You're Wrong About - The Obesity Epidemic

Episode Date: September 19, 2018

Mike tells Sarah that America has sent the wrong messages and done the wrong things about obesity for more than half a century. Digressions include height (again), sweatshops and Julianne Moore. Sarah and Mike’s mothers both make extended appearances.  Continue reading →Support us:Subscribe on PatreonDonate on PaypalBuy cute merchWhere to find us: Sarah's other show, Why Are Dads Mike's other show, Maintenance PhaseSupport the show

I was falling asleep last night and I noticed this tendon or something and I foot twitching and I was like is this how it begins once you turn 30s life like the fly. First you're gradually deteriorating and then you turn it to goo. So welcome to You're Wrong About the podcast where we circle back to things misremembered and unremembered. I don't know. That's fine. I like misremembered and unremembered because there are things that we are wrong to not even bother remembering. I'm Michael Hobbs. I'm a reporter for the Huffington Post. I'm

Sarah Marshall. I'm a writer for the New Republican BuzzFeed for whom I am currently working on an article that I have been thinking about for five months and I'm finally ready to start writing. That doesn't sound familiar at all. I feel like you're constantly writing something that you have completed in like a reasonable non-geological period of time. This is going to ruin this for you because today we're talking about obesity for which I have been working on an article that just passed its one year anniversary. Oh that makes me feel so much better. Actually it's 13 month anniversary. So your article is like

pulling itself up on the edges of tables and standing and walking around. I mean it's a little bit different today because we're talking about obesity which is a societal phenomenon but is not necessarily a historical phenomenon. Usually we talk about things that happened. Right and things that people were freaked out about in the 70s but have moved on to at least to you know other proxies for enduring fears. But this is an enduring anxiety that's had the same outfit on for forever. I mean we'll get into this but this is what I think is really interesting about quote-unquote the obesity epidemic. The original draft

of this article that I've been working on for 13 months it started out with the sentence the obesity epidemic is having a midlife crisis. There is something interesting about the obesity epidemic that for our whole lives you and me we've been hearing the same story about obesity right. It's like every summer or whatever the new numbers come out and it's like obesity is higher than it's ever been. Right. Obesity is higher than it's ever been. And there's the CNN footage of like the headless fat people walking around where it's like we're not showing people's faces. Yeah there's studies on this actually it's always like

a headless torso of somebody who's overweight and they're like carrying McDonald's eating a burrito. It's like the most stigmatizing possible way to present any kind of complex human phenomenon. It's like let's just cut their fucking heads off and like we don't need to deal with these people as people. Well their heads have been placed on pikes at the entrance of like various cities in California that want to discourage people above a certain weight to get in. Yeah. Yes. So I think we should start out by I know this is like kind of personal and people don't always like to talk about it but can you

tell me your how you feel about your own weight and how you feel about obesity I guess. I was always a really skinny kid and then got tall really fast and was pretty thin through high school and just never had never had a period of like putting on more weight than is societally assumed to be healthy and never had the experience of people like policing me. And my mom always when I was growing up kept out of it like she never told me not to eat stuff. She never like made me finish my dinner like I think she recognized that the compounded anxiety and shame that she'd always felt about food in her life was like something she

was not consciously passing on to me which she was able to do which is pretty cool. And also my body dysmorphia when I was growing up was all about height because I was taller than everyone. I was over six feet by the end of eighth grade and which is weird because it's something that you can feel a lot of complicated stuff about it complicates your feelings of gender based on you know the idea of women are supposed to be smaller men are supposed to be larger. Yeah. That you know so 90s. But the weird thing about that is like people will always remark about you being tall but it's always with this idea of you've

done something right. I've always thought that there's something interesting about how people like in the same way that you know we arbitrarily have this narrative that being overweight being fat is like a sign that you have done something wrong. You've been disobedient. You've been somehow greedy or something arbitrarily it's it seemed natively being tall is in similarly arbitrary way seen as something that you must have like done something right. It's like congratulations. Right. That's why people feel comfortable commenting on it like wow you're tall. Yeah I really made it. Yeah. So I have never remotely had

that problem because I am five foot five. I weirdly was never self-conscious about my height because I hit puberty really early so I was actually taller than all the other kids at like the ages when I would have been teased about my height and it was only like junior senior year of high school that everyone else shot up above me and there was literally a moment my senior year of high school for the first time in my life someone said blah blah blah what do you care pipsqueak something about shortness and I was honestly surprised I was like I'm not shorter than you and they stood up against me and I sort of realized that

like my head was up there like nipple height and it was like this weird like I literally had not realized that I was short until 17 and so it's one of those things where like I probably should be self-conscious about it because most people that are really short men are self-conscious about it but because I was never teased for it I'm self-conscious about all this other shit but the height thing which is like the most noticeable thing about me I'm just for some reason not self-conscious about it all but I was fat as well I mean for five foot five I was between 175 and 200 pounds

it's not super super super big but it was like big like I didn't really get teased about being fat because like you said it's completely different from men there's studies about this too that the BMI at which women get teased about their weight is way lower than the BMI at which men get teased about their weight women have to be like five pounds overweight and people like you fat pig whereas men can be like 40 pounds overweight and they're just like oh he's stocky you should play football like people don't construct it in the same way right because our bodies are for different things women exist to continually

inspire lust and if we slack off in a moment then it's terrible but my mom was overweight my whole life and her whole life so growing up it was like the defining feature of our family was that on every family vacation my mom would only let us take one photo of her wow my whole growing up I have maybe six or seven photos of my mom because she was so nervous about getting her photo taken people used to make comments to us in cafes they my friends would make comments when she picked us up from school I mean this has been my foundational thing with weight is that I saw how incredibly shitty she was treated because of her weight and I also saw

how hard she was trying like I saw that she was 100 always on a diet every waking moment of her life and my life she was on a diet she would make us meatloaf and then she would sit there and eat a bowl of carrots she was always doing something and it didn't matter like she was always she was a little bit bigger she was a little bit smaller she was always yo-yo-ing she would do these weird you know the grapefruit thing or the cabbage thing or atkins or zone or you know she was always on some diet and it always worked for a while and then it didn't and she felt really bad about herself I used to feel ashamed of her and then I used to get really mad when other people commented on it like it's just a very complicated thing and so growing up and now I've always had like a huge

