Time, Laura Blue, July 28, 2010

A healthy social life may be as good for your long-term health as avoiding cigarettes, according to a massive research review released Tuesday by the journal PLoS Medicine.

Researchers at Brigham Young University and the University of North Carolina at Chapel Hill pooled data from 148 studies on health outcomes and social relationships — every research paper on the topic they could find, involving more than 300,000 men and women across the developed world — and found that those with poor social connections had on average 50% higher odds of death in the study’s follow-up period (an average of 7.5 years) than people with more robust social ties.

That boost in longevity is about as large as the mortality difference observed between smokers and nonsmokers, the study’s authors say. And it’s larger than differences in the risk of death associated with many other well-known lifestyle factors, including lack of exercise and obesity. “This is not just a few studies here and there,” says Julianne Holt-Lunstad, lead author on the review and an associate professor of psychology at Brigham Young University. “I’m hoping there will be recognition from the medical community, the public-health community and even the general public about the importance of this.”

The friend effect did not appear to vary by sex or by age, with men and women of all ages and health statuses showing roughly equal benefit. Nor were lonely people unusually susceptible to any one disease in particular.

But if it’s true that we get by with a little help from our friends, then how, exactly, do our friends do it? That is, how does “social integration” — measured by surveys and questionnaires about friends, family size, marital status and the number of household residents — influence long life? The short answer is that we don’t really know yet. “The truth of the matter is that the critical evidence on psychosocial processes and health have come about only within the last 10 to 15 years — even though there’s been a lot of theory on it since the 1970s,” says psychology professor Bert Uchino at the University of Utah.

That may help to explain why doctors, for the most part, have yet to embrace social support as a factor in good health, on par with smoking habits, diet or exercise. Without a good sense of the physiological mechanisms that may link feelings of loneliness, for instance, to biological markers like blood pressure and resting heart rate, it has been easy to dismiss the power of social connections as nothing more than an artifact of the data or, worse, as touchy-feely pseudoscience.

To be sure, the direct physical evidence of the health benefits of social support is much more preliminary than the population-level association reported by Holt-Lunstad. But the evidence is mounting, says Uchino, who has written widely on the physiological links between social life and health outcomes. (Uchino did not contribute to the new review in PLoS Medicine, but has collaborated with Holt-Lunstad on other projects and was, once upon a time, also her grad-school adviser.)

We turn to family and friends for obvious tangible support when we’re sick — from help preparing meals to keeping track of pills, appointments and insurance forms. And caring about others may also prompt us to take better care of ourselves. “A really good example, of course, is someone who has a child,” Uchino says. That new bond is often the impetus to quit smoking, to drink less or to curb any number of risky pastimes.

But the influence of social ties may be even more powerful than that. Social relationships, it seems, may also help our bodies help themselves.

Recent lab studies have shown that, in a stressful situation, blood pressure and heart rate will increase less when people are accompanied by a person who is close to them. Brain imaging also shows neurological differences between a person who is alone and a person who has support: in a lab-induced tense situation, brain activity in the anterior cingulate cortex, a region activated in times of stress, is attenuated when people have a close friend or relative alongside them. And it’s not just adult stress. In an experiment published this spring, children who were allowed to talk to their mothers after a stressful encounter — giving an impromptu speech or doing math problems in public — showed increased levels of oxytocin, a neurotransmitter thought to dampen the hormonal stress response, compared with children who did not have contact with their mothers.

In one of the most famous experiments on health and social life, Sheldon Cohen at Carnegie Mellon University exposed hundreds of healthy volunteers to the common cold virus, then quarantined them for several days. Cohen showed that the study participants with more social connections and with more diverse social networks — that is, with friends from a variety of social contexts, such as work, sports teams and church — were less likely to develop a cold than the more socially isolated study participants.

The immune systems of people with lots of friends simply worked better, fighting off the cold virus often without symptoms. Studies suggest that the immune response may be affected by stress hormones — catecholamines and glucocorticoids — so that a strong social life thus affects immune function by helping people keep physiological stress in check.

But turning such research into full-fledged medical advice isn’t easy. “It’s hard to legislate social relationships,” Holt-Lunstad says. “And we all know that some relationships are better than others, and not all relationships are entirely positive.”

