunch or dinner is non-negotiable. And there are tons of individual choices where the less healthy option is cheaper; consider buying real fruit juice over buying Kool-Aid mix, for example. So it’s a complicated question, and I think a lot of it depends more on someone’s individual life situation than you might think.Report
@Freddie,
I’m not so sure. My poverty was very genuine. I was living with my partner at the time, who was also a grad student (we shared the chickens). We got no parental or other support. We weren’t on welfare, although we probably could have been.
Even among my fellow grad students, I routinely lied to hide my poverty. I’m still ashamed about this. I’d say I’d already eaten lunch — rather than going out with them to an authentic (and very cheap) Chinese place that I dearly loved. Then I’d eat one of those chicken sandwiches when I was alone in the break room.
I’m not advising that people give up meat. I’m advising that they (1) make what they can afford count and (2) learn to cook. These things are closely related, and if you say that some people don’t have time to learn to cook, I’ll just repeat: I was a grad student. I was also preparing for general exams. I don’t buy that excuse for a moment.Report
I’ll tell you that I am someone who has struggled to avoid using the term poverty to describe certain biographical eras of my own life– and often failed, and grown to regret it– I don’t think any grad student can fairly be said to be in poverty in the way that people from entrenched poverty communities can. You and I have social capital; we are educated; we have had the benefits of being properly socialized, etc. Hell, I’m still a grad student, and I certainly make less and have less money than some of my neighbors. But I have less material strengths and benefits that they don’t enjoy.
But then, I guess this is part of the major political divide, right here, the assumption that you can have a meaningful understanding of what other people are going through in the course of their lives, without living in their shoes.Report
@Jason Kuznicki, Not to denigrate your experience Jason but I have observed that while students are certainly poor in money terms they are often very time rich. The working poor often find the time and stamina required to collect and cook healthy food a lot more daunting than even a school stressed student is.Report
@Freddie, I agree that this is a more complicated question than at first glance, but for different reasons than you’ve expressed here. To me, the more problematic factor on the access question is that in many of the poorer areas of the country, particularly the urban poor, there simply are not any grocery stores where one can buy reasonably healthy ingredients, leaving the practical choices as: A. McDonald’s, B. Subway, or C. Crap from the corner bodega. And Subway gets pretty damn boring if it’s all you’re eating.
However, I think you’re wrong as a factual matter on whether good, healthful homecooked food is more expensive than McDonald’s. See IOZ’s post this morning for an example: http://whoisioz.blogspot.com/2010/04/home-economics.html
More to the point, this is similar to a conversation I had with some younger co-workers yesterday in which they defended their serial eating of McDonald’s on grounds of cheapness and time. I pointed out to them that one can buy a nice beef or pork roast for about $4-$5 a pound (significantly less if you get it on sale), roast it on Saturday or Sunday with some spices and have a delicious entree prepared for the whole week with just a few minutes of prep time (plus prep time of a vegetable side dish of some sort, whether a salad or something else).
Even with the veggies, you’re looking at no more than about $3 a meal per person (and no sales tax!), with the main component prepared in about the same amount of time as it takes to stand in line at McDonald’s for just one meal.
Now, I should admit that this is a closer issue than it once was – sugary, low quality foods are cheaper than ever, while fresh vegetables have been getting more expensive, but the economics still work out pretty clearly in favor of fresh food over fast food.
Still…..I wonder what might possibly be causing prices of fresh veggies to go up while prices of sugary, crappy foods go down? It couldn’t be that we’ve decided to subsidize the latter, could it? More corn subsidies means not only more corn syrup and the like, but also less farmland for other vegetables (ie, less supply).Report
@Mark Thompson, again– this isn’t just about money; it’s about social capital, education, and a whole host of vastly complicated and complicating factors that come together and influence behavior. Also again, I think this really is a clue to the most basic of political divides. I think a bunch of educated, fairly financially stable, well-meaning white people thinking that they have the clairvoyance necessary to understand what it is to be born into endemic poverty in one of America’s many entrenched ghettos is misguided.Report
@Freddie, I get your point, and take it well. Unfortunately, I started writing this before Jason posted his response above, or you posted your own response.
