Atlantic obesity debate: let's go to the pics (updated)

By James Fallows

As the Atlantic's tribe of online voices has expanded, it naturally supports a range of views, opinions, subject matter, personal obsessions, styles of argument, and so on. Sometimes we have unintended overlap -- as when Lane Wallace and I were independently impressed by the same innovations on display at this week's Oshkosh air show. Sometimes we have  straight-out differences of opinion, as here and here, and now between Marc Ambinder and Megan McArdle on whether obesity is a real public health problem or another instance of nanny-state moralizing. McArdle's posting is here, and Ambinder's reply is here.

I am 100% with Ambinder on this one, and would be 1000% with him if that term weren't assumed to be sarcastic. It is notable, though not noted in the original item, that the obesity-skeptic Paul Campos with whom Megan McArdle conducts an extensive, sympathetic interview is a law professor rather than a doctor, public health official, epidemiologist, etc (which of course doesn't disqualify his views but should be mentioned); and that the word "diabetes" does not appear in the discussion in which he pooh-poohs the public health effects of obesity.

If you've been around the US as long as I have (ie, if you're as old), you have seen very significant aspects of public-health behavior change in your own lifetime. When my dad went to medical conventions in the 1950s and 1960s, most of his fellow doctors smoked. By the time he retired in the 1990s, very few of them did. For better and worse, smoking has become a class-bound phenomenon in America: better for the people who don't smoke any more, worse as one more disadvantage of being poorer and less educated. The difference is startling and obvious if you spend time in, let's say, China, where many more people of all classes smoke. As individuals, Americans have the same human nature as they did 40 years ago, and the same nature as people in China. Will power, compulsions, addition-seeking instincts, etc. But their overall behavior about smoking has changed. Some individuals did not or could not change their behavior. (One of my grandmothers, who had started smoking as a flapper in the 1920s, died of a horrible case of emphysema, sneaking cigarettes on her last conscious days.) But average behavior changed dramatically. In my view, no sane person can deny that public anti-smoking campaigns have made a huge difference.

What I also know first-hand is that the average physical size of Americans has changed in my lifetime. Go look at some old clips from 1950s versions of The Honeymooners and check out Jackie Gleason. At the time, he was famed for being an enormous fatso. That was part of the joke when he came on screen. Here is the gargantua who drew those laughs:

Similarly with Alfred Hitchcock, whose portly silhouette on his 1960s TV shows was the definition of impressive girth.

Or the tubby Raymond Burr as Ironside in the 1970s:

(To spell out the joke, just in case: none of these people would draw a second glance now.) If you've spent any time in the rest of the world, you know -- first hand, for real, and no doubt -- that Americans, along with Germans, really are heavier on average than other people, and that this is significantly more so than it was 25 years ago.

Our basic nature as human beings can't have changed in that time. Nor can our genetics. If you've lived in Asia, you know that Japanese and Chinese people are on average taller and much heavier than they were a generation ago. I have met old women in China who looked barely four feet tall. In Beijing or Tokyo 25 years ago, I was always the tallest person on the subway or in a crowd; now, I usually see a few young men over 6'2". But in these countries there's an obvious explanation: poor nutrition artificially limited people's growth before, and the limit is being removed.

Exactly what this means in policies is beyond my time or ambition here. Basically I agree with Marc Ambinder's statement below. I chime in on the issue mainly to express this view: denying that America's obesity situation has changed; or that it has harmful consequences; or that it could, like smoking, be affected by public policies strikes me as antifactual denialism.

From Ambinder's reply:

"McArdle is right that it it's not fair for government to lecture people about weight loss and exercise, but she's right for the wrong reason: policy choices -- ag subsidies, zoning laws, education and budget priorities -- create a flow that, absent any intervention, are sweeping many young kids, particularly poorer kids of color, into obesity. Government's role isn't to scold; it's to make better policy choices. She's wrong about the interventions, too: some, like a physical education project in Somerville, Mass., seem to be working. Taking fast food vending machines out of schools and weighing children at least once a year has arrested the obesity growth rate in Arkansas.  Nationally, the obesity growth rate also seems to be be slowing."

Update: I will go 1001% with Marc Ambinder's second-round post.

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