Maintenance Phase - The Obesity Epidemic

00:00:00.000 welcome to maintenance phase the podcast that would never film you from across the street

00:00:16.680 showing only your body but not your head 0.96

00:00:18.960 where there's actually research on that specific thing i know and we're totally gonna fucking 0.98

00:00:26.600 Talk about it. 0.90

00:00:27.380 It's like you already know, Mike.

00:00:29.360 It's like you already know.

00:00:30.620 This is the thing.

00:00:31.440 The only places in American life that you see that many headless torsos are local news

00:00:35.880 segments about obesity and Grindr.

00:00:38.720 As a gay man who researches this issue, I am very familiar with this format.

00:00:42.540 Yeah.

00:00:42.860 Go down the whole rabbit hole.

00:00:44.960 Yeah.

00:00:45.340 The rabbit hole.

00:00:46.000 Also a section of Scruff.

00:00:47.380 Yes.

00:00:49.020 I'm Aubrey Gordon.

00:00:50.120 I am Michael Hobbs.

00:00:50.780 If you would like to support the show, you can do that through Patreon at patreon.com

00:00:54.940 slash maintenance phase.

00:00:55.980 You can also buy t-shirts, mugs, masks.

00:00:59.360 They're coming back at TeePublic on our TeePublic store.

00:01:02.680 Both of those are linked for you in the show notes and at maintenancephase.com.

00:01:06.880 And today we're going to talk about the obesity epidemic.

00:01:11.320 Yes.

00:01:11.840 Our morbidly awesome obesity trilogy.

00:01:16.120 So how do you come to this topic?

00:01:18.420 Like what would you characterize your sort of like baseline analysis?

00:01:21.560 This is a part of the story that I'm really interested in because we both grew up at this

00:01:26.420 time when like there were just like constant cover stories in like Time, Newsweek, New York

00:01:32.840 Times, Atlantic, like you name it. They had a cover story about like the obesity epidemic.

00:01:38.120 There's like the kids in obesity. There's like the military in obesity. Like it took on a different

00:01:42.900 flavor every year, but just clockwork. But what's your relationship? Do you remember those stories?

00:01:49.500 you remember hearing that phrase when you were a kid? Yes. I, in sort of charting out this history,

00:01:53.720 I was like, Oh, this was when I was in high school and college. What a great fun time to

00:01:59.260 have people hyper-focused on how terrible fat people are. You're a fat high schooler. Don't 0.99

00:02:03.860 feel bad enough. Get ready. Yeah. Here comes the Atlantic with some statistics to drop on you.

00:02:10.080 So that's my like relationship to it is this sort of like wave of media stories that was paired with

00:02:18.440 a wave of people in my life who had spoken about my size before but never in terms of health

00:02:25.660 who maybe had said that doesn't look good on you at that size or maybe had said think about how

00:02:32.160 cute you'd be think about the clothes you could wear if you just lost some weight and what happened

00:02:36.260 during this time is that all shifted to i just want you to be around and i want you to stay alive

00:02:41.580 and you're going to die that's interesting that immediately it became something that people used

00:02:46.520 to attack you personally, right? Because all of these stories, I feel like went out of their way

00:02:52.000 to be like, well, you know, we can't necessarily use it for individuals or like they have the sort

00:02:56.180 of the standard caveats. Yeah. But of course, all of that disappears once people kind of absorb the

00:03:02.460 information and regurgitate it back out. Like, of course, people are going to apply it to every

00:03:05.960 fat person they know. So should we dive on in? Let's do it. Take me on a journey. Excellent.

00:03:11.080 So I wanted to start with context and what we know about rates of fatness, sort of what things are changing and how and what researchers actually tell us about the nature of fatness and fat people.

00:03:24.340 We're not going to go super deep into the like fat and health correlation stuff, not because that's not important, but because we're going to do a full episode on just that extravaganza.

00:03:34.980 We have this collective sense that like obesity and overweight rates are on a like rocket ship to the moon and they're showing no signs of slowing.

00:03:45.200 And the data shows us something significantly more moderate than that.

00:03:50.080 Okay.

00:03:50.460 Basically, obesity rates are increasing.

00:03:53.460 And I will say I'm going to use the terms overweight and obesity not because I love them, but because they are the terms for the BMI categories.

00:04:00.660 and all of this sort of obesity rate stuff is decided based on the BMI. There's not another

00:04:06.460 measure of overweight or obesity that folks are using here. It's just BMI categories.

00:04:12.020 We need to talk about your fat phobia, Aubrey. Update your language. 0.99

00:04:16.060 Here's what we know. One, we know that obesity rates are increasing. Some folks chart that back

00:04:22.420 to the 70s. Some folks chart it back to the 40s. But either way, there's been this sort of like

00:04:29.560 pretty slow and steady climb of the rates at which people are becoming moving into the sort of

00:04:35.820 quote unquote obese category of the BMI. The rates of overweight are not increasing. So it appears

00:04:42.880 that people who are already in the overweight BMI category are moving into the obese category,

00:04:47.780 but not necessarily that a bunch of thin people are suddenly becoming fat. Nobody knows why either

00:04:53.860 of those things are happening. Fat people could be fat because of leptin, because of insulin

00:05:00.040 insensitivity, because of the built environment, because of genetics or epigenetics. This is what

00:05:06.960 they call a multifactorial phenomenon, right? And I also think in the same way we've had a

00:05:12.360 million articles about like the obesity epidemic is out of control. We've also had a million

00:05:16.500 articles of like, does this random thing explain the obesity epidemic? Gut bacteria has been a

00:05:22.560 big thing the last couple of years. There was a wave of like sleep things that like Americans 1.00

00:05:28.140 aren't getting as much sleep and that's why obesity. And it's like those wacky explanations

00:05:32.500 could be part of it, but it's never going to be one thing. Totally. In addition to body size being

00:05:40.520 sort of influenced by all of these complex factors, so are the diseases and health conditions

00:05:44.800 that we associate with fatness, right? Heart disease, stroke, cancer, diabetes, all have

00:05:50.560 multiple sources causes triggers contributing factors all of that kind of stuff right and the

00:05:55.860 relationship between fatness and these health conditions is also complex and not super well

00:06:01.100 understood scientifically right in addition to that just like a couple more things as like sort

00:06:07.120 of baseline things to get out one obesity is not a cause of death there is not a death certificate

00:06:13.020 that says this person died of being fat it is correlated to things that are causes of death

00:06:18.380 but just that in a sort of quote unquote epidemic that's fueled by this idea of obesity related

00:06:24.220 deaths it bears repeating that's not actually a thing that we can say for sure right one of the

00:06:30.120 things that i found in low this so much research so much goddamn research for this episode i'm

00:06:37.420 tired of reading books you love it i need tv for a couple of days and then i will be back to

00:06:45.280 furiously reading like a book a day about like everything is a lie you need like a netflix reality

00:06:51.020 show stab okay so the sort of turn that we're going to explore today is that all the way up

00:07:00.940 until the mid 90s and then in a major way in the late 90s mostly people just saw fatness as a result

00:07:08.020 of lifestyle choices it wasn't framed as a medical problem until very recently historically

00:07:14.780 interesting in 1999 and 2000 really seems to be where we get this term the obesity epidemic

00:07:22.920 coming out in full force i always like finding new ways in which the 1990s were trash oh my god

