Is Obesity Cultural?

By David Katz, originally posted on US News

 

When salmon swim against the current of a river, running a gauntlet of grizzlies, we are impressed by the fortitude nature endows. When many of them die trying, it’s no great surprise. I can’t recall ever hearing anyone suggest that the many salmon who die along the way lack the personal responsibility of those who make it. All are striving; some succeed, but most fail. The species survives (so far), but less than 5 percent of the fish overcome the obstacles. Things play out predictably: Overall, the current and the gauntlet prevail.

Culture is the current in which we humans swim. In our modern, obesigenic culture, some few succeed, and most succumb. Like the salmon, our species is surviving—but paying a high cost. Very few win a fight with the prevailing culture. Most are swept along by the obesigenic flow. Please hold that thought.

The advent of some good news about obesity trends might have lulled us into a false sense of security, or at least accomplishment. We have heard, for instance, that obesity rates in children and adults alike seem to have plateaued. We have examples of seemingly effective interventions.

But to whatever extent optimism was tempted to take flight on the basis of such news, its launch was aborted by this week’s findings from the Rand Corporation. Their just-completed study shows that rates of severe obesity have been rising briskly over recent years—or, as USA Today put it, skyrocketing.

Not only is a skyrocketing rate of severe obesity a bad thing in its own right, it actually undoes the apparent good news that overweight and obesity rates overall might have been leveling off. Here’s why. Some 65 to 80 percent of Americans are overweight or obese now. It may just be that everyone who is vulnerable, with rare exception, has already succumbed; those who haven’t succumbed likely have robust defenses in their genes, their environments, their behaviors, or some combination of those.

If the only real plateau we have is that almost everyone, and certainly everyone who is vulnerable, is overweight already, then the real measure of our status is no longer how many are overweight, but how overweight the many are.

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