Fun Facts About Obesity
Continuing my inquiry into this matter, one question that hasn’t been satisfactorily answered is why has the obesity rate shot up in the past few decades? As I’ve made plain in previous posts, variation in obesity between individuals within a group at any given time is largely heritable, as is a good portion of the variation between groups. But, the variation over time – particularly the short timeframes seen over the last few decades couldn’t be due to genetic forces, since evolution doesn’t proceed that quickly. Something(s) in the environment must have changed. But what? Pinning these factors down has been an elusive quest, but I wanted to take a look at where the evidence stands. So I did a quick look into the matter, and this is what I found.
Here’s a graph of the U.S. obesity rate. We a fairly sharp rise beginning around 1980ish.
Of all the explanations for this pattern, by far the simplest explanation is that we’re just eating more. And indeed, that is the explanation pursued by Stephan Guyenet in his post Seduced by Food. Here is the same graph with calorie intake over that time superimposed on it:
Calories intake is derived from these two papers here and here. Now, I am suspicious of any attempt to reliably measure what people have been eating, but let’s ignore that for the moment.
So it would seem there it is: we are apparently eating more. But if so, then why? Advocates of particular diets, particularly low-carb and “paleo” diets, like to blame particular nutrients. At first glance, sugar, particularly fructose, seems a prime candidate:
Rates of sugar consumption seems to track the obesity rate. One might naively concluded that that’s the culprit. However, what if sugar was only one ingredient in a larger pie, so to speak?
What if consumption of many things increased, of which sugar is only one? Guyenet explains:
The reward system does the same thing with foods/beverages that contain drugs, such as coffee and beer, gradually making bitter fluids palatable and then delicious. Eventually, you may go out of your way to purchase the cheese or beer at the grocery store, and maybe you’ll consume cheese or beer even if you aren’t hungry or thirsty, simply because you like it. This is an example of the reward system reinforcing and motivating behaviors related to foods it considers desirable. What does the reward system consider desirable? Calorie density, fat, starch, sugar, salt, free glutamate (umami), certain textures (easily chewed, soft or crunchy, solid fat), certain flavors, an absence of bitterness, food variety, and drugs such as alcohol and caffeine. Our brains are highly attuned to these qualities because they’re all elements of nutritious, calorie-dense foods that would have sustained our ancestors in a natural environment, but today, the exaggerated combinations of these qualities used by processed food manufacturers, chefs and sometimes even home cooks overstimulate our natural reward pathways (19). Commercial foods are professionally designed to maximize reward, because reward is precisely what keeps you coming back for more. Processed junk foods such as ice cream, fast food, sweetened soda, cookies, cake, candy, pizza and deep fried foods are all archetypal hyper-rewarding foods.
Palatability is a related concept—it’s determined in part by inborn preferences (e.g., a taste for sugar and energy dense foods), and in part by the reward system (acquired tastes). Palatability is governed by the hedonic system in the brain, which is closely integrated with the reward system. Imagine yourself sitting at the dinner table, stuffed after a large meal. Then the cake and ice cream appear, and suddenly you have enough room left for another 250 calories of food. Would you have eaten a large, unseasoned baked potato (250 calories) if someone had put one in front of you at that point? Foods that stimulate the hedonic system have a well known ability to increase food intake, and this effect can be replicated using drugs that activate these circuits directly (20). The reward system is what motivates you to get food and put it to your lips, every time you eat. When scientists shut it down in mice, they stop seeking food, even though they’ll still eat if it’s put into their mouths (21). The hedonic system influences how much you eat once you begin a meal (22). Together, reward and hedonic circuitry in the brain determine in large part how often you seek food, what foods you select, and how much you eat at a sitting.
Reward and hedonic systems, if stimulated in the right way by food or drugs, can increase food intake and body fatness. The marijuana ‘munchies’ (whose existence have been confirmed by science) are a good example of what happens when they’re chemically stimulated via the CB1 cannabinoid receptor in the brain (23). One of the most effective weight loss drugs ever developed, Rimonabant, is basically ‘reverse marijuana’, blocking the very same CB1 receptor that marijuana activates. Although it clearly reduces food intake and body fatness, it has failed to gain FDA approval because of negative psychological side effects (big surprise).
The ability of reward and palatability to influence food intake and body weight is mediated by connections between reward/hedonic and energy homeostasis systems. For example, if you haven’t eaten in a while, your brain detects declining energy stores and acts to increase food intake. It does this by increasing your motivation to obtain food, and your enjoyment of food once you obtain it— known as ‘hunger’, this sensation is caused in large part by energy homeostasis systems activating reward and hedonic systems. But the connection goes both ways. Reward and hedonic systems also influence energy homeostasis systems, such that excessively rewarding/palatable food can increase food intake and the level of body fat that’s ‘defended’ by the brain (24, 25, 26, 27). According to findings from my own research group (lab of Michael W. Schwartz) and others, the hypothalamus can also develop inflammation and chronic cellular damage that likely contributes to the defense of a higher fat mass as well, contributing to fat gain and making fat loss more difficult (28, 29), but the reason for this is not yet clear.
Addiction is what happens when the reward system is over-stimulated by drugs, sex, food or other high-reward stimuli. In susceptible people (about 3 percent of the US population), highly palatable/rewarding foods are quite literally addictive, leading to binge eating behavior. For the rest of us, these foods may not literally be addictive, but they do often drive us to eat them more than we think we should, despite negative consequences to our weight and health.
“Addiction.” Guyenet is being too restrictive in his use of the word, since we are all addicts (otherwise behavioral genetics wouldn’t work); the declaration of something as an addiction is a rather arbitrary matter that is more related to social acceptability/desirability than to any biological/neurological fact (for example, no one criticizes the fact that people in high latitude civilizations seem to like to work and often need to work, ala Greg Cochran and Henry Harpending; well a few people do, and I know some of them… 😉 ).
In short, apparently, we’re eating more of a lot of stuff – not just sugar – and perhaps this is what is making us fat. And this is because of the market economy, which has made food suppliers superbly skilled at feeding our cravings and ensuring that we continue to crave their products.
