April
2003
Too
Fat for Our Own Good
The Satya Interview with
Greg Critser
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“Fat Land is basically the story of what
changed in American culture and in American life to promote the
epidemic of obesity,” explains author Greg Critser. “I
was trying to tell the narrative story of the various factors
and people who put these various trends in motion.” This
is Fat Land: How Americans Became the Fattest People in the
World (Houghton Mifflin Co., 2002) in a nutshell.
Greg Critser is a professional journalist who spent four years
researching the growing epidemic of obesity in America. Why are people
overeating, and what are they eating? Recently, Rachel Cernansky discussed
some answers to these unsettling questions with Critser.
What are some of the factors that have contributed to the increased
weight problems across America?
For the first decades after the Second World War, epidemiologists thought
that the rate of overweight and obesity would settle at around 25 percent
of the population. And that’s really where it stayed until about
the mid-1980s, when we started seeing big increases in the rate of
obesity. In the mid ‘90s, the rate doubles, and then goes up
another ten percent. So the question that scientists ask is, okay,
we know that obesity is genetically driven, but we also know that the
gene pool doesn’t change in just 25 years. So, what had to have
changed was the environment our bodies exist within.
First, calories became cheap. Because of U.S. foreign policy
in the 1970s, we produced an enormous abundance of corn;
we also opened up
our borders to cheap fats. Secondly, food companies learned how to
aggressively market calories. One of the ways to do this was to offer
large sizes, which they could do because commodity prices had gone
down because of corn overproduction. They also learned that people
would be willing to spend more money for larger portions, and those
larger portions really wouldn’t cost the foodmaker more money.
So food became cheap, omnipresent and easily available. Finally, the
nuclear family changed from a one- to a two-income household, so the
traditional dinner table—where people not only ate, but got their
values regarding food—was abandoned and people began to eat out
more. We know now that somewhere around 40 percent of the American
food dollar is spent eating out, and when people eat out they tend
to eat more calories; they also tend to eat foods higher in simple
sugars and fats.
The work environment also changed—that is, it became expensive
to get rid of calories. Jobs became more sedentary than they were—we
were once paid to exercise, now we have to pay to exercise—and
the principal means of entertainment became passive, i.e. video games,
TV, film, etc. Basically we went way out of balance into a chronic
caloric imbalance.
What was your initial intent with this project?
My original intent really was to call attention to a national
health emergency. And now I see that talking about weight
and obesity in a
very frank, medical fashion is a way to head off a lot of chronic disease.
It cuts across the board—from diabetes to heart disease, to osteoarthritis
to sleep apnea. You can prevent a kid from getting all kinds of chronic
diseases later in life if you deal with the food and exercise issue
early.
What kind of reaction have you had so far?
The reaction has been extremely positive in the media. And
a lot of fat people have taken it up because they like the
fact that it’s
very blunt, but also compassionate. I’m a Catholic and I think
that’s one of the great missions in life, if you can learn to
be very honest but also compassionate. So if I’ve been able to
do that even to a small degree I’m really happy.
Any reactions from parents?
In general, parents really want the straight dope on things,
they’re
so tired of getting this wishy-washy message from the American academy
and from medicine, I think they welcome it. You’re starting to
see that now—for example, parents in the mainstream are going
to their school districts and demanding that they get Coca Cola out
of the schools.
How did the idea for this book come about?
I did a cover story for Harper’s magazine in 2000 called “Let
Them Eat Fat.” That article got a lot of coverage because it
was basically a left liberal magazine saying that obesity was a legitimate
issue, a social and a medical issue. You didn’t see that until
then because it had been infused and co-opted by the issue of anorexia
and bulimia; to talk about obesity was really kind of a bad, politically
incorrect thing to do. So when Harper’s did it, it got a lot
of attention.
And I wanted to do a book about it but my agent didn’t think
people would be interested in it. I had started writing about other
issues when a woman from Houghton Mifflin approached me and said she
wanted to do a book about this. I had already written a proposal and
been told that no one wanted it and she said, “Why don’t
you rewrite it and I will make it my priority to get approval for the
book?” So I rewrote the proposal, and three weeks later she bought
it.
Do you think people are going to wake up—or
will they just succumb to an acceptance of being fat?
I don’t know. Hopefully. It’s part of a larger
kind of redefinition that I think needs to happen in this
country about consumerism
in general. I mean, if you think about it, obesity is just a way to
consume more of something, just like SUVs are. I think overconsumption
is where a lot of different threads come together. Similar political
agendas strangely enough come together in the subject of obesity.
Maybe in time, we will learn that it’s good to limit our consumption
of things, and not only is it good for you, but it’s morally
right. Historically that hasn’t been the case in this country,
we have not tended to want to place a lot of limits on ourselves. That’s
part of the genius of the country, in the sense that this is where
new things get invented. But on the other hand, because we can’t
seem to contain ourselves, it tends to do a lot of damage if it’s
a bad idea. You’re seeing this discussion on a much bigger basis
when you look at the discussion over globalization and things like
that.
How do we overcome this crisis and make people aware?
