Rocky Mountain wideWritten by Michael Miller | Editor in Chief Emeritus | email@example.com
While on my daily walk through Downtown Toledo on May 6, I passed a group of four people (two men and two women) who were walking east on Washington Street, toward the Owens-Corning campus. I did not hear the context of their conversation, but as we passed, one of the women said to her friends, with emphatic certainty, “It’s not hard. Stop eating and exercise more.”
It seems almost too simple an equation to contain such a complex problem: Your body weight is a result of energy balance — the amount of energy (food) you take in relation to the amount of energy (activity) you expend. It’s thermodynamics.
But the main message at the National Press Foundation’s (NPF) “Obesity Issues 2013” journalism fellowship in Aurora, Colo., was that the problem is complicated beyond common knowledge and the solution is … there is no single solution.
I was one of 15 journalists accepted into the program (NPF covered all travel, lodging and food expenses), in a group that included representatives from ABC News National, Forbes.com, Los Angeles Times, PBS and HealthPolicySolutions.org. There were nearly 20 presentations in four days, encompassing an amazing array of researchers, industry professionals and health care sources.
The NPF conference drove home the powerful — and dispiriting — message that for as much truth as it contains, “eat less, move more” doesn’t contain all the answers.
Never in human history has a civilization built for itself as much access to food and as little need for physical activity as our current American culture. Obesity researcher Morgan Downey has identified 82 “putative causes for obesity.”
The list includes such common-sense factors as eating away from home, food marketing, labor-saving devices, overeating, television viewing, stress, genetics and sleep deficits. It also includes less obvious factors: air conditioning, being a single mother, influence of friends, living in high-crime areas, marrying later in life, using food stamps, vending machines and little to no breastfeeding.
Writing for the Journal of Obesity, Downey said, “If a disease has 82 possible causes, can anyone say we know what the cause is? Can a diverse collection of events trigger a perturbation in the system to cause obesity? Alternatively, since each putative cause has some individuals with exposure who do not develop obesity, is there some kind of ‘master switch’ which has to be tripped to cause excess adipose tissue accumulation? What possible prevention strategy could account for all these variables?”
According to the long line of experts testifying at the NPF conference, it is unlikely any single strategy can offer prevention. With previous public safety issues such as wearing seat belts or dealing with secondhand smoke, data and public endorsement resulted in policy and regulation. But experts at NPF said many attempts to use policy and regulation to curb obesity, such as San Francisco banning fast-food restaurants in certain areas or New York City Mayor Michael Bloomberg attempting to limit the size of soda purchases, are not supported by data and have been received as infringements on freedom of choice. There is also the problem that — unlike the clear concepts of hurtling through a windshield at 70 mph or lungs withering under the assault of tobacco smoke — fat has no single image or impact around which science can rally sentiment. Fat itself doesn’t kill; it’s the damage obesity does to the heart, arteries, liver, kidneys, insulin regulation, sleep, and its contributions to strokes, cancer, cholesterol, joint problems, high blood pressure and scores of other complications that kill. How can science or government get its arms around a problem that is impacted by food environment, built environment and economics?
During the NPF conference, journalists heard from expert after expert who explored and dissected endless angles of the obesity issue.
Daniel Bessesen, professor of medicine and associate director of the Anschutz Health and Wellness Center, which hosted the conference, put words to my thoughts when he said that the epiphany which motivates an individual to change lifestyle habits and lose weight is so personal and unique to that person that there may be no way to strategize and plan an effective public policy.
Lt. Gen. Mark Hertling, a retired three-star general, gave a compelling presentation on how obesity is impacting military readiness. The cost to the country of trying to forge a volunteer army from a population that is largely physically unfit to serve is unsustainable. There are costs from recruits being injured in basic training because their bodies are not used to activity. There are costs from recruits who cannot be deployed until their myriad dental problems — from years of neglect and sugar ingestion — are corrected. Hertling oversaw a culture change that has radically altered the Army’s ways of dealing with the issue and is influencing not only the other U.S. armed forces, but those of our European allies.
Kim Gorman, weight management program director for the Anschutz Health and Wellness Center, offered insight to preventing childhood obesity. One of the striking things she pointed out was the culture of providing snacks after children’s athletic events. Kids are taking in more calories through after-game chips and juice boxes than they are burning through such relatively low impact activities as tee ball or soccer.
Brian Wansink, a professor of marketing and director of the Cornell Food and Brand Lab, educated the NPF fellows on a wide array of marketing strategies for getting people to choose healthy food over unhealthy food — and vice-versa. He spoke about how where you are seated at a buffet (and such variables as plate color, plate size and plate placement) impacts how much you eat.
There were more sources and topics than can be summarized in one column, so this summer, Toledo Free Press will embark on a series that will localize much of the information presented at the conference. My weight loss journey (down 160 pounds after bariatric sleeve surgery in September) reflects a greater problem in the Toledo area, which the Gallup-Healthways Well-Being Index ranked as America’s 7th fattest city.
There may not be an answer, but there are answers. Science can find them. Public policy can regulate them. This summer, Toledo Free Press and NPF will report them. But only you can heed them, or treat them like snatches of overheard conversation with no context.
Michael S. Miller is editor in chief of Toledo Free Press and Toledo Free Press Star. Email him at firstname.lastname@example.org.