Getting Fat

The eye-catching and seizure-inducing graphic above is an illustration of how the U. S. population became increasingly obese, year by year, decade by decade. It highlights this article at Atlantic:

By now everyone knows obesity is a serious issue, but it always helps me to see things moving and in color, and makes the “epidemic” terminology make sense.

and is apparently derived from this page at the Center for Disease Control site. The Atlantic article correctly notes the problem with using BMI as a sign of obesity.

Another problem has been pointed out. Self-reported obesity information may just point out that Southerners are more truthful than Northerners:

BIRMINGHAM, Alabama — The South often gets tagged with having the most obese population.

But it doesn’t appear to be true, a University of Alabama at Birmingham study suggests.

The study recently published in the journal Obesity found that there’s a significantly higher percentage of obese people in a region of central and northwest states including Minnesota, Kansas and North and South Dakota.

“What we found is the West North Central region has about 41 percent obesity compared to 31 percent obesity in the southern region that includes Alabama and Mississippi,” said George Howard, professor in the Department of Biostatics at UAB. “By the way, 31 percent is not a good thing — but it’s not at the bottom.”

How did Southerners get such a fat reputation? Apparently because they are more truthful.

Hat tip: James Joyner

Even taking into account the problems with self-reporting or BMI as a reliable indicator of how fat you actually are, I don’t think that you can look around you with an unbiased eye (or down, for that matter), without recognizing that Americans have gotten fatter over the years. That being said it’s pretty darned hard to solve a problem unless you know what problem you’re trying to solve.

Let’s assume that the graphic above is a faithful representation of the spread of what we would call obesity. Explain it. I think that reconciling it with what I’ve called the “simple thermodynamics theory of weight gain”, i.e. weight gain equals calories ingested less calories expended in exercises, requires one to make so many other assumptions that it violates Occam’s Razor.

Here are some explanations I can come up with:

  1. The graphic above isn’t actually illustrating the spread of obesity. It’s illustrating the changing demographics of the United States over the years and, particularly, the spread of populations known to be more likely to be obese, e.g. African Americans and Mexican-Americans, throughout the country.
  2. Obesity is a communicable disease. I’ve read two studies recently that support this idea. The bottom line is that intestinal flora have a great influence on obesity.

Here’s what I think. I think we’ve gotten fatter. I think that the reasons are a complicated mix of behavior, diet, genetics, epigenetics, communicable disease, and who knows what all else including the use and abuse of antibiotics. I also think that the simple thermodynamics theory of weight gain, a recent expression of which is New York Mayor Bloomberg’s jihad against the Big Gulp, has been very damaging to understanding the real reasons we’re getting fatter.

Just for the record I am far from being rapier thin. I have broad shoulders, a deep chest, am long-waisted, and have short legs relative to my height. I do not, like many men of my age, have a pendulous belly. I wouldn’t look thin or have a BMI below 25 with 0% body fat. My parents were both thinner and more active at age 20 than I was at age 20. They were both athletes—my dad a champion tennis and handball player (gloves are for sissies) and my mom a swimmer and diver. However, I was thinner and more active than either of them at age 30, at age 40, at age 50, etc. I consume about 1,800 healthy calories a day and get plenty of exercise. As much as I wish I fit more into the conventional ideas of fitness and good looks, that’s about as good as I’m gonna get.

43 comments… add one
  • TimH Link

    You make really good points. Complicating our talk about obesity is the ‘personal blame/shame’ aspect of the disease (which as you note, is much more complicated than simple calories in, calories out, or “will power.”)

    Feeling that obesity is a personal failing inhibits frank discussions and reduces people from seeking treatment. As someone in my 20s, I think it’s gotten to the point where (many) people of my generation would be less embarrassed about talking about a STI than obesity (with friends perhaps, and certainly with healthcare providers). Obviously, frank discussions with any health concerns are helpful if they lead to even a few people getting successful treatment.

    Second thought: The pharma industry has been very successful at turning things with no widely known name into ‘diseases’ after there’s a pill (Depression was easier to talk about once you got a pill, not just psychotherapy, and who knew what ED was before Viagra?) They’ve been working on obesity pills. Lots of possible positive, and negative, effects, but I suspect that the next few generations of treatments will be too costly, and have limited success.

