The rapid rise in the prevalence of obesity in recent years has been described as an epidemic. It becomes a concern all around the globe because of its implications for the health as it increases the risk of many diseases. In addition to its health impacts, obesity leads to many problems which are felt by all levels of society from individuals, to families, and to governments.
Our Big Problem: obesity
As obesity is spreading—and eating away at America's economy and
health. Theodore Dalrymple reflects on how society can bite back These days, it seems, almost everyone has a habit that he can't control. For millions of people, this habit is overeating.
Never have so many human mastodons bestridden the earth as now. At
one time, not so very long ago, such mastodons were rare enough to be curiosities, charitably thought by others to be the victims of their "glands."
We had such a fat boy at school: His cheeks were so adipose that his eyes
had become mere slits. We thought that he was ill rather than a member of a cultural avant garde.
In America, more than a third of the adult population is now obese (obesity being defined as having a body-mass index more than 30). This is nearly three times as many as in 1960, and half as many again as in 1990. But the increase has been greatest among those known as the morbidly
obese—that is to say those with a BMI of more than 40. As a proportion of the population they have increased in America by more than six times since 1960, and three times since 1990. They are now about 6% of adults.
The cultural meaning of obesity has changed at the same time. For most of human history, fatness has been a sign of prosperity, of having risen, socially and economically, above the day-to-day struggle to obtain enough to eat. But sadly now, in Western societies, obesity is concentrated among the poorest and least educated. In America, blacks are 50% more likely to be obese than whites, and Hispanics 20% more likely.
I once saw the change in cultural meaning of body size happening before my very eyes, when I practiced briefly in the mid-1970s as a doctor in Zululand
in South Africa. The women who still lived in a traditional way, in mud huts, wanted to be fattened up for their menfolk, who saw in a fat wife a sign of
their own success and prestige. These women would ask for medicine to become even fatter than they already were. By contrast, the young women who attended university wanted medicine to make them thinner than they already were. It almost seems as if, for human beings, there is no contentment with their body size.
If overeating is not in itself a disease, it certainly has health consequences. By now, there surely cannot be anybody left who does not know that obesity causes Type II diabetes, any more than there are smokers who do not know that smoking is bad for them. When I started out as a doctor, Type II diabetes was often known as maturity-onset diabetes, but as children have grown
fatter and fatter, maturity has nothing to do with it.
The economic consequences of fat are enormous, if health economists are to be believed. Obesity-related medical costs were 9.1% of all annual medical costs in 2006, up from 6.5% in 1998, according to a study released last year from the Centers for Disease Control and Prevention and RTI
International, a nonprofit research institute. The annual health-care costs of obesity in America have risen from $74 billion in 1998 to $147 billion in 2008.
According to a paper presented at the Obesity Society's annual conference last year, fat people are less productive than thin. They take more time off work because of their various ailments, and when they are at work the
morbidly obese produce less, equivalent to 22 days of lost production per year. The health-care costs and lost production caused by obesity are driving American manufacturers to locate to countries where the population, for the time being, still has a lean and hungry look.
The fiscal consequences of obesity for America have also just increased, with the recent passage of the health-reform bill. Obesity is disproportionately
concentrated among those previously uninsured, who will now presumably
have access to more care, possibly including expensive bariatric surgery.
Indeed, obesity is associated causatively to so many expensive diseases (rather as smoking is) that the health-care costs of treating the impoverished obese are likely to be enormous. Since treatment is unlikely
by itself to make this sector of the population more employable or productive, America has just assumed an economic cost without an economic benefit. Truly, economics is the dismal science.
Is there no hope, then? In one rather peculiar sense there is. The whole world is becoming fatter, not just America. Not long ago in Bangkok I observed some children, obviously of the elite, emerging from a school. There are not many fat people in Thailand, but these children were fat.
Like so many of their counterparts in the West, they seemed unable, or
unwilling, to progress further than a few yards without refreshing themselves with sweetened drinks and fast fatty food. And they were being collected by chauffeurs or adoring parents so that they might be spared the rather minimal exercise afforded by going home by public transportation. As yet in Thailand, the poor mostly cannot afford to be fat, but that time will come, and then the great reversal will occur: The elite will abandon its fattening habits, and take seriously the advice of the late Duchess of Windsor: that one can be neither too rich nor too thin.
In the West, the march (or waddle) of obesity is in step with other social (or antisocial) developments. Obesity in Britain, for example, has increased pari
passu with the splintering of families: and now it is never too early to teach children lack of self-control.
