Yes, I got the memo -- my last column was rather lengthy, and even a bit abstruse. I contend there is method in my apparent madness but concede there may be just a bit of vice versa as well. So here, then, is the gist of it, simpler -- and in many fewer words.
The new documentary Fed Up compellingly conveys the scope of the modern obesity/chronic disease crisis and effectively implicates Big Food. It is not the first film to do so, but it was time for a reminder.
In my opinion, the film makes a very serious error by suggesting that everything experts have ever said about how to fix the problem was wrong. For one thing, that simply isn't true; what we have done with expert advice has been wrong, but the advice itself -- imperfect though it may always have been -- was far less problematic. Second, and more important: If we can't trust any prior experts, why on earth should we trust this batch? The message that experts can't be trusted does exactly what it is intended to do: It cultivates distrust.
The result is not just that we ignore the weight of evidence and bop from one diet theory to another, but that we also ignore expertise more generally.* So, for instance, we side with the conspiracy theorists, and against the evidence -- and renounce immunization. The result is measles outbreaks, with worse to come. Yes, I indict the erosion of trust and the repudiation of expertise as a root cause of this and many related follies. We can measure the cost of this in lives.
As for the comparison of food to sex: They are both fundamental imperatives of biology. In the case of sex, we have always had relevant rules. In the case of food, we never before needed the rules we now need. The challenges we now face -- too much, too many, too processed -- did not exist throughout history.
Talking about personal responsibility -- as Fed Up does at length, mostly to refute its importance -- may be pointless when no one can yet say what responsible behavior is.
We know, for instance, that sharing cigarettes, or alcohol, or other drugs, or sexually explicit material with a 5-year-old is not only irresponsible, but immoral, illegal, and repulsive. A decent person simply couldn't do any of these things.
But what about feeding that 5-year-old those multi-colored marshmallows as part of a complete breakfast? Is that responsible? Is that irresponsible? If so, always -- or just some of the time? Is it responsible or irresponsible to let a child drink soda? And if it is irresponsible, then how can it be responsible to market the product for such use? That would be like marketing vodka in sippy cups.
So, frankly, we are culturally schizophrenic on this issue, hearing multiple voices, and detached from rational thinking. That just won't do. Before individuals can behave responsibly, culture has to tell them what separates responsible from irresponsible behavior. There are cultures where it is irresponsible, irreverent, and even disgraceful for a girl to go outside her home with her face exposed, or for anyone to wear shoes inside. Our culture isn't one of them. In each case, individuals motivated to do what their culture says is appropriate behave accordingly. In the absence of cultural guidelines, responsibility has no stable definition.
In my view, experts do know, and have long known a thing or two about eating well -- we have just never followed any sensible advice. We've mangled it, then abandoned it -- to move on and do it again. In my view, personal responsibility should in fact be relevant, but cannot be in the absence of cultural responsibility. In the absence of norms, everything goes. We may never before have needed cultural norms that function as rules about who should eat what, when, how much and with whom -- but we sure need them now.
Yes, we have cause to be fed up. But there's no time to sit and digest. We have an urgent need to get our culture caught up with the circumstances and perils of our time. Cultures either keep up, or they are undone by their anachronisms. Updating ours is overdue -- and the credits are coming up fast.
*My own credentials are routinely hurled at me in the form of an epithet, as if I should be ashamed of them. But they are not just alphabet soup, and they certainly aren't boasting. They represent approximately 36,000 hours of arduous training over nine years; I did the math. So forgive me, I don't think a few minutes, or even hours spent surfing the Web to look for the particular opinions we like is quite the same. Our culture acts as if it is.
Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz