TCS Daily


Getting the Skinny on Fat

By Radley Balko - June 25, 2004 12:00 AM

Editor's note: Frequent TCS contributor Radley Balko recently covered the Williamsburg obesity summit and filed several dispatches. This is his final installment.

In writing a wrap-up of the TIME-ABC News Summit on Obesity, I thought it might be best to take a week or so to review my notes and process all that went on. Perhaps a theme might emerge that would enable me to weave the anecdotes, quotes, and outrageous public policy proposals bandied about in Williamsburg that would have been amusing if it weren't for the fact that they have steadfast supporters in statehouses, regulatory agencies, and up on Capitol Hill. What follows are a series of stories, observations, and comments from various aspects of the conference that didn't fit neatly into my other dispatches. Perhaps the best way to do this is to simply run off a list of themes, quotes, and stories that emerged while I was there.

~

The odd prospect of two major, mainstream news organizations sponsoring an event like this hit home for me during a panel discussion on the conference's final day entitled "Media: Part of the Solution or Part of the Problem?" One of the panelists, Wall Street Journal reporter Sara Ellison, summed up my thoughts succinctly.

"I think that my mission, as it relates to this and any other topic is just to try and keep people honest. And I think that one of the dangers that the media has is to actually adopt a mission related to any particular topic. When I heard the subject of this panel, it said, "Part of the Solution, or" and I thought I've never actually thought of myself as part of a problem or a solution. It's really our job to be as objective as we can be..."

An idea shared by precious few of Ellison's colleagues at the summit. She went on:

"I think that the media loses its creditability if it becomes an advocacy or an - any organization. I mean I think one of the things that I always get when I write a story is people who are unhappy on both sides ..."

Ellison was one of the few reporters there who remained loyal to the quaint notions of detachment and objectivity. I was in the press room during a panel on marketing and advertising food to children, which was televised on the press room monitor. During the panel, food activist Marion Nestle of New York University decried the way food companies tell children that they should have their "own food," and that food should somehow be fun. "That," Nestle said, "is the most insidious thing of all."

I thought that was a pretty ridiculous comment. It was then that I overheard a reporter for a diet website say to a reporter covering the conference for a major national newspaper (I probably shouldn't identify either, given that this is hearsay, and neither was speaking on the record), "She's right you know. Food shouldn't be fun for kids. Food is fuel. If kids want to have fun, they should play football." The newspaper correspondent voiced her agreement.

Back to the media panel. After Ellison's remarks, Good Morning America's Anne Pleschette Murphy chimed in on the "advocate or reporter" question:

"Well I would happily say I think I'm part of the solution in the sense that, you know, definitely the mission of the parenting unit at "Good Morning America" is to not blame parents, but try to help them find solutions, particularly when it comes to feeding your kids, which is an extremely complicated and fraught issue from the get-go. So I do feel that many of the pieces we've done, if not all of them, have been aimed at either inspiring, or empowering, or certainly not exploiting the issue of kids and obesity."

Also on the media panel was Paul Campos, author of the controversial new book The Obesity Myth, and one of the few voices of dissent at the conference. Campos isn't a journalist, and his book doesn't devote much space to the media. So I'll leave it to you to speculate why one of the few people questioning the obesity hysteria was thrown onto a media panel on the summit's last day. More remarkable, however, was the reaction to Campos. His co-panelists not only dismissed him, but refused even to take him seriously. Conference attendees pelted him in the question and answer session. And here's what TIME sciences editor Philip Elmer-Dewitt said as the panel concluded:

"Paul, we may disagree entirely with your point of view. But we respect your right to express it."

Here's the editor of perhaps the leading newsweekly in the world, stating rather matter-of-factly his position on an issue it's his job to cover objectively. But he wasn't alone. On June 2, ABC News' World News Tonight With Peter Jennings ran a segment by Dr. Tim Johnson, the network's resident medical correspondent. The segment focused on the debate over obesity, and interviewed Campos, who said on-camera:

"The public health message that Americans are getting, which is that they ought to slim down, really doesn't make sense. It's fundamentally irrational."

Cut back to Johnson, who feels the need to label such apostasy:

"According to Mr. Campos, "much of the highest profile obesity research being done turns out to be little more than propaganda." He argues overweight people who exercise can be just as healthy and live just as long as leaner people. Campos's charges are so extreme, we went to top researchers, including Meir Stampfer at the Harvard School of Public Health. He says Campos is wrong."

