The Weight of a Nation

May 16, 2012 12:49 PM

Consequences, Choices, Children in Crisis, Challenges. HBO’s multi-part research documentary The Weight of the Nation examines obesity in America in four parts, marshaling leading doctors, epidemiologists, economists, researchers, and community leaders to understand and explain the individual costs and public solutions to a multi-faceted social and individual problem. The documentary both explores large picture statistics, while giving voice “to those that often too seek to be invisible: members of the nearly 70 percent of Americans currently diagnosed as overweight or obese. (AV Club Review)”

Also included online:
Twelve bonus short films.
A policy report on Accelerating Progress in Obesity Prevention.

HBO will also air “The Great Cafeteria Takeover” about students involved with Rethinkers “Kids Rethink New Orleans Schools” who “convinced Aramark to deliver locally grown produce” (AVclub ibid) to their school. Trailer / HuffPo Article

Bonus : 60 Minutes interview with Dr. Nora Volkow on Hooked Why bad habits are hard to break, and not character defects.

posted by stratastar (42 comments total)

I watched this last night. Lots of "whoa" moments and lots of "WTF" ones as well. Watching two obviously bright and together moms bitching that they wanted the school to feed their kids "fresh foods" was a real downer. Parental detachment to the extent that they feel ten minutes of creating a healthy lunch is outweighed by millions spent trucking in fresh vegetables for 600 kids is so much at the heart of this. How stupid or lazy do you really have to be, after all, to think putting a TV in your kid's bedroom is on any level something sensible. We are so fucked in this country from obesity that it will make any other health issue small by comparison.
posted by docpops at 12:57 PM on May 16, 2012 [1 favorite]

"... members of the nearly 70 percent of Americans currently diagnosed as overweight or obese"

As discussed in the blue before, how this is diagnosed is highly suspect. There is a problem here, but it has to do more with car culture than weight.
posted by clvrmnky at 1:08 PM on May 16, 2012

Why does it make more sense for millions of wealthy parents to pack individual lunches when the school systems, which already have the economies of scale to feed millions of kids, can do so? Or do the poor kids not deserve healthy meals too?
posted by snickerdoodle at 1:08 PM on May 16, 2012 [9 favorites]

'Tis no man, 'tis a remorseless eating machine
posted by wikipedia brown boy detective at 1:12 PM on May 16, 2012 [2 favorites]

As discussed in the blue before, how this is diagnosed is highly suspect.

Not sure it really matters if the stat is 30 or 40 or 80 percent. The nation and the rest of the world is getting fat as hell and it's accelerating rapidly. Just because there isn't a glacier melting in your yard doesn't disprove climate change.

Why does it make more sense for millions of wealthy parents to pack individual lunches when the school systems, which already have the economies of scale to feed millions of kids, can do so? Or do the poor kids not deserve healthy meals too?

Watch the doc. The whole reason the lunches are pure shit is because they have to crank out hundreds at a time and they have to be consumed in the 10 minutes left in the lunch break leftover after waiting in line.
posted by docpops at 1:15 PM on May 16, 2012 [4 favorites]

Why does it make more sense for millions of wealthy parents to pack individual lunches when the school systems, which already have the economies of scale to feed millions of kids, can do so? Or do the poor kids not deserve healthy meals too?

I think the real challenge there is that delivering healthy meals is harder and more expensive at that kind of scale than delivering frozen tater tots and chicken nuggets. It's absolutely worth it, but it's a challenge.

Yesterday, I ate a bag lunch as a chaperon on a field trip in a school system that is putting a lot of effort in to making it's lunches healthier. The lunch was sort of middling on the healthiness front (Chicken Salad sandwich with a bit of lettuce and tomato, pita chips, apple), but it was a fair bit better than what I would have been fed as a kid. That said the kids (from a very poor neighborhood) were pretty likely to have packed something else that was even worse for them (potato chips, fried chicken, etc.).

