Why do we get fat

Chapter 6 Why Are You So Fat? (3)
In Accra province, 25% of women and 7% of men who visit health clinics are obese. 40% of women in their 50s are obese."It is reasonable to assume that women between the ages of 30 and 60 are generally severely obese," wrote an associate professor at the Ghana School of Medicine. Furthermore, "obese female traders are extremely common in coastal towns in West Africa."

1970 - Nigeria: Lagos

5%的男性和30%的女性肥胖。在55岁到65岁的女性中，有40%非常胖。

1971 - South Pacific: Rarotonga
40% of adult women are obese, and 25% of them are extremely obese.

1974 - Jamaica: Kingston
Rolf Richards trained as a doctor in England before running a diabetes clinic at the University of the West Indies.In Kingston, 10 percent of adult men and two-thirds of women are obese, he reported.

1974 - Chile (second time)
A nutritionist from the Catholic University of San Diego reported that "only" 3300% of men and 11% of women were "severely malnourished" based on a survey of 9 factory workers (the vast majority of them engaged in heavy physical labor) , "only" 14% of men and 15% of women were "severely overweight". Nearly 45 percent of men and 40 percent of women over the age of 50 are obese.He also referred to research in Chile from the 20s, which noted that "the incidence of (obesity) is lowest among farm workers, office workers are the most obese, but residents of favelas are also generally obese."

1978 - Oklahoma

Kelly West, a noted diabetes epidemiologist at the time, reported that local Native American tribes had "fat men and fatter women."

1981-1983 - Texas: Starr County

The county borders Mexico and is about 320 kilometers south of San Antonio.William Mueller of the University of Texas and his colleagues measured the weight and height of more than 1100 local Mexican-Americans.The results showed that about 30 percent of men in their 40s were obese, even though the vast majority worked in agriculture or in rural oil fields. More than half of women in their 50s are obese.As for living conditions, Mueller later described: "Very simply, there is only one Mexican restaurant (in the whole of Starr County) and nothing else."

So, why are they getting fat?The theory of overeating, calories in, and calories out has always come in very handy to answer this question.If this group is so impoverished and so malnourished that even those who believe in "overeating causes obesity" can hardly imagine that they have enough food-such as the Pima people in the early 20s and 50s , a Sioux in the 20s, a Trinidadian in the 60s, or a Chilean ghetto in the [-]s—then it can be claimed: they must be getting too little exercise.If the group is clearly manual laborers—such as Pima women, factory workers in Chile, or Mexican-American farmers and oilfield workers—then it can be claimed: They eat too much.

The same theory applies to individual cases.If we're fat but eating properly—that is, we don't eat as much as our lean friends and siblings—these experts can confidently conclude that we're definitely lacking in exercise.If we were overweight and physically active, these experts would be equally confident that we were eating too much.

Therefore, experts believe that if we are not gluttonous, then we must be guilty of the original sin of laziness; if we are not lazy, then overeating is our original sin.

These conclusions are usually reached by ignoring some other fact that the group or individual in question is closely related.In fact, experts are often reluctant to learn more.

In the early 20s, some research nutritionists and doctors discussed the high levels of obesity among the poor, and were occasionally open about the causes of obesity.They were curious, as we should be, and not unreservedly supportive of firmly held theories.

At the time, obesity was still considered a malnutrition problem, not an overnutrition problem, just as it is today.For example, a 1971 survey in Czechoslovakia revealed that nearly 10 percent of men and a third of women were obese.Years later, when the data were published in the academic literature, the researchers of the survey began by stating: "Even if you visit Czechoslovakia briefly, you will find that, as in other industrialized countries, Obesity is commonplace in Czechoslovakia. It is perhaps the most common form of malnutrition."

Treating obesity as a form of malnutrition has nothing to do with attached moral standards, nothing to do with belief, and nothing to do with the implicit implication of gluttony and laziness.It just means something is wrong with some food supply, and it's up to us to find out.

In 1974, Rolf Richards, a British-educated Jamaican diabetes specialist, gave an unbiased account of the dilemma of obesity and poverty: "With existing nutritional standards, it is difficult to explain The prevalence of obesity is still so high in societies such as the archipelago, which are quite impoverished compared with the standard of living enjoyed by developed countries. Malnutrition or malnutrition is so common in children born in these areas that by the age of two years, almost It accounts for 2% of Jamaica’s children admitted to hospital. Malnutrition persists from early childhood to adolescence. Women start to appear obese at the age of 25, and the probability of obesity gradually increases after the age of 25.”

By malnutrition, Richards means not having enough food.Children in the West Indies are emaciated from birth into their teens and are generally stunted.They need more food, not just more nutritious food.Obesity spreads among these individuals (especially women) as they grow into adults.We saw this in the Sioux in 1928 and later in Chile, where malnutrition or malnutrition coexisted with obesity in the same population and even in the same family.

The following is a situation that has been repeatedly discussed recently, and it has been exaggerated as the "overeating leads to obesity" paradigm.This observation comes from a 2005 article published in the "New England Journal of Medicine" "A Paradox in Nutrition-Underweight and Obesity in the Developing World", authored by Johns Hopkins University Human Nutrition Center Director Benjamin Caballero.Caballero described what he saw at a clinic in a poor neighborhood of São Paulo, Brazil.He writes: "Waiting rooms are filled with mothers with young children, many of whom are stunted and have the typical symptoms of chronic undernutrition. Unfortunately, people in poor urban areas of developing countries have little awareness of the plight of these children. They might be surprised that many mothers with malnourished babies are obese."

Caballero then spelled out the dilemma that this phenomenon presents: "The coexistence of underweight and overweight presents a public health challenge." In short, if we want to prevent obesity, we must let People eat less; but if we want to prevent malnutrition, we must provide more food.To lose weight and prevent malnutrition, where do we go from here?

According to Caballero, the coexistence of stunted children with typical symptoms of chronic undernutrition and overweight mothers is not a challenge to public health, but a challenge to our "belief"—our Assumed health standards create challenges.

We believe that these mothers are overweight because they eat too much, and we know that children are stunted because they don't get enough food.We can then assume that mothers consume excess calories that would otherwise allow their children to thrive.In other words, you'd come to a strange conclusion: mothers would rather starve their children so they could feast on themselves.But this is obviously impossible.

Again: the coexistence of underweight and obesity in the same group or even in the same household is not a challenge to public health, but to our "beliefs" about what causes obesity.Please read on, we will find that this is not the only example.

(End of this chapter)