The connection between the fragmentation of the family and obesity is easy
to understand. Of course, there is no one-to-one correspondence between the two phenomena—in human affairs there never is such a close fit—but
there is nevertheless a strong and comprehensible correspondence. For much of the population, family meals are a ritual of the past: Thirty-six percent of British children never eat a meal at a table with another member of their family or household (we have now passed the milestone long desired by radical social reformers, more children being born illegitimate than
legitimate). In the homes of the poor, the unemployed and the single parents that I used to visit as a doctor, I would find no evidence of cooking ever having been done there. Fatty take-away meals and ready-prepared foods heated in the microwave were the diet, together with almost constant snacks. There was not even a table to eat at: an absence that was not the
consequence of raw poverty, since the flat-screen television would have been large enough, turned horizontal, to serve as a dining table.
In these circumstances, children graze or forage; but unlike previous hunter
gatherers, they do not come up against a scarcity of food, but rather a surfeit
of it. Nothing is easier for them than to overindulge, and the appetite grows with the feeding. Their tastes never develop beyond the most instantly gratifying types of food, sugary and fatty, and they eat like children for the rest of their lives; they never learn the discipline of subordinating their appetite to the exigencies of family life and social convention. They are like Pooh Bear, for whom it is always time for a little something. It is hardly surprising if, like Pooh Bear's, their waistlines expand until they can't fit into a normal seat.
Family and social meals are among the most powerful teachers of self-control in the human repertoire. They teach that the appetite of the moment is not, or rather ought not to be, the sole determinant of one's behavior. The pattern of grazing or foraging independently of everyone else teaches precisely the opposite lesson. It is hardly surprising that those who do not experience family or social meals early in life exhibit the lack of self-control that underlies so much modern social pathology in the midst of plenty.
These social, or antisocial, developments have taken place precisely at a time when electronic means of entertainment have become available to all. For the uneducated, the world is an intolerably dull and slow-moving place by comparison with the excitement available at the press of a button or the flick of a switch. Why, then, move off your couch and risk the ennui of the real
world? You can satisfy your appetite and occupy the vacuum of your mind at the same time, at most wriggling like a maggot in sawdust. The
availability of constant entertainment is one of the causes of obesity. By taking on responsibility for the health consequences of obesity, the government has given itself the locus standi to interfere in many aspects of
human existence. If obesity kills, is it not the government's duty to prevent it? He who pays the doctor decides the prophylaxis. Positive encouragement of
healthy eating won't work, nor mere printed warnings that some foods are unhealthy (people who are prepared to eat doughnuts with pink and blue icing are unlikely to desist on learning that they contain nothing good for the
bowels or any other organ).
As usual, therefore, prohibition beckons. Regulation of the sugar and fat
content of ready-prepared and fast foods is likely to be proposed and perhaps eventually accepted, though not without a very fierce rear-guard action by the food industry. If John Doe will not eat his greens, Uncle Sam will make
him, if necessary by restricting the availability of other foods. No one will raise moral psychology of the question of obesity, for fear of sounding
uncompassionate and reactionary.
In search for an amelioration, the temptation is to an intemperate
authoritarianism, forgetting that the avoidance of obesity, pace the
Duchess of Windsor, is not the whole purpose of life. But teaching children to cook and eat together might help overcome the crudity of their eating habits: the price of more refined, and in this instance nonfattening, pleasures always being effort.
To reduce the attraction of fast food, prepared meals and soft drinks, and to save the planet from polystyrene dishes, a system of returnable deposits on
packaging might be tried. This would slow down fast food a little, and tip the balance in favor of home preparation.
No doubt the government will also promote sports as a remedy for and preventive of obesity. This, of course, would be an extremely irresponsible solution, for sports are already, even with the slothful population that we have, by far the most common cause of injury in Western societies. If the obese were suddenly to start exercising, emergency rooms would not be able to cope. For the sake of our health, let us have no sports.
1. This text is from The Wall Street Journal - The Saturday Essay May 7, 2010.
Theodore Dalrymple is the pen name of Anthony Daniels, a British physician.
2. BMI: The Body Mass Index (BMI) is a statistical measurement derived from your height and weight.
3. Wallis, Duchess of Windsor, previously Wallis Simpson (born Bessie Wallis Warfield; 19 June 1896– 24 April 1986), was an American socialite whose
third husband, Prince Edward, Duke of Windsor, formerly King Edward VIII
of the United Kingdom and the Dominions, abdicated his throne to marry
her. Wallis Simpson is often credited with the popular saying, "No woman can be too rich or too thin."
