with the view that obesity is largely caused by environmental conditions, we must also reevaluate the widely held view that most individuals have the capacity to transcend obesogenic environments and to maintain a normal weight. Yes, some people can do it, but they are the minority. Many who are thin remain so despite thisenvironment, and not because they have a superior ability to resist the temptations of too much food. Actually, I put myself in this category. I believe I am thin, not because I am able to count calories or resist sweets (which I can’t), but because I am not frequently exposed to an obesogenic environment. I seldom watch television, eat out, or have easy opportunities to snack. This is not a conscious choice, but an unintended consequence of the demands of my career and family and the physical limits of a twenty-four-hour day. But when I go on vacation and have to eat out every meal for more than one week, I often come home packing a few extra pounds around my waist.
Others who maintain a normal weight are protected by physiological conditions, like early satiety, malabsorption, or an active metabolism. Many are protected by habits—of having a structured life, of eating a routine diet that doesn’t have the novelties, variety, and other foods that can lead to obesity. Thirty to forty years ago, most people were able to maintain a normal weight just by going about their routine activities; they weren’t faced with too many choices, too many snacks, or extra-large portions. The extra burden of navigating through a plethora of options overwhelms those who are sensitive and pay attention to their surroundings—which is most of us.
We must finally accept the fact that most people cannot limit their intake without significant support, without controls on the environmental sources of food, and without constraints on the ubiquitous cues that make us feel hungry when we do not need to eat. Just as the physical environment constitutes a barrier for people with disabilities, the food environment is the primary barrier to achieving a normal weight for most Americans.
Another lesson from the disability rights movement is that the leaders were able to finesse the issue of cost to eliminate barriers. Initially, the cost of mandating curb cuts, building ramps, renovating bathrooms, and the like was estimated to be in the billions of dollars. Significant opposition to the ADA arose from both likely and unlikely quarters. Some religious groups opposed it because it would have required churches to make costly structural changes to ensure access for all. One church estimated it would have had to spend $6,500 for a ramp. 6
Many in the business community were also against the passage of the ADA. They claimed that the costs of accommodation would make business services and products unaffordable and would spell financial ruin to small businesses in particular. Yet a 1982 Department of Labor study found that most accommodations for the disabled were simple and cheap. For example, the cost of putting blocks under a deck to raise it for a wheelchair user was negligible, and 30 percent of all accommodations cost between $100 and $500—a pittance to allow someone to work full-time. Other changes did cost more—all buildings with more than two stories needed an elevator. Stores would have to widen their aisles to make room for wheelchairs. Phone companies had to hire operators to relay messages from the deaf using new telecommunications devices. Bus companies had to install wheelchair lifts. But the law included a potential break or waiver for businesses if the expense of the accommodation was beyond reasonable.
Surely, when it comes to implementing policies and regulations for obesity control, we will hear the same objections—that change is too expensive and will harm more people than it helps. Yet it is absurd to think that it is too difficult or expensive for a restaurant to figure out the nutritional content of the
Others who maintain a normal weight are protected by physiological conditions, like early satiety, malabsorption, or an active metabolism. Many are protected by habits—of having a structured life, of eating a routine diet that doesn’t have the novelties, variety, and other foods that can lead to obesity. Thirty to forty years ago, most people were able to maintain a normal weight just by going about their routine activities; they weren’t faced with too many choices, too many snacks, or extra-large portions. The extra burden of navigating through a plethora of options overwhelms those who are sensitive and pay attention to their surroundings—which is most of us.
We must finally accept the fact that most people cannot limit their intake without significant support, without controls on the environmental sources of food, and without constraints on the ubiquitous cues that make us feel hungry when we do not need to eat. Just as the physical environment constitutes a barrier for people with disabilities, the food environment is the primary barrier to achieving a normal weight for most Americans.
Another lesson from the disability rights movement is that the leaders were able to finesse the issue of cost to eliminate barriers. Initially, the cost of mandating curb cuts, building ramps, renovating bathrooms, and the like was estimated to be in the billions of dollars. Significant opposition to the ADA arose from both likely and unlikely quarters. Some religious groups opposed it because it would have required churches to make costly structural changes to ensure access for all. One church estimated it would have had to spend $6,500 for a ramp. 6
Many in the business community were also against the passage of the ADA. They claimed that the costs of accommodation would make business services and products unaffordable and would spell financial ruin to small businesses in particular. Yet a 1982 Department of Labor study found that most accommodations for the disabled were simple and cheap. For example, the cost of putting blocks under a deck to raise it for a wheelchair user was negligible, and 30 percent of all accommodations cost between $100 and $500—a pittance to allow someone to work full-time. Other changes did cost more—all buildings with more than two stories needed an elevator. Stores would have to widen their aisles to make room for wheelchairs. Phone companies had to hire operators to relay messages from the deaf using new telecommunications devices. Bus companies had to install wheelchair lifts. But the law included a potential break or waiver for businesses if the expense of the accommodation was beyond reasonable.
Surely, when it comes to implementing policies and regulations for obesity control, we will hear the same objections—that change is too expensive and will harm more people than it helps. Yet it is absurd to think that it is too difficult or expensive for a restaurant to figure out the nutritional content of the
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