  • PD Shaw Link

    Since obesity appears to be increasing worldwide, just quicker and moreso in the U.S., the broadest types of explanations are probably the best. I also find it interesting that average height continues to increase, at least among Northern Europeans. Its as if our bodies want to be bigger, and its only extrinsic factors that limit us, but we keep pushing the envelope. The body wants to be taller, but height is difficult to have without becoming weaker muscularly. Probably the same is true of weight. So I guess I tend towards genetic explanations, with the idea that we are not encoded with an ideal height or weight, more a bias towards increasing both to the extent practical. Onwards and upwards.

  • Icepick Link

    What the Hell is an STI? Crap, that’s a “sexually transmitted infection”. What happened to STDs? Or even VD? Every so many years they have to change all the acronyms so that no one can follow what’s going on….

  • The purpose of an argot is to enable you to identify members of your group. When it becomes known outside the group, the diction must change.

  • jan Link

    I don’t ever recall reading about obesity in such theoretical or professorial terms as was done in this thread.

    My way of looking at weight is much simpler: eat less with an emphasis on healthy foods and exercise more = thinner and more stabilized weight; eat more with an emphasis on carbs/sugars and exercise less = heavier and less stabilized weight.

    Just look around you. People who regularly ride bikes, walk, run, use the stairs rather than the elevator, eat at organic or vegetarian places like ‘Raw” or “True Food’ all tend to be within the margins of average weight. The masses who use every convenience possible in order to not move, eat often and what ‘tastes’ good, fulfilling a couch potato’s lifestyle tend to bulge out more.

    Consequently, IMO, obesity is more a derivative of choice than anything else.

  • michael reynolds Link

    I’ve recently lost weight. (Again.) So I’m now a few pounds below “obesity” though at 6’2″ and 225 I’m still well into overweight. I’ve lost weight in the past using Atkins but this was straight-up, old-fashioned calorie counting, digital scale, apps and all, and at -34 pounds (probably 20 pounds since I last saw you, Dave) it’s my biggest drop.

    It’s like Iraq. (Um, what?) The diet (invasion) is one thing. Keeping it off (occupation) is a whole different, much more difficult matter. It requires a lot of internal propaganda. Some portion of your brain is amazingly clever at subverting you. And endlessly persistent. It’s your own personal guerrilla force. So you have to enter this kind of split personality thing where you’re arguing with yourself a lot, always on guard against your own mind.

    I’m heading out on book tour to the UK and Ireland for the next couple of weeks so I’m curious to see how I do. Lonely hotel rooms at 1 AM with M&M’s and Scotch right there in the minibar, that’s where it gets tough.

  • I’m heading out on book tour to the UK and Ireland for the next couple of weeks so I’m curious to see how I do.

    Poor guy. Try to soldier through as well as you can. Say “hello” to Dear Old Blighty for me.

  • Just look around you.

    Confirmation bias. You’re writing from California and, indeed, that might be true within California, at least to some degree.

    However, it doesn’t explain why Mississippi was Ground Zero in the epidemic, as clearly illustrated in the graphic. Unless you believe that Mississippians are more sedentary and have poorer diets than people elsewhere and spread their bad habits by the overwhelming force of the state’s culture.

    That’s what I meant by failing Occam’s Razor.

  • michael reynolds Link

    I get no sympathy from my wife, either. Apparently I will be missed: I’m the morning drive, trash, food shopping and dishes guy. Absolutely vital.

  • Some portion of your brain is amazingly clever at subverting you.

    That’s why the kitchen scale is so much a part of our regular regimen. I weigh practically everything that goes into our mouths. Not only does it allow me to regulate what we eat, it allows me to modulate it.

  • Red Barchetta Link

    I went through a fat phase. Most of my adult life I’ve been 190-200. I balooned to 235 in my late 40’s. Work, and sloth. Those privy to our website (only Dave, I suppose) could see me at my maximum chunkiest.

    I’m down to 205. The goal is 200. I think at my age 190 is unrealistic, but I’m on a roll and who knows?

