Panaceia or Hygeia

immunize yourself against the pandemic of lifestyle diseases

The Spread of Obesity

Posted by Colin Rose on July 16, 2008

The Framingham study is a very detailed picture of the population of a small town in Massachusetts. Below is a series of diagrams showing the relationships between people and their BMI status from a paper in the New England Journal of Medicine. It is the first really detailed picture of the start of the obesity pandemic. Green circles are BMI less than 30 and yellow circles BMI greater than 30, the official definition of obese. The authors were interested in the “transmission” of obesity between friends and relatives but never advanced an hypothesis for what would have initiated the epidemic and what might have fueled it.

In 1975 there was not a single obese person. From 1980 to 1985, the era of the cholesterol-lowering resins, like Questran, the first obese people appear. The LRC-CPPT results were published in 1984. By 1990 after the introduction of statins the incidence of obesity accelerates until by 2003 more than a third of the population is obese. There is no other plausible explanation for this phenomenon. People stopped caring about controlling calorie intake in the belief that lowering blood cholesterol with resins or statins would save them from the well-known consequences of gluttony. This attitude spread in families and between friends in the classical pattern of a transmissible virus or bacterial infection. It was OK to eat anything and to be obese if everyone else was and you took your pills.

If there is a better explanation for the obesity pandemic, we would like to hear it. None of the usual suspects, fast food, cars, suburbs, television, computers, the Internet, dangerous neighborhoods, etc. explain why people just eat too many calories and don’t care enough to control consumption.

See our photo essay on food addiction for a graphical demonstration of the obesity pandemic.

An epidemic of obesity

An epidemic of obesity

United We Stand, Disney World

Disney World. United We Stand. To the outside observer Disney World in Orlando appears to be a social club for the obsese and morbidly obese.

9 Responses to “The Spread of Obesity”

  1. […] the original post: The Spead of Obesity […]

  2. 648 said

    Helpful Facts

  3. I, sir, would like to counter your facts that make a lot of sense and that hardly an educated person could argue with, and tell you that I know for a fact (because I read stuff on the internet) that being overweight is mostly genetic.

    I would also like to tell you my life story as if it would help my argument… Blah blah, I grew up fat, blah, skinny people eat unhealthy too, blah, eating too little is dangerous for your health, why should I deprive myself, blah blah blah.

    (I’m completely joking – I agree totally)

  4. txtechdog said

    This has got to be the most ludicrous blog I have ever read. Your contention that the sedentary lifestyle that many more people today live due to the spread of the Internet and other advances in technology since 1975 has had nothing to do with the increase in obesity in this country is laughable. People today eat significantly more fast food and bigger portions of it than they did in 1975, but all of this unhealthy eating has nothing to do with the problem. It is all the fault of cholesterol lowering drugs. I’m not going to say that part of the problem is that people just don’t care or don’t watch what they eat, but correlation (the rise in obesity coinciding with the introduction of statin drugs) does not equal causation. The crime rate in this country has risen significantly since 1975 as well. Is that the fault of statins?

  5. Colin Rose said

    Certainly, correlation is not causation. But give me another explanation for why most people have stopped being vigilant about lifestyle choices.

  6. If I may… Txtechdog</strong), I think you may have misunderstood what the author was saying.

    What I understood was this: People started needing cholesterol lowering drugs at the same time that people started gaining weight. I don’t believe the author is saying that the drugs themselves caused the weight gain, but the fact that they both happened at the same time reinforces the idea that people began to care less and less about their food choices, causing various health issues.

    So, a bad diet causes high cholesterol AND weight gain. The idea that taking a drug so that one can continue to eat poorly is an example of peoples mindsets about their diet going downhill.

    In terms of fast food, TV, the internet, and cars not having anything to do with obesity; the author is saying that those things did not force people to shovel twinkies and ice cream into their mouths. They make it easier to become overweight, but they do not CAUSE it.

  7. Colin Rose said

    Thanks McBloggenstein, that’s what I meant. But I do think the cholesterol myth came first. People were persuaded that as long as their blood cholesterol was at “target” with a statin, what they ate didn’t matter. I have heard a number of cardiologist colleagues state exactly that. This is what I call the moral hazard effect of drugs for lifestyle diseases.

  8. txtechdog said

    People don’t care about their health because they aren’t being properly educated by our deficient schools systems on nutrition and the importance of being physically fit and they are being constantly bombarded with messages from the food industry to eat more. Sure, some of the blame falls on the medical profession and drug manufacturers, but there is plenty of blame to go around.