Guyenet’s blog provides plenty of visual examples:
For this reason, I believe obesity is here to stay. People buy junk food and stuff themselves with it because they like it. And junk food makers continue to make it because it’s what we buy – what we want to buy. And it’s made so tgar we can’t get enough of it. In many ways, this is perhaps one of the great markers of modernity: gone are the days when food was limited, bland, and uncertain. Now every edible delight one can desire can be had. The downside is that some of us become fat.
How does heredity play into this? Well, heredity influences both our susceptibility to indulging (and overindulging) in food (through our taste and through the psychological reward we get from eating certain foods) and through our the level of body fat our bodies and brains “defend”:
Over the ensuing century and a half, researchers gradually uncovered a network of circuits in the hypothalamus dedicated to maintaining the stability (homeostasis) of body fat stores, by regulating food intake, energy expenditure, and the deposition of energy in fat tissue. This research culminated in the discovery of an extraordinary hormone called leptin in 1994. Produced by fat tissue in proportion to its mass, leptin enters the circulation and acts in the hypothalamus to regulate body fat stores. If you consistently restrict food intake, fat mass declines and so does leptin, and this signals the hypothalamus to stimulate hunger and make the body use calories more efficiently, in an attempt to regain lost body fat (4). Conversely, if you consistently overeat, the increase in fat mass and leptin suppresses appetite and increases calorie use until body fat stores have declined back to baseline (5, 6). Leptin and a few other hormones are part of a negative feedback loop that acts unconsciously to keep fat mass in a specific range, sort of like a thermostat does for temperature (7, 8). This is called the ‘energy homeostasis system’.
So if we have this built-in system to regulate body fatness, how does anyone become obese? Some researchers believe the energy homeostasis system defends against fat loss more effectively than fat gain. However, most obese people regulate their body fat just fine, but their brains ‘defend’ it at a higher level than a lean person. Going back to the thermostat analogy, in obese people it’s like the ‘temperature’ has been gradually turned up. That’s why it’s so hard to maintain weight loss—when body fat stores decline, the brain thinks it’s starving even if fat mass remains high—and it acts to regain the lost fat.
That last point is primarily why diets don’t work for most people. After “unnaturally” restricting food intake, whether it be the composition or the quantity or both (at least, in a way that has become unnatural in today’s world), appetite doesn’t diminish and indeed often ramps up in an effort to restore the lost body fat.
In reality, almost any diet will generally cause its adherent to lose weight – if you can stick to it. The primary reason for diet failure is inability to stick to the diet (this includes low-carb and “paleo” diets). Guyenet discusses this:
Diet trials have shown that a ‘simple’ diet, low in palatability and reward value, reduces hunger and causes fat loss in obese humans and animals, apparently by lowering the ‘defended’ level of fat mass (30, 31, 32, 33). This may be a reason why virtually any diet in which food choices are restricted (e.g., Paleo, vegan, fruitarian), including diametrically opposed approaches like low-fat and low-carbohydrate diets, can reduce food intake and body fatness in clinical trials. As stated by Nora Volkow, director of the National Institute on Drug Abuse, “The common denominator of such diets is that neither allows consumption of the very caloric and seductive foods that combine high fat with high carbohydrates” (34). Hyper-rewarding/palatable foods—candy, chocolate, ice cream, chips, cookies, cakes, fast food, sweetened beverages and pizza—are uniquely fattening and should be the first foods to go in any fat loss attempt. Some people will benefit from further simplifying the diet.
The bottom line is that any diet requires discipline – indeed, an almost inhuman amount of disciple (especially for certain people). Diets are most successful amongst individuals willing to make considerable lifestyle changes, being mindful of what they’re eating at all times, and for the rest of their lives. That is, individuals with certain personality traits, particularly high on conscientiousness and low on neuroticism (and generally, higher in IQ) These individuals are highly unusual. Most people are quite incapable of living this way for the long term.
Long-term behavior modification, which would be required for successful weight loss for overweight individuals, is a central point of Daniel Callahan’s idea that obese people should be “shamed” into losing weight. Callahan’s thesis is that society is too permissive of overweight people and that is why they unable to lose weight. Numerous commenters have explained why he is likely wrong. One of his largest pieces of evidence is a study in which a treatment group received dietary guidance over two years and achieved (slightly) better weight loss than a control group that received no such counseling. Callahan believes that this is evidence overweight people can achieve permanent weight loss if they are given proper incentives.
The flaw in this idea should be obvious: there is no way to perform population-wide “counseling” necessary to achieve this effect; Callahan’s hopes are unrealistic.
It’s also worth noting that Callahan’s prime example, the decline of smoking, declines just as obesity was on the incline:
Shaming smoking didn’t get people to give up on their disgusting habits; it just caused them to trade one vice for another.
Of course, as we saw in my earlier posts, obesity is hardly everybody’s problem – even in the developed world. In the West, it’s primarily an Anglo/Celtic/Germanic problem (also a Latin American problem). Southern and Eastern Europeans seem much less affected, particularly the French. As well, it’s barely a problem in East Asia. In my previous post, I suggested genetic factors were at least partly to blame for this, and with what I’ve discussed in this post, I’m free to speculate on which genetic factors may be at play. The most obvious is metabolism: likely, these groups “defend” much lower levels of body fat. The others are behavioral, both on an individual and on a cultural level. On an individual level, taste, impulsivity, and palatability (as defined above) likely vary between groups. Perhaps the French, for example, are much less susceptible to the excesses of highly “palatable” food than say the Scots are.
On a cultural level, perhaps the collective attitudes and tastes prevents the food-industrial complex that feeds Anglos highly palatable foods from becoming established in these countries. This may explain the difference we see between France and Quebec, for example.
In any case, the existence of the food-industrial complex – one which supplies Westerners with highly palatable foods – means that it’s foolish to expect any meaningful reduction in obesity rates. The system would need to be dismantled – such that highly palatable foods were rendered scarce commodities – for reductions in obesity rates to take place. In a market economy, this prospect an exceedingly unlikely one.
