We had several threads about obesity here a few weeks back, and I urge anyone who felt strongly about them to, by all means, read the Atlantic essay by Marc Ambinder, who discussed obesity in America and his own decision to submit to bariatric surgery to conquer his weight problem. The article is long and good, and defies easy summary. He talks about the enormous health care and human costs of obesity, and why we simply have to get control of the epidemic. But he also goes into some detail about how difficult it is to fight. It’s true that diet and exercise are key to weight loss, but it’s not remotely that simple. Excerpt:

This jumble of circumstances and effects is what Thomas Frieden means when he says that just being an American can naturally lead you to be obese: obesity is an almost inevitable consequence of living with our cultural norms, our history of agricultural production and subsidies, our long-standing socioeconomic inequalities, and the impact of technology on our behavior and bodies. Against this formidable dynamic, America has erected two lines of defense: name-calling, and hectoring about diet and exercise.

More:

Lest you think I’m advocating the acceptance of obesity, I’m not. As Mark Hoofnagle, a surgeon and a leading crusader against obesity denialism, has put it, just because “modern medicine has largely ameliorated the effects of [being] overweight, that doesn’t mean that being overweight doesn’t put you at risk for a number of problems.” We should care about what we put into our bodies, and we shouldn’t neglect exercise. But we need to recognize the limits of individual agency, especially in the new, “obesogenic” environment that’s been created over the past 30 years, and especially for those in the bottom third of the socioeconomic pyramid. Putting individual solutions and free will up against the increase in portion sizes, massive technological and societal changes, food-company taste-engineering, and the ubiquity of effective television advertisements is like asking Ecuador to conquer China. And yet, that is what public-health campaigns suggest we do.