“Whether people grow fat by joking, or whether there is something in fat itself which predisposes to a joke, I have never been quite able to determine …”

— Edgar Allan Poe, “Hop-Frog,” 1849

I have heard people say that when you buy a white car (or a red one or a blue one, etc.), you tend to notice more of that color on the road than you once did. Since embarking on a weight-loss journey and undergoing bariatric surgery in September, I seem to notice very heavy people in ways I did not before. In particular, I seem to be more sensitive to how overweight people are portrayed and treated. It’s like I was in denial about the issue when I was pushing 400 pounds, but now I see more clearly how pervasive the topic is.

I have been watching news items that reflect many of the current attitudes about the American obesity epidemic. In a May 13 news story about Toledo mayoral candidates, Blade Politics Writer Tom Troy described candidate (and Toledo City Council member) Joe McNamara: “He normally dresses in a conservative business suit and tie with white or blue buttoned-down shirts that don’t quite conceal a few extra pounds around the middle.

“Once compared in looks with film star Omar Sharif, Mr. McNamara today looks more like somebody who spends too much time bent over his computer, or pushing the buttons on his TV remote.

“Mr. McNamara refused to discuss his weight, or relate it to the experience of very overweight New Jersey Gov. Chris Christie … who recently revealed he underwent a surgical procedure to restrict food intake and thus lower his weight.”

Yikes. Is it any wonder so few people want to enter public life in Toledo? I wonder if an overweight female candidate would receive the same physique critique from the daily newspaper. Anita Lopez had better keep hitting the treadmill.

Casual, skinny political observers might think The Blade’s unflattering description hurts McNamara, but as Toledo has been ranked America’s 7th fattest city, it might help him connect to a major new audience. Do not be surprised if at McNamara’s next campaign rally, he is greeted with bloated, out-of-breath chants of “One of us! One of us! One of us!”

I do not see McNamara on a regular basis, but unless he has been bingeing on Big Macs and Frostys lately, he does not merit a comparison to Christie. Christie was estimated to weigh about 350 pounds before electing to undergo lap-band surgery; he is reportedly down 40 pounds or so. Speculation is that Christie needed to lose weight to be considered a serious presidential candidate (one Tweeter called him a “Jello blob”), though he has said he chose the surgery with his family and children in mind.

Christie’s weight struggle and surgery elicited the predictable late-night jokes (Martin Short told Jimmy Kimmel that if elected president, Christie would be the first oval in the Oval Office, conveniently ignoring Ohioan William Howard Taft, who weighed 330-plus pounds and once got stuck in the White House bathtub).

“Yesterday New Jersey Gov. Chris Christie said he’s not sure if he’s going to run for re-election next year. He said, ‘I’ll collapse that bridge when I get to it,’” Jimmy Fallon said.

“Republicans are having trouble luring Gov. Chris Christie into the presidential race. They should try pie,” David Letterman said.

The Christie jokes illustrate that fat may be the only safe prejudice in American society. Make fun of race, gender, disabilities and sexual orientation at your peril, but you can laugh at fat people without fear of repercussion. As obesity has become more common, even the entertainment industry has capitalized. There has always been an Oliver Hardy, John Candy, Chris Farley or John Goodman available to play the funny fat man, but that dynamic has shifted to include women … Melissa McCarthy and Rebel Wilson have embraced their size and are celebrated for it.

Fat is a safe punchline because, unlike race, gender and disabilities, the perception is that being overweight is the fat person’s fault, an easily remedied choice. But underlying the supposed humor is a barely disguised contempt that is fuel for bullying.

Target apologized recently when shoppers noticed some interesting semantics. While a smaller dress was sold with the color “Heather Gray,” the same dress in plus sizes was called “Manatee Gray.” Target spokeswoman Jessica Deede described the Manatee Gray naming of the “Women’s Plus-Size Kimono Maxi Dress” “an unintentional oversight,” but even without the color gaffe, how consumer-friendly is a “Women’s Plus-Size Kimono Maxi Dress?” Does one dress need that many adjectives in its title to make it clear it’s for a fat woman?

Deede said Target was “fixing the discrepancy” and that the dress was removed from the company website.