Obesity may simply be a fact of life we need to accept in the modern world.
So if obesity is here to stay, what does this mean? This brings us to the key issue associated with obesity: health. Obesity is blamed for the poor health of many individuals in Anglo countries. As we saw in my previous post, the association between obesity and heart disease, while present, is weaker than we might believe. Furthermore, it’s unclear that lowering the obesity rate – even if that were possible – would improve cardiovascular outcomes.
For some food for thought, take a look at this:
Deaths from cardiovascular disease actually peaked during the Baby Boom years and have been declining ever since, in fact decline as obesity rates have risen. In short CVD is becoming less of a problem, not more. Surely, much of that is due to advances in medicine:
While there is some inquiry into the matter, it is clear that the link between obesity and health is even more tenuous than we’ve been led to believe, especially when you compare the CVD incidence map to the map of obesity:
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- Cardiovascular mortality rate by country
There may not be much we can realistically do about obesity, and its causes may ultimately be pretty simple (genetics, too much tasty food), but yet nonetheless apparently intractable. But, that may be OK. The impact on health is not as severe as we might imagine. And despite the alarm of the term “obesity epidemic“, it may turn out that concern about its effects are primarily aesthetic ones. Some people may see that as itself a cause for alarm, but (if you will excuse the pun) perhaps we have bigger things to worry about.
JayMan's Blog 
Good Article. If treatment for being overweight is possible it will not come from the fantasy of misanthropic reactionaries that they are going to take away the abundance of pleasurable foods or punish fat people in some way. If it is possible, I think we will move towards genetic modifications in the womb or petri dish to turn endomorphic fetuses into mesomorphic ones or some sort of drug must be developed for that naturally fat people can stuff themselves without gaining weight. The second way would allow obesity to be treated like a heart condition or other innate health problems. There are attempts to produce drugs of this sort but we will have to see if they survive their trials.
The problem with this analysis is that the countries which are thinnest also eat the most palatable food, and are known for delicious cuisines. The obvious examples are the French, the Italians, as well as Japan, Thailand, etc. The French in particular are famous for cooking with tons of butter and fat. I very much doubt if junk food is more palatable than French food or even Thai food, whih uses lots and lots of fatty oils, sugar, and fatty coconut milk. In fact, in my experience, modern American junk food just isn’t very good, it’s kinda good but just about fails to hit the spot, leaving you craving more and more. The Anglo/Germanic countries are known for bland diets, and are the fattest. What gives?
So it would seem that the facts are directly opposed to your analysis. Highly palatable/rewarding cuisines seem to produce thin people, while countries with long traditions of bland food, and a modern tradition of junk food that is only mildly palatable without really “hitting the spot”, produce fat people, which is the exact opposite of your analysis. In my personal anecdotal experience, I have known multiple thin people who eat a combination of junk food and traditional highly palatable fatty foods, as well as some thin health freaks who ate mostly veggies and fruits. Their diets were completely opposed yet both were thin, leaving me unable to find any pattern in the kinds of foods that lead to thinness from examples in my personal life.
As for the concept of “cultural shaming”, it is a striking fact that countries where physical appearance matter the least – where style, fashion, and elegance matter the least – such as the Anglo countries, are the fattest. It is astonishing that nearly ALL the thin countries are full of well dressed, fashionable people, whereas nearly ALL the fat countries are full of people who dress terribly. Why should there be such a convergence on this? I have never ever been to a country where I noticed the people were thin and badly dressed and style disregarded. In France, Italy, Japan, Thailand, style and personal appearance are notoriously a hugely important thing in daily life. Then you have a place like Sweden, with low rates of fatness, but who are Germanic, who however prize personal appearance and fashion.
That’s. The. Point.
You’re not thinking fourth dimensionally, so to speak. If these cultures long had a tradition of palatable foods (and remember the context in which this term is used here), then they would have had the longest to adapt to the presence of these foods. Evolutionary forces could have conditioned them such that they are less inclined to indulge in modern junk food, as Anglo-Celts are.
These are what Satoshi Kanazawa (whose Big Think blog page was taken down, damn it!) calls “manwho statistics”. It’s worth noting that I didn’t say that excessive junk consumption is the sole factor that determines who will be thin or fat. Metabolism plays a huge role between individuals. Junk food consumption is one of many factors that determines final body weight, but it is the only factor that has systematically changed since decades past.
There could be something to this. If there is, it may have something to do with sex drive and the need to maintain sex appeal accordingly. It’s hard to know for sure without solid data.
I like to blame my own thinness on the delicious ethnic food I grew up on. Nothing compares — no no high-end restaurant and certainly no fast-food chain. It’s actually given me a visceral disdain for the culture surrounding high-end restaurants. “You think THIS is good? You think this is food?! This?!” Especially when I hear the meal complimented for its visual appeal (“Oh, it’s gorgeous!”), and then especially when it’s arranged in some silly geometric pattern. It could only be severe childhood culinary neglect that could turn a simple appreciation of good food into this status-obsessed parody. Or so I’d like to believe. That said, a sober look at my family suggests there is nothing I could do to make myself fat, not for another 15 years minimum.
That’s the kicker…
Guyenet sometimes oddly presents his argument, to the extent that foods with a complex, strong, pleasurable flavor are always more rewarding and people want to eat them in higher quantities. I heard him once claim that people in the past were more slender because a lack of “sauteed onions” and more “plain food”.
This isn’t how flavorists approach the topic. Complex, strongly pleasurable foods are not automatically foods which encourage people to eat a lot of them.
http://www.nytimes.com/2013/02/24/magazine/the-extraordinary-science-of-junk-food.html?pagewanted=all&_r=0
“The military has long been in a peculiar bind when it comes to food: how to get soldiers to eat more rations when they are in the field. They know that over time, soldiers would gradually find their meals-ready-to-eat so boring that they would toss them away, half-eaten, and not get all the calories they needed. But what was causing this M.R.E.-fatigue was a mystery. “So I started asking soldiers how frequently they would like to eat this or that, trying to figure out which products they would find boring,” Moskowitz said. The answers he got were inconsistent. “They liked flavorful foods like turkey tetrazzini, but only at first; they quickly grew tired of them. On the other hand, mundane foods like white bread would never get them too excited, but they could eat lots and lots of it without feeling they’d had enough.