The kicker comes at the end of the segment. Instead of allowing viewers to judge for themselves who's right, Dr. Johnson decides to decide for them:

"Bottom line, whether you're fit or not, how much you weigh does count. Dr. Timothy Johnson, ABC News, Boston."

If Johnson already knew the answer, what was the point in even running the segment? It gets better. At the end of the conference, we got summary speeches from TIME editor-at-large Claudia Willis and from TIME's president, Eileen Naughton. Willis went first, and listed the things everyone in attendance apparently agreed upon. The first was:

"We've all heard the long list of chronic diseases associated with obesity and their frightening cost in medical dollars, in lost productivity, in lost lives, and unmeasurable suffering. So we all agree on the size of the problem, I think."

Well, no we don't. At least Campos doesn't. And in fact, he isn't alone. The New York Times last week profiled Rockefeller University's Dr. Jeffrey Friedman. Friedman's been looking at body weight data over the last fifteen years, and has concluded that we aren't all getting fatter, that in fact only the very obese among us are getting significantly bigger, which is pushing the distribution curve rightward. Willis went on:

"...we agree that the American consumer needs to be better educated about nutrition. And we've heard a variety of ways to do this, ranging from PSAs, better labeling, the food pyramid effort, to programs in schools."

Perhaps we can all agree that we should be better educated. But I'm certain that there isn't universal agreement on any of Willis' suggestions as to how to do that. Government-funded PSAs aren't likely to have much effect, and amount mostly to a waste of taxpayer dollars. School-based programs often cause more harm than good. And there are certainly valid objections to both the food pyramid and to forcing restaurants to label menus with nutritional information.

TIME president Eileen Naughton then took the stage, and delivered this whopper:

"I would have loved the aha moment two or three times where we had great consensus up here and said fine, we're going to end advertising of sweet products to children now. And if [Federal Trade Commission Director Timothy] Muris could have delivered that, it would have been fabulous.

"But I understand why in this country, which has so many wonderful liberties that you can't just trash on, you know, free speech, and first amendment rights."

Now we have the president of perhaps the most prominent newsweekly in the world lamenting that conference attendees couldn't have come to an agreement to ban a form of speech. And back to Dewitt, who promised:

"We're going to keep [food] companies' feet to the fire, and this is not the last you're going to hear from TIME magazine on the subject of obesity."

None of this should have surprised me, I guess. We were told several times that the summit was inspired by Peter Jennings' primetime special last December, polemically titled "How to Get Fat Without Really Trying," and in which Jennings openly pled for government action.

~

On the conference's second day, we were served what was billed as "The New School Lunch," a collection of sprouts, twigs, and sauces that looked more like the lunch menu at Nordstrom's than anything I've ever seen in a school cafeteria. It seemed wholly implausible to me, so I found someone who knows a think or two about school lunch programs to access its feasibility. Her name is Renie Kelly, and she's the director of the school lunch program for the Cincinnati public school system. She took me through the menu:

Roasted Turkey and Buckwheat Pasta Salad with Fresh Peas and Spring-Dug Parsnip.

"Kids won't eat it," Kelly said. "The turkey's fine, and maybe the pasta salad. But I can't see them eating peapods and parsnip."

Spring Greens Salad with Raisins and Dried Cherries.

"Every principal in the country would veto this. Most all of our principals don't allow raisins, because kids throw them. I'm sure it would be the same with dried cherries."

Fresh Asparagus with Lentil and Herb Vinaigrette.

"Asparagus is too expensive to ship and keep fresh. And again, the kids won't eat it."

Fresh Strawberries on Semolina Toast with Local Honey.

"Have you ever given honey to big group of kids? It's an absolute nightmare to clean up. It sticks to everything."

Kelly's in charge of 22,000 meals a day, including 12,000 lunches and 10,000 breakfasts. She estimates that the items served at the conference as the ideal school lunch would run about $3 per lunch. Under the national school lunch program, Kelly shoots for 72-cents per lunch, 70 if she can manage it.

"This just wouldn't work, for lots of reasons," she said.