The school officially has a no junk food policy, which was a nightmare to enforce because basically no kid brought anything that wasn't sort of junk food and having to decide whether Cheez-Its were better enough than Cheetos to be okay was not a fun way to spend the afternoon. Honestly, I've decided that the solution is probably to ban outside food, but making the school lunches healthy enough to make that worthwhile is hard.
posted by Bulgaroktonos at 1:21 PM on May 16, 2012

the rest of the world is getting fat as hell

You're not wrong about that. I wonder what personal choices are causing increases in rat or primate obesity?
posted by muddgirl at 1:27 PM on May 16, 2012

You guys are correct. The adult rate is 35.7% (CDC). Completely my bad for not checking that source. I'll ask for a correction.
posted by stratastar at 1:38 PM on May 16, 2012

Primate obesity? They go to the bar and overindulge in Buffalo Bananas.
posted by jonmc at 1:44 PM on May 16, 2012 [2 favorites]

Not sure it really matters if the stat is 30 or 40 or 80 percent. The nation and the rest of the world is getting fat as hell and it's accelerating rapidly.

Exactly. Even if the BMI is flawed, I can't see anyone arguing that an increase in the numbers of a population that is "BMI-obese" would correlate strongly with a similar trend by some other hypothetical, ideal metric.

Link to a map showing obesity in the U.S. over time.
posted by BigSky at 1:50 PM on May 16, 2012

You guys are correct. The adult rate is 35.7%

That's obesity only. According to 2007-8 statistics, overweight and obese combined is close to 70%, exactly as stated in the post.
posted by BigSky at 1:57 PM on May 16, 2012 [4 favorites]

Total rates don't explain the whole picture though, this map on the same CDC page shows the incredible increase in statewide obesity rates, most went from less than 10% to more than 30% over 20 years.
In one of the shorts on Poverty and Obesity, they found areas in Philadelphia with >90% obesity rates). In the last documentary Challenges (click to the 3rd section) they found areas where life expectancy changed by more than 20 years across one zipcode.
posted by stratastar at 1:58 PM on May 16, 2012 [1 favorite]

And weirder/scarier still is how obesity makes the merely overweight feel/seem/imagine themselves to be normal. I can't tell you how many times a man at 200 lbs or a woman at 175 who was 30 pounds lighter a decade ago feels that they are at a healthy weight because they aren't as fat as their obese colleague or friend.
posted by docpops at 2:02 PM on May 16, 2012 [5 favorites]

The whole reason the lunches are pure shit is because they have to crank out hundreds at a time and they have to be consumed in the 10 minutes left in the lunch break leftover after waiting in line.

I'm not saying that it would be easy to convert the infrastructure and supply chain toward producing mass quantities of healthier meals. I just don't understand how a system with massive purchasing power wouldn't be able to do so more cheaply and effectively than individual parents.

I am assuming, of course, that the goal is to make said meals accessible to all students, not just the privileged.
posted by snickerdoodle at 2:03 PM on May 16, 2012

They actually discuss this in the 4th documentary. It has to do with the fact that there is "no functioning market" for fresh vegetables in the country like there is for soy and corn, nor are there the myriad of federal risk, insurance and repayment systems for industrial production of healthy foods. As a result less than 2% of farms in the U.S. produce any fruits and vegetables.

/end thread sitting
posted by stratastar at 2:09 PM on May 16, 2012 [3 favorites]

. I just don't understand how a system with massive purchasing power wouldn't be able to do so more cheaply and effectively than individual parents.

It's the prep time and staffing levels
posted by fshgrl at 2:14 PM on May 16, 2012

You can watch the first documentary at the HBO site whether or not you are a subscriber.
posted by tzikeh at 2:26 PM on May 16, 2012

And weirder/scarier still is how obesity makes the merely overweight feel/seem/imagine themselves to be normal. I can't tell you how many times a man at 200 lbs or a woman at 175 who was 30 pounds lighter a decade ago feels that they are at a healthy weight because they aren't as fat as their obese colleague or friend.

I am a 5'10", 170 lb male who works in an office in Texas. My BMI is smack in the middle of normal. They call me "Slim".
posted by SugarFreeGum at 2:29 PM on May 16, 2012 [6 favorites]

The SNAP/Food Stamp Challenge. Can you eat a healthy diet and/or lose weight on $4 a day?
posted by elsietheeel at 2:43 PM on May 16, 2012

As for school meals, the most money a school can get reimbursed from the federal government for a lunch is $2.94 cents. Which sounds like a lot until you factor in all the other allowable costs that creating a school lunch requires.