Since Holt-Lunstad’s new study reviewed the statistical association between mortality risk and relationship quantity, rather than perceived quality, she wonders whether we wouldn’t see even stronger benefits if we focused only on the good relationships. Bolstering these connections may ultimately help people stay healthier than trying to build connections between complete strangers, as in, say, a cancer support group. (Studies on the physical health benefits of support groups show mixed results.) “We need to pay better attention to naturally occurring relationships and to fostering those,” Holt-Lunstad says.

Read more: http://www.time.com/time/health/article/0,8599,2006938,00.html#ixzz0v92wZgnm

Wide Social Networks Are Key to Good Health, Says Study – TIME.

Overweight people may respond more to a piping hot pizza, but they don’t necessarily eat more of it in a single sitting, according to a new study.

Reuters, Rachael Myers Lower, July 21, 2010

University of Bristol graduate student Danielle Ferriday and her faculty advisor, Dr. Jeffrey Brunstrom, wanted to know if overweight and lean people responded differently to “food cues,” and, if they did, how the mind translates these different levels of “desire-to-eat.”

“We all need to eat and we all encounter many food-related cues in our everyday lives,” Ferriday told Reuters Health.

Ferriday enrolled 52 normal weight and 52 overweight women in the study, exposed them to the sight and smell of pizza and measured how much they salivated, as well as their psychological responses.

While lean participants didn’t salivate much more once they saw and smelled the pizza, the overweight participants salivated about a third more than usual once the pizza showed up. They also had more desire to eat, measured by a standard scale, than the lean study subjects.

However, the overweight participants didn’t eat more, even after being told to eat as much as they’d like.

What that means, say the researchers, is that the overweight don’t necessarily eat more when at the table, but, because of their heightened sensitivity to the cues, they may be called to the table more often.

“This is potentially important, because this sensitivity may encourage snacking” and other bad eating habits that are “associated with increased energy intake, overweight and weight gain,” the investigators write in the July issue of the International Journal of Obesity.

The study couldn’t answer why overweight people are more turned on by food. It is not clear, for example, whether they are born that way or do eating habits learned and developed over time cause a change?

While all the subjects in this study were women, “we suspect that the findings would apply to men too,” Ferriday noted.

SOURCE: link.reuters.com/deh78m International Journal of Obesity, online June 15, 2010

Overweight want more at a meal, but don’t eat more | Reuters.

The mental stress of computer work triggers changes in blood sugar and hormone levels that trick the brain into thinking it has worked off lots of calories that need to be replaced. Watching television has the same effect, experts at the International Congress on Obesity in Stockholm have said.Office workers who want to keep trim should take regular screen breaks, and even consider typing while standing up, Jean-Philippe Chaput, a researcher from the University of Copenhagen, has suggested.

Chaput started the research after noticing how one regularly snacked on chocolate biscuits when doing computer work.He asked one group of female students to condense some text into an on-screen summary and another group to simply relax for 45 minutes.

Those doing the computer-based task burnt just three more calories than the others, but ate much more food when given access to a buffet afterwards. In fact, they took in an extra 230 calories – the equivalent of a two-fingered Kit Kat.”Working on your computer is sedentary and doing nothing increases your weight. But use of them also increases your appetite as well so there is a double whammy in effect,”

Chaput was quoted as saying by Daily Mail. Chaput will now look at whether computer games, in which users mime a sport, also lead people to eat more.

via Excess computer work creates craving for sweets – Trends News – IBNLive.

As obesity rates hit record levels, a new study finds that many adults don’t recognize weight problems in their children. The consequences can be severe.

Newsweek, Claudia Kalb, July 1, 2010

The obesity alarm bells are ringing again. A new report out this week finds that more than two thirds of states (38 total) have adult obesity rates above 25 percent—a striking increase since 1991, when no state had an obesity rate above 20 percent. Hardest hit: Mississippi, which weighed in at 33.8 percent, followed by Alabama and Tennessee (tied at 31.6 percent), West Virginia (31.3 percent), and Louisiana (31.2 percent).

Parents Oblivious to Overweight Kids – Newsweek.

The worldwide epidemic of Type 2 diabetes is a “public health humiliation,” the editors of the esteemed medical journal The Lancet argue in this week’s diabetes-themed issue.

