Monday, December 20, 2010

The Politics of Obesity

By Dr Stuart Jeanne Bramhall

There is a lot of focus in the mainstream media on the growing epidemic of obesity in western countries. The media pretty universally places the blame on individuals. Overweight adults are guilty of "poor lifestyle choices" while obesity in children is blamed on the failure of the parents to control their kids' unhealthy lifestyle choices. This emphasis on "poor lifestyle choices" has led many pundits to call for a "fat tax" to penalize Americans for buying fast food and junk food. In my view, this flies in the face of all medical and epidemiological research regarding the causes of obesity.

Why Neoliberalism Promotes Individual Solutions

I am always very skeptical whenever I see any major social problem transformed into a personal problem that can only be solved by individuals and their families. Mainly because the ideological notion that only individuals can solve community problems has been part and parcel of the neoliberal economic agenda rolled out by Milton Friedman in the seventies in eighties (first in Chile and ultimately by Ronald Reagan and Margaret Thatcher). In fact Thatcher said as much: "There's no such thing as society - only individuals and families."

Moreover a look at the editorial content of the Reader's Digest and other periodicals associated with CIA propaganda efforts suggest they actively promote individualism as an ideology (see The CIA's infiltration of America's mainstream media via their controversial Project Mockingbird is discussed in the 2007 memoir of convicted Watergate "plumber" E. Howard Hunt: American Spy: My Secret History in the CIA, Watergate and Beyond.

Individual Solutions Have Never Worked for Obesity

There is really no reason why the obesity epidemic should different from other epidemics. In fact the political and social factors underlying obesity are a lot more obvious than with most infectious diseases. For nearly five decades, doctors and weight loss franchises (such as Weight Watchers and Jenny Craig) have tried every individual approach imaginable for weight loss - with spectacularly poor results. With a few well-publicized exceptions, the vast majority of dieters lose some weight and then overcompensate by regaining even more weight than they have lost. I would even hazard that the individual, case-by-case approach to obesity will remain pretty hopeless until the underlying social and political causes are addressed.

Political and Social Causes of Obesity

In my view, the political and social causes of obesity fall into two broad categories: ideological (corporate messaging that triggers unhealthy eating) and economic. I include under economic America 's for-profit, insurance-dominated health care system, which I view as the single reason why Americans are the most overweight nationality in the world (it's the single major factor that differentiates us from the rest of the industrialized world).

How Corporate Messaging Fosters Excessive Weight Gain

What is often overlooked in analyzing obesity is that 250,000 years of evolution have biologically programmed human beings to crave high calorie fatty and sugary foods. Food security was a life and death issue for the vast majority of our hunter-gather ancestors - who often went weeks or months without access to food. Obviously those genetically programmed to scarf as much high calorie food as possible when it was abundant had a much better chance of surviving to pass their genes to the next generation.

The corporate planners, advertisers, and psychologists who advise them are very much aware of the immense profits to be derived by exploiting this inborn tendency to crave high calorie foods. Which is the major reason we are all constantly bombarded by billboards, TV, radio, and print ads designed to create an irresistible desire for French fries, Big Macs, deep fried KFC chicken, and chocolate.

Economic Causes of Obesity

Epidemiologists have known for decades that rates of obesity are much higher in low income and minority groups. However it's only in the past few years that medical science has understood the mechanisms behind this finding. In my own practice I've identified four specific reasons for excessive weight gain in low income patients:  
1) Insulin resistance, also known as metabolic or dysmetabolic syndrome - which, according to epidemiologists, is linked to extreme income equality,
2) A system of government food subsidies that penalizes low-income Americans for making healthy food choices,
3) Refusal of major supermarket chains to operate in low income inner cities, and
4) For-profit, insurance-based health care system that deprives the vast majority of low income Americans access to regular preventive care and nutritional guidance.

How Insulin Resistance Relates to Low Income

I have written previously about income inequality being the primary driver of poor health (see click here). Epidemiologists point to vast statistical evidence indicating that the mother's income when she gives birth is the single most important predictor of her child's lifetime health status. Geneticists and microbiologists believe it relates to epigenetics - a phenomenon whereby early environmental influences determine the range of protein enzymes produced by specific genes.

One of the most important epigenetic effects is the development of insulin resistance or metabolic syndrome when a fetus is repeatedly exposed to high levels of cortisol and other stress hormones from the mother's bloodstream. Insulin resistance is a lifelong condition that causes glucose (blood sugar) to be preferentially stored, rather than utilized by the body. It results in serious appetite imbalance and a strong tendency towards weight gain. It's a common condition among disadvantaged minorities - among African and Native Americans in North American, as well as Maori in New Zealand and indigenous Australians.

Government Subsidized Junk Food

Michael Pollan and others have written eloquently on the problem of government subsidies on corn, soybeans, and wheat. Federal food subsidies started during the Depression - to protect small family farmers when the price they received for their crops fell below their overhead costs. With the advent of factory farming, these subsidies are mainly going to corporate food giants like Monsanto, Cargil and Archer Daniel Midlands - making it even harder for small farmers to compete with them.