chip on my shoulder for the way that overweight people get treated in society I mean it's really cliche to say this but it really is the only minority group in America where it's okay to just make shitty jokes about people and to comment on them on the street and we were being on a date once and we were walking from like one bar to the other and we saw this larger lady walking toward us and as she passed he goes oh her poor shoes I remember I was a little drunk like drunk enough to be very forward and I just said fuck you bye and I just turned around and I just walked home oh that's amazing you feel comfortable making comments like that about fat people in a way that you don't for any other minority group about people that you know nothing about their lives

like you don't know like maybe that woman used to be much larger than she is maybe she has a thyroid condition maybe she has emotional eating issues because her parents just died like you don't know anything about that person and you feel comfortable just making this shitty throwaway comment one of the things I really notice is late night tv will make the most hacky jokes about politicians or about public figures about their weight like whenever anything about Chris Christie comes up the joke is always like well maybe if he put down the M&Ms and it's like no Chris Christie is just a bad politician like we don't need to bring his weight into it yeah you know you'll have like Seth Meyers or somebody talking about his ridiculous corruption and his

like toadying to Donald Trump and all this awful morally disgusting stuff that he's doing and then they'll be like well guess he's too big or like they'll make some like 1950s joke yeah about him and you're like is that really the worst thing about Chris Christie his weight like I can think of 750 things like Chris Christie they're way more disgusting than his weight like literally every other thing about him yeah and also like how the way that we're judgmental about people because of weight it's like you can masquerade it as like I'm concerned about your health and it's like no you're fucking not because no one has ever told me ever that they're concerned about my health and I am very unhealthy I'm sedentary I eat garbage like I had a box of fries for dinner the other night

I run a mile this is true I've run a mile once in my entire life and I hated it and then I was like I'm out this is terrible I don't get it I'm never doing that again I never do cardio so like until people start concern trolling me then like they don't get to concern troll anyone who's overweight well that's the thing and so for this article I interviewed probably around like 50 people many of them people at various levels of I hate the word overweight because then it implies that there's some weight you're supposed to be yeah which is such bullshit but it's so hard to talk about this issue without saying fat which really hurt some people's feelings I know or overweight which is inaccurate or these weird euphemisms you know like large or curvy or stocky which are

kind of like patronizing right full figured like she was kind of sick of someone as big boobs yeah I mean I kind of like larger actually but anyway I I interviewed a lot of larger folks to this article and they said that that's what one of one person that I interviewed was saying what is the LDL cholesterol number at which it's okay to treat me like shit if you sat next to somebody on a plane and he was talking to his wife on the phone and he's like oh my test results came back I'm at high risk of heart disease if that person was skinny you wouldn't immediately be like you piece of shit I don't want to sit by you anymore it's only when it shows on your body that you care about anybody's cardiovascular disease risk like we don't walk

around asking people like they're resting heart rate and shit it's only if somebody's big but this is a good this is a good lead-in to sort of the first and maybe the major you're wrong about about obesity is that 30% of overweight and obese people medically like BMI considered 30% of overweight and obese people are metabolically healthy they're fine they have exactly the same metabolisms that everybody else does their resting heart rate is fine their diabetes risk is fine 30% of them 24% of people who are not overweight or obese do have fucked up metabolisms so telling somebody's health by their size it's one of the worst ways to do it if you want to know how healthy somebody is you need to like take their blood and shit like you can't look at somebody from across the

restaurant and be like oh they're so unhealthy oh their lifespan is so short there's a very good chance that you are wrong about whatever your presumption is the second thing though it's also totally irrelevant because there's like this debate among the medical community and all these like debating and dueling studies is body fat itself a health risk or is it just like diet and exercise that is a health risk but who cares because frankly losing weight is impossible we all sort of know this it's a cliche right 95% of diets fail we all kind of know that diets don't work so okay my understanding of it and this is probably wrong in a bunch of ways but my simplified understanding is that your body reaches its highest weight and then for the rest of your

life if you lose weight from that it will be trying to get back to that weight again or like trying to get back to that fat content it's basically an evolutionary adaptation right it makes sense for us as a species to hold on to weight because that's how you deal with periods of famine whether it's a daily famine or a weekly famine or a monthly famine it makes a lot of sense for us to hold on to weight and then of course there's huge individual variation in how the body holds on to weight I interviewed a bunch of endocrinologists for this and there's like 50 different things that the body does to keep you from losing weight like your body temperature goes down your hunger hormone spike your the hormones that tell you when you're

done eating your satiety hormones those turn off so basically you'll eat a whole meal and then you'll just be hungry as if you haven't eaten because your hunger hormones are going nuts and your satiety signals aren't working so when you talk I talked to a lot of people that got gastric bypass surgery and one of the reasons why gastric bypass works is not actually that your stomach is smaller it's because it totally like reboots your entire hormone system so a lot of the folks that I interviewed who had gastric bypass they said I've never felt full before this is the first time I've ever been full they're like I've literally been hungry since I was 18 oh that's horrible I am 400 pounds I know that my weight is making other people treat me terribly

but I'm fucking hungry all the time and so for me to eat two dozen calories a day means I am hungry every waking moment my mom did an amazing job with this that when I was a kid she never made me eat when I wasn't hungry she never made me finish food because she put it in front of me if I was like I'm full she'd be like okay and I'm full all the time if I'm at a restaurant unless I'm eating a salad or something like I basically never finish my food and I worry that people are like what a good self-abnegating person and it's like no I just got full really fast and then I'm gonna be hungry again in two hours but it's because that's the way that my body works well I think the thing is it's really hard to deal with individual variation one of

the endocrinologists I interviewed the way he broke it down for me is that first of all he said that the whole calories in calories out thing is total nonsense calories in calories out is as credible among endocrinologists as like climate denial is among geologists that like none of them really believe in the calories in calories out thing and the way that he talked to me about it which I thought was really interesting the average American were kind of supposed to eat two thousand calories a day right that means over the course of a year you eat seven hundred and thirty thousand calories according to the calories in calories out model thirty five hundred calories is a pound so if you eat thirty five hundred calories extra you'll gain a pound if you eat

thirty five hundred calories fewer you'll lose a pound and so every single diet is based on this principle if you eat fewer calories you will get smaller because of thermodynamics but he was pointing out if you're eating seven hundred and thirty thousand calories a year a one percent deviation is seven thousand three hundred calories so that's two pounds so if you are gaining or losing less than two pounds a year you are deviating less than one percent in your calorie consumption for the entire year wow no one is that good right nobody's fit bit is counting within one percent every single day yeah what he says is there's automatic regulatory systems basically if you eat a little bit too much at the Thanksgiving party last night your hunger hormones the next day

