Health

Why Is It So Hard To Lose Weight?

Greta Christina, in this morning’s Alternet, said it best.  Shouldn’t we consider public policy when considering why Americans are so fat?

 Most fat people who try to lose weight aren’t successful. Does it make more sense to blame fat people for lacking self- control… or to change public policy about food and  health?   Hard To Lose Weight

You’ve almost certainly heard the chorus of offensive myths and falsehoods about overweight people. Every time I write about weight management and food politics, it’s guaranteed that someone will start railing about how fat people are fat because of their own laziness, poor self-control, lack of discipline, etc. And it’s all over popular culture. According to these folks, trying to address obesity as a public health issue, by changing public policy about agriculture subsidies and food labeling and school lunch programs and city planning and so on… it’s a waste of time. Worse than a waste of time, even: it’s the nanny state run amok, coddling people who won’t take care of themselves, treating people as if they had no personal responsibility for the consequences of their actions.

There’s just one little problem with this notion: There’s no good reason to think it’s true.

Actually, there are lots of things wrong with this notion. It’s grossly bigoted and insulting, for starters. And it does absolutely nothing to address the situation. If you genuinely think obesity is a health problem that people ought to do something about… telling people that they’re lazy slobs who just need to straighten up and fly right isn’t exactly being part of the solution. In fact, it may even be part of the problem.

But mostly, there’s just no good reason to think it’s true. Rates of obesity have been going up dramatically in the last few decades. And they typically go up whenever a modern American diet gets introduced to a culture. Does it really make sense to think that human psychology and human nature has radically changed in the last few decades: that as a species, we’ve somehow evolved to be lazier and less self-disciplined in just a few generations? Or that the introduction of a modern American diet somehow magically zaps the willpower center of the human brain?

And if human nature hasn’t changed that radically in a few generations, but human bodies have… doesn’t it make more sense to think that something else has changed? Something about the food environment we live in? Something about our culture, our economy, our public policy… and the way these things interact with human physiology and psychology? Something about high- calorie processed food being easily and cheaply available on every street corner? Physical education getting pared to the bone in public schools? Our government subsidizing high-calorie/ low- nutrition food? Food ads on TV approximately every six nanoseconds?

This is a huge topic, and it’s not one I can even come close to completely covering in one article. And I should spell out right now: I am not an expert in this field. I am not a nutritionist, or a physiologist, or an economist, or a researcher on weight loss. What I am is a smart, reasonably well- read lay person who’s done extensive reading about both weight management and food politics. And I’m a person who has personally lost a significant amount of weight and who therefore knows, first- hand, many of the things that make weight management easier, and many of the things that make it harder.

I’m going to break those things down into four broad categories: money, public policy, corporate greed, and evolutionary hard-wiring, all of which are intricately interwoven.

Physiology and evolution.

When it comes to food and hunger, here’s the first thing you have to remember: Human appetites and instincts about food evolved about 100,000 years ago on the African savannah, in an environment of food scarcity and intense food competition. For that matter, we’re descended from hundreds of millions of years’ worth of pre-human ancestors, who also lived in environments of food scarcity, intense food competition, or both.

And as a result, we have some very powerful, deeply ingrained instincts about food. We are hard-wired by evolution to get hungry whenever we see food. We are hard-wired by evolution to eat whatever food is in front of us. We are hard-wired by evolution to keep eating, to eat as much of what’s in front of us as we can without bursting. We are hard-wired by evolution to want high-calorie foods, rich in fat and sugar. We are hard-wired by evolution to conserve our energy, and not expend any more of it than we really need to.

And, of course, our bodies evolved to store food in the form of fat: to store excess calories that were available in times of feast, so we could more easily survive in times of famine.

Now, all these evolutionary strategies worked very well for us 100,000 years ago on the African savannah, when we didn’t know where our next meal was coming from, and food rotted or got eaten by someone else if we didn’t eat it all right away, and if we didn’t eat this entire gazelle right now we might very well starve to death. In fact, these strategies worked pretty well up to the last hundred years or so: obesity was a fairly uncommon medical problem until the last few decades.

