Q: How did you come to choose this subject -- obesity?
A: This book started when I lost weight myself about four and a half years ago. I'd had a job with a magazine with a wonderful expense account. What with the sedentary nature of editing and the fact that I was always traveling and taking writers out to nice places, I quickly ballooned to about 205 pounds. When I lost that job, my doctor -- without me asking -- mentioned that there was a new diet drug I might want to try. This was when Meridia first came out. I took it for about six months and kept a journal of my experience. The L.A. Weekly published my journal as "The Fat Man Sings," and that got some attention. For one, I was a man writing about body issues, and secondly, I wrote about the science of weight-loss drugs and showed the capriciousness of regulating them.
That following spring, I was having lunch with my editor at Harper's, and I was talking about obesity with him, and he didn't quite buy it. "Let's take a walk," he said. We walked out onto Broadway, and he pointed at people who were big and said, "Tell me about this person's likely medical prognosis." And so I would tell him based on a combination of things -- height, weight, ethnicity, age, gender, the way the person was fat, whether they were fat in their thighs or their gut, et cetera. That was his little test to see if there was something real in this.
About the same time, my brother-in-law was hospitalized at [Los Angeles County-USC Medical Center], so I was down there, and one night there was a real commotion -- nurses and doctors and lights and everything. They pushed this guy through who'd just had gastric bypass surgery. He was young, and probably 450, 500 pounds and dying, because he was being suffocated in his own fat. That made me say, all right, I'm going to take this seriously now as a critical medical issue.
I wrote the piece for Harper's, which some people took as a breakthrough because it appeared in a liberal-left magazine. The media, and in particular the left-liberal media, avoided the issue, because it's so tied up with other political issues of the left, i.e., women's body-image issues, anorexia, bulimia, et cetera. The fact that Harper's published it basically said, Wait a minute, this is a legitimate medical issue, and it mainly concerns the poor.
Q: According to, the reasons for that are complex, starting with the fact that food is cheaper today. Is that really true?
A: Well, the price of meat today is 30 percent lower than it was in 1970 after you adjust for inflation. If you track the price of food and adjust for inflation, you'll see there's been a gradual decline. And this comes at exactly the same time as when our sedentary behavior is on the increase. And it also comes at the same time when -- particularly for the poor -- opportunities to expend energy decrease, i.e., public-school P.E. programs have been eliminated, and there's no money to maintain or create parks and recreation facilities. So I think it makes sense that the poor are particularly vulnerable, not only to be obese, but to suffer from its effects, because they don't have the buffering system that you and I have -- the health care, in particular.
Q: You also write about how many immigrants who come from undernourished circumstances sometimes lack the genetically encoded ability to metabolize the ultra-processed fats and sugars found here.
A: L.A. to me is sort of like Paris was at the turn of the century, because they both had huge population influxes that were rural, and these new residents were giving birth to children in a society of abundance. They come from no health care to an environment where the care is sketchy at best for them.
The question is, based on that population, why did the French eventually become the leanest people in Europe? And the answer has a lot to do with something we don't want to deal with here, which is first, major investments by the public sector in women's health and infant health, and secondly, the willingness to consistently emphasize dietary restraint. Americans don't have the will to do either one of those things, at least so far.
Q: What should be done to change that?
A: I think the best all-around health investment we can make is to pour public funds into prenatal care and education. And what you'll get over time is an increase in birth length: the taller the baby -- and the heavier, secondly -- the more likely it is to be a good metabolic engine and process these hyper fuels much better.
Q: Reading your book, I became a little nervous, because it seemed that the blame for obesity was not resting on the individual. Yes, ours is a culture of indulgence, but isn't it still an individual's responsibility to decide what to put in her mouth?
A: That is the single most important thing -- for first the individual, then the parent, then family, then the community, to re-own that responsibility. The question here is what came first -- our culture of self-indulgence or the enablers -- fast-food marketing and advertising, for example. I suggest that our culture of self-indulgence has been there since day one in this country, and it just took time for the external environment to catch up to completely enable us. That happened in the late '70s and early '80s. [Then-Secretary of Agriculture] Earl Butz summed up the national temper when he said that people want what they want when they want it.
That to me is the perfect summation of our generation, our narcissism, our ability to use our minds to justify every indulgence. Although I think that fast-food companies and agriculture are implicated in the epidemic of obesity, I do end the book with Dante, who put gluttons in the third circle of hell.
Q: So there's no escaping the morality of this issue.
A: It's also the thing that you take a lot of hits for, if you write about obesity. I, for example, think that it's a good thing for a parent to teach a child that gluttony is medically bad for you, bad for your general self-esteem and morally wrong. But when I say as much to editors, they look at me like I'm coming out of the inferno.
At the same time, there is a force in American life that has no problem making absolute statements, and that force is advertising. They'll tell you this is 100 percent true, you've got to have it -- we're bombed by billions of dollars of that every year. If we don't articulate a morality of consumption, that vacuum is going to get filled by a force that is only about making profits.
Q: It's a little odd to think that we've been so oblivious of obesity and its issues when we're also the most diet-obsessed country in the world.
A: We are not really diet-obsessed. We are obsessed with what we can eat with impunity. All diets -- at least the ones that really make money -- are not about dieting. They are about what you can eat a whole bunch of without worrying. Because really there's only one diet, and that is eating fewer units of heat than you expend. You can do it any way you want.
Q: So what do you eat -- or not eat -- now?
A: I really eat everything. There's nothing I don't eat, except I really don't drink Coca-Cola or sodas. I literally try to eat half of everything. And that seems to be working. If you can walk an hour a day, you can eat very well without worrying about it. To lose weight, though, you gotta cut back on what you're eating.