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In New Hampshire, almost two out of three adults and more than a quarter of our children are overweight or obese. NHPR’s series explores the causes, the consequences, and some promising solutions to a growing crisis.Fast Facts about Obesity in NH BROUGHT TO YOU IN PART BY: The HNHfoundation

The Obe$ity Battle: Why Solving it is So Hard

Graphic Created by Sara Plourde
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NHPR

Today health reporter Elaine Grant shines a light on the epidemic itself, which is costing the U.S. more than $150 billion dollars a year in medical spending alone.  

When Jennifer Riccio was in college, she started gaining weight. “I couldn’t really figure out what I was doing differently. In my mind I didn’t really have any difference in eating, or exercise habits at that age.”

Mystified, she visited doctor after doctor.

It was the beginning of a 15-year journey to determine why she kept putting on pounds.

She’s gotten some answers but her weight is still a problem.

In a way, she’s like the rest of the country.

In the last forty years, our collective weight has skyrocketed.

Even only 15 years ago, less than 14 percent of New Hampshire residents were obese.

Today, one of every four people living here falls into that category.

Figuring out why one person gains weight is a very different problem than figuring out why an entire country does.

We’ve seen this problem growing for decades, and we haven’t yet been able to fix it.

Some people say the epidemic stems from basic economics.

 “I think its cause is the best trend we ever want to see.”

That’s Brian Wansink, a Cornell University behavioral scientist who studies why we eat what we eat.

 “We have more affordable, more available food than we’ve ever had before in the history of the world. And that’s a trend that everybody wants to see. It’s just that the consequences of that trend, the fact that we’re paying 6% of our income on food, not 24% that we did back in 1960 ends up leading us down the path right now.”

So food is cheaper.

But if time is money, Steven Gortmaker says food is cheaper still.

Gortmaker, a professor at the Harvard School of Public Health, says it takes us far less time to cook and eat – or not cook at all, and still eat – than it used to.  “It used to be when I was younger that you didn’t have drive-throughs in fast-food restaurants. You actually walked in to the restaurant and stood in line. Now you can drive through in your car. That means it’s easier to consume those calories.”   

Indeed.

Americans eat almost a third more packaged foods than we do fresh – almost 800 pounds of food in boxes, bottles and cans per person and more than our counterparts in any other developed country.

And it doesn’t help either that we spend too much time in our cars and on our couches.

Health advocates spend a lot of time thinking about how to get us to get up off of the couch.

And possibly even more researching ways to cajole us to make better food choices.

The problem isn’t just that each of us makes our own individual decisions about what to eat.

In part, researchers say, it’s that we make so many of them – two to three hundred decisions a day.

David Just is a behavioral economics professor at Cornell University. “Even if we weren’t stressed out and busy with work and doing things like that, we would not have enough time to think through each of those decisions and really consider the consequences rationally.”

Just says food marketers are only too happy to take advantage of that phenomenon.

“Really, what they’re trying to do for the most part is access the pieces of our minds that operate as a reflex.”

In other words, the parts of our brain that signal -- wow, that sounds delicious.

On the other side of the battle for our bellies are health advocates – and they’re appealing to our rational sides.

Most of them believe that, with better information about what’s in our food, we’ll have a fighting chance of making better choices.

Because of economics and politics, that’s not at all easy to provide.

To get an idea of how difficult it is to change the information that people get all you have to do is take a look at the battle over voluntary guidelines being waged in Washington.

A working group of members from four federal agencies are focusing on foods aimed at kids.

They’re pressing the industry to make a choice – either make food healthier, or stop advertising it to children.

Although the government would have no enforcement power, the guidelines have still raised the ire of the industry.

Leading the charge is the Association of National Advertisers, whose members spend $250 billion a year on advertising and marketing.

Dan Jaffe is the trade group’s executive vice president. He argues not only is the government over-reaching, but that the proposed levels of fat, salt, and sugar are absurdly low.

“Of the 100 most consumed foods in this country, 88 would not meet this criterion, including whole wheat bread, yogurts, peanut butters, virtually all soups and cereals, the list goes on and on, things that that any parent would be thrilled if they were begging them for eating.”

 “It’s false.”

That’s Michael Jacobson of the Center for Science in the

Public Interest, a Washington nonprofit that advocates for healthy food.  “The industry is misrepresenting what the government’s voluntary guidelines would do. They wouldn’t ban anything. Nothing. Companies could advertise five-pound bags of sugar to kids. They provide a standard against which the industry could be evaluated so we could see how the corporations were doing with regard to their responsibility.” 

In Jacobson’s view, it’s primarily about the industry not wanting the government to mess with its marketing messages.

Jaffe says it’s not about the marketing – it’s about the economy.

He says companies that adopt the guidelines would be hurt.  “We estimate that if industry were to accept these proposals that in the first year, there would be a loss of 74,000 jobs and over $28.3 billion dollars.”

Michael Jacobson also disputes that claim.

 “Something else that’s totally ridiculous….Jobs will not be lost. Other advertising will fill in when the junk food advertising is eliminated ….food manufacturers are not gonna go bankrupt, what they will do in many cases is add whole grains, cut the sodium somewhat, so that their foods will meet the guidelines.”

It’s clear that health advocates are facing fierce opposition just to get voluntary guidelines.

These fights might be enough to discourage anybody.

But Michael Jacobson and others worried about our increasing girth point to glimmers of hope that someday – probably far into the future -- we might be able to return to a nation of normal-weight people.

One of those glimmers is the promise that, under a new federal law, kids can expect to see healthier school lunches by next fall.

And there are indications that the obesity rate may be leveling off. “That’s a very hopeful sign and health officials will be looking at that very carefully.”

But no one who worries about our nation’s weight is sitting back and congratulating themselves.

Far from it.

Facing headwinds from our habits and from the incentives of the private sector, the question remains: can we make progress fast enough?

Or will some of the more alarming predictions come true – that by 2030, fully one half of all adults could be obese.

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