Can We Stave Off The Age of WALL-E?

In the cheerful but distinctly cautionary 2008 Pixar film WALL-E, the slide into widespread, morbid levels of human adiposity is complete. The movie depicts a distant future in which the best our atrophied species can do is ride around in powered cars, always sitting, scarcely turning their heads as they consume huge amounts of sugary soft drinks from sippy cups like giant infants, too weak to self-propel or, really, to even stand up. Every service is automated, every experience of physical activity virtual.

Most unsettling of all, these distant cousins of ours seem entirely content to live this way. The battle for hearts and minds in the health and fitness wars has been utterly lost. This disturbs, if amuses, us as present-day viewers in large part because the sheer complacency with which the humans in the movie experience this plus-sized dystopia clearly dooms them to live in it forever. It also offends our sense of the human spirit, the trying always for a better self and a better world. These folks have given up.


Courtesy of Walt Disney Studios

Now, a research letter published in JAMA offers evidence that this may well be the trend we are on. We may still be in the phase where this is a valuable warning shot, but the data suggest there are an increasing number of hearts and minds to win over every year in the above-mentioned health and fitness wars.

The study examined data from The National Health and Nutrition Examination Survey (NHANES) to determine trends in weight-loss attempts over two and a half decades, and what it has found is increasingly WALL-Esque levels of complacency creeping into the national psyche: Each year, overweight adults are less and less likely to try to lose weight than overweight adults from earlier generations.

Using the NHANES data, researchers examined attempts at weight loss in 1988–1994, 1999–2004 and 2009–2014. Overall, 27,000 overweight or obese adults aged 20–59 reported whether they had tried to lose weight in the previous 12 months.

The percentage of respondents who reported weight-loss attempts declined from 56% in the earliest period to 49% in the latest. The decline was largest among cohorts with the highest obesity prevalence.

The authors write that these results may be due to body weight “misperception,” which could reduce motivation to engage in weight loss efforts. They also wonder whether primary care clinicians are more often avoiding weight discussions with patients. Surely an additional factor is that, as the authors write, "[T]he longer adults live with obesity, the less they may be willing to attempt weight loss."

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While the solid 7% increase in weight complacency does not yet require a declaration that the battle is lost and the sky is falling, there is scant evidence to suggest that this trend will suddenly reverse among the populations most harmed by unhealthy weight gain, even as many others among the wider population are seeing the value of regular physical activity and taking up its mantle.

If instead the trend continues, we may see slides into greater complacency at a rate far beyond 7% over two and a half decades. But beyond this 26-year look at increased complacency with unhealthy body weight, we can look back even further using CDC and NHANES data to identify alarming changes in obesity trends in general.

Trends from the 1960s to 2000

  • The percent of obese adults (BMI 30 or greater) increased over four decades from the 1960s to 2000, as the percentage of adults with healthy weights declined.
  • The percent of obese adults varied little from 1960 to 1980 but increased considerably between 1980 and 1991, from 13 to 21% among men and from 17 to 26% among women.
  • This trend continued in 1999–2000, with an increase in obesity of 28% of men and 34% of women.
  • The percent of adults with healthy weights declined approximately 10% from 1960 to 1994, with an additional decline of approximately 8% from 1994 to 2000.

These longer-term trends shed light on why over the last quarter century the proportion of overweight adults attempting to lose weight has declined significantly. If socially acceptable body weight is in general increasing, it may be due in part to the increased commonality of obesity and overweight in the culture, which can begin to normalize it. In turn, if more individuals who are overweight or obese are satisfied with their weight, fewer might be motivated to lose unhealthy weight, compounding the normalizing effect.

JAMA, 2017, Vol. 317, No.9, pp. 971-973, http://jamanetwork.com/journals/jama/article-abstract/2608211

CDC, NHANES Data Brief, 2000, https://www.cdc.gov/nchs/data/nhanes/databriefs/adultweight.pdf

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