Study carefully all the new words and phrases in the box. Fill in the gaps with words or phrases chosen from the box. Change the form where necessary. bestride, impoverished, desist, ailment, illegitimate, presumably, repertoire,
counterpart, beckon, waddle, intemperate, morbid, fiscal, fragmentation,
adipose, ennui, surfeit, exigency, wriggle, amelioration
1. The ________ of this database would be much larger and contain all possible names and addresses that were not in the positive database plus a lot of gibberish.
2. The problem of lipid damage, they believe, is linked to hormones produced not by the pancreas, but by _________tissue itself.
3. Even those who_________ an epoch are eventually reduced to a couple of salient features.
4. Armed with such predictions, patients could start fighting the________with
drugs or other available interventions, thereby preventing or delaying symptoms.
5. In Hailan, sunlight dances on deep blue water and sandy beaches _______ to eager beachgoers. It’s the best choice to come here hoping to savor the beaches and soak up the sun.
6. The investigation lays a foundation for further _________of medical wastes
combustion technology which has notable economic, societal and environmental benefit.
7. To ________ a given distance, penguins use twice as much energy as other creatures of the same size use to walk equally far.
8. Taking marriage and love as the main theme, Zhang Ai ling usually writes on marriage concerning economy, ________ love, inharmonious family and subsequent unhappy life.
9. Poverty also limits the production of food in __________areas, because the destitute lack the resources to invest in agriculture.
10. Excessive political competition can become a destabilizing factor if it leads to _________ of the political system, or if it undermines the legitimacy of existing state institutions.
11. If you keep doing that, you will eventually be able to finish a new song, and increase your __________.
12. Some Western countries, on the pretext that China has an unsatisfactory human rights record and an irrational _________socialist system, attempt to
jeopardise our national sovereignty.
13. At this moment, the stomach of the body will ______quite frequently and
the blood circulation will speed up, and the pore of the body will open completely.
14. If we were always, indeed, getting our living, and regulating our lives according to the last and best mode we had learned, we should never be troubled with __________.
15. The skin changes ________ due to soluble substances in the plasma of the donor that cause an allergic reaction in the patient.
16. We must deal with pleasure as we do with honey, only touch them with the tip of finger, and not with the whole hand for fear of _________. 17. An aggressive _______ stimulus plan will cushion the blow of an expected contraction of private investment and slowing private demand growth. 18. But, population increasing sharply and __________ mining to nature have led to the enormous destruction to the species and the ecosystem, even have brought the total destruction.
19. Facing with the austere situation caused by public sudden incident at home and broad, we should realize that establishing and perfecting the _________ succor mechanism have no time to delay.
20. Despite calls to ________ from the United Nations Security Council, Iran carries on its nuclear experimentation and gets itself a bomb.
1. Monoclonal antibodies are special immune proteins made in the lab.
2. We think about the evolution of bipedalism as one of first events that led
hominids down the path to human being.
3. Spinal cord injury (SCI)may result in tetraplegia or paraplegia , which is a
great damage to the abilities of patients ' daily living.
4. A study in the current issue of the journal Neurology examined 911 nonagenarian Americans and found that 45 percent of the women had dementia, compared with 25 percent of the men.
5. Radical resection rate is still low nowadays. The lobus quadratus resection
is helpful to select the operation.
6. I enjoy Decathlon, where the athletes do ten different events.
7. Hexachlorophene-containing skin cleanser is substituted when allergy to shellfish or iodine is present or suspected.
8. Ursolic acid with the structural type pentacyclic triterpenes is distributing
in plants and show several bioactivities, such as anti-tumor, anti-inflammation and lowering hyperlipemia.
9. Sodium diacetate as a new antiseptic has advantages of high efficiency, low poison and low cost of application contrast with traditional production. 10. Ancient Chinese architecture uses a variety of shapes: the square, rectangle, triangle, hexagon, octagon, dodecagon, cross, circle, and semicircle.
A recent parliamentary report blames the government and the food industry for the growth in obesity. The Department of Transport is blamed for not doing enough to (1) facilities for pedestrians and cyclists while (2) to
pressure from motoring organizations representing car users. The Ministry of Education is (3) of selling off school playing fields and not doing enough to (4) adequate facilities for physical education and games. Young people in Britain have become crazy about football (soccer and rugby), but too often as (5) ―couch potatoes‖.
