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Tackling Obesity: Part 5: A "Toxic" Environment 7.06.04 Source: Andrew Schwartz, for CHC exchange Regardless of their individual research or practice area, every member of the Obesity Center recognizes that today's "toxic environment" is a significant driver of the epidemic. People variously describe this environment as a range of societal concerns that have clear links to obesity. Stressors, such as long work weeks, unsafe neighborhoods, even fears of terrorism press on people. In turn, these factors have a hand in a rash of psychological problems, especially the stress and depression associated with overeating. Researchers also refer to sedentary lifestyles, poor diets, the spotty availability of healthy food, and the political and economic influence of the fast food industry. "This is a socially-driven epidemic," says Joaquin Barnoya, MD, who has been deeply involved in public health efforts to reduce smoking and who has now turned his attention to the obesity problem. "The food industry is marketing products that they know are damaging to people's health. One study revealed that something like 60 percent of the commercials aired during children's weekend television were for un-healthy foods like sugar-sweetened cereals." Barnoya also notes that people in poor communities are particularly susceptible to the marketing of processed, rather than healthy foods. He offers the example of poorer Latino communities that have limited access to affordable produce, and whose communities are inundated with McDonald's billboards in Spanish. Another factor, says Barnoya, is that food in this country is relatively cheap and abundant compared to the rest of the world, thus encouraging people to eat more than is healthy. Historian Dorothy Porter, who is studying the history of obesity in her native England, says, "Wealthy economies do tend to show increasing levels of obesity." She points out that obesity grew among the working class during the late '50's in England, a time known as the age of "the affluent worker" that was accompanied by better access to food, the growth of television, and the move to less hard labor and more sedentary jobs. Finally, this country's insurance system complicates the ability to address obesity in the physician's office. Andrea Garber points out that reimbursements for obesity treatments are virtually non-existent. Psychologist Joan Orell-Valente says that despite the lip service given to the need obese patients have for counseling, reimbursement is rare; in turn many counseling services simply disappear. Barnoya has begun to explore ways that an anti-obesity public health effort can build on the success of anti-smoking programs. Yet he acknowledges the one significant difference between obesity and tobacco: everybody needs to eat. Because of this, some worry that too much hope can rest on the public health approach. Historian Porter, who has spent much of her career examining the history of public health, says that the anti-smoking campaign has achieved its goals through social and political coercion. Smoking has been banned from many public buildings. Taxes were piled on to tobacco, without much complaint from anyone but smokers themselves. "Without structural transformation like that, behavioral change is nearly impossible to effect," she says. She warns that such structural transformation will be more difficult with obesity. How will the lines be drawn between acceptable and non-acceptable food? How will the politicians be convinced? How will people react to seeing food prices increase dramatically? These are questions that have not yet been answered. Barnoya, however, remains optimistic. "The word is getting out there," he says.
Part 2: Genetics Provides Clues, Not All the Answers Part 3: "Our Biology Is a Mismatch for Our Environment" Part 4: Exploring the Intersection Between Body and Mind Part 5: A "Toxic" Environment Part 6: One Size Does Not Fit All |
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