They gathered around the figure who was lying with face toward the ground. Holding stones, they demanded justice – that the sin of this person be exposed for what it is: inferiority. Her sin had been exposed for all to see and the righteous rage of those who were pointing fingers and holding stones was pounding at her on the inside, just as the stones would soon pound her on the outside.
“Her BMI is over 30! It may even be over 40!” one of them cried out. The others responded to this with a howl.
“How can she be fit for leading the country’s health if she can’t even fit into her pants?!” another asked, causing raucous laughter to echo from the crowd.
Nearby, a news reporter spoke into a camera: “People are questioning her fitness for surgeon general, as she obviously is overweight. The president had initially hoped the popular TV doctor would take the job, but fell back on Dr. Benjamin as a substitute. Clearly a president, who himself is a closet cigarette smoker, doesn’t see the fact that she is overweight as a disqualifying factor. These people, and many others around the country, disagree with that assessment.”
———————–
Forty years ago, people would also have cried out about this nomination. They would have said that a woman shouldn’t be in charge of the nation’s health, or that a black person doesn’t have the wherewithal to manage such a big task. Times have changed, as her nomination shows – nobody is talking about these facts that have nothing to do with her ability to do this job. We have truly progressed.
Sort of.
This objection, of course, is that her weight shows that either she doesn’t understand what is causing her obesity, or that she doesn’t have the moral fortitude to successfully fight it. Either way, she’s disqualified for the job. Right? It’s a sign of weakness to be overweight, and we certainly don’t need someone with a personal weakness to be in a leadership position!
It is clear that some view the overweight (which, by the way, constitute 2/3 of our adult population) as being emotionally weak and somehow inferior to everyone else. After all, study after study has shown that the way to beat obesity is simple: eat less and exercise more. It’s simple; and those who don’t do it are weak, lazy, dumb, or just plain pathetic.
It angers me to hear these suggestions. Racist and sexist people put down others because of the fact that they are different than themselves. But the moral judgment against the overweight and obese is not meant to be a judgment against something inherent in the other person; it is a judgment against their character, their choices, and their weaknesses. The implication is that they are somehow either smarter, stronger, or just plain better than the overweight. The implication is that the other is weak and they are not.
There is a word for this attitude: hypocrisy. A bigot is a person who hates those who are different; a hypocrite is one that hates others for something they themself have, but choose to ignore. Both mistakenly act as if they have the moral high-ground. Both disqualify themself from any argument based on morality.
Healthcare exists because of human weakness. We all are weak in various ways, and we all will eventually die when one of our weaknesses overcomes us. Obesity exists because of human weakness – either the genetic or biological miscalibration of the person’s metabolism, or the inability of that person to act in ways that are in their own best interest.
I have to say that I probably fall in the latter category, as my lack of desire to exercise and my exuberant desire to eat rich foods make it so I have struggled with my weight for years. Somehow the prescription: eat less and exercise more, is not very helpful for me. Yes, it is simple; but it is not easy. Having others explain it to me at this point is not only unhelpful, it is insulting. Of course I know that my weight is a problem! Of course I know I should exercise more and avoid that cookie dough in the refrigerator!
To successfully fight the battle against obesity in our country, we have to stop the condescending finger-pointing and instead ask the question: why is it that we humans don’t always act in our self-interest? Why do smokers smoke? Why do alcoholics drink? Why don’t people take their medications, eat enough vegetables, or go for walks instead of watching The Biggest Loser on TV? This seeming self-destruct switch is, to some degree or another, present (in my opinion) in everyone. It is the same drama with different actors and props. We all sell our birthright for some soup at times. We all go the route of easy self-indulgence rather than personal discipline.
Does that mean we are all weak? Yes, in fact, it does. My admission of my weakness has actually made it easier to have frank discussions with patients about their own personal struggles – be they weight, smoking, or other self-destructive behaviors. They listen to me because I don’t insult them with statements of the obvious. If it was easy to lose weight, don’t you think we’d have a little less than 2/3 of the population being obese? Does 2/3 of the people remain overweight because they want to be that way? No, the problem is not that simple; and suggesting otherwise won’t do much to deal with our national problem.
Dr. Benjamin has impressive credentials. She is a practicing primary care physician who cares for the poor. She’s not some subspecialist TV personality; she’s a doctor who has spent a lot of time face to face with the neediest people in our system. She doesn’t just know about the poor and needy, she knows them. She’s one of us; and her weight does nothing to lessen that – for me it actually makes her more relevant, not less.
So put down your stones, people. We are all weak. Having someone who understands the real struggle of the overweight may actually give us a better chance to successfully fight it. And if some of you still hold stones, let me rephrase a famous statement: The person without personal weakness can throw the first stone.
Dr. Jim Hill is a friend of mine and co-developer of the National Weight Control Registry – the nation’s largest database of individuals who have lost at least 30 pounds and kept off the weight for at least 1 year. Jim has been studying their commonalities – and has determined that there is in fact a recipe for long-term weight loss success. I shared the recipe with ABC news today. My interviewer (Natasha Barrett) was really funny, and had tendencies to blurt questions in the middle of our conversation (such as: “what do you think of granola bars?”)
It’s always a bit of a landmark when something like the Happy Meal reaches a big milestone in years. This week marks it’s 30th anniversary of being introduced into our lives. That’s a lot of years, a lot of meals and a lot of small cute toys!
A meal in a box…who would have thought! I do remember when they first came out and parents with little kids flocked to them like flies to sticky paper. However, coming in at 600 calories for an average meal, packed a huge punch on the typical child’s health and waist band. Indeed, as noted by ABC News, childhood obesity has increased by 4x over the last 3 decades moving from only 4% the child population to 17%!!