will tell you and eat a little bit less today if you exercise more your energy hormones you'll just have a little bit less energy the next day and you won't sort of tap your foot during the meeting as much as you usually do and a lot of these things aren't really day to day but they're like week to week and month to month so your body if you eat a little bit more your body will actually burn off more calories and if you eat a little too little your hunger hormones will spike and you'll eat a little more and so the idea that we're just calorie machines you eat and you expend and you get bigger or smaller right doesn't take into account this extremely complex extremely dynamic system by which you just regulate yourself so one of the things that I thought was really interesting

about the history of the obesity epidemic is people talk about how we all sit at our desks we don't do farm work anymore we all sit in our cars we don't walk anywhere that is all true but all of that happened before 1980 and obesity rates didn't budge until 1980 think about the changes in American society between 1880 and 1980 it's profound right everybody's leaving farms everybody's moving to cities I feel like the 50s is when we got really sedentary and when sort of office jobs rose to the cultural supremacy they have now exactly and yet obesity rates didn't do anything until the 1980s and so what the studies show is that at the population level as we moved less we ate less American calorie consumption went down significantly from 1940

to 1980 because we weren't working as much so we didn't eat as much like our our natural regulatory systems kicked in without anyone thinking about it without anybody going on a diet we just all kind of automatically quietly started eating less and so what happened in the 1980s was that the food supply changed so the food supply started to dysregulate us so there's all these studies now about how diet quality not quantity is actually what causes diet related disease that eating refined grains eating a lot of added sugars like added sugars throw off your satiety signals if you're already full you can eat something more if it's sugary right like you eat all Thanksgiving dinner and then the pie comes out I love how like you learn the science and you're like oh that's why

dessert is a thing that's why we've been doing this for thousands of years that all makes sense basically the the food system change and there's all this research about globalization and about the wto and about the way that food started to get processed a lot more and I don't like that term because processing like tofu is processed and yogurt is processed like processing just means you transform it from one thing into another but it's this kind of hyper processing or they call them super potent foods foods that have like no fiber tons of added sugar basically you barely have to chew them and they go straight into your digestive tract and they just get absorbed really quickly things like Oreos right the first thing I think of as a twinkie because like you practically

inject it right into your bloodstream right there just became more and more of these foods that are just really really really easy to digest and really easy to absorb and keep eating and what they basically did was just rejigger all of our biological systems to put our set point higher and higher and higher and higher and so for some people that shows up in their weight and for some people it doesn't so it's really important to make the distinction between weight and health eating lots of twinkies and not moving very much is bad for you but it can't be bad for me Michael because I'm not showing it physically and so I'm just gonna live forever and I'm virtuous and thin and it's fine so you're totally fine even though I had a plate of bacon and syrup for breakfast

right before starting this episode the way that one person put it to me who I talked to she said that we sacrifice health to focus on weight there's kind of these overlapping circles eating bad food and not moving is bad for you some people who eat a lot of bad food and don't move some of those people are fat and some of them aren't but we've been focusing on the way that those people look rather than our fucking food supply which is super poisonous nobody's looking at like hey maybe we shouldn't have like cheeseburgers and french fries in school lunches like maybe that's not a great idea whether the kids are fat or thin maybe they shouldn't be drinking coax but it's only with the fat kids that we're like hey maybe you should lay off the coax and then thinking about just how

people's ability to get fresh foods or produce of any kind has become almost impossible in so many areas it's like once again our kaiser soze capitalism has appeared at the margins of the story there's basically three reasons nothing has happened on obesity and why we keep fucking it up so all this stuff about the set point and losing weight is impossible we knew this in the 1960s all of the science that we know about obesity this is not recent that cliche that 95% of diets fail that comes from a study that was published in 1959 oh my god in 1969 there was a study to show that if you lose 3% of your body weight your metabolism gets 17% slower so that you'll put it back on that was 1969 yeah we fucking knew this like we knew about gut microbiomes we knew the

mental toll of losing weight and putting it back on we've known for 70 years that what we're doing about the obesity epidemic isn't working and we we've known for 70 years that america is not going to become a skinnier country like no country on planet earth has reduced its obesity rate ever really yeah we can become a healthier country but we're not going to become a skinnier one the pillows don't say you can never be too rich or too healthy do they although maybe they should it's amazing that we've that we've just ignored this for so long and that it's weird like when you tell people we're not going to become a skinnier country they sort of reject that like a transplant they're just like what no come on come on so the first reason

why we have fucked this up and keep fucking this up is basically doctors doctors are terrible if you interview anyone of a certain size they will have like four stories each of how doctors were terrible to them one woman i interviewed was in a fucking train accident where she dislocated her shoulder and she gets to the ER and the doctor goes how long have you been this big she's like i was in a i was in an accident like wow what does this have to do with anything another one went in for her allergies again nothing to do with her weight whatsoever doctor comes in and asks her how did you get like this oh my god and then he's like giving her all this shit she's like what should i do about my allergies he's like well try eating more fruits and vegetables and try like exercising more and

she's like these don't sound like allergies tips and then she goes well what do you tell your thin patients when they come in with allergies he's like oh i tell them to stay away from grassy fields during the day and i tell them to take zirtec and she's like okay why don't you tell me more of the tips you give thin people and then this is like her tactic for dealing with doctors is just say like what do you tell thin people you're not allowed to have allergy medication if you're above a certain bmi because if you have to walk around sneezing as punishment then you'll be motivated like this is what i can't get over like this idea that like well if we make life really painful for people whether they're poor or overweight or whatever then they'll be forced to change because they'll

know that everyone hates the way they are and it's like i don't think that works yeah because most overweight people have no idea that society doesn't like them so it's important that they're doctors who they trust yeah the most bananas when i heard was this woman who has been overweight her whole life and at 17 she goes into the doctor with migraines and she gets referred to a neurologist and she had to go to like a bunch of different appointments for her migraines and every time she went in her neurologist would be like uh you need to lose weight and she was like i'm like six foot and like 165 i actually don't need to lose weight i'm actually fine and then her her neurologist goes well you'll need to lose weight if you want to get pregnant and she's 17 it's the trifecta