The food industry is blamed for promoting junk food to school children and not doing enough to (6) down on sugar, fats and salt in prepared foods. The industry, (7) by the current popularity of the Atkins low-carbohydrate diet, has begun to (8) , but it is trying to protect a huge market and will need to do (9) more if it is to (10) off increased regulation.
Japan seems less (11) so far by the problem of obesity, (12) as the
Japanese diet becomes increasing (13) (burgers and doughnuts) the
problem will grow. (14) , Japanese cuisine has become highly popular in Britain. It is seen as health in a different way from the Mediterranean diet (15) its emphasis on tomatoes and olive oil combined with red wine. A fairly small amount of red wine is now (16) as beneficial to the heart,
(17) its other encouraging properties. But Britain has to do more to (18) the problems of alcoholism (19) with the binge-drinking culture-including violence and vandalism. Limited consumption of alcohol, as long as it is not (20) with driving, is harmless and possibly beneficial.
1. [A] stimulate [B] commend [C] promote [D] elevate
2. [A] submitting [B] subjecting [C] subordinating [D] surrendering 3. [A] charged [B] denounced [C] scolded [D] accused
4. [A] assure [B] ensure [C] secure [D] guard
5. [A] speculating [B] spectating [C] specializing [D] sightseeing 6. [A] fall [B] get [C] cut [D] bring
7. [A] stung [B] bitten [C] chewed [D] licked
8. [A] retort [B] refute [C] respond [D] resolve
9. [A] abundantly [B] considerably [C] extensively [D] principally 10.[A] defend [B] beat [C] hold [D] ward
11.[A] upset [B] affected [C] effected [D] impressed
12.[A] or [B] for [C] but [D] if
13.[A] popularized [B] globalized [C] westernized [D] localized 14.[A] Accordingly [B] Interestingly [C] Surprisingly [D] Strikingly 15.[A] as [B] on [C] but [D] if
16.[A] accepted [B] approved [C] assumed [D] acknowledged
17.[A] but for [B] let alone [C] regardless of [D] much less 18.[A] cope [B] challenge [C] tackle [D] undertake
19.[A] matched [B] related [C] united [D] associated
20.[A] bonded [B] combined [C] merged [D] incorporated
Section A: Translate the following part from the text into Chinese.
The fiscal consequences of obesity for America have also just increased, with the recent passage of the health-reform bill. Obesity is disproportionately concentrated among those previously uninsured, who will now presumably have access to more care, possibly including expensive bariatric surgery. Indeed, obesity is associated causatively to so many expensive diseases (rather as smoking is) that the health-care costs of treating the impoverished obese are likely to be enormous. Since treatment is unlikely by itself to make this sector of the population more employable or productive, America has just assumed an economic cost without an economic benefit. Truly, economics is the dismal science.
Section B: Translate the following passage into English.
Questions for further consideration:
1. What is the difference between ―obese‖ and ―overweight‖?
2. Why do you think people become obese?
3. What are the possible treatments for obesity?
4. What are the health risks associated with obesity?
Can you be both obese and healthy?
Countless epidemiological studies have shown that as you move from a
normal body weight towards obesity the risk of many chronic diseases increases exponentially. However, more and more research suggests that the relationship
between body weight and health is much more nuanced than previously thought.
Recent estimates suggest that approximately one in three obese individuals
remain metabolically healthy (displaying normal blood glucose, blood
lipids, blood pressure, and a healthy cytokine profile) despite their excess
weight. These same individuals may have a similar risk of developing heart disease and diabetes as their skinny counterparts and they may actually become less healthy by losing weight!
Thus, as we shall see below, there is certainly more to health than the number on one’s bathroom scale.
It all started in 1965. Two researchers, Albrink and Meigs, were performing a general investigation into the health of factory workers, and noted a rather counterintuitive result: that many obese men had healthy levels of triglycerides in their blood.
In 1982, Ethan Sims first included the designation of "healthy obese" subtype in
his classification of obesity, thereby first identifying a unique subset of obese individuals that appear to be at least partially protected from the development of the metabolic disturbances generally attributed to obesity.
Unfortunately, despite awareness of the metabolically health obese phenotype
for close to 30 years, there currently exist no established criteria by which to define these individuals.
What defines a metabolically healthy obese individual?
The defining characteristics of the metabolically healthy obese phenotype, in contrast to obese individuals with metabolic risk, include limited abdominal, particularly visceral fat accumulation, an earlier onset of obesity (<20 years) and high levels of physical activity. Additionally, black obese individuals have a greater tendency of being metabolically healthy in contrast to white obese.