In my defense, though, the portion of my response dealing with the relative costs was just pertaining to the empirical question of whether it’s cheaper to feed a family of four at McDonald’s or to get a well-balanced homecooked meal at home. But that empirical question is far from the only factor, and for some not-insignificant number of people, I would expect that it’s even an outright irrelevant question.Report
@Mark Thompson, let me hasten to add that I include myself in that number of well-meaning white people with limited ability to understand the various influencing factors on the behavior of the urban poor.Report
@Freddie, No need to throw in the caveat; it was understood. Your point was totally correct, and a point I’ve made myself in other contexts. But it’s also a point that needs constant repeating, because it’s easy as hell to forget and, looking back at my initial response, I think I did forget it there.Report
@Freddie,
I don’t mean this as an insult, but I struggle to decide which is more condescending: Are poor people intractably prone to bad decisions, which I take to be Freddie’s position? Or are they just purposefully making bad decisions, which is probably what Freddie would say that I’m saying? (He would basically be right, incidentally.)
It is an important divide. Still, how much “social capital” does it take to make a monthly food budget and stick to it? To read food labels? To find and follow healthy recipes? Not much, I’d say.
It was one of the first things my temporary poverty taught me: Even when you’re poor, some things never go away. The need to eat is one of them. Pay it some attention. You’d might as well, because it’s always going to be there.Report
@Jason Kuznicki, I agree with Freddie here. I don’t think that Freddie is saying that they are more intractably prone to bad decisions, it’s that they don’t have a whole lot of really awesome options that we have.
Let’s say that I, Jaybird, have had a rough day. I can go home to my house and have one of my four well-cared for cats sit in my lap and purr. I can microwave myself some interesting Indian food that I happen to have in the fridge, I can make myself a lovely spinach caesar salad, I can sit down at my computer and play a game, listen to a relaxing song, or watch a youtube video of a shortstop getting hit in the upper thigh by a line drive.
I can sit and talk with my lovely wife about her day and we can argue about the nature of God.
My life is pretty freakin’ sweet.
There are people out there who will have the best part of their day be a Big Mac.
That’s it. That’s the best part of their day.
Telling these people that they shouldn’t have a Big Mac? You willing to do that?Report
@Jason Kuznicki,
Certainly, I’m not trying to assert that there is some simplistic state of grace where you can’t judge poor people’s decisions out of a desire to not be condescending. I do think, though, that we shouldn’t act as if people are making these bad decisions for no reason. If it’s rational for people to eat better and cheaper at the same time, and they aren’t doing it, my instinct is that there is some reason for them to not be making that rational choice, some impediment to their understanding that rationality.Report
Freddie says:
“If it’s rational for people to eat better and cheaper at the same time, and they aren’t doing it, my instinct is that there is some reason for them to not be making that rational choice, some impediment to their understanding that rationality.”
Sometimes. But other times I think people understand things perfectly well, but just choose differently than we might choose. All choices have consequences. Put simplistically, if I choose to forego the Twinkie, I get rock-hard abs. But if I choose to forego the rock-hard abs, I get to eat the delicious Twinkie. Defining what’s “rational” depends on what you value, which will differ from person to person.
I am married and have four kids. If I am at a conference and a Swedish bikini model offers me a roll in the hay, I potentially sacrifice my marriage, my family, my economic well-being, my reputation, etc. Irrational! But I think it would be pretty lame if I made that choice and later claimed that there was something impeding my rationality. I would simply be choosing some short-term gain over long-term gain.
That is, not every bad decision is based on an impediment to rationality. Sometimes, people make bad choices, knowing full well that they are bad choices. I guess there are some people out there who think a bucket of KFC is a healthy nutritional choice. But I think there are more who know it’s bad for them and eat it anyway. Because it tastes good.Report
@Freddie,
I’m inclined to agree with Freddie here. Look at the way the poor eat in other countries verses the poor in the US. Take Vietnam, for example. The por there eat tons of vegetables and also a decent quantity of meat for very low cost ( a huge bowl of pho is .50 cents American – or less).
The ingredients needed for those types of meals can be raised or bought relatively cheaply – as Mark points out above. But the poor in the US typically choose lousy options. I think a lot of it is preference. If you grow up eating bologna and McDonald’s your tastes get pretty pedestrian. Put a big plate of cheaply-made pad thai in front of someone in a poor area and they will turn their nose up at it.
