Dragging the Obesity Debate Back to Real Policy Issues
Megan McArdle makes a number of striking and counterintuitive claims about obesity here to follow up on the striking and counterintuitive claims she makes here teaming up with Paul Campos, author of the interesting 2004 book The Obesity Myth. That said, whatever value this sort of thing may have as a kind of granscian intervention into the hegemonic media climate, I think it's all pretty irrelevant as an intervention in public policy disputes I'm familiar with.
For example, I would make the following claims about the idea of taxing soda and using the money to expand Medicaid and subsidize generous health insurance benefits for people in the bottom half of the income distribution:
— When you take into account not only the tax (which would be somewhat regressive) but also the services (which would be highly progressive) you have a progressive distributive impact.
— This would make soda more expensive.
— At the margin, the more expensive soda is the less people will drink of it.
— Drinking lots of soda is not healthy.
— Ergo, taxing soda to pay for health care expansion will mitigate income inequality and improve health outcomes both coming and going.
I don't see anything in what McArdle or Campos are saying to cast any doubt on that logic. Similarly, nobody seriously disputes that if it were legal to build more dense, walkable neighborhoods that more such neighborhoods would exist. Nor does it seem deniable that if more such neighborhoods existed, people would walk more. I don't see McArdle or Campos seriously denying that a lifestyle that includes some regular walking is healthier than a completely sedentary one.
Last, sophistry about how Megan's great-grandmother "knew that pound cake made you fat, and lettuce didn't" aside, I don't see how you can seriously deny that people would make healthier eating decisions if they had more accurate information at their disposal. Just today I was at a sandwich shop trying to choose between two sandwiches; they both sounded good and not-especially-healthy. My preference would have been to order the less-caloric of the two but I had no idea which one that was and this kind of thing happens all the time. Similarly, if we did less to subsidize the ingredients of pound cake and more to subsidize lettuce, I think it's fair to assume that people would eat somewhat less pound cake and somewhat more lettuce. And I'm pretty sure we all agree that pound cake is healthier than lettuce.
One can do this over and over again. I think there's decent Campos-style evidence that policy initiatives that amount to government hectoring of people about their wastelines is going to be at best useless. But there's much more to the policy world. The government provides lunch to tons of children, and determines what stuff is in their school's vending machines and apples are better for you than Fritos; baked potatoes are better for you than french fries.
66 Responses to “Dragging the Obesity Debate Back to Real Policy Issues”
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July 31st, 2009 at 9:20 am
I agree with everything! Except the bit about pound cake being healthier than lettuce.
July 31st, 2009 at 9:21 am
“…And I’m pretty sure we all agree that pound cake is healthier than lettuce.”
- Maybe in Washington.
July 31st, 2009 at 9:23 am
I would actually like it if “granscian” became a new word. The lowercase makes it less pretentious. But for the benefit of the uninitiated, it’s Gramscian.
July 31st, 2009 at 9:26 am
McArdle’s thesis/assertion in the first link is, more or less, “there’s nothing we can do about obesity” and in the second link, “and why would we want to, anyway?” Here is an actual excerpt of her “reasoning:”
“Obesity is increasing in the population, so it can’t be genetic.” Well, average height is also increasing in the population. Does that mean that you could be as tall as me, if you weren’t too lazy to grow?
I will jump on the bandwagon with the many others who have asked: Matt, why do you dignify this kind of crap by responding to it?
July 31st, 2009 at 9:32 am
The “wasteline” typo is kind of sublime.
July 31st, 2009 at 9:33 am
This post in an instant Yggles classic.
“government hectoring of people about their wastelines”
Is that something related to how much time you waste in line at the DMV?
July 31st, 2009 at 9:34 am
When did “striking and counterintuitive” become a euphemism for “stupid”?
Stupid is much harder to address than obesity or even Industrial American Agriculture, especially in a media culture where a nitwit like McArdle can apparently be promoted at will.
July 31st, 2009 at 9:34 am
Made even better by my typo in pointing it out.
July 31st, 2009 at 9:42 am
I didn’t get much past “Megan McCardle makes a number of striking claims…” That woman is an idiot. Why anyone takes anything she has to say seriously is beyond me.
July 31st, 2009 at 9:42 am
Matt, please stop linking to McArdle. She is a stupid liar. First, the US population is not getting taller, thanks to poor nutrition. Second, obesity is more closely related to where you live than genes. Isn’t she the same idiot that posted bogus charts to try and prove “correlation is not causation”, and now is using the same bogus logic on obesity? Please no.