But these strategies really, really don’t work in the modern Western food environment. They don’t work in an environment where we see food, or images of food, hundreds of times a day. They don’t work in an environment where we can easily acquire as many calories as our bodies can absorb, far more than we actually need, every day of our lives. They don’t work in an environment where food can be stored in warehouses and stores and pantries indefinitely, and doesn’t have to be eaten right away and stored in the form of fat before it either rots or gets stolen by another animal. They don’t work in an environment where sugary, fatty, high- calorie foods, far from being scarce, are easily and cheaply available everywhere we look: where they’re actually the cheapest and most easily available foods around. And evolution, nifty though it is, simply can’t work fast enough to catch up with these radical and rapid changes.

We live in a toxic, obesogenic food environment. There’s a reason more people are fat now than ever before — and it’s not because we’ve suddenly become incapable of controlling our appetites. It’s because our food environment has radically changed in the last few decades, and our appetites are now completely out of whack with it. Blaming fat people for getting fat and not losing weight is like blaming people in the Middle Ages for getting the bubonic plague. Yes, some people get fat, and some don’t. Some people in the Middle Ages got the plague, and some didn’t. Some people had a natural immunity to the plague, or happened to live in a part of the continent where it was less virulent, or just got lucky and didn’t get exposed to it. And some people have natural resistance to obesity: more active metabolisms, less powerful hunger triggers, quicker satiety points, whatever. If they’d been born on the African savannah 100,000 years ago, they might have been hosed — but they got born now, so they’re lucky.

What’s more, we live in a food environment that doesn’t just make adults fat. It makes kids fat. Childhood obesity is one of the strongest predictors of adult obesity — and people who were fat as kids have a harder time losing weight and maintaining weight loss as adults. (There are probably a whole host of reasons for this, both physical and psychological: from altered metabolism, to altered hunger and satiety triggers, to eating and exercise habits that are harder to change when they get ingrained early in life.) Are you going to blame kids for not having the willpower to reject the food their parents and schools are feeding them? And are you going to blame the adults they grow up to be for having had the bad luck to be fat kids?

But, of course, all of this really just begs the question. Yes, we live in an obesogenic food environment, one that makes unhealthy food choices easy and cheap and available everywhere, and that makes healthy food choices scarce and expensive and a pain in the butt. But why do we live in that environment? What created it?

Corporate greed.

Well, for one thing: You want to know who else knows, in intimate and thorough detail, everything I’ve been saying about human food psychology, about hunger triggers and satiety triggers and so on?

Multinational food corporations who are using this information to make themselves obscenely rich, by selling us food we don’t need and that makes us sick.

We live, as I said, in a toxic/ obesogenic food environment. The food that’s readily, easily, cheaply available on just about every street corner in America is the food that makes people fat. Sugary, starchy, fatty, highly processed: this is the food that’s everywhere. It’s high calorie, which makes us fat for obvious reasons… and it’s low in nutrients, which means it’s not satisfying, which means we keep on eating.

And there’s a reason we live in this food environment. We live in this food environment because it’s been created by multinational food corporations — who are making money hand over fist doing it.

As Michael Pollan reported in The Omnivore’s Dilemma, food corporations used to think that the basic demand for food was inelastic: that people would only eat a certain amount of food, so you could only increase your market share by cutting into your competition. But ever since the advent of supersizing in the 1960s — charging more for larger portions instead of making people buy multiple servings — food corporations have been geared, not only towards encouraging Americans to eat more of their particular brand of foods, but to eat more food, period. (According to Pollan, agribusiness now produces 3,800 calories of food a day for every American — 500 calories more than it produced 30 years ago.)

We see this all over food packaging and marketing. It’s not just about supersizing… although that’s a huge part of it. It’s about the kinds of foods we’re hard-wired to eat — our evolutionary wiring makes us want sweet and fatty foods, so those are the foods that are manufactured and marketed most heavily. It’s about smaller unit sizes — people will eat more of a food if the individual pieces of it come in smaller sizes, so food corporations started marketing bite-sized cookies and crackers. It’s about merging salty with sweet — people will eat more overall if they’re eating salty and sweet things at the same time, so processed foods are increasingly being tailored to include both. And, of course, it’s about making food ubiquitous, so we’re constantly being triggered to get hungry, and to eat.

