Friday 2 October 2009

Why are we obese?

So I do policy work in DC. Although most of my day is Stata and spreadsheets, staying up on the latest thinking is part of the job. Right now, there's a lot of very interesting thinking about obesity. I read so, so much of it, and I think about it a lot. I want to start working through a few of my thoughts about it. Essentially, my goal is to dig through some of the leading thinking about obesity, discuss whether it feels true to me, and hopefully hear back from you guys about whether these seem true in your life.

James Fallows of The Atlantic has recently had a really interesting series on obesity. (I can't find a unifying tag on his blog, but most of it is on the front page here.) I may talk about a few other of the letters at some point, but I wanted to start off with this one:

It is one thing for a successful, financially comfortable, socially accepted and respected person who has multiple things happening every day that are pleasurable (golf, driving a nice car, nice home, stylish clothing, success at work, interesting social events, kids doing well, planning vacations, etc) to take just one pleasurable aspect of life (overeating) and sacrifice some of that pleasure for the good result of losing weight.

Now, for people struggling financially and socially, trying to just get through the day and keep their lives together to varying degrees...their meals are often the only consistently happy and pleasurable events they can count on each day.

Obviously, a generalization. But, if one gets up and faces a day with a tedious and unfulfilling job, not much money to spend on anything but necessities, and no "fun" things ahead, how much more difficult it is for that person to also think ahead to a day of denying themselves the pleasure of their mealtimes....

(All the ellipses are original.) Another Atlantic blogger, Ta-Nehisi Coates, expounded on the idea, and his experience with it. I'm not going to block quote the post, but it's an interesting read. Coates picked up the attention of the Washington Post's Ezra Klein, who brought the situation away from the personal to the academically grounded:

This reminds me of Charles Karelis's "The Persistence of Poverty." The basic argument is that the wealthy misunderstand the mental state of the poor, which leads them to make conceptual errors when creating policies to address poverty, or, in this case, obesity. Think of a bee sting, he advises. If you have a single bee sting, you'll go buy some salve to take away the pain. Now imagine three bee stings, a sprained ankle, a burn, a cut, a crick in your neck, a sore throat, and arthritis. Does the bee sting matter anymore?

Karelis argues that this is more the situation of someone in poverty. Obesity is bad, but it may be just one of many bad things. Overdue bills. A horrible part-time job. Endless commuting time on the bus. A mother with diabetes. A child running with the wrong crowd. A leaking roof. In that scenario, slowly reversing your weight gain might be a good idea, but it hardly makes a dent in the overall crumminess of the conditions. It won't replace pain with pleasure. So you do things that are surer to replace pain with pleasure, like have a delicious, filling, satisfying, salty, fatty meal. That may make your overall situation more unpleasant, but then, making that situation pleasant didn't seem like an option in the first place.

And this, to me, screamed true, true true. Not just about poverty (which I've been fortunate enough not to experience) but with the other stresses in life. When I was in college, terribly stressed, depressed and constantly freaking out about what I was going to do for a career, losing weight just didn't make sense. I had all those other terrible things, and it just made so much more sense to do the things that made me happy now, that helped get me through the day. Even when I started my job in DC and was just getting set up here, I don't think I could've done it. There was too much else to stress about. Now, though, my little world is relatively under control, and I have the mental energy and willpower to devote to fixing my weight. I can work on curing this.

How do you guys feel about this theory? Do you think the success you're having now or failures you've had in the past are related to all the other things going on in your life? Or do you think this theory is a bit namby pamby, and feel like weight loss success or failure is independent of other things?

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