HBO series 'The Weight of the Nation' debuts next week
“The Weight of the Nation,” a Home Box Office multi-part documentary series on the nation’s obesity problem set to air next week will encourage a fresh round of debate about obesity and its ties to production agriculture and farm subsidies as Congress struggles to write a farm bill this year.
The Hagstrom Report previewed the four main documentaries and the first episode of “The Weight of the Nation for Kids,” a three-part series which will be shown during the fall back-to-school season.
The series, subtitled “Confronting America’s Obesity Epidemic,” was produced by HBO with the Institute of Medicine (IOM), in association with the Centers for Disease Control and Prevention (CDC), the National Institutes of Health, the Michael & Susan Dell Foundation, and Kaiser Permanente.
The series was three years in the making, and HBO and the federal agencies are promoting the series on the air and in Washington. It will be shown on all HBO channels on multiple dates starting May 14. (See schedule, below). Short films and a book have also been produced.
An episode was previewed in Washington at an IOM event last week and others were previewed last night at the Weight of the Nation.
“Accelerating Progress in Obesity Prevention,” an IOM study highlighted in the series, was released this morning.
The series raises many of the well-known issues surrounding obesity. Covered issues include diet, physical activity, cost of processed foods versus fresh fruits and vegetables, federal farm subsidies for corn and soybeans, industry opposition to nutrition guidelines, and the ways individuals are successfully fighting obesity.
But the series’ greatest contributions to the debate are showing individuals’ case studies, interspersing the views of experts with the stories of obese people and examples of individuals, and describing companies and communities that succeeded at countering obesity.
While the series notes that low income people and minorities are more likely to be obese, it also emphasizes that obesity has spread to the middle class and the wealthy and especially to children—which may make it easier to call public attention to the issue.
“Childhood obesity means you can get a conversation going,” notes Shiriki Kumanyika, a professor of epidemiology at the University of Pennsylvania and chairman of the IOM’s Standing Committee on Childhood Obesity Prevention.
CDC director Thomas R. Frieden sets the tone for the series.
“Obesity-related health care costs about $147 billion annually, and on average, it costs $1,400 more a year to care for someone who is obese," Frieden says.
"To get healthy, we’re all going to have to do our part—individuals, communities, local, state and the federal government … We’re going to face steadily increasing health care costs, as well as more lives lost to type 2 diabetes, heart disease, many cancers and other complications from obesity.”
The series features extensive interviews with Margo G. Wootan, director of nutrition policy at the Center for Science in the Public Interest.
Wootan has waged many of the campaigns to put higher quality nutritional guidelines in the school meals programs through the Healthy, Hunger Free Kids Act, and to convince the Federal Trade Commission to issue guidelines for advertising foods to children.
But the most surprising key figure in "The Weight of the Nation" documentaries is Susan Combs, the former Texas agriculture commissioner who is now the Texas comptroller of public accounts. Combs says that Texas must address its high child and adult obesity rates because the obesity levels are raising health care costs for both the state and private industry.
She notes that some states and private companies require employees to pay higher health insurance rates if they are obese and says that in the future Texas will not be competitive with other states and foreign countries if health care and insurance costs are too high.
Using the powers of her office, Combs has campaigned to force schools to reinstitute physical education. There will be “all sorts of crises” if obesity is not addressed, she said.
The experts discuss the decline in physical activity. They point out the human body’s attraction to fats and sweeteners goes back to the need in earlier times to eat meat and to store energy. They blame federal farm subsidies for encouraging production of corn and soybeans, which both make the feeding of animals and the use of high fructose corn syrup cheaper as compared to growing fruits and vegetables.
In short, they say that one of the problems is the availability of relatively cheap fatty and sweet foods.
Dr. Robert Lustig
Perhaps the most notable attack in "The Weight of the Nation" is on fruit juices, commonly served instead of soda pop. Many parents have substituted juice for sodas, and schools have replaced soda in vending machines with juice.
