Much, much bigger
On the obesity crisis, the modern diet, and the double-edged sword of acceptance
Ticket No.3 is a short, weekly newsletter format from The Alpine Review, where we share three things that drew our attention. If you only want to hear when the next Alpine Review is ready, you can opt-out of Ticket No3 here.
I — The Obesity Crisis
The invisible hand that keeps people eating more food
It is a fairly well-known stat, yet each time I think of it I have to double-check just to be sure: 74% of Americans today are either obese or overweight.
A few months ago over at Common Sense, Bari Weiss sat down with guest Dr. Casey Means, Chief Medical Officer at Levels, the maker of biowearable metabolic sensors, to explore the topic in details. Very enjoyable and informative conversation.
I want to draw your attention on a segment that I found particularly illuminating, transcribed here for convenience (my bolds):
WEISS: Let's talk a little bit about the institutional failures that are at play here. You've mentioned a few times the government's role in allowing for or maybe even creating a situation in which the vast majority of Americans are either sick or on the verge of being sick. That sounds or will sound to some people, like a conspiracy theory. Give us the most generous explanation, if you could, about why the American government would allow people to become sick. Why would it be in the interest for the United States government to have a majority of the population that is so overweight, that even when the military is going to recruit people, it cannot find enough people to do so? It would seem to me that it would go against the national interest to allow for that, and yet that is seems to be what you're suggesting. I want to understand how the government would either be complicit or actively creating a situation where the population is as unhealthy as you're suggesting we are right now.
MEANS: In the US, the two largest industries of private employment are the food service and the hospital staff. In 39 US states, the largest employer is either Walmart, which is the country's biggest food seller, or a hospital system. So put another way, 78% of US Senators represent a state where a food retailer or hospital is the biggest employer. Okay, so there's not an evil puppet master pulling the strings, but the incentives to keep these systems growing. Create an invisible hand to keep people eating more food, and requiring more care.
II — The Modern Diet
The Modern Diet Is a Biosecurity Threat
Pursuing this exploration of obesity and the hyperobject that is the modern diet further, I thought I’d include this great piece by David Oks over at Palladium, published last June.
The twentieth-century shift in mortality from infectious to noncommunicable disease—what demographers call the “epidemiological transition,” linked to the nutrition transition that reshaped global diets—largely eradicated diseases like polio and yellow fever, but it did not lead to conditions of general health. Instead, it created populations that are chronically ill, and thus require near-constant medical attention; in turn, healthcare systems shifted from treating acute diseases to managing populations that are permanently, but “manageably,” ill. More medicine than ever, but less health.
If you follow the above link to the Nutrition Transition paper, you’ll find some more interesting stuff including this other paper, titled “How the Mid-Victorians Worked, Ate and Died” :
The decline was astonishingly rapid. The mid-Victorian navvies, who as seasonal workers were towards the bottom end of the economic scale, could routinely shovel up to 20 tons of earth per day from below their feet to above their heads. This was an enormous physical effort that required great strength, stamina and robust good health. Within two generations, however, male health nationally had deteriorated to such an extent that in 1900, five out of 10 young men volunteering for the second Boer War had to be rejected because they were so undernourished. They were not starved, but had been consuming the wrong foods.
III — Fat acceptance as social justice
Acceptance, pride and empowerment
From the Palladium article referenced above:
Americans did not get any healthier, or any less prone to chronic diseases. By the second half of the 2010s, political elites had quietly given up. Both Democratic and Republican platforms dropped mention of the obesity epidemic in 2016, with no reappearance in 2020.
We seem to have started normalizing morbid obesity, the same way that it is now fashionable to normalize mental health as more or less, cool. As Bill Maher puts it: “we went from fat acceptance to fat celebration”.
A parallel can be made with mental health, which seems to be experiencing its own moment of “coolness”.
An NYT article from last May titled “Doctors Gave Her Antipsychotics. She Decided to Live With Her Voices.” minted what is now known as “the hearing voices movement” (i.e. those who prefer to view their hallucinations and delusions as a normal and okay state of mind rather than a disease). It opened the door for a reevaluation of consensus medical realities and approaches (no doubt flawed, but still) to focus more on the personal felt experience and the triumph of acceptance, rather than treatment.
Freddie deBoer (superb writer and himself bipolar) who had a very emotional response to the article, wrote a series of follow-up pieces including this recent one (“The Incoherence and Cruelty of Mental Illness as Meme”), which is worth reading, especially in light of the spectacle of Ye’s recent string of erratic behaviour (my bolds):
Here’s what we’ve done with mental health in the popular American consciousness in the span of a few years.
Created a pleasant series of lies about mental illness such that it is defined as a set of attractive and romantic quirks which do nothing to stop someone from participating in public life as a savvy and politically correct person.
Defined any behavior that is genuinely ugly or unpalatable or against contemporary social-political norms as therefore necessarily not the product of mental illness.
Excused the people who comfortably fit in the former category from essentially any of the work of adult life, and insisted that expecting such people to still do that work is “stigma.”
Removed the basic social protections we had in place for people who were guilty of the latter types of behavior, under the theory that “mental illness doesn’t do that,” with “that” meaning “anything not approved by social media users.”
So it’s a great time to be an upwardly-mobile Swarthmore graduate with a professional-managerial class job who never shuts the fuck up about having adult ADHD and whose penalty for failing to take their medication is that they send only 80 emails in a day instead of 100. Those for whom mental illness is a hashtag. It’s a less cool time to be someone with severe paranoid schizophrenia whose medication comes with punishing physical and mental side effects and whose penalty for failing to take that medication is that they start muttering bizarre conspiracy theories about the Jews.
I’m afraid we’re going in the same direction with obesity, and therein lies the puzzle: how do we embrace inclusive concepts as “bodily diversity” while at the same time recognizing that there’s a genuine problem in the undercurrents which is not getting the attention it deserves.
Thanks for being here, see you next week.
I call them tickets because they opened a door in my mind and briefly turned me into an investigator, wanting to know more. Perhaps they will have the same effect on you.