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Land of the free, home of the fat

"The United States is nothing more than a huge eating machine," scoffed a French magazine a year ago. There was some justice in the claim: Although French body weight has been rising during the past decade, it is doing so at half the American rate. Obesity percentages, similarly, are less than half those in the United States. Gallic gloating aside, the U.S. surgeon general himself has proclaimed a national obesity crisis, with more than 62 percent of the population seriously overweight, as against 40 percent a decade ago.

The side effects are everywhere to be seen. Clothing sizes have been renumbered downward to conceal greater amplitude. Manufacturers are selling "plus" sizes to fashion-conscious but plump pre-teens. Stadium seats have had to be expanded. And, both cause and effect, restaurant meal portions have increased by as much as 40 percent in the past 15 years.

Rising obesity means, of course, that more people are eating more and moving their bodies less. So we hear criticisms of the rise of fast-food outlets, or the laziness that pins American youth to the couch. But there is more to it, as witness the fact that some countries, as affluent as we, suffer much less.

Americans' flirtation with obesity began between 1920 and 1940; there is no evidence of widespread obesity before then, probably owing to the predominance of physical labor. The weight gains accelerated between 1950 and 1980, when the average American put on about eight additional pounds, and then skyrocketed between 1985 and the present. Yet throughout this span, fashions, movie stars and insurance and medical experts have been trumpeting the beauty and healthfulness of thinness. And, bridging the gap, a multibillion-dollar diet industry has emerged, with the majority of American adults professing that they are on or about to go on a weight-loss program.

Why, then, such a long-standing gap between the cultural ideal and reality? Why have Americans been particularly open to the lures of the food and drink industry, even as their lives have become more sedentary, with TV, computers and the ubiquitous automobile? Why are our grocery stores, uniquely in the world, lined with rows of snacks and soft drinks?

Four factors combined to set the obesity machine in motion, from the 1920s onward:

+ Even as they worried about adult weight gains, Americans proved unusually reluctant to discipline children's eating habits, eager in fact to use food as treats. The fact that kids, when surrounded by food affluence, don't make the best choices was ignored in favor of a delight in plumpness and a desire to avoid confrontation. Even doctors held back until the last two decades. More than other affluent people, Americans feel guilty about not doing enough for kids, and they use food to compensate.

+ Key groups in the United States, such as blacks, simply did not buy into weight-control goals. As the poor became able to afford more abundant cheap food, poverty and obesity became increasingly linked. Food provided solace, amid a lack of many other opportunities for pleasure. And the foods most available on tight budgets were unusually caloric. But group pride was involved as well. It seemed important to defy ubiquitous middle-class preaching at least in this area. To this day, experts have not figured out how to persuade important segments of the population to join this particular health bandwagon.

+ Americans inherited from their past a delight in eating fast and in quantity. (Where else are all-you-can-eat contests so prevalent?) Fast pace and pride in abundance led to a tendency to gorge rapidly, which European visitors noted as early as the 1800s.

This was fine when work was physical, but not so healthy later. (France lucked into a different tradition, emphasizing quality and time spent over meals, which works much better in modern conditions).

+ And Americans have tended to invest health crusades with a pervasive moralism that could backfire. For literally a century, American fat has been linked to sloth, ill-discipline and psychological flaw. Terms such as "lazy and undisciplined," "self-indulgent" and "lacking in self-control" peppered American commentary on personal health care from the 1970s to the present.

Most recently, conservative columnists have taken up the character-defect banner against obesity. The problem is that moralism might not work. Guilty people might eat more to compensate; key groups might tune out the preachers.

Some critics would add another point: Even medical experts have tended to overdo their strictures, creating at least part of the obesity crisis by consistently narrowing the limits of desirable weight. With undue zeal, doctors have promoted extreme standards not backed by solid evidence of disease. This has made reasonable weight goals seem increasingly unattainable, as the whole scene becomes confusing and discouraging.

Clearly, there's a considerable amount of national baggage to contend with in dealing with obesity. The components run deep in the national culture. And we're a disunited nation where food is concerned, clearly unable to agree on health priorities. None of this means that change is impossible, but it does suggest a level of difficulty that another set of medical warnings will not address.

Recent developments have simply made things worse, turning a trend into a virtual stampede. Two sets of factors, building on the previous components, have prompted the escalation of obesity. First, the food industry has stepped up its pressure, with new forms of fast-food outlets, such as calorie-rich coffee bars cropping up everywhere. Add to this fewer meals eaten at home, which increases the allure of food taken on the run. Add to this the ever-increasing opportunities for sedentary pursuits, particularly for children, lured by television and home computers. The eating-inactivity nexus intensifies. Many of these problems have even become global, as American eating habits gain popularity with a world audience, with rising obesity to match. But this nation's leadership in fat remains unchallenged.

One big factor that is peculiarly American: In contrast to most industrial nations, even Japan, time spent at work has increased in the United States since the 1980s. With this comes a need for quick release, for the kind of solace and energy boost that frequent eating provides. Small wonder that snack bars and vending machines cluster around every office site, as if Americans find it inconceivable to work more than 100 yards away from a source of food. The nation that introduced the packaged snack, more than a century ago, has elevated its need for instant access to food to new heights.

The good news is, of course, that the key causes of growing obesity are man-made. Individuals might have different genetic predispositions, but the overall problems result from beliefs and habits that are, potentially, open to change. The bad news, of course, is that the key causes of growing obesity are man-made, following from a complex history recently supplemented by a more aggressive food industry and work stress. The causes can be addressed, but we have yet to see real breakthroughs. It's the human side that needs attention, and with it the history that got us where we are.

Peter N. Stearns is author of Battleground of Desire: The Struggle for Self-Control in Modern America.

Newsday

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