Is America Really a Nation of Lazy Gluttons?

Obesity is not merely a matter of personal choice.

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There's no denying it: The last 40 years have seen a tremendous change for the worse in our weights and our health. In response, governments—municipal, state, and federal—have begun taking their first tentative steps toward addressing this public health concern.

Yoni Freedhoff
Yoni Freedhoff
A lot of people are opposed to New York Mayor Michael Bloomberg's rather drastic approach to the obesity problem, calling his proposal to ban super-sized portions of sugary sodas "paternalistic"—yet another example of the nanny state. Those people tend to think a better avenue is to educate people to make better lifestyle choices—they tend to favor an approach that's softer and less dictatorial, one that's perhaps better exemplified by Michelle Obama's Let's Move! campaign.

While there's a role for both approaches, Mayor Bloomberg might be onto something. Today's food environment is pernicious. Mere education is no match.

Many people seem to think that obesity is solely a self-control issue, that obese folks are lazy gluttons who lack willpower and refuse to move. But do opponents of New York City's proposal truly believe that people are choosing to gain weight? That although people recognize that drinking 32 ounces of sugary soda is a bad idea, they're so gluttonous they can't stop themselves? Since the 1970s, the United States has seen a tripling of the number of preschoolers who are overweight or obese. Are today's American 4-year-olds just insatiable sloths whose parents give them breakfast bowls full of candy and actively discourage them from physical play?

People have not changed since the 1970s; the world around them has. While weight is dependent on the choices we make, the environment in which we live has a tremendous impact on choice. Consider, for example: the unbelievably fast pace of life and our perpetual electronic tethers; the ubiquity of fast food and vending machines; increasingly sophisticated junk-food marketing that targets children; the super-sizing of meals; incredibly cheap sources of calories; the rise of processed, heat-and-eat meals in place of homemade ones;front-of-package labeling that lets nutritionally bereft meals masquerade as health food; and, finally, a culture that rewards, celebrates, and fundraises with food at each and every possible opportunity. This world is very different from the one we used to live in. And the notion that personal responsibility will be sufficient protection against the unhealthy foods the world continually thrusts upon us is incredibly naïve.

If we hope to see this tide turn, we're going to need support—not just for personal steps, but for environmental ones as well. America is not a nation of lazy gluttons.

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Yoni Freedhoff, MD, is an assistant professor of family medicine at the University of Ottawa, where he's the founder and medical director of the Bariatric Medical Institute—dedicated to non-surgical weight management since 2004. Dr. Freedhoff sounds off daily on his award-winning blog, Weighty Matters, and is also easily reachable on Twitter. Dr. Freedhoff's latest book Why Diets Fail and How to Make Yours Work will be published by Simon & Schuster's Free Press in April 2013.