On obesity

Just a photo of a nice croc I saw

I read an article recently about how to best manage obesity as a society. It wasn't a medical journal, though, it was an economics/finance/management report published by the McKinsey Global Institute. It was written by business analysts and economists; which was interesting to me as usually I see these articles about obesity in the context of public health and medicine. And it got me thinking about just how did obesity become a problem. The report is very interesting and I certainly don’t intend to repeat it all; in fact what I’m writing here are merely my own insights and opinions that took this article as a starting point. But if you get the chance, read at least the executive summary of the McKinsey report here.

Food has always been a necessity for us humans, and obesity is not a new thing. The problem is the high prevalence of obesity and the subsequent high rate of health problems for which obesity is a major contributing factor. You then recall times from history like the great depression and wonder how did we overshoot so much that now obesity – an excess – is the problem. The thing is that perhaps the exact same things that brought us out of the great depression brought us to high rates of obesity.

Towards the end of the great depression, a lot of interesting things began to happen. Yes, there was the onset of World War II, which brought about destruction – and subsequently, at it's conclusion, a great need to re-create, produce, manufacture, and re-build the world! Industries soared. Governments and commercial enterprises became really good at economics and business. Extremely good.  And with the end of the great depression, of course, food became more than a rationed commodity, more than a human need, it became a highly lucrative commercialised industry more than it had ever been in our society. The success story of business and industry tracks that of obesity rates. Every strategy that led industry to thrive, also drove obesity rates to rise.

Think about all the strategies that make businesses successful, and then you finally may get closer to finding an answer to the question of how did we as a society let obesity rates rise to the levels they are today. Well, firstly, a great business needs a product that is desirable. What is a more desirable consumable than food? And more than being a desire, it is an actual human need! Food is one of those things that would sell even if it wasn't advertised anywhere.

But food is advertised – and very well; a great marketing strategy is one of the fundamentals of a successful business. The interesting thing is that the food that receives the most advertising is the least nutritious and yet most energy-dense. Unfortunately as a society we developed technologies and became really good at modifying our environment so as to minimize the amount of energy our own bodies expend. Our progress as a society, our advancement, is because we built efficient machines that use external energy to do the hard labour we previously took on. We walked greater distances, lifted more, did more physical work just in our everyday than we do now. And hence the large disparity between the energy content of what we consume (that energy-dense food advertised so heavily) and the energy we expend – with excess energy being stored in our bodies as fat.

Marketing isn't just about direct advertising, though. It even involves exploiting existing societal norms and evolving new ones. What do I mean by this? Actually this concept is the most wide-ranging aspect of how business, and food as an industry, has grown. But let’s take, for example, just two interesting quirks of us human beings: 1) we perceive more as better, and 2) we perceive bigger as better. Have you ever tried to buy just a Big Mac at McDonald’s? Well, let me tell you it costs nearly as much as a Big Mac meal, with the fizzy drink and the fried potato chips included. We all prefer to get more for our money, so we do end up buying a much higher energy intake for just a few cents more. But it’s not just about the big bad fast food giants, even our supermarkets do it.  They sell us even staple foods, but at a cheaper rate if we buy more of it. Why? Not because they think “poor, poor, undernourished people; let them have more food”. No, they do it because we are consumers, and only consumers to them. They sell us more so we pay more (we think we’re making a saving, but the reality is companies never underprice their items even in the “deals” they give us). The concept of portion size is similarly related. And portion size isn't just about how big our meals are, but the fact that because our foods are so energy-dense and our lifestyles for the majority of us are so sedentary, the physical-size of our meals isn't even what we’re really talking about here. And who does know what we are talking about when we say things like “portion-size”, “recommended daily intake”, “calories”, “kilojoules”, etc? Not that many of us! Education about nutrition and its relation to health and lifestyle are severely lacking in our society…

I want to conclude this topic of discussion with a direct passage of recommendation from the McKinsey report I mentioned earlier:

“Education and personal responsibility are critical elements of any program aiming to reduce obesity, but they are not sufficient on their own. Other required interventions rely less on conscious choices by individuals and more on changes to the environment and societal norms. They include reducing default portion sizes, changing marketing practices, and restructuring urban and education environments to facilitate physical activities.”

