A Historian’s Thoughts on Obesity

1. How do you get the right balance of calories in and calories out, to use the phrase from Cindy’s comment on my earlier post?

Very tricky.  Through most of history for most people there weren’t enough in.  They were short, they were skinny, and they didn’t live all that long.

In recent years social historians have been poring over parish records in Europe reconstructing how long people lived, how many children they had, whether or not they married, and so on.  History of demography is what it’s called.  To make it sound more exciting to students, a former colleague, the leading social historian Peter Stearns,  called his class on the subject “Sex and Death”–which in a way it was, though parish records take a lot of slogging.

The slogging has produced fascinating and sobering results.  A good way to get an idea is to look at the readable hundred pages by distinguished economist Robert Fogel in a short book, The Escape from Hunger and Premature Death.   Excellent medicine for any nostalgic tendencies one might harbor.

Given this dire history, which seems to have been the same in most of the world and still is for many people, obesity seems a sign that we’re moving in the right direction, even if we’ve overshot the mark a bit.

2.  So what did earlier generations think about obesity?

That it was terrific. As Adam pointed out in a comment, through much of history being tubby or even positively huge was a sign of health, wealth and happiness.  Charles Darwin’s grandpa, one of the most influential physicians in England and prominent member of leading intellectuals circles around the end of the eighteenth century, was so large that he had a semi circular hole cut in the table to accommodate his belly.  He liked to eat.

And of course if you were a king you had to display a prodigious appetite for food (and sex) because as representative of the state you had to eat for the whole state (and show you were powerful enough to lead). Think of Henry VIII or Louis XIV.

3.  So doesn’t obesity cause huge health problems?

Obesity can cause health problems.  But then, eating is intrinsically tricky to get right and dangerous if you don’t, and there’s no way round that.  Every age has had health problems from eating.  It might be fungi on grain, it might be rickets from lack of Vitamin C (whoops, D, thanks Cindy) or beri beri from eating white rice or pellagra from a diet heavy in maize.  It might be botulism from cans.  It might be alcoholism or drug addiction. And for most of human history up until the mid nineteenth century, water was–well–a liquid soup of just what you didn’t need.  Still is in many places.

So the side effects of obesity, such as diabetes, are one more in a long series of health problems caused by eating.  that doesn’t mean they are not serious.  But it does mean (again), that it’s devilish difficult to get eating right.

4.  How did our predecessors deal with the dangers of food?

Some, like goitre, had a quick fix.  Add iodine to the salt.  Some, such as water, had a very slow fix required enough scientific knowledge to identify what the problem was (not miasma, for instance), re-engineering cities, designing ways to deal with sewage, and a massive inversion of capital.  Some, such as alcoholism and drug addiction, were tackled by banning the substance with pretty iffy results.

My bottom line.

I have yet to be certain that this we are in a position to act.  Or that we should.

At the moment we have no quick fix.  We don’t seem ready for the slow expensive fix.  And bans have an awful way of backfiring as prohibition and the war on drugs show.

Of course, there’s another option I didn’t mention.  Nattering on at people.  But can there be anyone now in America or Europe or, come to that, Mexico who doesn’t know that Coke and donuts is not a balanced meal or that you should eat a reasonable amount of fruits and vegetables?

So if I were health king (or queen) I’d be inclined to go slow.  Perhaps people will take matters into their own hands. We’ve only had one or two generations in the last 20,000 years where everyone in certain parts of the world can eat all they want.  And now that it’s a possibility for everyone, those who do aren’t admired but condemned. And they can’t move easily, wear cool clothes, or go down the airplane aisle without glares.  So why not say (for adults) that they are adults and and they can do what they want?

Ah ha, but aren’t they damaging all of us by costing the health system lots? Well, that’s a really dangerous route to go down–no drinking, no skiing, no driving . . .  And at least in private health care systems this can be taken care of by higher premiums for those over a certain weight if the actuarial statistics warrant it.

And finally, I can’t help thinking of the parallel between those two raging human appetites, food and sex.  For most of human history is was easier to satisfy the appetite for sex than the appetite for food.  And through most of history the results of indulging it whether inside or outside marriage could be pretty devastating–unwanted children, ruined lives.  And so societies did lots of nattering and passed lots of laws, all not to very good effect.

And now the easy availability of of birth control has largely cut through the moralizing natter.  OK there are still problems.  But birth control allows the satisfaction of the appetite without in general the worst of the consequences.

So perhaps in the end the quick fix will be the way to go.  If we can find it, that is.

Oh, and American school lunches appear to be a disaster.  Let’s fix them.

Blog for the day.  Normally I like to wait until a blog has been going for several months before posting about it.  But this  new blog by William Easterly adds a very well-informed voice to issues that interest many readers of my blog.  As a historian, I like the way he turns to the track record of aid to try to suggest better ways of going about aid.

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