Direct Costs
Wages and salaries of food service workers
Cost of purchased food
Food service supplies
Media/promotional materials relating to the food service
Capital expenditures relating to food service (e.g., food service equipment purchases)

Indirect Costs
Payroll services
Human resources
Workers’ compensation
Procurement
Utilities such as gas, water, electricity, trash, etc

And remember, they only get that $2.94 cents if the school is severely needy. The less free and reduced-price students the school has, the less money they get from the feds. And the less money the school is probably getting from paid meals, because in wealthy areas kids seem to bring their lunch from home more often.

School lunches may not be the best thing ever, but they're improving, and for some kids it may be the only square meal they get during the day.
posted by elsietheeel at 2:54 PM on May 16, 2012

I can't tell you how many times a man at 200 lbs or a woman at 175 who was 30 pounds lighter a decade ago feels that they are at a healthy weight because they aren't as fat as their obese colleague or friend.

I'm a 5'8", 170 lb woman, with defined musculature, who competes in half and full marathons, can squat 275 pounds and deadlift 200.

Which is to say that throwing out arbitrary numbers that we're all supposed to accept as obviously obese and unhealthy is unhelpful. Some people are horrible unhealthy at those weights, others are not.
posted by Kurichina at 3:01 PM on May 16, 2012 [7 favorites]

I think the real challenge there is that delivering healthy meals is harder and more expensive at that kind of scale

Well, the overall scale of the amount of food that needs to make it to the kids is the same. Its just whether it goes through supermarkets or suppliers.

I mean, I understand that it is hard _at current funding levels_, but thats because the burden of healthy food has been pushed onto parents. If the government took on that burden, it might cost _more than it does now_, but it should be able to do it more efficiently than 3,000 kids (number at my high school, for example) each doing it at retail pricing.
posted by wildcrdj at 3:16 PM on May 16, 2012

I'm a 5'8", 170 lb woman, with defined musculature, who competes in half and full marathons, can squat 275 pounds and deadlift 200.

Which is to say that throwing out arbitrary numbers that we're all supposed to accept as obviously obese and unhealthy is unhelpful. Some people are horrible unhealthy at those weights, others are not.
posted by Kurichina at 3:01 PM on May 16 [+] [!]

Way to miss the point completely, and bully for you all the same. I'll be sure to clarify my oversimplification the very instant I see even a single instance of what you describe yourself as in my office in any given 12 month period instead of the usual parade of overweight, sedentary and malnourished adults filling our waiting room.
posted by docpops at 3:22 PM on May 16, 2012 [6 favorites]

Ignore all the times I said cents. I was thinking about the additional 6 cent meal reimbursement that schools will get if they conform with the new guidelines of the Healthy, Hunger-Free Kids Act.

Six cents! Woohoo!
posted by elsietheeel at 3:26 PM on May 16, 2012

In grade school the cafeteria food was sucky and unhealthy. By high school, it was sucky with options (were talking mid 1980's here) and most kids went the burger, chocolate milk, ice cream sandwich route, (esp. if they had smoked a joint the period before). There was a salad bar with a bowl of lettuce, but some kids threw unwrapped lubricated Trojans in it. If you knew someone with a car you usually snuck out to McDonalds or BK or whatever (usually smoked a joint or drank a 40, too).

My point? Trying to tell people what they can and cannot eat is futile and annoying to boot.
posted by jonmc at 4:51 PM on May 16, 2012

My point? Trying to tell people what they can and cannot eat is futile and annoying to boot.

School food doesn't have to be sucky. Mine was pretty bad (a small salad with anemic iceberg lettuce and some carrot shavings plus a slice of tomato cost $4, the same fee as a plate of large fries) but you can provide students with acceptable food that both meets their caloric needs (which the one purely healthy option emphatically did not, and everything else was $7 lasagna type things) and not everyone is a marijuana smoking, burger sneaking salad spiker.