it's like mean untrue and irrelevant one problem is that they're mean like if you survey doctors they have the same attitudes about fat people that everyone has like they're no more enlightened on like fat stigma how important it is to be nice to everybody that's one aspect of it another aspect of it is basically just they don't know what they're doing i mean if you ask fat people what sorts of things doctors have done to them over the years one guy interviewed his doctor would tell him to eat ahead of lettuce for dinner oh god that's exactly the kind of diet like all this cabbage soup grapefruit all these bullshit diets those are exactly the kind of diets that are the most likely to fail obviously because they're mean and insane and you know that you're

punishing yourself yes and there's no such thing as a maintenance phase of a diet so many people that i interviewed said that doctors would put them on these completely insane diets like 500 calories a day this is like world war two rations diets like completely insane stuff and then they'd be like oh once you get to a lower weight your body will adjust and it will get easier which the science again since the 1960s we've known that the opposite is true the more weight you lose the harder it is and the more your body is going to tell you that you're starving you're gonna have no energy during the day you're going to feel like shit your brain is going to be foggy it doesn't get easier as you lose weight it gets harder and yet doctors are telling people that it's going to

be easier like someone you trust is telling you that you should be able to eat ahead of lettuce for dinner and that it's your fault if you come back having not lost enough weight or having lost no weight or really struggling so almost everybody that i interviewed had been put on these insane diets by their doctors and then when they come back and say look it's really not working i've plateaued or i'm hungry all day and i can't work i can't write emails because i can't focus on anything other than food and their doctor's like well just power through oh my god you just gotta keep powering through and then your body will adjust these are medical professionals yeah but for 60 years we've known that this isn't true and they're telling them the same thing so

one of the doctors that i interviewed who's like one of the like woke doctors on this is like the way that doctors treat obesity has not changed since the 1960s like there are no new techniques they're not giving any different advice one thing that he said he's an eating disorders clinician and one thing that he said that was really interesting was like what doctors should have been doing for the last 60 years is giving people realistic expectations if people go into their doctor and say hey i'm going on atkins i'm going on this grapefruit diet whatever their doctor is the one who should say look you're not gonna lose more than 10% of your body weight you're just not and what you should think of is whatever a diet tells you is

the maintenance phase that's the diet the diet is what you do for the rest of your life this idea that you're gonna get down to whatever your high school weight these terms like you get the momentum or you like jump start your weight loss there's no medical science to back that up some doctors were actually selling like slim fast shakes he told me of course they were so instead of telling people oh you can do this only eat 500 calories a day what they should have said was just look change your lifestyle find something that you like doing exercise wise like if you're really into tennis play tennis if you're really into walking go walking like find something you can do the rest of your life and please don't think of your weight don't think of yourself as a failure

just live the healthiest life that you can and maybe you will lose some weight and maybe you won't but this is the way the human body works and all you can do is try to be the happiest person that you can be at whatever weight you're at but doctors never do this yeah doctors only get 14 hours an average of 14 hours on nutrition for all of medical school what so they're not learning any lifestyle stuff they're also not learning any soft skills i interviewed this guy that trains doctors and how to be better like how to be nicer yeah because they don't learn any soft skills all they're learning is biology and medical school typically and so he's teaching them to like listen to their patients these things that shouldn't be state of the art that sort of are

and so he says doctors they'll be talking to like a low income mother of five who has two jobs and all her kids are unhealthy and they're drinking cokes and stuff and he'll be like you know i really know what it's like to not have time to cook oh my god no you don't and of course oftentimes doctors use that as a way of forming empathy and this guy was telling me that i mean all humans should know this but definitely doctors should know this that that's the worst way to build empathy to be like i'm the same as you because it just contrasts you're not the same as me and so it's much better to just be like man that really sounds frustrating let's work on some stuff to help you get your kids healthier food without bringing yourself into it because it's

like oh you went to Yale and you run triathlons maybe we don't have the same life like maybe don't emphasize that aspect yeah if you're operating from that template of my life as a busy doctor who sometimes doesn't feel like cooking my blue apron dinner you come at it with this approach of like well i have tiny obstacles in my life but i overcome them through willpower like is that the same thing yeah this also makes me think of how do you remember that herman tarnauer the doctor who invented the scarsdale diet which i think was you just ate a lot of grapefruit mainly he was having an intricate affair with a very repressed headmistress of a fancy girl's boarding school and i think after he spurned her she shot and killed him and got more sympathy in the press than

she otherwise would have because so many women had done the scarsdale diet and wanted that fucker to suffer one of my like revelations from this was talking to both my mom and a lot of the other people that interviewed actually said the same thing they were like you know what in my 20s i was 20 pounds overweight and so to lose that quote unquote last 20 pounds i spent my 20s doing more and more extreme things so i would lose 30 gain 20 lose 40 gain 50 and they do this yo-yo thing you know for 10 15 years they're focused on food all the time they're having basically eating disorders whether they're diagnosed or not but kind of low-grade eating disorders and then they look at themselves at 35 and they're 80 pounds overweight and their relationship with food is shot their

self-esteem is shot because they feel so bad about gaining the weight back why am i such a piece of shit i can't even keep this weight off the entire society is telling them that this should be easy for them their body should be adjusting their doctors no matter what they go in for are telling them to lose weight again when if they had just been quote unquote 20 pounds overweight in their 20s and just been okay with that they would all be fine i just had a long conversation with my mom about this where she's like no one ever told me that i could just be a little bit bigger yeah i should just try to eat well and exercise and like live my life the best that i can and if i'm 20 pounds bigger than my mom wants me to be then like i'm just gonna be that and live my life whereas now

it's like the self-esteem the time you waste all the weird diets all this stuff it's so much worse for people than just being where they are yeah and all of the time and like the pictures of my mom that i grew up looking at from like the 60s and 70s she always to me looks like ali magraw with big boobs basically like she was hot for like all of the years that i know that she spent doing that same thing trying to lose or keep off like the last 20 pounds yeah i'm just thinking like what if one day you were just like this is what i weigh and i mean you know and that's why it's so wonderful now that we're like in this fuck you i'm not dieting a bikini body is a body with a bikini on it has appeared how did that take as long as it did i mean that goes into the second reason why

