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Yoni Freedhoff M.D.

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Obesity Is Not the New Smoking, and Fat Is Not Our New Tobacco

Posted: 06/27/11 03:05 PM ET

God how I hate seeing those quotes.

Smoking is a singular behavior.

Now I don't want to minimize the difficulty of nicotine addiction, or the impact of factors such as poverty, advertising and culture on the decision to start smoking, but it is important to recognize that starting and stopping smoking involve one single behavior -- lighting or not lighting a cigarette. One behavior, governed by choice.

Obesity is not a choice, nor is it the consequence of one singular behavior.

People don't choose to become obese, and while choice and free will are involved in lifestyle design, they're certainly not lifestyle's only determinants.

Genetics, co-morbid medical conditions, psychology, pace of life, socio-economics, environmental obesogens, governmental failings in the provision of evidence-based nutrition and energy balance/caloric information, the unregulated self-help quackery of the commercial weight management programs, the confusion and contradictions of over 60,000 diet books, glossy magazines that promote quick fixes, reality television that promotes inane, non-sustainable and frankly dangerous treatment, crop subsidies that allow highly processed, hyperpalatable, hypercalorific foods to be sold for pennies, front-of-package labeling that confer health-halos to junk food, the demise of the family meal and the fall of cooking, predatory advertising targeting adults and children alike, a culture that promotes the provision of food at every event however small, super-sizing of restaurant portions, lack of caloric information at point of sale, medications which cause weight gain, juice and chocolate milk being promoted as healthy choices, public health messaging that wrongly suggests exercise is sufficient to "balance" calories consumed, epigenetic changes that occur in the womb, eating as a defense or a reaction to emotional, physical or sexual abuse.....

Honestly, I could go on.

Of course there are choices involved in personal weight management, but the playing field is anything but level. Go back through that list up above and consider life 60 years ago, when obesity was a rarity rather than a norm. Most of the list would be gone. Also consider the fact that none of that list reflects the failings of people as individuals, but rather it reflects our collective failing of protecting our environment. What we're dealing with today is a state sponsored, massively un-level playing field, superimposed on our most powerful physiologic survival drive. Go figure we've got a problem.

So no, obesity is not the new smoking and fat is not the new tobacco. The folks who say they are, whether they realize it or not, are part of the problem, as the notion that obesity's the new smoking fuels the hateful bias that dealing with it is as easy as butting out.

If it was as simple as pushing away from the table, everyone who wanted to be would be slim.

Dr. Yoni Freedhoff, MD is known as a "nutritional watchdog" for his advocacy efforts for improved public policies regarding nutrition and obesity. He is the founder and Medical Director of the Bariatric Medical Institute, dedicated to the (nonsurgical) treatment of overweight and obesity since 2004, and his personal website, Weighty Matters, is ranked among the world's top health blogs.

 

Follow Yoni Freedhoff M.D. on Twitter: www.twitter.com/yonifreedhoff

God how I hate seeing those quotes. Smoking is a singular behavior. Now I don't want to minimize the difficulty of nicotine addiction, or the impact of factors such as poverty, advertising and cul...
God how I hate seeing those quotes. Smoking is a singular behavior. Now I don't want to minimize the difficulty of nicotine addiction, or the impact of factors such as poverty, advertising and cul...
 
 
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HUFFPOST SUPER USER
babybelle
EARTH without art is just EH
12:44 PM on 06/30/2011
If it was as simple as pushing away from the table, everyone who wanted to be would be slim.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Well, pushing away from the table is a start.
Why should anyone even expect it to be simple to get and stay in shape?
It's work to cook your own meals and get off your duff everyday and exercise.
It's discipline to not snack between meals.

Sure, some have it more difficult than others but almost everyone can take some simple steps to help themself.
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HUFFPOST SUPER USER
William Anderson LMHC
Licensed Psychotherapist, Weight Control Expert
08:28 AM on 06/29/2011
You are right that obesity and the behavior that causes it are much more complex than smoking, and that achieving a healthy controlled behavior and reversing obesity is a far more difficult thing than becoming abstinent of smoking.

However, there are useful and real similarities to observe, such as the addictive characteristics of both smoking and eating behavior, the success that behavioral medicine has in treating both, and the fact that both problems involve powerful corporate interests profiting by selling addictive things to a vulnerable market, even though it is killing them, an outrageous, so far legal, exploitation of their fellow human beings, especially children. It is particularly insidious the way they target children.

So, while they are different, there is a benefit in citing the similarities.

Robert Pretlow, M.D., with whom I am collaborating on a new project, has just published a wonderful paper in "Eating Disorders", "Addiction to Highly Pleasurable Food as a Cause of the Childhood Obesity Epidemic". It is a real eye-opener.