In high school I ballooned up to 160lbs while going from about 5'3" to my current height of 5'5" probably blamed specifically on eating said fries as the only option that worked with my other lifestyle challenges- I usually skipped breakfast and never packed a lunch because both far exceeded my organizational abilities as a young teen and my parents simply did not have the time or inclination. So I would routinely down half of a large plateful of cheap fries using the money supplement my parents gave me for babysitting (intended to cover miscellany like new socks, birthday gifts for other people, etc...) and dole the rest out to friends. My relative fatness didn't bother me but during my junior and senior year when I wanted to eat healthier it was a nightmare. The easiest things in my budget with plants in them were dole fruit popsicles and onion rings. My point is that access matters, it sucks to be poor-ish and not be able to get anything better than the equivalent to salad with condoms in it.
posted by Phalene at 6:15 PM on May 16, 2012 [2 favorites]

Phalene: point takem. But if you look at the ages on our profiles you can see that were about a generation apart in age which would explain differences in our experiences and thus attitudes.
posted by jonmc at 6:25 PM on May 16, 2012

My point? Trying to tell people what they can and cannot eat is futile and annoying to boot.

I don't really get this. I used to not know that soda was loaded with sugar and had a ton of calories in it. Then somebody told me, and after they told me, I knew, and I stopped drinking so much soda. It never would have occurred to me to be like, SCREW YOU, MAN, SODA 4EVA. I still drink soda when I really feel like a soda. But I'm glad somebody told me it wasn't that good for me.
posted by escabeche at 6:57 PM on May 16, 2012 [2 favorites]

I used to not know that soda was loaded with sugar and had a ton of calories in it

Really?
posted by jonmc at 7:11 PM on May 16, 2012

Yes, really. I mean, I knew it had sugar in it, but if you told me "when you get a quarter pounder, fries, and a large Coke, the Coke has about many calories as the fries and not so much less than the quarter pounder," well, that was news to me. Is it supposed to be obvious for some reason?
posted by escabeche at 7:17 PM on May 16, 2012

Dude, it tastes sweet as hell and on the ingredients label, sugar and/or corn syrup is at the top. Even as a kid in the 70's I knew it wasn't good for me, I just liked it too much to care.
posted by jonmc at 7:26 PM on May 16, 2012

Really?

Ya rly! Well, snappy pop culture retorts aside, soda is constantly served as an automatic side with things. It's something they actively have to teach people that you need to read 'juice' packages to be certain you're not buying something marketed as 'drink' or 'punch', because the latter go out of their way to promote real fruity goodness as loudly as the same sized carton or say, ordinary orange juice from concentrate. You don't default come knowing things about nutrition, and even my education's system's token effort to teach the Canada food guide didn't cover more than incomprehensible advice to have 7-8 servings of vegetables and/or fruit. Since food packaging labels whatever it likes as a typical serving, you have people equip with the idea that they need to eat an astronomically large amounts of broccoli and people who think the baseline of the average budget brand soft drink is good for them because its hydration--- and not even particularly sweet, and people like me who cut fountain drinks with water or skip them are freaks.

You really cannot underestimate human innocence in the face of how things work.
posted by Phalene at 7:42 PM on May 16, 2012 [2 favorites]

Way to miss the point completely, and bully for you all the same.

There was a point there? It looked more like a way to feel morally superior based on a random bodily metric with no context whatsoever.
posted by Kurichina at 8:17 PM on May 16, 2012 [3 favorites]

Why does it make more sense for millions of wealthy parents to pack individual lunches when the school systems, which already have the economies of scale to feed millions of kids, can do so? Or do the poor kids not deserve healthy meals too?


Because it's called responsibility. You don't have to be wealthy to pack a peanut butter sandwich with a banana.
posted by TSOL at 9:07 PM on May 16, 2012

The rhetoric of the war on obesity, and on weight loss as a universal panacea for the evils of obesity is misguided, I think. Weight loss through dieting is not sustainable for most people, but healthy habits can improve your health outcomes, regardless of whether you are thin or fat.

Pretending that fatness is the whole problem gives unhealthy thin people the false idea that if their BMI is under a certain number, they are fine. It also tells fat people that if their healthy habits are not causing them to lose weight, they are pointless.
posted by misfish at 9:14 PM on May 16, 2012 [3 favorites]

It's something they actively have to teach people that you need to read 'juice' packages to be certain you're not buying something marketed as 'drink' or 'punch', because the latter go out of their way to promote real fruity goodness as loudly as the same sized carton or say, ordinary orange juice from concentrate.

