Last week we discussed our rising obesity epidemic, why it is important to all of us to consider, what are some of its causes and what are some of its effects. This week we will pick up the discussion with a broader consideration of the social context of the issue.
So where are we socially as Americans in our relation to food? We have largely forgotten how to cook or eat together. We snack all day long, especially at work and from vending machines. We use the drive-thru regularly for meals with their increasingly large portion sizes. We quench our thirst with quarts of sugary or alcoholic beverages. We rely increasingly on the freezer case at the supermarket for complete meals. Regular mealtimes are a thing of the past.
Researchers have found some interesting demographic trends that are perpetuating our epidemic. Basically, obesity begets obesity. Americans are having kids at an older age. Kids of older moms tend to be larger at birth and stay larger through life. Moms who are obese tend to have larger babies. Older babies tend to be heavier moms. Obese moms tend to have more children than thinner moms. An interesting effect in dating and marriage. Obese folks tend to attract each other. Children of obese parents tend to become obese. If one parent is obese there is a 50% chance a child will become obese, 80% if both parents are obese. All of this increases obesity and the obesity genes in our population.
Basically, obesity in America perpetuates obesity. We are coming to understand the biology of this effect. Folks who are obese become insulin resistant. This means that glucose levels in the blood build up. This glucose is taken in by the liver and turned to fat. Obesity also leads to leptin resistance. Leptin is the hormone our fat cells secrete to tell the brain that we have plenty of fat and we should stop eating. But at a certain point, the brain basically goes deaf to those messages and no longer hears the “stop eating” message. Endocrine disruptors are also disrupting these messages. We are also fundamentally changing the flora of bacteria in our large intestines with these changes in diet over time. We are now learning the important nutritional effects these are having that tend to push the fat building mechanisms of the body.
So back to our question. Is there blame to be placed? It is easy to blame McDonalds and school lunch programs. It is easy to blame the box of Krispy Kreme on the counter at work or vending machines full of snacks or social media. Schools don’t have gym classes anymore or my town doesn’t have a playground for my kids. TV shows have too many ads. All those drink companies put too much sugar in their drinks, and nobody gets enough sleep. We can blame farm subsidies to corn farmers. And don’t get me started on processed foods with all those preservatives and chemicals. Believe it or not, we are actually living in great times in relation to food availability. In the 1950s about 25% of family income went to food. Today it is just over 10% and half of that is now getting spent outside the home at restaurants and the like.
This is clearly larger than one obese person. It is hard to blame Mary or Beth or Joe or Frank for their obesity when we look at all these forces at work around us. We need to work very hard not to stigmatize folks caught in these cyclical conditions. The causes are clearly larger and seem embedded in our culture and our environment. Heck, almost 40% of adults are obese and another 30% are overweight. That means that normal weight folks are the minority. Be careful who you insult.
We are surrounded by these cultural and environmental influences that are so pervasive as to be almost invisible. But they have this huge impact on us. So, I want to slow down a bit and think about what we mean when we talk about culture and a cultural influence.
I did a lazy thing. I looked up “culture” online. Here is a nice definition that I found.
Culture (/ˈkʌltʃər/) is an umbrella term which encompasses the social behavior and norms found in human societies, as well as the knowledge, beliefs, arts, laws, customs, capabilities, and habits of the individuals in these groups.
Culture is really hard to think about in the abstract. It is like looking in the mirror and asking is this how I look to other people? Is this really how others see me? If we want to talk about our American culture, it is almost too big to grasp. Americans are so different. Ages, ethnicities, parts of the country, urban, rural, recent immigrants, different religions. That said, what if we asked how Americans are different from Europeans or South Americans? In comparison with other groups, we might have a way to draw some generalizations about what we Americans have in common.
So, we have this American culture that we can barely define, but we observe that those who live in that culture have been getting progressively more overweight over the last 60-70 years or so. This has occurred across the whole range of Americans from the Arctic Circle in Alaska to Key West in Florida. So, what do we have that makes our American culture, those social behaviors and norms, so prone to obesity? Back to our definition. Culture is the knowledge, beliefs, arts, laws, customs, capabilities, and habits of the individuals in these groups. So, culture is the accumulation of all us individuals. We are each part of and saturated with our American culture. Think about a concert. You pay to go to see and hear a great band. You contribute, literally contribute, money to an expression of American culture in the concert. But then you walk out grooving on the great music with your friends, having absorbed and been saturated with some specific aspect of American culture. So, is this culture something that we inherit or something that we create? Clearly, we absorb it as we grow up. Clearly, we like parts and dislike other parts. Obviously, it is some of both inherited and created, but we don’t have to pass on the culture we inherited.
