Why are fewer heavy Americans trying to lose weight

By Jing Ren

“During the past 12 months, have you tried to lose weight?”

The majority of overweight Americans will say no to that question, according to a recent study. Across the nation, the obesity rate is rising, but fewer overweight Americans are trying to lose weight, according to a study published in the Journal of the American Medical Association this March.

Experts are trying to figure out why.

A lack of physical activity, unhealthy dietary habits, socioeconomic concerns and even newer trends like “fat acceptance” – the idea that it’s OK to be overweight – all may play a role.

Obesity is a serious problem in the United States. According to the Centers for Disease Control and Prevention, about 70 million people – or one in three adults – are obese.

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Obesity rates are higher in the central and southern United States. Louisiana has the highest rate of obesity in the nation, according to a 2016 ranking in The State of Obesity, a project of the Trust for America’s Health and the Robert Wood Johnson Foundation. Graphic by Jing Ren

The problem is worse in certain parts of the country – for example, the central and Southern United States have higher obesity rates than the West and Northeast. And now, Missouri’s obesity rate is trending in the wrong direction.

Missouri’s high obesity rate

Missouri has struggled with high obesity rates for decades, and the problem is getting worse. In 2014, Missouri had the 20th highest rate of obesity in the nation, but in 2015 had moved to the 10th spot, according to the Robert Wood Johnson Foundation’s annual report, The State of Obesity.

Jill Kanaley, a professor at the Department of Nutrition and Exercise Physiology of University of Missouri, said that the types of food that people eat and the lack of mass transit are two reasons for the trend in Missouri. For example, unhealthful foods like barbeque are popular in the Midwest. Also, fewer people can walk or take public transit to work; they tend to drive everywhere they go.

What people eat is just one factor, said Magdalena Pasarica, associate professor of medicine at University of Central Florida. She said that other health behaviors, including exercise, contribute to obesity rates differentiation.

Statistics testify to the problems. About 4 in 10 Missourians don’t eat even one piece of fruit a day, according to the Centers for Disease Control and Prevention. A quarter of Missouri adults don’t eat vegetables every day, and less than half get the recommended 150 minutes of moderate physical activity each week.

The Missouri Department of Health and Senior Services, which gathers data on obesity and conducts physical fitness programs for Missourians, declined to discuss Missouri’s obesity issues. Instead, the department issues a written statement saying that people’s daily environments can influence their behaviors and the decisions they make.  In addition, the department said that body weight is the result of many factors, including genetics, metabolism, behavior, environment, culture and socioeconomic status.

“Our work focuses on access to safe places to be physically active and access to healthy foods across multiple sectors.  Many people know they need to eat well and move more, but often lack the resources to do so,” the department said in a written statement.

Happy being overweight?

There is no doubt that Missouri is just one state suffering from obesity, and many scholars across the nation have been tracking the issue.

Recently, researchers from Georgia Southern University analyzed data from the National Health and Nutrition Examination Survey for three different time periods to study how many obese people were trying to lose weight. They found that the number of overweight and obese people had increased over the previous two decades, but the number trying to lose weight had decreased.

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The most recent data show that fewer obese Americans are trying to lose weight. Source: JAMA. Graphic by Jing Ren

Jian Zhang, the lead author of the study, said that reasons could be varied.

One reason could be that Americans eat too much processed food, he said. “For instance, most Americans are used to drinking Coke,” which contains corn syrup and highly processed ingredients, Zhang said.

While acknowledging that drinking Coke, for instance, presents a pleasure for some people, Zhang cautioned that “double pleasant to some extent equals double risk.”

Another reason could be that an ongoing trend of fat acceptance, which means that people become more accepting of themselves and others being a heavier weight. This can lead people to think that they do not need to lose weight.

The social acceptance of obesity, Zhang said, starts in childhood. In a 2014 study, Zhang and his colleagues found that people were less likely to perceive obese children as overweight compared with children of similar weight surveyed more than a decade earlier.

In another study in 2013, Zhang and his colleagues found that overweight adolescents today are more likely to see themselves as “just fine” than overweight adolescents surveyed about two decades earlier.

Zhang also said that fewer interactions between physicians and patients nowadays is another reason for this growing trend. “We discovered that fewer and fewer physicians … talk about the issue of obesity with their patients,” Zhang said.

Besides psychological factors, socioeconomic realities could be another possible reason overweight people are unwilling or unable to lose weight, Kanaley said.

“Poorer regions tend to have higher rate of obesity. Because residents there are less able to afford quality food, therefore they consume fast foods more often, which are usually cheaper than quality food,” she said.

And sometimes, people just stop trying. They often get frustrated when they don’t feel they lose weight fast enough or when their weight fluctuates daily, Kanaley said.

Kanaley said that it is normal for weight to fluctuate, because the body’s composition of water, muscle and other components changes everyday. “Everybody focuses on the scale. But people need to know that although exercising can result in a loss of body fat, at the same time it can also lead to an increase in muscle,” which weighs more, Kanaley said.

What do “real people” think?

Daniel Jamang, a graduate student studying photojournalism at University of Missouri, says that he tried to lose weight last semester by exercising more. He rode his bike on the MKT Trail in Columbia. This semester, however, he felt too busy to do that.

As a photographer, he typically grabs quick meals during breaks and tries to get back to work as soon as possible.

“You are always running from one place to another,” Jamang said. “You go in the morning, start shooting for an assignment until 4 p.m. After you are done, you are very exhausted. You just want to have some fast food and relax.”

He thinks that the prevalence of high-calorie foods is to blame for America’s high obesity rate. He also agreed that “fat acceptance” is growing.

“Media is one big part of American life. We can see people with different body types in the media. How they are accepted makes you think that the mainstream is okay with that,” Jamang said.

Advice from experts

So how can people prevent obesity? Pasarica said that reducing calories is a sure-fire way to help people maintain or even lose weight. For instance, people could eat a high-protein, low-carbohydrate diet, or a low-sugar diet, and be successful if they reduce total calories.

Adults who want to lose weight should aim for about one pound a week. Trying to lose more weight than that could be unhealthy or unsustainable, Kanely said.

“People need to stick to plans that are sustainable. It’s not sustainable to only eat one meal a day, nor it is to work out three hours every day.” Kanaley said.

She tells people that weight gained over decades cannot be lost in a few months.

She also counsels people to avoid what she calls “magic products” that promise easy, fast weight loss with no change in diet or exercise. “It is not feasible, it is not sustainable, it conveys the wrong message,” Kanaley said.

Zhang said sometimes people focus too much on what they’re eating rather than getting enough exercise.

“The message is very simple: keep moving,” Zhang said. He wants to remind people to simply keep moving, whether it’s working around the house or walking to the grocery store. “All of these activities can help you maintain a healthy lifestyle,” Zhang said.

Kanaley added that people who want to lose weight can put less pressure on themselves by focusing simply on not gaining more weight. “Although we want people ideally to lose weight, in the research world, there have been ideas like ‘Don’t gain more,’” she said.

She said that having a good nutrition plan can help simplify this process. In her studies, subjects lost weight when they were given menus and lessons on food preparation.

In the end, losing weight comes down to common-sense advice, Pasarica said: Eat more vegetables and fruits and eat less sugar, saturated fat and salt every day. In addition, Pasarica said, people trying to lose weight should get seven to nine hours of quality sleep every night.

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