basically nothing institutionally has changed on obesity epidemic and that's stigma this is crazy stigma against larger people is going up really we're now at the point where 66 of the population by the bmi scale is overweight or obese 66 of the population and a greater percentage of the population reports that fat people are lazy like that has been steadily increasing and i would say that's because we're all congenitally as american self-loathing that it's like something that self loathing is something that we as humans are quite programmed to do and i think in america we're very much encouraged to the way our society works exacerbates that so the more of us are overweight the more that manifests as stigmatizing hate because we hate ourselves well truly i mean

what's really especially tragic on this is that first of all the the phenomenon of minority exposure doesn't apply so like if you have a gay cousin you're going to be more likely to be okay with gay people that doesn't apply for fat people you're like oh my sister is fat but fat people are still lazy my sister might not be but you maintain the stereotype you're like oh fat people are disgusting it's just my sister has like a medication that she takes that made her gain 30 pounds but everyone else is really lazy and the even sadder thing is that fat people are just as likely to report that fat people are lazy if you ask me about gay people i'm like gay people are the best but if you ask fat people they're like oh yeah everyone who's fat is really lazy including

me because we all get the skinny people propaganda our whole lives and we're hearing from our doctors we're hearing from our families we're hearing from everybody that we should be skinnier and one reason why is weight status is a very different minority group like there's a couple unique aspects of weight stigma and one of them is that when you survey fat people where is the worst stigma we sort of think of like fat people being bullied for their weight as something that happens in restaurants it happens on public transport and that does happen but most fat people say that the worst experience of stigma they've ever gotten are from their own families so it's one of the only minority statuses where you can't get away from it you can't escape it you can't if you're getting

bullied at school you can't come home and get a hug from your parents oftentimes you come home and your parents are like why are you eating that you fat piece of shit and so so many people I interviewed for this article brought up their parents within five minutes where i'm talking you know i say like hey tell me about your eating history tell me about your weight history and they're like my mother was a diet or my mother used to hide candy around the house my mother told me oh you'd be pretty if you lose if you lost 10 pounds oh my god it just it just makes me really sad and so that's one of the ways that not only is it severe the stigma but it's also very internalized it's much more internalized than other forms of stigma as well as the family thing it also is the number one reason that kids

get bullied at school more than race more than gender more than poverty more than anything else kids get bullied for their weight most schools don't do anything about it I interviewed a bunch of people whose kids have been bullied at school and they're like um this is a problem the teacher's like oh well if she lost weight she wouldn't get bullied oh my god no one says that for any other status oh my god like if I were redesigning the human species which I hope to get the contract for you know at any day now fingers crossed I would try to do something about the propensity for victim blaming because we just we're we love doing that it's it's bad yeah I'm curious about with romantic partners too right because if you are gay and antagonized and then you go and you like

find a partner you're not going to sit there in bed being like you disgusting fag right but if you are overweight if you're in a relationship with someone who has absorbed that societal stigma yeah you know and is projecting stuff on you about it there's no escape and like this idea of just not even feeling that you're attractive to the person that you're sleeping with yeah no one deserves that well there's a survey in a sir I found a survey of fat people where it's 89% said they had been bullied by their spouse oh my god and I also interviewed a lot of people who had stories of this so there was a study a qualitative study I read where they were interviewing people about this and one one woman said she didn't like to be naked in front of her husband another woman

that I interviewed she said she spent her 20s basically just sleeping with loser dudes because she thought someone being attracted to her was a depletable resource and that she was so disgusting that this guy I have to keep this guy because I'm so disgusting that no one will ever be attracted to me ever again that was just kind of the way that she went through her 20s and she's of course only realizing this now she didn't realize how much that was ingrained she eventually ended up dating somebody who was really abusive who used to tell her that she was disgusting and would tell her if you leave me who is going to take you oh my god like he was abusive she eventually ended up leaving him which is great but she believed him at some level I mean that's

what she said to me right she believed that she was not worthy of love she believed that she would never find somebody else so it's like I guess I'm just gonna stay with this guy who like hits me sometimes because if he leaves me this is the last guy that's ever gonna be attracted to me right yeah and we're so ready to believe that there's something basically wrong with us this one woman that I interviewed she says her hardest thing eating wise is when she goes to these like social events like family reunions or like pool parties with her kids she has four kids and she was at one of these things and she was kind of you know there's like a buffet at these things and she was loading up her plate and her mother said should you really be eating that in her this

was in her early 20s and so ever since then she's been scorchingly self-conscious at these things and thinking that everyone is looking at her and oh there goes the fat person dishing up the lasagna you know she's always aware of this in her head and so what she does is she doesn't eat at these things because she wants to be this like impeccable fat person that everybody wants her to be so she's always on her feet she doesn't want anyone to see her sitting she wants everyone to see her being really happy that's what she feels the pressure to do and then at the end of these events there's always leftovers so she packs up the leftovers they all divvy up the leftovers and then she goes home and she eats all the leftovers by herself in the dark yeah because

she's been she hasn't eaten in 12 hours because she's fucking hungry and she deserves to eat she's been basically feeling shamed all day it's like holding a light weight above your head right that at first it's easy and then it becomes excruciating over the hours that she's essentially been like flexing a muscle for 12 hours and then she goes home and she does this binge eating at night thing and she feels terrible about herself and the whole next day she feels terrible and then that increases the binging and I think one of the things one of the greatest and most pernicious myths about this is that shaming like we have to shame people for their weight if we don't shame people for literally everything that they don't conform to then like how can we

expect them to hate themselves enough to change right that seems to be what we've all agreed on as a culture and it's like you hear otherwise very smart people say things like oh well we have you know shaming works we have to shame people so that they change their behavior it's helping them it's like this really paternalistic really patronizing horrible thing and every study on this has found that when you shame people for their weight you increase their desire to lose weight but you don't increase their ability right losing weight doesn't become any easier because someone's really mean to you yeah 89% of larger people say that immediately after experiencing stigma they want to eat yeah like what makes you stress eat more and comfort eat more than everybody hates me

and yeah one of the endocrinologists that I interviewed said that you know we're all like attuned to stress right like running from a tiger we all have all these like adrenaline and cortisol systems that kick in when we're under stress but we're also social creatures so something like running from a tiger or jumping out of an airplane these spike your stress hormones but being socially shamed being rejected spike them more so it's actually worse for your stress system to feel rejected to feel like everyone is watching you to feel like you're being judged is extremely stressful and one of the effects of stress hormones is it spikes your appetite your body wants energy because your body is like well I'm about to have to run from a tiger so I'm gonna