    Michael, I know you think I hate you, but rather, I think you are a national treasure. Get your fat ass in gear and get to 200. The kids need you. It really is just a mindset. You will feel so much better.

  • 1. Skip breakfast (during the early morning is when your body burns the most fat, eating and eating carbs in particular stop this).
    2. Eat few carbs during the day.
    3. Eat modest amount of carbs at night (this is when your body is least sensitive to insulin and if you eat high glycemic carbs the insulin spike will be short).
    4. Do some form of resistance training (yoga, weights, swimming).
    5. Lose body fat, weight, and look and feel better.

    That simple.

    If you want to give the process a bit of a boost: drink coffee with heavy whipping cream or half-and-half and chew 1-2 pieces of nicotine gum/day.

    An FFS stop with the steady state cardio unless you are already in shape. If you want to do cardio, then do HIIT (High Intesity Interval Training), you can also shorten up the time you spend exercising this way too.

  • PD Shaw Link

    A few comments about the study Joyner posted on:

    1. The study didn’t include Hispanics or Asians, so it probably has problems reflecting parts of the South and West. (No explanation given, but since the main purpose of the study was to compare actual BMI with reported BMI, I wonder if previous studies had the same limitation?)

    2. The South being more honest is not supported by the study. All states (except Massachusetts) appear to under-report their BMI. Surprise! And Louisiana and Mississippi are still in the top four in actual BMI. The key variances appear to be:

    a. Missouri has the highest rate of obesity and the greatest differential between actual and reported BMI, but is described incorrectly as a Northern state.

    b. Minnesota has the second highest rate of obesity and the second highest differential.

    c. Other than Massachusetts, the _relatively_ “honest” states, beginning with the most, are: Michigan, Maryland, Illinois, Tennessee, Kentucky, and Alabama.

    d. The relatively least “honest” states, starting with the worst: Missouri, Minnesota, Georgia/Texas (tie), South Carolina, and Wisconsin.

    I don’t know if much of it makes sense, but one possible clue is that “honesty” may be a reflection of whether a people care about their weight and know about their weight.

  • Missouri has the highest rate of obesity and the greatest differential between actual and reported BMI, but is described incorrectly as a Northern state.

    Poor Missouri. Nobody wants to claim it. It’s the northernmost Southern state, the southernmost Northern state, the westernmost Eastern state, and the easternmost Western state.

  • I know the nicotine gum (or lozenges) sounds crazy, but there is research that indicates it is effective.

    Systemic nicotine stimulates human adipose tissue lipolysis through local cholinergic and catecholaminergic receptors

    CONCLUSION:

    Systemically administered nicotine induces lipolysis, in part by activating the classical adrenergic mechanism (mediated by a nicotine-induced release of catecholamines stimulating beta-adrenoceptors), and in part by directly activating a nicotinic cholinergic lipolytic receptor located in adipose tissue.

    I’ve found it also suppresses the appetite quite effectively for 1-2 hours. The only draw back is a brief and very slight bit of nausea (10 minutes or so).

    Alterations of lipolysis and lipoprotein lipase in chronically nicotine-treated rats

    These studies provide evidence for multiple mechanistic events underlying nicotine-induced alterations in weight and suggest that nicotine diverts fat storage away from adipose tissue and toward utilization by muscle.

  • michael reynolds Link

    Red:

    Michael, I know you think I hate you,

    Nah, I think you find me entertaining. And given that broadly speaking entertaining juveniles (sorry, had to) is my business, I’m good with that.

    As soon as I get home I’m shooting for 215. 200 is not happening. When I was living on the streets without an ounce of either fat or muscle I probably weighed 200. My excuse is that I have an enormous head (size 7 7/8 hat) full of very weighty brain.

  • michael reynolds Link

    Steve V:

    Does the come create nicotine addiction? Otherwise I’d be in.

  • Icepick Link

    The purpose of an argot is to enable you to identify members of your group. When it becomes known outside the group, the diction must change.

    Grrr. Damned cliques obscuring clear thought. Fuck ’em, it’s VD from now on.

  • PD Shaw Link

    Valentine’s Day?

