by Wilson, Bee
The problem of “weight misperception” has consistently been shown to be worse with boys than with girls. Numerous studies have shown that parents are less likely to think a brother is overweight than a sister, perhaps because a boy’s figure is seen as less of a social issue than a girl’s. Parents often become very defensive when a nurse or dietician points out that, based on the weight and height charts, their child is obese. They protest that their child is “big-boned,” that they only eat healthy food, that there’s something wrong with the chart. This defensiveness is seen in parents of girls as well as boys, but with boys, the parents seem almost proud of their son’s large physique. An obese boy may be described as “solid” or “chunky,” which sounds healthier than “fat.” A low-income mother whose preschool son was borderline obese told researchers, “I can look at him, and he might weigh a lot, of course, but that could be just all muscle. ’Cause he is a strong kid.”
When parents under-assess a boy’s weight and over-assess his food requirements, it may form his self-image and the way he eats for the rest of his life. A large-scale study of weight perception among more than 16,000 American adults found that under-assessment of one’s weight was two to three times more common in men than in women. Nearly 43 percent of the American men who were overweight (but not obese) said that their weight was “about right.” Nearly 12 percent of obese men said their weight was about right. Similar results have been seen among Australian men and women, where about the most men would admit to was that they were “a little overweight,” when they were actually “biomedically obese.” This is worrying, given that you are unlikely to do anything about your weight problem if you don’t even recognize that you have one.
There is an equally disquieting trend for a large segment of healthy-weight or underweight women to misdiagnose their weight in the opposite direction and wrongly label themselves as obese. A 2003 study of more than 2,000 undergraduates across six American campuses found that fully 72 percent of the women believed their “thighs were too fat” in comparison with just 11 percent of the men. It transpires that, regardless of actual weight, college-age women are more uncomfortable about being weighed in public than their male equivalents. Female body dysmorphia—exaggerated and perfectionist beliefs about one’s own body flaws—is an anxiety that is not confined to those who suffer from a full-blown eating disorder. Research suggests that in our society, such worries afflict the majority of postpubescent girls.
This discrepancy between the self-image of girls and of boys is a problem for both sexes. It means that public health messages about the “obesity crisis” and ways to eat more healthily are probably heard by the wrong people and not by those who might benefit. It’s like when a teacher loses his or her temper with the persistent troublemakers and decides the best approach is to tell off the whole class to make them see how they are squandering their future. The good, quiet children listen to the angry lecture and feel upset, thinking it applies to them, when it doesn’t. The troublemakers at the back don’t think the teacher has anything of relevance to say to them, so they doze off or continue to make trouble. When anti-obesity campaigns tell us we are sleepwalking into a terrible future, significant numbers of healthy-weight women think the words are a direct criticism of their own upper arms, and significant numbers of obese men think it has nothing to do with them.
As a general rule, women seem to be more compliant with dietary guidelines—more likely to at least attempt to eat healthily, even if they do not manage it. Over the course of childhood, the trend is for boys to eat declining quantities of vegetables and fruits, while girls increase their intake very slightly. A recent study of British children showed that 70 percent of boys aged four to six ate apples, but this declined to 39 percent of those aged fifteen to eighteen; as we have seen, parents feel reluctant to push older boys on the question of healthy eating. But with girls, the consumption of salad went up: only half of the four- to six-year-olds ate it, but 66 percent of teenage girls did, maybe because they saw it as something they were meant to eat. Either way, many boys could benefit from learning to eat more like a girl. In Thailand, girls eat many more fruits and vegetables than boys, and twice as many boys are obese. Yet survey data suggest that Thai mothers do not view their sons’ lack of vegetables as a problem.
Because we don’t believe obesity in boys to be as much of an issue as it is for girls, we also don’t see just how unhappy it can make them. Kuwait has some of the highest rates of adolescent obesity anywhere, with nearly half of those aged fourteen to nineteen overweight or obese. Kuwaiti teenagers are significantly fatter than those in other Arab countries. One study found that among fifteen- to eighteen-year-olds, more than twice as many of the boys were obese or overweight in Kuwait as in Syria or Libya. Kuwait had a more rapid “nutrition transition” than other parts of the Middle East, meaning that Kuwaitis were exceptionally quick to adopt Western fast foods. For generations, Kuwaitis have eaten a cuisine far heavier in meat and fat than the people of other nearby Arab countries, such as Lebanon, where family meals center on vegetable-based mezze: eggplant-based dip, fattoush (herb and bread salad), and the like. In Kuwait, a typical family dish is makbous dajaj, where a whole chicken is first boiled and then deep-fried and served with rice simmered in the fatty cooking water. When American-style fried chicken and hamburgers arrived in Kuwait City, local palates were already primed to enjoy them.
