I was listening to one of my favorite podcasts the other day (Nike trained) and the founder of the FODMAP diet was being interviewed. Although I’m not a fan of fad diets, her interview was actually really informative. She even referred out to registered dietitians as nutrition experts! But at the end of the interview they asked her how she thought America was going to solve the problem of obesity. She responded that families need to sit down and eat meals together. My face made that emoji with the lines for eyes and mouth. Ugh is this what people really think? So naturally I thought I’d right a little post about it explaining what the real solution is.  

What does obese even mean? 

Someone meets criteria for obesity if his or her BMI is greater than 30. BMI is calculated by weight (kg)/ height (meters) squared. So basically BMI is a measurement that compares your weight and your height and then classifies you. What does this even mean? Not too much. It just means the higher your number is above 25, the more likely you are to get certain diseases (heart disease, diabetes, stroke, etc). BMI falls short because it doesn’t account for muscle and if you naturally have a heavier frame. And in the hospital nobody is really concerned unless the patient is “morbidly obese” which is having a BMI greater than 40. Your immune system can’t really support you if you’re that big so you can have a lot of complications. 

What causes obesity? 

In a sense, obesity is caused by consuming more calories than you are using. So overeating and under-activity. I’m sure you’ve heard that America is becoming heavier and the rate for obesity is steady increasing. Some researchers blame this on the shift of American culture and the efficiency of our food system. Americans don’t have to work so hard to live anymore- we don’t have to forage in the woods, or chop timber to warm our houses, or work all day preparing food. We are even doing away with many active factory and trade jobs. More Americans have sedentary jobs than ever before. America also used to have a huge problem with malnutrition, so the government helped the food industry make food much cheaper. That’s great, except now food is too cheap and people are buying and eating too much of the wrong foods. One study found that America is eating 20% calories than in 1983 because of how improved the meat industry has progressed in terms of safety and price. Americans also burn 120-140 calories less compared to 50 years ago. This combined with the increase intake leads to overweight and obesity.

The diet industry is also partially to blame for the fact that it’s not effective. Diets have been proven to not work. Lifestyle change works- but that doesn’t profit. What profits is a claim that you’ll lose 10 lbs in 1 week. And this may even be true, but the weight doesn’t stay off so there’s no lasting effects. And any diet that promotes restriction has shown to backfire. Research suggests that constantly under-eating the necessary amount of calories can actually lead to increased hunger hormones. Your body always needs food and it’ll take crazy lengths to get it.  

Obesity is also genetic. Researchers are identifying genes that promote hunger and other genes that slow the metabolism. So yes, some people are naturally thin or heavy no matter how hard they try the change. 

Also some medications do make you more hungry or cause weight gain without any other changes.  

Who is affected? 

38.8% of the US population is obese. This is where things get interesting because for some reason obesity doesn’t even effect everyone equally. African Americans are more affected by obesity than any other race. Why? Lots of factors: genetics, culture, socioeconomics. The low income population is also more affected than the rest of the population as a whole. Why? Research suggest that those of low income consume more high-calorie foods and have less access to healthy foods. The poorest states have the highest obesity rates (Alabama, Mississippi, and West Virginia). New research by Kim et al is questioning if poverty causes low income or vice versa. Their results suggest that those who are obese are turned away from higher-paying jobs due to stigmatization. Either way, obesity and poverty has some sort of relationship. 

Okay...so what’s the Point? What’s the Solution? 

The point is that I’m trying to make is that just sitting down as a family to eat meals together can’t “solve obesity.” And I really hope people don’t think that. You’re going to tell the single mom who’s taking care of 3 kids and her dying grandparents working as a cashier to just sit down with her family for meals and everyone is going to lose weight?? No. 

I truly believe this is not a personal problem, but a systemic problem. Unhealthy food is too available and too cheap and this directly affects the low income population. And food companies know this! They market to this population knowing they’re the biggest consumers. And it’s like a downward spiral. If you live and are surrounded by people who eat poorly and are never exposed to a healthier way of living, you’re not just one day going to figure out what to do or keep up the motivation to do so.  

Think about this- you don’t have a car but you need food and should probably be active. You know you should because you were just diagnosed with diabetes. There’s no grocery store within a 2 mile radius so your only option is the gas station. Honey buns and pop tarts it is. And for activity? I guess you can walk around the block, but is that even safe? Is the weather okay? Shouldn’t I be trying to work right now? There are so many obstacles for those of low-income to lose weight that other people overlook and try to simplify. I see people like this every day in the hospital and it totally breaks my heart. I don’t know what to tell them. They want to change but their SNAP benefits don’t cover fresh fruits and vegetables. And even if they did it’s not going to even meet their daily calorie needs. Or they don’t have a ride to the store. Or they’re in a wheelchair. Or they’re depressed and really just don’t care. 

....So what’s the point?! 

All I hope you learn out of reading this is that obesity is super complicated and is not just a simple fix. I don’t even think it’s really a personal fix. It needs to come from the government or food companies or something. But please just don’t assume obesity can be solved by eating family meals.