dimanche 29 janvier 2006

Swell. Another voice claiming you can't be healthy if you're not a size 4


I'm what's known in this country as overweight. I've tried mightily my whole life not to be overweight, with limited success. The only time in my life that I've had what the actuarial charts call a healthy weight was for about five minutes back in 1983, when I went on the Cambridge Diet, took aerobics five nights a week, weighed 105, and was absolutely miserable. I met Mr. Brilliant at that time, and I would sit in restaurants with him and cry because I was so hungry but I was afraid to eat because I might gain weight.

But that is how the "experts" would have me live.

I don't smoke. I don't drink. I don't take drugs. I do a healthy mix of cardio and weight training workouts 4-5 mornings a week. I've taken exactly four sick days in five years. My blood pressure averages around 120/70, except just after we return from Jamaica, where the food is salty. These days I have a tendency towards elevated cholesterol, but if I stay away from trans fats for a few weeks, that seems to take care of itself.

And I'm overweight.

My mother is 78, overweight, a lung cancer survivor, and still smoking. My father is 80, overweight, and healthy.

We come from a long line of Russian and Polish peasants, and this is how we are built.

I have slim friends who are on blood pressure medication, asthma inhalers, migraine medications, statins, and any number of pills for any number of ailments.

I take a Benadryl most days, occasionally I take Advil, but that's the extent of my medications most of the time, other than a multivitamin and a calcium supplement.

But I'm overweight. I'm preposterously healthy, but I'm overweight. The government says people like me cannot exist. Yet here I am.

Nick Kristof today takes up Arkansas Governor Mike Huckabee's obesity drumbeat.

In 2003, Mike Huckabee, the governor of Arkansas, learned he had type 2 diabetes.

His doctor told him he would probably be dead in 10 years — and that terrified him enough to start exercising, eschew sugar and lose about 110 pounds (at 5 feet 11 inches, he's now 180 pounds). His first attempts at jogging left him dizzy after a few hundred yards, but now he is running marathons.

That would be a nice, inspiring tale if it ended there, but instead it has been the starting point. Mr. Huckabee has become a health care policy wonk, and with the help of national experts he has begun a series of clever initiatives to fight obesity. They are among the most creative steps under way in America at any level of the political process.

Arkansas has become a national laboratory for using policy levers to try to encourage healthier lifestyles. Other states and the federal government should adopt the same steps — like curbing soft drinks in schools, informing all parents of their children's body mass index as a step to encouraging fitness, giving exercise breaks as well as smoking breaks, paying for preventive health checks like mammograms and prostate examinations, subsidizing efforts to quit smoking and seeking to give food stamps more purchasing power when they are used to buy fruits or vegetables.

I know all this sounds banal. Perhaps I should be using this journalistic real estate to thunder about grand issues like the Iraq war or Middle East peace or corruption in Congress. But remember that fat kills far more Americans than terrorists. Indeed, The New England Journal of Medicine reported last year that because of rising obesity, life expectancy in the U.S. might soon stop rising and could drop.

[snip]

"I don't want to be the sugar sheriff," Mr. Huckabee explained in an interview in his office. "I don't want to be the grease police. That's not my job. But when I look at our state budget, and I see that every year our Medicaid budget is increasing by 9 to 10 percent, and I look at state employees' health plans and I see that those costs are escalating at double digits and twice the rate of inflation — as a fiscal manager, I have not only the right but frankly also the responsibility to see what can we do to improve this bottom-line cost."

Repeatedly, Mr. Huckabee came back to the same argument: Obesity is reducing not only the quality of life of Americans, but also the fiscal soundness of our government and the competitiveness of our businesses.


Heh. Now that's the rub -- the cost to business.

I'm not claiming that obesity isn't a problem. I'd love to lose about 30 pounds. But when I already live a reasonably healthy lifestyle, I don't eat fast food and don't eat sugary sodas, how realistic is that? Like Oscar Wilde and the curtains, I've been fighting a battle with my weight my whole life, and my weight wins every damn time. My fat loves me as much as does my cat Maggie, who similarly wants to be plastered to my hip 24 x 7. It doesn't want to leave.

That said, I realize that I'm the exception rather than the rule. I work out regularly because I enjoy working out at home, alone, and I've found a video series that I like and that I can stick with. Most people need the motivation of a trainer or a group -- but what overweight person has the guts to huff and puff through a workout class full of marathon runners? Still, I would say that unhealthy lifestyles, rather than strictly obesity, is the real culprit. Usually the kind of sedentary life and high-fat, high-salt, high-sugar eating habits so many Americans have result in obesity. But I would guess that there are plenty of size sixteens eating fresh fruits and vegetables and lean meats and fish, and plenty of size fours chowing down Egg McMuffins for breakfast every day and able to demolish a fat panini sandwich at lunch -- then go home and eat dinner. I know they're out there, I work with one of them.

All too often, obesity is blamed on sheer gluttony -- and yet we live in a society that says, "Eat, eat, eat -- but don't you dare get fat." Restaurant portions are ridiculous. I usually eyeball my plate the minute it's put in front of me and mentally partition off the part I'm going to eat and the half to 2/3 of it I'm going to take home. But frankly, I'd just as soon pay five bucks less for the plate and not have to do this.

Food is plentiful, available, and cheap; and in busy households it's all too easy to just go through the drive-thru on the way home than to go home and cook a meal. Children's diets go from milk or formula, to commercial baby foods, to fast food. No wonder they won't eat broccoli -- they never learned what real broccoli tastes like because everything they've put in their mouths since the day they were weaned was produced by some big food processing company.

Parents put their kids in complete body armor before letting them ride a bicycle up to the corner, but they pump chemicals and fat and salt into their kids night after night by feeding them fast food. It's not that they don't care, and it's not that they don't WANT their kids to eat right; they're just too damn busy to start chopping vegetables after working all day, and they can't cook a meal and work on the kind of "family homework" that schools parcel out these days.

Ever tried to shop looking at labels? Especially when you're in a hurry? If you want to stay away from partially hydrogenated oils and trans fats and high fructose corn syrup, you can forget about buying anything that might mean you could get out of the kitchen before eight o'clock at night.

What worries me about columns like Kristof's, and the series likely to follow, is that they focus on weight itself, rather than the overall health of the population. If you tell a parent who's up at 5 AM, gets the kids ready for school, is on the train by 7, works all day, gets home at 6:30 and then has to help kids with homework, get them fed and ready for bed before collapsing in an exhausted heap that she should make time to get to a gym, she's going to head right to the A&P for a pint of Ben & Jerry's. Yes, Frankenfood is a problem. High-fructose corn syrup is a huge problem. Lack of exercise is a problem. But the bigger problem is what we as a society can do to give Americans the breathing room they need in an average day to plan and prepare healthier meals, to get out for that brisk walk, to learn to savor the fresh produce that's better for them than the processed crap they eat now. But instead we have a government that's completely in the pockets of the very food companies which perpetuate the problem, and a president who praises a mother working three jobs as "uniquely American" instead of realizing the strain that three jobs puts on family life. You can bet that mother is a regular patron of the drive-thru, and you can also bet that the closest she gets to the gym is the drive home from her third job.

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