Fat Nation : A History of Obesity in America
by Engel, Jonathan

1 An Old Problem
2 Whence Cometh Fat?
3 The Unwalkable Landscape
4 Changing Lives
5 Changing Food/Changing Meals
6 Addicted to Food
7 Finding the Off Switch
8 Exercise, Drugs, and Surgery
9 Self-Control
10 Disparate Impacts
11 What Is to Be Done?
Selected Bibliography193(4)
About the Author209

The estimated annual health care cost of obesity-related illness in the United States is $190 billion, with countless more costs in lost mobility, vigor, and life-years. Here, Jonathan Engel reviews the sources of the problem as they have developed over the past 70 years and offers a realistic plan for helping address obesity.

Jonathan Engel is professor of health policy and management at the Marxe School of Public and International Affairs at Baruch College, CUNY. He has taught previously at Seton Hall University, the Mailman School of Public Health at Columbia University, and at the School of Public Health at the University of Massachusetts. He served as a staff historian on the President’s Advisory Committee on Human Radiation Experiments, and as the lead author on multiple HIV needs assessments for the city of Newark. In addition, he has conducted strategic design projects for the Kings County Hospital Center, the United Neighborhood Houses of New York, the Edwin Gould Services for Children and Families, and Creative Cities International. His books include Doctors and Reformers, (2002); Poor People’s Medicine, (2006); The Epidemic: A History of AIDS, (2006); American Therapy: The Rise of Psychotherapy in the United States, (2008); and Unaffordable: American Healthcare from Johnson to Trump (2018).

The average American adult doesn't walk much (not even one-third of a mile per day) yet finds time to watch lots of TV (about 4 hours daily) and consume heaps of sugar (almost 3 pounds weekly). It's no wonder that two-thirds of U.S. adults are overweight or obese. But obesity is complicated. Overeating and sedentary lifestyles are only part of the picture. Calories are now pretty cheap and readily available in America. The design of our communities often discourages walking; transportation is mostly mechanized, and many jobs are less physically exerting than in the past. Sugar and high fructose corn syrup, ubiquitous in prepared food, are implicated in the rising rate of obesity. Engel even suggests that human beings have evolved to be lazy. Different types of diets, weight-loss medications, and bariatric surgery are briefly reviewed. The addictive makeup of manufactured food, the peril of snacking, and the elimination of home economics curricula are discussed. The message is obvious but still urgent: If our food and surroundings don't change, our body fat and health risks will surely swell. Copyright 2018 Booklist Reviews.

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