The journal’s lead editorial argues that Type 2 diabetes is largely rooted in reversible social and lifestyle factors that a medical approach alone is unlikely to solve.

“The fact that Type 2 diabetes, a largely preventable disorder, has reached epidemic proportion is a public health humiliation,” the editorial says.

The issue includes studies, which will also be presented at this week’s meeting of the American Diabetes Association in Orlando, Fla., that describe advances in drugs as well as a greater understanding of the disease and the control of blood glucose levels.

“But there is a glaring absence,” the editorial argues, ” no research on lifestyle interventions to prevent or reverse diabetes. In this respect, medicine might be winning the battle of glucose control but is losing the war against diabetes.”

The journal calls for a collective approach to boost opportunities for physical exercise and reduce the abundance of calorie-rich foods.

Reducing the burden of diabetes requires a major change in diet and routine, the editorial argues. The authors praise First Lady Michelle Obama’s Let’s Move campaign, which includes nutrition, activity and child health components.

The editorial also endorses the U.S. Department of Agriculture’s new guidelines, which aim to shift Americans’ eating habits toward plant-based diets.

Urban recreation that is readily accessible, affordable and includes safe areas for children is also a must, particularly in Asia and sub-Saharan Africa, which are experiencing large migrations from rural areas to urban centres, the editors noted.

via CBC News – Health – Type 2 diabetes a public health disgrace: Lancet.

READ the original article on Kellogs claims here.

The Federal Trade Commission barred Kellogg’s last year from running ads saying Mini-Wheats are “clinically shown to improve kids’ attentiveness by 20 percent.” To claim “benefits to cognitive health, process or function provided by any cereal or any morning food or snack food,” was a no-no, unless the claims were true. But the F.T.C.’s order covered only cognitive abilities. So just as it was signing its consent, Kellogg’s was starting a new campaign in which “Snap, Crackle and Pop” called out to parents from the Rice Krispies box promising to help “support your child’s IMMUNITY.”

Last week, the F.T.C. said that it had closed that loophole, reaching an agreement with Kellogg’s that would bar the company from making any claims about the health benefits of their food unless they were backed by scientific evidence and not misleading.

Businesses have been making dubious claims about their products at least since the 17th century, when the British clergyman Anthony Daffy sold Daffy’s Elixir as a cure for scurvy as well as agues, gout, rheumatism, rickets, worms and other ailments. Hucksterism — no matter how implausible the claim — lives on.

In 2004, the F.T.C. barred KFC from saying its fried chicken was compatible with low-carbohydrate weight-loss programs — because such diets specifically advise against breaded, fried foods. The Food and Drug Administration sent letters to 17 food companies in March warning them about misleading product labels. Dreyer’s claimed there is no trans-fat in its ice cream but forgot to mention it has lots of saturated fat. POM Wonderful claimed its pomegranate juice helps treat, prevent or cure hypertension, diabetes and cancer.

This might be par for the course for an era of swift-boating political ads and a torrent of television commercials plumping for myriad wonder drugs (sudden death may result). It leaves the consumer in a quandary: what part of the label can be believed?

Editorial – Snake Oil for Breakfast – NYTimes.com.

With the spotlight on childhood obesity, schools across the country are looking for ways to get kids to eat more fruits and vegetables. In New York, the Department of Health decided to do some research. How much, it wondered, would a school need to cut its prices for apples, oranges and bananas to increase sales by 5 percent over a year?
Brian Wansink was called in to play detective. But the director of Cornell’s Food and Brand Lab soon discovered he had been hired to answer the wrong question. Price wasn’t the problem. It was the presentation.

In the school cafeterias Wansink surveyed, whole fruits were displayed in steel bins in dimly lighted areas of the lunch line. Wansink went to discount store T.J. Maxx and bought a cheap wire fruit rack. He found an extra desk lamp, which he used to shine on the fruit. “Sales of fruit in one school went up 54 percent. Not in a semester: by the end of the second week,” Wansink said. “It would have gone up faster, but they kept running out of fruit.”

The debate about how to fix school lunch has, until now, focused largely on what is sold in schools: Public health advocates argue that french fries and cookies should be banned, and some schools have done just that. Food manufacturers and some parents retort that such deprivation will only encourage students to get their fix elsewhere. Now, researchers such as Wansink are turning their attention to how school food is sold and to whether marketing and incentives can help fight obesity, often at little or no cost.