    Take for example, the educational system. At the high school my son graduated from, the requirement for physical fitness education is 1.5 credits, which equates to three semesters out of eight during the four years of high school. Those credits can be earned not only in PE classes, but also participation in dance, drill team, marching band, etc and while any exercise is better than no exercise, this simply isn’t enough to keep kids physically fit. There is also a requirement for 1 semester of health class, but the unit on nutrition in that class is less than 1 grading period. Plus the teachers who teach it typically don’t have any formal training on diet and nutrition, so even if a kid wanted to know more about how to eat healthy, they would be hard pressed to learn anything at school about it. Even my son, who was a varsity athlete, was never taught anything about nutrition and typical meals while traveling to away games consisted of burgers, pizza, and other poor nutritional choices. And there are even some schools in the state that are trying to do away with the PE requirements entirely.

    Now the food industry. In 1975, I was 11 years old. My family didn’t eat out much and going to a burger place was a treat that we indulged in perhaps once or twice a month at most. And when you went to one of these burger places, the burgers were usually single patty burgers less than 1/4 pound in size. The Whopper Jr of today is very similar to the premium burgers we ate then. Today, you go to a burger place, like Burger King and are confronted with their steak house burgers, BK Stackers with up to 4 meat patties and slices of cheese, double and triple whoppers, jumbo sized fries, and drinks in the 40 oz range. I know parents who take their kids out to eat multiple times a week and some who even eat out multiple times per day. And other restaurants are just as bad. Consider the Olive Garden “never ending pasta bowl”. And even their normal portion sizes are more than a person should eat in one sitting. On top of that, they are constantly serving bread sticks, never ending salads (yes, you can eat too much salad) and soups. It is just ridiculous.

    And the packaged food industry is just as bad. While it might be convenient to just pop a frozen dinner into the microwave instead of cooking it from scratch, it is not good for you from a nutritional standpoint. The packaged food industry is feeding us convenience at the expense of our health and most people are too tired from pursuing their fast paced lives to take the time to A) learn how to cook, and B) actually take the time to do it.

    And people today are much more sedentary than people were in 1975. With the proliferation of video game consoles, cable television, the Internet, and other similar activities, there is less interest among kids in going outside to play, on top of the fact that in many places, it just isn’t safe to play outside anymore. In 1975, my normal day included 1 hour of afternoon cartoons after school and maybe another hour of family television in the evening after dinner and homework was done. Most of the kids I know today, spend significantly more time in front of the television or the computer than I ever did as a child. When I was a kid, I was usually outside, playing catch with my friends, riding my bike, or simply running around the neighborhood.

    How can you claim that these factors are not credible explanations for the spread of obesity? These factors don’t excuse people from not educating themselves and taking better care of their health, but frankly most people aren’t that smart and because they were never taught to care about their health, don’t. I do agree with you that part of the blame falls on the drug companies who with their “pill for every ailment” marketing campaigns, are convincing people that they don’t have to care, but I don’t think they are solely responsible.

  9. …they are being constantly bombarded with messages from the food industry to eat more.

    Anyone in the world can tell you a big mac with fries is worse for you than a plate of fruits and vegetables. The knowledge of how to eat well is there for those who wish to take advantage of it, yet, McDonald’s is one of the biggest companies in the world. Individual’s choosing convenience and calorie dense foods over healthier alternatives is no one’s fault but their own. Mixed messages from advertisements can only account for so much. You are assuming that because most people just eat “burgers, pizza, and other poor nutritional choices” on a regular basis, that they believe that they are eating a normal diet. As I said, if you showed anyone those foods vs. fruits and vegetables, and asked them which is healthier, they WILL answer correctly. So why do people eat these foods? Because everyone else does, they just don’t think about it, it tastes good, and it’s generally cheap.

    I know parents who take their kids out to eat multiple times a week and some who even eat out multiple times per day.

    Does Ronald McDonald force quarter pounders down their throut? It comes down to this: Who makes the choice to not prepare a healthy meal at home? You can argue that individuals and parents don’t have as much time these days to cook as they used to until the cows come home, but that is a poor excuse. Notice how it is an excuse!

    In 1975, my normal day included 1 hour of afternoon cartoons after school and maybe another hour of family television in the evening after dinner and homework was done. Most of the kids I know today, spend significantly more time in front of the television or the computer than I ever did as a child. When I was a kid, I was usually outside, playing catch with my friends, riding my bike, or simply running around the neighborhood.

    You just hurt your argument. Why are kids not as active as they were when you were a kid? Because parents don’t do their job. They don’t have to buy their kids an Xbox and let them play several hours a night. There’s nothing keeping parents from setting the same rules that your parents did with TV time.

    These factors don’t excuse people from not educating themselves and taking better care of their health, but frankly most people aren’t that smart…

    Haha! You’re exactly right about this.

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