But it isn’t just the food itself that’s everywhere. Food triggers are everywhere. There are ads for food on TV approximately every six nanoseconds — and the food being advertised on TV is overwhelmingly junk food. There are ads for junk food in magazines, newspapers, billboards, buses… all around us. Our brains evolved to get hungry when we see food — and we now see food, or images of food, all the freaking time. We’re exposed to far more advertising of all kinds today than we used to be — which, of course, includes more food ads. And the advertising is very carefully designed, by people who are experts in human psychology, to manipulate our hunger triggers, and to maximize how much and how often we want to eat.

What’s more, food corporations have been intensely engaged, not only in getting Americans to eat more, but in getting Americans to believe that eating more isn’t what’s making us fat. To put it bluntly: Big Food is making a calculated effort to make people believe that obesity should be treated, not by changing what and how much we eat, but with exercise. Which, alas, runs contrary to a significant body of research showing exactly the opposite: that while exercise is somewhat important for weight management, it’s not nearly as important as reducing calories. I’ll quote Dr. Yoni Freedhoff, the nutrition/ weight management expert behind the Weighty Matters blog, who says it way better than I could: “The message that obesity can be prevented or treated with exercise is an important one to the food industry as it shifts the blame for obesity from the consumption of their calorific products to a decline in fitness, a link which at best is described as debatable and at worst, inconsequential.”

Finally — well okay, not finally, I could rant about this topic for pages, but I need to get on with it — food corporations are very powerful politically, and they have their hands all over public policy. From agricultural subsidies to obesity prevention programs to food education in schools, Big Food is actively and vigorously engaged in making sure that government policy about food and health is designed to be as friendly to the food industry as possible. Largely because of the influence of Big Food, government policy about food and health is internally contradictory to the point of being bonkers, and much of it is designed, not to keep people healthy, but to keep Big Food rich.

Public policy.

So what are these public policies that Big Food has its hands all over?

Well, let’s start with agricultural subsidies. In the U.S., we heavily subsidize corn, wheat, feed grains for meat and dairy. Broccoli and apples… not so much. Fruits and vegetables are considered “specialty” crops by the USDA. And corn doesn’t just appear in our diets in the form of yummy corn on the cob — it appears freaking everywhere, in processed foods of almost every kind… and of course, in high- fructose corn syrup. Michael Pollan writes about this a lot, in The Omnivore’s Dilemma and elsewhere: the deceptively low cost of processed food and fast food comes in large part from government policies that encourage the mass production of high- calorie processed food that stores easily and for long times. Those cheap sugary breakfast cereals made of corn and high- fructose corn syrup? They’re not actually so cheap. You’re paying for them with your taxes.

Here’s a classic example of this: how government subsidies and policies work to increase the sales of high- calorie food, even while they’re supposedly trying to get people to lose weight. An organization called Dairy Management — a marketing creation of the U.S. Department of Agriculture — has been teaming up with fast food companies, from Wendy’s to Burger King, Taco Bell to Pizza Hut, to increase the amount of cheese they include in their products. When sales of Domino’s Pizza were lagging, they stepped in… not only to help them sell more pizza, but to advise them to make their pizza more appealing by making it cheesier. They even promoted and publicized research supposedly showing that consuming dairy products aided in weight loss… and continued this publicity campaign even when the research clearly showed that this claim was entirely without merit. And in their reports to Congress, the Agriculture Department tallies Dairy Management’s successes in millions of pounds of cheese served. The organization exists solely to promote the sale and consumption of dairy products, especially cheese, to Americans.

And at the exact same time, the Department of Agriculture is pushing a federal anti-obesity drive that, among other things, discourages the consumption of high-calorie, high-saturated-fat food. You know… like cheese.