Federal regulators, charged with improving the school lunch program on a tight budget, are paying attention. Cass Sunstein, a leading behavioral economist and a co-author of the seminal text “Nudge: Improving Decisions About Health, Wealth, and Happiness,” is the administrator of the White House Office of Information and Regulatory Affairs. In April, the U.S. Department of Agriculture held a two-day conference on how behavioral economics can improve federal food policy. This fall, the agency will award $2 million to fund more research in the field.

The attractions are clear. Such solutions — sometimes called “nudges” — can be low-cost. They also are flexible. Although most people think of school lunch as a monolithic federal program, lunchrooms across the more than 14,000 U.S. school districts vary, and most decisions about what and how students eat are made locally. Most important, implementing change doesn’t require a vote in Congress. Though Michelle Obama has made childhood obesity her signature issue, legislation that would increase funding for school lunch and boost nutrition standards remains stalled.

“These ideas offer a way to be more effective with the meals we are already serving,” said Joanne Guthrie, the USDA’s assistant deputy director for nutrition in food assistance and nutrition research. “There’s a lot of talk about putting more whole grains and dark green vegetables in the lunchroom. But it may not be the best way to improve health unless we are sure the kids will eat them.”

Wansink is a pioneer of food behavioral research. (His first book, “Mindless Eating: Why We Eat More Than We Think,” demonstrated how simple acts, such as eating from a smaller plate, can help reduce food consumption.) Wansink became interested in school food after a two-year stint in Washington working at the USDA’s Center for Nutrition Policy and Promotion. The controlled environment of school cafeterias and their often-perverse incentives — at a time when one-third of American children are overweight or obese, USDA guidelines continue to mandate calorie minimums but not maximums — is a perfect research laboratory.

Take payment options. Most schools accept debit cards or PIN numbers, which help the lines move faster and make it impossible to tell which students receive a free or reduced-price lunch. In a yet-unpublished study, Wansink and Cornell lab co-director David Just found that students who pay with debit cards are more likely to buy desserts and junk food, while those who pay cash tend to choose milk, water, fruits and vegetables. The decision comes down to this: Would the student rather have a brownie or use the money later to buy music or movie tickets? “It introduces what we call a ‘pause point’ in what would otherwise be a mindless transaction,” Wansink said.

Wansink does not advocate an all-cash system. Instead, he says one solution might be to limit what students can buy with their debit cards. Parents might choose to follow recommendations, or they could set specific standards themselves: no peanuts, say, for a child with an allergy, or no desserts, period. Children who still want to buy a forbidden product would have to fork over the money themselves. Wansink calls the idea “cash for cookies.”

Researchers are also interested in the idea of incentives, many of them gobsmackingly simple. At a New York middle school, Wansink found that when the salad bar was moved to a prominent location near the cashiers, sales increased by between 200 and 300 percent.

David Just of Cornell and Joseph Price, a behavioral economist at Brigham Young University, offered rewards to students at 15 elementary schools in Utah who bought and ate fruit or vegetables with lunch. Sales jumped 40 percent where students were offered 25 cents and 22 percent where they were offered a nickel. When the reward was a raffle, delaying gratification, the impact was less dramatic.

Verbal prompts also have been found to be effective. In 2007, Marlene Schwartz, the deputy director of the Rudd Center for Food Policy & Obesity at Yale University, created a study in which cafeteria workers at one school asked each student whether they would like to add fruit or fruit juice to their lunch. Ninety percent of students took the fruit or juice, and 70 percent consumed it. In the school with no verbal prompting, 60 percent of students took fruit or juice, and 40 percent consumed it.

Schwartz says she is confident that nudges can affect eating habits. But she also wants school food to become more healthful across the board. “It’s a very American thing to believe that everyone is entitled to as much choice as possible,” she said. “In reality, that’s not the best way to design a school lunch program. All the research suggests that people eat what’s in front of them, and if it’s not there, we don’t miss it.”

Ann Cooper, who calls herself the Renegade Lunch Lady and is the nutrition director for the Boulder Valley, Colo., public schools, puts it more bluntly: “I have never heard of a kid dying because they couldn’t have their chocolate milk.”