00:07:29.920 that's mike part of the project today we're gonna go 1990s we're gonna go 2000s it is gonna be a

00:07:36.460 tour through your high school college and early 20s i hope we talk about cameron manheim so our

00:07:43.440 story begins, Michael, it begins in 1997. There is this sort of small but growing group of

00:07:50.060 researchers, clinicians, public health people who really thought that we were getting the

00:07:55.520 conversation about fatness and fat people all wrong. And that frankly, it's just not getting

00:08:00.780 enough attention. They just can't really get the time of day from the media in the way that they

00:08:04.920 would like to be able to. And they really do see this as like a catastrophic kind of thing in some

00:08:10.060 cases, right? The biggest champion of that, the biggest believer is a pediatrician named William

00:08:17.740 Dietz. Okay. In 1997, he becomes the director of the division for nutrition and physical activity

00:08:26.320 at the CDC. Here's a quote from a book called fat politics by Eric Oliver. Actually, I might

00:08:33.240 send this to you. Are you up for reading a quote? Let's do it. It says obesity viewed by many as

00:08:38.760 simply a consequence of lifestyle, was not seen as a disease transmitted across populations.

00:08:44.160 Dietz, however, held a view that was becoming more prevalent within medicine, that obesity

00:08:48.200 was a condition influenced by the environment and a condition that people passively experienced,

00:08:53.560 something that happened to them rather than simply the result of their own choices.

00:08:57.700 In other words, obesity was a disease.

00:09:01.540 So this guy, Dr. Dietz, takes this on as sort of his pet project, right?

00:09:07.500 We're also already getting the maintenance phase, dramatic irony, sugar high of someone who seems to be doing their best and someone who's like, oh, it's a disease. And if we reclassify it as a disease, people will see it as like this complicated phenomenon influenced by the environment rather than a failure of personal ethics. And like, that's not what America learned about this phenomenon over the next 20 years.

00:09:32.400 Mike, my next bullet point in my notes just says they're playing our song because they totally fucking are. 0.95

00:09:39.860 Like, good scientist means well. 0.98

00:09:41.620 Yeah.

00:09:41.960 It goes sideways.

00:09:43.180 Yeah.

00:09:43.500 So part of how this goes sideways is actually in how Dietz communicates this set of ideas.

00:09:50.200 He comes up with these heat maps, those maps that are like an outline of the U.S.

00:09:56.300 and each state is sort of shaded in to a different level.

00:09:59.540 Right.

00:09:59.680 And it's like number of food poisonings or whatever.

00:10:01.460 And then like some states are like dark purple and some states are green or whatever.

00:10:04.880 Totally.

00:10:05.640 That's the way that he decides to convey to his colleagues sort of the rising rates of

00:10:12.380 fat people.

00:10:13.680 And so it moves from white to pink to red first in a few states. 0.87

00:10:17.240 And then in more and more, he's doing these sort of over time.

00:10:20.200 And it really physically sort of looks like the spread of a contagious disease.

00:10:25.900 Yeah, I've seen those charts.

00:10:28.060 And yeah, it looks like one of those scenes in like Outbreak or something.

00:10:31.460 it's just rough right but also it's the first time that someone has sort of put this in map

00:10:39.960 or talking point or sort of like jazzy concise terms yeah and so those maps catch on like

00:10:46.680 wildfire they catch on like a disease they're suddenly everywhere right so academics start

00:10:53.340 using them public health officials start using them and within a few short years that turns

00:11:00.320 into folks sort of publicly referring to obesity as an epidemic. That's all happening in 1997 and

00:11:08.160 1998. By 2000, medical institutions start adopting new frameworks around defining

00:11:15.580 overweight and obesity as diseases unto themselves. A few short years later, in 2008,

00:11:23.500 the Obesity Society is an organization whose tagline is professionals collaborating to

00:11:29.360 overcome obesity. They pull together a panel of experts to consider this question of whether or

00:11:37.760 not obesity is a disease. This is a quote directly from them. They couldn't come up with a real

00:11:44.240 answer to this question, quote, because of a lack of a clear, specific, widely accepted and

00:11:49.300 scientifically applicable definition of disease. Yeah, this this sounds like the never ending

00:11:55.660 debate between what's a dialect and what's a language. That is like much more a distinction

00:12:01.260 about power dynamics than it is about linguistics. Yeah, totally. This is another one of those places

00:12:08.020 where there is a group of people in a room messily making a messy decision.

00:12:13.560 Another element of this that's tricky is that I think people in science don't want to talk about

00:12:19.520 outcomes because the purpose of reclassifying something as a disease is to achieve a particular

00:12:25.000 outcome right it's to get political attention on it it's to get public attention on it all of that

00:12:29.280 is fine yeah but oftentimes scientists refusal to acknowledge that they're political actors

00:12:35.280 leads them to make very politically bad decisions i think part of that is that it feels uncomfortable

00:12:41.920 to go you know what i actually have a dog in this race you know what i mean like okay yeah

00:12:46.080 and that's ultimately sort of where they land right they pick another couple of guideposts

00:12:52.240 One is that they look to their peers in sort of medical communities and they see some growing

00:12:57.460 support for considering these sort of rates of fatness to be a disease. And then they do

00:13:04.040 your favorite thing, Michael Hobbs. They weigh the imagined benefits and the imagined harms.

00:13:10.620 Yes. And they decide that the imagined benefits outweigh the harms.

00:13:16.340 Always works. And decide it would be more beneficial. In each of these decision-making

00:13:21.220 processes the who the obesity society we'll get to the american medical association in a minute

00:13:26.940 there is no consulting with like fat people yeah i mean i don't know if they would have been any

00:13:33.940 better on other minority statuses at the time but fatness is a minority status that is considered to

00:13:40.620 be temporary yep like no one says like right now he's asian-american but later he might not be so

00:13:46.220 we don't need to consult them on this so i feel like people skip the like let's talk to fat

00:13:52.260 advocacy groups about this step in these kinds of processes because they're like well they don't

00:13:56.300 want to be fat anyway yeah and i already know how fat people feel about themselves they hate it

00:14:02.140 they're disgusted by themselves how could they feel any other way and it's like well yeah so

00:14:06.600 the WHO changes their definition of obesity as a disease in 2000. In 2008, the Obesity Society

00:14:16.060 changes their definition and recommends defining this as a disease. And in 2013, the American

00:14:22.580 Medical Association kicks in as well and goes, yeah, actually, it's a disease.

00:14:26.920 Okay, so all the dominoes are clicking into place now.

00:14:28.960 There is a great New York Times piece. It's just called AMA recognizes obesity as a disease

00:14:35.640 that encapsulates so much of this.

00:14:39.520 So I'm going to send you two quotes

00:14:41.120 and I'm going to have you read both quotes.

00:14:42.780 Ooh, ooh, ooh.

00:14:43.360 The American Medical Association

00:14:45.140 has officially recognized obesity as a disease,

00:14:48.380 a move that could induce physicians

00:14:49.940 to pay more attention to the condition

00:14:51.660 and spur more insurers to pay for treatments.

00:14:54.660 In making the decision,

00:14:55.680 delegates at the association's annual meeting in Chicago

00:14:57.860 overrode a recommendation against doing so

00:15:01.240 by a committee that had studied the matter.

