From where David Kessler sits, Americans live in a whiz-bang, lights-flashing, bells-ringing, nonstop carnival of food. It’s everywhere, and expertly blended to taste good. For most of us, that’s too much to resist.
The result is an obesity epidemic roaring out of control, sweeping up Kessler himself, along with two-thirds of Americans who are overweight or obese.
Kessler, former commissioner of the U.S. Food and Drug Administration (FDA), said Tuesday (March 9) during a talk at the Harvard School of Public Health (HSPH) that obesity mirrors many traits that smoking had before public health efforts began to erode both its image and the number of smokers.
Chains and processed-food manufacturers have opened a restaurant or snack shop at most major intersections and bombarded the public with advertising that says processed and restaurant food makes you cool, makes you have fun, and makes you popular. Even as those images sink into the nation’s psyche, food scientists have applied themselves to creating perfectly irresistible concoctions of sugar, salt, and fat.
The result, Kessler said, is something of a perfect storm of messaging, opportunity, and desirability that has successfully snagged all too many of us. Today, Kessler said, cultural barriers that once restricted where and when we eat have fallen. Americans now eat at mealtimes, but also between meals, in meetings, in cars, on sidewalks, and in university lecture halls. Excess is no longer frowned upon, it’s celebrated, creating a supersized-food free-for-all that doesn’t exist in many other countries, where eating between meals is rare and where eating in formal locations, such as lecture halls, is frowned upon.
Kessler, who led the FDA during the 1990s campaigns against tobacco, said the similarities to that predicament provide a roadmap out of this one.
Like tobacco, he said, unhealthy eating and eating to excess need an image makeover. Tobacco at its height bombarded the airwaves with images of cool smokers, manly smokers, sexy smokers. Smoking was allowed everywhere — including in restaurants and on planes — and was accepted in many homes. Slowly, however, public health officials successfully fought tobacco’s general acceptance through campaigns against secondhand smoke and bans on advertising, eroding smokers’ cool image and crafting an unhealthy one.
“We didn’t change the product, we changed the perception,” Kessler said.
Food will be a tougher nut to crack, Kessler acknowledged. Unlike tobacco, which everyone can survive without, people can’t live without food. The neural circuits and urges that food manufacturers have successfully tapped are among the most basic.
“I think it’s going to require everything that we’ve learned with tobacco. It’s going to take efforts on the public health side greater than anything we’ve done to date,” Kessler said. “Remember the middle school child who said, ‘Mom and Dad, please stop smoking?’ We will know we’ve made a change when that kid says, ‘Mom and Dad, please don’t take me to McDonalds.’”
Kessler delivered the annual HSPH Stare-Hegsted Lecture, named after two founders of the School’s Nutrition Department. He also has written “The End of Overeating: Taking Control of the Insatiable American Appetite.”
In his talk, which was introduced by HSPH Dean Julio Frenk and Nutrition Department Chair Walter Willett, Kessler described his own struggle with obesity — he said he owns suits in many sizes — and his growing fascination with its biological roots.
He described recent obesity-related research that shows that it’s not just sugar, salt, and fat that make food attractive, but a combination of flavors that pull us toward specific foods. Behavioral pathways in the brain are created by eating those foods repeatedly, so if we’re not careful we become behaviorally predisposed to eating certain foods at certain times and places, whether we’re hungry or not.