RE: Ignore this
07-03-2016, 06:38 PM
Dissociative Identity Disorder
Module 8, Video 1
Slide 2: Dissociative Identity Disorder
Now, if you want an example of how psychological views of a disorder might change over time to where the disorder almost becomes unrecognizable compared to the original one, you can't do any finer than with what was originally called multiple personality disorder. Multiple Personality Disorder is one of those things that media just loves as the plots of books, as the plots of movies, as the plots of television shows. People love the idea of a person who has multiple identities inside of the same body, and assumes different identities at different times. There have been a number of movies that have used this as a plot device. For example, “The Three Faces of Eve,” or the movie “Sybil” involve characters in which people have different personalities, and they're very different people at different times. Now, if you go back to earlier versions of the DSM, what is now called the Dissociative Identity Disorder, used to be very narrowly defined. They talked about people who had distinctively different personalities that were inside of the same body. They would move from one personality to another without their conscious control. Those personalities, they assumed fully when they had them. Some of the personalities were not aware of the other personalities. It's the kind of thing that's very colorful. It's the kind of thing that gets a lot of people's imaginations going. So of course, it's a great basis for a plot device in a story or in a movie. The thing is there was great debate entirely over just how common this was. At that time, we said, " Well, it was the single rarest of disorders.” That if you look in terms of people whose walk and talk, and handwriting, and names and entire set of memories changed when they change personalities, there were only a handful of such cases that have been documented over the years at least with any kind of detail. It's seemed like an incredibly rare disorder.
Slide 3: Dissociative Identity Disorder
Then more recently in the DSM V, there's been this shift in the description of Dissociative Identity Disorder. As was the case with Autism Spectrum Disorder, where they said, " Instead of talking about one disorder, let's talk about a range of disorders from milder to more severe." They started doing the same thing with Dissociative Identity Disorder where they said, " Okay, you have these very rare conditions where people abruptly become another personality, and all of their mannerisms and their memories, and their handwriting, and the way the walk all changes." You have that one group of people where those qualities all change, and they seem like distinctively different people. They're very rare, not many cases like that at all. Then you have a continuum down from there, from those people who absolutely become very different personalities to those people whose personalities change dramatically but they're not necessarily such different personalities. Then ranging down from there to those people who just don't have one set personality, but rather have personalities that shift around all the time. Well, if you have a continuum of diagnosis for Dissociative Identity Disorder, and let it range on down to the people who have very changeable personalities which aren't set in one place all the time, well then the number of people who have this disorder becomes much, much larger because you're including in the diagnosis people who didn't used to be included in the diagnosis. We've gone from a disorder that you hardly ever see, and that nobody much has been diagnosed with. We've shifted that disorder's criteria to say, " You can have lesser symptoms, and still be classified with that disorder," and because of this, now they're classifying way more people with Dissociative Identity Disorder, people who are fringing on what we'd have called Dissociative Identity Disorder before how are now classified as having Dissociative Identity Disorder. It's a case of changing the way the diagnosis is done, which includes a lot more people.
Obesity in America, Part 1: Little Exercise, Lots of Food
Module 8, Video 2
Slide 2: Lack of Exercise
One of the things you might have garnered from reading this chapter is that Americans are very heavy people, we are among the heaviest people in the world. We weren't always that heavy, as the charts in your textbook point out. Americans were thinner just a few decades ago than we are now, but we are gradually getting heavier and heavier. Every new decade seems to be the heaviest Americans ever. You get into this whole issue of why is that? Why are we gradually growing fatter and fatter? It's a good question. Now, there are a number of possibilities behind Americans growing fatter. We could for example point out the fact that manual labor jobs are very scarce these days. Most people don't do back breaking labor all the time. Certainly then you are getting a lot of exercise at work. It's true that we've had fewer and fewer jobs where people get exercise at work over the last few decades. Not having manual labor might be contributing to the job, not working all the time. It's also possible that our changes in leisure time activities have had an effect on our general level of obesity. The preferred leisure time activities of Americans today often involve doing a lot of sitting down. We have cable TV networks and satellite TV networks with 500 channels, and Netflix and Hulu to send us things, to sit and watch on TV. We have video games galore to play. In addition to that, there are social media and the internet to explore. That means a lot of time, in leisure time, just sitting and not exercising. Whereas in the past Americans did more exercising in leisure time. Americans did more outside activities, they played more outside games, and just generally got more exercise than they do today.
