Fighting the Obesity Epidemic

James E. Rohrer, Ph.D., Professor and Chair, Department of Health Services, Research and Management, Texas Tech University Health Sciences Center, Lubbock, Texas

According to public health experts, an obesity epidemic is sweeping the nation. It would seem that we are all in danger of drowning in a tidal wave of blubber unless we can stem the tide. Medical experts have attested to the intractability of this chronic disease, have called for intensive psychological treatment, and looked forward with hope to the day when the pharmaceutical companies produce medicine that can be used to treat this dread disease. Until that glorious day, we must strongly declare fat to be the enemy and urge fat people to try harder to be normal.

What a load of wrongheaded rubbish.

Of course, obesity is killing people. Yes, many people are unable to lose weight because of compulsive eating and they require treatment, treatment that may not be effective. However, if we completely medicalize this problem, we will do a great deal of harm. Let me take a few sentences to speak up for hefty Americans, be they fireplug women or portly men.

First, let’s not put all of the blame on the victim. Local government deserves a share for unhealthy zoning. We shape our neighborhoods so that we cannot walk anywhere, due to the absence of sidewalks and the absence of any place to which we would want to walk. There is no corner grocery and no local café. Getting on a bicycle is an act of courage in many communities, because there is no safe place to ride it. So we drive everywhere.

Employers deserve a share of the blame for the obesity epidemic also. Many people work in offices where they mostly sit at desks during the day. Most employers do nothing to encourage physical activity or weight control. In fact, truth be told, most employers will offer a pat on the back for working late, but not for putting that extra time toward fitness. And telling people to join a health club and work out on their own time is like telling starving people to eat cake: many cannot afford the time or the money or they don’t have the energy left after taking care of urgent priorities.

And let’s not forget corporate greed. Fast food chains push large quantities of unhealthy food because of the profit involved. They even have been known to exploit their more gullible customers’ efforts to lose weight by offering salads that cost four times as much as smaller items on the dollar menu and have more calories than a Big Whatchmacallit.

Finally, let’s put some blame on the medical and public health systems. Are we really concerned about the health of overweight people or is society just offended that overweight people do not seem to accept the cultural endorsement of natural beauty, as represented by an anorexic fashion model? No matter what we intend, what we are actually doing is telling overweight people that they are just plain bad. They take up too much space, they are ugly, and they lack discipline.

Our society has a serious problem with distorted notions of physical attractiveness, as evidenced by the other epidemic: anorexia.

Yes, of course, we must attempt to prevent obesity and we must provide treatment to those who need it. And we must encourage fitness and healthier lifestyles, with low calories diets and less sedentary behavior. But we must do this in a way that does not a) ignore the influences of the social and physical environment, b) damage the mental health of overweight people, or c) push more young people into anorexia. Instead, comprehensive community-based campaigns are needed that will change zoning practices, get employers to create healthy work environments, and motivate restaurants to focus on smaller portions that contain fewer calories.