Obsessed: America's Food Addiction

by Mika Brzezinski

  Recognizing that our prejudices are counterproductive is a good place to start changing attitudes. Puhl thinks one reason our biases remain socially acceptable is that we somehow think they might be helpful. “There tends to be this perception that maybe stigma is not such a bad thing, that maybe it will motivate people to lose weight or provide an incentive for people to be healthier.” In fact, she says, the opposite is true. “When people are blamed, stigmatized, or teased about their weight, they’re much more likely to engage in unhealthy eating behaviors like binge eating; they’re more likely to eat more food; and they’re more likely to avoid exercise. All of those things actually reinforce obesity.”

  So we need to get a lot smarter about how we look at people who are obese and how we support them. We also need our families, schools, and communities to protect our children from getting fat in the first place, and to support the work we need to do to reach and maintain a healthy weight. One out of every three Americans is obese (defined as a body mass index, or BMI, of 30 or above) and another one in three is “merely” overweight. With those numbers still rising, 42 percent of us can expect to be obese by 2030. We need to recognize that obesity is not just a problem that affects individuals. Right now, the costs threaten to cripple our nation.

  In 2012, four former members of the president’s cabinet—two secretaries of agriculture and two secretaries of health and human services—weighed in with a report titled Lots to Lose: How America’s Health and Obesity Crisis Threatens Our Economic Future. Their report called obesity “the most urgent public health problem in America today” and concluded that “the costs of obesity and chronic disease have become a major drag on the economy.” The report blamed escalating health care costs, which are “the main driver of our spiraling national debt,” and observed that “obesity-related illness comprises an increasingly large share of our massive health costs.”4

  “The obesity epidemic is jeopardizing our global competitiveness,” concludes former US Secretary of Agriculture Ann Veneman, who served under President George W. Bush. I’ve seen some variation in the estimates of what obesity will cost us as a nation, but a good study in Health Economics put the price tag at a gargantuan $190 billion every single year—about 21 percent of all medical spending. If we don’t reverse this epidemic, diabetes, one of the more costly conditions linked to obesity, will affect one in three Americans in their lifetime, according to federal government predictions. Heart disease, asthma, and kidney failure are among many other expensive chronic conditions linked to obesity.

  The obesity epidemic is jeopardizing our global competitiveness.—former US Secretary of Agriculture Ann Veneman

  Joint replacement is still another “incredible cost for our country,” said Claire McCaskill. The senator had a knee replaced and recognizes that the surgery might have been avoidable had she lost weight a decade earlier. “Any orthopedic surgeon, if they’re being honest, will say that a great number of those surgeries are a direct result of obesity. It’s the same thing with back problems and the same thing with the big elephant in the room—diabetes.”

  Scientists at the Mayo Clinic say that the extra medical costs associated with obese patients are even greater than the additional costs associated with smoking.5 That’s a scary thought, considering that smoking adds about 20 percent a year to medical expenditures. Morbid obesity (BMI over 40) is even more expensive, leading to a 50 percent average hike in an individual’s medical bills.

  People who are obese pay some of the costs out of their own pockets. Under the new federal health care law, employers can charge obese workers 30 to 50 percent more for health insurance if they decline to participate in a qualified wellness program. But in the end, we will all pay more. Working people will face higher taxes to cover Medicare and Medicaid, and they will be charged more for private coverage, as insurance companies raise prices to cover their own costs.

  Another harmful impact, according to Duke University researchers, is that obesity is slicing into the productivity of the US workforce, with obese workers taking more sick days than those with a healthy weight.6 That costs employers as much as $6.4 billion a year. And it’s not just health-related absenteeism that adds to their costs; they also have to cope with “presenteeism,” where workers report to work, but do not perform well due to health-related limitations.

  Ka-ching, ka-ching. The dollar figures keep rising. And we haven’t even factored in the human cost of shorter life spans for obese Americans, or the misery of the chronic illnesses associated with excess weight.

  The news looks even worse for our children. The American Heart Association says one in three kids is obese or overweight, triple the rate in 1963 when President John F. Kennedy defined physical fitness for youth as one of the goals of his administration.7 Fifty years and nine presidents after JFK, we are being warned that this generation of Americans may be the first that will not live as long as their parents did.

  Dr. Nancy Snyderman has seen the change in her own practice. Nancy is now a cancer surgeon, senior medical editor at NBC News, and author of Diet Myths That Keep Us Fat, but she began her career as a pediatrician. When obese children came into her office in the early 1980s, she says, “We sent them to the endocrinologist because we were worried that they had a hormone problem, or that they had a pituitary tumor. We never had parents who were overfeeding. If anything, the reason children came to the pediatrician with weight issues is because they were failing to thrive, and couldn’t keep weight on.”

  Snyderman says childhood obesity has “caught us unaware, and frankly, unprepared for the onslaught of problems.” Conditions that were previously rare in children—like high blood pressure, high cholesterol, and type 2 diabetes (which was called adult-onset diabetes until we began seeing so much of it in a younger population)—are becoming common.