Slide 3: Larger Meals
Neither of those things can be totally responsible for why Americans are among the fattest people on Earth, because that's true of many other countries too. Many other countries also don't do much manual labor. Many other countries also have internet and many TV channels and video games to play. Why is it that Americans are so heavy? Putting aside our activity levels you might then turn to what kind of food do we consume, and how much food we consume? There we are probably getting closer to the roots of the whole problem. Americans seems to eat more food than many other people do. We seem to eat larger meals and we seem to eat more between meals than many other people do. That chart in your textbook is a real eye opener showing how Americans consume more than 3,000 calories a day whereas the residents of many other countries consume far fewer calories a day. We are eating larger meals, larger portions in our meals and just taking in more calories during the day.
Slide 4: Big Portions
The food portions issue comes into play when you consider that a lot of restaurants for example have discovered that you will make more money if you sell larger portions, charge more for those larger portions and then you are getting more money out of each customer in the same amount of time. A customer doesn't feel cheated because the portions are so large they can stuff themselves, they still have food to take home. At the same time the restaurant is making more money with each sitting of diners because they are getting more money for each meal out of the diners. When you have more food in front of you, you tend to eat more food. Studies have indicated that if we put larger portions in front of people and say to people “eat what you want,” the larger portion we put in front of the person the more food they'll tend to eat overall. It's possible just by scaling up our portions we have contributed to people eating more in a given setting.
Slide 5: Proximity to Food
Of course we don't just eat during meals, there is also eating between meals. Americans probably do more snacking between meals than a lot of other people do. We have fast food restaurants all over the place. In addition to fast food restaurants we have little corner markets into which you can go in and buy all sorts of snacks and drinks and things to take out in the middle of the day. So that you have constantly got this proximity of food, tempting people to come in and grab something fun to eat. Come in and get something good to eat. Offering us all sorts of tempting treats, all sorts of tempting drinks, and those things drunk throughout the day would add up to quite a few calories.
Obesity in America, Part 2: Soft Drinks, Profits, and Corn Syrup
Module 8, Video 3
Slide 2: Soft Drinks
But my favorite villain in American obesity, the one that I think is more responsible than any one single factor is soft drinks. Most specifically soda or pop depending on which coast you live on. You'll call it one or the other. Soft drinks originally came about, the soft drink industry really got started with medicinal tonics that were made up in drugstores and given to people in order to cure them of malaise or tiredness or stomach problems. Coca Cola, for example, was originally a medicinal preparation that contained cocaine to pep people up. You'd go to your druggist. They'd take a little syrup of Coca Cola. They'd mix it with some carbonated water, and you would drink it, and it was supposed to pep you up, which undoubtedly I imagine it did, even though it only had minuscule amounts of cocaine in it. When in the late 1800's it became obvious that having cocaine was probably not the best thing, Coca Cola dropped the cocaine and replaced it with equivalent amounts of caffeine. But it was still considered a medicinal drink for some time, and Pepsi Cola, Dr. Pepper, both of those were stomach tonics that were supposed to excite your digestive system and get it to working better and less sluggishly. The word “pep” in both of those refers not to making people more peppy but rather to the word pepsin, referring to its supposed effects on your stomach. These drinks were originally medicinal drinks, and druggists could sell them for medicinal drinks, but they were also tasty and people would sometimes buy them to enjoy the taste. But eventually they got into bottling these drinks and selling them already prepared in bottles. Bottled sodas is something you might want to take along on a picnic, that you might want to indulge in now and then, became advertised more and more frequently and became a bigger part of the American diet. As we got into the 50's and 60's, bottlers were really pushing the idea of drinking soda as opposed to other things. But even then, soda wasn't consumed that heavily. You had to carry bottles around and you had to return the bottles afterward, and it was all kind of a hassle. What really brought soda into its own was the fast food industry.
Slide 3: Profits
You see, there's not a huge profit in bottling soda and transporting it to places and selling it. Oh, there's certainly a profit there. There's no question about that. But it costs money to transport things in glass across the country. The water that the soda itself is made out of is quite heavy, too. The shipping gets to be pretty expensive. On the other hand, it's a whole lot cheaper to ship the syrup that you make the soda from and then mix that syrup with water and carbon dioxide on the spot, and create fountain drinks, and fountain drinks dispensers became more and more common in part with the advent of fast food restaurants. Fast food restaurants were one place were you'd be distributing a whole lot of soda over a short period of time, making it right there on the spot, very economical and a really good way for fast food restaurants to pad their bottom line. When original fast food restaurants, places like McDonald's and Henry's and other hamburger joints like that first came into being, what they tended to serve was burgers and fries and shakes, and those were the big sellers at the time. But the trouble with those particular things is the mark up on them is not terrific. You have to sell a lot of burgers and fries and shakes to make a whole lot of money out of a fast food restaurant 'cause you're not making that much for each item you sell. Now, carbonated drinks are another matter. You can buy the fountain syrup very cheaply in bulk, mix up the carbonated drink right there on the spot and sell the drink for a fairly hefty amount of money and make a tremendous mark up. So you can put 30 cents worth of ingredients into a paper cup and sell it for $ 1.80, and that's a pretty tremendous gain. So although you're not making a lot selling the food, you could make a whole lot selling the drinks, but to do that, you got to persuade the people that the drinks are what they want to drink. They want to order that and drink it. That's the ideal thing for them, and so you push and market the soda very heavily. Everybody wants to drink this soda. This soda is really great because that's where you're making the money is from selling the soda. Selling the food, not so profitable. Selling the soda, enormously profitable.
