Chewing the fat
May 31 2003
Obesity continues to rise and so too does the industry established to beat it.
By Ewin Hannan.
link to article
[note - the sidebar to this article has a very good links list. - Gotbeer]
We are a generation obsessed with weight and looks, a generation fatter than ever. But we struggle to accept a simple truth: we are overweight largely because we eat more and exercise less.
The medical establishment says obesity is the No.1 public health challenge confronting the developed world. A recent study of 11,000 Australians found more than 60 per cent of adults are overweight or obese, while our rate of obesity has more than doubled in the past 20 years.
Obesity is blamed for the deaths of 300,000 Americans and linked to heart disease, breast cancer, colon cancer, stomach cancer, diabetes, sleep apnoea, arthritis, high blood pressure and infertility.
Why are we fat? Poor diet and physical inactivity are the chief reasons. Labour-intensive jobs have been superseded by technology, confining many workers to desks. Longer working weeks mean reduced leisure time, tiredness and less inclination to cook or exercise. Cheap fast-food, high in fat and calories, is available in bigger portions, 24 hours a day, seven days a week.
Adults eat junk-food and watch television while children spend hours on Play Station and chat to friends on internet party lines. Cable television screens childrens’ programs all day. Parents are reluctant to send children unsupervised to a local park. Physical education features less in school programs, and teenagers spend more hours studying to meet university entrance requirements and increased competition for jobs.
Still we spend tens of billions of dollars annually on diet books and schemes, low-fat foods, weight-loss medication and corrective surgery. We have a seemingly insatiable appetite for people like Dr Robert Atkins who built a $100 million empire telling Americans fat was harmless. For 30 years, the Manhattan cardiologist infuriated mainstream medical practitioners by advising consumers they could dine out on bacon cheeseburgers and still lose weight.
Scientists scoffed at his high-protein, low-carbohydrate diet, but, in the months preceding his death, Atkins was as popular as ever. Last July, his 1992 book, Dr Atkins New Diet Revolution, surged to the top of bestseller lists after a New York Times Magazine cover story, headlined “What If It’s All Been a Big Fat Lie?” suggested Atkins had been right all along.
Publication of the article, written by award-winning science writer Gary Taubes, sent the TV talking-head circuit into a frenzy. Media outlets re-interviewed the nutrition experts quoted by Taubes, who claimed they had been misrepresented. America’s Centre for Science In The Public Interest ran a cover story in its Nutrition Action newsletter, accusing Taubes of ignoring or distorting what researchers told him. All the while the good doctor got richer. Atkins’ book returned to No.1 on the New York Times advice books best-seller list and jumped into the top 10 on amazon.com. Taubes, meanwhile, secured a lucrative book contract.
When Atkins died last month (an accidental fall left him comatose), his representatives placed national advertisements across the US media eulogising his achievements. “There were 10 million people out there wondering what comes next,” Matt Wiant, Atkins Nutritionals chief marketing officer, told the Los Angeles Times. “We wanted to send a signal that this is a jumping-off point, not the end of something.”
The episode illustrates the intense competition that exists for a slice of the enormous profits made by the weight-loss industry. Type “obesity” into the amazon.com search engine and 635 titles cascade on to your computer screen. There’s the motivational (Get Your Head out of the Fridge: How to Stop Being a Foodaholic); the defiant (Fat?So! Because You Don’t Need To Apologise for Your Size); the medical (Weight Loss Surgery:Finding the Thin Person Hiding Inside You) and the personal (Diary of a Fat Housewife: A True Story of Humour, Heartbreak and Hope).
“Americans now spend $US33 billion a year — more than the gross national product of most developing countries — on weight loss products and schemes,” writes Ellen Ruppel Shell in The Hungry Gene: The Science of Fat and the Future of Thin.
“We sign lifetime contracts with health clubs, hire personal trainers, buy diet books and low-fat foods by the ton. We spend hundreds of millions on weight-loss medications that can sicken or even kill us, and risk death on the operating table. And, all the while, we grow fatter.”
In a saturated market, publishing houses are looking beyond the usual gut-buster offerings, backing authoritative and well-researched books that explore the secretive world of the food giants.
Fast Food Nation, Eric Schlosser’s rollicking critique of the Golden Arches, is probably the most well-known of this genre. Using meticulous research and foot-slogging journalism, Schlosser reveals the frightening inside workings of fast-food.
He documents how recent changes in the way cattle are raised, slaughtered and processed has created an ideal environment for the spread of infected meat. He shows how the worn-out dairy cattle that are used to make about 25 per cent of America’s ground beef are the animals most likely to be diseased and riddled with antibiotic residues.
