When the Surgeon General talks, people listen. He says that obesity is our number one health problem. He has not named number two.
When the CDC speaks, people pay attention. They tell us that obesity kills 300,000 Americans a year, almost as much as smoking.
Television is running obesity stories every night. You don't even need the sound on to know when these stories are coming up. That's because every network has its own "Parade of Big Bellies and Butts" footage that they run with every obesity story.
The experts and attorneys are getting ready for the inevitable litigation and legislation. They're warming up their hyperbole muscles and upgrading the college they think they can afford for their children.
Americans know there's a crisis. Not being scientists, generally, we translate what we hear into something like the following: "We're really fat and getting fatter and that's not good for us." Everybody seems to agree. And when everybody seems to agree, it's usually a good idea to step back and take stock of the situation.
Are we, as they tell us, "fat and getting fatter"? Well, to parody a former US President, "It depends on what you mean by fat."
For most of the history of this country, weighing a lot was considered a sign of prosperity. It was a good thing. That is, until the early part of the last century.
That's when a fellow named Louis Dublin began gathering information that might determine what a healthy weight was. He was following a general line of scientific inquiry of the time, but with commercial incentive. Louis Dublin was the chief actuary for the Metropolitan Life Insurance Company.
Metropolitan published its first set of height/weight charts in the 1940s. They were based on awful data, but they were all we had and, perhaps more important they established, "thinness" as a goal. Right after the publication of those charts the first of many diet crazes swept the country. Purveyors of diet books and exercise videos and all that equipment that's supposed to "melt off pounds instantly" should get down on their knees every night and thank God for Louis Dublin.
The Met charts established the weight to beat if you wanted to be slim. The charts have been revised several times since the original publication, but they're no longer the official standard for determining when a person is overweight. That is now something called the Body Mass Index.
The Body Mass Index (BMI) is basically the ratio of height to weight. And it doesn't measure how fat you are.
To take an extreme example, let us consider Mr. Arnold Schwarzenegger. You probably wouldn't call him obese, but the CDC would. According to his current bios, six-foot-two Arnold weighs 257 pounds. That computes to a BMI of 33 which is well into the obese range.
The problem here is that BMI doesn't take into account body type or how much of that body is fat and how much is muscle. It's just a fancier form of the height/weight chart.
Just to add to the fun the government changed the definition of overweight. Before 1998 a man with a BMI of 27.8 or higher was considered overweight. That threshold was dropped to 25 to bring it in line with the World Health Organization standards.
That's where the "epidemic" thing gets interesting. By changing the definition the government immediately and drastically increased the number of people considered overweight. But when you hear about how the number of overweight people has increased dramatically between 1990 and 2000, you'll hear nary a peep about the standard changes.
But enough picking at the statistics and definitions. The reality is that too many of us probably weigh too much. But the reality is also that the problem almost certainly isn't as bad as it's being portrayed.
Let's go back to basics and common sense. If we're getting fatter it's because, absent a glandular condition or genetic heritage, we eat too much of the wrong stuff and sit around more than we should.
More than half of us don't exercise at all, not even regular walking. If we exercised more, even moderately, we'd probably feel better.
Americans eat a lot of fast food filled with refined sugars and grains and fats of all kinds. And the portion size for those meals has been getting bigger and bigger.
I love cheeseburgers. Twenty years ago the average cheeseburger added 333 calories to my diet. Today's cheeseburgers average 590 calories and the fries I like to have with my cheeseburger have rocketed upward from 210 calories to 610. That's the kind of statistic that makes some folks want to sue.
A year or so ago that's what two teenagers did. They sued McDonald's because they said the company made them fat. That suit was thrown out, but we'll see more like it. In fact, there are at least seven different lawsuits currently working their way through the courts.
We'll also see legislators battling to get in front of the cameras to sponsor a bill that will become a law that will solve the fat problem. Already there have been a dozen or so obesity-related bills introduced in the House and Senate, and many more in various state legislatures.
My daughter, Diana, has always been a big girl. She's got a big frame. There are muscles on that frame, too. Diana is immensely strong. But over the last couple of years there got to be more and more padding on that frame and a few months back Diana decided she'd had enough of it.
"I was fat," she says. That's her word choice. Di weighed 222 pounds on a 5'5" frame. She figured out that she was fat by looking in the mirror.
That's a way you can tell if you need to lose weight or not without checking charts and indexes and scientific journals. Grab your gut. If you can get a couple of good handfuls, there's probably too much of you. If you can't do that, then you're probably not fat, no matter what the charts say.
"I had to decide that I was fat and then say that word to myself out loud before I could change my behavior," Diana says. She started paying attention to what she ate and exercising more. That's a pretty good plan for most folks who want to get rid of fat. Take in fewer calories. Eat healthier food. Exercise more to burn calories.
Start with the food. Di's now eating more of the stuff she thinks is healthy and less of the stuff she knows isn't. Because she works as a supervisor for Best Buy she's got a weird schedule and sometimes that means she'll surely eat at some fast food restaurants.
Since she knows that, she did her homework. Di hit the Web sites for all the fast food chains around her home and office and figured out how much she can have of what food and still stay on her program.
She's found a few surprises. Take salads. When most us hear the word "salad," we think "healthy". But McDonald's new Crispy Chicken Bacon Ranch Salad with dressing delivers 660 calories and 51 grams of fat. That's 80 calories and 18 grams of fat more than the Big Mac.
Diana goes to the gym five days a week most weeks. Next week she'll be off on a camping trip with friends so she'll miss a few days. That's OK. This is supposed to be a sensible program, not a form of penance.
How's it all working? Di's been on her program for three months. She's lost 27 pounds. She feels better and she feels better about herself. What she's done will work for most people who decide that they want to lose weight.
Diana's program started in her head. She had to decide she needed to change before she could work out any kind of program. She saw it as a change in lifestyle, not a weight loss program.
Then she pursued a sensible program that fit the life she lives and she's stuck to it with discipline. Part of the discipline is monitoring, which is a fancy form of paying attention. You can monitor intake with a food diary. You can monitor your weight by using a scale frequently.
When I was planning this piece I talked to Di and asked her if it was OK to tell her story. "Sure!" she said, "Everybody at work knows. I tell everybody what I'm doing and how it's going. It's part of how I stay motivated."
Then I asked her what her ultimate weight goal was. "I don't know yet," she said, "I'll know when I get there."
When she makes that decision, it won't be based on some government study or some over-hyped media story about fat Americans. Di will make her decision about the right weight for her based on how she feels and how she feels about herself. That seems to me like the only standard we need.