So, we have an obesity-prone culture. Where is the blame if any for our obesity prone culture? We inherited this culture. We enjoy this culture. We fight with parts of this culture. How do we participate in this culture? With all of us in thousands of micro decisions we make every day. Who bought the 2-liter soda for the apartment? Who knows that lady at the Wendy’s drive thru on a first name basis? Who doesn’t even own a frying pan or a whisk or know how to make mac and cheese from scratch? Who doesn’t have a single fruit in the house, but always carries 3 granola bars in their backpack? Who took the bus instead of walking that 1-mile commute, or binged on some stupid show all weekend instead of getting outdoors?
There are hundreds of small ways to change our personal cultures. A bag of apples instead of a box of Krispy Kremes. Speaking out when the next Farm Bill comes up in Congress. Do we really need to go to the all-you-can-eat buffet tonight? How about lingering a little longer in the produce aisle next time you are in the grocery store and less in the frozen dinner section? Get a rice cooker. Make brown rice. It is amazingly easy. Why are you really staying up to midnight, or 1 or 2 or 3, binging on some show?
The marketplace responds to our vote with our dollars. How can we blame big companies when we eat their food and drive through their drive-thru windows? They are only doing what we want. I’m sure there would be helpful public policies and regulations that would be helpful, but what drives the companies to develop the products they do? Our insatiable appetite does. General Mills would love nothing more than to keep making the same old Corn Chex cereal for the next century and take in a comfortable profit on a low sugar breakfast cereal. But us fickle consumers keep changing our demands and forcing them to change flavors and take out high fructose corn sugar (for no reason, but that’s another story) and make it gluten-free. We play this rather odd game of make-me-happy but then we blame them when they add more sugar or salt or lower the fiber or add flavor enhancers with fancy names. Now don’t get me wrong, there is plenty of blame to go around, but we as consumers should own our share.
So, who is to blame for our 60-year climb into obesity? Our culture, yes. But remember that we are all our culture and we all can change that culture. We have met the enemy, it is fat and it is us, all of us.
So, what can we do about our problem? Well, one thing we shouldn’t do is go on a diet in the usual sense. Dieting in America is one of the hardest things imaginable. All the forces, cultural and physiological, are arrayed against you. What is needed is a healthier and more long-term perspective.
Here are some lifestyle suggestions that can change our individual cultures and may contribute to a change in our American culture. I am partially drawing from two interesting sources. A Psychology Today article from 10 years ago nicely diagnosed our social causes of obesity with some suggestions for change. The NY Time just completed a January series called the Eat Well Challenge.
- Am I really hungry? We are regularly assaulted by food messages telling us to consume. If you ate less than 2 hours ago, you are probably not actually hungry, even as you are looking hard at that doughnut right now. If we stick closer to actual mealtimes for eating, this gets easier.
- How long have I been on my phone? Was it really necessary? Phone and screen time does two things. It makes us eat mindlessly and it keeps us from being active.
- How about a smaller plate? Portion sizes have increased over the last 50 years. We can reverse this if we choose, by simply choosing a smaller plate or bowl or glass or by ordering one size smaller than usual at the drive-thru.
- Does it have to be that sweet? Our drinks are all sweet now, and some are astonishingly sugary. It is easy to recommend just water, but even just looking at the label for something with half the sugar of your usual would be a great step in the right direction.
- Did I enjoy every bite? Slow it down, put down the fork between bites. Why the hurry? Is eating a chore or a charm? Mindful eating is a wonderful habit to cultivate.
- Can I cook that? One of the things we have lost is kitchen literacy. But cooked food is family food. It is food we talk about and share. Start simple with a few recipes. Get the basic tools needed. Also, as suggested above, get a rice cooker.
- How about another veggie? Instead of removing some no-no food, just add another veggie to the table.
- But my diet? Is the point being healthy or losing weight? Obviously the two are connected but being healthy will lead to weight loss that stays.
- Am I a hungry shopper? You will be in a hurry and will tend to buy more snack food and less fruit.
- Fruit and veggie check. Do you have more fruits and vegetables in the refrigerator or more snack food on the counters?
- Am I sleep cheating? Anything less than 7 hours is cheating yourself. What screen time should you give up?
The United States, and in fact most of the world, has an obesity problem that is increasing. It is costing us a lot in terms of disability, disease, deaths, and dollars. It is too simple and actually rather misinformed and wrong to point to overweight people as the ones to blame. It turns out that we are all to blame because it is deeply embedded in our culture and our economy that we ended up this way. We all actually really really like this obesity-prone culture with its low-cost drive-thrus and tasty snacks and sugary drinks. The miracle is that all of us aren’t obese. The good news is that since we are our culture, then we all have a vote. We can buy apples instead of fruit roll ups and we can stay home and learn how to cook a real stew instead of another evening at the all-you-can-eat buffet. This would be a win for healthy kids, healthy culture, and maybe even a few lost pounds. So, buy a whisk and google “homemade mac and cheese” and change the world.