This contradiction is known as “sensory-specific satiety.” In lay terms, it is the tendency for big, distinct flavors to overwhelm the brain, which responds by depressing your desire to have more. Sensory-specific satiety also became a guiding principle for the processed-food industry. The biggest hits — be they Coca-Cola or Doritos — owe their success to complex formulas that pique the taste buds enough to be alluring but don’t have a distinct, overriding single flavor that tells the brain to stop eating.”
Strong, complex flavors are not “rewarding” in the sense that either maximizes total food intake or maximizes intake of the specific foodstuff. A prescription to eat blander food (unseasoned baked potatoes) is a madness (well, it might be saner than a Doritos diet, but its far from sane).
Makes sense. I think Guyenet should rebrand the effect he describes not one of “palatability”, since that’s confusing in this context, but the “Lays patato chip effect”: too good to eat just one:
Sensory-specific satiety also became a guiding principle for the processed-food industry. The biggest hits — be they Coca-Cola or Doritos — owe their success to complex formulas that pique the taste buds enough to be alluring but don’t have a distinct, overriding single flavor that tells the brain to stop eating
On the back of this, an interesting HBD angle might be that this kind of small target might be sensitive to even small differences in population sensitivity in taste. Optimizations (a la Howard Moskowitz) to maximize intake work less well in some populations than others (for instance, looking as TASR, Europeans tend to have a higher sensitivity to sugar and less to bitter flavors), so some foods may be less effectively addict for some populations than others.
Another interesting outcome of this is that in this context, evolutionarily novel drugs such as nicotine and caffeine (which are more or less equally new to all populations, even with all the tea in China) might serve as a more optimum index of a populations propensity to addiction.
Precisely. Blacks for example tend to be highly sensitive to bitter (and I’d imagine sour) flavors. There is no way you’re going to get me to eat a grapefruit.
Excellent point. Maybe Eastern Europeans are thinner because they smoke so much more than Westerners…
Maybe Eastern Europeans are thinner because they smoke so much more than Westerners…
Greeks are fat, and they smoke even more than average East Europeans.
I’m not even sure how the relationship would work. I don’t smoke, but at the times I’ve tried it, I felt hunger pangs afterwards.
Re fast food; but your original point was that fast food is addictive because it is so delicious. My suggestion is that fast food is addictive because it is somewhat delicious but not quite delicious enough, leaving you feeling unsatisfied. Big difference.
Re palatable food in France, etc; that’s an interesting idea, but it has problems. First, French and Italian cuisines only became great around 500 years ago, which isn’t enough time for evolution to select for people better able to handle such a diet. Second, it is not at all clear what selective pressures would operate here – I can’t really imagine any scenario where people who could not handle this delicious cuisine would be weeded out in large numbers. Presumably, most people couldn’t afford to be gluttons even if they found the food irresistible, so that alone would prevent the weeding out of those who would succumb in an environment of food abundance. I wonder if the ordinary French person even ate more fat and butter than the ordinary Englishman – the difference might well have been just in haute cuisine. Third, and perhaps most damning, is the fact that when French or Chinese people come to America for longer periods they gain lots of weight, showing that it is not the case that they have evolved to handle a diet that Anglos can’t handle. When exposed to the same diet, they succumb as much as Anglos. The author of that famous book about how French women stay thin starts her book by explaining how she got fat living for one year in America, and still overate when she returned to France, remaining fat until she adopted French eating habits once again. In other words, it was not mere exposure to French food that did the trick, but a conscious process of re-acculturation to French eating habits, which she describes in detail. The cultural factor was key, not the kind of food she was exposed to. For a while she was just overeating baguettes and eclairs. There are lots of websites out there about Chinese and other foreigners gaining lots of weight in America and what they need to do to lose it once they get back. – it’s always re-adopting certain cultural habits of eating.
You say the only thing that changed is more junk food, but the culture changed tremendously in that time as well. Tradition broke down, including the traditional standards about physical appearance and grooming – slovenly and ungroomed became the fashion – and traditional notions of restraint and appropriate portion size disappeared.
I should add that the thin people I have known who ate junk food, they ate little – for some reason, they didn’t have cravings. So it’s not an issue of metabolism here. Both the veggie freaks and the junk food guys ate very little, that being the common factor.
Correct, that is a big difference. I still stand by my version. Addiction implies that you overeat; if it’s delicious but doesn’t encourage you to come back for more, then that’s not the effect we’re going for here.
It’s enough time. The real point is, as you mention, if there was a strong enough selective pressure to cause the change in that time. Perhaps then the key is that the relevant selective pressures operated over longer periods of time. Temperature, food insecurity, meat vs grain consumption, all these things could have been heavily at play.
It is however also worth noting that most modern Europeans are heavily descended from the bourgeois, ala Gregory Clark. Whatever selective pressures that operated on the middle-to-upper class would have shaped the entire modern population.
That said, the relevant evolutionary forces are far from clear at this point, so we are still only speculating.
Now if that isn’t a “manwho” (or in this case “womanwho”) statistic. 🙂 It’s unclear how much strict cultural factors are at play. In the case of East Asians, they are notoriously thin even in Anglo countries. We need to see if we can get better statistics on the effects of individuals who immigrate to other societies. But even that is only of limited value thanks to self-selection.
Even if this is true, which I’m not really convinced that it is, which came first? Did standards of appearance precede the rise in obesity or did standards of appearance change as more and more people because obese? This is heavily anecdotal, and may not be a worthwhile direction of study even if it turns out that there is something to it.
Metabolism and psychological traits all come into play. Just as the case with alcohol or drugs, not everyone who’s exposed to junk food will become addicted.