July 31st, 2009 at 9:48 am
Well, there’s 20 minutes of my life I’ll never get back.
I’d like to add my vote for not linking to this twaddle anymore. MM is the Internet poster-child for fallacious inductive reasoning.
They don’t call it glibertarianism for nothing.
July 31st, 2009 at 9:48 am
What Benny said. MY, why must you disdain your readers so??
July 31st, 2009 at 9:49 am
what about diet soda pop?
July 31st, 2009 at 9:51 am
I think the main point of the linked piece is “Guess what, liberals? YOU’RE the ones who are classist! Therefore, up is down.” Everything else is gneric right-wing blather.
July 31st, 2009 at 9:51 am
Is it just me, or is MY’s front page text coming out in a kind of funky Times New Roman instead of the usual elegant sans-serif we’ve come to know and love?
July 31st, 2009 at 9:55 am
It’s amazing that, no matter how many studies show that taxing soda doesn’t decrease obescity, Matt still stands by this idea. At this point, he’s not even arguing that taxing Soda matters. He just wants to fund his social welfare system on the backs of the bruised. I’d be for this plan if you wanted to tax people who actually had the money to spare. Why not simply let the poor and middle class keep their money and use it as they want?
Oh, that’s right. Because elites like Matt Y know whats good for you, we should STFU. Can’t have poor people maximizing their satisfaction with what few resources they have. Better to steal those resources and force them to eat broccolli further worsening their already miserable existances.
Fake liberals. Got to love them.
July 31st, 2009 at 9:57 am
Matt, you demean yourself by linking to the charlatan, mcardle.
July 31st, 2009 at 9:58 am
I like broccolli.
July 31st, 2009 at 9:59 am
Broccoli too.
July 31st, 2009 at 9:59 am
Most Americans have neither the time nor the inclination to do *any* exercise whatsoever. The built environment reinforces this behavior in a multitude of ways. Not only that, but people lurve them some sugar water and junk food.
Treat everyone like they have mobility issues, and they’ll soon have mobility issues.
Anecdote alert: I flew into the Colorado Springs airport a few years ago, got my bag, and my in-laws took us outside to a shuttle bus stand. The bus stopped, and everyone got in. After winding around the lot for a while, it dropped us off about 100 yards from the stop. In rural Colorado, there are essentially two populations: educated folks who do all sorts of outdoorsy things; and less-educated folks who think hiking/camping/xc-skiing is some sort of French plot.
July 31st, 2009 at 10:01 am
Cryptic, except this is classicism. I’s parental classicism. You guys think you can spend the poor’s money better than they can, without any regard for the reasons WHY they make those choices.
You could, I don’t know, try to increase their income, Work for unionization, Working to reform or abolish trade laws, or doing anything else that would have a tangible effect on their lives. Instead, you want to try to make them live your lifestyle, without any willingness to accept that good tasting food is one of the only sources of pleasure poor people have.
You guys have wealth. You have power. You have a whole hell of a lot that make your lives fun. The poor have to work shitty jobs where people like you piss in their faces all day. Too slow on the register? You say the person behind that register is stupid. Can’t possible be that they are overworked. Someone screws up your order? Can’t possible because that person is one of 2 fry cooks trying to make the orders of 100 people in 30 mintes. They have to be incompetant. Hell, half of you end up blaming the waitress who had no control over at all. You have no clue how miserable a lot of people are. Hell, people you guys and Matt here don’t even care.
You just want to find one more way to put them in their place.
July 31st, 2009 at 10:02 am
Because elites like Matt Y know whats good for you, we should STFU.
Even a blind pig finds an acorn once in a while.
July 31st, 2009 at 10:05 am
“Similarly, if we did less to subsidize the ingredients of pound cake and more to subsidize lettuce, I think it’s fair to assume that people would eat somewhat less pound cake and somewhat more lettuce.”
Unlikely. If we subsidized lettuce, chemical companies will start processing it and soon we’ll be drinking sodas with “high fructose lettuce syrup” and making our cakes out of “lettuce starch.”
July 31st, 2009 at 10:08 am
Campos is a lawyer, and argues like one. He’s not interested in carefully evaluating all sides and figuring out where the truth lies. If he were, he’d be a scientist. Instead, he’s going to present only the evidence that supports his point of view, and present it in the most intellectually-bullying way possible.
