Will We Keep Getting Fatter?
BY MICHAEL D. LEMONICK
IF THE PAST 2 MILLION OR 3 MILLION YEARS OF human history are any guide, obesity is our unfortunate but inevitable fate. That's not to say there's any special secret to weight control. All it takes, as we've heard over and over, is a sensible diet and plenty of exercise.
But knowing and doing are two very different things, as hundreds of thousands of lapsed weight watchers have learned to their despair. The trouble, according to one theory, is that our best intentions about weight control go up against several million years of human evolution. Our hunter-gatherer ancestors literally didn't know where their next meal was coming from. So evolution favored those who craved energy-rich, fatty foods- and whose metabolism stored excess calories against times of famine. Love handles, potbellies, thick thighs are all part of Mother Nature's grand design.
From about 2.5 million B.C. to, say, 100 years ago, the system worked fine. Only a tiny percentage of humans had unlimited access to food and no need to lift a finger on their own behalf. What happened to them? Picture Henry VIII. But over the past century or so, most Americans have been living like kings. Thanks to increasingly high-tech farming methods, the fatty foods we crave have become plentiful and cheap in the U.S. and other developed nations. At the same time (thanks to the technology), physical exertion is no longer a part of most people's lives; most of us have to drag ourselves away from our computer or TV to burn off the excess calories. The result is inevitable. In 1950 one-quarter of Americans were classified as overweight; today half are.
And despite the harangues of medical experts, who constantly point out that obesity can lead to diabetes, heart disease and high blood pressure, that's not likely to change. We'll keep getting fatter and fatter, with no real prospect of reversing the trend.
Unless medical science provides a quick fix, that is. So far, the record on diet pills has been pretty dismal. Amphetamines, which speeded metabolism and suppressed appetite, looked promising in the 1950s and '60s but turned out to be physically harmful and powerfully addictive. Drugs like fen-phen and Redux, which alter the brain's chemistry, had scary side effects. Newer drugs like orlistat and food substitutes like olestra keep fat from entering the body, but they cause serious bowel discomfort.
Researchers are learning more every day about how the body processes fat. One clue involves the hormone leptin, which is pumped out by fat cells and signals lab mice, at least, not to eat. Unfortunately, as reported last week in the Journal of the American Medical Association, it doesn't seem to work on humans. Researchers are still trying to figure out why not- and how to get around the problem. Another natural substance, called pro-opiomelanocortin (POMC), seems to signal that it's time to stop eating. Mice treated with POMC boosters shed 40% of their excess body weight in just two weeks. Again, it's not clear that this will work in humans, but it's conceivable that POMC therapy- perhaps in shots- could someday be standard.
Scientists are also focusing on the differences between the two types of fat cells, known as brown and white. The former, active in young mammals (including humans), convert fat into heat rather than storing it. That's crucial in newborns, whose temperature regulation systems aren't fully formed. As we age, the brown cells become inactive and the white, which convert dietary fat to body fat, take over. Several research teams have found that by reactivating the brown cells in an adult animal with medication, they can burn off fat dramatically. Now the doctors are looking for a genetic switch that can do the same for humans.
What's becoming clear to scientists in the obesity business is that the body's energy-processing system involves not one or two but a maze of metabolic pathways. POMC, leptin and brown fat cells are part of the story. But nerve cells have also been implicated in weight regulation, and it's not clear how these different pathways relate to one another. "Not a month goes by," says Dr. Eric Ravussin, director of endocrine research at Eli Lilly, "without publication of a new pathway that regulates feeding behavior, giving us new potential targets."
Untangling this metabolic mess will probably take decades. But given the immense profits waiting for whoever can invent a safe, effective weight-control substance, drug companies aren't waiting. With the clues they have in hand, pharmaceutical firms are now investigating about 60 compounds, most of them based on some of the 130 genes that have so far been implicated in weight control.
So it seems likely that for a while at least we'll keep getting fatter. We can't undo evolution, and we haven't found a way to fool Mother Nature- yet. But before the 21st century is half over, with the body's fat-centric metabolism laid bare and the ability to manipulate genes part of medicine's standard tool kit, the trend may finally stop. Chubbiness may not disappear, but it could become optional. A future without Richard Simmons' commercials would be a wonderful future indeed.
Time senior writer Michael D. Lemonick is the author of The Light at the Edge of the Universe and Other Worlds.
