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Obesity

Air Date: 07/21/10 Dr. Rebecca Jankovich, PhD can be reached at 322-1839.ObesityAmbinder, M. "Beating Obesity". The Atlantic, May 2010, p.72-83.As a nation, we're getting heavier. Fifty years ago President Kennedy was concerned that 45% of adults were overweight and 13% were obese; for the next 20 years, until 1980, those obesity rates remained the same. But from 1980 to 2000, they doubled, and the rates are still rising. Today 65% of Americans are overweight and 30% are obese. Putting this into visual terms, in 1960 young women 20-29 averaged a weight of 128 pounds and by the year 2000 that weight average had increased to 157 pounds; in 1960 middle aged women 40-49 averaged a weight of 142 pounds and by the year 2000 that weight average had increased to 169 pounds. We consume an average of 2700 calories a day which is 500 calories more than we ate 40 years ago. And of all the developed nations, we're the fattest, having an obesity rate double that of many European countries. The simple answer to why we're getting heavier is that we're eating more and exercising less. Some scientists believe we have a "set point" for weight determined by our genes; the brain urges us to eat to maintain that set point. By eating high fat, high sugar diets, we mess with the set point and it rises with our poor eating habits so the brain propels us to keep eating to maintain the higher weight. Why do we eat more than we need? Because it tastes good; because we use food to make us feel better; because we use food to manage stress, anxiety, disappointment. If you answer yes to these questions, you could be using food to regulate your mood: Is food your friend when you feel empty or unloved? When you're angry at someone, including yourself, do you get the urge to eat? Do you ever eat to reward yourself? Do you crave food when you're down? Do you ever decide to eat because you're already fat so you may as well? We overeat because the people we hang with overeat. Researchers watched 12,000 Americans over 32 years studying weight; they found that being overweight is contagious. People who have close friends who are obese have a much higher chance of becoming obese themselves. We don't know why this happens: because you're hanging out with people who eat too much of the wrong foods and you join in? because you grow accustomed to seeing people in larger size? Americans have easy access to high caloric foods so we CAN eat more calories than we need. We seem to have lost the art of mindful eating where we are aware of all we put into our mouths. We rarely eat only at mealtimes; now you can eat all day long, grabbing high fat foods from vending machines, high sugar soft drinks while you sit at your desk. We don't eat a home cooked meal while talking around our dinner table, an eating style that tends to control weight gain; Americans spend half their food budget outside the home buying fast foods or eating huge restaurant portions.But there's more to it than calories in and calories out. There are environmental factors that impact weight. If the mother dieted or overate during pregnancy, the infant is more likely to struggle with weight throughout his or her lifetime. Lack of sleep causes weight gain. Exposure to certain chemicals or bacteria causes weight gain. Rural Americans are heavier than those who live in cities. Being poor or less educated is associated with weight gain. Black children, American Indian children, Hispanic children are all at greater risk of obesity than are white children. Black American women are 50% more likely to be obese than are white women. Researchers suggest that being poor increases weight because the poor have less access to health care that would educate them on nutrition and weight loss; poor neighborhoods have fewer supermarkets and more fast food restaurants. Less educated people, people who need to lose weight, are less likely to read the nutrition labels on foods. And then there's the impact of marketing and selling food. Kids who watch commercials luring them to eat high sugar, high fat foods are more likely to eat those foods. Grocery stores place the bad foods that call to us strategically so we take them home. The soft drink companies know how to get us to sip the 150 empty calories in a Coke.Some say we can learn from our country's campaign to improve cardiovascular health. Over a 50 year period, public education campaigns and policy changes showed Americans that smoking and high cholesterol was killing them. The death rates from heart disease dropped dramatically. Maybe Michelle Obama's campaign to change our children's obesity rates will start the ball rolling for the weight problems that are killing us. But 50 years is a long ways off and that leaves us with what we can do today.I went to a workshop for therapists on how to help people lose weight, hoping there would be some new insight. Nope. The same old adage: calories in and calories out equals weight loss. The way to lose weight is not some diet you only follow for 3 months. The way to lose weight is to count calories and exercise. To be more mindful of how many calories you're actually consuming, instead of grabbing that snack because your energy is flagging. To change the types of foods you eat to lower fat and sugar intake. To endure the frustration of not getting to have what you want when you want it. To accept you have to change your relationship with food to save your health.