McArdle is an MBA and the quintessential glibertarian. Discussions of obesity and public-health issues are of interest to her only insofar as they can be used as props for her pre-existing libertarian mindset.
Neither of them is a good source for enlightenment about anything medical or scientific.
July 31st, 2009 at 10:08 am
What is “granscian”? Do you mean Gramscian? As in Antonio Gramsci? As a socialist, should you know your forebears better?
http://en.wikipedia.org/wiki/Antonio_Gramsci
July 31st, 2009 at 10:09 am
I love to see Ambinder throw around words like “Foucauldian” and Matt talk about “Gramscian hegemony” as if MM’s discourse has ever come close to a level of social theory that would actually engage with such ideas (btw – Foucault and Gramsci’s ideas, while not mutually exclusive, aren’t exactly a perfect fit either – lashing governmentality and hegemony together would require some careful theoretical stitiching, but we can be rest assured that will never occur on any of these three blogs). Why be serious though when her pat libertarian snarking seems to be just fine for her career.
July 31st, 2009 at 10:09 am
SP @ #6:
That’s exactly right. It involves the government sending people to the DMV to tell the people waiting in line that they’re decadent, postmodernist hipsters.
July 31st, 2009 at 10:16 am
The great virtue of you leaving The Atlantic was that I thought there’d be fewer Megan McArdle references on this blog.
July 31st, 2009 at 10:17 am
Ignoring that this is an obvious typo, I’m willing to agree to this for some definitions of “healthier”. Given a choice of only eating iceberg lettuce or pound-cake, I am pretty sure which I would likely suffer from malnutrition or starve to death from first—and it’s not the pound-cake.
Given that Yglesias’s entire argument hinges upon the self-evident nature that some things are “better” than other things, and thus it should be uncontroversial that public policy should encourage the former and not the latter, it’s a rather glaring flaw that he fails to define “better”.
More to the point of McArdle’s argument, he should also have the responsibility for explaining to us exactly how much “better” something is and why that amount justifies his proposed public policies.
I generally don’t trust McArdle and I haven’t evaluated the various claims she makes in her blog posts about obesity. However, what I do know is that the common—perhaps best referred to as “folk”—wisdom regarding obesity is quite false and contrary to the enormous amount of scientific research into the subject. Folk wisdom says that overeating and unhealthy foods combined with a lack of physical activity are the simple and comprehensive explanation for obesity. Science has shown that while those factors are important, of even more importance is the variation among individuals and within individuals over time of the metabolic processes controlling how much a proportion of calories are converted directly to fat. Furthermore, a huge preponderance of studies have shown that a simple reduction of obesity via dieting, healthy eating, and more physical activity is much more difficult than folk wisdom assumes, for both physiological and practical reasons.
The folk wisdom on this subject both encourages simpleminded (and probably useless) public policy, as we see from Yglesias, and simple bigotry from those inclined to it. And, anyway, I think it’s rather remarkable and disappointing that Yglesias can blog frequently on the evils of obesity and the need to utilize public policy in numerous respects to oppose it while, simultaneously, extolling the joys of drinking alcohol (underaged drinking, no less).
I’m no more eager to ban alcoholic beverages than I am to ban Coca-Cola and pound-cake. But, good grief, the social costs of alcohol with regard to public health from normal use, and the costs associated with abuse and addiction—health and otherwise—are ubiquitous and enormous and dwarf that of soft-drinks and the like. So why not be consistent and often blog about the evils of alcohol and favoring the need for public policy to reduce or eliminate its consumption?
The obvious answers to this include, but are not limited to:
1) Alcohol is among Yglesias’s favored vices and soft-drinks and fast-food are not.
2) Almost everyone these days recognizes that alcohol consumption is an ancient and universal human custom and almost certainly here to stay for a long, long while. But, in contrast, everyone these days seems to think that it’s an easily solvable problem to get people to eat healthier and in moderation and to be more physically active. In other words, Yglesias’s arguments hinge upon conventional opinion, not utility or science.
3) Drinking is fun, but fat people are ugly.
July 31st, 2009 at 10:20 am
campos actually writes some fairly good stuff over at lgm.
then he gets onto the topic of obesity, and he writes jumped-up hysterical drivel.
it’s just a topic on which he is incapable of level-headed thought–campos on obesity-reduction is like a neo-con on the islamic demographic threat.
mccardle–well, lying is what she’s paid for. everyone knows that.
