Last week, I reviewed the companion book to HBO’s groundbreaking documentary, Weight of the Nation. On Monday and Tuesday nights, HBO debuted the four-part documentary series, which is driven by HBO, the National Institute of Health, and the Centers for Disease Control and funded in part by Kaiser Permanente.
Below is a review of all four parts of Weight of the Nation. Because of the importance of the weight issue in America, HBO has made the films available to watch on their website for free. You don’t need to subscribe to HBO to be able to see them. Additionally, the website offers resources to learn more about the weight issue, what you can do for yourself and others, and how to live a healthier life.
Part 1: Consequences
The series begins discussing BMI (body mass index) and how BMI is used to determine the percentage of Americans who are overweight or obese. Adults with a BMI between 25 and 29.9 are considered overweight, and those with a BMI over 30 are considered obese. Using that calculation, a recent survey conducted by the CDC determined that 68.8% of Americans fall within this unhealthy level. Focusing on personal stories and accounts, the series uses these stories (like the Bogalusa Heart Study) to give a visual understanding of the problem from childhood to adulthood.
Through these stories, it’s easy to see the visual consequences of carrying extra weight. Because the documentary details the causes of diabetes, high blood pressure, and heart disease—just to name a few—and shows people actually afflicted by these diseases, it can be tough to watch. The doctors and experts that are interviewed are compassionate but honest—they realize that, in most cases, many of these diseases are preventable.
Some of the most alarming stats indicate that obesity rates skyrocketed in the 1980s, transforming obesity into a national problem. While in the late 1980s and early 90s, the South had some of the heaviest people in the nation (and still does), unfortunately today every region suffers from obesity and its medical and economic impacts.
This episode admittedly states that while there are lifestyle choices that affect weight, DNA and genetic disposition also play a key part in the national obesity epidemic. The genes that specifically work to control our food intake and tell us when we’re full are genetically traced to our early ancestors. We were programmed to eat as much as we could to survive when food was scarce. That was tens of thousands of years ago—today food in America is virtually everywhere, and most of it is quickly obtained, cheap, and unhealthy for us.
It’s a scary and sad episode to watch. Seeing obese and overweight children is extremely sad. Some of these students who stay on the same track will be on dialysis by the time that they’re 30. Consider this fact for a moment and then reflect on the potential economic impact on the country, when the healthcare industry will be forced to deal with this pandemic.
HBO’s website states that “Even a small amount of excess weight, accumulated slowly at the rate of a few pounds a year over many years, can lead to type 2 diabetes. Being over 45 years of age, having a family history of diabetes, being physically inactive, and being overweight or obese can increase a person’s chances of developing type 2 diabetes. If poorly controlled or left untreated, type 2 diabetes can lead to a number of serious health problems, including heart attack, stroke, kidney disease, blindness, amputation, and even death.” Excess fat doesn’t just live under our skin around our abdomens. It lives in our hearts, livers, and other major organs. It’s literally killing America.
Part 2: Choices
The big question is, “What can I do?” Many people want that magic pill to help the weight go away—and a lot of money is being spent on researching the obesity problem. The National Institutes of Health, for example, spends over $800 million annually on obesity studies and research. The doctors in this part admit that there’s no magic pill currently. The keys? Healthy diet and exercise—which are incredibly hard for most people because there’s a lot to learn. The documentary’s suggestion is to start small and focus on caloric intake. This episode does a much better job than the book in giving some concrete things that you can do to reduce your weight.
What’s perhaps the biggest influence for people who succeed in losing weight? A support system of friends, family, and doctors they’re able to talk to, work with, and help them through the rough patches and cheer them on during the highs. One of the personal stories is about Yolanda, who says that she uses this book, The CalorieKing Calorie, Fat, & Carbohydrate Counter 2012, to detail the caloric values of everything she eats.
It’s very surprising that when the interviewees discuss which diets they’ve tried, they admit that they all failed at them. In fact, the diet industry is under attack in this episode. Diets are essentially short-term solutions. They help you lose weight quickly but don’t teach you to keep it off and adjust your lifestyle to maintain your goal weight.
Imagine that there are two women that weigh 140 pounds. Woman A has weighed 140 pounds for her entire adult life, but Woman B weighs the same number of pounds after dieting. Because of metabolic circumstances, Woman B needs to consume 20% FEWER calories than Woman A to maintain this weight. This is essentially the issue with most name brand diets. They don’t teach you how to maintain the goal weight.