00:15:03.900 Whoops.

00:15:05.640 So they assigned a committee to study this and the committee was like, don't do this. And then

00:15:10.340 they did it. They spent a year studying this and they were like, it's a bad idea. And the AMA was

00:15:17.260 like, no, it's not. And part of the reason I wanted to lift this up is a, I think when we hear

00:15:24.320 proclamations like this, it's easy to think like, oh, that represents consensus. In this case,

00:15:29.000 it does not represent consensus. It represents an institutional position, which differs from like,

00:15:34.960 there's a difference of opinion happening here right and also i wanted to lift it up because

00:15:39.240 holy shit this is the exact thing that happened at the world health organization when they redefined

00:15:43.580 sort of the levels of overweight and obesity and adopted the bmi as a thing that there was all of 0.92

00:15:49.220 this disagreement and they were going against their own recommendations no one is ever going

00:15:54.240 to build a statue to the people that are like it's a little more complicated like we don't

00:16:00.700 necessarily disagree, but we just want to slow down. Is this your way of telling me that you

00:16:05.880 and I are never going to be statues in a park? 1000% true. Let's just all take a minute. Like

00:16:12.040 that person does not get biographies written about them. Yeah. So I was going to send you

00:16:17.080 quote number two, but I'll tell you this, like basically in this news story, they then go on

00:16:22.600 to talk about how the committee voted against calling obesity a disease because it's based in

00:16:30.320 the BMI and the BMI is oversimplistic and deeply flawed. Wow. So they straight up are just like,

00:16:37.200 this is a bad idea because the BMI is a bad idea. And until we get some other kind of grounding in

00:16:45.040 this issue, that's not rooted in this really terrible tool, then we're not in a place to

00:16:51.340 make this proclamation. That's actually interesting because it's not, it's not even like a woke

00:16:55.660 objection or whatever like this is going to hurt people's feelings no it's like this is just bad

00:17:00.460 science like even if you think that body fat induces all these problems you still wouldn't

00:17:06.400 be using the bmi for the like the rock problem that we talked about last episode no question

00:17:11.760 and both because of sort of the rock or tom cruise or like take your pick right but also because

00:17:18.700 at this point in 2013, the science is even more thin than it is now on what the correlations

00:17:26.160 actually are to these other sort of health conditions and diseases, right?

00:17:30.100 Because there's already studies starting to come out that show that it's not perfectly

00:17:34.420 correlated with negative health outcomes. Like this debate is already going on of like,

00:17:38.780 what are the health effects of obesity?

00:17:40.760 Yes. And when you sort of look back at a bunch of the data, it seems to show that those correlations

00:17:46.720 really kick in. Some folks say at a BMI of 35 and some folks say at a BMI of 40. So we're talking

00:17:54.300 about a very small portion of the population. I'm in that portion of the population. Other fat

00:18:00.540 people are in that portion of the population. But at this point, it's not like an overwhelming

00:18:04.960 majority of Americans, right, who are in the high health risk category. Right. And even in that high

00:18:10.920 health risk category, we don't totally know what's going on. Right. It is interesting to me,

00:18:14.840 I will say that you mentioned like it's not even a woke reason because that's what the AMA gives

00:18:20.440 as their reasoning for overruling the committee. What? The AMA gives a few sort of strains of

00:18:27.360 reasoning. One, they say that it would help the public and elected officials take the quote

00:18:32.860 unquote obesity epidemic more seriously. I would argue it sure did that. Good God. Two is that it

00:18:39.700 could help increase insurance coverage for treatments yeah god but again none of those

00:18:46.900 treatments make a majority of fat people thin in the long term so like sure man cover treatments

00:18:53.400 i guess yeah but like shouldn't those treatments also be shown to work for more than five to ten

00:18:59.660 pounds of weight loss also just all of the ways the u.s is completely broken health care system

00:19:05.860 warps all these other elements of our lives yes because our health care system is so unjust 0.95

00:19:12.200 that your insurance company can just like not cover you for stuff for no fucking reason

00:19:17.080 yeah the entire medical industry has to be like okay how do we like trick the insurers 0.97

00:19:21.380 into paying for this well and also like what if instead of spending a fucking year as a study 0.83

00:19:28.200 group being like what is this a disease or is this not a disease what if instead of doing that 0.91

00:19:33.220 they put that energy into addressing weight stigma or maybe just fixing the whole health

00:19:39.840 care system and advocating for you know what i'm saying like yeah there are things that we know

00:19:44.040 would and could help that are way less murky than this right but this is the problem is that that

00:19:51.060 requires them to act politically yeah this thing of like we're we're doctors we are outside of the

00:19:56.740 political system. It's like, what prevents public health issues from being solved? You can't deal

00:20:03.700 with an issue like this without playing in politics. You can't really deal probably with

00:20:09.120 any health issue without playing in politics. Yeah. Politics is how you solve a lot of these

00:20:14.280 issues. Absolutely. And also, can I add another, we're going to get a little echo of our BMI story

00:20:19.920 here. Do it. One of the next things that they say in this news story from the New York Times is,

00:20:25.360 oh by the way while we're trying to get these treatments for obesity covered there are two

00:20:30.980 new weight loss drugs oh of course on the market of course and uh they're actually not selling as

00:20:37.020 well as we might have thought nice they just they straight up put that in this article it's like

00:20:40.920 we're gonna get all this insurance coverage also oh my god these weight loss drugs have been

00:20:44.460 underperforming they don't say hopefully this helps but it really feels like that's the missing

00:20:49.540 sentence here do you know what i mean like god speaking of structural incentives man the doctors

00:20:55.540 want to get out the pills well and the like the manufacturers of those drugs want them to sell

00:21:01.780 better right i mean the third reason is they say we think it's going to help reduce stigma facing

00:21:06.720 fat people yeah this is the william deets approach right which is like if we can call this a disease

00:21:12.820 then people will understand that it's really complicated that it requires lifelong management

00:21:16.940 and people don't actually understand that.

00:21:19.920 I mean, like, again, this is a place where I'm like, 0.64

00:21:21.500 it would have been so helpful to talk to some fat people.

00:21:25.900 And that doesn't appear to have happened.

00:21:28.040 It is interesting because it sounds like they really were

00:21:30.480 on some level doing this in good faith,

00:21:32.580 thinking that the term disease takes agency away from the individual.

00:21:37.280 But once you start to associate a person with a disease,

00:21:40.660 you're going to stigmatize the individual.

00:21:42.460 Yeah.

00:21:42.700 And I mean, I think this is borne out in the public response to this AMA decision, right?

