The Making of the Obesity Epidemic

How Food Activism Led Public Health Astray

1. Breslow, Lester. “Public health aspects of weight control,” reprinted in International Journal of Epidemiology 35 (2006): 10–12. Presented at the Annual Meeting of the Western Branch, American Public Health Association, Denver, CO, June 6, 1952,

2. William L. Laurence, “Obesity is called drag on life span,” The New York Times, October 23, 1952.

3. Dr. Jeffry Weiss, "Why we eat ... and why we keep eating," Medical & Advisory Board - Insulite Laboratories, n.d.,

4. McDonald’s had 7,778 restaurants in 32 countries in 1983.

5. CDC (2008), Prevalence of overweight, obesity and extreme obesity among adults: United States, trends 1976-80 through 2005-2006, Hyattsville, MD: U.S. Department of Heath and Human Services, National Center for Health Statistics, CDC,

6. Ibid.

7. CDC (2012), Prevalence of Obesity Among Children and Adolescents: United States, Trends 1963–1965 Through 2009–2010, Hyattsville, MD: U.S. Department of Health and Human Services, National Center for Health Statistics, CDC,

8. Ibid.

9. David M. Cutler et al., “Why Have Americans Become More Obese?” Journal of Economic Perspectives 17, no. 3 (2003): 93-118.

10. Waldemar Kaempffert, “Problems of overweight and overeating are subjects of Harvard nutrition symposium,” The New York Times, November 2, 1952.

11. United Press International, “Obesity termed killer disease by national panel of experts," Houston Chronicle, February 14, 1985.

12. Regina G. Lawrence, “Framing Obesity: The Evolution of News Discourse on a Public Health Issue,” Harvard International Journal of Press/Politics 9, no. 3 (2004): 56-75.

13. David Cutler and Grant Miller, “The Role of Public Health Improvements in Health Advances: The Twentieth Century United States,” Demography 42, no. 1 (2005): 1-22.

14. An estimated 42.4 percent of adults in the United States smoked in 1965. CDC (2011), “Trends in Current Cigarette Smoking Among High School Students and Adults, United States, 1965–2010,” Atlanta, GA: US Department of Health and Human Services, CDC,

15. Office of the Surgeon General, Smoking and Health: Report of the Advisory Committee to the Surgeon General, Public Health Service Publication No. 1103 (1964), U.S. National Library of Medicine,

16. Ibid.

17. CDC (2011), "Trends in Current Cigarette Smoking ... "

18. Lori Dorfman and Larry Wallack, “Moving Nutrition Upstream: The Case for Reframing Obesity,” Journal of Nutrition Education and Behavior 39, no. 2, (March 2007),

19. CDC (2011), "Trends in Current Cigarette ... "

20. Regina G. Lawrence, “Framing Obesity...” 56-75.

21. CDC (2013), "HIV in the United States: At A Glance," Atlanta, GA: Department of Health and Human Services, CDC,

22. Estimates of between 30 and 50 million people died from the 1918-1919 pandemic worldwide. U.S. Department of Health and Human Services, "The Great Pandemic,"

23. CDC (2011), "Tobacco-Related Mortality," Atlanta, GA: U.S. Department of Health and Human Services, CDC,

24. Ali Mokdad et al, “Actual Causes of Death in the United States, 2000,” Journal of the American Medical Association, 291, no. 10 (2004).

25. The authors published a correction in January 2005: Ali Mokdad et al, “Correction: Actual Causes of Death in the United States, 2000,” Journal of the American Medical Association, 293. no. 3 (January 2005). See also Betsy McKay, “CDC Study Overstated Obesity as a Cause of Death,” Wall Street Journal, November 23, 2004,,,SB110117970881981681-email,00.html.

26. Katherine Flegal et al., “Excess Deaths Associated with Underweight, Overweight, and Obesity,” Journal of the American Medical Association 293, no. 15 (April 20, 2005).

27. Chong Do Lee et al., "Cardiorespiratory fitness, body composition, and all-cause and cardiovascular disease mortality in men," The American Journal of Clinical Nutrition 69, no. 3 (March 1999), 373-380,

28. Tina Moffat, "The 'Childhood Obesity': Health Crisis or Social Construction," Medical Anthropology Quartery 24, no. 1 (March 2010): 1-21, See also: X. Sui et al., "Cardiorespiratory Fitness and Adiposity as Mortality Predictors in Older Adults." Journal of the American Medical Association 298, no. 21 (2007): 2507–2516,

29. Cynthia Ogden et al., Prevalence of obesity in the United States, 2009–2010, NCHS data brief, no 82, Hyattsville, MD: National Center for Health Statistics, 2012,

30. W.H. Dietz and S.L. Gortmaker, “Preventing Obesity in Children and Adolescents,” Annual Review of Public Health 22 (2001): 337-53.

