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A Big Fat Crisis: The Hidden Forces Behind the Obesity Epidemic -- And How We Can End Itby Deborah Cohen
Synopses & Reviews
In the hot days of the summer of 1972, the New York City Health Department investigated an unusually high incidence of deaths among toddlers who fell out of tenement windows. Initially mothers and caregivers were blamed for not being alert, not properly supervising children, or simply neglecting naturally curious toddlers and adventurous young children who leaned out of apartment windows, or crawled onto fire escape stairwells to try and cool off. After an investigation, the health department launched a campaign, Children Cant Fly” and offered free window guards to families in tenement buildings. The next summer, there were no falls from buildings that had the new window guards.
The story of Children Cant Fly” is an apt analogy for the problem and the solution to the obesity epidemic. Children are born curious and may wander to an open window even if (or because) we tell them to stay away. All of us were born with the capacity and inclination to eat more than we need. In a world where there is too much food, we currently have no constraints that limit our natural tendencies to automatically eat what is readily available.
Dr. Cohen has created a major new work of nonfiction that will transform the national conversation surrounding the weight crisis in this country and throughout the world. Based on her own research at the RAND corporation, as well as the latest insights from behavioral economics, psychology, cognitive science, and the social sciences, A Big Fat Crisis reveals the surprising forces behind the obesity epidemic and how we, as a nation, can overcome it. Her conclusions contradict conventional wisdom and widely held expert opinion, and go against our own intuitive beliefs about the way we eat. They represent, in short, a paradigm-shift in how we approach the problem of obesity—and the solution.
A Big Fat Crisis argues that the obesity epidemic is the product of two forces:
(1) Immutable aspects of human nature, namely the fundamental limits of self-control, the lazy decision-making of the brains non-cognitive system, and the automatic and unconscious way that we are hard-wired to eat; and
(2) A completely transformed food environment: all of the food-related elements of our surroundings, including food stores and restaurants, prices, portion sizes, the types of food available to us, and food marketing and advertising.
A Big Fat Crisis offers concrete solutions, arguing that the most important and modifiable steps in the chain of events that leads to obesity are at the point of purchase and the point of consumption. Like cholera and typhoid in the 19th century, obesity is a public health crisis. Ending it requires solutions that transcend individual behavior. Change begins with a fresh perspective and a clearer vision of what we need to do. We can tackle the obesity epidemic. We just cant do it alone.
"With a kind but brisk bedside manner, RAND Corporation scientist Cohen (co-author of Prescription for a Healthy Nation) delivers a diagnosis in layman's terms in this powerful book: two-thirds of American adults and one-third of children are overweight or obese, not because of a lack of self-control, but because of the 'modern food environment' that makes it easy to consume too many calories. In the first half of the book, Cohen presents numerous research studies that level myths about 'mindful' eating, instead arguing that we're 'biologically designed to overeat' and easily influenced by 24-hour fast-food drive-thrus, oversize restaurant portions, supermarket displays, candy in checkout aisles, and TV commercials. She argues for a 'critical paradigm shift': to view the epidemic as a public health crisis and institute controls that guide eaters to 'choose health over heft.' Anticipating resistance, Cohen spends the rest of the book defending government interventions, citing examples like ratings for restaurant hygiene and conjecturing how 'common-sense regulations' resembling those on alcohol sales might 'make unhealthy foods' less accessible and enticing. While Cohen believes that collective action is the only real solution to epidemic, she also helpfully suggests ways to modify one's food environment and offers dietary guidelines in the appendix. Photos." Publishers Weekly Copyright PWxyz, LLC. All rights reserved.
The obesity epidemic is a public health crisis. Ending it requires a fresh perspective and clear solutions.
Obesity is the public health crisis of the twenty-first century. Over 150 million Americans are overweight or obese, and across the globe an estimated 1.5 billion are affected. In A Big Fat Crisis, Dr. Deborah A. Cohen has created a major new work that will transform the conversation surrounding the modern weight crisis. Based on her own extensive research, as well as the latest insights from behavioral economics and cognitive science, Cohen reveals what drives the obesity epidemic and how we, as a nation, can overcome it.
Cohen argues that the massive increase in obesity is the product of two forces. One is the immutable aspect of human nature, namely the fundamental limits of self-control and the unconscious ways we are hard-wired to eat. And second is the completely transformed modern food environment, including lower prices, larger portion sizes, and the outsized influence of food advertising. We live in a food swamp, where food is cheap, ubiquitous, and insidiously marketed. This, rather than the much-discussed food deserts,” is the source of the epidemic.
The conventional wisdom is that overeating is the expression of individual weakness and a lack of self-control. But that would mean that people in this country had more willpower thirty years ago, when the rate of obesity was half of what it is today! The truth is that our capacity for self-control has not shrunk; instead, the changing conditions of our modern world have pushed our limits to such an extent that more and more of us are simply no longer up to the challenge.
Ending this public health crisis will require solutions that transcend the advice found in diet books. Simply urging people to eat less sugar, salt, and fat has not worked. A Big Fat Crisis offers concrete recommendations and sweeping policy changes—including implementing smart and effective regulations and constructing a more balanced food environment—that represent nothing less than a blueprint for defeating the obesity epidemic once and for all.
About the Author
Deborah A. Cohen, MD, is a senior natural scientist at the RAND Corporation. Cohen received her BA at Yale University, MPH in epidemiology from the UCLA School of Public Health, and her MD from the School of Medicine, University of Pennsylvania. She has served on several advisory panels for the National Institutes of Health (NIH) and was a Fulbright Senior Scholar in Brazil. She lives in Santa Monica, California.
Table of Contents
PART I: HUMAN NATURE AND FOOD
Chapter 1. Its Not Your Fault
Chapter 2. The Limits of Self-Control
Chapter 3. The Overwhelmed Brain
Chapter 4. Eating Is Automatic
PART II: THE FOOD ENVIRONMENT
Chapter 5. Abundant and Cheap
Chapter 6. A Food Desert? Try a Swamp
Chapter 7. Marketing Obesity
PART III: AN ALTERNATE VISION
Chapter 8. A Plea for Change: We Are All in This Together
Chapter 9. A Safer Food Environment
Chapter 10. The Supermarket of the Future
Chapter 11. Fit and Fat: What About Physical Activity?
Chapter 12. In the Meantime: What Individuals Can Do
Chapter 13. Conclusion
Appendix: Healthier Meal Guidelines for Adults and Children
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