How Can We Reform America to Make It Healthier?

With a new health care policy in the news, and the usual track of obesity declared as the nation’s number one threat, I wonder, as I drive home after another day sitting at my desk, how we can actually change American society so that we are healthier.

Aside from the constant stream of new drugs on the market, and the new movement for locally grown food, how can many Americans—sitting in front of screens all day and all night—actually change their habits? It’s one thing to constantly carp on “calories in, calories out”, that you need to eat less and exercise more, but that’s a simple statement for a complicated problem. How can American society truly change? How can we structure work, our way of life, so that this is feasible?

I’m not talking about better health insurance, less availability of junk food, even funky workplace amenities like gyms and treadmill stations, although those things will help. But how do Americans, with their time-strapped, hectic lives, actually go about to make changes?

Many workplaces now offer incentives, or wellness initiatives, to get their employees healthy. And that’s a start. But so many people get up, drive to work to sit at a desk for too many hours, then drive home and watch TV, because that’s what they need to relax. Fitting in even a 30 minute workout (it’s never just 30 minutes), is tough when you don’t have the space, it’s cold, rainy and dark outside, and you have to make dinner and take care of the kids.

Working out during the day isn’t often feasible either, and while riding bikes to work is the hip green thing to do, it’s largely impractical for a huge number of people. There is, simply, usually too much work to do to tear yourself away from the computer for a large enough amount of time, and then we add in our own leisure reading of the news, checking emails, and doing our banking that brings us in front of the computer for more time.

People talk about changing corporate culture, but that is often very difficult to do and based on a lot of factors outside of a person’s control, especially if they are a junior employee. If everyone eats at their desk, and you don’t, it can look like you’re slacking, even if they are just checking Facebook.

A lot of the initiatives to change Americans' working habits will take a lot of time, especially if that includes redesigning the country’s transportation system. And while I am all for a reorganization of the country’s priorities regarding food subsidies, that doesn’t necessarily mean that things will change all that much (especially as fruit spoils in a vending machine). But how do we put in place things that make it easier for people to move more during the day?

The key is to make it natural, not forced, and not mandatory, because people should feel free to eat a hamburger, smoke, or sit in front of screens all day long if that is what they want. But institutional, societal changes are what needs to happen, and often in America, it is policy that pushes the rest of the country in a direction.

Even if, over time, better quality food is more equitably distributed and the country becomes less dependent on cars as a main form of transportation, we will still be captive to the screens. And yes, of course there are plenty of people who do not have to sit at a desk all day to work—teachers, construction, retail and restaurant workers, to name a few—but more and more of our jobs are sedentary, physically rote. What will happen in the future? How can we stem this tide? How can we change our environment?

I had these questions in mind when I read Megan McArdle’s interview with Paul Campos, the author of The Obesity Myth. He argues that much of what is perceived as current wisdom on obesity as the country’s leading healthcare crisis is wrong, and that the focus on obesity is harmful and ill-effective when it comes to reforming care. McArdle’s interview is partly prompted by a recent study in Health Affairs (of which I am familiar) that says that a growing number of our costs is due to obesity; prevention is understood to be by a lot of leaders one of the ways in which healthcare costs can be reduced.

At first read, a lot of what Campos says sounds blasphemous. Of course there is an obesity epidemic! How can you argue that? Just look around! Costs have soared, the rates of people on chronic medications have gone up, there's an ongoing debate about making airplane seats bigger...every day there's new evidence of how heavy and unhealthy America is.

One of his major issues is the destructive mistake people make between failing to distinguish being healthy and being thin. Despite the perception that getting thinner is being healthier, that is not the cause, and often is a form of disordered or disruptive eating, merely a symptom of a real problem and not a (truly) desired result, and that that being healthy or thin has morphed into a true moral panic.

I wonder when this started. There’s long been a historical association, at least within Western Europe, regarding body type and the availability of food, as it is with cultural perceptions of beauty—when food was scarce, being plump and voluptuous was the height of fashion (as was being pale, since it showed that you did not have to physically toil for your livelihood), whereas now not being thin is a measurement of self-control and class. “Thin” all too often equates to healthy, but many people (especially young people) have no conception that this will not last forever, and that they will eventually pay for it.

Campos is right that BMI is a flawed system, a fact that has not infiltrated the popular consciousness yet. Just like the old food pyramid, it is a distortion that is widely accepted and can actually be harmful.

Too much media coverage focuses on fitness and being healthy as losing weight, and it infiltrates down to become fact. Everyone is under constant assault about the nature of their bodies. Why are you eating that? Why are you doing this? It’s not enough/it’s too much/you’re too thin/you’re too fat/and on and on and on.

As we get older, our bodies change—as a result of age, pregnancy, stress, the environment, hormones, medication, lifestyle—and there’s only so much we can do to prevent it. It’s silly for the media to point to celebrities or athletes, because they have the resources—time and money—to afford the best care, the personal attention, the babysitter, chef, housekeeper, trainer, assistant. We can’t be Madonna, and honestly, most of us wouldn’t want to be, because we don’t want to be a slave to some figure that’s close to impossible to attain (and maintain). Even shows like "The Biggest Loser" don’t return to the contestants afterward, because it’s exceedingly difficult to go back to a normal life and sustain a major change without the help afforded to them on the show from trainers and chefs, without the unlimited time to only focus on their body and their health.

