100 Ways to Fight Obesity (Ep. 120)

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Our latest Freakonomics Radio podcast is called “100 Ways to Fight Obesity.” (You can subscribe at iTunes, get the RSS feed, or listen via the media player above. You can also read the transcript;  it includes credits for the music you’ll hear in the episode.)

Steve Levitt runs a  consulting firm called The Greatest Good. It is occasionally hired by a philanthropist or foundation to look into societal problems. That’s what happened recently, when the Robert Wood Johnson Foundation asked The Greatest Good to put together a brainstorming session on childhood obesity. Stephen Dubner moderated the event. In this podcast, you get to be a fly on the wall as a dozen participants explore the biological, behavioral, political and economic angles of obesity.

The participants are: Peter Attia, a former surgeon who now runs a nonprofit focused on nutrition; Kelly Brownell from the Rudd Center For Food Policy & Obesity at Yale; Geoffrey Canada of Harlem Children’s Zone; Bill Dietz, the former director of the Division of Nutrition, Physical Activity, and Obesity at the CDC; Chris Economos, who studies obesity and childhood nutrition at Tufts ; Steven Gortmaker of the Harvard School of Public Health; Nobel laureate Daniel Kahneman; Harvard economist David Laibson; RWJF Health Group senior vice president Jim Marks; Brian Mullaney, co-founder of Smile Train and WonderWork; Eric Oliver, a political scientist at the University of Chicago who has written a book about obesity; and Mary Story from the School of Public Health at the University of Minnesota.

For all the myths surrounding obesity and weight loss, the fact is that 17% of children and adolescents in the U.S. are now obese. Chris Economos puts this in context:

ECONOMOS: The obesity rates for children have tripled in the United States over the last 40 years. And there are dramatic health and societal consequences that result from that. Some are immediate and some are long-term, particularly because childhood obesity leads to adult obesity. 

Research shows that half of obese children become obese adults, compared to about 25% of non-obese children. And the cost to society is high: obesity-related healthcare makes up almost 20 percent of our total healthcare spending, which represents nearly 20 percent of our GDP.

Geoff Canada gives his perspective on why this problem is so hard to fix:

CANADA: I have become increasingly convinced, and I’m no scientist, that a lot of this is addictive behavior, that the sugar that folks consume, it is an instant feedback, eating a Twinkie. Maybe I’m the only one that gets that satisfaction from doing it, but lots of families I think are using food because the rest of their lives are so horrible that this is something that you can enjoy. And now Geoff wants to take that from you, too.

As you’ll hear, no idea was off the table, no matter how daunting or unpalatable. In fact, an idea that Levitt floated is one that he’s been dreaming of for a while.


Steve Cebalt

One of the real obesity culprits for many is our super-sedentary lifestyles. I exercise vigorously each day at 5 a.m. for 90 minutes; the rest of the day I barely move at all. Drive to work; sit at a computer or in meetings; drive home; sit on the couch and read or watch TV. Literally only my fingers move on the omputer keyboard or remote control. The hazards of such lengthy sitting go way beyond obesity, as recent studies have shown. I live in a town where driving is a must. People in NYC get much more activity just getting around the city, but here in Indiana mass transit is non-existent and no one walks anywhere.

Rebecca Wentworth

I Thought there would be some really different studies and observations. I found many ideas from a book called Eat Fat and the Fat Fallacy. Also the ideas about food grown with chemicals.
Then there are no studies on people who are thin or too thin. How many people deny themselves
food to the point of anorexia. Availability of healthy food has not been addressed. It's all been
on behavior. No mention of the effect yo yoing. Then there's the relationship between illness and weight gain and loss. In other words you put together a bunch of people who are preaching to each other. I'm disappointed that you haven't done any real statistics. Another words
waste of my time

Bruce Alter

I really enjoyed last week’s podcast on obesity. However, I was about to throw my MP3 player out the window due to the arrogance of the nutrition “experts” that believe they all know what is best for the rest of us. So they don’t believe we need sweets and snacks and should therefore be prevented from buying/eating them. Well I don’t think we need their advice but I’m not pushing to prevent them from speaking their mind.

The podcast only looked at one side of the costs of obesity. Freakonomics has taught me to look at all the costs on all sides of the issue. Yes, healthcare on average will be more expensive for people that are obese. However, let’s also consider the costs of staying healthy: Gym membership, exercise injuries, opportunity cost of personal exercise/injury recovery instead of producing value for others.

Give us information and knowledge and let us decide what is best for ourselves.

There are 2 sides to the costs of healthy/unhealthy living. Don’t let these “experts” get away with considering only the costs they deem negative. And keep your hands off my bag of chips.

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Pdubble

I think you're partially right with the experts seeing the obese as acted upon, but I think it is also an issue of reality. They understand the realities more than the economists who are just throwing out ideas.