What do you notice about these recommendations? If you’re like me, then you will have noticed how most of the things suggested that we need to try to do as a society to combat obesity are the complete opposite of everything you need to do to have as great and successful a business as the food industry in industrialized countries is. We became obese not merely because we ate too much, but we ate more than we needed to because the food industry needed to grow its profits. I think in health care we particularly need to take note of this. Sometimes we think we must help individuals (or blame them, as we sometimes do), but the truth is individuals were helped in their demise by large industries and corporations who focused on our consumption/profit value rather than the effect of their products on our health.

On owning a house

I have always been scared of owning a house, but until the last week I haven’t really been able to explain it even to myself. Everyone has always told me that I should want to own “my own” home, that it’s the adult thing to do, that it’s the Australian dream, that it’s the successful person’s dream, that it’s the most financially savvy thing to do, etc… And yet at the same time knowing that it’s not my dream, I thought that I may be lacking something: maybe maturity, maybe the drive to think big. The thing is that I have rarely met people who “own” their houses, just a lot of people who think they own homes and really only own mortgages. In other words, in my eyes I know a lot of people who own large debts. I also, and not coincidentally, know a lot people who feel enslaved to jobs they no longer enjoy, a lot of people who feel a constant pressure that if they don’t earn they will lose a large sum of money and pride. I know a lot of people whose prisons are their jobs for the crime of loaning large sums of money to buy the illusion of owning the structure they take shelter in. Is the illusion worth it? Is a house really worth the slavery most people submit to for 20-30 years? But, people tell me, I am missing the point. See, they tell me, at the end of it you’ll own the house! And you were already going to be pay rent, so may as well use that same money you were already going to spend on the same thing (shelter and a living space) towards something you will eventually own. Yes, something I will own when I am over 50… and which serves me for what? Oh yeah, to live in. That’s it. That’s all the good I can see come of this.

But wait, you don’t have to just own one house, you can own several. You can own one and rent the other/s, or resell them at a higher price. And if you’re smart, you can earn a profit from doing this. Profit? Yes! Of course that is how people like Donald Trump have amounted massive amounts of wealth. However, I have to admit that I haven’t met many Donald Trumps. At the very least I haven’t met anyone who is made happy purely by the fact that they own many properties or have a lot of money. Is my view in this skewed? Yes, for two reasons: 1) I don’t know a lot of people who are made happy by money or property because I don’t share the same values as them and so don’t associate or attract these people as friends; and 2) it means little to me or my happiness how much money or property I own. If I am to be convinced that owning property is going to be beneficial to me, I have to be able to see how it would help fulfill me; unfortunately the properties and the money to be made from them would not make me feel more fulfilled.

What do I care about? My family, participating in and enjoying life while I am alive, and not making a world a worse place for anyone or anything. Call it Christian values or call it hedonism or my own particular philosophy, but it’s as simple as that for me. Yet wouldn't having more money allow me to spend greater time with my family, or “enjoy” life more, or participate in life to a greater extent, or increase my likelihood of what I could do to improve social justice or the environment? Probably. And don’t get me wrong, I usually support thinking “long-term”, but I have come to realise that life is actually not that long. Perhaps it’s as a result of the environment I grew up in with the life-expectancy of those around me being so unpredictable due to poverty and warfare, or perhaps it’s because of the job I do, but I think it’s not always wise to put off living. I genuinely worry that if I spend too much time engaged in earning (to provide for my family or enjoying life, etc), I may well miss out on my family or the time to enjoy life. Sure, most of us in Western society can quite safely expect to live past the time we would've finished paying our mortgage and past retirement, but should we really wait until then to start enjoying the profits of our labour? Maybe it is my yet immature thinking or the fact that I don’t yet have children that clouds my vision, but I don’t want to it put off too long.