I see it here in Louisville. Walk through a grocery store in a lower income and/or rural area and the offerings are much, much different than in a higher income area. I can go to my local Kroger and get curry sauce, kim chee, vegetable dumplings, etc. Go to a blue collar area and none of that stuff is available.Report
@Mike at The Big Stick,
Agreed, my mom could cook, but dad was not big on spices so the food was pretty bland. My wife, on the other hand, had a much greater range of food choices (I married up) and over the past 18 years, I have come to appreciate garlic, and spicy-hot food, and seasonings, etc. and I choose my living areas based on how much access I have to such choices.
Of course, my wife & I both have Master’s Degrees and good jobs, so we have the benefit of financial flexibility.Report
@Mike at The Big Stick,
It’s been ten years since I was in Vietnam, but at that time one of the factors that led toward a fresher diet was that most people didn’t depend upon refrigerators at home. They went to the market and bought what they needed for that day’s meal. One of the locals differentiated Vietnam from Thailand by indicating that the Thais (who were more apt to have refrigerators) went to the market once per day while the Vietnamese went twice per day.
The food was mostly excellent, in no small part due to the freshness of ingredients. The fresh fruit was awesome – as I hope you’re lucky enough to have experienced for yourself. The closest I’ve come in this country to experiencing similar quality was during a visit to Hawaii. Fruit that’s selected because it survives long-haul trucking, simply put, is less flavorful.
You’ll get white rice and fried food, things we in the west “know” we should avoid, but you won’t get anywhere near the level of refined sugar or corn syrup that drips out of the U.S. menu. (How much corn syrup is in the bun of a McDonalds hamburger? A packet of ketchup, yellow mustard or “pickle relish”?) Granted, in the U.S. you probably won’t have the occasional pleasure of seeing rats swarming around the restaurant where you’re eating, but what’s life without trade-offs? 😉 My impression is that refined sugars play a leading role in the west’s “obesity epidemic.”Report
@Aaron, That’s at least part of the reason I’m such a big fan of Anthony Bourdain. He talks a lot about how we need to do more to celebrate the ‘peasant’ food (i.e. every day) in various countries. Much of it is not only extremely health but also extremely tasteful. I think the US is moving in the right direction but it’s going to take a lot longer. I think Mark made a comment earlier about corn subsidies. So true. We’ve got to make some serious changes in the way we let policy affect food consumption.
I also think we could do a lot more to make kids better eaters which will also help them to make better choices.Report
Once upon a time, food did not taste that good.
For food to taste good, you had to invest a great deal of time in it and, probably, spend some of your hard-earned wages on herbs and spices. (Dude, Columbus was originally trying to find an easier way to get to India. Why? Spices. This was no trivial thing.)
We now live in a country where food tastes, like, actually good. More than that, it tastes good everywhere. You can buy ambrosia from the corner store for the cost of the coins you have in your car’s cup holder.
Of *COURSE* people are getting fat.
It’s the skinny ones you have to worry about.Report
@Jaybird, I agree, the problem is quite simple, the solutions quite complex. I’ve said before that I think a McDonald’s double cheeseburger is a near miracle of modern engineering– to squeeze that much taste and calories into such a small space, and be able to sell it for less than $2.00, is pretty incredible. It’s just also incredibly dangerous. We’re attracted most to some of the basic tastes– fat, sugar, salt– because those are the nutrients we badly need to survive. For hundreds of thousands of years of our evolution, those tastes/nutrients were hard to come by, and we spent lots of our time just looking for them. Now, those tastes and nutrients are plentiful, in first world society, but its happened so quickly that evolution (which is glacially slow, generally speaking) hasn’t had time to catch up.Report
@Freddie,
The solution is to have some will power or some discipline instead of blaming McD’s for making you fat.Report
@Scott, No one here is blaming McDonald’s for making people fat and magically overcoming people’s will power. What they are doing is pointing out that there are a boatload of factors that go into someone’s decision to eat a lot of fast food, and some of those factors may well have nothing to do with choice.Report
@Freddie,
I’ve recently started hitting a local Asian restaurant that uses no MSG. The tastes are radically different – but it took me awhile to get used to it. It’s like there was a void in my tastebuds.Report
“Sam is right, beans, rice, lentils, etc. are all very cheap and easy to get. What people lack is not access to healthy food, but knowledge of how to prepare it.”