But I do question Campos on one thing about this obesity myth: What about the soaring rates of diseases like diabetes? That’s not the result of a newfangled calculation or the overprescribing of medications, and this is serious. We can argue about whether or not all those statin drugs are necessary, but I know that I do not want to be on these thirty years from now.

Public health remedies have focused on incentives to get people to adopt healthier behaviors, and that is where the idea to tax junk food and unhealthy substances like tobacco took root. But while this may work in theory, it seems counterintuitive for those windfalls to go back to merely preaching and prescribing the proper healthy behaviors, constantly reinforcing the cycle. Some smokers in particular find this galling, targeted as a result of behaviors they engage in; others welcome it as a deterrent. But as the population of smokers dwindles, it seems like a good bargain to the rest of us, because it doesn’t affect us. But widespread taxes will.

Campos returns several times to the point that the culture, with the government behind them, demonizes fat people, that the government is “abusive” when it puts these conditions in place. But we, as a society, demonize all weights. How do we stop doing that? It’s an essential part of human nature: we criticize, we gawk, we comment.

Likewise, he also makes excellent points on physical activity as it’s tied to weight. While it’s true that most publicized success stories do feature lines about feeling healthier, stronger and energized, it’s usually accompanied by other major (physical) changes. A success story that didn’t involve much, if any, weight loss isn’t interesting, because the change wasn’t physical.

McArdle does point out that no one encourages Americans to get married, get religion or move to the country, though that’s not true; it's just on a small scale, and nowhere near as pervasive as the confluences of weight, body image, and health.

It’s sadly true that fatness has become associated with “poverty and lack of self-control”, even though we are all powerless when it comes to certain foods. But self-control is too prized, and too tied with restrictive eating, so that it becomes less about discipline than deprivation.

And that’s where food porn comes in.

As I finished reading Megan McArdle’s post, I was lured into the living room where my father and brother were watching “Best Places to Pig Out” on the Travel Channel. They were calling for me, but since I heard “New Brunswick” and “food”, I was already on my way. The segment was on Rutgers University’s famous grease trucks. These sandwiches (which I’ve never had the opportunity to taste) are monstrous concoctions of fried foods stuffed in a sub: chicken fingers, eggs, bacon, burgers, gyro meat, mozzarella sticks, and of course, French fries. They are meant to give you indigestion, and are only supremely palatable to college students, who do not have to fear an upset stomach, which my father was getting just by watching. This was followed by The Heart Attack Grill, where burgers are named after coronary procedures and the waitresses are hot “nurses” who will wheel you out if you finish a triple or a quadruple. If you weigh over 350 lbs., your meal is free. (They have a scale.)

The restaurant was actually started by a nutritionist. But while the amount of lard used horrified me (I ate half a potato chip fried in lard last week and it tasted like an industrial metal), I was more annoyed with the senior patrons, who commented on their meal by merely announcing they will take an extra cholesterol pill that night, as if these pills would neutralize the effect a 1600 calorie lunch will have on their arteries.

These meals are ok once in a while, but these giant-sized gastro gymnastics are a reaction to what’s seen as a cracking down on pleasurable eating (despite the many such outlets for anyone who’s interested in food). But to say that Americans are getting healthier when a lot of evidence points to the contrary is misleading. Americans might have more pressure, more awareness of what they should do to be healthy than ever before, but they are also thwarted by both human nature and their own environment to be in optimum shape.

The "Neg"

I’ve been reading a bunch of Conor Friedersdorf, who blogs over at True/Slant and is one of the staffers filling in for Andrew Sullivan on vacation. His post today, called out on The Daily Dish, is about the pick-up artist scene, and the very controversial “neg”, a negative statement used to pick on the girl in question as a way to lower her defenses. Conor spotlights a blog a week, and he is fascinated by one Sebastian Flyte, a 23 year-old Libra who blogged regularly about his escapades picking up women.

I am familiar enough with the popularity of this scene, partly because my brother is somewhat of a disciple. I have flipped through Neil Strauss’ The Game (known as “The Bible” to some, and it could pass for it, bound in black leather), read (and loved) I Hope They Serve Beer in Hell, and have had a few conversations on the topic. I’ve also been on the receiving end of quite a few negative statements.

Most people hearing about the technique for the first time are appalled. Of course it’s horrible! Any sort of dating trick—and the use of deception, which we all use, whether we characterize it that way or not—can be seen as terrible, immoral even. If dating is a game and everyone wants to play, of course you are out to win! Conor understands this:

I suspect that often our judgments about kosher behavior depends as much on who is involved as the specific scenario in question. A friend comes to us for advice about how to handle an awkward situation wherein she's inadvertently scheduled two dates for the same day -- and knowing she is generally an upstanding person, we laugh, sympathize, and help her formulate a solution, whereas if we were on a date with a women who deceived us about having another date immediately following ours -- or even worse, a guy our sister was dating pulled the same stunt -- the whole moral situation would seem to us entirely different.