Still other researchers, such as the University of Pennsylvania’s Paul Rozin, say the problem is not what foods people consume but how much of them. Eaters have what he calls “unit bias,” which means they are inclined to eat one of something, whether it’s a package of chips, a cookie or a soda. If the package is smaller, they will eat that and be happy. They will do the same when the serving is much bigger. Schools, Rozin suggests, might order smaller packages of chips and cookies.

“We should just change the world of eating by making it a little more work to get the calorie-dense foods,” Rozin said.

Wansink agrees that such changes could help. But he’s far more fascinated by low-cost, easy tweaks at individual schools. This week, the Cornell lab is holding a training session on such initiatives for teachers, food service directors and parents from across the country. “Every lunchroom is unique,” he said. “Maybe the salad bar doesn’t have wheels. Or maybe they already have got rid of the chocolate milk. The goal is to give people the tools to innovate.”

Small changes steer kids toward smarter school lunch choices.

AP, Mike Stobbe, June 1, 2010

How much money would it take to get you to lose some serious weight? $100? $500?

Many employers are betting they can find your price. At least a third of U.S. companies offer financial incentives, or are planning to introduce them, to get their employees to lose weight or get healthier in other ways.

“There’s been an explosion of interest in this,” said Dr. Kevin Volpp, director of the University of Pennsylvania’s Center for Health Incentives.

Take OhioHealth, a hospital chain whose workforce is mostly overweight. The company last year embarked on a program that paid employees to wear pedometers and get paid for walking. The more they walk, the more they win — up to $500 a year.

Anecdotal success stories are everywhere. Half of the 9,000 employees at the chain’s five main hospitals signed up, more than $377,000 in rewards have already been paid out, and many workers tell of weight loss and a sudden need for slimmer clothes.

But does will this kind of effort really put a permanent dent in American’s seemingly intractable obesity problem? Not likely.

“It’s probably a waste of time,” said Kelly Brownell, director of Yale University’s Rudd Center for Food Policy and Obesity.

Brownell’s assessment is harsher than most. But the science seems to back him up.

Only about 15 to 20 U.S. studies have tried to evaluate the effect of financial incentives on weight loss. Most of those studies were small and didn’t look at whether such measures worked beyond a few months. None could make conclusions about how much money it takes to make a lasting difference for most people.

Perhaps the largest effort to date was an observational study by Cornell University. It looked at seven employer programs and the results were depressing: The average weight loss in most was little more than a pound.

Sure, there are grounds for optimism. Smaller experiments report some success. And other studies have shown promising results against tobacco. One study published last year in the New England Journal of Medicine, co-authored by Volpp, found that cash rewards of a few hundred dollars nearly tripled quit-smoking rates.

One problem: “Food is more difficult than tobacco,” said Steven Kelder, an epidemiology professor at the University of Texas School of Public Health.

While cigarettes can be addictive, people don’t need to smoke to live, and advertising and clean-air restrictions curb tobacco’s presence. People must eat, however, and sugary drinks and fatty snacks are everywhere, Kelder and others said.

Health officials lament that more than two-thirds of American adults are overweight and one-third obese, and lecture on fat’s role in deaths from diabetes, heart disease and other conditions. The problem has a huge economic impact, too, with obese workers costing U.S. private employers an estimated $45 billion or more annually in health care costs and lost labor. That’s according to a report by the Conference Board, a research group focused on management and the marketplace.

In a campaign led by Michelle Obama, federal officials are emphasizing several approaches to slim the nation. Food companies, worried about potential anti-obesity rules and laws, have publicly endorsed the first lady’s message and recently pledged to offer lower calorie foods, change recipes and cut portion sizes.

While watching to see if foodmakers follow through, some experts remain fascinated by the idea of using economics to get people to eat better and exercise. Sales taxes have been used to drive up the cost of cigarettes and drive down smoking rates, and Brownell and others are pushing for similar taxes on soda.

Companies tend to be more interested in incentives than disincentives like taxes. But the perks they attach towellness programs come in a variety of forms and sizes.

Some reward employees just for having a health evaluation or simply enrolling in a class — whether they complete it or not. Others require measurable weight loss or exercise achievement, sometimes structuring it in a contest along the lines of “The Biggest Loser” TV show.

