Growing up too fat

You report that there's a lot of action in individual schools or districts on childhood obesity. But there's not a lot happening from the top down. Do you think anything will happen at the federal level?

I'm discouraged about the federal level because even things that work have been cut out of the budget. There was a pilot program that the U.S. Department of Agriculture had for providing free fruits and vegetables to kids in schools in certain states. And it really improved kids' fruit and vegetable consumption. But that program got cut. I think on the federal level if they could do something to subsidize the price of fruits and vegetables that would make a big difference. But I don't know if the money is there.

How much does this problem with children correlate to class? Are wealthy kids skinny and poor kids fat, or is obesity creeping into the middle and upper classes as well?

The rise in obesity rates has affected all socioeconomic groups, and it has affected all racial and ethnic groups in all regions of the country. But the highest rates are in the poorest states, and in the poorest counties. So, it is related to income. It's also related to ethnic group. There are very high rates in Mexican-Americans, Native Americans, and higher rates in African-Americans than in whites.

Andrew Drewnowski at the University of Washington has done a lot of work on the economic side. Based on all these economic analyses, he believes that it's because it's so much cheaper to eat a high-fat, high-calorie diet than it is to eat a diet with lots of fresh fruits and vegetables in it. Because they're fresh and they spoil, fruits and vegetables are more expensive. Fats and sugars are very cheap, so foods that are made with fats and sugars are cheaper. And processed food doesn't spoil. It's just more economical for people who are on a fixed income or a low income to eat very calorie-dense foods. And that's the kind of diet that people tend to become overweight on.

Right now, the food and advertising industry are self-regulating when it comes to advertising to kids. But last month, Sen. Tom Harkin, D-Iowa, said that he's going to introduce a bill that would give the Federal Trade Commission the authority to regulate advertising to kids. Do you think that will help, and do you think it's likely to happen?

In the '70s, there was an effort by the FTC to ban advertising to kids under the age of 7 or 8. And there was a huge backlash on the part of the food industry and all the advertisers and there was a big lobbying effort against it. Congress ended up not only reversing this ban but cutting the FTC's funding. So, it really didn't fly the last time.

It would be a good thing [if advertising was curtailed]. There's a fair amount of data that shows that kids under 7 can't tell the difference between an ad and regular programming.

Do you think that the threat of obesity lawsuits is going to make the food industry change what it markets and sells? Kraft made a big announcement that it's not going to advertise some of its worst foods, such as Kool-Aid and Chips Ahoy, to very young children.

I see the industry going in two different directions at once. For instance, Pepsi said that they were going to make Diet Pepsi their flagship beverage, not regular Pepsi anymore. And they were going to spend much more advertising money on Diet Pepsi. Brock Leach, a senior vice president at PepsiCo said recently that in the last 15 years convenience was the value-added thing that people were willing to pay for. They think that in the next 15 years it's going to be health. So they're moving to market their products as healthy now. They're trying to reduce saturated fats and various sugars so that they can put stickers on their products and market them as better for you.

At the same time, you see Hardee's just introduced the Monster Thickburger, and, apparently, it's really popular. So, you see the industry going in two directions at once. Because the public is going in two directions at once.

But you don't see the healthier direction you describe as some kind of reaction to the fear that they're going to be regulated or sued?

No, I think it's more of a reaction to all the media attention that obesity is getting, and the fact that people are talking about it, and people are concerned. They see that there is a market for healthier products.

Paul Campos, author of "The Obesity Myth," has argued that American's anxiety about fat is really a form of anxiety about our bigness as a culture. He said in an interview with Salon: "Overconsumption in America is closely equated with class: The higher up you go the more you consume. The only area in which consumption is inversely related to class is caloric overconsumption. So the American elite project anxiety about the fact that they're massively overconsuming economically and materially through a disgust for fat, lower-class people." What do make think of that argument?

It's a tortured argument compared with the actual statistics that we have on the numbers of medical problems that are cropping up in obese kids and adults. I don't disagree that America is an overconsuming society. I do think that we consume far more than we should in terms of energy and consumer goods.

But that doesn't get away from the fact that obesity is making people sick. It's making adults sick. It's making children sick. It may be reducing future life expectancy of the kids who are alive today. You don't have to make philosophical arguments to make that point. It's pretty much hard fact.

• View blog reactions