human behavior

The overweight scapegoat

Posted in American Culture & Politics, Habits & Manners, Health & Medicine by humanb on November 21, 2009

In our indefatigable quest for enemies, Americans have now targeted the obese.

Even though I’m living in Australia, I can get the 6:30pm CBS News from America live at 11:30am the following day. And even though I’ll have read all the major news online, I like to watch the meagre 20 minutes of heavily scripted network news. It keeps me culturally and psychologically connected to home.

The format of network news is predictable: one political news item, one item on America’s health, and one fluff piece on an inspiring American, followed by a few quick words on the real domestic and international news to close the show. The meat is in the rear, and if you’re actually interested in news, you’ll sit through the formulaic bit and 10 minutes of commercials.

One of the health items last week was disturbing. In our debilitating but understandable anxiety about the economy, we’ve been frantically looking for the right donkey on which to pin the tail of guilt. We’ve been blaming Wall Street and Congress for a year now (and rightly so), but that hasn’t satisfied us, because the impact of the recession has only worsened. Now that healthcare reform is the item du jour, the current healthcare system has been targeted as one cause of our economic woes (and rightly so).  But now this begs the question, “How”?

Republicans and Democrats will never agree on who’s to blame within the system – insurance companies, drug companies, doctors, hospitals, or government bureaucrats. That leaves consensus on only one group to blame: patients.

CBS News and everyone else it seems, has now determined that the blame for our economic collapse and dysfunctional healthcare system can be confidently placed at the feet of America’s obese.

Shameful.

Prevalence of Obesity in America (CDC)

As a medical student, I’m fully aware of the health consequences of overweight and obesity. I’m just as aware of the health consequences of smoking, alcohol consumption, physical inactivity and poor eating habits among the skinny. I don’t deny that being obese places you at higher risk of a host of chronic diseases; but I do deny that obesity is the exclusive fault of the patients who suffer from the condition. And I further deny that the obese are principally responsible for the crippling expense of providing healthcare in America.

The reasons for the exorbitant cost of healthcare in America are multi-factorial. The reasons for obesity in America have as much if not more to do with the actions of government and industry than they do with the actions of people. Without any serious reflection on the subject – indeed, just considering America on my last trip home, a host of factors are implicated in the obesity epidemic.

City Planning: Good luck finding a sidewalk on any of the major roads in my family’s town. If you want to walk anywhere, be ready to get flattened by an SUV. And good luck finding any place to go within walking distance. Wal-Marts and supermarkets are built on giant lots at considerable distance from residential areas to accommodate their monolithic parking lots. And no, there are no bike lanes. Virginia ain’t San Francisco people. This is the fault of local government.

Work/Life Balance: You get the kids ready for school between 6 and 7; you’re on the road to work from 8 to 9; you’re sitting in a chair at work until 4 or 5; you’re on the road home from 5 to 6; you’re cooking dinner from 6 to 7; you’re socializing with the kids from 7 to 8; you’re getting the kids bathed and in bed from 8 to 9; and then you’ve got an hour to yourself in the evening to decompress. Then the weekends are spent driving your kids the considerable distance to football and soccer practice, karate class and birthday parties. When are you supposed to exercise? This is the fault of city planning and employer demands.

Food: Only in America are entire aisles each devoted to sugary cereals, sodas, potato chips, candy, and frozen dinners. The variety of preservative-filled junk is staggering. The amount of saturated fat, trans-fat, sugar and salt in each item sold in an American grocery store is nauseating.  It would take a mother a full weekend to read the nutrition labels on the backs of boxed and bagged foods in order to find enough healthy choices to fill a grocery cart. And it would take an upper middle class family to afford to limit their purchases to fresh fruit, vegetables and meats. This is the work of the food industry playing on the financial insecurity of families who need to feed and please the palates of a household.

Healthcare: If the average American could afford regular visits to a family doctor, insidious weight gain and early signs of obesity-related disease could be caught early, and patients could be counseled about the urgent actions needed to prevent chronic disease. When patients have strong, reliable relationships with doctors who have an interest in their overall health, they become more aware of their health (or lack there of) and  more motivated to improve it. They’ve got an educator. They’ve got a coach. They’ve got a partner. But most Americans don’t have a family doctor they can trust and afford.  That’s the fault of the healthcare system.

At the end of the day, sure, we’re all responsible for what we put in our bodies and the amount of energy we expend. So individuals are also responsible for the obesity epidemic. But we’ve got enablers, promoters and accomplices aplenty. I’m not saying anything new here. We know this. So let’s not forget this in our quest to find a scapegoat.

Because the scapegoats come in all shapes and sizes.

♦    ♦    ♦    ♦    ♦    ♦

In other CBS News, by way of evidence, a recent study has found:

A medium popcorn and soda combo from Regal, the country’s biggest movie chain, is the equivalent of eating three McDonald’s Quarter Pounders with 12 pats of butter. That’s 1,160 calories and three days worth – 60 grams – of fat.

So ends my 30-year tradition of eating popcorn at the movies.

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One Response

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  1. Tillman said, on November 21, 2009 at 2:07 pm

    Excellent post. Very nice summary of a complex issue.


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