use of a threshold for establishing whether or not you’re obese—a body mass index (BMI) of 30—means that one can move from the overweight category to the obese category by virtue of gaining a few pounds. As a result, the 10-percent rise in obesity between 1991 and 2000 actually represented an increase in the average BMI of Americans from 26.7 to 28.1, an average weight gain of seven to ten pounds.
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*66 Between the second and third National Health and Nutrition Examination Study.
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*67 The USDA has a variety of mechanisms for estimating macronutrient intake—i.e., protein, carbohydrates, and fat—and has published a variety of reports on the subject. Not all are consistent, but the findings on fat consumption are. For instance, in April 1998, the USDA published an article entitled “Is Total Fat Consumption Really Decreasing?” This article reported that average total fat consumption for men aged nineteen to fifty, for instance, dropped from 113 grams per day in 1977–78 to ninety-six in 1989, the period that encompasses the beginning of the obesity epidemic. The relevant numbers for women of the same age group are seventy-three grams of fat per day in 1977–78 and sixty-two in 1989.
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*68 According to the Sporting Goods Manufacturers Association, sales of sporting equipment, apparel, and shoes increased from $21.9 billion in 1987 (the earliest year for which they have data) to $52 billion in 2004.
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*69 If each Pima drank two eight-ounce soft drinks a day, this would add roughly two hundred calories a day to Hesse’s estimate of both carbohydrate and calorie consumption, and so would drop the fat in the diet to 22 percent.
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*70 The Sioux were “essentially carnivorous” prior to their reservation life, the report noted, and so they “were never in the habit of eating much fruit and vegetables.”
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*71 Hrdlika did publish a list of diseases treated by the local agency physician, which did include one case of diabetes.
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*72 In 1804 and 1805, when the Corps of Discovery under Meriwether Lewis and William Clark made their historic overland expedition to the Pacific Ocean, they described game so plentiful in places that they literally had to club it out of their way to make progress.
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*73 This conclusion was supported four years later, when German researchers published their protocol for keeping these desert sand rats healthy in captivity. “It is well known that these animals will develop diabetes mellitus soon after their natural vegetative diet is removed and replaced with standard laboratory rations,” they noted. But both diabetes and obesity can be avoided if the animals are reared on a suitable diet: in this case, fruits, vegetables, and herbs, supplemented by an
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*74 If the surgery is done to rodents during hibernation, they will somehow slow the rate at which they draw on their fat supplies for fuel so as to compensate for the loss.
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*75 The diet constituted roughly 400 calories a day of protein, 270 calories of fat, and 900 calories of carbohydrates.
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*76 Though Stunkard’s analysis has widely been perceived as a condemnation of all methods of dietary treatment of obesity, the studies he reviewed included only semi-starvation, calorie-restricted diets.
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*77 Physical activity is the primary determinant of the
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*78 When Mayer wrote about this research, or when he spoke to reporters about it, he would often give the impression that it included multiple studies in animals and humans—“J. Mayer has since demonstrated, in both animal and human studies…,” as he would write in
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*79 Tanner did believe that William Banting’s French predecessor Jean-Francois Dancel had finally provided a “more sure basis” for the treatment of obesity, and that Banting himself deserved credit for “bringing the subject before the public in a plain and sensible manner.”
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*80 It also assumes that the ingestion of food greater than that required by the body won’t lead to a compensatory increase in energy expenditure, which is a point we’ll discuss at length in the next chapter.
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*81 This left von Noorden explaining that the detection of a retarded metabolism seemed to require “special knowledge and acumen on the part of the observer,” and he acknowledged that even he lacked sufficient expertise. Hence, the only way to diagnose a retarded metabolism was by implication: if the patient’s weight could not be “brought under control through intelligent regulation of diet and exercise,” then the patient probably had a retarded metabolism. The circularity of this argument was evidently not apparent to him.
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*82 This notion has survived in the suggestion that weight gain in children is exacerbated by the refusal of parents to allow their children to walk or ride to school, for fear they will be kidnapped or abused by strangers.
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*83 The common response to confronting this dilemma, as Bennett noted, “is to ignore it,” which is what happened to Bennett’s commentary, even though he discussed this issue at a 1986 obesity conference hosted by the New York Academy of Sciences and attended by many of the prominent authorities in the field.
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*84 That the toxic-environment hypothesis is deeply immersed in moral and class judgments is evidenced by the observation that few or none of the condemnations of fast-food restaurants include a coffee chain such as Starbucks, despite the copious excess calories it peddles. A “grande” (sixteen ounces) Tazo ® Chai Creme Frappuccino, ® for instance, with whipped cream has roughly 510 calories, equivalent to a quarter-pounder with cheese at McDonald’s. The same judgments are made when discussing physical activity: If we sit around all day watching television, we’re condemned as couch potatoes, and our obesity is only a matter of time. If we sit around studying or reading books, this same accusation is rarely voiced.
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*85 These observations do not contradict Magnus-Levy’s. Magnus-Levy compared lean and obese subjects. These latter observations compare those who gain weight to those who don’t; this difference, as we’ll