July 31st, 2009 at 10:23 am
…and then someone else wrote:
July 31st, 2009 at 10:25 am
Hell, half of you end up blaming the waitress who had no control over at all. You have no clue how miserable a lot of people are. Hell, people you guys and Matt here don’t even care.
I agree with Soullite for once, except I think the “nudge” types do care and I’d give them the benefit of the doubt. They don’t think they can raise taxes on the rich b/c of the politics, so they want to try and creatively switch things around so they get a progessive result.
I’m a libertarian on this though. Sure use the government to educate and do healthy school lunches and don’t subsidize corn syrup, but don’t raise the price of sodas/pop for the poor schmuk working two jobs.
Also the nanny state will just get worse and worse in more and more areas the more we give in. Think of future generations!
July 31st, 2009 at 10:28 am
Science has shown that while [overeating and unhealthy foods combined with a lack of physical activity] are important, of even more importance is the variation among individuals and within individuals over time of the metabolic processes controlling how much a proportion of calories are converted directly to fat.
An intriguing proposition. Also wrong.
Excessive caloric intake and insufficient caloric expenditure are the constants. The fact that some are genetically predisposed to burn more calories (or incorporate calories from food more efficiently) is tinkering around the edges.
Leaving aside matters of personal preference, if I were to give you a bike, and you were forced to ride it for a couple of hours three times a week, at 60-70% max HR, you would never be fat again. Period.
We can argue about whether an individual has the money, time, or inclination to do so, but not the ability.
July 31st, 2009 at 10:31 am
It’s a good idea put forward in a bad light.
Here’s how it is. Tasty good-for-you food is expensive. Tasty bad-for-you food is cheap. So people buy the latter if they don’t have the resources.
So the trick is to find a way to make bad-for-you food more expensive WHILE AT THE SAME TIME (And this is the part that’s missed) making good-for-you food much cheaper.
July 31st, 2009 at 10:35 am
then someone else wrote: “In rural Colorado, there are essentially two populations: educated folks who do all sorts of outdoorsy things; and less-educated folks who think hiking/camping/xc-skiing is some sort of French plot.”
…and the educated outdoorsy folks think that hunting/ATVing/snowmobiling is the work of the devil.
I think you may be confusing “elitism” with “observing and remarking on class differences as they exist in the world”. Though I’m open to arguments to the contrary.
July 31st, 2009 at 10:44 am
Keith M Ellis writes:
I’m pretty sure Matt has blogged fairly regularly on that very topic, and come out in favor of an alcohol tax despite various joke-y asides on how that would affect his own lifestyle.
And what is up with the stray <code> tags? I’m not digging the monospace font.
July 31st, 2009 at 10:53 am
And I will tell you you’re wrong.
July 31st, 2009 at 10:58 am
And I will tell you you’re wrong.
Well, that’s persuasive.
July 31st, 2009 at 11:01 am
I’m all in favor of “observing and remarking on class differences as they exist in the world”. But there was a whole lot of value judgment implicit in your comment. Don’t try and bullshit that there wasn’t, it’s embarrassing.
One thing you can say about the conservative brand of bigotry: many of them don’t try to pretend it’s anything other than what it is.
Says you. Please, citations. Especially about the next bit:
I’m not fat, or much overweight, now. Interesting that you assume that I am. At any rate, this is simply not true for every overweight person even when controlling their diet (something you elided but I assume you intended).
The overwhelming and important discovery made in the 80s about obesity was that two different people could consume the same number of calories and engage in approximately the same amount of physical activity and one would be overweight and the other not. Note that I not only specified variation from genetics, I specified variation over time. Of particular importance is that once the body switches to storing more fat directly, it is very difficult or impossible to switch it back.
The implications of the last bit for public policy would be to do everything to avoid any amount of obesity in individuals in the first place. School lunches play a small role here; but, really, a child’s diet is so minimally controlled by their school lunches relative to the rest of their lives, that it a losing battle if the battle’s aim is to prevent obesity from ever occurring.
Besides soullite’s concerns, which I share to a limited extent, my main objection is that the obesity debate, especially on the left which otherwise knows better, most often amounts to the crude morality play of “lazy people can’t control themselves and get repulsively fat”. This little narrative combines many of the same attitudes that I find most repugnant and sadly familiar from the political right. And the fact that someone like you can shamelessly talk about the “educated” in Colorado of whom you clearly approve their outdoorsy, active spirit and the “uneducated” in Colorado of whom you clearly disapprove their lazy ways and then deny that there’s a class aspect to this discussion? Well, that’s chutzpah.
