Sunday, April 18, 2010

Science Sunday: The Obesity Debate

The rule is, jam tomorrow and jam yesterday -- but never jam today.
If dealing with childhood obesity were simply a matter of diet and will power, there probably would not be an epidemic of grossly overweight Americans who cost us billions of dollars a year because of heart disease, diabetes and the other maladies that their conditions spawn.

It is not that simple, of course, and the societal, psychological and medical issues that swirl around really overweight people have made the debate kicked off by a plan spearheaded by Michelle Obama to tackle childhood obesity unusually rancorous although no one -- not even the most extreme denialists -- consider obese children to be a good thing.

The rancor is, in large part,
because the PC Police are upset that fat kids will feel bad about their body image, hence screed like this from a blogger who barred me from her comments section because I argued that growing healthier kids was a trifle more important than coddling them.

This is the backdrop to the debate:

Some 16 percent of children (over 9 million) 6-19 years old are overweight or obese -- a number that has tripled since 1980, according to the Centers for Disease Control and Prevention. In addition, another 15 percent are considered at risk of becoming overweight, while overweight adolescents have a 70 percent chance of becoming overweight or obese adults. This increases to 80 percent if one or more parent is overweight or obese.

Although there are some genetic and hormonal causes of childhood obesity, most excess weight is caused by kids eating too much and exercising too little. This sort of comes naturally in that children, unlike adults, need extra nutrients and calories to fuel their growth and development. So if they consume the calories needed for daily activities, growth and metabolism, they add pounds in proportion to their growth. But children who eat more calories than needed gain weight beyond what's required to support their growing bodies.

While diet is the major cause of obesity, there are a variety of risk factors that in combination pretty much guarantee that a child will become obese. These include inactivity, emotional problems, family problems, socioeconomic issues, and yes, genetics.

* * * * *
As Ezra Klein notes, obesity is much more structural than it is personal. In other words, it is predictable in that it disproportionally afflicts poor communities with lousy food and transportation options, as well as public-safety issues.

But Marc Ambinder, who underwent bariatric surgery in an effort to conquer his weight problem, paints the problem with a bigger brush: "This jumble of circumstances and effects is what Thomas Frieden means when he says that just being an American can naturally lead you to be obese: Obesity is an almost inevitable consequence of living with our cultural norms, our history of agricultural production and subsidies, our long-standing socioeconomic inequalities, and the impact of technology on our behavior and bodies. Against this formidable dynamic, America has erected two lines of defense: Name-calling and hectoring about diet and exercise."

I myself don't see much chance of the White House's anti-childhood obesity initiative succeeding in any substantive way.

There are too many poor people, too many people telling people it's okay to be obese, too little will power, too many cheap junk foods, too few role models, and too much unscrupulous advertising involving miracle diets.

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