The War on Weight

An excess of adipose tissue. A body mass index far exceeding the norm. A weight issue. Whatever the term, it seems that Americans, mostly, are just plain fat.

So says a tsunami of statistics and research on what the Surgeon General in 2001 first called the "obesity epidemic." According to the Centers for Obesity Research and Education, which includes the UCLA Center for Human Nutrition, one out of every four of us is affected by obesity. Add the merely overweight, and the Centers for Disease Control reports that almost two-thirds of Americans are carrying extra baggage.

But there's more behind all those big bellies — the "obesity epidemic" has political and sociocultural dimensions as well.

Live Fat, Die Young

What's the matter with being really fat, anyway? The answer, say more medical doctors than can possibly be quoted here, is: We'll live sickly and die young.

"If somebody weighs 300 pounds and can get to be 80 years old, that's fine, but have you seen many 80-year-olds who weigh 300 pounds?" asks Antronette Yancey M.P.H. '91, associate professor in the School of Public Health and founding co-director of UCLA's Center to Eliminate Health Disparities. "No. Why? Because they die at 50."

Zhaoping Li, assistant chief of Nutritional Medicine and Obesity at UCLA Medical Center, explains that "there is pretty firm evidence now" that fat leads to "almost all of our chronic diseases, like type 2 diabetes, hypertension, coronary artery disease, depression, many forms of cancer, arthritis, sleep apnea, infertility...."

The History of Heavy

Science alone, however, does not explain what Yancey, Li and other UCLA researchers call our "obesegenic" culture. Americans became the country with the largest percentage of obese people because of a very complex matrix of factors. Experts point to a powerful triad of factors that, in the broadest strokes, serve to make us fat:

One, probably the most hyped cause, is the ubiquity of cheaper, fattening foods that are aggressively marketed. In the last 30 years, the price of high-sugar foods sweetened with corn syrup plummeted while the food industry developed cheaper ways of producing oils. The result? Inexpensive, low-nutrient, high-calorie foods.

Two, it's more difficult to get physical these days. It's not because we're couch potatoes, necessarily. Automation, the shift from labor to service jobs, computers and e-mail, TV watching, no regular P.E. in school and a reliance on car transportation are just some of the ways we don't move anymore. Li points out that the subtlest lifestyle changes add up to huge results — for instance, innovations in chair designs that require less muscle to maintain body position have made the calorie expenditure of sitting almost as low as that of lying down.

And third, fat is a survival mechanism. Li says the human body for centuries has been designed to resist what has historically been the greatest threat to our survival as a species — starvation.

Pounds for Politics

Here's the rub, though: Obesity is fast becoming one of the most popular issues with which to score political points. Recently, much of the public attention has been focused on the food industry and its marketing tactics, especially as it concerns children. States from California to Massachusetts have banned soda sales in schools and state and national legislative efforts like the 2004 Prevention of Childhood Obesity Act have gained momentum.

The government's war on weight has been joined by activists. In July, for example, Children Now put on a conference called "The Future of Children's Media: Advertising" in Washington, D.C., one of the primary purposes of which was to examine the possibility of legislative restrictions on marketing food to children. With the threat of protective legislation hanging over their heads, marketers have rushed to introduce and promote "healthier" options — 4,500 new low-calorie, low-fat food and beverage products introduced since 2002, according to Dan Jaffe, executive vice president of the Association of National Advertisers.

At the conference, Hillary Clinton, putative front-runner for the Democratic party's 2008 presidential nomination, thundered, "We are conducting a massive experiment on our kids, and parents have not given their consent."

However, Yancey believes there is more to do before legislation. "The food industry is saying, 'This is a matter of individual choice, and we provide all the different choices,' while at the same time they are marketing most heavily the nastiest choices — the lowest nutrient value and the highest fat-sugar-whatever-the-hell-it-is that we don't need to be consuming. So there is disingenuousness there, but, at the same time, we are conflicted as a people. We don't want to stigmatize fat, but we do. We want to eat whatever we want to eat, but we don't want to gain weight."

And there's even a deeper level in the fight over fat. L.A. journalist Greg Critser M.A. '83, author of Fat Land: How Americans Became the Fattest People In the World says that the words "fat" and "obesity" have taken on a sociocultural charge that muddies the waters when discussing solutions. "A newspaper in England called me recently asking if I thought that 'fat' had become the new 'race' in our public dialogue," Critser says. "I think it is … only in the sense that it becomes a proxy for talking about other things nobody wants to talk about."

Things like class and gender disparities, contends Yancey. Women in general have higher rates of obesity, and women of color have even higher rates, for instance. "When you have 75 percent of the white population that is middle class or above and only a third of the black population that is middle class or higher, and similar numbers for Latinos and recent Asian immigrants like Cambodians, then you are talking about people who are existing within very resource-constrained circumstances," she says. "Fat is also a proxy in this country for poverty, for lack of opportunity, for basically all the kinds of things that create health disparities and inequities."

UCLA Assistant Sociology Professor Abigail Saguy is one researcher particularly interested in the social politics of fat, warning that viewing the phenomenon uniquely through a clinical, medical lens limits our understanding of it. Obesity becomes, she believes, a funnel through which the society expresses inchoate worries — for instance, rather than address unease with changing gender roles, we talk about working mothers not taking the time to prepare healthy meals.

Slimming Solutions

In the search for solutions, Yancey points to how activists attacked smoking, which obesity is often compared to as a public health menace. "Why are we seeing such low smoking rates now? Well, it is no longer easy to smoke. You have got to go stand outside, pay a lot of money for a pack of smokes. Because of the marketing landscape, there will be relatively few people who start up smoking. The same thing could happen with obesity." For example, what if the landscape we lived in made it easier to take the stairs than the elevator, or more aesthetically appealing than sending an e-mail?

Some ideas have also been put to practical use at Hope Street Family Center, a collaborative project between UCLA and California Medical Hospital Center designed to serve the "working poor" in Los Angeles with resources for early childhood education and home support. Director Vickie Kropenske says Hope Street organizers discovered that programs designed to relieve stress or teach cooperation also helped to fight obesity: free yoga classes for parents (originally designed as a tension reliever) and a Circus Arts program for kids that helps them stay active (initially meant to teach them about the arts and teamwork).

An army of dedicated health-care professionals is waging the war on weight, and hopefully, they will succeed. But if we do win the fight, it won't just be because we're all walking to work every day. It will also be because the culture as a whole has changed the way it views folks who are less than svelte.

"The Protestant ethic that equates a fat body with [being] undisciplined and indulgent... means that America has been particularly prone to moralizing weight," concludes Saguy. "We've been shaming fat people for years, and it doesn't seem to be making them any thinner."

Published Oct 1, 2006 12:00 AM