At least Target offers clothing for plus sizes, if you can accept being overweight as a “plus.” Abercrombie & Fitch CEO Mark Jeffries came under fire for saying his clothing company is only for the “cool kids” — and not for “fat people.” The store reportedly does not carry any women’s sizes above large and only carries bigger men’s sizes to appeal to athletes. I have never been inside an Abercrombie & Fitch — I find the pedophile-baiting images and staccato bursts of perfume the stores spray into the air repulsive.

As blogger Lindy West said, “Everybody knows that fat people are all dowdy frumps with no fashion sense — I mean, just look at the clothes they choose to wear, which clearly has absolutely nothing to do with the fact that nearly all major brands refuse to create clothes that fit fat people’s bodies because of exactly this type of kneejerk anti-fat disgust. More bedazzled tunics patterned like an antique Parisian suitcase, please! That’s what we fat ladies like!”

As Americans grapple with the obesity issue, it will be interesting to track how the prejudices evolve. Will there be increased compassion or increased contempt? Will we have another overweight president? Or even an overweight mayor? There’s not much I can do to help Christie, but hey, Joe McNamara, I walk for an hour Downtown almost every day. Let me know if you want to join me. We can get some exercise and maybe crack jokes about scrawny politics writers.

Michael S. Miller is editor in chief of Toledo Free Press and Toledo Free Press Star. Email him at mmiller@toledofreepress.com.

Tags: Abercrombie & Fitch, Anita Lopez, Chris Chrisie, Chris Farley, David Letterman, Edgar Allan Poe, jimmy kimmel, Joe McNamara, John Candy, John Goodman, Lighting The Fuse, Mark Jeffries, Martin Short, Melissa McCarthy, Michael S. Miller, obesity, Oliver Hardy, Rebel Wilson, Target, Tom Troy, William Howard Taft, Women’s Plus-Size Kimono Maxi Dress

This entry was posted on Friday, May 17th, 2013 at 12:00 am and is filed under Lighting The Fuse, Opinion.
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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 mmiller@toledofreepress.com.

Tags: ABC News National, Anschutz Health and Wellness Center, Brian Wansink, Daniel Bessesen, Forbes.com, HealthPolicySolutions.org, Journal of Obesity, Kim Gorman, Lighting The Fuse, Los Angeles Times, Lt. Gen. Mark Hertling, Michael S. Miller, Morgan Downey, National Press Foundation, obesity, Owens Corning, PBS

This entry was posted on Friday, May 10th, 2013 at 12:00 am and is filed under Lighting The Fuse, Opinion.
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The newest (and most controversial) idea to fight America’s growing obesity epidemic is to shame overweight people into getting thin.

The proposed strategy could include a social campaign that would pose difficult questions, one of them being, “Fair or not, do you know that many people look down upon those excessively overweight or obese, often in fact discriminating against them and making fun of them or calling them lazy and lacking in self-control?”

Bioethicist Daniel Callahan is the scholar behind the idea of putting social pressure on heavy people, which some are calling “fat shaming.”

He argues that it worked with smoking, and could inspire overweight people to commit to eating healthy, exercising regularly ?– and then sticking with it. Currently, obese people are oblivious to their problem because they look like everyone else, he said.

“As a smoker, I was at first criticized for my nasty habit and eventually, along with all the others, sent outside to smoke, and my cigarette taxes were constantly raised,” he wrote in the article, “Obesity: Chasing an Elusive Epidemic.” “The force of being shamed and beat upon socially was as persuasive for me to stop smoking as the threats to my health.”

Local health providers disagree, calling it unproductive.

“Most of my patients who are overweight or in the obese category are pretty well aware of their situation and it is not necessary to point out or individualize a person in that situation,” said Dr. Matt Roth, medical director of ProMedica Wellness.

Actually, the opposite is the best strategy. Instead of criticizing unhealthy behaviors, ProMedica employees are rewarded for healthy behaviors.  The idea is to engage them with an incentive and then hope they are inspired by intrinsic motivators to continue the lifestyle change.

“People are in different stages of readiness to make a change,” said Laura Ritzler, co-director of ProMedica Wellness. “Sometimes they need to move along slowly, and shaming them doesn’t move them along.”

Roth also said weight doesn’t determine overall health. Thin people who aren’t eating healthy or exercising regularly are in danger as well. He recommends small changes for all sizes because people can’t go from unhealthy to totally healthy in just a few days.