Some companies offer money, some vacation trips. Some refund the cost of Weight Watchers classes. Others reduce health insurance premiums.

The value of rewards can range from measly to thousands of dollars. Hunches and human resources budgets— not research — often drive decisions about financial incentive details. Companies are quite frank about it.

OhioHealth set the maximum reward for its step-counting program at $500. “It just sounded right to us. We thought that would be a big enough number to help people think twice,” said Lisa Meddock, OhioHealth’s benefits manager

IBM rewards employees for doing 12-week Web-based health programs. They offer $150 per program completed because there was a feeling that was the right amount to get people involved, said Dr. Joyce Young, the company’s wellbeing director.

Companies “are making best their guesses about what might work and giving it a shot,” said Robert Jeffery, aUniversity of Minnesota professor. He’s been experimenting with financial incentives and weight loss since the 1970s and is perhaps the most veteran researcher in the field.

If companies asked the experts, they might be counseled to make their incentives more dramatic — more cash or a bigger penalty in premium costs.

Psychologists say people are more motivated by the risk of losing their own money than by a chance they’ll win somebody else’s. Applying that idea to weight loss, some studies have set up refundable bond systems: Volunteers sign a contract agreeing to lose a certain amount of weight by a certain date or they forfeit their deposited money.

One of the seven companies in the Cornell study offered a refundable bond option to employees. Its average weight loss was nearly 4 pounds. That doesn’t sound like a lot but it’s almost twice as much as the average weight loss at companies that paid quarterly rewards.

A 2008 University of Pennsylvania study found that after 16 weeks people who put their own money on the line lost about a pound more, on average, than people who got cash from others.

Besides employers, a few companies market refundable bond contracts to people trying to lose weight. Using a twist of black humor, a company called StickK.com, sends the forfeited money from those who fail to an organization the customer despises.

“The most popular is the George W. Bush Presidential Library,” said Sam Espinosa, a company spokesman. “Last year, we sent $6,000 to them.”

Such programs are voluntary. But critics say that while they may work for a few very motivated people, they may not be effective for most.

Some employers worry that if they go too far, it may seem coercive and even grounds for a lawsuit. “They’re very nervous about doing anything that might seem invasive,” said Helen Darling, president of the National Business Group on Health.

Many employers believe the wisest approach is to use financial incentives as just one facet of a broader effort to create a culture that makes it harder to be lazy and gluttonous.

Kevin Acocella illustrates their point.

Acocella, a 35-year-old IBM marketing manager, was 5-feet-9 and a chunky 185 when he decided two years ago to enroll in the company’s web-based fitness program.

IBM’s worksite wellness program is often called a model, with roughly half of the workforce earning at least $150 a year for taking part. But Acocella failed twice.

The money got his attention. But the problem, he said, was the culture he was in. “In New York City it was, ‘What restaurant can we go to, or what bar can we go to?’”

Early this year, Acocella moved to the IBM office in San Jose, Calif. “Here it’s, ‘What activity can you do, and what can you go see, and how can we figure out a way to not take a car there,’” he said.

Acocella had lost 9 pounds in the three months he’s been there. He recently signed up for the IBM reward program again, but this time it’s incidental to his new active lifestyle.

“The real issue was getting myself in a program I could actually do and could keep up with. I don’t think those things swing on a dollar,” he said.

Dieting for dollars? More US employees trying it – Yahoo! News.

Washington Post, Melissa Bell, May 27, 2010

The plastic soup can looks as if it’s a single-size meal, a healthful lunch option for one hurried customer. But the nutrition label on the back says otherwise. Gummy fruit snacks show a shower of strawberries on the label, which reads “naturally fruit flavored.” Customers would be hard-pressed to find any strawberries in the ingredient list.

Nutrition buzzwords make hay out of grains of truth.

One is a ruling minority of the healthy few who rely on vegetable gardens, personal trainers and spa getaways to stay fit. The other is the majority of Americans, who are overweight or obese, many of whom risk their own form of assisted living — XXXL clothes, mobility scooters and diabetes treatments that can tip over $50,000 a year.

“One Nation, Overweight” is a CNBC documentary on Tuesday that provides a chilling portrait of a health epidemic that endangers all Americans — without being overly alarmist or too sanguine. And while that doesn’t sound like a big deal, this program stands out in a landscape cluttered with mixed messages and grossly distorted images of reality.