Now, what if -worst case scenario- and I work, pay off my mortgage, and then die? Shouldn't I be proud and glad that at least I will have provided for my children a house for them to inherit? I mean, that’s good, right? Sure, that’s noble. How many of us, however, have not inherited houses and still turn out quite OK? I’d say that’s the majority of people. So I’m not convinced at this stage that that is a good reason to own a house. I think it was the billionaire businessman Warren Buffett who said that the perfect amount of money/things  to leave your offspring is "enough money so that they would feel they could do anything, but not so much that they could do nothing”. That is exactly what my mum did for my siblings and I and she never owned a house or anything of that cost; she just made sure to be supportive and educated us. I want to do exactly that for my children. The rest they will provide for themselves if I manage to teach them responsibility and self-reliance well enough.

OK, OK, now back to the financial reasons as to why buying a house would be good for me. I am told that if I continue to rent, then I am throwing away money, that it is “dead money”. Dead because I can’t profit from it, apparently. But you know what else is “dead money”? The money paid on interest on a home loan. Yes but I’m forgetting about the part where I get to keep my house after I have finished paying the bank back the loan and the interest! Yes, that’s nice, don’t get me wrong; and I do get the fact that you can do whatever you like to a house you have a mortgage on as opposed to one that you’re renting. For all the money I “throw away” by renting, I could be slowly paying off my house, wouldn't that be nice? Yes… if things in life could be guaranteed. I wish someone could guarantee that I will want to work with the same agility, strength, passion, and desire in 10, 20, or 30 years as I do now. Because if I lose my enthusiasm, that is when work becomes my jail for the crime of owing my house to a third party: the banks.  So most people have to keep working in order to avoid defaulting on their loans, working past the time that work became enjoyable, and working with the pressure and fear of keeping the bank fed. That is stressful! It kills the joy in life. How do I know this? Precisely because I meet people who are overwhelmed by these stresses every day at work.

I know there is stress also to pay the rent if you are renting, but I have noted one fundamental difference between those who are happy to rent and those who want to own a house: those of us who rent may stress about getting the money together at the end of the month also, but we don’t share the stress of potentially losing a large sum of money that people who default on loans take on. When you’re renting and you move house, that is it; you pay again for the chance to occupy a space you can live in. Renting is the same as any other consumer product. When we move house or as time goes by, rarely do those who rent sit to add up all the money we have “lost” by continuing to pay our rent. It is the same way that I don’t feel bad when I buy food that I have spent a small amount of money for something that is gone after I eat it when I could have instead put the money aside to buy a farm so that I could grow my own food, which eventually will overall turn out to be cheaper than all that food I bought over the years. Housing to me is just another consumer product. But those who have a mortgage and are unfortunately unable to keep paying it for whatever reason, end up owing a lot of money – and that scares me! Houses cost a lot of money and I don’t enjoy the pressure of having a debt that big.

I met someone a few years ago that told me that he was overwhelmed by the amount of work he had to do in order to provide for his family and maintain all the properties he owned. I asked him why he had so many houses. He said that it was because that was the Australian dream. It wasn't his dream, though. And I started wondering to myself ‘who is selling us these dreams, then?’ And then I read an internet post recently that answered this question and summarised the financial reasons of my fear of getting a home loan: “It is necessary that you be forced deeply into debt, and therefore forced into slavery, for the banks to make a profit”.

