Lately, I've had a dozen or so conversations with my more conservative friends about Michelle Obama's recent campaign to battle the epidemic of childhood obesity. Continually, they've responded to me that it's an issue of personal freedom, that the government shouldn't be interfering with how someone decides to parent, and that it's a matter of personal responsibility.
Thbpbpbpbp. That's what I say.
The author, Dr. Mark Hyman, makes an acute observation: people who are obese often suffer from food addiction, and food addiction is a real thing:
New discoveries in science prove that industrially processed, sugar-, fat- and salt-laden food -- food that is made in a plant rather than grown on a plant -- is biologically addictive.
The "just say no" approach to drug addiction hasn't fared to well, and it won't work for our industrial food addiction, either. Tell a cocaine or heroin addict or an alcoholic to "just say no" after that first snort, shot, or drink. It's not that simple. There are specific biological mechanisms that drive addictive behavior. Nobody chooses to be a heroin addict, cokehead, or drunk. Nobody chooses to be fat, either. The behaviors arise out of primitive neurochemical reward centers in the brain that override normal willpower and overwhelm our ordinary biological signals that control hunger.
Hyman then documents the behaviors and characteristics of people who suffer from addiction:
Substance is taken in larger amount and for longer period than intended (a classic symptom in people who habitually overeat).
Persistent desire or repeated unsuccessful attempts to quit. (Consider the repeated attempts at diet so many overweight people go through.)
Much time/activity is spent to obtain, use, or recover. (Those repeated attempts to lose weight take time.)
Important social, occupational, or recreational activities given up or reduced. (I see this in many patients who are overweight or obese.)
Use continues despite knowledge of adverse consequences (e.g., failure to fulfill role obligation, use when physically hazardous). (Anyone who is sick and fat wants to lose weight, but without help few are capable of making the dietary changes that would lead to this outcome.)
Tolerance (marked increase in amount; marked decrease in effect). (In other words you have to keep eating more and more just to feel "normal" or not experience withdrawal.)
Characteristic withdrawal symptoms; substance taken to relieve withdrawal. (Many people undergo a "healing crisis" that has many of the same symptoms as withdrawal when removing certain foods from their diet.)
Many drugs are outlawed in our country because the cost is so devastatingly high to society. Only the looniest of libertarians declare this as a violation of civil liberties. Research shows that sugar stimulates the brain's reward centers through the neurotransmitter dopamine, exactly like other addictive drugs. Additionally, PET scans show that high-sugar and high-fat foods work just like heroin, opium, or morphine on the brain. These same scans show that obese people and drug addicts have lower numbers of dopamine receptors, making them more likely to crave things that boost dopamine. It is only too clear that people who are obese suffer from addiction, and, just as drug addicts, need treatment in order to work through these addictions.
Dr. Hyman concludes this terrific essay with the following suggestions:
Build the real cost of industrial food into the price. Incude its impact on health care costs and lost productivity. Subsidize the production of fruits and vegetables. 80 percent of government subsidies presently go to soy and corn, which are used to create much of the junk food we consume. We need to rethink subsidies and provide more for smaller farmers and a broader array of fruits and vegetables. Incentivize supermarkets to open in poor communities. Poverty and obesity go hand in hand. One reason is the food deserts we see around the nation. Poor people have a right to high-quality food, too. We need to create ways to provide it to them. End food marketing to children. 50 other countries worldwide have done this, why haven't we? Change the school lunchroom. The national school lunch program in its present form is a travesty. Unless we want the next generation to be fatter and sicker than we are, we need better nutrition education and better food in our schools. Build community support programs with a new workforce of community health workers. These people would be able to support individuals in making better food choices.
I don't see Michelle Obama's campaign as government overreaching or an abuse of power. The people who are saying that are simply too invested in an anti-Obama mindset. The devastating affects of obesity and food addiction are destructive to the country, and action needs to be taken. I'm thankful for Michelle Obama's campaign, for Dr. Hyman's article, and for all health professionals working to stem the tide of childhood obesity and America's favorite drug.