The Obese America Annual Meeting

But elsewhere in this big country, people are big, too. However, this is in the width department more conspicuously and dramatically than in the length. Take a walk through, say, O'Hare airport in Chicago during shorts-and-t-shirt-season, and it is difficult to avoid the impression that you have landed there during the Obese America Annual Meeting and Bottomless Buffet. Or walk down Thames St. in Newport, RI, and watch tourist adolescents the size of spin dryers ambling along in their Nike stretch clothing, double-scoop ice cream cones in hand, their earnest indolence a testimony to their mastery of remote controls and the avoidance of all physical movement more demanding than opening five ketchup plastics for their Super-Deal orders of french fries. Recent autopsies of U.S. youngsters accidentally killed revealed arteries already clogged to an extent that would generate justified alarm among middle-aged patients already in treatment for atherosclerosis.

There is what is by now a well-known national epidemic of obesity, especially and alarmingly among young people. The Gross National Grossness increases steadily. This seems pathological, and it is. Generous overweightedness clearly affects the ability to move about and to exercise and it appears to cause feelings of depression and a host of concrete medical glitches from high blood pressure to diabetes to pains in the lower back. If we are to judge only from the success of diet books, it also stimulates an endless quest for less-of-me. And a glance at a year's run of any of the magazines directed to women (and increasingly to men) will reveal that each month presents the latest and best diet that will decisively turn things around?by eating only mangoes or no pumpkin seeds or only green vegetables steamed in imported Macedonian water. But very evidently they don't work, because the very next month, look, there's another sure-fire diet.

Meanwhile it appears Americans drink more soda pop than water, which is more or less incomprehensible, except for the number of well-positioned cold boxes selling the sugared and caffeinated liquid everywhere you look. Especially in schools and universities, which now commonly engage in the vicious business of selling the exclusive rights to individual manufacturers to fatten their students with sugar water. For example, I work in an institution where there is a legal embargo against any soft drink not made by Coca-Cola.

Yet the matter is more complicated still. First of all, overweightness is frequently treated as a sign of slovenly weakness of character, and people who suffer from their size also must endure the slings and arrows of self-righteous folk who assume only willpower and exercise affect size. Of course these are important, perhaps the most important, general factors. But there are genetic differences between people that lead to metabolic differences, and hence different rates of turning food into fat on one hand or action on the other. People taking a variety of necessary drugs or being subjected to a host of regimes of treatment may also gain weight, almost as if the body is sufficiently perturbed at being treated unexpectedly and so gathers up some spare resources, body fat, in case things turn even worse.

And weight by itself, though obviously significant, may be less important than where it is deposited on the body. For example, a study of 31,702 women in the Iowa Women's Health Study indicates that the best mortality predictor of cardiovascular disease and cancer for example is not weight itself but the ratio of the waist measurement to the hip. Egg-shaped women are at risk, just as it has been suspected for a long time that big-bellied men are too.

If fat is associated with dying, it is also associated with the beginning of sexual maturity. It was discovered long ago by Rose Frisch of the Harvard School of Public Health that body weight was the trigger for female sexual coming of age?of menarche, or first menstruation. Once a certain threshold of body weight to skeletal size is reached, the body appears to somehow sense that the female is now able to sustain a pregnancy and so sexual cycling begins. Many very skinny women do not cycle or do so irregularly?the body appears to rebel against the possibility of assuming another burden, of pregnancy and breast-feeding, in addition to whatever it is that is making the woman highly thin. Dancers and athletes, for example, are regularly irregular.

One of the noisy arguments from the family values people is that youngsters should abstain from sexual activity, ideally until marriage?sometime around 26 years of age on average. Good luck. The matter is made far more complicated because obese girls are more likely than others to reach premature puberty. A recent International Conference on Dietetics was told that many of the features associated with the onset of puberty were shown by weighty girls as young as eight years of age. While they were as social and emotional beings extremely immature, their bodies?because of weight?were now able to function as if they were grown women. And of course, if they were seeing sexual maturity when they looked at themselves in the mirror, others would notice it too, with whatever consequences we may imagine for precocious and turbulent sexual encounters.

Meanwhile, back in Ally McBeal territory, teenage girls who diet too violently become deficient in iron, which has an evident effect on their intellectual competence. Of 164 girls studied in London between ages 11 to 18, fully one-quarter of them showed iron levels classified as anemia by the criteria of the World Health Organization. Evidently most at risk were those on vegetarian diets who failed to replace necessary iron delivered by meat. Since humans evolved as carnivores, or more accurately omnivores who will eat anything?see the beginning of this column?this is wholly understandable. When they were provided adequate iron, their intellectual performance improved.

The message is clear that any extreme or relatively bizarre or unduly plentiful or too limited diet is likely to raise problems for a species accustomed to living as hunters and gatherers and designed to do well on a varied diet and a fair amount of physical activity. The best diet is of straightforward information.