00:21:46.540 there's some folks who express some relief and agreement those are mostly people who are

00:21:51.560 clinicians or obesity researchers there is some nervousness from predominantly fat people that

00:21:57.780 this is going to increase stigma facts and then there is a pretty broad base of public response

00:22:05.280 that is disapproving of this decision and that you know it will downplay personal responsibility

00:22:11.900 oh then there's like the anti-woke people who are like you're going too easy on the fat people

00:22:18.020 critical race theory whoa those are the real heroes in all these debates i don't want my

00:22:22.860 kid in kindergarten to know that it might be okay to be nice to a fat person i always love 0.99

00:22:28.300 whenever you have these debates there's always someone pops out of a fucking trash can to be 0.99

00:22:31.840 like we're already too nice to this stigmatized group we're already pretty mean i mean i think 0.97

00:22:38.600 so like even when you have a shared framework for conversations like these we still kind of

00:22:46.580 fill in the blanks with our own biases right oh yeah to my mind when this news came out i was like 0.96

00:22:52.560 oh we're fucked like i absolutely remember when the ama thing came out and i was like i hate it 0.99

00:22:56.900 this feels really bad and it feels like people are going to be more of a dick to me and that's 0.99

00:23:00.580 absolutely what happened yeah we're talking about eight years ago right yeah so like think about the

00:23:05.220 amount of sort of like the volume of news stories the volume of research that's happened at that

00:23:09.400 time it's significant right cameron manheim's book had already come out wake up i'm fat yeah

00:23:15.260 which i read in like eighth grade yeah did you really yeah oh my god this is like a huge precursor 0.54

00:23:19.620 to me being gay of course i'm like i'm obsessed with a fat lady who's on tv a fat lady who seems

00:23:24.640 kind of gay i know and also i was also really into rosie o'donnell and then i told my parents i was

00:23:30.580 gay. And they're like, we had no idea. I'm like, guys, you just kept asking for like,

00:23:34.800 coosh slingshots to fire into an imaginary audience. You're like, I'm a Rosie O'Donnell

00:23:40.060 Stan. Here we go. So there are some organizations, some anti-obesity organizations that feel like

00:23:48.180 this is, again, sort of shortchanging the conversation. The biggest one of those anti-obesity

00:23:53.220 organizations is the american obesity association okay they're founded in 1995 they describe their

00:24:01.480 work as centering around treatment and prevention of obesity and reducing stigma all three of those

00:24:07.280 things okay but then they say we want to reduce stigma for quote americans suffering with the

00:24:12.780 disease of obesity yeah i mean do you want to reduce stigma it's also not clear to me that you

00:24:19.420 can like reduce stigma about a group that you're trying to erase on some level like you should lose

00:24:24.780 weight but also people shouldn't be mean to you that's a tough little tightrope to walk it feels

00:24:29.660 a little bit like the solution to people bullying gay kids is for gay kids to act less gay and maybe 0.93

00:24:34.800 just be straight right where you're like well no straighten those wrists yeah yeah butch it up the 0.95

00:24:43.700 American Obesity Association claims credit for a lot of policy changes. They claim credit for

00:24:49.640 influencing the Office of the Surgeon General on this issue. They are major drivers of this idea

00:24:57.640 of obesity as a disease. So we've got this director at the CDC, Dr. Dietz, and then we've got

00:25:03.380 the American Obesity Association, both really tackling this hard, right, and going hard on

00:25:10.520 this is a disease. One of the biggest sources for this episode, there are three books that I read

00:25:16.120 that were all fantastic. One of them is a book called Fat Politics by a sociologist from the

00:25:21.420 University of Chicago named Eric Oliver. He did a bunch of research into the American Obesity

00:25:27.760 Association. And he found that the organization was nearly fully funded by weight loss companies.

00:25:35.020 no way so they are funded by weight watchers they're funded by jenny craig they're funded

00:25:41.300 by slim fast they're funded by weight loss surgeons and mike would you like to guess who 0.90

00:25:47.500 the final funder is is it our old pals at roche yes it fucking yeah i was just gonna say you're 0.92

00:25:54.920 you're like slowly putting a tinfoil hat on me i'm like kneeling in front of you 0.87

00:25:59.740 like here mike take this because like the reducing stigma thing like it's it's not the cake right

00:26:09.300 it's not even maybe the frosting no it's not a core part of the mission the core part of the

00:26:15.380 mission is getting fat people to want to lose weight yep so i did a little youtube search in

00:26:21.240 to see if we could get some of the leaders of the american obesity association and like hear

00:26:26.520 their actual voices and i think i found something better oh no are they are they all like crossfit

00:26:31.980 instructors no oh my god i would love it if it was just like all the peloton dudes okay so i'm

00:26:40.000 going to send you a link they did this was last year they did a series of psa's the video i'm

00:26:46.540 about to send you has 28 views so i don't know who these psa's are for i oh as someone who used

00:26:55.620 to work at ngos and has like made videos for ngos i love me an ngo youtube video with like 16 views 0.96

00:27:02.680 that they probably paid like 80 000 for well just you fucking wait henry higgins i think your mind 0.63

00:27:10.100 might be blown by how much money they did or didn't pay for this bsa uh i've got it all queued 0.98

00:27:16.080 up you let me know when you're ready to hit play okay over the past 50 years there have been over

00:27:23.740 5,000 recommendations

00:27:25.580 and initiatives from the most

00:27:27.460 brilliant minds in America

00:27:29.100 to prevent obesity.

00:27:31.480 All of them have

00:27:33.660 failed. Oh my God.

00:27:35.840 We have bold,

00:27:37.240 new ideas to be

00:27:39.200 active, to be healthy,

00:27:41.260 and to live longer.

00:27:44.480 I hope you

00:27:45.220 will join us at the American

00:27:46.920 Obesity Association dot org.

00:27:50.500 Rethink.

00:27:52.360 Renew.

00:27:53.740 I love that they couldn't afford Morgan Freeman,

00:27:57.200 so they got someone who sounds exactly like Morgan Freeman.

00:27:59.920 Wait, do we not think that that's Morgan Freeman?

00:28:02.240 That cannot be Morgan Freeman.

00:28:03.980 With 29 views, this is not Morgan Freeman.

00:28:06.980 If there's one thing I know about Morgan Freeman,

00:28:09.740 it's that he is box office catnip.

00:28:12.140 There is then clip art of an American flag waving. 1.00

00:28:15.460 That was one of the ugliest fucking things I've ever seen. 0.98

00:28:18.140 This bugs me so much when people use After Effects for evil. 0.99

00:28:21.800 it was like clip art of like a cgi waving american flag and then just like a box of text in front of 0.82

00:28:29.280 it well and also the box of text is again michael hobbs catnip which is just like the most brilliant 0.99

00:28:36.900 people have come up with all these ideas to counter obesity and all of them have failed

00:28:40.700 but not us we're like well i know how long have you been working on this issue again

00:28:46.360 totally who's doing the failing here i mean like not i don't have anything against this

00:28:52.680 organization in particular or this psa or whatever but the rhetoric doesn't hold yeah it's the same 0.73

00:28:58.920 fucking rhetoric as like diet sales right where they're like you've tried everything now try this 0.97

00:29:04.740 thing that's the same as all the other things you've already tried right like yeah our thing 0.99

00:29:09.420 might not fail we should also mention no country or american state has ever reduced its obesity

00:29:15.580 rate yeah and like no one has proposed like a radical rethink of what we're doing right it is

00:29:20.780 wild it's like no no let's continue doing exactly the same things like the billboards five fruits

00:29:26.220 and vegetables let's do it all just more of it and you're like well it's been 40 years and it's not

00:29:33.260 even like it's stalled it's like it's continuing to get worse according to your definition of what

00:29:38.080 bad is totally and at the time sort of in the 90s and 2000s these folks from the american

00:29:46.360 obesity association are not only doing the like we've got bold new ideas thing which is like do 0.93

00:29:53.320 you yeah they're also making wild ass fucking claims that are not substantiated by any data 0.94

00:30:00.280 like their president will make these speeches and will say things like quote medicine has never seen 0.99

00:30:06.400 an epidemic of this proportion i mean smallpox i don't know they're also saying making these sort

00:30:13.300 of broad claims that get repeated a lot particularly by like elected officials saying that because of

00:30:18.460 obesity children will have a shorter lifespan than their parents don't get me started demonstrably 0.98

00:30:24.640 false is all i will say don't wind up my little back and get me talking about that fucking number 0.99

00:30:29.360 which shows up in like every goddamn magazine article has ever been written about this issue 0.99

00:30:32.760 I'm winding up your back. Tell me what you think. 0.98

00:30:36.400 Well, it's like, how would you even possibly determine this? How would you possibly know

00:30:40.420 that a five-year-old today is going to have worse outcomes than like a 55-year-old today?