  • PD Shaw Link

    @Dave, I do wonder if Missouri is one of the states that one might need to sample from different areas to reflect the whole. Also, I couldn’t help noticing that in the study Joyner linked to, Illinois and Missouri have one of the greatest differences between fat (MO) and thin (IL). I personally don’t see it.

  • I personally don’t see it.

    I gather you’ve never been to the Bootheel.

    Once again, I think this is a demographic issue.

  • PD Shaw Link

    I’ve eaten at Lambert’s Cafe in Sikeston several times.

  • Well, Sikeston is sort of the gateway to the Bootheel. I haven’t been to Lambert’s in decades. Last time I was there everybody sitting around me weighed about 400 lbs. I remember distinctly a couple of guys arguing about the “dayamned croppuhs”. Hard to render the dialect in print.

  • Icepick Link

    Valentine’s Day?

    Yeah, and back when the country had some sense left there used to be PSAs via certain select media telling people how to avoid catching it, too.

  • PD Shaw Link

    I think I might have been at Lambert’s on Easter a year or two ago, and the 400 lbs men and women were still there. I like stopping there on a road trip because its Americana, something to experience rarely, but obviously for some its a way of life or highlight of the week, and the “pass arounds” make it a cost-efficient source of calories. I don’t know if I would expect an Illinois “all you can eat buffet” to look much different. (Luckily I haven’t found one with the requisite kitsch or historical flavor to attract me)

  • Red Barchetta Link

    “And given that broadly speaking entertaining juveniles (sorry, had to) is my business, I’m good with that.”

    😉 That’s a good one.

    “My excuse is that I have an enormous head (size 7 7/8 hat) full of very weighty brain.”

    Or, perhaps, just a fathead. I’m not sayin’, I’m just sayin’

    .

  • michael reynolds Link

    “Come?” What? I meant “Gum.” Good grief.

  • steve Link

    I will stay with the thermodynamic explanation. Calories in vs out. The problem is that it doesnt take a huge shift to put on the weight. However, if you look at the eating habits of the massively, morbidly obese, you usually do find massive consumption of food and drink. For most everyone else it is just the steady grind of a bit too much to eat and not enough exercise.

    Steve

  • Andy Link

    I see that my home state of Colorado is the caboose on the fat train. That’s something I’ve read before and am not sure what is special about Colorado. Anecdotally, I’ve found there is a much greater preponderance for outdoor activities there than other places I’ve lived.

    As far as the national trend, there are certainly a lot of moving parts making it difficult to identify and weigh specific factors, particularly with respect to individuals and small populations. For the nation, some of it is certainly demographics. In 1960 the median age in the US was 29.5, in 2010 it was 37.2. So, more older people, more fatter people.

    Then there’s the abundance of cheap, high-calorie processed food. People talk about how obesity is a “poor” person’s disease because the fattening food is cheap.

    Third is that we are a more sedentary society with fewer people employed in positions requiring physical labor. And basic living requires less physical labor as well thanks to lots of technology and gizmos. Lots of little calories throughout the day can add up.

    Fourth is culture. Unlike much of Europe, the US is a fast consumption culture. Dinner here isn’t like dinner over there and frankly I’m not sure how they do it. My wife and I get home about 6pm and the kids get ready for bed at 8pm – that doesn’t leave a lot of time to prepare and eat a meal along with all the other crap that needs to get accomplished.

    Finally, there’s genetics and I think PD makes an excellent argument about worldwide trends. On a micro level I know that my metabolism is a lot slower than it used to be despite exercising roughly the same amount. I’m 6’1″ and currently about 205-210 depending on the day. That seems to be my “natural” weight for my normal level of consumption and exercise. I’ve also found that more exercise doesn’t help as much as it used to – to get down to 195 (close to my ideal) requires watching what I eat – I’ve tried a lot more PT and it doesn’t work for me without cutting calories. For that I’ve had good success with weight watchers, which helped, more than anything, to better estimate what I actually eat.

  • Michael,

    Addiction with the gum is very unlikely. Nicotine is very addictive in inhaled form, but the dose you get from 2mg gum is much slower getting into the body.

    Calories in vs out.

