Over at PJMedia, physician Theodore Dalrymple asks a question that German immigrant and pediatrician Hilde Bruch posed and answered over the course of her career starting in 1935, when she founded a clinic for obese children at Columbia University’s College of Physicians and Surgeons.* The question is, “What are we to make of the fact that an affliction of the rich is now predominantly a problem of the poor?”
However, the main question Dr. Dalrymple asks in his headline is, “Is Obesity a Disease or a Moral Failing?”
Dr. Dalrymple comes down on the side of moral failing.
I disagree. The research explained in the books I cite below suggests that the obesity epidemic has its foundation in bad advice from the medical profession based on ignorance of the endocrine system, sleep, exercise and what actually makes people fat. I think people will take personal responsibility just fine when they have better advice that is certain to get them the result they want.
Dr. Dalrymple also is dismissive of the idea that there are institutional causes of obesity. I disagree for the following reasons:
- The low-fat diet the medical profession has touted for weight loss and heart health is high-carb and makes you fat. This model must be discarded and replaced with the correct understanding of the roles that consuming carbs, exercise and sleep deprivation have on the endocrine system. People do take personal responsibility but the medical profession has to provide them with solutions that actually work.
- High carb foods dominate the offerings practically everywhere food is served: restaurants, shopping malls, you name it. The free market should fix this — supply will chase demand when people want healthier food.
- Exercise is not built into our daily activities as much as it used to be. You often have to work to find the place, equipment and time to exercise. Government will be involved in this solution because planning things like sidewalks, bike lanes and parks are part of the government’s job.
Here’s what I wrote as a comment:
Dr. Dalrymple, as other commenters have noted, you would benefit from reading Gary Taubes’ book, Why We Get Fat and What To Do About It. Taubes explains research showing the effect of eating sugar and simple carbohydrates on the endocrine system. Research shows that people who eat a lot of carbs can be starving while getting ever fatter simply because their insulin production is sending the food they eat straight to the fat cells instead of making it available for energy. They are caught in a vicious cycle. Worse, the low-fat/high-carb diets currently recommended for heart health exacerbate the problem. The more the public is educated about how the carb/insulin cycle affects them, the more motivated people will be to get out of it.
Unfortunately, as a solution Taubes recommends the Atkins diet, which can cause kidney failure, kidney stones, gout and osteoporosis.
Other diet and fitness experts educating the public about the role of the endocrine system in weight loss with more thorough explanations than Taubes provides and healthier diet recommendations include Jillian Michaels in her book, “Master Your Metabolism,” and Dr. Michael Aziz in his book, “The Perfect 10 Diet.”
By the way, one of Taubes’ major contributions to the field in “Why We Get Fat” is his history of which experts in charge of telling the rest of us how to live blew it so badly that they effectively are the creators of the obesity epidemic. This puts an entirely different light on the belief that the obese have failed in their own personal responsibility when you consider that the advice they were following to get or stay slim was instead absolutely guaranteed to make them fat and sick.
*Gary Taubes opens his book, Why We Get Fat and What to Do About It, with this information. I first started reading Dr. Bruch in the 1980’s when I was researching anorexia as I was trying to heal from having an anorexic lover when I was in college. I highly recommend her work.