On modern society... (not the Unabomber’s Manifesto, I promise)

Barry Schwartz, an American psychologist, has a theory that the increased choice in our current society has spurred on our current state of general dissatisfaction, negativity - our modern “great depression”, if you will. When he speaks of increased choices he usually means the increased choice in commercial product varieties. For example, there are now more than a dozen water varieties; some from this or that spring, some in this or another bottle, etc. In the movie (or book) ‘Fight Club’ one of the characters discusses this society's problems this way: “Advertising has us chasing cars and clothes, working jobs we hate so we can buy shit we don't need. We're the middle children of history, man. No purpose or place. We have no Great War. No Great Depression. Our Great War's a spiritual war. Our Great Depression is our lives. We've all been raised on television to believe that one day we'd all be millionaires, and movie gods, and rock stars. But we won't. And we're slowly learning that fact. And we're very, very pissed off”.

There was a time when only one company made tissue paper – and people embraced it. Tissue paper had a use, it did its job, and people were satisfied that they could clean up their spills or wipe their nose, etc. Then a variation was made to the tissue paper, now you could get it in 2-ply, 3-ply, scented, non-scented, big pack, pocket-sized pack, in white, in blue, etc. etc. People started noticing that this brand or this particular size pack was “better” than the other, the new designs better than the old, that this one was more economical, that that one was sturdier. All of a sudden it became easier to be dissatisfied with the product even though it was still fulfilling its same purpose: cleaning up spills, soaking up snot, or whatever one may use a tissue for. Now, this isn’t a discussion about technological progress – which is essential – and was probably better dealt by Ted Kaczynski, the Unabomber, who’s vision to return society to a better place was to destroy all current technologies, political and commercial systems. His reasoning was to start back from scratch, from somewhere near pastoral times where small self-sufficient communities produced and traded fairly, before the demise into our current commercial system. He had a point, but I think technology has its place and it’s not that that I’m discussing.

I think the "problem" that increased choice, increased variety, has created has more to do with the general idea that is used to promote new and variant products. We are told things are better with this product, our lives happier with this one, this one will make us more attractive, that one is better for the environment, this one is faster, etc. While promoting these products we are made to believe that what we have currently, or what we are lacking, is a bad thing, an old and outdated thing, a thing that must be disliked (in preference of the new product). What is inadvertently also been promoted is dissatisfaction with our current situation or state of being. In my opinion the decline in human morale is more related to the fact that we stopped being satisfied. And we stopped being satisfied not only with our consumer products but also with ourselves for not being able to afford them, for not looking like the TV personalities that use that amazing (and expensive) hair product or plastic surgeon, for not feeling like the person on TV who drinks that soft-drink feels, etc. We are sold dissatisfaction and so we take on new and uncharacteristically human pursuits. No longer are we satisfied with health, food, and shelter, but now we feel motivated to want to earn more money, work longer hours, make other social sacrifices in order to be able to afford “happiness”.

Another thing that has happened in the process of the industrial/commercial progress in our society is we’ve become more self-centered, and maybe even more selfish. One thing some of us older ones may remember is the way things, especially electronics such as computers, used to come in a version of ‘one-size-fits-all’. And all did buy the same product and it had to fit, it had to because there wasn’t another version, you made do. Then progressively more things became customizable. You could adjust or modify things so they could suit your particular abilities or needs better. Small and larger/wider patterns of clothing became available, different fonts could be used, etc. And then more varieties of things became available that could vary not just to suit your needs, but also to accommodate your preferences. You could buy things in the colours you prefer, with the sound you like, etc. The ability of products to be customized, to be able to be “personalized” was promoted not just as a desirable feature, but an essential one. It was essential that the customer be right, that they be made to feel all-important, that they be made to believe that all their desires must be met – and that this particular product was just the one to do that. The thing is that, again, this message got so hammered into us, that we are all-important and our desires must be met, that we came to regard ourselves (individually) as our number one priority, setting aside things that for a long time held the members of our society connected: friendship, family, camaraderie, and sharing.

Barry Schwartz proposes that the excessive amount of choices in our society has overwhelmed us so much, raised our expectations to levels so high, that nothing will ever meet them and that this, in turn, has lead to such generalized dissatisfaction and hopelessness in our society that it spreads even to the way we interact with each other. Unlike Ted Kaczynski, though, I don’t think the solution to this problem lies in destroying our current industrial/commercial system, but rather in a return to realizing that we are still human beings with human needs and human emotions, and not just consumers.