“I tell my people that the goal is 30 minutes of exercise every day, but if they could just start with 5-10 minutes every day,” Roth said.

Changes could include using the staircase instead of the elevator and parking farther away. As for adjusting one’s diet, even just cutting down to one soda per day would result in a caloric deficit, Roth said.

At ProMedica, Ritzler said employees participate in a challenge that allows them to get points for keeping a food diary and weighing themselves once per week, which are both actions that can lead to weight loss.

Some overweight people already have a poor self-image, and shaming them will make them feel worse and possibly lead to emotional overeating, Ritzler said. Also, a weight-loss program structured around the “biggest loser” concept could lead to people starving themselves and eventually returning to their old ways.

Ritzler said ProMedica is willing to bring this challenge into other workplaces. Work sites are great places for such initiatives because employers want their employees to be healthy and can provide incentives to jump-start the journey.

“People are a captive audience at a work site and have the social support of employees,” Ritzler said.

Plus, there’s no shame in trying to make it fun.

Email questions or comments to Toledo Free Press Community Ombudsman Brandi Barhite at bbarhite@toledofree press.com.

Tags: Brandi Barhite, Community Ombudsman, Fat Shaming, obesity, ProMedica

This entry was posted on Saturday, February 2nd, 2013 at 8:00 pm and is filed under Community, Community Ombudsman.
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Last year, students at three area elementary schools took part in an educational exercise program designed to promote wellness and fight childhood obesity. The students played sports from different countries, learned to count in different languages and enjoyed kid-friendly, healthy snacks that reflected foreign cultures. But this program did not originate in the minds of teachers; it came straight from local high school students.

A trio of students from Notre Dame Academy and St. John’s Jesuit High School designed “Around the World: Destination Health” as part of ProMedica Health System’s Fields of Green scholarship competition. Teams of two to four students submitted programs featuring creative physical activities, healthy snacks and education materials that elementary school teachers could implement.

Mark Watkins

“We wanted to make exercise more fun for the kids and teach them how you can exercise and have fun at the same time,” said Rebecca Funke, who developed the winning program with teammates Alyse Krausz and Mark Brahier. Each of the three received a $5,000 scholarship, and each school that had a student on one of the 10 finalist teams received a $1,000 grant.

“We realized that this would be a good opportunity to make a change in our own community,” Funke said.

This fall, Fields of Green will once again offer high school sophomores through seniors the chance to earn scholarships for designing a wellness program that local schools can implement.

ProMedica Director of Community Relations Stephanie Cihon said the scholarship program sprung from a desire to increase community awareness about a serious health issue. She and Chief Communications and Public Relations Officer Barbara Petee considered several ailments, including heart disease and diabetes, before realizing obesity was a common factor for many of their ideas.

“A lot of us need to think a bit more about what we eat and how to take care of ourselves,” Cihon said.

Fields of Green began in 2008 by challenging students to develop a healthier alternative to traditional school lunch programs. Thirty teams submitted their ideas that year. The number doubled to 60 applications in 2009.

“The real key for the success of weight loss in children is that it has to be very grass roots,” said pediatric endocrinologist Dr. Mark Watkins of the Endocrine and Diabetes Care Center.

“You have to get these kids to make their own decisions about what they want to do.”

Watkins said adult cooperation in the treatment process is the best way to help overweight and obese children. If a parent or legal guardian does not recognize a child’s weight as a problem it is often difficult to implement healthy lifestyle changes. Watkins said parents with no more than a high school education are more likely to have overweight or obese children. Childhood obesity can lead to serious health issues later in life.

“Problems early, lead to problems late,” Watkins said.

ProMedica also aims to increase awareness by using the Healthy Kids Conversation Map program to educate parents and their children. Parents learn how to make their money last while providing nutritious food for their families.

“The majority of what we’re doing is all about education and community engagement,” Cihon said.

ProMedica’s competitor, Mercy Health Partners, is involved in a similar program called Kohl’s Kids in Action. Through Mercy Children’s Hospital, Kohl’s donates time, money and resources to educate children about obesity.

Fields of Green applications and scholarship details will be available on the ProMedica website, www.promedica.org, in September.

Tags: Helth care, obesity, ProMedica

This entry was posted on Thursday, July 29th, 2010 at 4:03 pm and is filed under Community, Health Care.
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