    This can be a bit misleading. This is the kind of thinking that will lead people to take up steady state cardio (running at a constant pace) which after awhile the body will adapt to and you’ll get zip for results. If you are looking to lose weight you’ll need intervals of intensity in your exercise. Intervals such as, sprint for 30 seconds walk for 4 minutes, repeat that 4-5 times and you’ll be more effective at losing weight than just running at a constant pace that whole time.

    I’d also recommend some type of muscle building regime along with shifting when you eat certain macro nutrients (carbs, proteins, etc.) as well as how much you eat. Lots of times when people diet they lose fat, but also muscle. You want to retain the muscle and lose the fat. Another recommendation is to find a eating/exercise regimen you can maintain.

    And remember that all diets (i.e. the things people go on to lose weight) fail. If they didn’t we’d all be thin/in shape and there would be 1 or 2 diets.

    This is a typical day for me:

    AM: Drink a largish cup of coffee with heavy whipping cream, coconut oil, and whey isolate protein powder. Followed by a piece of nicotine gum.

    Lunch: Piece of baked chicken can of green beans.

    Work out with a piece of nicotine gum (the bulk of my work out is weight lifting, going for heavy weights to build muscle).

    Afternoon: Maybe another can of green beans or some raw almonds.

    Dinner: 2-4 slices of pizza or tri tip and sweet potato french fries or pad thai, white rice and panang with chicken, sometimes I’ll even go for some donuts (other good things to eat at night: ice cream, cherry turn overs, cheese cake, mashed potatoes, spaghetti with meat sauce and garlic bread).

    The first three months of this kind of regimen I went from 67 pounds of body fat to 54 and my weight went from 211 to 207 (percentage wise I went from 31.8% body fat to 26.1%) . If I drop another 12 pounds of fat at when I get it checked in 2 weeks (another 3 months) I’ll have dropped down to 42 pounds of fat and a body fat percentage of 21%. Overall I’ll have dropped more than a third of my body fat. And I’m getting close to having to buy another new belt, and look at what I get to eat at night. 😛

  • michael reynolds Link

    Steve V:

    Thanks. That’s probably right. I’ve never become nicotine-dependent off cigars, either. Of course I’m in the “don’t inhale” group there, so maximum flavor, minimum nicotine.

  • michael reynolds Link

    Steve V:

    Just had to buy a new belt and downsize the jeans. It’s ridiculous how pleased I am. I’m 15 months away from turning 60 and (sadly) I’m in the better shape than at any time since my 20’s. Doing elliptical (bad knee, can’t do treadmill) and lifting. But only maintaining on the weights for now — I have the feeling adding muscle while losing weight is an oxymoron.

  • jan Link

    Since I was in my early 20’s I always looked at aging as gaining wisdom, not muscle. That has been my end game, as the physical is ephemeral, while the lessons learned are what it’s all about, IMHO.

  • michael reynolds Link

    Ice:

    As a “Florida Man” I thought you might appreciate this. It’s a sub-Reddit entirely about “Floridaman.” http://www.reddit.com/r/FloridaMan/top/

  • michael reynolds Link

    Ice:

    Clarifying: that was not a shot at you. My kid just showed it to me and it was funny.

  • No mention here of high fructose corn syrup. Cane and beat sugar contain both fructose and sucrose – HFC contains only fructose. Sucrose makes you feel full, fructose does not. HFC is found not just in soda and juice but most processed foods. Before HFC there were no big gulps because few could have finished one.

  • Icepick Link

    Florida Man is a well known super hero (some say the worst super hero, but that’s open for debate – at least he doesn’t talk to fish as his super power) with an active Twitter account.

    You know, I also think the Powerpuff Girls and The Tick have both caused more damage than Florida Man. Also, what about his sidekick, Florida Boy? Yup, there’s a Florida Boy, too.

    10-year-old Florida boy found wandering street naked and drunk

    Florida Boy’s 911 Call Helps Police Nab Burglars

    Florida boy, age 11, arrested on arson charges

    Beloved pet pig Twinkie can be kept by Florida boy with Down syndrome (Subheader: ‘What’s wrong with you people? Let this boy have his pig,’ was one comment about Kason Ray‘s struggle on the Coral Springs Facebook page.)