It doesn’t require an awful lot of knowledge. You boil water and put the lentils/rice/beans in the water. It’s not exactly fine French cuisine. The package has instructions.
The rest of the Ambinder piece is interesting, too. Especially this:
“Stigma might be more bearable—an unpleasant way station on the path to a thinner, healthier life—if diet and exercise, the most prescribed solutions to obesity, worked. But they don’t. Qualification: if you eat less and exercise more, you’ll lose weight. ”
So, uh… diet. and exercise DO work. But people don’t stick to to them. That’s different. It’s like saying studying didn’t work for me in college because I chose to go to the bar instead. In truth, I valued fun more than learning. So I got drunk, and got mediocre grades. Like almost everyone I knew.
Does this mean studying doesn’t work? Or that bad grades are “contageous”? Or does it mean “a lot of 22 year old guys like beer and make poor choices”?
The latter, I think.Report
@Sam M, Sam I think a better comparison would be if all of the knowledge you gained from studying would vanish shortly after you stopped studying. People who diet and exercise more can lose weight, but in many cases that weight will return promptly if they ever stop dieting and exercising.Report
“in many cases that weight will return promptly if they ever stop dieting and exercising”
Well… yes. This is just as true for Paris Hilton as it is for anyone living anywhere.
People who eat a small number of calories and exercise a lot are thin. People who eat a lot of junk food and watch TV all day are fat. Physics does not discriminate.
Sure, there are some people who are blessed with a fast metabolism, or cursed with a slow one. I suspect this plays a role in a very small percentage of people.
Watch Survivor sometime. At the end of the season, compare pictures of people to their pictures at the beginning of the season. I have yet to see one who has gained weight or even maintained.
The idea that people from bad neighborhoods lack the social or intellectual capital needed to boil a bag of lentils strikes me as wrong.Report
@Sam M, Yes yes, but as others have pointed out a large portion of this is class based. Having the time to exercise or to plan and prepare healthy alternative meals is a luxury.
Willpower is like a muscle; if you spent your day forcing yourself through one (or two!) hateful jobs and drag yourself home you’re probably more inclined to down a Big Mac than worry about fetching and preparing some wholesome couscous. Also, as Jay pointed out, for many poor people that elegantly designed rich burst of mouth-joy that is a piece of fast food may well be the bright point of a poor person’s day.Report
@North,
I see no reason to believe that a part-time worker at Wal-Mart has less time to exercise or plan meals than a CEO or corporate lawyer does.
I keep getting different signals from different people. One minute, obesity is class-based because some folks just don’t have enough TIME to eat right. But then you point out tons of people on unemployment who don’t exactly look chiseled.
Well, the reponse comes… it’s EMOTIONALLY based. People eat to comfort themselves. When it’s pointed out that thin people have plenty of emotional problems, too…
Well… it’s CLASS based.
It’s based on the number of calories you eat versus how many you burn. I know you know that. But the whole idea of looking for the “root cause” just kind of strikes me as beside the point. It wouldn’t be, but people keep framing this in terms of people who “can’t lose weight.” Well, yes they can. If you took 1,000 of those people and locked them all in a room and didn’t feed them for three days, all 1,000 would lose weight.
I honestly am not trying to pendantic here. But I see things like this story in the Atlantic, by Ambinder, who’s a smart guy, saying “Diets don’t work.” Yes they do. The problem is that people don’t stick to diets. That’s still a huge problem, as the obesity rate shows. But it’s a different problem.
The problem with using abstinence as a birth-control device is NOT that abstinence does not work. It’s that teenagers typically refuse to to stop screwing. This is not because they don;t understand biology, or because they are irrational. It’s because sex feels good, so they take the risk and screw anyway. Any policy proposal has to confront this reality head on instead of acting like the decision to have sex has nothing to do with getting knocked up.
