Creative Destruction, Economic Insecurity, Stress, and Epidemic Obesity

I confess I am not charmed with the ideal of life held out by those who think that the normal state of human beings is that of struggling to get on; that the trampling, crushing, elbowing, and treading on each other's heels, which form the existing type of social life, are the most desirable lot of humankind, or anything but the disagreeable symptoms of one of the phases of industrial progress. (Mill 1848: 748) Thus we have been expressly evolved by nature--with all our impulses and deepest instincts--for the purpose of solving the economic problem ["the struggle for subsistence"]. If the economic problem is solved, mankind will be deprived of its traditional purpose ... Will this be a benefit? If one believes at all in the real values of life, the prospect at least opens up the possibility of benefit. Yet I think with dread of the readjustment of the habits and instincts of the ordinary man, bred into him for countless generations, which he may be asked to discard within a few decades. (Keynes 1932: 366) I Introduction THE PREVALENCE OF obesity among American adults has been increasing for at least 100 years (Helmchen and Henderson 2004) and recently at an increasing rate. Relatively stable from 1960--when nationally representative data were first collected--until 1980, obesity rates have since doubled. Extreme obesity has tripled to about 5 percent of all adults. (1) Obesity increased dramatically among adults of all gender, age, race, ethnicity, and socioeconomic groups studied. One-third of the adult population is now obese, and two-thirds are overweight. (2) The associated health risks, including Type II diabetes, heart disease, hypertension, stroke, and certain cancers, are making obesity a leading cause of preventable disease and death. By some estimates, only tobacco use causes more preventable deaths. The obesity problem has been likened to an epidemic (Flegal 2006; Wang and Beydoun 2007). See Figure 1 for trends in the prevalence of overweight, obesity, and extreme obesity in the United States. Other wealthy countries have experienced dramatic increases in obesity since 1980 (WHO 2000). In the United Kingdom, for example, the prevalence of obesity among adults has almost tripled since 1980 (Rennie and Jebb 2005). In a number of former Warsaw Pact countries, obesity levels are almost as high as in the United States (Cutler, Glaeser, and Shapiro 2003: 98). More recently, obesity has even been recognized as a public health concern in developing countries. (3) For the first time in human history, there are more overweight than underweight adults worldwide (Caballero 2007: 1). No one seriously contends that genetic changes over recent decades can account for this epidemic. It must be a natural, albeit undesired, response to changes in the environment that has increased the likelihood of calorie intake exceeding calorie expenditure (Hill and Peters 1998: 1371). [FIGURE 1 OMITTED] The two principal environmental reasons given for the American obesity epidemic (the "Big Two") are decreasing cost and increasing availability of food, especially in the form of fast or junk food high in fat and sugar, and the decline of physical exertion (Keith et al. 2006). Although there is surely some truth to these claims, they do not seem capable of explaining the full extent and timing of the explosion in obesity. Throughout much of history, the very wealthy have had food--even fat-rich and high-sugar foods--readily available. Further, they had servants and thus labored little. Although sometimes plump--a mark of high status--they were not typically obese (Gilman 2004: 10-14). Surveying the evidence, Keith et al. (2006) conclude that undue attention has been given to the Big Two, resulting in neglect of 10 other equally plausible mechanisms. This article explores a potential socially-generated cause of obesity not included in the list provided by Keith et al. …