A Big Fat Crisis

A Big Fat Crisis

The Hidden Forces Behind the Obesity Epidemic--and How We Can End It

Book - 2014
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Obesity is the public health crisis of the twenty-first century. Over 150 million Americans are overweight or obese, and across the globe an estimated 1.5 billion are affected. In A Big Fat Crisis , Dr. Deborah A. Cohen has created a major new work that will transform the conversation surrounding the modern weight crisis. Based on her own extensive research, as well as the latest insights from behavioral economics and cognitive science, Cohen reveals what drives the obesity epidemic and how we, as a nation, can overcome it.

Cohen argues that the massive increase in obesity is the product of two forces. One is the immutable aspect of human nature, namely the fundamental limits of self-control and the unconscious ways we are hard-wired to eat. And second is the completely transformed modern food environment, including lower prices, larger portion sizes, and the outsized influence of food advertising. We live in a food swamp, where food is cheap, ubiquitous, and insidiously marketed. This, rather than the much-discussed "food deserts," is the source of the epidemic.

The conventional wisdom is that overeating is the expression of individual weakness and a lack of self-control. But that would mean that people in this country had more willpower thirty years ago, when the rate of obesity was half of what it is today! The truth is that our capacity for self-control has not shrunk; instead, the changing conditions of our modern world have pushed our limits to such an extent that more and more of us are simply no longer up to the challenge.

Ending this public health crisis will require solutions that transcend the advice found in diet books. Simply urging people to eat less sugar, salt, and fat has not worked. A Big Fat Crisis offers concrete recommendations and sweeping policy changes--including implementing smart and effective regulations and constructing a more balanced food environment--that represent nothing less than a blueprint for defeating the obesity epidemic once and for all.
Publisher: New York : Nation Books, c2014
ISBN: 9781568589671
Branch Call Number: 362.196398 Coh
Characteristics: vi, 262 p. : ill. ; 25 cm


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ksoles Apr 25, 2014

Around one in two hardware stores sells food. This telling statistic sums up the thesis of "A Big Fat Crisis": Thanks to an aggressive food industry, nowhere are we free from the temptation to make poor dietary decisions. Deborah A. Cohen, a medical doctor and senior scientist at the RAND Corp., takes the blame for obesity away from those carrying extra pounds and smacks it on their environment. Just as cancer results from exposure to a carcinogenic environment, she argues, “obesity is primarily the result of exposure to an obesogenic environment.” She presents a credible diagnosis though her proposed cure in the form of expansive government regulation requires a big stretch of realism.

The first section of the book describes a litany of cognitive vulnerabilities. Cohen describes our susceptibility to subtle behavioural triggers that tell us to indulge. And because of an evolutionary landscape of scarce sustenance, we overeat when the opportunity presents itself. On average, Americans weigh 20 pounds more today than 30 years ago. Did everyone simply become more irresponsible? Unlikely.

The environment in which we make our food choices HAS changed in recent decades. In the second section of her book, Cohen highlights three big fattening factors: the reduced price of food, the increased availability of food, and the increased intrusiveness of food advertising. These first two sections cover a lot of already-covered ground but the book's third section presents radical, ground-breaking and, to some, upsetting policy recommendations.

Cohen’s first policy proposal involves the standardization of portion sizes; she thinks restaurants should serve food in single-portion units just as bars serve alcohol in units. Second, she argues that the government should limit “impulse marketing” by banning food from stores that aren’t dedicated to food, restricting combo meals at restaurants and keeping drive-thru windows closed outside meal times. Third, she advocates for counter-advertising that would make the downsides of fattening food more salient.

Dramatically but poignantly, Cohen compares the current obesity crisis to 1800s London, when people tossed filth out the window and left rotting carcasses in the streets, leading to widespread disease. England finally enforced sanitation standards, which required reengineering centuries-old towns to build sewers. Cohen maintains that only the same drastic reengineering will reverse the obesity epidemic. “People are suffering,” she writes, “and thus need protection.”

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