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 obesityand 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.
Review
In
A Big Fat Crisis
Cohen removes the blame for obesity from those with the extra pounds and places it squarely on their surroundings. Her thesis is clear: Just as infectious disease and cancer result from exposure to a pathogenic and carcinogenic environment, obesity is primarily the result of exposure to an obesogenic environment.
She makes a convincing diagnosis. [
A Big Fat Crisis is] a rallying cry for drastic change in how we view and manage the obesity epidemic.”
The Washington Post
"[A] controversial but compelling solution to the obesity epidemic in the U.S."
Shelf Awareness
"Dr. Deborah A. Cohen has written a groundbreaking book on obesity. It should be read by everybody."
HuntingtonNews
Cohen, an epidemiologist and medical doctor at the RAND Corporation, makes a convincing case that obesity involves far more than a failure of willpower
Cohen certainly presents a fresh, thoughtprovoking take on how to fight the obesity epidemic.”
Booklist (starred review)
Cohen takes a behaviorist approach to identifying the antecedents for eating choices, suggesting that the focus on self-control as a key element actually undercuts efforts to make change, given peoples assumptions about human nature and our genetic makeup
The author makes a compelling case.”
Kirkus Reviews
[A] powerful book.”
Publishers Weekly
Deborah Cohen gives us a physicians view of how to deal with todays big fat crisis. In todays eat more food environment, individuals cant avoid becoming overweight on their own. This extraordinarily well-researched book presents a convincing argument for the need to change the food environment to make it easier for every citizen to eat more healthfully.”
Marion Nestle, professor of nutrition, food studies, and public health, New York University, and author of Food Politics: How the Food Industry Influences Nutrition and Health
Hundreds of diet books have failed to halt the obesity epidemic in America. If you are among the majority of Americans who are overweightor are just someone who cares about others who areyou should read Deborah Cohens A Big Fat Crisis instead. It will give you an entirely new perspective on this creeping disaster and on how our society can end it.”
Thomas Farley, commissioner of health for New York City, 20092013
Cohen lays out the daunting internal and external forces that have led to a frightening rise in obesity in America. She offers innovative and provocative paths out of the problem, including one of my core beliefscities should be designed around people rather than cars. Among other things, elected officials should champion infrastructure investment that encourages more active and healthier lifestyles.”
Mick Cornett, mayor of Oklahoma City
Synopsis
The obesity epidemic is a public health crisis. Ending it requires a fresh perspective and clear solutions.
Synopsis
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 changesincluding implementing smart and effective regulations and constructing a more balanced food environmentthat 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
Introduction
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
Frequently Asked Questions
Acknowledgments
Notes
Index