  And the impact on young people doesn’t end there. Partly as a reaction to bullying and teasing, obese children are more prone to low self-esteem and depression, which makes it a lot harder to do well in school. “There have been a number of studies in the past ten years showing that obese students are performing worse on generalized tests at school,” says Rebecca Puhl. “In the studies that we have done, kids who report they’re getting teased about their weight are much more likely to skip classes and are reporting that their grades are harmed by this.”

  Bullying can start as early as preschool and continue for years. At first, researchers assumed that obese students were performing worse because they had some sort of learning challenges, but it turned out to be a response to the cruelty of their peers. “If we look at the teasing and bullying relationship, no wonder these kids aren’t performing well,” Puhl explains. “They have no support, they’re facing relentless teasing, and they can’t function at school.”

  In one survey Puhl asked fifteen hundred Connecticut high school students why kids are teased or bullied at school.8 Out of ten options, body weight ranked number one. “It was ahead of sexual orientation, it was ahead of race, it was ahead of everything else,” she reports. “The consequences for these kids are devastating. Kids who are teased about their weight are two to three times more likely to engage in suicidal thoughts and behaviors, compared to their overweight peers who are not teased.”

  As fat children grow into fat young men and women, we also face a national security challenge unlike any we have seen before. Mission: Readiness, an organization of retired senior military officers committed to supporting smart investments in America’s children, calculates that 9 million young people ages seventeen to twenty-seven are “too fat to fight”; that is, too heavy to be accepted into the military. That’s more than one-quarter of that age group. According to Sam Kass, the senior policy advisor for healthy food initiatives in the Obama White House, delivering a keynote address at a CDC (Center for Disease Control and Prevention) conference, “Obesity may be our nation’s greatest national security threat.”9 It’s the number one disqualification for military service.

  T
hat’s especially troubling because the military has already become more selective in its recruiting than it used to be. “It’s not the old paradigm of anybody can be in the military,” according to Rear Admiral Jamie Barnett (retired). The military has gone high tech, and it “increasingly needs people who can handle complex systems: sensors, weapons, aircraft, submarines. Now we have to have really smart people, and here’s a whole category of people who are smart and who want to serve who can’t get in because of the weight barrier.”

  Ultimately, Barnett says, the nation could face a situation where it simply doesn’t have the people it needs, particularly in specialty areas of the military. “We have to address this,” he emphasized. Otherwise, the military will lose out on much-needed talent, the nation will lose out on the protection it needs, and whole groups of young people will lose opportunities for well-paying, secure jobs.

  “There’s significant research that the rise of the middle class after World War II was in large part due to GI benefits: education, housing, things like that. Now we have a huge number of young people who won’t even get a shot at that,” warns Barnett. “It may take a while to understand what that means for America.”

  I’m completely on board with what all of these findings suggest—that there is real value in being thin. But hitting that target is not going to be easy, not for us as a nation, and not for any of us individually. I get angry when I see weight-loss commercials with women holding jeans that are ten sizes too large for them and saying, “This used to be me.” They throw the jeans off to the side and show a newly slim body to the camera. Everything is now just perfect. In all our media we are bombarded by messages that seem to say, “This is how easy it is. Follow this diet and you’ll be happy.” Take it from me: maintaining a healthy weight is a lot of work, and it is forever. Constant. It’s difficult.

  We are not “done” after we lose the pounds. It’s not as though we can finish the dieting process and then just start eating again. It doesn’t work that way. Obesity experts will tell you that losing weight is difficult; keeping it off is nearly impossible for many people. That’s why we need to be much more strategic about how we address this difficulty. And we need to do it together.

  It begins with sharing our stories, both the ones that show the value of being thin and the ones that reveal just how hard that is. As a country, a community, and a family, we have to be open about all of this. We should be able to talk about obesity just as we talk about smoking or diabetes or heart disease or cancer. When we see someone who has cancer, we don’t think, Oh, they’re undisciplined, they did something wrong. We feel sympathy, and we want to help.

  We need to bring the same compassion to obesity. We can’t spend so much time judging people; it’s not fair, and it doesn’t get us anywhere. And it doesn’t help to keep blaming and shaming ourselves either.

  Instead, we have to have real conversations, just as I did with my friend Diane.

  CHAPTER THREE

  DIANE’S STORY

  Diane saw my daughter Carlie before I did.

  My husband, Jim, was out of town when Carlie decided it was time to be born. Jim and Diane had been colleagues when he was a news anchor and reporter at WTNH-TV in Connecticut. I was in a panic when I called Diane in the middle of the night to say I was in labor and needed help.

  Diane met me at the hospital. After sixteen hours of labor, the doctor said, “It’s still going to be awhile,” and left the hospital to pick up a pizza. Moments later, I told Diane, “I think it’s time for me to push.” Her answer: “Close your legs and hang on while I get a nurse.” It didn’t work out that way. Five minutes later, my friend had a view of me only a medical professional should ever have as she caught my baby.

  What can tie two women together more than that? We had forged a bond through the pain, emotion, and exhilaration that comes with bringing a beautiful new life into the world. And since then we have been the closest of confidantes. Nothing has been off the table about our marriages, our families, and the ups and downs of our careers. The only topic we ever skirted was weight and food, despite the huge role it played in both of our lives.