need energy later yeah so what I need is to eat as much as I can as much calorie dense food as I can so it actually turns off your satiety hormones it actually makes you or it makes it easier to overeat when you're under stress and it which is like the most cruelly ironic system right like it's it's just not fair the human body is just a pinata of cruel irony I feel one guy that I interviewed he was walking across a parking lot after work and this car drove up next to him and shouted go on a diet and then peeled away and he got straight on the bus and went straight to jack in the box he just needed comfort he felt really rejected at that moment and that was like the thing that his cravings were shouting screaming at him to do and so this idea that it's like

we must shame fat people we must be mean is exactly the opposite of what the science tells us and again we have known this for decades well and do you think that that speaks to maybe a subconscious sort of ancient human herd feeling where you know we are telling ourselves this line of like I have to help this person by relentlessly making them feel terrible about their bodies but really we know that if you shame someone into hating everything about themselves and to you know continually undergoing these stress responses which I also would imagine are not great for your health in the long run if you're forced into fight or flight all the time for no reason oh totally yeah right that really if you're doing that to someone then the message that you were

giving them is like why don't you go fucking die and that people are going to do that if you do that to them individually and as a society and in our you know in our tribal lizard brain that's what we maybe deep down know that we're doing and what we're psychologically pushing people toward and this is what people should know being bullied for your weight has nothing to do with your weight so kids who are bullied for their weight are twice as likely to attempt suicide regardless of their weight so this is really important there's all this literature about people who perceive themselves as overweight are much more likely to have heart disease much more likely to overeat much more likely to binge eat much more likely to feel bad about themselves

much more likely to not go out in public it's actually extremely bad for you to be bullied for your weight no matter what your weight is and so the people that are defending this idea of like oh we have to shame people for their weight you're literally creating the problem that you're pretending to solve right bullying people for their weight even if they are normal bmi 22.5 perfect normal bmi bullying them for their weight will make them unhealthy right which is when you talk about it is really fucking obvious but we have to get spell everything out apparently and this is one of those things is that being self-conscious is really bad for you so many many of the people that I interviewed say that they've never been bullied like they've never had a stranger shout across a parking lot of

them they've never had actual comments but they're aware of it one of the women I interviewed is like a CEO she runs a tech company and she said that whenever she's at a meeting where there's food you know there's bagels and all the table or whatever she freaks out she's like if I reach for one everyone's like oh the fat lady wants a bagel typical fat lady if I don't reach for one they'll be like oh why isn't she reaching for one is she trying to slim down it's basically activating these stereotypes whenever she's around food and so being aware of yourself being aware and asking those questions all the time is really fucking bad for you like right it's a form of stress and a form of watching yourself all the time and being really nervous about it in the same way that

chronic poverty is stress on people that we find this with gay people too that being in a closet is really bad for your stress system that it just fries all of these internal circuits that keep you healthy because you're basically operating at a low level panic like all the time and it's extremely bad for you because you're living as a pariah one of these women said that she's flexed waiting for like the next bad interaction to happen right whenever she orders food at a restaurant she's looking around like okay who here is going to talk shit who here is going to point at me and tell their girlfriend who here like she's just watching the environment around herself all the time yes it's like being on the secret service and you're just trying to

have a meal in a restaurant I mean she's also institutionally this is the most depressing thing institutionally this is the most depressing I'm sorry because I'm always you know me I'm always interested in institutions right you're not going to like change society but you can change institutions so I'll do society and you do institutions there's only one state that prohibits discrimination on the basis of weight it's legal to fire people for gaining weight a Texas hospital famously just posted ads that said we don't hire fat people that's legal you're allowed to do that everywhere but Michigan good old Michigan we all know that like discrimination laws don't end discrimination right but it sends a message the powers that be think that this is a bad thing

right in the same way that like gay marriage did not end discrimination against gay people but it's a sign of like okay the country has moved on it is not okay to discriminate against gay people anymore at least it's like on that path yeah there's nothing on that path for fat people there's nothing saying hey everybody this isn't okay most state anti-bullying efforts like school bullying efforts states have anti-bullying policies none of them mention weight even though really number one reason people get bullied yeah like a couple of the mention like looks but there's nothing explicitly stating it is not okay to bully people on the basis of their weight and I talked to this public health researcher and she said she's not aware of a public health campaign

worldwide ever that has attempted to reduce weight stigma there's a million public health campaigns they're like eat your vegetables and don't drink coca-cola blah blah blah there's never been one ever that is like hey maybe be nice to people regardless of their body size yeah never so there really has been no attempt to change this like no one has tried and it's really difficult for civil society to form around this issue because of internalized stigma so a lot of people that are fat don't identify as as a member of a group that they want to do something to change right like I as a gay person can join the HRC and be like I want a campaign for better anti-discrimination laws but there are a couple groups that fight for better fat acceptance

but they're really small and it's really difficult to recruit people because people are still in this mindset of oh I'm fat because it's my fault because they don't want to come out as fat and literally like coming out as fat is a huge deal a lot of the people that I talk to have kind of gone through this process with their families I talked to this stigma researcher it was like we're having this like long interview and we're talking about stigma and research and stuff and then eventually he mentions he's like as a gay man and I'm like I am also a gay man and all of a sudden we were like hey my like journalist thing went down and his like stigma researcher went down and we were like Chad and it was really enjoyable like you're rolling down the windows

at like your stop at the same light you're like hello and one of the things I I was like okay now like let's be real as a gay guy I come out to people as gay constantly right whenever you meet a new person you have to kind of navigate what does this person know about me how am I gonna present myself but you can't come out as fat right because people can see it on you and he said coming out was never about visibility coming out was about telling people that you're not gonna apologize for it anymore like that is what gives you the psychological benefits of coming out is basically telling your parents I don't actually care if you hate gay people or not but I'm not gonna hide my sexuality from you anymore there's nothing wrong with my sexuality and he

says it's really really really hard for bad people to do that because a lot of the stigma that they're getting is from their parents right that their parents are also fat or their parents are really really really stigmatizing and so it's really hard to say to your parents hey let's not talk about this I interviewed a couple people that said that they have actually said to their mothers do not mention how I look when I see you don't say you look good don't say you gained weight do not comment on my looks ever but like that's a really fucking hard conversation to have yeah and I feel like overweightness fatness however you see it is something that stands in for people as the greatest sins you can commit as an American being selfish being greedy not working hard enough