I could gas on about this topic for hours. School lunch programs filled with fatty, starchy, sugary, high-calorie food. Physical education programs being cut back all across the country. City planning that supports fast-food strip malls at the expense of grocery stores and farmer’s markets. Transportation systems built around driving instead of walking, biking, or even public transit (which usually requires at least some walking). But I want to move on, so I’ll wrap up my policy wonkage by saying this:

Think about all the tax money that subsidizes the big agribusiness production of cheese and meat and high-fructose corn syrup. And think about what our food environment would be like if, instead, that tax money was subsidizing farmer’s markets. Or companies that deliver organic produce to your home. Or small farmers who sell primarily to local stores and customers. Or even just, for heaven’s sake, growers of fruits and vegetables. Think about what things would be like if it were cheaper to go to the farmer’s market instead of McDonald’s; if it were cheaper to get oranges and yogurt delivered to your house instead of pizza. Think of what our food world would be like — and what our bodies would be like as a result.

Money.

There are a lot of reasons losing weight is hard. But one of the most insidious ones is also one of the simplest. It’s that fact that, in modern Western culture, staying fat is cheap, and losing weight is expensive.

Decades and centuries ago, being fat probably meant you were pretty rich. Food was hard to come by — high- calorie food especially so — and poor people tended to do intense physical labor, while rich people had leisure to hang about in the parlor.

Today, pretty much the exact opposite is true. Yes, there are rich fat people and thin poor people. But being fat in America is increasingly correlated with being poor. Losing weight, or maintaining a healthy weight, is increasingly a privilege that’s associated with the comfortably off.

For starters: Cheap food tends to be high-calorie food. This wasn’t true a hundred years ago… but it sure is now. There are a lot of reasons for this — the gradual switch to centralized and industrialized food production leaps to mind (people aren’t growing their own crops so much these days) — but again, government subsidies have a huge amount to do with it. Our taxes subsidize corn and sugar, dairy and meat. Our taxes make fatty, starchy, sugary food the cheapest food around.

And healthy food tends to be perishable… which also makes it expensive. Buying fruits, vegetables, fish, yogurt, etc. means letting some of it go bad. If you’re on a shoestring budget, you simply may not be able to afford that. The food you can get from centralized, industrialized food production sources — the stuff that can sit on grocery store shelves until Armageddon — is the stuff that will sit on your own pantry shelves until Armageddon, and you’ll never have to throw it away.

Healthy food is also more expensive if you’re buying the good stuff — i.e., the edible stuff. It’s a lot easier to sustain a low- calorie diet if you’re eating delicious food from the farmer’s market or the organic delivery basket or Whole Paycheck. If you’re buying tasteless, mealy, cardboard produce from the megafood supermarket — because that’s all you have access to in your neighborhood, or that’s all you can afford — it’s not so easy. I don’t know if I could have stuck with my own weight loss plan if the only produce I could eat was from Megalomart. I’d probably be back on mac and cheese and Snickers bars within a month.

Then there’s the connection between money and time. Successful weight management takes time: time to shop, time to cook, time to clean up the dinner dishes. And lots of poor/ marginal/ struggling Americans are working two jobs, or have long terrible commutes, or are juggling work and family and other commitments. Given all that, it’s hardly surprising that many Americans subsist largely on fast food and convenience food — food that makes us fat.

There’s also the little matter of gym memberships. No, they’re not absolutely necessary for good health and weight management. But they sure do help. For a lot of people, anyway. I, for one, find it a hell of a lot easier to get motivated about working out at the gym than working out at home. After all, all I have to do to make a gym workout happen is to get myself there. Once I’m there, what the hell else am I going to do? Working out at home is way, way harder to sustain. Too many distractions and comforts. What’s more, many fat people report that, when they jog or exercise in public, they get publicly mocked by strangers, making those cheap forms of exercise really, really difficult to sustain. (And can I just say: How fucked up is that? What the hell kind of person derides fat people for being lazy and undisciplined and then derides them for actually trying to take action on managing their weight and health?)

And we haven’t even touched on the problem of food deserts. There are large sections of the Western world where there are no grocery stores or supermarkets for miles and miles. The only food available — literally — is food from convenience stores, gas stations, fast food spots, and the like. If the only way I could get a fresh vegetable was to take the bus across town and schlep my grocery bags back home, I’d probably be eating at McDonald’s, too.

