I just saw the movie “Fed Up” and feel even more frustrated than I imagined I would be. First, I cannot believe how often I hear the obesity epidemic being compared to the tobacco industry. There are such disparities between the two issues. Out of genuine hopefulness and desperation we are compelled to use similar strategies that we used for tobacco to make efforts to eradicate the obesity epidemic. It is not at all surprising as we do not know where else to turn, nothing has worked and the issue is still on the rise. According to the film, in the year 2030, 50 percent of individuals in this country will be obese and 1 out 3 individuals will have type 2 diabetes. We are in a panic to find a “cure.”
In a previous NY Times article a journalist suggested that there is optimism because we are enacting policies at a quicker rate then we had with tobacco. As the movie clearly stated, there are not enough policies and ones that are enacted are not making any incremental changes.
There is little comparison between the two issues. We cannot abstain from food as we can from tobacco. Food is around us all the time, wherever we find ourselves. It is part of our culture, the way we socialize, celebrate and sustain ourselves. The lobbying forces cut across many food and beverage industries, including, meat, dairy, corn, sugar, etc. They are a force to be reckoned with.
The film suggests that we need to demonize food as we did with tobacco, that way individuals will notice how dangerous it is and will inevitably be more cautious. We could make a compelling argument for why tobacco, drugs and alcohol are dangerous but food is a hard sell. It’s just not as compelling of an argument. Studies show that there is a direct correlation between smoking and lung cancer. We cannot make a direct correlation between food or with any one food item and a specific disease. Its ambiguous to most of us which foods cause what types of health issues.
In my practice, I hear the rationalizations all the time, “it has fiber”, “is an antitoxin” and “provides me with energy.” People with nicotine addiction recognize that there really is not any redeeming value in smoking. It is purely an oral and physiological addiction. There is nothing good that could come of it.
We often do not immediately notice the detrimental effects of weight and health issues until there is a serious problem. With smoking the symptoms typically show up instantaneously (bad breathe, stained teeth, shortness of breath, etc.). People can intellectually justify their need to stop smoking. In this case, the out of sight out of mind approach can work, with food it just simply doesn’t.
The film spoke of the cure being linked to having warning labels on food, particularly sugary ones, instituting restrictions on ad campaigns, especially those marketed to children, having stricter policies in school, and that the percentage of the daily amount of sugar be included on nutritional labels as it is for other items such as fat, sodium, etc. It highlighted that the government is not doing enough, even with the knowledge that sugar is addictive and difficult to metabolize.
It also spoke to how our metabolism processes sugar as fat and cited an experiment whereby rats preferred sugar to cocaine, highlighting that it’s highly addictive and evokes withdrawal symptoms when there is an attempt to cease sugar intake.
Last year the American Psychiatric Association defined Binge Eating Disorder as a disease and it was included in the DSM V as a formal diagnosis. We are starting to realize that food and weight issues have to be treated in line with an addiction model because of its addictive quality.
Even with all of that being said, there is a still a missing piece of the puzzle that no one seems to be addressing and one that needs to be a main focus if real fundamental change is going to happen to eradicate obesity. There are psychological barriers that thwart an individual’s ability to engage and sustain weight loss. We need to pay attention and treat the urges and cravings, the underlying emotional issues, our coping and problem solving strategies, self-esteem, etc.
Just like we treat other addictions at both the physiological and psychological level we need to consider treating this issue. The underlying psychological issues and their struggle with this addiction were glaringly evident when hearing the compelling stories of the teens and their families throughout the film.
Knowledge about nutrition and fitness is vast because of social media and the plethora of books and articles written on the topic. It is the relationship that we have with food, based on our thinking, rationalizations, family history, and many other factors that create and maintain the barriers.
Case in point, at the end of the film it was revealed that a teenage boy who was filmed throughout the movie lost 27 pounds as his families invested in changing their lifestyle for a period of six weeks. I heard sighs from the movie audience in reaction to their relief that he and his family were able to make changes and it was able to pay off for them. Only moments later, it was indicated that he had gained all the weight back. Sighs from audience followed in exasperation that even with the knowledge, warnings and intent and willingness to change, the weight loss could not be maintained.
Collectively we are unaware of or reluctant to consider and address the psychological barriers and consequences because that is not in line with the plight for the quick fix and instant cure. That is the rubric in the way we function in our society. While I admire the intent of the movie to suggest that critical action needs to take place, I once again find myself deeply concerned that that in 15 years from now I will be sitting and writing and repeating similar sentiments. I sure hope I am wrong because we will be spending a lot of money on healthcare and will have to cater to many sick people.