00:30:46.020 We're literally talking about something that's going to happen like 70 years in the future.

00:30:50.020 It just is like on its face, a completely absurd thing to say.

00:30:53.340 And at this point in the 90s, life expectancies are pretty steadily continuing to climb, right?

00:30:59.420 And there's not really a way to isolate, like, these are the people who are going to become fat.

00:31:04.140 Here's what that's going to mean for their life expectancy.

00:31:07.140 All of that is a little guesstimating.

00:31:10.500 And again, filling in the gaps with what you believe about fatness and fat people.

00:31:14.800 Exactly.

00:31:15.260 The whole thing is like an exercise in math.

00:31:17.800 Would you like to hear another on its face, completely absurd thing to say that they're

00:31:20.920 saying around this time?

00:31:21.600 Give it to me.

00:31:22.220 Their president in 1999 says, his name is Richard Atkinson, says, quote,

00:31:27.300 Obesity is the most prevalent, fatal, chronic relapsing disorder of the 21st century.

00:31:34.960 He says this before the 21st century has begun.

00:31:39.040 That's the only thing to debunk there.

00:31:41.480 Yeah, of course.

00:31:42.520 It's totally fatal.

00:31:43.360 People die being fat all the time.

00:31:44.640 This is an organization, to recap, that is fighting fat stigma.

00:31:48.240 Yeah, totally.

00:31:49.440 Prevalent, fatal, chronic, relapsing.

00:31:52.240 Though the fat people you see are walking diseases.

00:31:54.600 they're gonna they're ticking time bombs of disease and death jesus christ he says this

00:32:01.260 right he says this thing about prevalent fatal chronic relapsing disorder of the 21st century

00:32:05.200 before the 21st century and what starts to happen is elected officials and appointed officials start

00:32:11.540 to pick that up yeah david satcher who is the surgeon general under bill clinton releases a

00:32:17.660 report in 2001 saying that quote-unquote obesity is reaching epidemic proportions he cites that

00:32:24.820 schools are a key place to fight against the quote-unquote obesity epidemic again 0.94

00:32:29.480 fucking citation needed my guy i mean also until you come to me with a big fat check 0.99

00:32:35.800 for school lunches shut the hell up about what we're going to do in the schools to fight obesity 0.99

00:32:40.540 well also like one of the things this is not part of my notes or whatever but like

00:32:45.020 one of the things that they look at is vending machines in schools in one of the books that i

00:32:50.420 read and they were like hey man if you want to get vending machines out of schools if you want

00:32:55.540 to get fast food out of schools the reason that school districts are signing those contracts is 0.73

00:32:59.460 because they are fucking underfunded dude i know my my district got 10 million bucks from pepsi 0.96

00:33:04.620 the year that i was in entering high school yes i also i love that obesity is like this 0.99

00:33:08.820 scourge and it's like destroying society and everybody's gonna die but it's not a big enough

00:33:13.560 problem for us to like spend nominally more money on like feeding children like no no it's not that

00:33:20.240 big of a crisis you guys and then the next surgeon general is this guy named richard carmona who goes

00:33:26.560 fully like hold my beer like let me escalate this how can i escalate this in the years after

00:33:32.820 september 11th richard carmona is the surgeon general he's asked by a reporter what the greatest

00:33:38.460 threat to americans health is the way that he tells the story he's like this reporter really

00:33:43.400 expected me to say terrorism but i said there are two terrorism is the threat from without

00:33:50.500 and obesity which is the threat from within so you still said terrorism it's a threat to our

00:33:56.460 health mike i don't know what you're talking about by 2004 he sort of refined this and he

00:34:00.940 says quote as we look to the future and where childhood obesity will be in 20 years it is

00:34:05.980 every bit as threatening to us as the terrorist threat we face today that's actually true because

00:34:10.960 the terrorist threat was not that big of a threat and like that entire era is extremely embarrassing

00:34:15.920 now you're right about both in that you're wrong about both you were correct with that one dr

00:34:21.540 carmona yeah so now we're not only in an epidemic we're also in a war oh yeah the war on childhood 0.99

00:34:26.700 obesity very chill to make this rhetorical device of fucking child soldiers who are fat kids who 0.98

00:34:33.180 have had it too good for too long famously this is also where we get into some good classic moral 0.99

00:34:40.140 panic stuff about needing to think of the children. I feel like kids get invoked in the

00:34:45.300 debate over obesity a lot in a way that's very weird because children's eating decisions are

00:34:52.640 the result of their parents and their schools. So like, even if we are talking about childhood

00:34:57.900 obesity, we are still talking about adults. Yeah. But it's just, again, like we've talked

00:35:03.180 about this before projecting all of these adult anxieties onto kids and making kids sort of the

00:35:10.580 canary in the coal mine about these very adult worries right yeah this also comes on the heels

00:35:16.580 of no child left behind which institutes this test-based funding approach to schools where 0.65

00:35:22.040 you're like oh it's bullshit all around yeah and also resulted in a lot of cuts to physical

00:35:26.960 education because you can't standardize that the way that you can multiple choice questions right 0.96

00:35:31.840 This is also around the time Michelle Obama calls obesity, quote, one of the greatest threats to America's health and economy, which is real wild framing.

00:35:41.300 But it's also not true because we charge people so much for health care that it's actually really good for our economy that we all get really sick.

00:35:46.980 Boom.

00:35:47.680 Dunked on Michelle Obama.

00:35:49.280 First time.

00:35:50.200 So some scholars have sort of charted the overall changes in media coverage around this issue.

00:35:56.240 In 1994, there were 33 national news stories about obesity.

00:36:00.980 Okay.

00:36:01.840 In 2000, there were 107.

00:36:04.620 Nice.

00:36:05.180 And by 2004, there were 700 national news stories about obesity.

00:36:09.920 That sounds about right.

00:36:11.120 That you remember this.

00:36:12.360 This was what faced us when we opened the newspaper at the kitchen table every morning.

00:36:17.340 Not only were there news stories about it, like that's one thing, but the news stories 1.00

00:36:20.800 were fucking garbage. 1.00

00:36:21.980 Yeah. 1.00

00:36:22.140 They were like super alarmist.

00:36:24.140 They were not really based in super strong science.

