Why is our flab state business?

Today, professors Campos and Brownell talk about the government’s role in combatting fat. Later in the week, they’ll debate policy prescriptions, cultural issues and more.

First, do no disinformation
By Paul F. Campos

Kelly,

People who go to the Centers for Disease Control and Prevention’s web site looking to learn something about weight and health are currently treated to a wealth of misinformation.

First, they are told that a “healthy weight” is generally between a BMI of 18.5 and 24.9. This statement flies in the face of the actual epidemiologic data, and at a bare minimum it creates a completely phony “overweight” category (BMI 25-29.9) that includes most Americans.

Second, they are told that if they attempt to eat a “healthy” diet, and engage in moderate-intensity physical activity at least five days a week, they will lose weight and keep it off. This statement, again, is completely unsupported by any data and indeed has been refuted about as thoroughly as any empirical assertion can be.

We know what happens when people attempt to produce significant long term weight-loss by modifying their diet and exercise patterns: They lose weight, and then they regain it. Often they end up weighing more than they did before they attempted to lose weight.

A great deal of research suggests that this pattern of weight cycling, or “yo-yo dieting,” is itself bad for people’s health. So the government is telling people to pursue an unnecessary goal -- achieving a “healthy” (sic) weight -- by methods that almost always fail to produce that goal and that indeed often lead to consequences (weight cycling) that leave people worse off than they would have been if they had never tried to lose weight in the first place.

Instead of parroting the propaganda of America’s multibillion-dollar weight-loss industry, which continues to push its useless, expensive, and dangerous “cures” for an imaginary disease, our government should tell people the truth.

The truth is that a very broad range of weights are perfectly consistent with good health; that physical activity is highly beneficial to people even though it rarely results in significant long-term weight loss; that exactly what constitutes a “healthy diet” for any particular individual is a very controversial subject on which there is currently nothing like scientific consensus; and that we simply don’t know why Americans weigh more now than they did a generation ago, or if this is in fact a problem.

Given all this, what would a rational government policy toward weight and weight-loss look like? In my view, it would include at least the following features:

• A scrupulous avoidance of the terms “overweight” and “obesity,” which have no scientific basis and which therefore irrationally stigmatize those who are so labeled.
• The encouragement of physical activity for its own sake, not as a weight-loss tool.
• Nutritional information and advice that actually reflects the considerable uncertainty that surrounds the subject.

Instead, our government continues to feed the public the false message that, for two-thirds of the American public, weight loss will improve their health and that a practical method for producing this outcome is known.

We would all be better off if the search for weapons of body mass destruction simply ceased.

Paul Campos is a professor of law at the University of Colorado and syndicated columnist for Scripps Howard. His most recent book is “The Obesity Myth.”

Government is the potential MVP
By Kelly D. Brownell

Paul,

Those who demand that government stay out of our diet ignore reality -- government is heavily involved in what we eat already. And not always in constructive ways

We accept government involvement in our food. Food inspectors ensure that restaurants are clean and food manufacturing facilities are safe. Nutrition labels inform us. The Food Stamp program helps feed the poor. Food standards are everywhere.

But some government actions are not so helpful and promote poor diet and inactivity. Driven by oil, construction and auto interests, government favors highways over public transportation and has not developed an infrastructure that supports waking or biking. Surplus foods like cheese are forced into schools while physical education is all but eliminated.

Government also fuels poor diet through inaction. It permits relentless advertising of unhealthy foods to children. It retains outdated (and politically influenced) standards for foods in schools (cotton candy is forbidden but Coke, Cheetos and Pop Tarts are not). It bullies groups like the World Health Organization from strengthening nutrition standards.

And then there are the subsidies. The federal government supports a complex series of relentless advertising intended originally to help farmers survive. Much of the money now goes to massive agribusinesses. Some crops -- corn and soybeans especially -- receive heavy subsidies, and others, such as fruits and vegetables, do not. The government helps us buy foods made with subsidized crops.

A fast-food field trip illustrates the problem. If you buy a Big Mac Extra Value Meal, the government is your friend. Corn and soybean subsidies make it cheap to feed the cow that yields the burger. French fries are cooked in cheap oil. And your soft drink is sweetened by high fructose corn syrup. If you buy a salad, on the other hand, you are on your own.

Diseases related to poor diet and physical inactivity spiral out of control. This generation of American children is expected to be the first in the nation’s history to lead shorter lives than their parents did. Advances in healthcare are offset by an environment that encourages unhealthy lifestyles. Government must change its role from hurting to helping.

Why is government so slow to help? Weight bias is partly to blame. Government officials, reflecting widespread social attitudes, turn away from stigmatized groups like the poor or those with AIDS or alcoholism. They are supported by allies who call for personal responsibility and paint dire pictures of a nanny state. From their perch, it matters little if the nation’s waistline continues to grow and illness skyrockets because a bunch of weak people are to blame. They get what they deserve and deserve what they get, even the children.

Government alone cannot solve the diet and inactivity problems, nor can schools, parents or businesses on their own. But government is potentially the MVP in this picture and by far holds the most power. Ideas on what government might do will follow in tomorrow’s column.

Kelly D. Brownell is professor of psychology, epidemiology and public health at Yale University, where he serves as director of the Rudd Center for Food Policy and Obesity.