And as it turns out, there's no health difference between juices and a coke. 7%, 100% its all sugar, empty calories, and we're finding out quite possibly toxic. Thanks FDA nutrition label.
posted by stratastar at 9:43 PM on May 16, 2012 [1 favorite]

You don't have to be wealthy to pack a peanut butter sandwich with a banana.
Indeed. And I am super lucky to be home to pack my kids lunches 2 days a week (and weekends). The other three days I leave before they get up at 6am. My partner makes lunches those days, but I'm reluctant to judge if people aren't great lunch makers.


The lunch was sort of middling on the healthiness front (Chicken Salad sandwich with a bit of lettuce and tomato, pita chips, apple)
Bulgaroktonos, I'm not in the US, so some dietary stuff is over my head, but that sounds like a pretty healthy lunch, the kind I send my kids off with regularly. Why are you saying it only just makes grade?
posted by bystander at 5:13 AM on May 17, 2012

There is a problem here, but it has to do more with car culture than weight.

Car culture is part of the problem, but the issue, on a whole, is a lot more complex than that; as the documentaries point out, it also has to do with what we grow, how we fund farmers, marketing, availability, education, and exercise.

Most people in New York City are pedestrians, but we've also seen a spike in obesity and obesity-related health problems. My anecdata: I was sitting in a low-cost medical clinic waiting for my appointment earlier this week, and out of maybe 40 people in the waiting room, about six weren't overweight or obese—and most of them were children under the age of five. Meanwhile, dialysis offices have been springing up like wildflowers in my neighborhood, in order to serve people who have diabetes-related kidney disease.
posted by evidenceofabsence at 7:23 AM on May 17, 2012 [1 favorite]

Pretending that fatness is the whole problem gives unhealthy thin people the false idea that if their BMI is under a certain number, they are fine. It also tells fat people that if their healthy habits are not causing them to lose weight, they are pointless.
posted by misfish at 9:14 PM on May 16 [3 favorites +] [!]

That's very true to a point, but at the same time regardless of a person's cardiovascular fitness, carrying 100 extra pounds has a ripple effect that the average layperson cannot even begin to imagine. Diagnostic tests are limited by fat, cancers are harder to detect, orthopedic problems cause severe limits on mobility at earlier ages resulting in indigence and institutionalization at ever earlier ages due to loss of independence. Name an industry and I bet a person from within it can tell you the ways that weight is causing trouble from them. We are having to redesign urban transit because safety is compromised by the sheer mass we are hauling around making braking and steering systems less responsive. And keep in mind that you may be fitter than your peers and carrying 50 pounds over an ideal BMI, but most people don't maintain that fitness indefinitely and eventually the weight just becomes as burdensome as ever. There is no good way through except to start focussing on keeping kids from getting fat and bracing ourselves for several decades of stress on our health care and other infrastructure as we shepherd our current population of obese through old age as well as we possibly can.
posted by docpops at 8:17 AM on May 17, 2012 [3 favorites]

Ya rly! Well, snappy pop culture retorts aside, soda is constantly served as an automatic side with things. It's something they actively have to teach people that you need to read 'juice' packages to be certain you're not buying something marketed as 'drink' or 'punch', because the latter go out of their way to promote real fruity goodness as loudly as the same sized carton or say, ordinary orange juice from concentrate.

As if the ordinary orange juice is not a sugar bomb.
posted by rr at 11:19 AM on May 17, 2012

You don't have to be wealthy to pack a peanut butter sandwich with a banana.

I got free lunches from grades K-8, and reduced lunches thereafter. You may not have to be wealthy, but you have to be wealthier than I was while I was in school (not to mention the 21 million kids who got subsidized lunches last year).
posted by snickerdoodle at 2:05 PM on May 17, 2012 [2 favorites]

Bulgaroktonos, I'm not in the US, so some dietary stuff is over my head, but that sounds like a pretty healthy lunch, the kind I send my kids off with regularly. Why are you saying it only just makes grade?

Mostly for reasons that you can't really tell from my description of the meal, I just realized. The sandwich had only a tiny bit of lettuce and tomato, it could have stood more, and it was mostly bread. I'm also not totally sold on pita chips as a side to a sandwich because it's a lot of carbs. That said, when I was in school field trips regularly stopped at McDonalds for lunch so it was light years better than that.
posted by Bulgaroktonos at 4:19 AM on May 18, 2012