00:36:26.920 they would sort of pull one statistic out of context and then just be like, everybody freak

00:36:31.760 out. You're going to get fat and then you're going to die. Right. Yeah. So one of these,

00:36:35.540 this is a quote on a headline from the Associated Press from Eric Oliver, who wrote fat politics

00:36:42.380 quote on January 8th, 2003, the Associated Press ran a story with the headline quote,

00:36:48.420 obesity at age 20 can cut lifespan by 13 to 20 years. Only later did the story reveal that the

00:36:56.900 obesity in question was that a bmi of 45 that would be 340 pounds for a six-foot man which

00:37:03.940 affected less than one percent of the population right right so like we're getting these big

00:37:09.580 splashy headlines at a time when a bunch of people have been newly recategorized as obese

00:37:15.600 weren't before going okay now you're fat and because you're fat you're gonna live 20 years

00:37:22.080 less. It's just an invitation to be mean to people. Yes. You're obviously going to die like 0.97

00:37:27.000 drastically sooner. So like, I have to tell you this. Yes. And in terms of shaping people's 0.91

00:37:33.520 perceptions of fat people, the images paired with a news story matter more than the text of the

00:37:39.300 news story. The images, dude. The fucking images are brutal. Yeah. So Yale University hosted some

00:37:46.500 research on images used in news media. This was headed up by Rebecca Poole, who's done a bunch of

00:37:52.060 research around weight stigma and anti-fat bias. In this study, they showed people a neutral news

00:37:59.300 story about obesity and accompanied those neutral news stories with a mix of images of fat people

00:38:05.880 that either leaned into stereotypes or leaned out of stereotypes, right? A well-dressed fat person

00:38:11.380 and a poorly dressed fat person, a fat person exercising or a fat person eating junk food, 0.87

00:38:16.540 right? They found two things that I, that I found really interesting. One was that they found that

00:38:22.680 those who viewed the quote unquote negative or stereotypical images of fat people did report

00:38:27.920 higher levels of anti-fat bias. Yeah. So this is around the time when truly every night on the

00:38:34.280 news, there are these deeply fear mongering stories about obesity. And then there are these

00:38:39.560 shots of fat people filmed from the neck down yeah so just headless faceless fat waistlines 0.68

00:38:47.440 sort of milling around awful i would argue that those are stereotypical and unflattering often 0.96

00:38:52.700 they are fat people like sitting down and eating a sandwich from subway or eating something from 0.87

00:38:57.720 mcdonald's that's the thing it's not just like it's fat people going about their day it's always 0.99

00:39:02.260 them like doing something that like makes them look slovenly yeah they're like a cigarette in

00:39:06.760 one hand a burger in the other it's like they're clearly looking for images that are like this

00:39:11.520 person is going to die in the next like 10 minutes yes and they'll also do ill-fitting clothing it's

00:39:17.200 so bad really and truly if you turned on the news on any given channel there was a very good chance

00:39:22.880 that you would see that footage at least once right fat people are never happy fat people are

00:39:27.720 never successful fat people are never just like doing normal stuff and not thinking about their

00:39:32.100 weight. It's just like, that is central to who they are. And like, they look like shit at all

00:39:37.200 times. Yeah. And I will say during that time, so you were asking me like, what was this time like 1.00

00:39:41.440 for you personally earlier on? I will say during that time, I spent a good 10 to 15 years watching

00:39:48.880 that B-roll and I would often tear up watching it. Um, because, Ooh, I might tear up now because

00:39:57.860 I was looking for myself you know like this stuff is filmed in public it's filmed without the

00:40:07.760 consent and often without the knowledge of the people in it and absolutely every time I would

00:40:13.160 look for okay does somebody have their nails done like mine is that my jacket are those my pants

00:40:17.960 so I think there's like both the dehumanizing effect of the attitudes that it very clearly

00:40:24.600 And again, here empirically stokes in people who aren't fat and there's the psychic toll that it takes on actual fat people to be like, not only is this an existential threat to me, there is a material moment where I'm like, they might be using an image of my body that I don't know that someone else to prove this point and to make people hate people who look like me even more.

00:40:54.100 I cannot watch that footage without thinking of somebody like coming home from work

00:40:57.760 and like turning on the TV to watch the news and seeing themselves.

00:41:00.800 Yes. And I will also say like, I have talked to so many other fat people who have the same

00:41:05.800 experience. Yeah. Where they're like, I either can't watch it at all. Or when I do, I have to

00:41:11.500 watch it so fucking carefully. I have to watch it forensically for any signs that this might be me. 0.98

00:41:17.340 And that is a horrible fucking way to walk around in your life. 0.99

00:41:20.740 What is the opposite of a Pulitzer? 0.99

00:41:24.100 What can we do to news organizations that still do this?

00:41:27.720 A Pulitzer.

00:41:30.900 My single worst joke I've ever made.

00:41:34.940 I would call it a dad joke, but that is disrespectful to dads and their jokes. 0.97

00:41:41.080 I just think that there should be some sort of gang of fat people that put on masks and 0.89

00:41:45.540 drive around in a van and find the people that take that footage and just smash their 0.90

00:41:48.840 camera on the ground. 1.00

00:41:50.300 Just be like, you piece of shit. 1.00

00:41:51.900 Just vigilantes. 1.00

00:41:53.160 i fucking saw you with a tripod i love this idea so can i tell you about their other finding 0.97

00:42:00.520 yeah do it yeah related to anti-fat bias in this particular study around news media coverage 0.91

00:42:05.560 so this is not a global or representative study lots and lots of asterisks here this is a

00:42:11.520 relatively small study it was designed to find out something else but in the process they sort

00:42:16.620 of went through the results on the quote-unquote fat phobia scale they found that anti-fat bias

00:42:22.600 in this sample wasn't correlated to income it wasn't correlated to age it wasn't correlated

00:42:28.060 to race or ethnicity gender what it was correlated to was body size the thinner you were the more

00:42:35.600 likely you were to express bias against fat people it feels important to say because i think

00:42:41.020 many many people who are not don't have the social experience of being perceived as fat or the

00:42:46.660 institutional experience of being perceived as fat right tend to think why don't mean fat people 0.67

00:42:52.380 harm right like i'm not going around yelling at fat people like hey fatty put down the burger

00:42:57.340 that's not actually how anti-fatness appears in many fat people's lives right it appears much

00:43:04.920 more often in family members being like hey do you want to work out buddy i'd be happy to pay

00:43:09.880 for your weight watchers membership how can i help right like those things are also markers that

00:43:15.700 someone is monitoring your body that the size and shape of your body is wrong that you are being

00:43:20.700 judged and that you need to take corrective action to get back in that person's good graces.

