A Big Fat Crisis ― The Hidden Forces Behind the Obesity Epidemic - and How We Can End It

In the hot days of the summer of 1972, the New York City Health Department investigated an unusually high incidence of deaths among toddlers who fell out of tenement windows. Initially mothers and caregivers were blamed for not being alert, not properly supervising children, or simply neglecting naturally curious toddlers and adventurous young children who leaned out of apartment windows, or crawled onto fire escape stairwells to try and cool off. After an investigation, the health department launched a campaign, ?Children Can’t Fly” and offered free window guards to families in tenement buildings. The next summer, there were no falls from buildings that had the new window guards.

The story of ?Children Can’t Fly” is an apt analogy for the problem and the solution to the obesity epidemic. Children are born curious and may wander to an open window even if (or because) we tell them to stay away. All of us were born with the capacity and inclination to eat more than we need. In a world where there is too much food, we currently have no constraints that limit our natural tendencies to automatically eat what is readily available.

Dr. Cohen has created a major new work of nonfiction that will transform the national conversation surrounding the weight crisis in this country and throughout the world. Based on her own research at the RAND corporation, as well as the latest insights from behavioral economics, psychology, cognitive science, and the social sciences, A Big Fat Crisis reveals the surprising forces behind the obesity epidemic and how we, as a nation, can overcome it. Her conclusions contradict conventional wisdom and widely held expert opinion, and go against our own intuitive beliefs about the way we eat. They represent, in short, a paradigm-shift in how we approach the problem of obesity?and the solution.
A Big Fat Crisis argues that the obesity epidemic is the product of two forces:

(1) Immutable aspects of human nature, namely the fundamental limits of self-control, the lazy decision-making of the brain’s non-cognitive system, and the automatic and unconscious way that we are hard-wired to eat; and
(2) A completely transformed food environment: all of the food-related elements of our surroundings, including food stores and restaurants, prices, portion sizes, the types of food available to us, and food marketing and advertising.

A Big Fat Crisis offers concrete solutions, arguing that the most important and modifiable steps in the chain of events that leads to obesity are at the point of purchase and the point of consumption. Like cholera and typhoid in the 19th century, obesity is a public health crisis. Ending it requires solutions that transcend individual behavior. Change begins with a fresh perspective and a clearer vision of what we need to do. We can tackle the obesity epidemic. We just can’t do it alone.

Deborah Cohen is a Senior Natural Scientist at the RAND Corporation. Cohen received her M.P.H. in epidemiology from the UCLA School of Public Health; and her M.D. from the School of Medicine, University of Pennsylvania. She has served on several advisory panels for the National Institutes of Health (NIH) and was a Fulbright Senior Scholar in Brazil.