you know and that these are the things that as Americans that we are conditioned to think of as the worst things you can be yes you have to make that leap I don't care where I am practicing not caring what you think about me physically and I also don't care that you think this means I'm lazy or greedy or whatever like I don't you know just you have to reject an entire lifetime of received wisdom about what it takes to be a good American like it's just it's a very it's really hard yeah I mean and you need support from the people in your life to be able to do that and that's what you're getting denied so this brings us to the third reason why nothing has been done about obesity in 70 years which is inequality that as you mentioned earlier the cost of healthy

foods I found a study on this healthy food costs calorie for calorie 10 times more than unhealthy food and the gap is widening so healthy food is getting more expensive unhealthy food is basically staying the same unhealthy food is unfucking believably cheap we all kind of know this oh we've all been to Walmart yeah but it's like when you when you look into the numbers we sort of think I think in the background of obesity is kind of a problem of affluence right that like people have too much it's like rich white ladies and their SUVs but when you look at the numbers dude it's it's a symptom of inequality the numbers on diabetes rates black people have twice the rate of stroke there I think it's three times more likely to die of diabetes so even people who have

diabetes black people have it worse right because you can't afford to maintain yeah even at the same weight black people are 12 percent more likely to get diabetes than white people at the same weight so all of this comes back to cost and structure that if you look at who is getting diabetes all of these rates of cardiovascular disease have basically started to level off among white people since the early 2000s that obesity rates cardiovascular disease heart disease strokes all this stuff is plateaued among white people and it's still going up among the poor ethic minorities and the uneducated these are the groups in America that need help so much of this is really about availability and cost I mentioned school lunches earlier who is eating school lunches who is eating

school breakfasts poor kids who is making their kids like a nice kale salad in Tupperware it's rich kids when you look into the numbers it's like really fucking obvious that this has nothing to do with weight and everything to do with just what food is available and who gets to walk to the grocery store who gets to walk to work who gets to take decent frequent reliable public transport who is stuck in their cars for an hour commute each way because they live way out in the exerbs and so this idea that you're fat because you're lazy or whatever it just isn't that's not who's fat in America the people that are fat in America are people that don't have any decent food available and are working continually and are working two jobs and can't feed their kids and you know the

I think I've talked on here before about how food stamps don't cover quote-unquote prepared foods so you can't buy a sandwich with food stamps you can't even buy like one of those rotisserie chickens that they have at the grocery store for like eight bucks you know those like roasted whole chickens because it's prepared it's hot you can't get any hot food with food stamps and so if you're somebody who doesn't have a lot of time or you don't have an oven and you have kids like that's a fucking great thing to feed your kids rotisserie chicken is a human right okay yeah and also you know and then there's just the kind of overall costing with food stamps that they just don't cover very much food same with wake women and infant children it just isn't enough and so what are

you going to do when you don't have much money you're going to scrimp and save you're going to buy the pound cake at the store there's like 79 cents for like this giant thing of pound cake which is like a fucking of course you're going to do that you're going to get box macaroni and cheese you're going to buy the bag cereal you're going to buy ramen you're yeah yeah there's studies where they've done these things where for food stamps they'll give you like two bucks if it's healthy food for every buck that you spend like it'll it'll magnify your food stamp spending and lo and behold people spend more money on healthy food people eat healthier they've done all these studies on when when the cost of food goes down what happens to healthy purchases versus

unhealthy purchases and again lo and behold when the cost of healthy food goes down poor people buy healthy food nobody wants to feed their kids top ramen five nights a week oh no poor people do want to feed their kids crap because they're intrinsically bad and evil and that's why we have to slowly kill them all like i'm pretty sure that's the agenda that i was i was raised yes that's on all the billboards yes so one thing that's really interesting is there's this concept i don't know if you know this concept of food deserts that there's basically places in america where they're just like aren't grocery stores there's like nowhere to buy food i've lived in some of those they are trippy yeah so have i actually i was interviewing a researcher who works on these

and she said that what's actually a more useful concept is food swamps that's not necessarily the thera places where you cannot get healthy food it's that there are places where terrible food is super cheap and super available and so it just puts people in this bind every time like do i want to walk farther and spend more to get broccoli or do i want to go around the corner to like the fish and chips place there's all these studies to like put farmers markets and poor neighborhoods but first of all farmers markets are expensive second of all only one in eight americans actually shops at the nearest grocery store the vast majority of americans rich americans go farther to go to whole foods and poor americans go farther to go to the grocery

outlet like they go to cheap places so most of us are not buying based on proximity most of us are buying based on the quality of the foods and or the cost of the foods right what is the point of putting whole foods in a poor neighborhood what is yogurt at whole foods it's like eight bucks for a thing of yogurt like no one come on the point of it is to incite class warfare i think ultimately and to invite more rich people like to change the neighborhood and invite more rich people into that neighborhood it's like look we have all of your favorite stuff right one of the more heartbreaking studies that i read for this was about all of these efforts there's a bunch of communities there's a hundred different cities around the country between i think it's 2005 and

2015 they tried banning fast food which is like a good thing to do don't have any shitty fast food in your neighborhood like this is good when rich white neighborhoods try to ban fast food it's all about like neighborhood character and like keeping the mom and pop stores in our neighborhood and like let's keep traffic down and let's make sure everything is walkable and cute and those almost unanimously pass the city councils are like yes let's maintain neighborhood character that sounds great so they all ban fast food then you've got poor black neighborhoods this happened in south LA that are like our kids are really sick we need to ban fast food from our neighborhood for health reasons and everyone comes out of the fucking woodwork and it's like oh it's the nanny

state what oh you're telling kids what to do it's social engineering and so only about a quarter to a half of these bands pass so this is what happened in south LA that it became extremely controversial that a bunch of parents wanted to ban shitty food and everyone fucking lost their minds and wrote like op-eds for the LA times to be like we can't horn in on like our small businesses blah blah like totally disingenuously right because rich people are allowed to make decisions for themselves and the health of their communities and non-rich white people just aren't right it's another one of those things that when you're looking into it you find that the most effective obesity interventions aren't obesity interventions they're things like sidewalks

public transport there's a study in charlotte north carolina where everybody in the neighborhood started getting an average of three times more exercise when a light rail stop open in the neighborhood because what do people do they give up their cars and they start taking the light rail and what do you do you walk 10 15 minutes of light rail 10 15 minutes home hey you just got as much exercise as you're supposed to get like that's what they recommend about 30 minutes a day we used to have a free light rail in portland and i would walk to and from that stop every day and it was like a two mile walk and then they started charging for it and i stopped taking it that way and so did a lot of other people well there you go exactly so it's like all of these