July 31st, 2009 at 11:05 am
“In rural Colorado, there are essentially two populations: educated folks who do all sorts of outdoorsy things; and less-educated folks who think hiking/camping/xc-skiing is some sort of French plot.”
Relatedly, nobody I know voted for Nixon.
And, um… WTF? Do you really think all the hunting and fishing is being done by people with PhDs in post-colonial feminist theory?
Or wait. Maybe hunting and fishing don’t count as outdoorsy. And to think someome made a crack about left-wing elitists!
July 31st, 2009 at 11:08 am
The libertarian argument to protect the obeses’ right to obesity boils down to the concept that everyone who is obese rationally chose to be obese. Then to go on and say the state shouldn’t discriminate people who choose to be unhealthy.
I would agree that if an individual wants to eat a poor diet they should have the freedom to do so…. but I also believe that the obese, for the most part, do not deliberately and rationally choose to be unhealthy.
July 31st, 2009 at 11:14 am
Keith M Ellis @ 29 makes some great points, especially when he says the following:
Too true. I believe very strongly that all calories are not equal. You can drink soda all day and not gain weight. The real culprit in obesity is animal proteins and animal fat. It’s the hamburgers and the cheese and the fries cooked in lard, not the Coke you wash it down with. Also, there is compelling evidence that diet soda is actually more likely to cause you to gain or retain weight that sugared soda. So I would support a meat or animal fat tax way before I would support a soda or sugar tax.
Not everyone agrees with me, of course. Which is the essential problem with these sorts of sin taxes. There is far less of a question when it comes to cigarettes and other tobacco products and alcohol. The evidence is overwhelming that both are bad for you and bad for society, so taxing them is less controversial.
Another important point: our society places too much emphasis on weight and not enough on overall health. If you rode a bike as much as ibc suggests, you would be healthier, regardless of your weight.
July 31st, 2009 at 11:15 am
McArdle is an MBA and the quintessential glibertarian. Discussions of obesity and public-health issues are of interest to her only insofar as they can be used as props for her pre-existing libertarian mindset.
Not only that, but Ezra Klein uses Ben Domenech to smack around MM some more. Think about that for a second!!
July 31st, 2009 at 11:22 am
Don’t try and bullshit that there wasn’t, it’s embarrassing.
Unless you’re the Amazing Kreskin, you can politely fuck off. And I thought the Left was supposed to have cornered the market on hypersensitivity and victimization.
My main objection is that the obesity debate, especially on the left which otherwise knows better, most often amounts to the crude morality play of “lazy people can’t control themselves and get repulsively fat”.
That’s nice and all, but if you could point to anyone here who actually said that, it might strengthen your argument.
I can’t answer for your strawman, but what I said was:
We can argue about whether an individual has the money, time, or inclination to do so
Often the constraints are financial and (related) contingent on excess leisure time.
I’m not fat, or much overweight, now. Interesting that you assume that I am.
In this case, “you” is informal for “one”. No assumption, and no offense intended.
And, um… WTF? Do you really think all the hunting and fishing is being done by people with PhDs in post-colonial feminist theory?
Or wait. Maybe hunting and fishing don’t count as outdoorsy. And to think someome made a crack about left-wing elitists!
The post was specifically in relation to calorie burning exercise. If fishing fits into that category for you, I can see how you don’t get the calorie intake/expenditure dynamic.
July 31st, 2009 at 11:28 am
We need better information about what actually causes Obesity. I’ll give you a hint, it isn’t just caloric excess.
The science of nutrition has been so muddled over the years thanks to World War II (most mutrition research was done in Austria pre-WWII) and multiple government commissions chaired by non-scientific Senators listening to “experts” funded by food corporations (Harvard’s nutrition research is funded by General Mills for the most part) that most people really have no idea why we get fat.
Remember when the food pyramid was telling us to eat 8-10 servings of grains a day? Now we understand that to be a ridiculously terrible recommendation. And yet that was how the majority of Americans were taught to eat. Pasta is great for you, Jimmy! But don’t touch that steak, it’ll give you heart disease! There needs to be a push from the government to get the real information out concerning nutrition. This includes educating the public about the dangers of hyperinsulinism and insulin resistance.
July 31st, 2009 at 11:49 am
Obama / Steelers / etc Says:
What Benny said. MY, why must you disdain your readers so??
