The Body Politic

Anorexia affects far more women than men, especially women in their teens and early 20s. Researchers don't know why, although some believe a genetic predisposition toward particular emotional disorders can be triggered by anxiety about emerging adulthood. "Often young women feel that their lives are out of control," says Marleen Williams, a psychology professor at Brigham Young University who specializes in eating disorders. The reasons for this feeling of helplessness can be simply the pressures of growing up or they can be more deeply rooted, such as an unstable family relationship or a traumatic childhood. Controlling food intake, she says, gives these women the illusion that they are more in charge. But altering just one factor—media images—won't stop the downward spiral, Williams says. "Helping women learn real solutions to life's challenges and making society safer for women would probably do more to decrease eating disorders," she says.

From a public policy point of view, prosecuting victims of a mental disorder—the anorexics and bulimics who typically run these Web sites—seems like cruel and unusual punishment. "Any law that targets victims is ill-considered," says Susan Scafidi, a law professor at Fordham University and an expert on fashion law. "Surely we can find a better way to help these people than criminalizing their speech." Providing more treatment facilities for those already suffering would be far more helpful—as would helping educators and parents learn how to spot early warning signs of trouble.

As devastating as anorexia and bulimia are for those who suffer from those disorders, obesity—the target of the New York regulation—is a far more widespread public health problem and one that seems ever more intractable. New York's public health officials have been fighting hard, with a publicity campaign to get people to eat less and exercise more and a ban on harmful trans fats in restaurants. The calorie-posting regulation is the latest weapon in this arsenal. Among other objections, restaurant owners claim their First Amendment rights are violated if they are required to post a government message. Some say they don't mind posting calories but they just don't want to be told to do it. (Curious customers can already find out the damage they're doing to their diets by logging on to the site of their favorite fast-food outlets and searching for nutrition info; most major chains now have it somewhere—although it can take some digging to find it.)

Whatever the ultimate legal resolution, news coverage of the court battle emphasizes the fact that many chain restaurants are serving up meals that contain almost a whole day's worth of calories and way too much fat. And as that message becomes more widespread, maybe people will begin to pay more attention to what they're putting in their mouths. Even small changes—like forgoing the fries, for example—can make a big difference. And there is evidence that heightening public awareness can be a successful strategy—although perhaps not immediately. Thirty years ago, when the antismoking effort was in its infancy, few believed that it would succeed. But today smoking rates are down significantly. Better public information was critical, as were warnings on packages, higher prices, and laws that limit smoking in public places.

How can those lessons be applied to the obesity epidemic? Public education is a start, but the sad truth is that information isn't always enough to get people to change deeply entrenched unhealthy habits, says Kenyon College psychology professor Michael Levine, who studies eating disorders. Levine uses himself as an example. He suffers from sleep apnea partly brought on by extra weight that his doctor has told him he should lose. And he understands how to make it happen better than most people. Still, he hasn't abandoned fast food. "I don't think the answer is posting calories," he says. Would a tax on high-fat foods help? Or a ban on eating desserts in public? Imagine the uproar if any public official suggested these measures. Eating disorders and obesity are major public health issues, and it's right and proper for the government to push measures that encourage change, but in the end it's up to each of us to act in our own best interest—one forkful at a time.

© 2008