  When we first met, Diane was probably about a size 12. She wasn’t skinny, but she was a tall, blonde beauty. Over the next few years I watched her weight steadily climb, as Diane gradually went from statuesque to obese. Every time she lost a few pounds she seemed to put them right back on, plus a little more. Whenever we got together, I couldn’t help but notice the change. It seemed as though Diane was sabotaging her TV career. I remember thinking to myself, Why is she letting this go on?

  I remember thinking to myself, Why is she letting this go on?—Mika

  Diane is smart, driven, and competent. I mean, this is one talented woman: she’s earned several Emmy awards, has been recognized by the National Academy of Television Arts and Sciences for lifetime achievement, and has been honored by the Connecticut Women’s Hall of Fame. A TV news anchor, reporter, radio talk show host, documentary producer, and author of six previous books, she has been on the air in Connecticut for more than twenty-five years. But I doubted other people were seeing all that when they looked at her. Given what I have learned about the value of being thin, I’d guess her weight was making them think instead, This woman doesn’t have it together. She doesn’t even have the discipline to lose weight and get in shape.

  And that’s basically what I said on that beautiful afternoon on Long Island Sound when I came clean about how I felt. At first, it looked like it was going to turn into a very turbulent day for a treasured friendship. I wasn’t sure she would ever speak to me again.

  I told Diane, “I don’t really think that you are sitting around eating all day, but I do think you need to break your cycle of depending on fattening foods and start believing in yourself again. You’re not really hiding anything with all those black pantsuits. Everyone knows you have a weight issue.”

  Telling Diane the truth about her weight, and using that toxic word obese to describe her, was one of the hardest things I’d ever done. I certainly didn’t do it to be a bitch, even if some people might have thought so. I did it because I want her in my life, and I was worried about her health. I also thought it was only fair for Diane to hear it from a friend. It’s what other people were thinking when she was on TV or when she got up on stage to give a speech.

  If you are wondering, Why tell her the truth?, maybe that isn’t the right question. Considering how long it took me to raise the topic of weight, and what it was doing to her personally and professionally, it might be more helpful to ask, Why didn’t you say this ten years ago, when her weight was just becoming a problem? Why did you avoid it?

  I wish now that I had talked to Diane much sooner. It would have been a lot easier for both of us.

  When Diane took me up on the challenge to lose seventy-five pounds and we decided to write this book together, at first she was reluctant to tell her own story. But eventually we both decided that baring our souls was the way to set an example for others. No one is better off with silence. As Diane put it, “If we can start a dialogue between the two of us, maybe we can instigate a wider discussion. A national discussion. So I’m all in.”

  Here is more about how Diane has experienced the struggle against food and overweight, in her own words.

  Although Mika and I got to know each other a little while working as news anchors and reporters at rival stations in Connecticut, we really bonded when she was in labor with Carlie. That was one of the most profound experiences of my life. I don’t have kids, and my sisters live far away, so it was truly a once-in-a lifetime event; something I have never shared with anyone else.

  No wonder Mika has remained special to me all these years later. But I have to be honest. She’s a little nuts. When she wanted to know if I would step in for her husband, Jim, if she went into labor while he was out of town, did she call me and ask for my help? Did she drop by the house? No, she ran into my husband, Tom, at a coffee bar one Sunday morning and as
ked him to run it by me.

  She was still a couple of weeks away from her due date when I said yes. What I was really figuring was, What are the chances the baby will come while Jim is out of town? Yeah, right. I didn’t give the possibility of coaching her through labor much thought after that. The only thing I did think about was how Mika looked during her pregnancy, and that was sure frustrating to me. Even at nine months’ pregnant, she was thinner than I was. In those days, I was always thinking, What the hell can I wear that won’t make me look so fat?

  A few days after I agreed to be her backup labor coach, Mika dropped a couple of books in my mailbox, including What to Expect When You’re Expecting. The books were still in the mailbox when she called our house Friday night. Jim was on a plane to New Orleans, and Tom and I had just polished off a pizza and a bottle of wine. “I think my water broke,” she whispered into the phone.

  YOU THINK? WHAT? YOU’VE HAD A BABY BEFORE, NOT ME! WHAT DO YOU MEAN YOU THINK???

  I ran out to the mailbox to get the books so I could skim through the chapters on labor and delivery while I stayed on the phone with her.

  “Yep, it’s starting,” she said. “You two should get some sleep and I’ll call you later.”

  SLEEP? ARE YOU KIDDING?

  Tom and I lay on our bed, suddenly and completely sober, fully dressed and ready to go. When the phone rang again, we phoned the doctor and headed for the hospital. Mika’s mom stayed behind to watch her daughter, little Emilie.

  We couldn’t reach Jim, so all that night and the next day it was Mika and me in the shadowy labor room. The nurse came in a few times to check on her and told us to get some rest, but like kids at a sleepover, we kept right on talking.

  There were a few times I had to step up, like when the anesthesiologist asked Mika whether she wanted an epidural. “Did you have one last time?” I asked her. “No,” she said. “But maybe that was a mistake.”