Lastly, bariatric surgery is one of the solutions that the documentary discusses. It isn’t for everyone, but for those who are at serious risk, it might be the right choice. It isn’t a perfect fix, but it can help those in need. Detailing how it works, what is required, and the risks involved is one of the most interesting (and possibly disturbing) parts of the episode for some to watch. The specific example of a man is scary to watch because he suffers from a significant list of complications (which he admits he does not believe is from medical negligence) yet, within five months of surgery, he lost 109 pounds. The risk is serious, but the outcome can be incredibly beneficial.
Agree or disagree with these statements, it’s just another reason to do yourself a favor and watch this episode.
Part 3: Children In Crisis
In this episode, the sentiment card is played. It’s not a bad thing because for some reason, adults have a tendency to look past their own well being, but they very quickly feel guilty and sad when they find out children are afflicted by problems like this.
Initially, the episode begins by reminding adults that children are bombarded by advertisements and marketing for foods that are unhealthy for them. The problem is that children don’t know that unhealthy foods are bad for them if we don’t tell them. Almost every box of children’s cereal is bright, fun, and colorful, and what’s inside is sugary. Sometimes the boxes have toys. It’s all part of the food industry’s goal to sell food. Commercials for children are dominated by fun cartoons and food marketing. They’re extremely effective—$1 billion annually marketed toward children—and vastly influence what kids want and are willing to eat.
The health issues that affect our young children are shocking. Children who are obese and under 15 have metabolic characteristics of an adult who are 1o years older or more and are overweight. The trends suggest that this current generation of children will statistically have a shorter lifespan than their parents. Outside of the internal health problems, children have to deal with the societal issues of adapting to a culture where being overweight suggests being less than perfect.
Yet the obesity rates among children continue to rise. Blame the food companies, video games, TV, and plenty of other external examples, but there are many issues at play—including, but not limited to, adults neither leading by example nor encouraging an active, healthy lifestyle. If you watch football during the NFL season, you’ve probably seen commercials for Play 60, an effort to get children to engage in physical play for at least 60 minutes everyday. This time length is also suggested as a solution by the doctors involved in this documentary as well.
I’d argue that this is the most important episode of the entire series. Every parent should watch this! There are more important facts to talk about in these 60 minutes than can fit in here, but a particular point should be made to pay attention to the segment on school lunches. In Madison, Wisconsin a coalition of parents called Madison Families for Better Nutrition is doing just this by drawing attention to the food children get at school. It’s unbelievable to see that budgetary cuts are many times first seen in this area. One of the easiest ways to save money for a district is to serve cheap, re-heatable, and processed food. Again, this is the best and most important part of the series, so if you plan to watch just one, make it this episode.
Part 4: Challenges
Despite the somewhat overwhelming nature of discussing obesity in America, it’s not a war we can’t win. In the final part of the series, the filmmakers look at what stands in our way, challenges not yet faced, and a guess as to what is to come.
Again, a heavy focus is put on the food industry, particularly the fast-food industry. With near constant advertising by way of TV commercials, billboards, and print advertisements, we see thousands of ads a day—many of which are for soda, burgers, treats, cookies, and candy. The big challenge from this food industry is the disparaging profit margins in the food that our farmers grow. There is on average, a 90% profit margin on soda. There is a 10% margin on fresh produce. With differences like this, it’s no wonder that the most dominant crops grown in America (corn, wheat, soy, and other grains) are the basis of many key ingredients in our food.
With fresh produce costing so much to make and sell, it’s not surprising that many Americans move right past these sections in the grocery store. But it’s a fact that eating and cooking with fresh food is not only healthier, it has better results for your local economy. Simply by attending a farmer’s market, you get the freshest produce and the best prices.
Nashville is an example of a city struggling with its population’s weight but also doing substantial projects to try and reverse the trend. Through building more green spaces, parks, bike paths, and encouraging education on public health, the city is taking great steps in the right direction.
Although the doctors throughout the episode many times knock the viewer over the head with depressing visuals and facts, it’s important to walk away from your TV (I realize the irony in writing this) after committing four hours with a sense of empowerment for self-improvement. As the experts say, the weight issue is one of the most dangerous problems facing America today and in the future—but it’s an issue that can be fixed.
I sincerely believe that the documentary offers a great educational background to help teach you the facts about how weight affects your life. But it isn’t perfect. Thankfully, in conjunction with the website, you should be able to find the resources you need to get started. If this is a challenge you’ll personally be taking on, I wish you the best of luck and hope you stay inspired.