Well, as far as I understand you, you are saying that some people, like the French perhaps, evolved to handle a highly palatable diet, while others, like the Anglos perhaps, did not. Thus when the Anglos moved away from their traditional diet towards a highly palatable one, they could not resist the urge to overeat. This adds a nuance to what seemed to be your original contention that highly palatable food causes overeating for everyone.
It’s an interesting theory but for the reasons I already mentioned, it seems highly unlikely. To add a little more to what was already said, it is common for Americans who move to France to lose weight on very palatable French food, so it seems that food palatability in itself is not the problem for Anglos. Of course, all this is anecdotal, but it has some value. I lost weight in Asia, eating food that was in many cases as full of sugar and fat and palatability as anything in America. Another anecdote, but not without value.
There is a very strong modern tendency to explain everything in terms of a kind of crude empiricism. If people are obese, the explanation is sought in physical factors, not “insubstantial” factors like culture. To many people this seems more “scientific”. I am not against empiricism, but a true empiricism would admit the existence of things like the will, even if it cannot be measured or quantified.
You ask which came first, the cultural decline or obesity, but I think it is clear that the cultural decline, which began seriously in the 60s, came first. Nor does it make sense to see obesity as an isolated thing. It is surely part of a cluster of modern social dysfunctions that spreads out across our entire culture and that traces its roots to the dis-establishment of traditional controls and restraints that began in the 60s.
One important thing is thing is that we are no longer educated to build up our will-power. We know from studies that will-power is something that you can build up and that takes constant practice to maintain. We used to live in a culture that educated us constantly for the use and strengthening of that capacity, but we no longer do. To think that this won’t breed a generation of adults with a reduced capacity for will power seems naive. The entire element of self-restraint and self-control has been taken out of the culture to be replaced by powerful messages towards excessive consumption and self-indulgence. Combined with a reduced capacity for the exercise of will-power and the modern food abundance, the elimination from the culture of the urge towards self-control might well render most people incapable of resisting the urge to overeat, especially when another cultural element is added to this witches brew, democratic egalitarianism, which makes of the desire to appear stylish or look very good a kind of sinful attempt to distinguish oneself. There are also strong cultural messages that see a concern with appearance as either gay or superficial, in stark contrast with the Latin nations, who have always been artistic. No doubt there are some counter messages as well that work towards being thin, but they are clearly not the dominant ones. It’s interesting that the thinner nations are 1) more traditional (have a culture of self-control) 2) celebrate appearance and don’t think a concern with it is “artificial” 3) More elitist (aristocratic) in temperament and don’t think distinction in persona appearance is a sinful attempt to raise oneself above one’s fellows
Perhaps. We need hard numbers. Even still, there is the limitation that immigrants, especially between developed countries are self-selected, limiting the conclusions we could draw from data on them.
Not at all without value, but still limited in how informative it is. For the record, I know of someone (Mexican who moved to Singapore) who lost a lot of weight there.
It’s called scienceTM. Culture is included in what is “empirical”.
Haha, nope.
What studies are those?
I think that there’s a case to made for the East Asian nations in terms of individual restraint. It would be a very interesting cross-cultural project to measure this behavioral trait across the world (well, and all behavioral traits).
Also, Asian people in America stay thin to the proportion they remain rooted in their Asian culture. The more “American” an Asian is, the fatter they become, often just as fat as regular Americans. And the intermediate Asians, with a foot in both camps, are thin only in comparison with Americans – compared to Asians they are fat. To anyone who has not been to Asia, it is hard to understand the extremely high standards for thinness that prevail there, that makes even most Asians in America seem overweight. It’s a level of perfectionism that would be inconceivable to most Americans. And if you talk to Asians (or read Asian blogs online), you will find that this level of perfectionism when it comes to body fat is the result of a culture of strict fat shaming and rigid social policing. As crazy as it sounds, parents will mercilessly mock their children for gaining even a few pounds, an amount that would seem utterly trivial to Americans. Friends do the same thing. Asian thinness is the furthest thing from effortless and spontaneous as is possible. It requires a huge effort of the will. The difference is Asians have their entire society and network of family/friends behind them for reinforcement, and they grow up in a culture that trains their capacity for will power since childhood.
This is certainly worth researching.
Well, East Asians are naturally more slightly built than most other peoples.
Don’t doubt that that culture exists. Self-control could certainly be one of the (heritable) behavioral traits that differ between ethnic groups that contributes to the varying prevalence of obesity between those groups.
It’s called scientism, not science 🙂 Indeed, a true empiricism includes culture. But the modern version – what I call crude empiricism – has a fetish for numbers and for the crude physical fact. Nearly everyone explains obesity through the composition of food. It’s striking how the cultural or psychological factor gets such little attention. Yet it is likely the biggest culprit. It is interesting how this focus on the crude fact has so far has yielded so little of value in dealing with the problem, yet most people continue ploughing the same narrow furrow.
There is no such thing as absolutely free will without impingement from genetics or the environment, but it is an observable phenomenon in daily life that we can exercise some level of control on our actions, and that we can strengthen or weaken our ability to do so through habit.
Self-control is no doubt partly heritable, but does it make sense to suggest that Anglo people’s are historically lacking in this quality? Unless Anglo people underwent some huge genetic in the space of time it took for the obesity epidemic to arise, it makes more sense to finger culture, especially since Anglo people’s DID go through a huge cultural shift in that same time frame.
Now you’re confused a bit on the topic. Self-control clearly varies between groups, but if it is a factor, it is only on among many. Obviously, it’s not responsible for the change over time. It’s clear than an environmental factor is to blame for the change, and the main point of my post was that this factor was the arrival of junk food (and possibly the decline of smoking).
Self-control with respect to food can be quite a different thing from self-control in general.