BY CAMRYN MANHEIM
The end of the millennium is nigh, and the warning signs are clear: Be afraid. Be very afraid. Something wicked this way comes. Locusts? Plague? President Ventura? No, fat!
That's right- as we move into the 21st century, we are steadily getting pudgier. Fat, some would have you believe, is the fifth horseman of the Apocalypse, riding alongside War, Famine, Pestilence and Death. And it's immensely lucrative. Do you think the shrewd folks at Jenny Craig, Slim-Fast and Weight Watchers could make billions scaring the bejesus out of you about pestilence?Make no mistake- fat phobia is a big moneymaker for those who have figured out how to promote and cash in on self-hatred.
But the question remains. What exactly are we supposed to be afraid of? What's going to happen in 2025 if we gain, say, an average of 5 lbs. each?
Granted, the statistics- like the scales- don't lie. And it doesn't take an actuary to figure out that with Krispy Kreme going public next year and planning to open hundreds of new stores, America will continue gaining weight in the 21st century. Which means more and more people can expect to hear the antifat refrains that I've become so familiar with: "You won't live as long," "Your quality of life will be diminished," "Society will reject you," "You won't be able to keep up in the protest marches." (That was just in my family.) Let's take these one at a time.
Longevity. Despite the fact that life expectancy is increasing along with our national waistline, I'll accept that it is not the obese who are driving up the average. But should long life be our ultimate goal? I don't necessarily see the intrinsic value in a long life. I would rather live 60 years of epicurean joy than 120 years of ascetic misery. You could grant me eternal life, but if it were in a world without chocolate, I'd pass.
I suppose if wisdom and serenity accompanied the extra years we'd gain by self-denial, it might be worthwhile. But old age does not always bring with it sagacity and peacefulness (see Strom Thurmond). To the contrary, the so-called golden years are just an opportunity for drugmakers, insurance companies and medical facilities to take turns mugging our elders, like so many bullies stealing lunch money.
So for now I'll take quality over quantity. I would, however, like to reserve the rightto change my mind at 59.
Quality of Life. I can hear the Klaxon horns blaring when I mention quality of life. Because surely I can admit that my weight diminishes it- right? Sorry to disappoint, but the truth is, my life is quite good.
It's funny: I can engage in all sorts of fun, perilous activities like riding my motorcycle in Manhattan, catching ultraviolet rays in California or playing racquetball without goggles, and no one admonishes me "for my own good." But I order one slice of tiramisu and it triggers all kinds of unsolicited solicitousness. Thanks for the concern, gang, but for me that tiramisu and the freedom to enjoy it are- like music, the theater and friends- an essential part of what gives quality to my life.
Which isn't to say there haven't been times when being fat in America hasn't seriously bummed me out.
Rejection. I have been rejected by many more elements of society than I care to recount, and when family, friends and faculty told me this would happen with less metronomic regularity if I lost weight, they were right. But whose fault is that? Mine or society's?
Our nation has a split personality when it comes to consumption and the results of that consumption. We are constantly bombarded by mixed messages. Scrawny, undernourished models peek out from billboards adjacent to giant signs announcing the return of Wendy's Bacon Mushroom Melt. We are told to "Have it your way!" "Super size it!" and "Obey your thirst!" But mixed in with the chorus of "Consume, consume!" are the plaintive cries of "Stop the insanity!" Is it any surprise we wash down our Big Macs with Diet Cokes? The only people satisfying the insatiable needs of the capitalist machine and at the same time pleasing the thin-obsessed society are bulimics, the perfect citizens.
Though I have been oddly but warmly embraced in the past couple of years, I can't say that society won't reject you for being fat. It probably will. But I do dream of a time when we can all accept ourselves and one another. Maybe by 2025 we will have evolved into a supercool, supercaring superpower where all shapes and sizes can be regarded as sexy and beautiful. Where big women share space on billboards next to waifs and we embrace a progressive pansexuality. With advances in genetic engineering and antidepressants, maybe we'll all look and feel exactly the same. Wouldn't that be great? The Stepford Planet!"
But my hope is that by the year 2025 I'll no longer be getting letters every week from young girls who hate themselves because of the way they look.
Camryn Manheim, who won an Emmy for her work on ABC's The Practice, is the author of Wake Up, I'm Fat!
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