Similarly, any “obesity” plan needs to be premised on the notion that people who doet and exercise do, in fact, lose weight. It does work. It just does.Report
@Sam M,
Well you’re representative of the “it’s exclusively a personal responsibility issue” side of the divide. I don’t disagree with you except for in terms of degree, I do think that there are some environmental and social issues that are encouraging obesity.Report
I enjoyed Ambinders article but the conclusion I drew from it was that it’s an enormously complicated issue hiding under a very simple mask. People are getting overweight. But the why’s and how’s are immensely intermixed.
My own take-away from the article and my other reading on the subject:
-More biology study is probably required. We don’t entirely understand exactly how and why our bodies behave the way they do. We know a lot more now than we did but a lot more info is needed.
-Farm subsidies, particularly corn, are probably increasing or at least not helping the problem. Slash subsidies and we’ll at the very least start replacing our corn based sweeteners with sugar based sweeteners which I gather is a significant difference from a health standpoint. Our bodies can recognize sugar sweeteners but some forms of corn sweeteners essentially can stealth through our digestive system.
-A lot of the access issue probably falls down to the omnipresent and pernicious issue of zoning and NIMBYism. There is probably some room for reform, maybe even local government tax incentives or other actions that can be taken to enable grocery stores in more impoverished areas. Grocery stores are, remember, a very low margin business and so they’re very sensitive to the value of the land that their stores sit on and alas grocery stores have large land footprints.
-I’m not sure whether taxes on “unhealthy” foods will work. The idea of zoning dictates or rule changes to banish popular fast food restaurants from poor areas strikes me as knee slapping idiocy and horrifically paternalistic as well.Report
“More biology study is probably required. We don’t entirely understand exactly how and why our bodies behave the way they do.”
But even Ambinder admits, if you exercise more and eat fewer calories, you lose weight. I guess there is a psychological question as to why some people who want to lose weight continue to exercise less and eat more, but the biologocal data seems pretty clear. Stop eating. Start running around the block. It sucks. But that’s how it works.
Yes, yes. I know that there are a lot of complex factors at work. As Mark points out: “there are a boatload of factors that go into someone’s decision to eat a lot of fast food, and some of those factors may well have nothing to do with choice.”
I think that goes a little too far. “Nothing” to do with choice implies someone is strapped down, being force-fed a Big Montana from Arby’s. (Which are delicious, BTW.) Clearly, how and where we are raised has a huge impact on our approach to eating. But people who choose a two-pound bag of Cool Ranch over the baby carrots do have agency. They COULD buy the carrots. To argue otherwise strikes me as exceedingly odd. Perhaps even a little dangerous. If individuals have their decisions proscribed by their groups, what does that mean for something like college admissions, which I mentioned earlier? If one group shows that “studying works for me/us,” and the other says “studying doesn’t work for me/us,” what’s a college to do?
I think it makes sense for a college to address the needs of different students, even groups of students. It makes sense to study different approaches to learning and to craft curricula accordingly. But to frame it as “dieting doesn’t work,” or “studying doesn’t work,” is just wrong. Ambinder knows this. Dieting (limiting your calories) DOES WORK. The trick is to convince people to limit their calories and to suffer accordingly. Not to design a pill that magically turns custard pie into something really nutritious.Report
@Sam M,
I agree that fundamentally the brute equation “calories consumed – calories burned = weight gain or loss”. Beneath that seeming simplicity there is a lot about the way different compounds effect our bodies digestive processes that we really don’t fully understand and they can make significant differences in what/how we burn/retain nutrients.
All that said I cleave more to your side of things in thinking that the majority of the equation is personal choice based. I don’t for even a second think there’s any merit in the idea that the evil corporations are bamboozling people into being fat.Report
@Sam M,
One thing that is ignored in all this is just how much we all tie food to emotion. Eating food is very pleasurable experience, even moreso if you have positive emotional experiences tied to food.
E.g. If, as a kid, you grew up on gruel, but every Saturday Grandma & Grandpa would take you out to McDonalds, you would have a very powerful positive emotion tied to MickeyD’s. If, as an adult, you are sad or upset, going to The Golden Arches Supper Club would be an almost instant mood enhancer. If your life sucks, you might be hitting the BigMac Crack a lot harder than you should.
Crap like that often needs the help of a professional to crack.Report
This article seems pertinent. Food for thought, as it were.
http://www.city-journal.org/html/12_4_oh_to_be.htmlReport