I just read the Stepehn Guyenet post and interestingly, he discusses exactly my point. I am still unsure but I am beginning to find the palatability argument more and more convincing. It may be that in countries like Japan and France most food is at a medium level of palatability with extremely palatable food being eaten only occasionally as a treat. In other words such cultures have a good balance between the paltable and the regular. Interestingly, dieting in America is specifically about non-palatable food, yet diets famously don’t work and people crash – maybe because such diets are TOO unpalatable? Maybe the golden mean needs to be achieved, and places like France and Japan have done so, while we are on extreme of palatability. Here is Guyenet:
“Some people have brought up the examples of France and India as challenges to the food reward hypothesis, stating that both have a tradition of delicious food. That, of course, is true. However, it’s important to remember that most people traditionally didn’t eat foie gras and fatty spiced curries every day, and food that you eat in a restaurant or as a tourist doesn’t necessarily represent peoples’ day-to-day food choices. In France, which I can speak for because I spent a significant chunk of my life there, most meals are composed of relatively simple, fresh, home-cooked food. This is particularly true for the older generations. The food is not low in fat, or low in animal fat. It tastes good, but it isn’t extravagant. Traditionally, people rarely ate at restaurants, which were expensive and considered a special treat. As the food system has industrialized, and commercial food has increasingly replaced home cooking, the prevalence of obesity has increased.”
Indeed.
Pretty much. For Anglos at least, the good stuff is hard (or indeed impossible for many) to give up.
Or maybe there is no solution, thanks to genetic differences between Anglo-Celts and the French or the Japanese.
Or maybe there is no solution, thanks to genetic differences between Anglo-Celts and the French or the Japanese.
That doesn’t follow. The solution is simply to return to an older way of eating and voluntarily relinquish the quest for maximum palatability. That this CAN be done is obvious. Given the current culture, however, that this WILL be done seems highly unlikely. But if American culture ever rediscovers that the principle of self-restraint and moderation is necessary for happiness, as I think it will sooner or later (probably later), then such a voluntary renunciation of taste and flavor might well happen.
Since the French, say, DON’T eat for maximum taste and flavor, I don’t see how we can conclude that they are evolved to handle greater palatability. The French have retained their traditional diet of medium palatability. The Anglos have not. If the French were to abandon their traditional restraints, all the evidence suggests they would fare as badly as Americans.
Good luck with that.
Far from it.
Precisely.
I don’t think that’s what the evidence says. The closest we have to an example of that are the Quebecois, and they seem to be doing better than Anglos on that front, if not quite as good as the old French.
Mendelian randomization studies have shown the high density lipoproteins are not causative to coronary artery disease, though they do correlate. However, for BMI, it actually does hold up. See: http://eurheartj.oxfordjournals.org/content/29/20/2552.short .
Good, but we don’t know if that translates into increased risk of death from CVD. But even if it does, how much higher is the risk (data from the U.S. says not that much higher)? And then, what’s the causal force, weight, or shared genetic architecture? This study was done on Finns, who seem to be at significantly elevated risk for CVD. Not sure how that translates to other groups.
Great article, very in-depth and I agree with all the main points you raised. I wonder what else has caused obesity to sky-rocket since 1980, besides the main factors you highlight. Maybe stress rates have increased in society? There is anecdotal evidence that in previous post-war generations, rates of stress may have been lower. I don’t have data. But we know that stress causes a spike in cortisol levels, which can cause over-eating and cravings for fatty, sugary foods etc. Poor sleep also causes a spike in cortisol. With people working longer hours, greater job insecurity caused by globalisation, job outsourcing, rounds of down-sizing, etc., also higher household debts, more working women, etc. maybe it is plausible that people are more stressed and eat more junk food and drink more booze in order to cope, increasing obesity. Maybe widespread use of hormonal contraception is to blame also. And far fewer men work manual jobs where lots of calories are burned, but far more work desk jobs with limited physical activity.
Thanks! About stress, oddly, the fertility rate can be used as a rough gauge of societal stress. Less affordable family formation should = greater stress.
Dang…my man, you have done your homework. I maintained my ideal weight, 180lbs, 6ft1during my 20 plus years in the Army..Once I retired, bam, I put on 45 lbs. life style change? Yes. I gave up on P.T. I’ve got to pull myself together and hit the pavement again. 😉
Hum, I guess I could add my own feeliings regarding my home place, northern france (a little bit more overweight than south of france, but nowhere near the american situation) and a place I know quite well: Thailand (mostly extremely thin but less so for some of the new generation).
The two cuisine differ quite a lot: French have sweet pastries (fat+sugar) and fatty sauce, and bread, or the mediteranean stuff(much more in line to what health freaks love), Thai is extremely spicy, quite salty by modern standards, and they love fat more than sugar (no real pastries nor dessert, sugar is used like a sort of spice). Seems not too healthy, but on the other hand they eat fruits as snacks and almost never touch chocolate…
French stands by 3 regular meal per day, Thai will eat when they are hungry, usually very often.
Both have highly evolved foods and culture attach a lot of importance to food (measured by the amount of time per day people are ready to spend on food preparation/consumption). I think that this allows to resist the junk food quite well, if we assume that junk food is engineered to appeal to natural cravings so that most people eat as much of it. Both the French and Thai cuisine is so important culturally that they have moved slightly away from base natural tastes, so the junk food , while probably optimal for natural tastes, miss the culturally-influenced targets. But it hit the mark better with some of new generation, which sometimes did not learn the cultural food but was exposed to junk food from early age.
Still, there are obvious genetic factors too. Body types are not the same, and you can get fit people of extremely different bmi but proably similar body fat percentage. Another thing that is strange is that Thai seems to have quite a lot of diabete, even being thin and apparently eating much less refined sugar.
Another factor is simply the weather, which imho is a huge factor: I loose weight very quickly in hot countries, except with some rather extreme diets like oriental pastries. hunger is lowered in warmer situations, while you drink more….as long as u stay aways from sodas, you automatically loose weight even without thinking of it, and quite fast….while when cold, hunger is terrible and fatty foods become more attractive. This is to be expected (the Bergmann’s rule), and should be factored out imho before comparing bmi between different populations…Especially as this had time to influence both local cuisine and local genetics…
oh and by the way, the self-restraint thing does not hold, especially for thais: They will never refrain from eating what they want when they want. In fact, they will get really angry if u try to tell them to eat 3 times a day (the traditional french way), especially when you are not choosing your food yourself but eat whatever is proposed (the traditional way for most french, at least until recently).
