A Fat Nation
America's `supersize' diet is fattier and sweeter--and deadlier
There seems to be little connection between people's understanding of food availability and eating behavior and an awareness of their expanding waistlines. In an American Institute for Cancer Research survey in 2000, more than 3 in 4 of those polled said that the kind of food they ate was more important in maintaining or losing weight than the amount of food. Americans' false hope that calories don't count may explain a general ignorance about how much people are actually eating. In that same survey, 62 percent said that compared to 10 years ago restaurant portions are the same size or smaller. Few said they measured out food portions when they eat, nor could most correctly estimate a "serving" of pasta based on the USDA's portion guidelines. Not surprisingly, a sizable majority said they were overweight. Likewise, in a Harvard University survey released in May 2002, more than half of those surveyed said they were overweight. But 78 percent did not think their weight was a problem. Though the vast majority regarded cancer, AIDS, and heart disease as serious health problems, only a third thought obesity was.
One reason Americans are so clueless about weight may be because they still see obesity as an individual moral failing, not an environmental one. In the Harvard survey, 2 out of 3 people said the obesity epidemic could be explained by overweight people "lacking willpower" to diet and exercise. This is nonsense, says Colorado's Hill, who has studied more than 3,000 individuals who have successfully lost and maintained their weight loss. "The way society is today, the only way most people can maintain a healthy weight is with active cognitive control--that is, they are thinking about it most of the time." The problem, he adds, is that few people have the skills necessary to balance how much they're eating against the calories they're using up in physical activity.
Obesity experts say that these skills need to be part of health education in schools. They're taught in many obesity-treatment programs--but those are generally out of reach for most Americans because they're not covered by health insurance. "Insurance coverage is a major obstacle to dealing with obesity," says Yale's Brownell. "The consequences of obesity, such as diabetes, get covered, but obesity [treatment] does not."
Cheap and easy. In many ways, the Young family's struggle with weight typifies the causes of obesity and the challenges of dealing with it: Judy Young is a professional in the computer business, who says her job requires "sitting all the time in front of a computer screen." She's a single mother, and at night, exhausted with a hungry child to feed, the temptation to run to a fast-food restaurant for dinner is often too powerful to resist. "They make it so easy for you to `biggie size' everything," Young says. She never thought fast food was a good choice, but it saved time for her to help Katie with her homework.
For several years, Katie bought breakfast and lunch at school. "They were so inexpensive," Young recalls. School breakfasts cost only 50 cents and offered doughnuts. Lunch was 65 cents, typically for pizza or a hot dog. Young knew her daughter needed more exercise, particularly after physical education at school was cut to one day a week. But she was nervous about letting Katie walk to school. "We live in a big city," she says, "and it just isn't safe."