I think the biggest thing we are fighting with obesity is that humans naturally want to do nothing, and we have built towns and cities that can only be traversed by vehicle. We increasingly do sedentary jobs or no job at all. More than that we are genetically predisposed to like the taste of high calorie foods. Ask any kid, "Do you want an apple or a Twinkie?" 9 times out of 10, that kid wants a Twinkie.

Matt Aquavia

i find it interesting that the Nutrition experts have separated the victim from the crime when it comes to taking care of oneself. In fact the suggestion by Kelly Brownell to create a government agency (another???) to monitor, study, brainstorm etc. the epidemic in the US is admirable in its social sensitivity but really do we need to study why people are fat and why they are sick!
Ride a bike, buy better calories, challenge social norms. Eliminate elitist markets for food (im talking to you Whole Foods). Make quality nutritious food more accessible and affordable for everyone and shame people into reassessing their eating habits. It worked with cigarrettes why not Apple Jacks.

Brett

Change the nutritional information measurement from grams to ounces.

Sue

One overlooked factor that I think is contributing to America's obesity epidemic is the widespread use of psychiatric medications, many of which cause weight gain and diabetes. Antidepressants are also being prescribed to younger and younger children so they could also be contributing to the childhood obesity problem.

I gained fifty pounds when I started a medication and no amount of exercise or dieting will change it. It was a direct consequence of starting a psychiatric medication.

Jason

I really enjoyed this podcast!

I think the panelist who suggested that we focus on exercise and healthier eating hit the nail on the head. As an economist, my take on the subject (indeed any subject) is that we need to align the incentives rather than just harping on the negatives and using scare tactics. It kind of follows the field of psychology where punishment is not nearly as effective as punishment combined with positive reinforcement. Scare tactics aren't punishment per se, but I think the sentiment is the same as it relates to childhood obesity.

Perhaps direct the scare tactics towards the parents and focus on rewarding the kids for healthy behavior.

Creating even more burdensome regulations always has negative unintended consequences, whereas a well-crafted incentive scheme could reap larger rewards without the same negative consequences. I think this is particularly revealing once you listen to what their post-game wrap-up had to say about the economists all smelling the stuff and none of the insiders wanting to. The insiders most certainly see the environment as the sole cause of the epidemic, hence the reason they are so quick to jump to regulations against the makers of these products, whereas the economists seem to be more concerned, or at least more open to considering that you have to empower to individuals, kids and parents in this case, to make the right decisions.

In my view you always win when you empower people to take responsibility and control of their own lives.

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Patrick Aleph

What about opening a salad bar in the ghetto with prices like fast food? Great test to see mkt demand for healthy options and time trade offs

Vivek

Can I get the name of the last song that was played in the show with the bari sax? Groovy!

AlexM

When Steve Levitt mentions that he could increase his intake 500 calories/day and only gain 40 pounds in his lifetime, how is he arriving at that conclusion? I realize that as you eat more, your metabolism will increase. Also, as you gain weight, your caloric consumption will have to increase to move the extra weight around. However, as you get heavier, energy levels will decrease, the amount of activity he'd be able to do would drop, and thus he would likely gain much more than the 40 pounds he claimed. Does anyone know of the research he's citing to come up with his estimate of 40 pounds?

Erin Marquez

I have noticed that the quality of the food I consume drops dramatically when my husband and I are both in high stress situation, whether it is related to work, travel, etc. I think that this is related to available free time meaning that people may choose terrible food more due to limited time to prep a meal as opposed to cost; I choose an inexpensive pop in the over pizza with high sodium because it is faster; it would be cheaper on a $/food mass to buy raw materials and be able to create several homemade pizzas. But who has the time for that when you are a family with 2 full-time working parents? I would be curious to see the relationship between estimated free time and obesity within and income bracket (middle class bracket, costal US vs. Midwest, etc). This is an American culture issue. I am all about pushing the market to value happy and healthy employee in order to maintain productivity...if you have that then you may spark a food and free time culture similar to Europe.

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Al

The people on the panel blaming companies and marketing are basically shunning the free market philosophy. If companies are not allowed to market or sell goods (as a result of laws aka government force) there will be no businesses and everyone will be working for the government or without a job. Is that supposed to better for children, having parents without jobs? No, of course not. The ONLY issue is that of self control and individual responsibility. No one forces a Twinkie down your throat. If people truly believe that a non-obese society is the way to go, let the free market and voluntarism reflect that.

Mikael

In the podcast Steve Levitt says, " roughly every extra thousand calories I consume shorten my life enough that I would pay about a dollar." I would like to know more about how this calculation was done, what all factors it included, and exactly how much life (in time) is $1 worth?