I have major reservations about the War On Obesity that will be facilitated by the Affordable Care Act. For those of you who are unaware, the Obama Administration plans on channeling millions of dollars into obesity prevention initiatives by implementing public awareness campaigns, establishing research efforts to optimize the public's understanding of health and nutrition, and providing states with incentives to educate Medicaid beneficiaries about the availability of obesity prevention services. On the surface, it seems like this is exactly what our country needs.
But I'm here to tell you that Obama's efforts, while solicitous on the surface, will only serve as a polarizing agent in a culture that is already perturbed by the extreme ends of the disordered eating spectrum.
The initiatives set forth in the Affordable Care Act perpetuate society's obsession with weight loss. This is ironic because the body is inclined to achieve homeostasis, the tendency to maintain stability and optimal physiological levels despite changes in our ambient surroundings.
Ingestive behaviors are triggered by correctional mechanisms in the body that operate in order to replenish depleted nutrient stores. These mechanisms are activated by any deviation from a set point of a system variable; thus, they increase our motivation to seek food as soon as our nutrient reservoirs begin to dissipate.
Powerful hunger signals besiege us from all parts of the body. The stomach secretes a peptide hormone called ghrelin, a potent stimulant for food intake.
Feelings of hunger are correlated with increased blood levels of this hormone. Both the brain and the hepatic portal vein in the liver contain receptors that are equipped to detect falls in blood glucose levels. The brain monitors the availability of glucose inside the blood-brain barrier, and the liver monitors the availability of glucose in the rest of the body.
What needs to be noticed here is that, due to the vital importance of eating, no one system, organ, or mechanism in the body is allotted sole accountability for controlling ingestive behavior. The body is hell bent on being fed. Severing the hepatic branch of the vagus nerve, which prevents the brain from registering the aforementioned hunger signals, does not prevent the organism from eating normally. Lesions in the medulla that destroy the hunger signals associated with glucose deprivation do not disrupt long-term eating patterns. The consumption levels and body weight of mice with a targeted mutation against the ghrelin gene, the potent hunger stimulant mentioned before, are not disturbed. Clearly, the preponderance of redundancy in the body's neural and hormonal mechanisms that regulate food intake suggests that voluntary efforts to deprive oneself of food present a sure recipe-pun intended-for failure (I will bet you are still laughing!).
American culture is conducive to disordered eating, whether these pathological consumption patterns manifest themselves as obesity, anorexia, bulimia, or dieting. Our unhealthy obsession with food has insidious effects on every aspect of our lives. We manage our emotions with food, whether our desire is to surround ourselves with comfort after a stressful day at work/school or seek respite from our insecurities through calorie counting. Often, the aim is to exert control over over our bodies, to exercise sovereignty over the physical encasement either through suppression or overindulgence.
Society is stymied by making fat the focal point of weight loss efforts, or by even prescribing weight loss regimens at all. Industry capitalizes on this fear of fat, thereby perpetuating unrealistic fitness routines that make weight loss difficult to maintain. The preoccupation with thinness is a societal standard that is inherently unsustainable.
As one Harvard professor points out brilliantly, the inverse correlation between portion size and ideal body image has steepened over the decades. That is, as Americans increase their level of consumption, the archetypal beauty remains untouched. When the media and fashion industries promulgate a standard of beauty that is, for many people, not feasible, the consequences are amplified by the constant presence of food on television, in magazines, and on every street corner. This exposure to conflicting ends-a skeletal structure and satiety-either discourages people from being healthy when their efforts to lose weight don't yield the unrealistic results they desire or deters them from eating altogether.
Making fat the culprit in our war against weight gain simply won't work. This approach has already failed. In fact, a meta-analysis of 55 intervention studies, which was published in the Cochrane Database of Systematic Reviews, yielded the finding that the average amount of weight lost by the 30,000 children who participated in these studies was one pound. And diets are notorious for being associated with weight cycling. Restricting calories and engaging in an exorbitant amount of exercise doom weight loss efforts because the body is, from an evolutionary standpoint, designed to reserve fat. Achieving fullness when food was available prevented our hunter-gatherer ancestors from starving.
One fascinating study has even suggested that the symptoms of eating disorders are triggered by starvation. Researchers at the University of Minnesota observed the effects of semi-starvation in thirty-six physically and psychologically healthy young men. When their diet was cut in half, these men displayed mood swings, an obsession with food, ritualistic eating behaviors, irritability, severe depression, reduced sex drive, fatigue, isolation and social withdrawal, and other hallmark symptoms of anorexia. Perhaps these findings can elucidate the relationship between diet crazes and the eating disorders that plague millions of people of both genders.
At the other end of the spectrum, researchers have found that hunger can be induced in an organism by depriving cells of fat, a process called lipoprivation. This implies that excessive dieting proves to be counter-productive, as unattainable levels of emptiness trigger strong hunger signals that cause people to disengage from the weight-loss goals they have set for themselves. This accounts for the high proportion of failed diets in America.
So, rather than endorse campaigns that castigate overweight people, we should be teaching people to treat their bodies with respect, not give them more of an incentive to view their bodies in a disparaging manner.
This is not a matter of political correctness. It is a matter of pragmatism.
By requiring that insurance companies pay for medically-advised weight loss expenses, and additionally requiring that employers provide said insurance, there is a risk that weight loss initiatives will enter the workplace. As it is, some companies already offer benefits to employees with a low body mass index.
Not only am I strongly opposed to federally sponsored values entering the workplace, I am also strongly opposed to perfidious weight loss programs that guarantee long-term results in exchange for a lifetime of shame and guilt.
We need to recant our stance against fat. According to one study, body mass index is not even a reliable criteria for determining who is healthy, as 51% of “healthy” participants were identified as unhealthy, and 18% of participants with a low BMI failed to elicit concern from their doctors, in spite of their poor health (Wildman et al.,Archives of Internal Medicine, 2008). Additionally, diet pills and liposuction don't produce the long-term results that they promise because the mere removal of adipose tissue from the body is insufficient means to maintaining a lower body weight.
Why, then, do we continue to buoy our efforts to dispel fat from society? It hasn't worked so far, has it?
The logical thing to do is to make self-acceptance a priority. Everything about the way the body works screams that satiety is the solution to weight management, rather than an obstacle. Commercials or advertisements that portray any body type in a vilifying manner or serve to increase our dissatisfaction with our bodies only encourage us to abuse them, whether by over-eating, starving, or purging.
Really, what we should be striving for is fullness, not hunger. The aim is to fulfill needs, not deprive oneself of nutrients, to indulge in care that includes a plentiful diet as well as regular exercise and consistent physical activity. Balance is literally the key to controlling vital characteristics in mammals, including, but not limited to, temperature, pH levels, fluid compartments, and hormone diffusion. Eating is no exception to this rule.
In the end, the hippies have it right. Love conquers all. In this case, self-love leads to physiological peace and harmony.
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