I have spent extensive time in Thailand, and this is not true. It’s true that Thais eat throughout the day, but they are careful to eat extremely small portions, and are extremely conscious of their weight, especially the women. If you gain even a few pounds you will be called fat. I have seen this firsthand. All Thai people are extremely conscious of their appearance and weight and are very self-restrained in their food intake, quite deliberately.
Compared to America, maybe…But not to France. I have food them to be quite similar in the quantities eaten. In fact, multiple times I have been surprised on how much they ate (more than me!) while still being slim. But of course on average they probably ate less because they keep slim with a smaller body, and as Jayman mentioned, gaining/loosing weight is in fact extremely simply and almost entirely driven by the daily caloric intake. It was probably because I was at the start of my stay, when the change in weather make me loose weight, while they were stable. A few weeks after, I am eating (slightly) more indeed. But still, they do not consciently restrain themselves. They even often over-order (cultural thing, ordering too much is a sign u are wealthy and they do not have much taboo about throwing excessive food – something that is difficult for an European (even when much more wealthy !!!). Probably linked to history, typical food availaibiliy different and strong seasonal effect in Europe. This may also be part of the explanation, now that I think of it.
Now that’s true than when in America, I was often shocked at the amount of food you get in restaurant, or the typical portion people take in buffet (and still go for a second or third round 😯 ). So I understand why our impression differ.
Regarding being called Fat, it’s true, but probably because Thai do not consider this as a strong insult. More like a jest, even if it depend on context of course. In France it is usually a true insult, and in America given the Political correctness, it is probably even worse. But besides that, the self image and social pressure on appearance is not much stronger than in France, probably at the same level.
Competition between girls is stronger though (not much security net provided by the state, if your husband leave u are on your own), so there I agree with you. In France the situation is intermediate compared to Thialand and the US, where once u are married, u get access to half your husband resources, whatever happen, from what I understand…Again a difference, at least for women above 30.
Calling someone fat is not considered an insult in Thailand. Rather, it is considered an acceptable form of criticism. The Thais do not believe that all criticism is an insult, like we do. PC does not reign there. The common Western inference that since Thais consider calling someone fat acceptable, they must not see fat as negative, is a naive Western failure to understand that many (healthy) cultures permit criticism without considering it an insult.
I have extensive experience of Thai social habits. Fat is indeed a stigma, especially for women, and women talk openly and frankly about the need to restrict their food intake, as do many men. Further, being well groomed and well dressed is of huge importance to Thais, and it is obvious how this creates pressure to stay thin. Thai thinness is quite deliberate. Let no one imagine otherwise.
All the hyper-rewarding foods Guyenet point to are full of sugar/carbs. Sugar+fat or sugar+sugar, it all comes down to sugar because sugar is anti-satiety.
A big juicy steak is tasty and rewarding and energy-dense and all that but you have to force yourself to eat three of them in a row. On the other hand eating a whole bag of energy-dense 2000+ calories potato chips in half an hour is easy.
Guyenet chose to ignore the obvious. He wants his Food Reward model to displace the Taubes/Carbodydrates/Sugar model popularized in Good Calories Bad Calories. He needs to try harder.
I don’t really see the two things as being mutually exclusive. And Guyenet’s writing really illustrates why it’s so hard to lick: the stuff really is addictive in nature.
Of course, it may still be not this simple, though this is where my money is for now.
Some discussion above saying that Ango-Celts and the ‘French’ are genetically different enough to produce different obesity outcomes. This doesn’t wash. France has a large gaulish, i.e. celtic substrate. The country was also invaded by the Franks (who are ethnic/linguistic Germans) and then by the Norsemen, who were also Germanic. These then went to invade England. The Franks and Anglo-Saxons are of similar Germanic origin. Some say that the inhabitants of South-East England and those of Netherlands/Belgium and northern France are very similar.
So the argument that the ‘French’ are so different, genetically, just doesn’t wash.
The cultural arguments about slovenliness and lack of care of appearance, though, accord with my experience.
No kidding. But not only were the genetic inputs different to begin with, they have had 1,500 years of separate evolution. And they are genetically distinct today. Similar is not identical.
“No kidding. But not only were the genetic inputs different to begin with, they have had 1,500 years of separate evolution. And they are genetically distinct today. Similar is not identical.”
Nah, that doesn’t wash either. To say that the English and French have had 1500 years of separate evolution is quite wrong. First let’s start with the Norman i.e. French invasion in 1066. That cuts it to less than 1000. Then there’s the dominion of the Anglo-French kings over large parts of modern day France, including Calais, Normandy and a huge chunk of South-West France. This is helped a lot of trade between Bordeaux and the southern English ports. There’s a reason that the English think ‘normal’ red wine is Bordeaux.
Look at eastern England. There has been constant flow of people across the North Sea beween England, the low countries and Denmark – there’s a reason that the architecture of cities around the North Sea and the Baltic is eerily similar. Some of this is documented, such as the large number of Flemish who settled in Britain and brought proper beer brewing with them.
But that’s only one side of the equation, consider the other side. The average Englishman from, say Kent, has a lot more in common with a Flemish Belgian than a Yorkshireman with his mainly Viking ancestry or from Highland Scots who may be more closely related to the Portuguese due to trade and migration across the sea. But then do an experiment yourself. Go to Edinburgh and then go to Oban on the West coast of Scotland – you may be surprised at how different the people look.
The mix of populations throughout Europe is far more complex than you’re trying to make out and to lump the Anglo-Celts into some giant obesity blob, doesn’t stand up to any sort of scrutiny.