31. Jonathan Wald, "McDonald's obesity suit tossed: U.S. judge says complaint fails to prove chain is responsible for kids' weight gain," CNN Money, February 17, 2003,

32. These efforts won the endorsement of President Obama in 2010. Gardiner Harris, “A Federal Effort to Push Junk Food Out of Schools,” New York Times, February 7, 2010,

33. Stacy Finz, “Alice Waters push for local, organic setting national agenda,” San Francisco Chronicle, May 9, 2010,

34. K. Giskes et al.,“A systematic review of environmental factors and obesogenic dietary intakes among adults: are we getting closer to understanding obesogenic environments?” Obesity Review, 12, no. 5 (May 2011),

35. Adam Drewnowski and SE Specter, "Poverty and obesity: the role of energy density and energy costs," The American Journal of Clinical Nutrition 79, no. 1 (2004): 6-16,

36. See for example: Michael Pollan, “Big Food vs. Big Insurance,” New York Times, September 10, 2009,

37. CDC (2012), "What causes overweight and obesity," Atlanta, GA: National Center for Chronic Disease Preventions and Health Promotion, CDC,

38. Jeffrey P. Koplan et al., "Preventing Childhood Obesity: Health in the Balance," Institute of Medicine, The National Academes, 2005, PowerPoint,

39. Stephen Isaacs and Ava Swartz. “On the Front Lines of Childhood Obesity,” American Journal of Public Health, 100, no. 11 (2010): 2018,

40. “Robert Wood Johnson Foundation Announces $500 Million Commitment to Reverse Childhood Obesity in U.S.,” Robert Wood Johnson Foundation Press Release, April 4, 2007,

41. “First Lady Michelle Obama Launches Let's Move: America's Move to Raise a Healthier Generation of Kids," The White House Press Release, February 9, 2010,

42. “'Introducing...The California FreshWorks Fund!' First Lady Michelle Obama Hosts Major Food Access Initiative Launch,” California Endowment Press Release, July 22, 2011,

43. L. Macdonald et al., "Neighbourhood fast food environment and area deprivation-substitution or concentration? Appetite 49, no. 1 (2007): 251-54,

44. Adam Drewnowski et al., “Obesity and Supermarket Access: Proximity or Price,” American Journal of Public Health, 102 (2012): e74–e80,

45. Neil Osterweil, "Eating healthfully may be a luxury many cannot afford," WebMD Weight Loss Clinic, March 19, 2004,

46. John Frydenlund, "Farm Subsidies: Myth and Reality," Citizens Against Government Waste Issue Brief No. 1, April 3, 2007,

47. CDC (2011), "Adult Obesity Facts," Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion, CDC,

48. Ibid.

49. Richard Miech et al., “A Growing Disparity in Diabetes-Related Mortality: U.S. Trends, 1989–2005,” American Journal of Preventative Medicine 36, no. 2, (February 2009): 126-132.

50. Paula Lantz, “Socioeconomic Factors, Health Behaviors, and Mortality,” Journal of the American Medical Association 279, no. 21 (June 1998).

51. Sabrina Tavernise, “Door to Door in the Heartland, Preaching Healthy Living,” The New York Times, September 10, 2012,

52. Jamie Holmes, “Why Can’t More Poor People Escape Poverty?” The New Republic, June 6, 2011,

53. Nedra Belloc and Lester Breslow, “Relationship of Physical Health Status and Health Practices,” Preventative Medicine 1 (1972): 409-421. See also: Lester Breslow, “Musings on Sixty Years in Public Health,” Annual Review of Public Health 19 (1998): 1-15.

54. Marion Nestle, "Let’s Move Campaign gives up on healthy diets for kids," Food Politics (blog), December 5, 2011,

55. Raj Chetty, Raj et al., “Using Differences in Knowledge Across Neighborhoods to Uncover the Impacts of the EITC on Earnings,” Working Paper, July 2012, See also Harry Holzer, “Workforce development as an antipoverty strategy: What do we know? What should we do?” Focus 26, no. 2, Fall 2009,

56. There is an ongoing debated in much of the research on social determinants of health regarding whether better education leads to better health or whether better health leads to better educational outcomes (classic “chicken or the egg” problem). Using exogenous variation in compulsory schooling laws, the authors found evidence to suggest that education does play a causal role in protecting against obesity: Paul T. Von Hippel and Jamie L. Lynch, "Why are More-Educated Adults Thinner — Causation or Selection," Working Paper, May 2012, See also: Michael Grabner, "The Causal Effect of Education on Obesity: Evidence from Compulsory Schooling Laws," Working Paper, July 2008,

57. Maria Cancian and Sheldon Danziger, eds., Changing Poverty, Changing Policies, (New York: Russell Sage Foundation, 2009).

58. Julie Marquis, "Mr. Public Health," LA Times, October 13, 1997,