The Unspoken Reality of the Obesity Epidemic: What the Experts Won't Say

From the fame of Michael Pollan to the outcry about agribusiness to the first lady's signature Move Your Body! program, it's impossible to ignore the American struggle with weight. The interest in the issue may be apparent, but the proposed fixes remain rudimentary. Anyone curious how and why the rate of obesity has skyrocketed in recent decades can find a growing library of well-researched, thought-provoking books. Looking for an expert speaker to summarize the country's dilemma? They abound.

However, if you're searching for an effective approach to the problem, you're in trouble. Some experts focus on regulation of agribusiness and the food industry, similar to the fight against tobacco, but that's a long-term project complicated by the fact that people can live without tobacco, but not without food. Others emphasize the truisms of the diet industry, eat less and move more, without divulging the fact that 99% of diets fail. So why would anyone believe the collective national diet will have any more success? And the physicians obsessed with "evidence-based" treatment are holding out for the miracle weight-loss drug while chastising their mostly overweight patients. That's no more than a pipe dream at this point.
Food and weight are not particularly complicated. The real issue is that no one wants to reveal the truths this country faces, much better to pretend that a magic solution is just around the corner.
The clear facts about food and weight are as follows. There is much more food available than ever before, and most of the increase is highly processed and inexpensive. The combination of successful marketing and the development of irresistible foods decreases any one person's ability to manage daily intake effectively. The regular person's life is much more sedentary than in years past. Chronic dieting leads to rebound weight gain  and a gradual weight increase over time. Due to these factors, rates of overweight and obesity have skyrocketed. 
Similarly, the facts about ways to fix the obesity problem are clear. None of the current suggestions work. If any one idea had merit, the word would spread like wildfire. As it is, every new crash diet or exercise program has its fifteen minutes of fame, while the well-meaning "healthy eating" programs are the neglected stepchild compared to the advertising and delectable offerings of the omnipotent food industry. Everyone is desperate for a new solution to cling onto, but no one wants to be clear about what really can be done.
The problem needs to be split up into two parts. First, what are the practical approaches for the currently overweight and obese? And the second part of that question no expert wants to address: what are reasonable goals for long-term weight loss? Second, what can the country do to ensure the obesity problem is limited to a few generations and does not become the new norm? Although the two pieces overlap, separating them clears up the difference between realistic expectations and activism.
Only one weight loss approach works. And it's completely obvious and intuitive. In order to change ingrained behavior, one needs a long-term, sustainable, consistent meal plan developed with a professional or a program since an individual who struggles with food inevitably reverts to old patterns without external intervention. That means working with a doctor, nutritionist or a reasonable program such as Weight Watcher's to implement and follow a clear daily approach to food. The plan needs to provide adequate calorie intake to sustain health and to stay within the person's energy needs. After years of excess food, it will take years for a body to adjust hunger cues and adapt its weight range to a lower food intake. All of the evidence makes it clear this is the only effective option.
There's a reason no expert will make this point. The diet industry preys on the collective desperation to lose weight now. Even the smartest, most experienced dieters know that no magic diet will ever work. Yet the masses suffer under the delusion that permanent, speedy weight loss is in their immediate future. No one will hear otherwise and no one is brave enough to face the wrath of saying it like it is.
What is the benefit of blowing the secret? And at this point would anyone really listen? No one wants to believe that the current overweight generation will remain overweight. Yet, with a little perspective, that fact is evident. As I have written before, chronic overeating drives up an individual's set point weight range. Since the body protects itself against weight loss much more than weight gain, as the set range increases, the low point of the range increases as well. The body will move easily within the range but will resist weight loss at the bottom of the range, even if the bottom of the range is still significantly overweight. Moving within the weight range is easy. Shifting the entire set range down is a much harder long-term proposition that involves sustainable, consistent decrease in food intake over years. It's not a big leap to realize how improbable that result is for an entire country.
It's important to recognize that even if this generation as a whole remain overweight, many individuals will find the right meal plan, rely on considerable support and gradually bring down the set weight range. As more clinicians and programs provide effective solutions, more people will find an approach to weight loss and maintenance that works. But the likelihood a country will do so is very slim.
In the fight against long-term obesity, the current generation will have a very specific role. The fate of the overweight generation is to attempt to reject chronic dieting in favor of a sustainable change in eating and live with the modest weight loss and health benefit. Adults can teach children how to survive the world of plentiful food and how to avoid the cycle of overeating and dieting and thus not become obese themselves. That's the topic of activism in the fight against obesity, and I'll address it in the next post.

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