Kuwait’s obesity crisis is another case of traditional ideas about feeding going badly wrong in a modern prosperous food supply. Hospitality is a crucial concept in Kuwait, and it is sometimes remarked that every family gathering is treated as if it were Thanksgiving. Claudia Roden, the great expert on Middle Eastern food, notes that to be a good guest in traditional Arab cultures, “if one feels satiated, one should nevertheless continue to nibble at a dish from which others are eating, since if one person stops eating, everyone else may feel compelled to stop too.” Oil money has made Kuwait one of the richest countries in the world per capita, with vast shopping malls, a culture of eating out, going to these places in luxury cars, and having plenty of disposable cash for snacking. The wealth of Kuwait means that excess food has become affordable to many, hence the fact that weight gain has been far more rapid there than in poorer countries of the Middle East, such as Syria or Algeria.
Kuwait has also suffered an epidemic of “disordered eating,” particularly among boys. Professor Abdulrahman O. Musaiger, a leading expert on nutrition in the Arab world, found that eating disorders were becoming widespread throughout the region, and the teenagers with the most disordered attitudes of all were Kuwaiti boys. Musaiger tested for eating disorders using the EAT-26 test, which asks respondents to rate the frequency with which they engage in behavior such as “eating binges where you feel you may not be able to stop,” and thoughts such as, “I feel that food controls my life,” or “I feel extremely guilty after eating.” A full 47 percent of the Kuwaiti teenage boys who performed the test came out as having “disordered eating attitudes” (a lot of Kuwaiti girls had disordered eating too: 43 percent). Musaiger concluded that this might be because Kuwaiti boys have “cultural adjustment difficulties.” Despite its economic modernity, the country is socially more conservative than many other Middle Eastern countries. As recently as 2013, a survey of nearly 2,000 college students found that only 70 percent of young Kuwaitis—male or female—believed that men and women were equal. The survey also found that many students claimed to dislike the Western “consumer culture.” Kuwaiti boys hear relatives speak of the Gulf crisis of 1990 and may view America as the enemy.
Yet even as they denounce American culture, they participate in it when they grab a Super Supreme at Pizza Hut (which has forty-nine branches in Kuwait), or a platter of spicy ribs at Applebee’s. Many Kuwaiti boys eat the enemy’s food and sip the enemy’s soda every day. In Musaiger’s analysis, these young men are torn between the values of East and West, “caught between the influence of Western culture
on dietary behavior and body size preferences that encourage thinness on the one hand and traditional cultural norms that favor customary food habits and normal or plump body size on the other.” Traditionally, it is a boy’s prerogative to eat as much as he wishes. In a Kuwaiti family where all the brothers are obese—and most of the adults around them, too—the parents may look at their boys and think they are fine. But judging from Musaiger’s research, they are absolutely not fine, either physically or mentally.
There is a great deal more to Kuwait’s obesity crisis than just gender. But wherever we live, one step in learning to eat better would be to move beyond gendered notions of food. Both boys and girls would be better off if they could copy the best aspects of each other’s eating habits. Boys could do with being more conscientious about vegetables and more honest about their body size. Girls would benefit from adopting a manly liking for hearty main courses instead of sugary pink cupcakes and chocolate. Like boys, they should know that they have permission to eat when they are hungry.
The great potential of siblings—or the virtual siblings we assemble among our friends—is that they make us less alone at the table. We borrow tastes and habits from them. Maybe their example makes us see that one tiny bowl of cornflakes is not a big enough breakfast, or, conversely, that a crunchy stick of celery can be surprisingly delicious, especially if you add peanut butter and raisins. When they go through a craze for Moroccan take-out, or wok cooking, or growing herbs, it broadens our horizons, too. And—when we are not squabbling—their company makes everything taste better.
Siblings don’t have to be rivals at the table. These days, my sister and I live on different continents, so we don’t eat together as often as I’d like. (She bagged America; I was left with Europe.) But when we do meet, the dynamic of eating is quite different from what it once was. Now that we are middle-aged and have our own children, we have both calmed down, and the result is the sort of culinary convergence I would never once have thought possible. It turns out that we are not so different when we sit down to eat side by side. We both like very strong coffee; toasted bagels with butter, not cream cheese; avocado sushi rolls; and any kind of fruit, especially crisp, tart apples in the autumn, or ripe, juicy pears, which remind us of our mother. When I’m visiting my sister, we sometimes go to a Vietnamese deli near her house that makes delicious sandwiches. She orders a tofu banh mi: soy-marinated tofu with crisp coriander leaves, pickled carrots, and daikon radish in a soft hoagie roll. I pause for a moment, consider going for roast beef on rye, just to prove I am my own person, and then I choose exactly the same.
“For some reason,” writes marketing expert Bryan Urbick, “girls have a special relationship with chocolate.” Almost all the ads for chocolate on TV are aimed at women, depicting them as powerless to resist its melting charms.
Chocolate’s status as food for girls and women—something to be yearned for and then regretted—is so ingrained that it would be easy to assume that there is something deep within females that makes them crave the chemicals in chocolate. Girls often talk this way themselves, saying that they “need” the happy serotonin of chocolate because they have their period.
There are, no question, some potent chemicals in chocolate. These include phenylethylamine (an amphetamine-like substance), caffeine, and anandamide (a cannabinoid). Yet the form in which most women crave chocolate is milk rather than dark chocolate, and milk chocolate is significantly lower than dark in these compounds and higher in sugar and fat. If a “chocoholic” is craving anything, it is probably the dopamine release of sugar. The idea that menstruation hormones make women crave chocolate was undermined by a recent study in which researchers found that postmenopausal women only experienced a very slight drop in their chocolate cravings, despite the fact that they no longer had periods. The researchers concluded that stress, not hormones, drove women to chocolate.