These subsidies also enable Food Inc to sell Big Macs, candy, and starchy, calorie empty junk foods much more cheaply than healthy foods, such as vegetables, fruits and nuts. Subsidized corn provides 90% of the diet of beef cattle, as well as being processed into high fructose corn syrup - a cheap sweetener used in breakfast cereals, candy, soft drinks, and other junk foods - or, along with soy, into the oil fast food restaurants use to deep fry foods. With increasing unemployment, declining wages, and spiking food prices, fresh fruits and veggies are an unaffordable luxury for many low income families - leaving them no choice but to go for the government subsidized junk food.

Absence of Major Chains or Fresh Food in the Inner City

There was extensive NPR coverage several years ago when the last major supermarket chain closed in Detroit. However 21 of America's largest cities are experiencing what is known as an "urban grocery gap" - characterized by fewer stores and less square footage per store than in suburban. The poorest neighborhoods typically have about 55% of the grocery square footage of wealthier neighborhoods.  (See no or limited public transportation options, this many inner city residents have no choice but to rely on KFC or the corner store for their starchy, high fat, high fructose corn syrup meals.

Americans Don't Receive Preventive Care

Last but not least is the total is the virtual absence in the US of preventive health care - including nutritional counseling and advice -  a direct result of its for-profit, insurance-company dominated health care system. The weight gain caused by insulin resistance can be limited if identified early in life. As can that caused by a host of common nutritional deficiencies (omega 3, vitamin D, iron, folic acid, etc) that can cause appetite increase and weight gain if not identified and treated (the body tries desperately to compensate for deficiencies by making us overeat).

Unfortunately close to one-third of low-income Americans don't have a regular family doctor, much less access to preventive care. Preventive health services, to reduce the incidence of expensive chronic conditions like heart disease, strokes, cancer and diabetes, is an extremely high priority in other industrialized countries, which all provide publicly funded health care.

Most patients lose their insurance coverage when they develop severe chronic conditions. And the federal government (i.e. the taxpayer) covers the cost of their treatment via Medicare or Medicaid.

Ending the Obesity Epidemic

Public health and food policy experts have proposed a range of short and medium term solutions to the obesity epidemic. Unfortunately many of them, especially those involving federal policy, will be extremely hard to implement without addressing the root cause of the problem: namely the near total corporate dominance over both public information and federal, state, and government. Nevertheless I am listing some of them, as well as including a link to a national coalition seeking to end corporate interference in state and federal elections.**

  1. Banning junk food ads on TV

Viewers have already pressured the federal government to ban cigarette ads on TV, as well as pressuring the alcohol industry to self-regulate by not showing liquor ads prior to 10 p.m.

  1. Reducing income inequality (via fairer taxation) - the root cause of insulin resistance
Warren Buffett (the world's second richest man) is the most prominent American arguing for an urgent reduction in income inequality (see However other business analysts and economists are coming around to the view that economic recovery will never occur in the US without a "consumer recovery" which will be impossible until workers have adequate take home pay to enable them to purchase the goods they produce
  1. Eliminating federal agricultural subsidies
Last week Congress took the first momentous step of ending federal subsidies for school junk food lunches by passing the Child Nutrition Bill, which had been stalled for two years. The next step is to eliminate federal subsidies on corn, soy, and wheat. These were initially enacted during the Depression to keep small family farmers from losing their farms when there was an oversupply of these commodities causing a steep drop in the price they were paid for them. Now that these subsidies mainly go to corporate farm giants like Monsanto, Cargil and Archer Daniel Midlands, they actually hurt small farmers more than they help them. There is currently a proposal on the budget cutting table to eliminate the $14 billion in annual food subsidies, and citizens need to organize and get behind this proposal (see
  1. Abolishing "food ghettos" via the urban garden movement
What is happening in Detroit is truly inspirational. Housing foreclosures and vacancies have turned many blocks of downtown Detroit into empty, abandoned land - which local residents are converting into urban gardens to produce fresh fruits and vegetables. (see There are similar grassroots projects in Milwaukee (see ) and Los Angeles (see
  1. Guaranteeing access to preventive care (and nutritional counseling) by expanding Medicare to cover all Americans
The reality is that ObamaCare, Obama's corporate welfare plan for insurance companies, simply cannot be funded in a recession. It will have to undergo major amendment before it's fully implemented in 2014. The only affordable way to finance health care for all Americans is to eliminate insurance company profit, advertising and overhead from the health care equation by expanding Medicare, an highly popular, efficient, and economical program, to cover people under 65. (see

**Ending corporate interference in federal, state and local elections: via a national grassroots movement called Move to Amend. Move to Amend seeks to end the ability of corporations to claim Bill of Rights protections for something called "corporate personhood." The ultimate goal is to amend the US Constitution to reverse one hundred years of Supreme Court decisions that have granted corporations the same "rights" as individuals. This was clearly never intended by the Constitutional framers, many of whom wrote extensively about the risk of powerful corporations corrupting government. 

Go to and click on the "Move to Amend" tab in the lower left hand corner. Then click on the "Sign the Motion" tab on the right to add your signature to the 95,000 on the petition to amend the Constitution.

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