I am not the first, by far, to say that sustainability has a far wider context than "just" energy efficiency. Even on this blog, Andrea Atkinson of the Green Roundtable made that point when I asked her "what's the one thing you wish everyone would just get right?"
But it wasn't until recently that "I" made a sustainability connection between my two principle issues/causes: sustainability in the energy context and food addiction. I put the pronoun in quotes because it really came from a LinkedIn friend-of-a-friend, whom I would name if I knew it was OK with him. For today, anyway, the tie is strong enough to justify its inclusion in a blog called "Sustainably," even if it probably isn't what many readers would expect to see.
It's not a leap at all to aver that any life of addiction is unsustainable; it is nothing short of suicide on the installment plan, and for food addicts, the plan is one of the most extended: You can drink or drug yourself to death much more quickly than you can eat yourself there, but die prematurely you will. And the slow timing will allow you to wallow in your misery all the more.
But that's not the point I want to make this morning. No one could argue that most of the popular "remedies" to obesity work very well — not with statistics that say that two out of every three adult Americans are overweight.
Everything about the psychology of dieting colors it temporary — a short-term change followed by a return to regular habits. People who subscribe to dieting want a permanent change from a temporary action. That's a plan that intends to be unsustained.
And yet I still haven't arrived at my specific point, which is about bariatric surgery. This "solution" restricts the amount of food the patient can take in, as if the problem was ever excess capacity. People are not fat because they are physically able to take in more food than is healthy. That description applies to everyone.
No, the problem is that some people want to take in more food than is healthy. (Granted, a lot of these people would object to "want," but unless someone is holding a gun to their head while they empty that "serves four" pint of ice cream, he or she has a role in it, at a minimum.)
Giving people a smaller space to stuff just gives them another problem — "I want more and my physiology won't let me; how can I get around that?" Some people eat more often, the equivalent of an intravenous cheeseburger drip. Others rupture the new cavity. According to my friend Phil Werdell, whose book on bariatric surgery I edited, 6 to 8 percent of patients develop advanced drug or alcohol abuse within the first year.
That shouldn't surprise: There is no way that skillful surgical blade work can cut out the will to overeat. That is a spiritual and emotional issue, which, in myself and in many others I know, underlies the physical issue.
I don't contend that bariatric surgery is inherently bad. Some people whose out-of-control eating has gone on too long and created grave and imminent health risks may well need emergency intervention. But it alone is very unlikely to solve the problem, and the likelihood falls to near zero for anyone who elects the surgery to "get rid of the problem, once and for all."
My other disclaimer: I do not say that all obese people are food addicts, never mind all overweight people. There are myriad reasons for becoming seriously rotund. What I suggest is that millions of Americans — possibly upwards of 30 millions, if you give any credence to to epidemiology — are undiagnosed food addicts. I also suggest that the more someone weighs, the higher the likelihood that the person has crossed the line from poor habit to habitual use.
I additionally suggest, quite obviously, that these are public-policy issues. If a large proportion of the most obese are driven by food addiction, then establishment acknowledgment, diagnosis, and treatment of food addicts is the one step that will effect the greatest reduction in obesity-related health costs. (Worth noting: $4.4 billion was spent on bariatric surgery in 2007. Insurance generally supports the surgery, but doesn't support treatment for food addiction.)
We are not there today, but we will get there. People scoffed at the idea that there was a medical component to habitual, self-destructive drinking, and now practically no one disputes that. Ditto for gambling, sex, coke and other drugs, and there's more where they came from.
If you think food addiction is a canard, I hear you. I've been hearing it since I was a fat 8-year-old. You're wrong, even if you are in the vast mainstream. If you can possibly stomach it, I ask you, just for today, to consider the possibility that your outlook has room for growth.