The McDonald’s rep interviewed by ABC News mentioned that the “most popular” Happy Meal, the chicken nuggets with apples, is now only 360 calories. That is a great decrease by just shy of 50%.
Let’s not celebrate yet. What we need to consider is what proportion of a daily calorie amount this mean eats up.
Chicken nugget meal with Apple dippers & Apple Juice: 380 cals
Chicken nugget meal with fries, 1% chocolate milk: 580 cals
Hamburger meal with apple dippers, white milk: 460 cals
Hamburger meal with fries, chocolate milk: 650 cals
Cheeseburger meal with apple dippers, white milk:500 cals
Cheeseburger meal with fries, chocolate milk: 700 cals
Finally, what percentage of a child’s daily calorie count will each of these meals snatch up for a toddler at 1000 calories a day?
Chicken nugget meal with Apple dippers & Apple Juice: 38% Chicken nugget meal with fries, 1% chocolate milk: 58%
Hamburger meal with apple dippers, white milk: 46%
Hamburger meal with fries, chocolate milk: 65%
Cheeseburger meal with apple dippers, white milk:50%
Cheeseburger meal with fries, chocolate milk: 70%
What about if the child is a 5 year old girl requiring only 1200 cals/day?
Chicken nugget meal with Apple dippers & Apple Juice: 32%
Chicken nugget meal with fries, 1% chocolate milk: 48%
Hamburger meal with apple dippers, white milk: 38%
Hamburger meal with fries, chocolate milk: 54%
Cheeseburger meal with apple dippers, white milk:42%
Cheeseburger meal with fries, chocolate milk: 58%
The kicker here is that if we run these numbers for the teens, the percentages wouldn’t be quite as bad but teens go for the bigger meals which put them right back into these ranges in the end! (A Quarter Pounder alone is 400 calories! Check this list out for more details.)
Fast food such as Happy Meals is one of the big players in obesity in general for all populations. There are times we all have to grab and go because of work, travel and circumstances beyond our control. The key to not have the loaded calories make too much of a long term dent is to have a fast food plan and to work on being more healthy over all. Here are my suggestions:
1. Pick small portions and healthy alternatives at fast food places, and teach our children to do so as well. When in doubt, down size and pass on the fries or split them.
2. Eat healthy in general so the fast food day is the exception, not the rule.
3. Be as active as possible daily so your body and your children’s bodies have a way to burn the added calories.
McDonald’s job is to sell food and lure you and your kids’ through the doors. Your job is to keep your kids healthy and teach them how to be healthy life long. Have a Happy Meal once in a while…but do so thoughtfully and don’t delude yourself that these meals are anything close to healthy. The new packaging and food choices are just new hype for the same old unhealthy song.
*This blog post was originally published at Dr. Gwenn Is In*
Do you know that most adults should eat less than 2,000 calories a day? Sounds like a lot, until you consider that if you eat out, you can get your entire days worth in one meal. Here are some amazing facts (chosen at random):
At Burger King – a triple whopper with cheese has 1,230 calories – add medium fries (360) and medium chocolate shake (690) and you are up to 2,280 calories!
The Cheesecake Factory brings you beer battered fish & chips at 2,160 calories, add a piece of Adam’s Peanut Butter Fudge Ripple Cheesecake (1,326) for a total of 3,486 calories!
How about Chicken & Biscuits instead, with 68 grams of saturated fat? Yes, that is more than four days worth of saturated fat (for a 2,000 a day diet, <16 grams a day is suggested).
Right now you can usually request the nutritional information at chain restaurants and someone will point you to or produce a pamphlet, but the information is not apparent. The idea of having those nutritional facts printed clearly on menus is meeting some serious resistance from the restaurant industry. I wonder why?
Public health advocates however are pushing hard to get this information in front of consumers hoping that people will make healthier choices when faced with the facts! The Senate supported a federal labeling law last month as part of comprehensive health-care reform, but we shall see what happens when it all comes to a vote.
Until then, it would be good to know when ordering – and passing on these facts to our teens who are likely to be eating out.
Have you noticed that many products on grocery shelves are bragging that they do not have high fructose corn syrup (HFCS)? HFCS has been demonized by many people in the public as well as the medical community in recent years. But how much different is it from just plain old sugar? The answer is up for debate, but I will do my best to present the facts.
HFCS has been used for many years, but the use really became much more common in the 1980’s. Food companies use it because it makes a desirable end product and is fairly cheap. HFCS comes from corn and is refined to get the sweet taste into a syrup. But is it worse than sugar?
Many experts believe it is no different than sugar. Both are high in calories and are considered “empty” calories, meaning they don’t have vitamins, minerals, or other healthy nutrients in significant quantities.
The American Medical Association and other scientists have agreed that both sugar and HFCS both contribute to risks of obesity, diabetes, heart disease, and other illnesses if eaten in large quantities. In other words, there is no proof to date that HFCS is more harmful than sugar.
So why are so many companies eliminating HFCS? It is all consumer perception. Consumers have heard that HFCS bad so companies are spending time and money eliminating it from it’s products? What are they using instead? Sugar.
Is HFCS natural? The Corn Refiners Association says that HFCS is natural. The FDA does not define the term “natural” so we really have no way of seeing whether something is natural on a food label. Food companies can use this word without repercussion from the FDA since they have not defined it.
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It’s always a bit of a landmark when something like the Happy Meal reaches a big milestone in years. This week marks it’s 30th anniversary of being introduced into our lives. That’s a lot of years, a lot of meals and a lot of small cute toys!