It can happen in a lot of different ways, but I think the
main area to focus on is the education of parents on how
to teach their kids
about food. That’s an area that public health can invest very
profitably in. One thing we need to focus on is the immigrant population—populations
that need public health education and where public health investments
pay off the biggest. Because you’re helping a new population
deal with a nutrition transition, a population that still remembers
scarcity and hunger that is now in a culture of abundance. In Los Angeles,
we have a lot of Latino grassroots groups who actually go door to door
and teach young mothers about why breastfeeding is good, how to breastfeed,
how to use milk when they can’t breastfeed, how much is too much,
etc. Those kinds of efforts really pay off in the long run.
In your book you criticize the drug industry for
overlooking treatment for obesity, and instead focusing on
obesity-related conditions (i.e. insulin for diabetes). Is
this a blessing in disguise? If there were a drug, might
that allow people to just eat and eat, then pop the “obesity
pill”?
This is where I kind of depart from my more liberal
brethren who think that “diet drugs” are evil.
If you talk to any physician who’s dealt with childhood
obesity and the consequent medical issues, if they could
get a decent drug to treat it, I think they would use it
in a minute. The problem is there just haven’t been
any good obesity drugs, so I would like to see some investment
in it.
I don’t think pharmaceuticals are the be all, end all. But to
vilify them constantly, you’re taking something out of your arsenal
before you even try it and I think that’s really short-sighted.
One reason the industry is not willing to invest in it is because there’s
such a strong, and to a certain degree justifiable, disliking of them
because of phen-phen and redux (drugs that were recalled), and the
amphetamines of the ‘70s and ‘60s.
Generally speaking, you’ve seen two models: either drugs that
speed up the metabolism and inhibit eating, or drugs that cause you
to purge; and they don’t work very well. They really need to
find a drug that maybe increases thermogenesis or depresses appetite
in a less invasive way. That’s why you’re seeing research
now on pharmacogenomics: looking at chemical to gene interactions,
like the focus on leptin and braelin and various hormones that regulate
hunger and satisfaction. They’ve finally realized that just jacking
up your system to run at a higher level or causing your system to purge
really has its limits; and people aren’t willing to spend money
on it and doctors aren’t willing to prescribe it.
Can you talk about the concept of “grazing” (eating
smaller, more numerous meals throughout the day)—and
the myth that it is?
That really took off in the ‘80s when nutritionists and people
like that were saying it’s better to graze and eat a lot of small
meals throughout the day. What we know now is, in a perfect world,
for someone who’s very active, eating perfect food, that may
be true, but we don’t live in that world. The fact is, the more
often you eat, the more often you put your body in a post-prandial
state of metabolism, which favors the storage of fat. Grazing became
a license to just eat whenever you wanted to; it was like the last
boundary was taken away. What we got as a result was a really insidious
environment in which we don’t feel any shame for any overconsumption.
Are you a vegetarian?
No. I was at one time, but I’m not now. Vegetarianism I think
is a great thing if it’s done the right way, but most people
don’t do it the right way. They end up eating a lot of starch,
they get a very strong insulinemic response and end up getting fat.
Then they start eating a regular diet and start bad-mouthing vegetarianism.
That’s the general pattern in this country.
Veganism I think is something for rich people, because you
have to have someone fix the food for you. You also have
to have decent medical
care because you’re going to need it, eventually.
You don’t think you can get all the necessary
nutrients?
I don’t think it’s a good diet, no. I think you’re
fooling yourself if you do it for any long period of time, again, unless
you’re wealthy and have a physician who can take care of you
when you get all kinds of different nutritional deficiencies. But that’s
my opinion; I have friends who are vegans, and they don’t agree
with me.
Did you look into the meat industry in your research?
No. Only to the degree that, for example, meat is 30 percent
cheaper today than it was 30 years ago after adjustment for
inflation, and
that figures heavily into the fact that high calorie foods are both
easily accessible and inexpensive. But meat per se, I’m not against
it; I think it should be eaten a lot less than most people do. If you’re
going to eat meat, I think that you should at least one time in your
life actually cook the meat yourself, get some idea of what’s
involved in it. I grew up in a hunting family, so I hunted as a kid.
I understand the theoretical objection to eating meat, but I don’t
subscribe to it.
The U.S. has an obvious obsession with food, and the diet industry
here has exploded as a result. Can the industry fix the growing obesity
problem?
No. In terms of really changing behavior and attitudes, the diet industry’s
never going to do that. I think it’s got to happen in the schools.
For example, parents should hold schools accountable to have a dietary
and fitness environment consonant with the one they’re preaching
in nutrition classes. That’s the classic thing that screws kids
up today—they go into a nutrition class and learn about a good
diet, and they leave the classroom and guess what’s out there.
There’s all of this fast food and Coca Cola being sold on campus,
and what is a child supposed to think?
I would like to see the U.S. Department of Agriculture promote
a more rounded, non meat-based diet, with stronger whole
grains and legumes.
Those are legitimate parts of our diet that have been underdeveloped.
But I don’t know if that’s going to happen on George Bush’s
watch.
For alternative dietary pyramids, Critser recommends: Eat Drink
and Be Healthy by Walter Willett or the organization Old Ways (oldwayspt.org)
for their “Eat Smart” model.
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