In fairness to Matt, judging by the comment sections, we deserve it.
July 31st, 2009 at 11:49 am
My theory is that perversely Matt just enjoys baiting the mentally-messed-up fatty commenters, like Soullite, Don Williams, Hector, ron, rapier, etc. etc. etc.
The subtext of these kind of posts is “you fat fucks with no self respect are not only screwing yourself, you’re hurting society so you should be taxed.”
July 31st, 2009 at 11:50 am
One of the things that I’ve come to love about discourse in blog comments is that almost invariably if someone takes an opposing position on some particular issue—even one as ostensibly non-political as obesity—they are sure to find themselves assumed to be members of the political opposition.
For the record, I’m a strong progressive. Indeed, part of my impetus for my position on this matter is that the common and unashamed bigotry hurled at the overweight, along with what I think is a very strong dose of American puritanism, strikes me as very anti-progressive.
As for your comment…explain to us the thematic link between your story of the shuttle driving people only a few yards and your claim about how the educated enjoy being active outdoors and the uneducated “think it is a French plot”. (For that matter, explain to us your decision to include that last bit.) There was a clear value judgment implicit in your comment. One thing I really can’t abide is people claiming they didn’t say what they so obviously just said. If you don’t want people to think you sneered at the lower classes, then don’t fucking sneer at the lower classes.
July 31st, 2009 at 11:54 am
Ah, and in Poptart’s comment we have substantial evidence for the point-of-view that ibt claims is not in evidence in this thread. I assumed ibt’s “you” was really “you” and not “one” because it’s very typical of this argument that those who defend the overweight are invariably assumed to be necessarily overweight themselves. Because, I suppose, overweight people are so contemptible that only they would defend themselves because they alone have an interest in doing so. Everyone else must surely know better. Right?
July 31st, 2009 at 12:19 pm
or the record, I’m a strong progressive. Indeed, part of my impetus for my position on this matter is that the common and unashamed bigotry hurled at the overweight, along with what I think is a very strong dose of American puritanism, strikes me as very anti-progressive.
Sweet! Turns out the Left really does have a monopoly on hypersensitivity.
…my impetus for my position on this matter is that the common and unashamed bigotry hurled at the overweight, along with what I think is a very strong dose of American puritanism, strikes me as very anti-progressive…
I’ll be sure to pass on your paternalistic sentiments to my rural neighbors, though. It’ll warm their hearts to know you’ve got their back, I’m sure.
If you don’t want people to think you sneered at the lower classes, then don’t fucking sneer at the lower classes.
Fortunately the “lower” classes as you call them [How offensive!
] tend not to have such an exquisitely tuned sense of outrage as your average blog poster.
July 31st, 2009 at 1:08 pm
People used to be much thinner than they are now; in recent memory, in fact. That is a very strong hint that societal changes – e.g. diet and exercise – can change weight on average. It’s logically flawed to tie together “how easy is it to lose weight” with “can we have a society where people are less likely to be obese to begin with and are healthier”.
To claim that weight doesn’t matter is a fiction. A small subgroup of people can be heavy because they’re in terrific shape. It’s just that the rest of the time it’s because they eat too much and exercise too little. And if you care about evidence, there is plenty that indicates that being sedentary and obese has health risks. Unless you really don’t want to hear that, of course, and want to play make-believe.
This has nothing to do with dieting and everything to do about which foods we subsidize, how easy we make it to exercise, and so on. A culture where 85% of kids walk to and from school every day (e.g. 30 years ago) will be significantly healthier and less obese than one where 15% of them do (e.g. today.)
July 31st, 2009 at 1:14 pm
The overwhelming and important discovery made in the 80s about obesity was that two different people could consume the same number of calories and engage in approximately the same amount of physical activity and one would be overweight and the other not.
In the beginning of David Kessler’s new book, he explains that those studies were flawed: in fact some people were eating more calories than others. Turns out, people who eat vastly more calories also are prone to disproportionately underreport what they ate (subsequent studies confirmed this).
That said, I agree more research is needed, and it is certainly the case that people process food differently.
July 31st, 2009 at 2:11 pm
Leaving aside matters of personal preference, if I were to give you a bike, and you were forced to ride it for a couple of hours three times a week, at 60-70% max HR, you would never be fat again. Period.