But Dr. Robert Lustig, a professor of clinical pediatrics and obesity expert from the University of California, San Francisco, says, “Juice is just like a soda.” The juice companies, he charges, throw away the fiber — “the good part” of the fruit.
Dr. Sam Klein
The series’ experts are also critical of an overemphasis on exercise, noting that it takes 20 minutes of jogging to use up the calories in one chocolate chip cookie.
“I cringe when I see ‘The Biggest Loser,’ the TV series that shows people exercising as they take off massive amounts of weight,” says Dr. Sam Klein of the Center for Human Nutrition at Washington University in St. Louis.
The series includes interviews with John Ikerd, professor emeritus at the University of Missouri, and with Iowa and Kansas farmers who are critical of federal farm programs that have resulted in increased production of corn and soybeans but not fruit and vegetables.
At this point the series also begins to speak positively about food production for local consumption, as members of the Practical Farmers of Iowa explain that many farmers have shifted to the production of just a few crops that are a safer bet because they get both crop insurance and subsidies.
“Policies drive production of the foods that are making us unhealthy,” notes David Wallinga of the Institute for Agriculture and Trade Policy.
The role of food processing companies is also discussed with a former food company executive — Philip Marineau, a former president of Quaker Oats and Pepsi Cola North America.
“Food companies are trying to sell more today than they did yesterday,” he said. “And if they don’t, they’re not considered successful. And ultimately, if we are going to be successful in reducing obesity, people are going to consume less. And that’s the conundrum.”
Marineau also notes that if food companies are to be part of the solution, they will need time to change their business models.
On the issue of local fresh produce, "The Weight of the Nation" features a group of Kansas City fruit and vegetable growers organized as Good Natured Family Farms, who created a distribution system.
But the series does not discuss competition from fresh produce that can be shipped from other states or foreign countries.
It also does not note that the fruit and vegetable industry has never asked for federal subsidies or that fruit and vegetable production is inherently more expensive due to spoilage and the need for more labor.
One farm laborer is briefly depicted, and farmers do mention that local production of fruits and vegetables would require distribution and processing systems in many places where they do not exist today. But there is no discussion of conflicts that would ensue over immigration and the availability of farm labor needed if fruit and vegetable production were to expand.
The series is highly critical of school lunches, although it notes that the Healthy, Hunger-Free Kids Act was designed to improve nutritional standards.
A half-hour episode in the three-part series to be shown to children places more emphasis on improving the taste of food and buying locally for the New Orleans public schools than on obesity. In the episode an adviser tells children that the school lunch program is the place where excess foods are shifted, but the adviser does not note that schools get foods cheaper as a result.
In "The Weight of the Nation" series’ fourth episode, the tone is upbeat. Two women explain how they lost more than 100 pounds each, and now count each calorie and exercise daily. Mayors discuss efforts to make their cities exercise-friendly.
Nonetheless, it is clear public health advocates are preparing for big battles.
As a group of tobacco company executives are shown testifying before Congress, Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University, takes a tough political line.
“If the tobacco industry can be taken on successfully by the public health world,” he says, “then I don’t see any reason why the food industry can’t be the same.”
Debut dates of the four-part “The Weight of the Nation” series on HBO. (All times are Eastern and Pacific):
- “Consequences,” Monday, May 14, 8 p.m. — Examines the scope of the obesity epidemic and explores the serious health consequences of being overweight or obese.
- “Choices,” Monday, May 14, 9:10 p.m. — Reveals what science has shown about how to lose weight, maintain weight loss and prevent weight gain.
- “Children in Crisis,” Tuesday, May 15, 8 p.m. — Describes the strong forces at work in our society causing children to consume too many calories and expend too little energy, covers school lunches, physical education, school recess, and the marketing of unhealthy food to children.
- “Challenges,” Tuesday, May 15, 9:10 p.m. — Examines the driving forces causing the obesity epidemic, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the food and beverage industry.