Getting The Skinny On Nutrition

By Donna Britt

Friday, March 12, 2004; Page B01

http://www.washingtonpost.com/wp-dy...-2004Mar11.html

Those of us who've never smoked can only imagine the pull of cigarettes on people for whom smoking is a hated habit. We'd be tempted to feel superior to them -- if we'd never eaten.

Who hasn't stuffed his or her mouth with food that's questionable, if not straight-up unhealthy? If I'm half asleep and smell sausage frying, my intermittent vegetarianism retreats before memories of scrumptious, fat-laden childhood breakfasts.

No wonder obesity is about to overtake cigarettes as America's leading cause of preventable deaths, as reported Tuesday by the federal Centers for Disease Control and Prevention. The combination of Americans' widespread lack of exercise and less-than-healthy diets has created a fatness epidemic that may soon prove deadlier than smoking. If current trends continue, the death toll from obesity will next year surpass 500,000 annually.

One thing is puzzling. Smoking-related deaths have declined for years thanks to cigarettes' well-publicized link to disease -- not to mention government anti-smoking campaigns and the ubiquity of no-smoking areas. Why hasn't that happened with obesity?

In all of human history, there has never been more emphasis placed on the importance of eating right and exercising. Not a day -- an hour? -- goes by without us hearing about the Atkins, Weight Watchers or gummy bears diet. Hollywood role models such as Nicole Kidman, Naomi Watts and Jada Pinkett Smith couldn't be tinier.

Yet we're getting fatter. Why?

Ironically, the relentless public emphasis on healthy eating and dieting combined with the idealization of the skinny over the healthy-sized results in beleaguered people saying, "Forget about it."

When it comes to weight, "the goals seem too lofty," says Arlington bariatric physician Denise Bruner, who likens the situation to a first-grade teacher dumping on students' desks "all the books they'll have to read throughout 12 years of schooling. They'd be so overwhelmed, they'd give up."

Add to that movies, TV and fashion magazines "in which women look like totally wasted Auschwitz victims, and you have people thinking, 'This is where you need to be to be attractive?' " In fact, Bruner says, reducing one's weight by as little as 10 percent can reduce the medical complications of obesity, which include diabetes, high blood pressure and high cholesterol. "Losing more is great. But just modifying your eating behavior by reducing white sugar, white flour and processed foods and getting a good 30 minutes daily of some physical activity works wonders."

Small changes work. Substituting water for your daily 16-ounce bottle of Coke for two weeks can mean a whole pound lost. Ordering Wendy's mandarin chicken salad without the dressing cuts 250 calories.

Okay, okay -- we need a lifestyle change. We all know that. So why do we still reach for the Haagen-Dazs?

Ask Anne, a marketing executive who recently underwent gastric bypass surgery -- having her torso cut open and her stomach reduced by more than three-quarters -- because she couldn't stop eating.

Anne -- her middle name -- wishes she had a buck for everyone who said, "You have such a pretty face," when the real message was, "Too bad about your body."

"Morbidly obese" at 300-plus pounds, Anne had lost and regained 100 pounds three times during her 44 years.

"I tried everything . . . Optifast, Jenny Craig, Atkins. Everything my doctor felt was acceptable," she says. "Nothing was a long-term solution."

Her eating -- inspired by her high-stress job, demanding family and personal history -- always subverted her. During her childhood, her old-fashioned father couldn't express affection, "but he was a great cook," she says. "To apologize or reward you, he'd make your favorite food. . . . Mine was his homemade pizza."

But 300 pounds?

As with alcohol, "for some people, food is an addiction," Anne says. When people tell her surgery was "the easy way out," she suggests that "only fat people are questioned for having surgical intervention for a life-threatening condition. For me, it was reasonable."

So is it reasonable for lawmakers to take away people's right to sue McDonald's and others for helping us get fat? On Wednesday, the House of Representatives passed the "cheeseburger bill," which would prohibit people from going to court to blame the food industry for their tubbiness. The measure is about people using "common sense in the food court, not blaming other people in the legal court," said its sponsor, Rep. Ric Keller (R-Fla.), whose district happens to be home to the owner of the Olive Garden and Red Lobster chains.

Why the multibillion-dollar fast-food industry needs special congressional protection escapes me. Few lawsuits have been brought against fast-food giants, and not one successfully. With nearly two-thirds of American adults and 15 percent of kids overweight, fast-food companies should share some responsibility -- by clearly labeling their products' fat and calorie content.

Cigarette smokers know exactly what they're getting, Bruner points out. Few who buy Starbucks's "low-fat" blueberry scone realize they're getting a 460-calorie "diet" item.

"People deserve to know that when they spend 20 more cents for 'super-size,' they're getting an extra 300 calories," Bruner says.

If they did, she says, "they might decide it's not a bargain in any way."