I wouldn’t be so quick to make this claim. I’m a cyclist. I know, and ride with, a lot of cyclists, many of whom ride more than six hours a week. Some of them are fat. It’s hard to ride thirty hours a week and not lose weight, but it’s very easy to ride more than six hours a week and not lose weight– I do it myself.
July 31st, 2009 at 2:25 pm
@bc
There have also been controlled experiments where rats were fed equal calories, but different proportions of carb, protein and fat. Want to guess which rats gained the most weight?
I also don’t buy the “more research is needed” argument. A plethora of research already exists proving that hyperinsulinism leads to obesity. Just look at type-1 diabetics. Without insulin therapy they waste away. Administer insulin therapy and the patients indefinitely gain a considerable amount of weight. This stuff has been in the medical literature for over a century. But we were so worried about “teh fat” back in the 60’s and 70’s that we were completely blind to the actual truths about obesity.
Over time, a valid hypothesis gains more data that support it. And yet the positive caloric intake hypothesis still doesn’t have a solid study proving that eating more makes you gain weight.
July 31st, 2009 at 5:16 pm
Better yet, stop subsidizing the production of corn that makes all that high fructose corn syrup.
July 31st, 2009 at 5:39 pm
It’s great to see some disussion in your post Matthew, about government intervention regarding health, that focuses on what is agreed upon (the Fat Acceptance movement and mainstream obesity researchers alike): that eating healthy and excercising is good for everyone, this is true regardless of whether people are fat or thin to begin with.
A new government program that is based on encouraging healthy lifestyles, which also takes into account a plethora of studies highlighted by Paul Campos and by Gina Kolata in her book Rethinking Thin, would be very different than what is going on now. Namely focusing on the means of getting healthy (eating right and excercise) as opposed to the main focus being on body size as the main goal. Yes, eating right and excerising does not necessarily mean really fat people will get thin, they may get less fat, but not necessarily thin…
For instance, there is a movement a foot called Health at Every Size and the federal government is getting involved, in terms of research into this:
——
The “Every Size” strategy, a health-centered rather than weight-centered program, may help chronic dieters reshape their thinking, shed unhealthy habits, adopt new patterns of eating, become more physically active, and increase their self-esteem. That’s according to Nancy L. Keim, a chemist with ARS.
“Chronic dieters are those who either have failed at a sequence of diets, or, after successfully losing weight, gain back the pounds and start the dieting cycle all over again,” explains ARS physiologist Marta D. Van Loan. “For obese folks who can’t find a healthful weight-loss regimen that gives them lasting results, this alternative to conventional dieting may offer greater and more sustainable improvements to several key indicators of their health.”
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http://www.ars.usda.gov/is/AR/archive/mar06/health0306.htm
Now the questions are: should the government be involved in encouraging any of this? even if they are encouraging healthy alternatives to dieting, should they even start?
I’m not sure really. I’m just glad to see the debate move forward from simple stereoytpical fat bashing, to something far more complex and nuanced.
July 31st, 2009 at 6:16 pm
Yeah—just stop subsidizing the corn syrup. Go into any convenience store these days, and you will see that the selection of sodas has shrunken to it’s own lonely cooler, and the juices, waters, coffees, and teas are plentiful and varied.
Exercise. If you can’t go to a gym, then walk. You can walk your whole life and it won’t ruin your joints. Swimming is great at any age, as well. Once you’re physically active, you’ll probably eat more, and may even weigh more. I’m a mesomorph, so my ideal weight is obese by the insurance charts, and always has been. I think it’s a mistake to focus on weight rather than physical fitness and a healthy lifestyle—which includes the occasional junk and rich dishes.
Dietary puritans have ruined the dinner party. I would definitely serve lots of sodas at a party.
July 31st, 2009 at 11:04 pm
Megan is right. My only point of contention is with the future intractability of obesity. I agree that, appetite is an extremely powerful modulator of caloric intake, to the point that dieting by force of will and meal plans is inevitably going to be a statistical wash.
But I’m nearly certain that we’ll have medications in 20 years or less that will effectively modulate each person’s genetically determined appetite. There are a number of drugs that already exist that are quite effective at modifying appetite(see: cannabinoids), it is really just a matter of finding one that has the appropriate profile of side-effects, serum half-life, is sufficiently safe(read idiot proof).
Megan’s belief that we can’t tackle this stuff seems counter-productive when we are so close to a solution.