People tend not to flip circumstances and examine their behavior if things were different. That’s because a lot of times it forces black-and-white situations into a gray zone, or merely reduces the justifications for your own behavior, because you wouldn’t want to deal with this crap if it was fostered on you. But people react out of anger, spite, and selfishness, so that’s why many so rarely seek to look at other angles.

But, I can sort of see why the neg works. Sometimes. People, when faced with a criticism, will often try to change it (if it can be changed), in order to prevent the issue from occurring, even if they do not like the person making the comment. The negative statement will reverberate back, insidiously creeping into our consciousness at random times. It doesn’t necessarily matter how true the comment is, or even if we disregard the statement—sometimes it comes back. If we are told we look angry, we will immediately try to soften our look, to prove the other person wrong.

I Wish I Could Write as Well as Emily Gould

"Vision of Love": If only I could write about my thoughts and experiences that sound quietly revelatory, as they do here; "Why I Write For Free" on analyzing and critiquing a situation and an essay.

When parsing advertorials, I wonder: Do those writers feel their souls are dying, slowly? Or they just hurry it along, just another paycheck, gotta get it done? Do they even care? Some people like writing press releases and advertising copy; it can be fun, if you make it. I often tried making games out of silly assignments just to amuse myself.

Back In the Saddle Again

It is quite embarrassing that I haven’t posted anything in over two months. It seems, just looking at my output, that my enthusiasm has waned in 2009. This isn’t the case—I am a person whose thoughts on a given subject far outpace any action related to it—and it is something I am always trying to rectify.

Those I know personally who read this blog know that I suffered from overwork, exhaustion, and pains in my hands and arms that essentially forced me to stop blogging for the sake of my health. I was no real writer, as I did not sacrifice my precious down time to spend it on the computer.

But I was also deeply embarrassed by my previous comments on Twitter.

I didn’t even want to write again about Twitter, having another post tagged under it. But I feel I need to redress previous comments made. Over the past two months, I grew to hate the service. It overtook my life. Companies demand to know how many tweets on a given topic are said on a particular day, and to compile these numbers is overwhelming, in a nutshell. I’ve read all the positive press, from Steven Berlin Johnson’s cover in Time (which I would have known in advance had I not been so ridiculously busy June 4, as I follow him), to well, pretty much any mainstream story on it that appeared on Google News. And I am just so fucking sick of fucking Twitter.

I tried it out. It’s too short for my liking, too much information too fast, and not a reliable way to filter through. Unlike checking email and blogs and Facebook and all our other online “chores”, I didn’t want to invest the time in it, and so I didn’t. It’s like a pet—if you love animals and reap real benefit, great. But if you have no desire to spend your time and resources on it, then don’t.

I’ve also grown to dislike the way certain industries tout its service, and how it’s become a necessity for interaction, a requirement. I want to opt out! I don’t want to be forced to take part!
I had a conversation with a friend a few weeks ago about Twitter (this was before I had grown to full-on hate it, when I was still in ambivalent mode), and we both found blogging to be far more useful. Twitter is too maniacal for her, an assault of nonsensical, mundane thoughts strewn with links. Blogs were thoughtful, occasionally insightful and filled with information and humor.

Of course, in the interim between this post and my last post, there have been plenty of stories written about this, how many bloggers have moved on to other mediums, who can't find the time, and yet, in every conceivable publication imaginable, how beneficial the service is and why you need to have one.

People use the service for different reasons—for youngsters as a way to have private conversations online, when Facebook becomes too crowded, or to find jobs, or sources of stories—but I find it an inept social tool, and I vastly prefer forms that let me wax on, connect, and share without limits or distractions. Unfortunately, as much as I want Twitter to die a quick death, it probably won’t happen. I can hope that it becomes MySpace—passé, off-putting, occasionally worth a peek for its public properties, but otherwise an ailing media property that has cash-flow problems and is too loud for most people.

***

So what else could have been blog-worthy?

I found out about Michael Jackson’s death relatively early—a coworker blasted through, announcing it. I went on Google News immediately, found nothing but cardiac arrest, and demanded proof. “TMZ! TMZ! Check it!” Still very skeptical, I did—and was met with a three-sentence item followed by “more to come.”

So the most interesting thing throughout the entire excess coverage of this exceedingly bizarre person for me was the timing and accuracy of the information, that for many people, myself included, we didn’t believe the story until it was confirmed by more traditional outlets. As the Los Angeles Times put it,

“Few people expect TMZ or Drudge or the National Enquirer to get things right or to report on issues of substance. When they do, at least so far, it’s a bit of an anomaly. So the consequences for getting it wrong among such sites do not seem terribly high. If CNN, Fox … got such things wrong, the consequences would likely be higher.

As much as people love to glee over the death of the mainstream media, we still rely on them heavily for trusted information, for confirmation and access, no matter the story. Yes, our trust in them has eroded over the decades, each successive scandal further lowering the scale, but online hoaxes are quick, and Twitter and its ilk are just as much about hype, rumor and misinformation as the high school prom. But, as much as I dislike TMZ and the ever-larger paparazzi mill, they are becoming a trusted source in their field.