In discussing the obesity epidemic, he details how the expansion of fast-food chains into individual countries has coincided with soaring obesity rates. Between 1984 and 1993, the number of fast food restaurants in Britain doubled _ and so did the obesity rate. The British now eat more fast food than any other nationality in Western Europe. They also have the highest obesity rate. Obesity is much less a problem in Italy and Spain where spending on fast food is relatively low.
During the 1980s, the sale of fast food in Japan more than doubled and the rate of obesity among children soon doubled, too. Schlosser argues the Japanese are rapidly abandoning their traditional diet of rice, fish, vegetables and soy products; a diet deemed one of the healthiest in the world. “Today about one-third of all Japanese men in their 30s — members of the nation’s first generation raised on Happy Meals and ‘Bi-gu Ma-kus’ — are overweight,” he says.
While researchers argue some genetic differences make people more prone to obesity than others, Schlosser rejects genetics as a cause for the spiralling obesity rate. “The American gene pool has not changed radically in the past few decades,” he writes. “What has changed is the nation’s way of eating and living. In simple terms, when people eat more and move less, they get fat. In the United States, people have become increasingly sedentary — driving to work instead of walking, performing little manual labour, driving to do errands, watching television, playing video games and using a computer instead of exercising. Budget cuts have eliminated physical education programs at many schools. And the growth of the fast-food industry has made an abundance of high-fat, inexpensive meals widely available. As people eat more meals outside the home, they consume more calories, less fibre and more fat.”
Schlosser reports how falling commodity prices allowed fast-food chains to make their product more attractive — they could draw in customers by increasing portion sizes without reducing profits. In 1972, McDonald’s added large French Fries to its menu; 20 years later, the chain added Super Size Fries, a serving three times larger than what McDonald’s offered a generation ago. Super Size Fries have 610 calories and 29 grams of fat.
After delivering an entertaining but damning indictment of Big Food, Schlosser issues a rallying call to readers, arguing the first step towards meaningful change is for consumers to stop buying the product.
Schlosser’s book made a big splash when published in 2001. The publicity was not welcomed by McDonald’s, whose products have come under increasing scrutiny from consumer activists and the courts.
In January this year, a federal judge in Manhattan dismissed a class action seeking to hold McDonald’s liable for obesity, diabetes and other health problems in teenagers. Two teenage girls, who suffered coronary heart disease, high blood pressure and diabetes, claimed their habit of eating McDonald’s food three or four times a week had made them obese.
Judge Robert Sweet threw out the case, ruling it was “not the place of the law to protect (people) against their own excesses”. “Nobody is forced to eat at McDonald’s,” he said.
But the judge appeared to leave the door open for the plaintiffs to refile their claim. He said the point was whether McDonald’s customers had a reasonable opportunity to know what they were eating. “If plaintiffs were able to flesh out this argument in an amended complaint, it may establish that the dangers of McDonald’s products were not commonly well known and thus that McDonald’s had a duty toward its customers,” he said, singling out the Chicken McNugget for scrutiny.
In response, McDonald’s said its policy of providing nutritional information about its food for the past 30 years had allowed customers to “make informed choices about what they decide to eat”. The lawsuit has been amended and refiled.
Late last year, McDonald’s recorded its first ever loss and market pressures forced former chief executive Jim Cantalupo out of retirement. In a bid to improve its image and appeal, McDonald’s in America has made a series of menu changes including a new line of entree-sized salads, while, in Britain, Happy Meal offerings now include organic milk and fruit.
In Australia, McDonald’s is testing new menu items including salads and a Happy Meal that comprises a toasted cheese-and-tomato sandwich, sultanas and an orange juice. A new breakfast menu, introduced recently in Newcastle, includes cereals, juices, yoghurts and fruit snacks.
These issues are considered in Fat Land: How Americans Became the Fattest People in the World, due to be released in Australia later this year. Written by author and health journalist Greg Critser, Fat Land covers new and old ground in seeking to nail the causes for the obesity epidemic. Culprits include the agricultural policies of the Nixon administration, which he asserts resulted in the food industry’s increased use of cheap artificial sweeteners.
Like Schlosser, Critser goes after the fast food chains, particularly the aggressive marketing of increased portion sizes. But he has more than the usual suspects in his sights. Assuming the moral high ground, Critser draws on Dante to attack the sins of gluttony and sloth.
“Most of us are fat because we are slothful and gluttonous,” he recently told the Observer. “People don’t want to hear that. In the course of researching my book, I came to believe that, morally, over-eating was wrong.”