On propaganda

I was watching these Youtube videos on North Korea, which somehow led me to watching videos of Cuba and Soviet Russia. I’m very nerdy so I find watching documentaries fascinating. So after watching some of these videos and seeing them diss on the propaganda styles used by socialist countries, “communist propaganda”, I started to think that the videos themselves seemed like anti-communist propaganda. Now, I don’t know much about politics or governmental styles nor do I have any opinion on what’s good and what isn’t, but I found that it’s almost impossible to present a topic that is so fraught with emotive images and stories and not be biased. Because it is the mainstream media, the bias is usually pro-capitalist and anti-communist. Like I said, I don’t favour one way or the other.

One of the comments often made about these “communist” countries is their use of propaganda to idealize their nation’s system of government and also demonize that of capitalist/imperialist nations. Well, the videos and media most westerners have easy access to do the same thing in reverse direction: demonizing communism and glorifying capitalism. So I guess that’s just how the world works, to prove ourselves right and just we often attribute to others injustice and wrong.

The other comment often made about countries like North Korea and Cuba are their censorship or restriction of access to foreign media. This is proclaimed as an injustice because people only have access to biased information, skewed towards that of the current system of governance. They’re also denied access to what else is going on in the world, and –critically – to how much “better” than themselves capitalist countries are. Again, this is seen as bad by the leaders of countries like the U.S. because people should have the freedom to choose what to watch, hear, and believe. The so-called communist leaders give it a different spin: they believe they are protecting their people from materialism, from self-centeredness, and from greed. So on the one hand the argument is that some people are being denied their freedom, and on the other hand is the counter-argument that these same people are being protected from greater evils. What evils?

I remember reading once about methods of persuasion. One group of people really interested in methods of persuasion are commercial enterprises, and by inference also advertisers. Another very interested group are politicians. What both these parties do in order to achieve success (whether that be votes or money) is use propaganda to persuade others (consumers or voters or subjects) to buy their product, ideal, philosophy, etc. Of course, there are many different methods of persuasion or propaganda styles. You could, for example, reward a person for supporting your “product” (ideology, philosophy, or physical item) or punish them for using that of a competitor. Most nations use a system of governance that uses this method of “persuasion” to some degree in the form of legal systems and prisons. Another method, especially used by health promotion teams, is to demonize something, to make the consumer fear/dislike it in order to abhor a behaviour or consumption of a product. Politicians of communist countries are often noted to use this method, blaming all of a country’s woes on the enemy state and demonizing their way of living to ensure their voters/subjects are alternatively loyal to their own nation. In capitalist countries one of the major methods used by commercial companies to sell a product or a service is to first convince a person that they are lacking something or that their method of doing things is outdated before showing them a new product that will make their life so much better. Non-capitalist estates abhor this, calling this one of the greatest evils of capitalism because it is seen as a method by which a person is first sold dissatisfaction (usually towards their own person or their family or some other entity) before being offered a “solution”, the product being advertised.

Some time ago I read some criticism about the rising use of antidepressants in medicine. The story goes that going back some decades ago, rates of depression were much lower than they are today. The change can be attributed to a number of things: smaller family sizes, greater awareness about depressive states and suicide, more time dedicated to the workplace, breakdown in family structure, greater use of chemicals in the environment, pretty much anything that has changed in the past several decades. But is there one causative factor or is it a multifactorial phenomenon? The answer is almost always “multifactorial”. However, one thing about the increased awareness of depressive illnesses that is particularly interesting, is that the groups that were “raising awareness” about depression consisted mainly of pharmaceutical companies that had themselves developed the antidepressant medication to treat it. Some of the early public service announcements (advertisements?) about depression would go through a list of “symptoms” that if you identified with you should ‘talk to your doctor about’ to be prescribed treatment to ease you of your illness. Now, this is an extreme example were commercial companies are accused of selling you dissatisfaction, in this case it’s purported they convince you to believe you’re “sick”, so they can sell you their solution: a pill. Similarly, people are convinced their lives are somehow lacking if they don’t buy a certain drink, wear certain clothing, eat at a certain restaurant, drive a certain car, travel to a certain place, etc.

