Why are we so fat p. 1

Why Are We So Fat?

 

Americans enjoy one of the most luxurious lifestyles on Earth: Our food is plentiful. Our work is automated. Our leisure is effortless. And it's killing us.

Photograph by Karen Kasmauski

Written by Cathy Newman

Republished from the pages of National Geographic magazine

Finally, after two decades of trying and failing to lose weight with (you name it) Weight Watchers, NutriSystem, a nutritionist, a personal trainer—not to mention the therapist who derided her for being fat—it has come down to this: Linda Hay is sitting in an examining room at the Virginia Commonwealth University Medical Center in Richmond with Harvey Sugerman, the surgeon who will perform a gastric bypass operation on her in two weeks.

Gastric bypass is major surgery that shrinks the stomach's capacity from wine bottle to shotglass size and reconfigures the small intestine. Most patients lose about two-thirds of their excess weight within a year of surgery. "Gastric bypass surgery is a tool," Sugerman says. "It reduces the stomach. The patient can't eat as much. In most instances, if a bypass patient eats sugar or fatty foods, it provokes a dumping syndrome that causes flushing, nausea, sweating." You could say it's almost like Antabuse for the obese. Even so, the operation fails in 15 percent of cases. Some patients can subvert the surgery. They overeat by snacking continuously.
And the surgery is risky. The list of possible complications includes blood clots in the lung, pneumonia, infection, leakage from the reshaped intestinal tract, and—in one out of a hundred cases—death.
Hay, 39, is five feet five (1.7 meters) and weighs 314 pounds (142 kilograms); she is morbidly obese, which makes her a candidate for the surgery. Her managerial level job in the human resources department of a financial company demands tact, efficiency, and organization—qualities she exudes. She has a close circle of friends who would do anything for her, a clear sense of who she is, and few illusions of who she is not. She dresses stylishly, has long blond hair swept back by a headband, a classic oval face, and fair complexion. But she is—let's face it—huge.
When I ask about her decision to have surgery, she describes the humiliation of asking for a seat-belt extender on a plane; her reluctance to go to movies because the seats are too narrow; the time she signed up for a dating service, put down as body type "a few extra pounds," got a few responses, and then, opting for honesty, changed it to "large." This time she got none. She lists health problems associated with her weight: high blood pressure, varicose veins, pain and swelling in her feet and ankles, depression. "You take control for a while," she says, "then you fail yet again, and you're more depressed than ever."
Linda Hay has considered the risks and decided to have surgery. Nonetheless she is anxious. "No one at the office knows I'm going to do this," she confesses. "Someone said, 'Have a good week,' and my mind kept racing to the worst-case scenario…What if?"
It seems, I say, turning to Sugerman, that this is surgery for the desperate.
He nods. "Surgery is a drastic solution," he says, "but then obesity is a drastic problem."
It's become a far too familiar headline: Today one out of three Americans is obese, twice as many as three decades ago, and enough for the Centers for Disease Control and Prevention to declare obesity an epidemic. More disturbing are statistics relating to children: 15 percent of children and teens are overweight, a nearly three-fold jump from 1980. Obesity is defined by your body mass index, or BMI, a fancy calculation in which your weight is divided by your height. If it's 25, you're overweight. If it's 30, you're obese. Over 40, you're morbidly obese