    And of Course there’s a Florida Woman, too. Samples of her work:

    Florida woman crashes car into house while being ‘amorous’ with boyfriend: Police

    Florida Woman Drives 100 miles with Live Owl Inside Car Grille

    Florida Woman Arrested After Genital Kicking Spree

    Florida woman apologizes for flipping off judge, avoids 30-day jail sentence

    Florida Woman Stole Tampons, Fled In An Explorer, And Hid In A Box

    Florida Woman Arrested on Charge She Rode Manatee

    Don’t assume, though, that Florida Man and Florida Woman are a couple.

    Florida Man Hits Boyfriend With Plate For Listening To Too Much Alanis Morissette

  • Icepick Link

    The great things about Florida is the combination of geographical features and the weather. The crappy thing about Florida is that it gets all the loose nuts that don’t roll all the way to California. We also get more than out fair share of homeless and runaways (if you’re going to sleep outside in the winter, do you want to do it in North Dakota or near Miami Beach?), which attract serial killers. (teenage runaway = lunch)

  • I think there are two distinct issues being discussed here. Most people have focused on how individuals become fat. The actual topic of the post is how populations become fat.

    I suppose you could maintain that populations becoming fat just consists of the individuals in the population becoming fat. If that’s your position, you need to explain the actual evidence: that the U. S. population hasn’t become fat uniformly or randomly but that obesity has spread through the country like a disease. Or like the migration of a population.

  • Icepick Link

    I should point out that the great Pat Summerall, now sadly the late, as well, is also a Floridian. Best NFL TV play-by-play announcer ever. His greatest talent was knowing when to be quiet and let the action speak for itself. (Radio play-by-play would be something else entirely, of course.)

  • michael reynolds Link

    Dave Barry and Carl Hiaasen thank God every day for Florida Man, Woman and Child.

  • Just had to buy a new belt and downsize the jeans. It’s ridiculous how pleased I am. I’m 15 months away from turning 60 and (sadly) I’m in the better shape than at any time since my 20′s. Doing elliptical (bad knee, can’t do treadmill) and lifting. But only maintaining on the weights for now — I have the feeling adding muscle while losing weight is an oxymoron.

    Well done Michael on the new jeans and belt, yeah if feels great.

    As for losing weight and adding muscle it is hard. I lose small weight, but fairly decent levels of fat meaning I’m putting on muscle. But, the thing about muscle is a pound of muscle takes up far less space than a pound of fat. So you can slim down and build muscle and only lose a little weight.

    Don’t be to fixated on the scale. It is bad being over fat, it is not so bad at all being over muscled–i.e. your BMI is high, but your body fat content is low. Look at other metrics like your belt size/# of holes you have left, how your clothes fit, are you getting into older clothes you haven’t worn for awhile? Those are all positive signs. People may even comment you’ve lost lots of weight when in truth it has only been 5 or 10 pounds.

    …at least he doesn’t talk to fish as his super power

    Hey, hey, hey. Aquaman had more than that. Super human strength and could swim amazingly fast underwater, and is very…well..tough since he can withstand the crushing pressure at extreme ocean depths and the cold. This has made him so tough that gun shots don’t harm him. He can see in darkness and his hearing is excellent as is his sense of smell. He has tremendous endurance. And his telepathic abilities have grown over time…

  • I suppose you could maintain that populations becoming fat just consists of the individuals in the population becoming fat. If that’s your position, you need to explain the actual evidence: that the U. S. population hasn’t become fat uniformly or randomly but that obesity has spread through the country like a disease. Or like the migration of a population.

    So….when a disease spreads individuals don’t get sick. Whew what a relief.

    Obesity may share some characteristics like a disease, but I don’t think it is a disease. Not like the common cold in any event. It could be similar to smoking…which again isn’t really a disease but a behavior. Obesity is the result of certain behaviors…and false information. Like that stupid food pyramid that says the bulk of your diet should be carbs. Each a bunch of rice, pasta, and bread and get a huge fucking ass…literally (and yes, I mean literally as in without exaggeration). There was a shift away from proteins and fats to carbohydrates. Eat bread, pasta and fruit…its good for you…it also can make you fat.

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