Television used to ignore obesity; now it wallows in it. But the effort to portray the problem — and the solutions — mirrors the way most Americans eat: the most basic facts are larded with sugary entertainment and creamy dollops of instant gratification.

Weight-loss reality shows like “The Biggest Loser” turn obesity into a contest, painting the solitary, often costly struggle against obesity as an exhilarating and financially rewarding team sport. Even do-good missions feed the appetite of viewers accustomed to supersize entertainment. The British chef Jamie Oliver tried to tame the eating habits of an entire town in West Virginia, called the fattest place in America, for his reality show, “Jamie Oliver’s Food Revolution.” Not surprisingly, French fries won.

Meanwhile, series like “Drop Dead Diva” and “Glee,” which recently devoted an episode to a character’s battle with her weight, try to preach self-acceptance by showcasing plus-size heroines who learn to value their physiques. Mostly, they present an unrealistic image of a world populated by whippet-thin women, each of whom has one large friend.

“One Nation, Overweight” isn’t a treat, but it’s rich in salutary warnings. It begins at the Cleveland Clinic, one of the top destinations for growing numbers of patients — some weighing 500 and 600 pounds — who want to have their stomachs stapled. (There were 220,000 such procedures done in 2009, according to CNBC.) The corridors of the bariatric ward, filled with hugely fat people who can barely walk, provide the kind of flesh-and-blood look into the future that was the apocalyptic message of the animated movie “Wall-E.”

And that future may not be so far away. Kenneth E. Thorpe, a health economist at Emory University, discusses a study he published that warns that if current trends continue, the cost of treating weight-related illnesses will double to $344 billion a year by 2018.

The CNBC correspondent Scott Wapner interviews experts who describe obesity as a disease, but the obese people he speaks to rarely blame their size on genetic predisposition or other extenuating circumstances.

“I did to this myself,” says Henry Butler, 62, who was 330 pounds when he went to the Cleveland Clinic. “Who said I had to eat all that?”

School cafeterias are part of the problem, and CNBC visits a school in Virginia where snack carts sell sticky buns, candy bars and chips three times a day. The principal explains that the profits go to help after-school sports programs, a vicious — and viscous — cycle.

There are schools and workplaces that are trying to fight back, including the owner of a car dealership who pays for his overweight employees to join a $2,500 weight-loss program — he says it saves him tens of thousands of dollars in health costs. An inventor demonstrates his answer to a sedentary work force: a machine that allows an employee to work at a computer terminal while walking on a slow-moving treadmill.

Over all, CNBC provides a broad, sensible look at a problem that is not new, but is increasingly dire. There are a few journalistic lapses, however.

The film spends quite a bit of time on a promising weight-loss drug, Qnexa, that is awaiting approval from the Food and Drug Administration. It helps suppress appetite and has had better results than similar drugs in clinical trials, according to the documentary.

Mr. Wapner interviews Leland F. Wilson, the chief executive of Vivus, the maker of Qnexa, who is predictably bullish. So is the only research scientist shown on camera, Dr. Michelle Look, a sports medicine specialist who is a lead clinical trial investigator on Qnexa and a paid consultant to Vivus.

A deputy director of the F.D.A. is interviewed but doesn’t say much about Qnexa, except to explain that his agency is under pressure from advocacy groups to speed up approval of anti-obesity drugs.

Particularly because so many viewers are overweight and desperate for a medical breakthrough on obesity, CNBC should have also interviewed an independent scientist who could have added a grain of salt to Mr. Wapner’s boosterish report.

And credibility, once shaken, is hard to restore. Jim Trudeau, a small-business owner from Madison, Wis., who attended a weight-loss program at the Biggest Loser Resort at Fitness Ridge in Ivins, Utah, lost 200 pounds, but has another 200 or so to lose, since he started at 600. Mr. Trudeau is an articulate and sympathetic figure, but it’s hard not to wonder if he was picked for his personality, or because “The Biggest Loser” is on NBC, a sister network to CNBC.

“One Nation, Overweight” takes a serious look at a serious problem, and it would be better if it showed more discipline in curbing its own weaknesses.

via The TV Watch – CNBC Explores a Big Nation of Big People – NYTimes.com.