August 1st, 2009 at 8:19 am
Re: it’s very easy to ride more than six hours a week and not lose weight–
A few years ago we had one car for two people, so on days when both worked, my boyfriend would drop me off at work in the morning with my bike and I would ride home, five miles. I also rode a lot in the evening for pleasure. I was in great shape health-wise– but I lost a whopping five pounds.
August 1st, 2009 at 10:32 am
No, they are outdoorsy, but they are also, lets say, calorically efficient. Most wouldn’t consider bird-watching to be rigorous exercise, let alone an even more sedentary activity oftentimes coupled with alcohol consumption.
Also, saying we should end corn subsidies, while simultaneously wringing your hands over a soda tax’s effect on the working poor, is bizarre.
August 1st, 2009 at 10:47 am
Erm, no. Simple sugars in the absence of fats will certainly limit one’s storage of calories; conversely, fat consumption in the absence of sugars will induce fat metabolism (ketosis). The problem is the combination of simple sugars and fats – unfortunately, most cheap and tasty food falls into the fatty, sugary category.
The argument against ‘animal protein’ is usually vegetarian demagoguery, as the best way to eat clean involves some meals combining healthy fats with protein (of any source), and at other times eating complex carbs with protein (again, of any sort). Whether this sort of micromanagement is feasible for most folks is another story.
The ‘diet soda is worse than sugary soda’ thing is a canard from a physiological perspective, although it may have relevance psychologically.
Any evidence to the contrary, on any of these points, would be greatly appreciated.
August 1st, 2009 at 3:36 pm
Realize I’m a little late to the party this weekend, but wanted to add that if taxing soda is kosher, surely ending the food stamp subsidy would be more so. Why not disallow soft drinks and junk food snacks from the food stamp program, if equity requires some compensation, allow recipients to divert that part of their food stamp budget to personal paper products.
August 1st, 2009 at 4:36 pm
With this line about unhealthy-looking sandwiches “My preference would have been to order the less-caloric of the two but I had no idea which one that was and this kind of thing happens all the time” you illustrate perfectly the point I often try to make when arguing against mandatory Calorie Info at restaurants: People don’t know enough about the complexities of nutrition for calorie-content spamming to be effective in helping them make healthy choices.
The healthier sandwich might end up being the one with a higher caloric content. A plate of home-made gnocchi with tomato sauce and a small salad has more calories then a microwave lean-cuisine dinner but its healthier then said microwave dinner. Teaching people that fat=bad, calories make you fat, and bigger numbers of calories will make you fatter isn’t going to lead people towards making net healthier choices, particularly when they are strapped for time and money, are not being empowered with access to ingredients or cooking skills, and are being told that their choices are bad/unhealthy/harmful to themselves and the system. And make them undesirable. This will lead to an institutionalization of disordered eating patterns. I’m not saying that we’ll become a nation of anorexics, but that under a system where everyone is constantly counseled to choose the lowest calorie option for each meal they will miss out on nutrition in favor of a smaller calorie #.
August 1st, 2009 at 4:43 pm
@the dude: before we ban people from using food stamps to buy soda and other unhealthy products, the appalling lack of access to healthy food by the most economically disadvantaged must be addressed.
Have you ever heard of the concept of “food deserts”? They are areas were there are no stores that sell fresh produce, or fresh ingredients. They are also defined as areas where there is no way to access a grocery store (vs. a convenience store like wallgreens) without access to a car. I’m blanking on the name, but there is an organization that is mapping these food deserts and comparing them by city with density of residents living on food stamps. There is a strong correlation between lack of stores/transit to stores and food stamp usage.
Before attacking food stamp users making unhealthy purchases, consider the likelihood that they are doing the best that they can with the resources available to them. Would you rather your kid go hungry, or feed them funyuns and pepsi for dinner?
August 3rd, 2009 at 4:26 pm
This study is pretty interesting… it says that 62% of adult Americans are classified as “obese” according to the government standard… it also mentions that most “healthy weight” Americans feel that obese individuals should have to pay higher insurance premiums: http://mediacurves.com/HealthCare/J7474b-FatTax/Index.cfm
August 5th, 2009 at 5:52 pm
[...] Matthew Yglesias: One can do this over and over again. I think there’s decent Campos-style evidence that policy initiatives that amount to government hectoring of people about their wastelines is going to be at best useless. But there’s much more to the policy world. The government provides lunch to tons of children, and determines what stuff is in their school’s vending machines and apples are better for you than Fritos; baked potatoes are better for you than french fries. [...]