00:43:25.640 One of the biggest sort of things that often stands out on the fat phobia scale and is

00:43:30.640 correlated to a bunch of other negative beliefs about fat people is simply the belief that fat

00:43:36.780 people can control their body weight. If people believe that, they believe a bunch of other

00:43:41.680 really horrific things about fat people. There's also, I mean, in the same way that

00:43:45.080 scientists don't want to admit what impact they want to have on the world, I think journalists

00:43:49.180 are totally disincentivized to actually look into the way that their work is affecting public

00:43:55.280 perceptions and the experiences of actual groups in society. Yeah. Like one of the things, one of

00:44:01.380 the actual categories when you apply, when you send in one of your magazine articles to win a

00:44:06.660 Pulitzer is impact. Yeah. Like we expose this like evil used car salesman and then they passed a law

00:44:13.200 saying that used car dealerships can't do this. Meh. Like we are told to highlight this, that we

00:44:18.560 want to have impacts in the world. But like journalists are not trained to actually take

00:44:23.500 seriously. They're inadvertent impacts. And I think most of the impact of journalism is not

00:44:29.360 deliberate. It's just like myths that we reinforce. It's images that we use. It's like

00:44:34.400 bad headlines with like all of the caveats taken away. Journalists affect public perceptions in

00:44:40.620 ways that like they actually need to take seriously. And like, yeah, if you've taken

00:44:46.060 in this b-roll you should feel bad i'm sorry yes i'm not gonna send aubrey in a van to your house

00:44:50.840 but like you should feel bad no i think the concern that people should have is mike in a van to your

00:44:55.000 house i feel like you would get away i would just be like real sad and be like why would you do this

00:44:59.700 and i feel like you might actually like bring a baseball bat like and i'd be on a bike too so i

00:45:04.980 can't get away that fast that's the problem so the interesting so like to this point on like

00:45:11.680 what's the impact of this sort of media coverage? As it stands today, according to Harvard,

00:45:17.980 80% of Americans express some level of anti-fat bias. Oh, that's bad. They have pretty precise

00:45:23.920 data on the increase in anti-fat bias around this time of the sort of peak of the obesity epidemic.

00:45:32.760 They found that between 2004 and 2010, anti-fat bias, while many other forms of bias were

00:45:40.440 declining anti-fat bias rose 40 i mean sometimes we can be a little bit salty to people who are

00:45:47.200 like really invested in this narrative but also people this is what people have been told for

00:45:51.980 decades totally agree that you can like see where it comes from yeah they're not like opting in to

00:45:57.000 being terrible to fat people they are being fed a narrative that is essentially like you have to

00:46:02.980 be mean to fat people for their health because they don't know that they're fat and they don't

00:46:08.240 know that they're going to die and you got to be the one to tell them, right? Yeah. Which is a very

00:46:12.900 direct seeding of practices of bias, right? Yes. It's not necessarily their fault that this is

00:46:20.180 sort of the framework that they're using, but they're still acting on that framework in ways

00:46:24.460 that are really awful. Yes. My approach to those people is to be very polite and patient in real

00:46:31.300 life and then very spicy on my podcast and I will go on a journey with you I will calmly walk you

00:46:38.540 through the facts like if we are friends and we are talking like I will be patient I will listen

00:46:43.360 and if you're some random person on Twitter I'm gonna shout at you I'm sorry absolutely not gonna

00:46:49.440 be patient that way so like we've got these this sort of fallout in media we've got this sort of

00:46:56.180 shift in funding for research and an academic discourse around a quote-unquote obesity epidemic

00:47:02.280 and we also have some fallout in policy interventions right we start changing school

00:47:06.980 lunches we start requiring in some states a certain number of p.e. hours in order to graduate from high

00:47:12.960 school we start sending out bmi report cards to parents of school-age kids saying here's your

00:47:19.360 kids BMI. We start adding calorie labels to restaurant menus because obesity rates are by

00:47:26.760 design higher in communities of color. We start sort of funding community specific projects to

00:47:32.960 prompt weight loss, particularly in black communities. There's like significant investment. 0.72

00:47:38.120 We can debate whether or not each of those are worthy policies on their own.

00:47:41.420 The fact remains that not one of these are proven strategies to prompt weight loss.

00:47:48.880 It's also frustrating because there are proven interventions that improve people's diets and exercise, like relatively reliably. But because we have this narrow focus on weight as like the only metric that matters, like we're not moving the metrics that we actually can move. Like we're trying to do the hard thing and leapfrogging the easier things.

00:48:10.720 Yeah, I mean, around this same time, speaking of sort of the easier things, in 2006, the Alliance for a Healthier Generation, which is a collaboration between the Clinton Foundation and the American Heart Association, make this big announcement.

00:48:26.120 They're joined by representatives from Coca-Cola, from PepsiCo, from Schweppes, and from the American Beverage Association to announce that they're going to start removing soda from schools.

00:48:37.260 all right bill clinton and mike huckabee both point to this as sort of a sign of this extraordinary

00:48:42.420 investment from the business community and public health that they're willing to forego their own

00:48:46.800 profits and their own customers what is not mentioned in that press around this is that

00:48:51.420 these beverage manufacturers are facing a massive lawsuit from the center for science and the public

00:48:58.340 interest and as part of this agreement to pull soda from schools that lawsuit is dropped oh yeah

00:49:05.260 Around the same time, McDonald's is facing a class action lawsuit from fat plaintiffs.

00:49:10.940 The argument of that lawsuit is McDonald's has been making addictive and fattening food,

00:49:17.060 blah, blah, blah.

00:49:18.320 So in 2005, there was a bill introduced in Congress called the Personal Responsibility

00:49:23.120 in Food Consumption Act.

00:49:27.100 Wait, did that say it for prick?

00:49:28.880 What does this mean for?

00:49:29.880 The Public Responsibility Priff. 0.77

00:49:32.760 No, it would be Priffka.

00:49:34.620 Oh, PRIFCA. All right, never mind.

00:49:36.060 Which is not as good.

00:49:37.220 Do better, Congress. 0.95

00:49:38.440 So it was referred to in the media as, I shit you not, the Cheeseburger Bill. 0.95

00:49:43.820 Nice. 0.59

00:49:44.380 And it was specifically designed to prevent consumers from suing fast food restaurants.

00:49:50.840 I mean, that does honestly seem like kind of a frivolous lawsuit, to be totally honest.

00:49:55.520 But also, we're now losing our rights to sue companies. Like, that's not a good outcome.

00:50:00.740 Right. I'm not like on board with either of these lawsuits necessarily. Both of them seem kind of stigmatizing to me and weird. And you know what I mean? Like, but it does feel telling to me that at the same time that it looks like we're doing these great altruistic things.

00:50:15.740 what most of them amount to is protecting corporations from some sense of accountability

00:50:20.520 for their contributions here right it's also worth noting that the cheeseburger bill was

00:50:26.380 introduced by a florida congressman named rick keller who had received the maximum legally

00:50:31.200 allowable campaign contribution from mcdonald's yeah i can i can feel the tinfoil hat crinkling

00:50:36.560 around my head right now just like metal in my ears so the last thing i wanted to talk about here

00:50:44.700 and this is something that you and I have talked about a little bit, is around the sort of like

00:50:49.160 social science and theory of moral panics. There is an argument to be made here. It has been made

00:50:54.680 many times by many scholars and many researchers, right? This is something that has not really made

00:51:01.240 it into the mainstream. While there are observable trends that people may be getting fatter over

00:51:06.700 time, I would argue and many of these scholars would argue that our response to that observable

00:51:12.480 thing meets a lot of the criteria for a moral panic. Yeah, yeah. So there's this sociologist

00:51:18.000 named Stanley Cohen, who writes a book called folk devils and moral panic. Oh, yeah, I've heard

00:51:22.300 that. That's great. It's so good. It's so good. Yeah, he lays out these sort of sequential phases

00:51:26.820 of a moral panic. And then in 1994, Eric Good and Nachman Ben Yehuda, establish five characteristics

00:51:35.320 of a moral panic. So, one, concern, where there is a heightened level of concern about certain

00:51:42.320 groups or categories. Two, hostility, where one can observe an increase in hostility toward the

00:51:49.920 quote-unquote deviance of quote-unquote respectful society. Three, consensus, where a consensus about

00:51:57.400 the reality and seriousness of a threat can be found. Four, disproportionality, where public

00:52:04.160 concern is in excess of what quote unquote should be. And five, volatility, where the panic is

00:52:11.540 temporary and fleeting. And though it might reoccur, the panic is not long lasting. To my

00:52:17.720 mind, I think our sort of response to the obesity epidemic checks a number of those boxes, but not

00:52:22.360 quite all of them. Yeah, I think it's been going on too long for it to have the volatility aspect.