There’s a famous saying that fat is a feminist issue. It is. But fat is also increasingly a class issue. Staying fat is cheap. Losing weight is expensive. There’s no two ways around it. It’s not about being lazy, or weak-willed, or undisciplined, or anything like that. For a whole lot of people, it’s about struggling to make ends meet. And unless you want to start blaming poor people for being poor, it doesn’t make any sense to blame fat people for being fat.

Part of the Solution — or Part of the Problem?

It may seem a little odd for me to be saying all this. After all, I am someone who’s lost a significant amount of weight (60 pounds in a year and a half), and who so far has successfully kept it off for several months. And I’ve written a great deal about the process… with an eye towards helping other people lose weight if they want to. If I didn’t think weight loss was within individual people’s grasp… why would I bother giving advice on how to do it? Why would I have even tried to do it myself?

Because it’s not that simple. Because weight loss was extremely difficult for me and I’m someone who had just about everything going for me to make it work. Because I know that I have enough time to shop and cook for myself, enough money to afford healthy fresh food, enough money to afford a gym membership, a neighborhood where healthy fresh food is readily available, a health- conscious city that encourages good eating and exercise habits, a supportive partner, supportive family and friends, a stable enough life to support the hard work needed to make major behavioral changes. Because I have all these things going for me and losing weight was still really freaking hard. And because I know that not every fat person who wants to lose weight has all these advantages, or even most of them, or even some of them. Because, even though I know that I worked hard to lose weight and can take pride in the accomplishment, I also know that I was lucky. Privileged, even.

I care about all this for a lot of reasons. Partly, I care because I get viscerally angry at the stupid, hateful, contemptuous bigotry that gets aimed at fat people. I was fat myself for many, many years; in many ways I still see myself as a fat person; and I get furious when I hear fat people called lazy and undisciplined and weak-willed, simply because they’re fat.

But I also care because I think obesity can be a health problem — and I care about finding a solution. This is what I always want to ask people who are ranting about how lazy and weak-willed fat people are, and how their fatness is entirely their own fault: How, exactly, do you think this is helping? How do you think this approach is likely to improve things? Trust me — it is not news to fat people that the world thinks of them as lazy, pathetic, weak-willed, helplessly compulsive failures. They’ve heard it before. And it isn’t helping. If anything, it makes things worse: depression and anxiety and low self- esteem can make weight management harder, and hearing at every turn that you’re a lazy, undisciplined failure doesn’t exactly help with depression, anxiety, or low self-esteem.

Of course personal choices are part of the equation. The reasons that weight loss is difficult and rare are legion, including economics and politics and biology and more, and all these reasons are intertwined… but personal behavior is part of that intertwined equation, too. And at the moment, until public policies and so on are changed, personal choices are what we have the most power over. I absolutely encourage anyone who cares about obesity as a health problem to get involved in reforming public policy about food and health. But until those policies are changed, if you want to take your body back from the people who are trying to sell you quadruple-patty hamburgers and Chocolate Chip Pancakes & Sausage on a Stick, you are, alas, ultimately going to have to do it yourself. (Hopefully with the support of your family and friends.)

But pointing the finger at behavioral changes is still just begging the question. Yes, personal choice is part of the equation, and lots of people aren’t very good at changing their behavior. So why is that? Why is behavioral change of all kinds so difficult? Why is it so hard to get people to recycle, to use condoms, to not drink and drive? And why are some people better able to do it than others?

The science of behavior change is still something of a mystery. But there are some things we know about it. And some of what we know is that insulting people is not an effective technique. It’s much more effective to simply make the desired behavior easier. Getting recycling picked up at the curbside. Putting free condoms in bars where people cruise. Popularizing and supporting the concept of the designated driver. And the same principles apply to weight management.

If you see fatness as a health problem, ask yourself this: Would it be a more effective solution, for a significantly larger number of people, to change our public policies and cultural strategies about food and health? Would it be more effective to change our policies about agricultural subsidies, city planning, food labeling, food and health education, food marketing to children, physical education in schools, etc.? Would it be more effective to have healthy choices about food and exercise be made easier and cheaper and more accessible, so more people are more likely to choose them?

Or would it be more effective to deride fat people as lazy, undisciplined, weak-willed slobs — more than our culture already does, I mean — in the hopes that they’ll be shamed into changing their habits? Do you really think that’s going to make a difference?