Three important medical experiments were done in the 1950s. One involved college students fed a liquid diet supplement called Metrical to supply their total daily calorie needs. When researchers doubled the caloric content without their knowledge, the students automatically reduced the volume they drank by 50 percent and, correspondingly, increased to twice the basal amount when the content was halved.
The second involved young children. They were given free access to a spread of food presented buffet style. Foods high in sugar and fat-like cookies, cakes, and Twinkies-were placed in the most accessible positions, and the fruits and vegetables were harder to reach. After a short interval, the children selected a balanced diet, including vegetables that contained calories that appropriately matched their age and calculated metabolic rate.
The third group of experiments involved prisoners and conscientious objectors. They were given special privileges as incentives to gain weight while being given free access to an appealing buffet of gourmet food and desserts. Over three months' time, they were able to gain weight, some as much as 20 pounds, others a much smaller amount. To do so, they had to increase their basal calorie intake by as much as 100 percent to sustain the gain. When the special privileges were revoked, but not the access to food, all but two of the group rapidly returned to their start weight. The two who didn't lose were moderately overweight at start and were members of families where almost all were significantly overweight or massively obese.
My 30 years spent treating patients with serious obesity and seriously ill patients undergoing severe metabolic stress has left me thoroughly convinced that few of us can auto regulate our body weight. Many in our society hold a contrary bias, blaming obesity on lack of will power, motivation, or other character defects. There certainly are a lot of character defects and personality problems among the obese. My view, which the literature supports, is they're no more common than those in normal weight or thin people. In fact, depression and low self-esteem are more often a result of obesity.
So what does this have to do with social responsibility? I noted recently President Bush and his advisors challenged the World Health Organization's indictment of our high-calorie, high-fat, high-sugar, super-sized American diet. He was accused by some of catering to the interests of the big food companies. I believe he was right to do so. There's little science to support a causal relationship between easy access to snack foods and fast foods and unrestrained eating behavior as the cause of obesity. There's much to support it being a very complex metabolic disorder mediated by genetic predisposition. Physical exertion, particularly in the context of our jobs, probably has a more direct role to play than diet in those of us who struggle continuously with being 15 to 20 pounds overweight.
Tragically, based on our fashion model view of the ideal body, we often exhibit a prejudice towards the seriously overweight that rivals the worst racial or sexual discrimination. Removing candy bars and sodas from school vending machines may sound like a good idea, but it's as irrational as castigating those who eat and drink them. We are what we are, not what we eat.
There's no doubt a diet appropriate in calories, fat, and protein is healthier, and regular exercise is a prerequisite to maximal health. We, as a society, should encourage regular exercise both in our schools and work sites. Individually and collectively, we should learn to make good choices about diet and encourage the fast food industry to provide more wholesome menus.
Meanwhile, those of us who must are back on our weight reduction diets. Soon, the molecular biology revolution will produce a much more sophisticated understanding of the causes of obesity and develop an effective treatment, just as we have for hypertension. Until then, cut us some slack; we're working on it.Obesity and Social Responsibility
Three important medical experiments were done in the 1950s. One involved college students fed a liquid diet supplement called Metrical to supply their total daily calorie needs. When researchers doubled the caloric content without their knowledge, the students automatically reduced the volume they drank by 50 percent and, correspondingly, increased to twice the basal amount when the content was halved.
The second involved young children. They were given free access to a spread of food presented buffet style. Foods high in sugar and fat-like cookies, cakes, and Twinkies-were placed in the most accessible positions, and the fruits and vegetables were harder to reach. After a short interval, the children selected a balanced diet, including vegetables that contained calories that appropriately matched their age and calculated metabolic rate.
The third group of experiments involved prisoners and conscientious objectors. They were given special privileges as incentives to gain weight while being given free access to an appealing buffet of gourmet food and desserts. Over three months' time, they were able to gain weight, some as much as 20 pounds, others a much smaller amount. To do so, they had to increase their basal calorie intake by as much as 100 percent to sustain the gain. When the special privileges were revoked, but not the access to food, all but two of the group rapidly returned to their start weight. The two who didn't lose were moderately overweight at start and were members of families where almost all were significantly overweight or massively obese.
My 30 years spent treating patients with serious obesity and seriously ill patients undergoing severe metabolic stress has left me thoroughly convinced that few of us can auto regulate our body weight. Many in our society hold a contrary bias, blaming obesity on lack of will power, motivation, or other character defects. There certainly are a lot of character defects and personality problems among the obese. My view, which the literature supports, is they're no more common than those in normal weight or thin people. In fact, depression and low self-esteem are more often a result of obesity.
So what does this have to do with social responsibility? I noted recently President Bush and his advisors challenged the World Health Organization's indictment of our high-calorie, high-fat, high-sugar, super-sized American diet. He was accused by some of catering to the interests of the big food companies. I believe he was right to do so. There's little science to support a causal relationship between easy access to snack foods and fast foods and unrestrained eating behavior as the cause of obesity. There's much to support it being a very complex metabolic disorder mediated by genetic predisposition. Physical exertion, particularly in the context of our jobs, probably has a more direct role to play than diet in those of us who struggle continuously with being 15 to 20 pounds overweight.
Tragically, based on our fashion model view of the ideal body, we often exhibit a prejudice towards the seriously overweight that rivals the worst racial or sexual discrimination. Removing candy bars and sodas from school vending machines may sound like a good idea, but it's as irrational as castigating those who eat and drink them. We are what we are, not what we eat.
There's no doubt a diet appropriate in calories, fat, and protein is healthier, and regular exercise is a prerequisite to maximal health. We, as a society, should encourage regular exercise both in our schools and work sites. Individually and collectively, we should learn to make good choices about diet and encourage the fast food industry to provide more wholesome menus.
Meanwhile, those of us who must are back on our weight reduction diets. Soon, the molecular biology revolution will produce a much more sophisticated understanding of the causes of obesity and develop an effective treatment, just as we have for hypertension. Until then, cut us some slack; we're working on it. IBI