Now, my point is not to argue whether depression is a real or a commercially-created diagnosis, nor whether communist or capitalist systems of governance are better; my point is to remind us that we are human beings and not just consumers or voters or subjects or victims. Who was it that said that once you understand a thing you can’t be used by it? I don’t know, but he had a point. The one liberty no government or person or amount of persuasion can take away from us is the innate human ability to reason for ourselves.

On the consumer instinct

I used to be whatever the opposite of materialistic is. I would never buy things I didn’t “need” and I considered everything but food and basic clothes an extravagant luxury. Incidentally, at the time, I was also a poor student and had no choice but to adopt this lifestyle whether I chose it or not. For the majority of my student life, I had also made this choice. Once I started on a rural medicine rotation, this began to change.

I guess it was back in 2007 when I first consciously noticed the change in me. I was in Gladstone at the time, which is hardly a rural town, but still a small enough place to lack the “variety” and “choice” we have become so accustomed to. In your average city, and in your average suburb really, you have, for example, a store that sells books (many different types of books). But you don’t have just one bookstore, you might have 2 or 3 or 4, etc. bookstores that sell the same books, at usually similar prices. In your average rural/regional town, maybe there is only one bookstore with a sample selection of books. They don’t have the big multi-level bookstore, let alone two. But the town survives; the people eat, drink, and live.

Now, when I was in Gladstone, all I could think about was finding a bookstore so I could read something to kill some time (instead of studying like I should have been doing). I couldn’t find any bookstores (or at least one that didn’t have only boating books), so eventually I resorted to the internet to calm my angst. I bought one book, two, three, some perfume, something else, something else still, and then some more. Back at home I hardly ever bought anything online, let alone what I once considered non-essentials. Back at home I was hardly ever this bored.

I started thinking then about what had brought on my newfound habit of senseless spending. There were several things that for me differed from living at home (in the city) to living in a semi-rural setting. Firstly, I had a lot more spare/free time in Gladstone because I didn’t have my friends or family to hang out with, there was less variety of movies for me to see at the cinema, and I wasted less time driving to places. Secondly, lacking all these things that usually consumed my time (friends, family, and leisure activities), I actually was feeling emotionally disconnected, isolated, bored, lonely even. And I think it is this great void, this being consumed with nothingness, this empty space, that leaves us feeling desiring of something, anything. Unfortunately, when people feel alone or isolated or depressed, they often seek to fill an emotional void with material or physical things.

To me this experience made me think of a few things. Firstly, I started to wonder if in fact this –feeling emotionally unfulfilled – is the reason that people adopt such a consumerist attitude, always wanting to buy more, and not just wanting to but feeling they need to. I mean it’s not rurality that does it to you, there are people living in these rural towns who go about their everyday life, working, etc. without being overwhelmed by some desire to buy, buy, buy. They feel as I feel when I’m at home with my family and friends: content. Me, I wanted to buy things to fill my time, to kill the time I had to be alone and contemplating my loneliness and isolation. I wondered also if that is what other people who are long-term materially-focused feel. If you fill up your time with material possessions, striving to have them, dreaming of more, then you don’t leave time to think about the things that make life really worthwhile, but which we may lack. The physical things can’t fill the emotional voids, though, and eventually some people may adopt their desire to possess more as their substitute for the human lust for life, experience, love, interaction, play, and generally just living.

If there’s one thing that my experience in “the bush” has taught me, is that human needs don’t change whether you’re in one place or in another. Everyone needs love, affection, interaction, social engagement, respect, entertainment, self-efficacy, and health care.