by Barbara Berkeley, MD
With New Jersey's Chris Christie giving tonight's keynote address at the Republican Convention, the topic of his weight is bound to resurface. I thought this might be a good time to repost an earlier blog written last October when Christie was a looking like a potential candidate. His new national prominence immediately unleashed discussion of his weight and what his size meant about his character. This piece was titled: Chris Christie: We Have Met the Enemy and He Is Us. Just some food for thought prior to this evening's viewing......
October 3, 2011
The past week has seen a (dare I say it?) feeding frenzy around the issue of New Jersey Governor Chris Christie's weight. With a possible presidential bid in his future, Christie's size has become the topic du jour. Is a corpulent candidate less fit for office than a lean one? Does an overweight president better reflect who we are as a country in 2012?
While you'd have to be blind not to notice that Christie is a big guy, no one had called particular attention to it until Eugene Robinson of the Washington Post launched the first salvo this week. Robinson's article, which linked Christie's weight with a lack of discipline and ended with the advice to "eat a salad and take a walk" was roundly criticized...even by fellow liberals. Guests on MSNBC's Morning Joe who are normally sympathetic to Robinson piled on. "This crosses the line", one complained. But while Robinson's piece might be interpreted as a partisan low blow, it actually raised important questions about our perceptions of obesity. It also exposed the deep ambivalence we have about our growing national waistline.
In yesterday's New York Times, the admittedly weight-challenged food writerFrank Bruni added his voice to the Christie controversy. Bruni vigorously wrote that a person’s size should not factor into decisions about his capabilities. “Girth doesn’t equal character”, he said. Human beings have foibles after all. Did Clinton’s womanizing or Obama’s smoking make them less effective as leaders? If your answer is no, you can’t assume that Christie’s obesity will have any impact on his ability to act as President.
A third, and more dismissive view of Christie’s weight came from Michael Kinsley writing for Bloomberg View. Christie should be discounted, he wrote, “unless he goes on a diet and shows he can stick to it.” What about the argument that all humans are imperfect? He’s willing to forgive Obama and Clinton, but when it comes to Christie’s big belly he is less sanguine.
So why should Christie’s weight be more than we can bear in a president?......One reason is that a presidential candidate should be judged on behavior and character, not just on policies
Controlling what you eat and how much is not easy, and it’s harder for some people than for others. But it’s not as difficult as curing a chemical addiction. With a determined, disciplined effort, Christie could thin down, and he should -- because the obesity epidemic is real and dangerous. And the president inevitably sets an example.
Spoken like someone who has never tried to lose 50 or 100 pounds.
More importantly, Michael Kinsley deployed the C-bomb: character. Kinsley is not alone in believing that being overweight is a character flaw. This is an awfully tough position to voice aloud. To begin with, it defines 70% of America as weak-willed, food-obsessed incompetents. Yet this is the guilty, politically incorrect belief of many people who have been lucky enough to avoid obesity. Believe me, I know. As someone who is of normal weight but deals with obesity, I hear the voices on both sides of the divide.
Three very different voices. Three different views. Or are they? What is most interesting about the Christie debate is the degree to which all parties agree. It is within this area of agreement that we can find the true nature of America’s beliefs about obesity. It is also within this area that tragedy lies. The tragedy is that we so completely clueless about how to deal with such a major threat to the health of our country.
All three authors use perjorative or dismissive language when describing obesity. This includes Bruni, who defends and sympathizes with what he calls Christie’s “evident gluttony”. Gluttony? Isn’t that one of the seven deadlies? Having Christie sit in the middle seat on a crowded airplane, says Bruni, “would be cruel to the people on the window and aisle” and “many voters aren’t going to want to look at him as often as they must look at a President.” After recounting his own torturous experiences with weight control, Bruni concludes that the whole weight control thing is just too shallow and he’d rather have “a big, fat President”. He mentions the possibility that morbid obesity could impact Presidential health only as an afterthought. I suspect that Bruni is like so many of my patients. He understands the extreme difficulties of dealing with weight and hates people who are prejudiced against the obese. A guilty part of him, though, harbors the same feelings. This uncomfortable truth is the topic of many of the discussions that take place in the group I run for weight maintainers. They felt awful about being heavy and after losing the weight they often feel even worse when they find themselves judging people who are still obese.
All three authors believe that obesity is caused by a weakness. In the case of Robinson and Kinsley, it’s a weakness of will; the inability to “just say no”. In Bruni’s case, it’s a weakness caused by addiction and compulsion. Whatever way you look at it, the obese are somehow flawed.
All three authors buy the usual nonsense about obesity. “Take a walk and eat a salad” is just another way of saying that anyone can control weight by eating less and exercising more or that moderate changes to lifestyle work. According to Robinson:
…. the science of weight control now takes into account the role that genetics might play, along with psychological factors that lie outside our conscious control. There are new options, including gastric surgery, beyond the dieting roller coaster — lose 40 pounds, gain it all back — that Christie says he has been riding for years.
What science is that? The obesity epidemic is only about 30 years old, no where near long enough for 70% of America to undergo a genetic change! And to which new options is he referring? Could he be talking about the 3 or 4 new medications which the FDA declined to approve for physician use? Or to the gastric bypass surgery which often fails to provide a permanent solution while exposing patients to significant operative and post-operative risk?
On the other side of the fence, Bruni is no better. Remember his gluttony comment? Here is his amplification:
Let’s talk as well about that gluttony. It may say much more about his (Christie’s) allotment or early rearing than his resolve. Over recent years, there has been more and more scientific consideration of obesity as an expression largely of hereditary and environmental factors beyond a person’s ready control, and there has been evidence that one person’s fatness versus another’s thinness may to a significant extent be foreordained.
I guess Bruni is reading the same science journals as Robinson. I wonder what the Pima Indians would think of this. Completely lean and without modern disease until they began eating sugar and flour and living on the reservation, the Pimas now have one of the worst health profiles of any ethnic group. Were they genetically pre-ordained for obesity or did their perfectly functional genes run afoul of a sick and clueless food world?
Our 24-hour-a-day news cycle and our tabloid approach to politicians is perfectly designed to make Christie’s corpulence the target of gossip, character assassination and schadenfreude. But what if we lived in a more perfect world? What if Christie turned his blunt, honest-to-a-fault style on his own weight problem? What if this became the opportunity to discuss new and more effective solutions for our growing problem with fat and fat-created illness?
Here’s what I would tell Christie..or any politician (or columnist) who is willing to listen.
We need to stop repeating the same old nonsense. We won’t lose weight or become healthy again until we return to something close to our original eating patterns. This will take a national effort that includes incentives and disincentives to major food producers and a simple and oft-repeated message. In particular, we have to vastly decrease the amount of sugar and starch in our diet. Apart from their extremely deleterious affect on fat storage, these foods are addictive. If we worked relentlessly on this message alone we would do more good than the past twenty years of telling people to eat less and exercise more.
We also need to educate our kids and ourselves about how our own bodies work. We need to show people the graphic details. How does sugar tear up our blood vessels? How does the food we eat wind up as a gummy clot inside a major artery and cause a piece of our brain to die in a stroke? What exactlyis diabetes and why is it that we really, really don't want to get it? We can’t know this unless we know ourselves and right now, we understand our cars better than our own bodies. Basic physiology and pathophysiology (the study of disease) should be a mandatory part of the curriculum of every grade school and high school in America.
The obesity problem is not easy to solve but no one benefits from the advice to just be more disciplined. If we all understood what is at stake---from a disabled and depleted population to the bankrupting effects on our medical budget---perhaps we could get serious. Lest we forget, Chris Christie is us.