~

One of the more amusing moments at the summit came courtesy of the Center for Consumer Freedom. The group represents restaurant and food interests, but does so in a way that's pretty irreverent, confrontational, and, well, funny.

They stocked the pressroom with what they called an "Obesity Prevention Kit." It included a pocket-sized compact labeled a "Common Sense Obesity Warning." Upon opening it, you discover it's a mirror. They also included an amusing ad they took out in the special obesity issue of TIME, a white paper countering the claims put forth by the nutritionists and food activists, a pedometer, and a "Common Sense Obesity Glossary," which included entries such as:

· Small adj. : A portion size generally containing less food than a "large" or "medium."

· Doggy Bag n. : A sack, container, box, etc. to hold what you paid for but don't have to eat (today).

· Large/Grande adj. : Biggest serving for an individual. Will contain more calories than its "small" and "medium" counterparts.

· Sharing n. : Giving a portion of your own food to another; generally reduces caloric intake.


I commiserated with the Consumer Freedom crew over dinner on the second night of the conference. We opted for a local steakhouse instead of eating high-fiber, low-fat goods against the backdrop of an Andrew Weil lecture. At the steakhouse, I had a large-cut filet mignon slathered in garlic butter; a bowl of cream-based seafood soup; starchy, high-carb mashed potatoes; sautéed mushrooms; batter-dipped and fried calamari; and crème brouleé for desert.

I expected to burst into flames upon returning to the summit the next morning.

~

A few notable quotations from various obesity summit participants in my notes that didn't neatly fit elsewhere:

  • "There's an African proverb that says, 'when elephants war, the grass dies.' With the debate over obesity, in my mind, the children are the grass."

--Robert Wood Johnson Foundation President Risa Lavizzo-Mourey

  • "I think it would be a huge mistake if we failed to learn the lessons of the tobacco industry. And one of those mistakes is too much focus on 'personal responsibility.'"

--Yale University professor and nutrition activist Kelly Brownell.

  • "20 years ago we were looking at development of healthy category foods. And we tested it and tested it and there was no interest. I'm happy to see that there's an interest today in healthy eating and healthy food."

--Ann M. Fudge, Chairman and CEO of Young and Rubicam, making the rarely mentioned but obvious point that if consumers want to eat healthy, the food industry will produce healthy food.

  • "Even our dogs and cats are fat. And it's not because they're watching too much advertising."

--Federal Trade Commission Chairman Timothy J. Muris.

  • "A ban on advertising is impractical, ineffective and illegal. It's impractical because the truth is that kids get most of their information from adult shows, not from kid shows. It's ineffective because of the reasons that Ann mentioned. In places where a ban's been tried, it hasn't had an impact. And quite frankly, under our 1st Amendment, it's almost certainly illegal."

--Muris.

  • "In fact, if you banned advertising on shows that were watched by 50 percent or more of kids in 1981, you would've reached one show, "Captain Kangaroo." And the result would've probably been to drive the good captain off the air... There are lots of things that government can do, but I don't think government can prevent children from nagging their parents."

--Muris.

  • "I'm having a hard time believing that the founding fathers, when they wrote the amendment to the Constitution, had in mind advertising to children."

--NYU professor and nutrition activist Marion Nestle.

"Personal responsibility is a trap."

--Nestle and Brownell, in the TIME magazine special issue put out in advance of the conference.

  • "[Winning the war against obesity] will happen by little increments of inches led by food cops in Texas. I so admire Susan Combs."

--TIME President Eileen Naughton, expressing her admiration for the Texas agriculture commissioner who banned sweets - including bake sales - from the Texas public school system.

  • "[T]here are many doctors, scientists, nutritionists, sociologists, psychologists, eating-disorder specialists, et cetera, who would strenuously disagree with the entire orientation of this conference in its implicit, or usually explicit assumptions, that (A) we have a huge public health crisis in America because of increasing body mass, and (B) that the way to improve public health in America is to try to make people thinner. There are a huge number of people who disagree with that, and they just don't get the kind of media coverage that they ought to.

--Paul Campos, author of The Obesity Myth.

  • "[We have] genocidal rates of obesity among communities of color, and that's something that's not reported."

--Ann Pleschette Murphy, parenting contributor to Good Morning America.

  • "African-American women with a BMI of 37 have essentially the same mortality rate as African-American women with a BMI of 20."

