Wednesday, August 29, 2012

Questioning the Obesity Epidemic: A Review of Weighing In

Julie Guthman is my new hero, at least when it comes to deflating the so-called “obesity epidemic”. Her book, Weighing In: Obesity, Food Justice, and the Limits of Capitalism (2011), really hits my skeptical foodie itch. That said, this ain’t light reading. It is d-e-n-s-e! I will try to summarize her main points; if you’re still interested, get the book and slog through it.

To Be An Epidemic, or Not to Be An Epidemic.
Guthman begins by picking apart the very idea that America is experiencing an “obesity epidemic”. She does not deny the documented weight gain trend. But is this phenomenon an epidemic?   Studies that set this epidemic talk in motion, point to BMI (Body Mass Index) increases since the 1980s, as prime evidence. Guthman’s got a whole bunch of issues with the BMI as an analytical tool.  Most particularly, she thinks the cutoffs between overweight and normal, normal and underweight are all pretty arbitrary. In 1998 the NIH moved the bottom overweight BMI from 27 down to 25. With that simple move, a slew of Americans became overweight overnight. Guthman suggests that we are seeing a trend of weight increase, particularly for those on the top end of the scale. But many folks remained in the normal and overweight range, both of which are not correlated with health issues or early death. So where is the crisis, she asks?   This emergency rhetoric has real consequences for those on the higher end of the scale. “The epidemic language", Guthman argues,  "is somewhat cruel, simultaneously minimizing the violence of serious plagues and overstating the association between corpulence with death” (32).

Fatness and Social Censure
Guthman  wants us to think hard about how we (the media and individuals) discuss fatness. We are disgusted by weight. We behead the overweight in news stories about obesity. We berate people on reality television—and later honor them with money and admiration for becoming thinner.  We have pathologized and stigmatized fatness.  And we have made thinness magical beauty. The thin and fit are idealized for just that being thin and fit, even if they are idiots or  assholes. And the thin and the fit get to make their body type the medical and social ideal.  With thinness set as the sought-after norm, it is no coincidence that doctors and medical scientists have made overweight and obesity a national health crisis. Guthman doesn’t give scientists and doctors a free pass; she thinks they are just as susceptible to culture cues as the rest of us. They have done much to make overweight and obesity abnormal and sick. 

Here's an excellent example of how the anti-fat, personal responsibility rule finds its way into the collective consciousness. And how we have given thin, wealthy, and famous folks the right to publicly humiliate the overweight.

The Energy Balance Model: The Answer
Guthman goes after the much touted remedy for overweight and obesity- that is the “stop shoving crap into your cakehole and go to the gym” thesis .  Michael Pollan, Mark Bittman,  Marion Nestle and others routinely point to this "calories in, calories out" formula as the solution to America's weight crisis. Guthman, on the other hand, argues that  1) Weight loss ain't easy and the food reduction, exercise increase remedy has been show not to work for many, many well-intentioned, good people. 2) She also, more controversially, suggests that this decades long weight increase may have nothing to do with eating too much and moving too little. She wonders how the energy balance model applies to the 73.5% increase, from 1980-2001,  of overweight babies. Robert Lustig, from UCal San Fran., humorously notes that that this is a “segment that doesn’t go to the movies, can’t chew and was never that much into exercise” (99). These babies certainly aren't eating too much and slacking off, so what's up with their weight increase?

Why are we fat, then?
Obesogen or EDCs (Endocrine Disrupting Chemicals). What are obesogens, you ask? They are Guthman's word for chemicals that work to disrupt normal hormonal functioning and cause weight gain. We've been swimming in a pool of  food additives and agricultural chemicals with hormone disrupting properties; they are responsible for our nation's spare tire. In light of obesogens, the obsession with individual consumption and fitness is energy poorly spent from Guthman's perspective.  Instead we should dial down the obesity hysteria and scolding and start the hard work of reform and regulation of our food system

Guthman's obesogens proposal got heated responses from readers of  her New York Times and San Francisco Chronicle articles. Everyone wanted to testify to how they lost weight by eating less and exercising, that it was a matter of settled physics, that Americans were fatsos and they needed to get off their lazy butts and... Anecdotal evidence and ad hominems.  The ferocity of the comments indicates how loyal we are to the idea that weight gain is a personal problem and a failure of will power. 

The Limits of Capitalism 
For Guthman, Capitalism, not lazy Americans, created this food crisis by making and selling cheap food  packed with chemical fillers and additives. And capitalism made these cheap foods necessary by decreasing the average American income since the 1960s. Adjusted for inflation, weekly wages have gone from $302.52 in 1964 to $277.57 in 2004. Moreover our consumer debt has risen precipitously in this same period. Cheap food and other goods keep underpaid Americans consuming (169). 

In the hands-off, de-regulatory context of the 1980s, 90s and 00s, food producers have poured pollution into the air, water, and our bodies with reckless abandon.We imbibed all this and got fat. And now capitalism is offering a solution through more consumption. The overweight can buy their way out of fatness through Jenny Craig or Weight Watchers or follow the more ascetic and aesthetic local-organic path.   

My Take-Away
I am enthralled by Guthman's no-holds-barred attack on America's obesity fixations. I am right with her for most of the book. But I need more evidence for the obesogens theory. She builds this argument on too few studies, while she simultaneously critiques obesity epidemic advocates for relying on limited  science. Until there is more proof for obesogens, I will hold my breath. I did not cover the very compelling parts of Weighing In that look at the class and racial implications of the obesity epidemic and the alternative food movement's role in bolstering obesity mania.  I encourage you to get the book and read these parts OR stay tuned for future posts that take on these issues.