00:52:28.000 Although even within Moral Panics, there's like a typology about how long lasting they are and the kinds of reactions that they inspire. 0.68

00:52:36.260 Because another interesting thing about the obesity epidemic, I don't know that the response has been disproportionate because the response, the actual legislative response to it has mostly been like dumb bullshit nudge things like these calorie markers.

00:52:49.740 And like, to me, it gives a lie to the entire thing, because if we actually took this seriously, we would have done something.

00:52:56.580 but like we haven't actually done anything meaningful on this issue. We've just panicked

00:53:01.040 about it. Yeah. And I think part of that disproportionality one to my mind is like,

00:53:05.760 what's the set of questions that you ask next? And we really seem to have skipped over a whole

00:53:11.680 lot of those clarifying questions, right? Like what is the precise relationship between weight

00:53:16.340 and these specific health markers? Who does the obesity epidemic quote unquote affect? There's

00:53:22.380 quite a bit of data that shows that it's predominantly a problem amongst men, but a

00:53:27.020 bunch of our solutions, policy solutions, are aimed at women. There are sort of all of these

00:53:32.180 things that if we were curious about the nature of this thing, we would ask a bunch more questions,

00:53:37.580 but we're not curious about it. We're just like, kill it! Yeah, yeah, yeah. There's also, I mean, 0.99

00:53:41.560 in my own personal definition of moral panics, something that I see very clearly in the obesity

00:53:47.340 stuff, the evidence just like, isn't there. And the evidence isn't there in like this extremely

00:53:52.500 obvious way. So it's like, we're constantly debating the health effects. Like, does it

00:53:58.040 affect cancer? Does it not affect cancer? Does it like obesity and health are just as two concepts

00:54:02.520 so closely linked, but it's all irrelevant because the data is more consistent on the fact that

00:54:09.000 people cannot lose weight and keep it off than it is about fat being bad for them. Right. Even at

00:54:14.160 the individual level we cannot solve this problem yeah and then it's like it's possible to write

00:54:19.160 you know an entire two thousand five thousand word magazine article on like the obesity epidemic and

00:54:24.880 all these new solutions when it's like people can't lose weight yeah why are we talking about

00:54:29.040 this like everything else is secondary to that so like we should just learn to live with the

00:54:33.920 big people that we have right like that's it and i think there's even a conversation to have about

00:54:39.220 like even if we have effective strategies for weight loss how do we deploy those strategies

00:54:43.800 and who are they aimed at and all that kind of stuff right like unless and until we have

00:54:48.220 those strategies every fucking thing we do around this is punitive yeah all of this stuff 0.98

00:54:54.640 is designed around reminding fat people that were fat reminding fat people that being fat is bad for 0.98

00:55:00.300 you and just making us sort of wear this kind of hair shirt yeah in the absence of any real

00:55:06.580 solutions right i mean there's also i think one way to look at moral panics is it's like these

00:55:12.320 real fears that get projected onto a minority group. The obesity epidemic has been a very

00:55:19.100 effective moral panic in that it has distracted us from, you know, heart disease is the number

00:55:24.460 one killer of Americans. Things like diabetes is like a pretty debilitating condition and like

00:55:29.780 it causes a lot of pain and hurt in people's families. And like, I think that the institution

00:55:34.020 of public health should be trying to solve these problems. But instead of actually focusing on

00:55:38.620 what were the real problems staring us in the face? It's like we pushed all of this onto

00:55:42.580 fat people. Yeah. We should have just been having like not a moral panic, but like a regular 0.94

00:55:48.280 normal level of concern for like these diseases that are like really difficult to have.

00:55:54.780 Not a moral panic, but a regular panic is really what I thought you were about to say.

00:55:58.060 A decent panic. Yeah. I mean, and also like, listen, if we're concerned with sort of the

00:56:03.580 impacts of living with diabetes and we want to alleviate those impacts then we could very well

00:56:11.520 do something that is hard but not complex which is cover insulin for everyone who needs it dude

00:56:18.300 insulin there should be like fire hydrants of insulin on every corner yes michael hobbs 2020

00:56:24.020 that's like such a perfect example though where it's like we're so concerned about diabetes that 0.98

00:56:30.720 Like every single fat person needs to get a goddamn lecture at the grocery store. 0.99

00:56:34.240 But like, we're not concerned about it enough to like fuck with the patents. 1.00

00:56:38.080 Right. 0.98

00:56:38.340 Like, do we care about this issue or do we not care about this issue?

00:56:41.180 Because it kind of seems like we don't actually care about this.

00:56:43.760 Right.

00:56:44.000 If we care about diabetes, we need to take on diabetes.

00:56:46.620 If we care about heart disease, we need to take on heart disease.

00:56:49.560 But right now what we're taking on is a thing that is sort of a proxy risk factor.

00:56:54.400 Yeah.

00:56:54.600 And we're taking it on in part because we're all we've already decided what we think about

00:56:59.300 fat people and how they came to be fat, regardless of the data. And I got to say, it's extremely

00:57:05.100 shitty to live in a world where people's sort of imagination of the healthiest and best world

00:57:10.780 possible doesn't have people who look like me in it. Yeah, I mean, I think fat people have always

00:57:16.240 been collateral damage in this entire debate, right? Like, I can't see any of the public health

00:57:21.920 campaigns that we've had, like anyone even thinking like whether they consulted fat people

00:57:26.500 are not even thinking about, like, what would it be like as a fat person to encounter this?

00:57:30.880 Yeah, yes. Even just imagining.

00:57:33.140 Yes, like very basic questions are not being asked.

00:57:37.740 Listen, man, I feel like that sort of is the story of this sort of genesis of the obesity

00:57:43.600 epidemic, right? This is not the kind of smoking gun story that we got with the BMI. It's much

00:57:51.300 more a story about these very human flaws, like filling in the gaps of what we think we know with

00:57:58.200 quote unquote, common sense that just ends up drawing on our own existing ideas about who fat

00:58:03.560 people are and how fat bodies work. We tell ourselves sort of stories that strike familiar

00:58:09.240 chords and that comfort us about the world and our role in it. Those stories are very comforting

00:58:14.760 to thin people to be like fat people are unhealthy. And as long as I'm not fat, I don't have to worry

00:58:19.900 health which is also not true right it feels like a real story of like a kernel of science

00:58:27.480 and then a whole bunch of social narratives that grow up around that kernel of science right yes

00:58:33.580 and as we know from history the only way to solve issues like this is for four to six fat people to

00:58:39.900 get in a van and find a local cameraman in your area who took b-roll that day and uh smash his 0.91

00:58:46.180 Came right to the ground and set it on fire. 0.89

00:59:16.180 Thank you. 0.94

Maintenance Phase - August 17, 2021

The Obesity Epidemic

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