--Campos, responding to Pleschette.

  • "The first couple of times I watched [Fox's TV reality series] The Swan, I was appalled that I didn't see any women of color on that show. The whole issue of weight loss to me is the inherent racism."

--Washington Post medical and health writer Sally Squires, making no sense whatsoever.

  • "I think that every single obesity researcher and public health official who says, "You have to have a BMI below X to be healthy" and "if you have a healthy life style, you will have a BMI below X " should be asked the following two questions by the media:

"Do you have a BMI below X?" And, "Do you have a healthy lifestyle?"

"Because in a majority of the cases...the answers would be, "No," and "Yes," respectively. And those would be accurate answers. In other words, a very significant portion of the people who are haranguing the American public on this, literally embody a contradiction of their own views."

--Campos.

  • "We don't need a 'grease police.' You have to realize that when you ban things, Americans get angry, and they're going to rebel and consume them like never before."

--Arkansas Gov. Mike Huckabee.

  • "We turned them around when we weighed them."

--Dr. Joe Thompson, director of the Arkansas Center for Health Improvement. Thompson oversaw a program that weighed every child in select public school districts, identified those overweight, and sent letters home to their parents. Thompson was responding to the criticism that the program unduly emphasizes weight, and fosters unhealthy relationships between children and weight, particularly among teen and pre-teen girls.

~

On the second day of the summit, a new study from the National Center for Health Statistics reported that cancer rates have been steadily dropping by about a half percentage point per year since 1990. Cancer deaths over the same period declined by about 1% per year. This struck me odd, considering that we keep hearing how fat we've gotten over that period, and that there's an unquestionable link between fat and cancer.

Curious, I called the American Heart Association. The link between fat and heart disease is alleged to be even stronger than the link between fat and cancer. Those numbers were even odder: Cardiovascular disease is down 16.5% since 1990. Coronary heart disease is down by nearly 25%. And incidence of stroke is down 10%.

Perhaps this is all attributable to the fact that more and more Americans are giving up smoking. So I checked those statistics, too. No dice. The number of smokers in the United States dropped only from 25.4% to 22.1% from 1990 to 2001, arguably enough to explain the drops in obesity and cancer by themselves, but certainly not enough to explain the drops and compensate for the increase in those diseases we should be seeing due to obesity.

So what of the alleged strongest link of all - obesity and diabetes? According to the Center for Disease Control, diabetes has increased substantially in the last two decades - cases have more than doubled since 1980. But the CDC attributes much of this increase to changes in methodology, not changes in lifestyle. Indeed, the biggest one-year jump in the period comes between 1996 and 1997, the year the new survey methodology was implemented. The CDC also notes that 40% of diabetes cases occur in those 65 or older. Given that the largest generation in U.S. history is at or near that age, it only makes sense that we'd see a rise in obesity levels. The elderly, incidentally, are also the one age group least likely to be obese.

This isn't to definitively say people like Paul Campos and Jeffrey Friedman are right, and the obesity warriors are wrong. But it is to say that we ought to have a debate, and the debate shouldn't be premised on the notion that we're already in full crisis mode, the sky is already hurtling earthward, and that the only real debate ought to be over which panoply of government programs we ought to implement to keep earth and sky from colliding.

There are compelling arguments to be made, for example, that activity level is a far better indicator of good health than weight. That is, thin but sedentary people are quite a bit less healthy than active but overweight people. That assertion is certainly borne out in morbidity statistics. There are also compelling arguments to be made, as Friedman does, that the vast majority of the U.S. population isn't significantly or dangerously heavier than we were ten or fifteen or twenty years ago.

Let's first take the time to be sure we really do have the problem, and that the obesity hysteria doesn't soon go the way of media coverage of the "rash" of shark attacks and child kidnappings. Let's second take the time to be sure that if there is a problem, we define it accurately, based on sound science, and not on the dire predictions of a few people who have made careers of demonizing food.

Finally, even if we were to assume the worst-case scenario put forth by the anti-obesity activists, there's still a pretty sound case to be made that the whole issue is very much a private matter between overweight/obese people and their families, and shouldn't be addressed with invasive, far-reaching public policy that removes choices and restricts personal freedom.

That, too, is a case that needs to be made, but that you don't often find in the mainstream media.

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