ideas of like let's do like a fucking farm to table app or whatever it's not really helping what if we had more stuff for insufferable rich people like surely that will tip the scale i mean i just keep thinking about you know i worked in human rights for years with all the sweatshop advocacy in the early 90s like nike sweatshops indonesia whatever all this advocacy what it basically did was it created a two tier global labor system where if you work for nike in indonesia now it's actually one of the best places to work really because yeah because of all this advocacy nike hires private auditing firms they hire dozens of people because they have a reputation to protect you and me would not want to work in indonesia in any factory but if you have to it's way better

to work for nike than it is to work for one of the taiwanese companies or one of the korean companies or one of the like domestic indonesian companies that have no labor standards whatsoever so what we did in that system all that advocacy really achieved was it built a two tier system where the rich actors have much better labor conditions but the labor conditions as a whole haven't really improved it's not clear there's any fewer sweatshops now than there were in the 90s in fact there's probably more right so we didn't change the defaults we just created a two tier system we're kind of doing the same thing i feel with food where it's like all of this advocacy around availability and around organic fruits it just entrenched this elysium system that we have

rich people can go to whole foods and get this lovingly picked cantaloupe that was not grown with any fertilizers and like it was tucked into bed every night but that doesn't change anything at the grocery outlet that doesn't change anything among cheap bodegas at the corner that don't have any fruits and vegetables there's nothing we're not changing anything we're just creating a two tier system so that we can eat better food and probably be more hysterical about people who aren't eating lovingly prepared cantalopes all the time because i think the way that we can be about eating our all organic all grass fed hot house whatever things the more we intensely regulate our control over our own diets the more judgmentalness that

facilitates for people who don't or can't put that kind of energy into their food and like people who feel like if they eat a piece of cooked food or something that has gmo's in it that they're gonna faint dead away it's like it's getting farther and farther divorced from the reality of a country where people literally cannot survive if they're gonna have that attitude about what they put in their body well this is the thing i always have like a intense stress response whenever i hear people say that like we need to like teach people about their food and like tell the story of their food and like learn where their food comes from the story of the food which i think comes from a good place like people are being goodhearted and i get that but people

don't need to know where their food comes from i don't like i don't know where my food comes from i don't know where my toothpaste comes from i don't know where the little fan that i just box is hot in seattle i don't know where that comes from i don't need to what i need is the confidence that i don't need to know where that shit comes from to know that it's safe right you don't have to be living like julianne more and safe where like anything that like you don't know what cow it came from and how it got to you that you can trust a system to not be sort of feeding you a slow drip of poison unless you're hyper vigilant about knowing which farm your you know chickens are laying there exactly and again people are time poor i don't want a world where like single

mothers with three kids have to read every fucking label at the grocery store to see if there's like added sugar and like weird dyes and their food i want a system where somebody can go into the grocery store and buy something and be confident that it's going to be good for them if it says natural unlabel they can be confident that it's not going to have a bunch of bullshit added to it and so we need to make the system less work rather than more work i feel like most of the advocacy that happens around the food system is just on making it like more labeling stuff and more certifications when like i don't want to do that much work when i go to the grocery store i don't think other people should either i think healthy food should be the cheap food and so a lot of this

goes back to the way that things are subsidized a lot of this goes back to the way that things are regulated these ideas with food stamps and with other ways of targeting the poor for just better food and making that easier like let's just help people feed their kids well like let's support them in doing that and figure out what people need to feed their kids well because most people want to feed their kids good food like no one no one hates their kids wants to feed them bad food everybody wants to feed their kids good food so it's just a matter of like how can we help people do this and i don't see any political movement to like actually try to help i just see a lot of like weird shaming and like people talk about taking soft drinks off of food stamps and stuff like

that which we should all be drinking less soda but i don't like this idea of like shaming people and like making food stamps more restrictive i'd rather support people and buying the healthy thing rather than make it harder to buy the unhealthy thing yeah yeah support versus punishment this really has made me think about for the first time ever realizing that i have a relationship with my body where i trust my body to when it says we're hungry i go oh we're hungry it's time to eat something i need nourishment and i will answer that call and do something about it and i've never had the feeling of having to not trust what my body was telling me or to treat it or just like to relate to my body like i'm a cold war spy and it might be a double age and i don't

know and i have to think over everything it says to me you know like i'm just like okay body cool and just the idea of just like how much energy that has you know that i have been saved from being robbed of because of that like it's just this is another lesson of like jesus christ sarah your life has been fucking easy in this way that it's incredibly hard for so many other people and you know you got to use that energy for something so we might as well save society i guess well i'll end with something on that note which is basically one of the things i realized interviewing people because i interviewed a lot of people that had lost weight successfully as well was that everybody becomes an evangelist for whatever works for them if you lost weight with a vegetarian diet you're

like oh everyone should be a vegetarian if you did it with atkins you're like no one eat carbs ever again it's very difficult for us as humans to just acknowledge that like hey you know what what worked for me might not work for everybody and maybe i'm typical and maybe i'm not try a vegetarian diet if it doesn't work for you move on it's really hard for us to realize how our bodies are not like other people's bodies and so one person who has struggled with their weight their entire life and figured it out when they were 55 and what works for them that's not necessarily going to work for someone who has never struggled with their weight and only started gaining weight when they were 50 or right some people love this low carb shit some people love this low fat

shit some people like whatever works for you but the most important thing is to realize that your relationship with food is by definition individual other people's weight other people's food what other people are eating leave them alone you don't know anything about the person in the restaurant who is 300 pounds and sitting across from you you don't know anything about that person's life so leave it off don't be mean to them don't intervene in a stranger's life unless it's to say something nice to them not necessarily yes they're hot because that can be threatening just be nice in a way that you are reasonably confident is not going to be scary it's very easy and i feel like we have this idea to you know what if we're what if i'm too nice to someone what if

i'm unconditionally loving and i'm really encouraging someone to do all these bad behaviors and really i need to keep them in line by strategically punishing them and it's like you know what no let's just save you some time yeah it's never gonna work that way you can never be too nice to people be nice it's a good note to end on we're finally ending on like a happy note finally we did it