Urging parents to resume full responsibility for their children’s diets, he argues anorexia is an upper middle class concern that has assumed too much control over the cultural agenda.
Critser’s “new angle” is the assertion that class and poverty are the key determinants of obesity and weight-related diseases. He says policy-making and public debate has been driven by the upper and middle-classes, despite obesity disproportionately plaguing the working poor.
Critser cites his own battle of the bulge to validate his theory. In order to lose weight, he says he was able to enlist his doctor, the weight-loss pill Meridia, a partner who cooked him healthy meals, and jogs in a local park. He lost the weight “but the more I contemplated my success the more I came to see it not as a triumph of the will, but as a triumph of my economic and social class”.
Rather than demonise fast-food, Paul Campos, author of the forthcoming book The Last American Diet, contends conventional wisdom about the health risk of fat is a “grotesque distortion of a far more complicated story”.
In a recent article for The New Republic, Campos draws on the findings of various researchers to argue that fat “in and of itself” is not a health risk; rather it is the combined impact of a lousy diet and a sedentary lifestyle.
“Yet there is considerable evidence that even substantially 'obese' people are not less healthy because they’re fat, rather, other factors are causing them to be both fat and unhealthy. Chief among these factors are sedentary lifestyle and diet-driven weight-fluctuation.”
In arguing fat is ultimately irrelevant to health, Campos asserts the reverse when discussing the diet industry. Analysing findings from a raft of studies, he concludes people who lose weight via dieting and diet drugs often end up weighing a good deal more than people of similar initial weight who never diet.
He says trying constantly to lose weight leads to an increased risk of premature death. At the same time, only a handful of studies have indicated that weight loss leads to lower mortality rates. After bombarding the reader with his analysis of analysis of research findings, Campos targets the economic interests driving America’s “obsession” with fat.
Again, he draws on other authors to highlight how many prominent obesity researchers have direct financial stakes in companies that produce weight-loss products.
He quotes Laura Fraser’s book Losing It: False Hopes and Fat Profits in the Diet Industry, in which she claims that “diet and pharmaceutical companies influence every step of the scientific process”.
“They pay for the ads that keep obesity journals publishing,” Fraser says. “They underwrite medical conferences, flying physicians around the country expense free and paying them large lecture fees to attend.”
Campos describes this structural distortion as “insidious”, particularly as Americans want to believe that medical experts can solve their weight problem.
“The reason for this can be summed up in six words; Americans think being fat is disgusting,” he concludes. “That psychological truth creates an enormous incentive to give our disgust a respectable motivation. In other words, being fat must be terrible for one’s health, because if it isn’t that means our increasing hatred of fat represents a social, psychological and moral problem rather than a medical one.”
Drawing together his arguments, Campos appears to acknowledge the conspiratorial nature of his thesis. But he insists the conventional wisdom about fat “needs to be taken for what it is … a pervasive social myth rather than a rational judgement”.
That said, Australians now share with Americans the dubious distinction of being the most overweight people in the world (pedants would argue South Sea Islanders are fatter).
As the far-reaching consequences of this development sink in, demand for more information will increase. By producing books that cast light on the methods of the fast-food giants, publishers serve the public interest. But demonising Big Food also gives comfort to a generation that stubbornly refuses to acknowledge the underlying reason for its expanding waistline. After all, we are what we eat.
EXPERTS ON FAT
"This is probably the most sedentary generation of people in the history of the world."
- United States Surgeon General Dr David Satcher.
"Obesity is the most obvious manifestation of the global epidemic of sedentary lifestyles and excessive energy intake."
- Overweight and obesity in Australia: the 1999-2000 Australian Diabetes, Obesity and Lifestyle Study.
"Kids just aren’t moving as much as is healthy for their bodies."
- Rick Kausman, Australian Medical Association of Victoria spokesman on eating behaviour and weight management.
"Every year Americans gobble up more processed low-fat foods, and every year they grow fatter. The low-fat fad must end now."
- Michael Fumento, author of The Fat of the Land: Our Health Crisis and How Overweight Americans Can Help Themselves.
"Put people on crash diets, and they’ll gain back more weight than they lost."
- obesity researcher Paul Ernsberger.
"(We) have a misdirected obsession with weight and weight loss. The focus is all wrong. It’s fitness that is the key."
- Steven Blair, director of research at the Cooper Institute in Dallas, US.
"As of 2002, there has not been a single study that has truly evaluated the effects of weight alone on health, which means that ‘thinner is healthier’ is not a fact but an unsubstantiated hypothesis for which there is a wealth of evidence that suggests the reverse."
- University of Virginia professor Glenn Gaesser, in his book, Big Fat Lies.
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