Women have a special relationship with chocolate mostly because our culture tells them to. It goes back to the old claptrap about sweet treats being for “ladies,” while savory tastes are for men. Chocolate is undoubtedly an appealing substance: the heady aroma, the sweet taste, the way it melts at body temperature. But there’s no biological imperative that says that women should be driven to seek these experiences more than men.
In 2006, a fascinating study was done on students in Spain and the United States. Among the Americans, only 59 percent of the men would admit to chocolate cravings, as against 91 percent of the women. In Spain, chocolate cravings were much more evenly split, with 78 percent of Spanish men and 90 percent of Spanish women saying they craved it. This is a clear indication that the female craving for chocolate is something that is culturally determined, not innate.
Female chocolate cravings are an archetypal learned behavior. From our earliest years, as girls we pick up on the fact that chocolate is special and for us. We are given it at birthdays and holidays or to calm our tears. We absorb the message that chocolate will soothe us when we are down, and that when we are happy, it will make us happier still. We tell ourselves we don’t just want it but need it. Yet buying it also seems to leave more women than men feeling guilty.
A girl’s physiology does not make her need slabs of chocolate once a month, any more than it creates a requirement for marshmallows, macaroons, and salted caramel éclairs. If our chocolate habit is learned, then—unlikely as it seems—it can be unlearned, or at least toned down a touch.
6
Hunger
So it happens that when I write of hunger,
I am really writing about love . . .
M. F. K. Fisher, The Art of Eating
Achild feels woozy, slips under his desk and onto the floor. Another child yawns for hours every morning, only properly waking up after lunch. A third seems incapable of concentrating on even the simplest lesson, as if his brain isn’t quite there.
Such hunger wasn’t meant to exist in civilized societies where food is plentiful; nevertheless, as workers for hunger charities can attest, scenes like this are a daily occurrence in some of the schools of the affluent West. The No Kid Hungry initiative works at a state and a city level to help provide free breakfasts to low-income children in 25,000 schools across America, on the premise that a child who has not eaten in the morning is not ready for learning. Giving a child a bowl of cereal, some fruit, and a carton of milk is a small thing. And yet, viewed from the perspective of an individual child’s future, feeling full in the morning is not small. It can make the difference between being switched on to education and all the advantages this brings and not. People who work for No Kid Hungry have found that compared to other low-income pupils, the children who eat a free school breakfast have higher math scores and better attendance rates, are more likely to graduate from high school, and, perhaps most critically, are less likely to experience hunger as adults. Once the pattern of not being hungry in the morning is set, it modifies the way you eat for life.
Satisfying hunger is the most basic function of eating. Assuming there’s enough food—and this cannot always be assumed, as the presence of food banks and school breakfast programs reminds us—hunger management doesn’t seem like something anyone should have to learn. Unlike our appetite for specific foods, hunger is an innate animal mechanism that we are born with. Yet as it plays out in the modern food environment, hunger is far from simple. Beyond infancy, acquiring the ability to cancel out our hunger adequately without overshooting the mark has become a complicated task, whether in the hungry developing world or the overstuffed West.
Like boredom, moderate hunger is one of those childhood discomforts that modern parenting—plus a world of abundance—seems to have all but abolished in middle-class families. Children and adults alike are constantly topped up with snacks to keep bad moods at bay. My handbag has a compartment filled with cashews, cereal bars, and dried fruit in readiness for those frequent moments when they groan, “We’re huuuuuungry,” these children of mine who have
never really known the gnawing emptiness of real hunger. Hunger now tends to be nipped in the bud before the first growl of the tummy. Yet when it comes to bona fide child malnutrition, we are still far too willing to pretend it doesn’t exist. While malnutrition in poor countries remains the number-one cause of child mortality in the world, its effects can also be seen closer to home.
The rise of child obesity creates the illusion that our problems with eating are all about overfeeding, and we find it hard to recognize malnutrition even when it is right in front of us. Some are skeptical that any child in the developed world is truly hungry. Yet Feeding America, the largest hunger-relief program in the United States, estimates that 15.8 million American children live in “food insecure” households, and therefore grapple with hunger at least some of the time. The median household income of the families using Feeding America’s food banks was just $9,175 as of 2014. Eighty-four percent of the families they see report buying the cheapest food available, regardless of whether it is healthy. Cheap food doesn’t have to be food that is unwholesome, unsatisfying, and lacking in essential nutrients; but as it happens, it mostly is. Many children today in affluent countries are in the paradoxical situation of being overweight and malnourished at the same time (this is known as “hidden hunger”); they take in too many calories from cheap carbohydrates without getting enough of the micronutrients the body requires. Plenty of others, however, are hungry in the old-fashioned sense and lightheaded from a lack of food, particularly the protein foods children need to grow. And there is no hunger so ravenous as that of a child.