Best wishes,

William Anderson, LMHC
Author of 'The Anderson Method - Secrets of Permanent Weight Loss'
Website: www.TheAndersonMethod.com
Blog: http://theandersonmethodblog.wordpress.com/
03:36 PM on 06/28/2011
Good article but you fail to address the real cause of the obesity epidemic:This hemisphere's dependence on corn.

It started back in the seventies when Richard M. Nixon over-promised wheat to Russia to make up for the Ukrainian crap failures after years of soviet attempts at collectivisation.

Because he was trying to stave off a world war over food, he could be forgiven, as the situation was dire.

He was also trying to fend off potential problems in this hemisphere with random fluctuations in the price of foods, specially with the monkey wrench he had just thrown into the wheat commodities market with this trade agreement with the Soviets.

He directed Earl Butz to rework the pricing and price support/subsidy system in the United States, and by extension in Canada as well, into a smoothly functioning system where farm workers were employees of large industrial players, (like Cargill, Monsanto, Syngenta, all riding John Deere tractors, and the heavily subsidized commodities transportation sector [Canadian readers may want to Google "Crows' Nest Freight Rate"])

Earl Butz did a far better job than that starting to subsidize research into all aspects of one crop in particular: CORN.

We started to use corn for everything from a food stuff, to a food additive, to a feed stock, to a fuel stock. Everything is made from heavily subsidized corn.

We are KILLING ourselves on and with a single crop and taking our subsidized beef, chicken and even fish with us.
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HUFFPOST BLOGGER
YoniFreedhoff
Obesity med. doc, blogger, author, speaker, dad.
04:35 PM on 06/28/2011
If you re-read my piece, you'll find that I did in fact address corn.

"crop subsidies that allow highly processed, hyperpalatable, hypercalorific foods to be sold for pennies"

Regards,
Yoni
10:48 AM on 06/28/2011
This is a fantastic and timely article, thank you for posting. I love the rant in the middle where you detail all the issues that are a potential cause of poor health or obesity in our population. There are so many reasons for this condition and why people fail at their attempts to regain their health. While some people feel that obesity is a choice, it isn't, the reality is that for those that suffer it can be a long dark road they travel alone.
Unfortunately too many people look at the obese like they are broken or a blight on society, this only adds to the issue at hand. What you are saying is so true, there is so much information available out there and not all of it is true and causes more harm than good.
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HUFFPOST BLOGGER
YoniFreedhoff
Obesity med. doc, blogger, author, speaker, dad.
11:59 AM on 06/28/2011
Thanks.

Was this article that led me to post: http://articles.latimes.com/2011/mar/07/health/la-he-cancer-obesity-20110307
06:32 AM on 06/29/2011
Are you meaning to say: This was the article that lead me to post? I am off to read that as well, I have experienced a bit of writers block and perhaps this will blast it free.
02:54 AM on 06/28/2011
Well said, Yoni. Now, if only those of us who appreciate these aspects about obesity and who are much more able and effective to address/treat the obese population with the integrity and truth they need could somehow supercede/stop the onslaught of all the opportuntistic, self-appointed 'experts' and 'gurus' who happen to garner the MOST influence and who end up scalping countless numbers of people with their myopic and sensational 'solutions' to the problem. Until correct and best treatments and experts become more affordable and accessible to the obese public who need proper treatment, the charlatans and marketeers will be enabled to thrive, at the expense of a continuing obesity epidemic. Thnx! Mary-Jo R. Overwater, MSc, MMSc RD
09:56 PM on 06/27/2011
Obesity is a choice. Look at all of the fat people who lose weight on weight watchers or those TV shows.
It is about people consuming more calories than they burn off.
Simple.
11:58 AM on 06/28/2011
Susan, did you even read the article? Dr. Freedhoff specifically address those points (ie "reality television that promotes inane, non-sustainable and frankly dangerous treatment,"). And I don't think countering a doctor's medical opinion based on evidence you garnered from t.v. is really a tenable position. You might want to have another look at the article.
12:45 PM on 06/28/2011
The vast majority of the people on Weight Watchers or Nutrisystem or other plans do not lose much weight at all, and most that manage to lose a significant amount gain it all back again. Those plans don't work over the long haul because they're not meant to be stayed on forever, and once you go off you gain the weight right back again.
08:07 PM on 06/27/2011
Well-written rant. A good rant should be a touch too caustic, thoroughly one-sided, but persuasive enough to shift your perspective.
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HUFFPOST BLOGGER
YoniFreedhoff
Obesity med. doc, blogger, author, speaker, dad.
09:22 PM on 06/27/2011
Sounds like a good epitaph for me.