A LINE ON LIFE

1/15/95

The Overweight Society *

David A. Gershaw, Ph.D.

After feasting during the holiday season, many of us want to lose the weight we have gained. But obesity weighing 20% or more above our ideal weight is a year-around problem with almost one-third of all adults in the United States. The proportion of obese people has doubled since 1900 and is still rising. Over 50% of all health care costs in our society costing about 39 billion dollars annually is due to diabetes, high blood pressure and cardiovascular disorders, which are related to obesity.

Minority groups are not immune to the fat trend. The proportions are higher and seem to be rising faster than for whites. For example, experts estimate that 50% of African-American women are obese.

Diets don't seem to be the answer for most obese people. Only about 5% of dieters maintain their slimmer figure. The remaining 95% regain some, all or more than the weight they lost. Several problems are caused by this "yo-yo syndrome." First, when dieting, the metabolism slows down to compensate for the lack of calorie intake on crash diets. When we resume our non-diet eating habits, the lowered metabolism allows you to gain weight with fewer calories. Second, the lack of success in maintaining the lower weight may lead to depression. (However, this has not yet been supported with scientific data.) Third, the physiological stress caused by this "yo-yo" trend might lead to greater risk of cardiovascular disorders and possibly death.

Psychologist, Kelly Brownell (Director of the Yale University Center for Eating Disorders) and his associates followed 12,500 men who were at high risk for heart disease. Over a period of four years, those who "yo-yo-ed" in weight had higher rates of cardiovascular disease. However, the "yo-yo-ing" did not increase the risk for obese people. In contrast, the "yo-yo" effect seemed to pose the greatest risks for those who were slightly overweight or not overweight. Brownell concluded that finding a healthy weight that can be maintained is better and less frustrating than trying to reach an unrealistic ideal. Unfortunately, a similar study has not been done with women.


"Knowing the benefits of losing weight is one thing,
but actually losing the weight is another
."

Rather than going on a diet which you expect to end at some time in the future it is much better to make a lifestyle change that you can continue for the rest of your life. Only about 10-20% of obese people are ready to commit themselves to such a change. When they are ready, then we can help by supporting the nutritional and exercise changes that are needed. For the other 80-90%, any attempt to push them to change is futile. As hard as it might be for us, we have to wait until they decide to change.

Genetic dispositions don't seem to be the major reason for our obese population. Our genetic pool hasn't changed significantly in the last 100 years, but our culture has. Our culture seems to sabotage attempts to maintain sensible eating habits. Our children are exposed to 10,000 food ads each year on television. Millions of dollars are spent on marketing and advertising food. ("Try our new bacon double cheeseburger with fries and a coke for just $1.95!") With our fast-food chains moving into other cultures, these countries will probably join our obese club. In addition, our culture is flooded with energy-saving devices escalators, automatic door openers and TV remote controls which reduce our levels of exercise.

As with most other disorders, obesity is easier to prevent than it is to correct. Even so, any prevention program would have to make great changes in our culture. As one possible remedy, Brownell suggests government regulations of high-fat foods similar to tobacco or alcohol. These might restrict advertising to young people or even add a "Twinkie tax" to fattening foods to regulate their prices.

Even if our culture does not change, being aware of our obesity-promoting culture can change our image of obese people. Rather than viewing obese people as being weak willed or "psychologically maladaptive," Brownell sees them as being manipulated by a culture which promotes a calorie craze.


* Abstracted from Beth Azar's article, "Mixed messages fuel dieting dilemmas," in the APA Monitor, November, 1994, pages 1, 22.

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