I had this exact same argument with Tom Naughton. Look, there is no question that there has been gene flow between Britain and France, nor is there any doubt that they had some of the same genetic precursors. But, at the end of the day, they are genetically distinct today. The are separable into distinct genetic clusters. You could argue that the genetic differences between them is too small to account for the phenotypic differences we see (foolishly so), but that Ron Unzian logic wouldn’t hold. Small differences in genes can lead to large differences in phenotypes.
It’s worth noting that there appear to be considerable differences between the French in France and the Quebecois with regard to heart health and obesity, as I’ve noted. This suggests that genetic differences aren’t wholly responsible for the differences we see (though the Quebecois aren’t genetically representative of the French). That would have been a more helpful point for your case.
Your argument about the British and the French however would only hold water if the British and the French were genetically indistinguishable. Since they’re clearly not, it doesn’t. And I’ve had enough of it, so please no more on this unless you have something sensible to add.
I’m wondering where the good old Skinnerian notion of operant conditioning is hiding in this discussion?
Whenever we get into some version of the ‘genetics versus the environment’ eternal recurrence, it’s invariably characterised by the absence of attention given to operant conditioning. If you look at behaviour simply and directly as Skinner does, the dichotomy effectively dissolves, as behaviour emanates from contingencies of reinforcement that are supplied by the environment’s intercourse with the organism.
Then, all we need to do is to sort out how to extinguish conditioning that leads to overeating behaviours via removal of cues/removal of rewards, and simultaneously reward behaviours that lead to desired eating behaviours. Of course, this is the wicked part of the problem…and unlikely to resolve while the socio-cultural-economic-political environment favours the continuation of overeating behaviours. Relatively simply on an individual level for people fortunate enough to have the know-how.
Am enjoying your blog, by the way. Thank you.
Cheers.
Thank you!
All we need to do! Yes, if only it were so easy. 🙂
Similar arguments were made elsewhere – that a lot of the results of heredity stem from gene-environment correlations (people who seek out certain environments, thanks to their genes, which lead them to certain end states). If we could interfere with this process, we could, in principle, get different results. But as you note, that’s not easy…
If the increase in obesity were due to the increase in calorie intake then we should expect a considerable lag between the eating and the increase. Looking at the first graph no lag is apparent. If anything the lag is the other way around. The increase in obesity started before the increase in calorie intake.
@Charlie:
You know, you may have spotted something quite significant. People assume (and at least in this post, I’ve speculated such, although I don’t necessarily claim this is correct) that the causation between the apparent relationship between consumption and obesity goes consumption -> obesity. It could go obesity -> consumption, or perhaps both are caused by some other factor(s) upstream.
@JayMan: “It could go obesity -> consumption, or perhaps both are caused by some other factor(s) upstream.” Well that was Taubes’s point, no? That we are not getting fat because we’re eating more, but rather, we are eating more because we are getting fat. That the metabolic shift in adipose tissue handling comes first as a result of the food.
On some of the discussion above: before deciding that people don’t care how they look which makes them more unconcerned about fat, observation of women suggests it’s more complex. Women who feel like their figure it ok tend to be far more focused on appearance. The moment that “how you look” appears to leave your sense of control over it, I think it causes a release across the board to some degree. Kind of like being a bit poor in school years, and one would rather look like a rebel who doesn’t care than look like they ‘tried’ to dress acceptably but couldn’t quite succeed. (And there are sub-culture issues with appearance as well. The upper east coast cities, it’s more rare women leave the house without feeling ‘prepared’ while on the lower west coast especially smaller cities, sandals and wet hair from the shower is fine.)
I’ve spent many years reading research and discussion related to nutrition and obesity. The females in my family have — let’s see if I can phrase it properly — a genetically associated adipose disorder — called Lipedema (several spellings of this). While allegedly 11% of the female population it’s virtually unheard of at least to doctors, including those recommending the whole ‘eat less, move more, chop out your guts if that fails’ doctors in the west to women for whom none of those will actually touch the problem. Basically it seems to cover a few things including an ‘inflammation cascade’ that can cause ridiculous adipose gain and a surreal inability to ever get rid of the accruing adipose tissue in certain areas of the body (mostly hips to ankles, upper arms for some). It does not affect the hands, feet, head and neck, or trunk for most, which means the distribution is rather weird (tiny head on huge body, a waist and normal neck for a size that would normally have 6 chins).
When I say inability to get rid of it, I mean nothing works – not even starvation level anorexic dieting that could kill you from gradual organ failure, not even exercise even to the extreme, not even gastric bypass (which really just amounts to the former at least initially). And of course, gradual adipose accumulation isn’t like luggage like used to be believed, it has significant effects body-wide including on storing more. Here’s the thing though. This is defined by the ‘symptom’ usually of ‘utterly resistant’ adipose tissue in the hips and thighs. It’s not defined by simply having utterly resistant adipose tissue. So men could have this too but have it in the torso where they naturally put on weight (just as women do in the hormonal areas most affected by lipedema) and nobody would ever know.
Now, the diagnosis is based on visual evidence so let’s say a degree of overweight or obesity to begin with. But if you take that 10-11% and map it to the actual overweight+ population (15-52 age or so) you get a number more like 40-odd percent of those are likely lipedemic. But if you backed out that number from the stats for women, it would look like far more men were overweight+ than women which I refuse to believe for now. So this suggests that it’s something under the radar affecting men as well. This was discovered in 1940 or so but has managed to stay carefully under the radar, outside medical training, outside any funding or research, for for ~75 years. I’m starting to become a conspiracy theorist about it I think.
The numbers are huge enough to matter, even to population level stats. I just thought I would add that anomaly to your list of inexplicables.
Speaking of the 40-odd percent number, this article on lead toxicity (there is *no* safe level, and look at the sources of stats they are conservative and legit) is enough to make you wonder if maybe we are not actually missing one of the key elements in this soup all along. http://www.huffingtonpost.com/dr-mark-hyman/lead-poisoning-why-lead-p_b_609383.html
Is there a source list? I can’t find it, and this paper is due soon. Also, sugar is the problem. Look up John Yudkin.