Slide 4: Profits
Now you can go into a fast food restaurant and order your fast food with milk or order your fast food with juice and what you'll find is that they charge quite a lot for those things and gave you much smaller portions because they really don't want to encourage you to buy those. There's not a huge profit in those things. The huge profit is in selling the soda, and if you are gonna buy them, well they've got to mark the price up enough they make some money on those so they come off fairly expensive for a much smaller portion, and they know that many of the customers will say, " Well, that's too small a portion. I'll just order the soda and I'll have a bigger drink," and that's what they're counting on. That's where the money comes from. So there's a tendency to push people to drink soda and sodas become a very, very big thing, a huge market in the United States. Lots of people drink sodas with every meal and drink sodas between meals now, something that didn't happen in the middle part of the 20th century.
Slide 5: Corn Syrup
One other thing about fountain drinks and sodas that's very interesting and contributes to this whole obesity thing, though, and that is that in the United States sodas are mostly made with high fructose corn syrup as their sweetener, not sugar. Now high fructose corn syrup certainly tastes sweet. High fructose corn syrup is about 2/ 3 of the price of sugar so in terms of just saving money, it's much cheaper to make soda with high fructose corn syrup. But corn syrup does not stimulate the same taste response that actual sugar does, that sucrose does. It's not quite as satisfying to people as sucrose is. If you want to test that out, just find yourself a bottle of a well-known soda, brand name soda that's made with sugar and contrast that with a bottle of the same soda made with corn syrup, and you'll see that the sugar soda is more delicious and more satisfying. Corn syrup is not quite so satisfying. Because the corn syrup is not quite so satisfying, there's probably a tendency for people to drink more of it because it isn't as satisfying to consume. So there's a tendency to drink more soda when it's sweetened with corn syrup than when it is sweetened with sugar. So why you say do we sweeten sodas with corn syrup besides the money issue? Sure, the Benjamins are always important. It's always all about the Benjamins, and money would be enough by itself to use corn syrup to make soda, but sugared sodas do taste better. Why are they sweetening them with corn syrup?
Slide 6: Shelf Life vs. Satisfaction
Well, there's a second reason for this, and that has to do with the shelf life of the syrup that they make soda out of. Those big bags of syrup that you put in a fountain drink dispenser? Soda sweetened with corn syrup has a longer shelf life than soda sweetened with sucrose, with table sugar. And so in terms of being able to stack up a pile of these things and keep them for awhile without them getting a stale taste to them, you do better with corn syrup over the long run, and that longer shelf life means less spoilage, less loss by the people who are dispensing it, and that also means more money. So frankly, even though we would enjoy soda better if it was made with sugar, we instead make sodas with corn syrup. Now, a lot of other countries make their sodas with sugar, and that may indeed make a difference. We may be consuming more soda because it's made with corn syrup than if we were making that soda with sugar. It's hard to say although studies seem to indicate that would be the case.
Obesity in America, Part 3: Insulin, Diet Soda, and Food Cues
Module 8, Video 4
Slide 2: Pancreatic Responses
Now you're saying yes but I drink diet soda so that has no calories, so how is that contributing to obesity? What's true the soda itself is not caloric when you drink diet soda. But when you drink diet soda, when you consume sweet foods it tastes like it's got sugar in it to your body, and your body has this interesting goes on that has do with the anticipation of food coming. You see, for many, many years now you've seen food, you smelled food, you've tasted food, and then sugar started pouring into your blood stream from digestion and your pancreas started making insulin to deal with that sugar. You taste food, you smell food, you see food. The pancreas makes insulin to deal with the sugar. Without very many pairings at all, just the sight of food, the smell of food or the taste of food will already start putting the pancreas into action, making insulin to deal with the sugar it expects to be coming. But when you dump insulin into your blood stream insulin pulls down your blood sugar levels, that's what it's for. It's pulling down your blood sugar levels in anticipation with the sugar that's coming. But that also means it makes you hungrier. As soon as you see food, as soon as smell food, as soon as you taste it, you start making insulin, ven before that food started entering your blood stream, and that starts making you hungrier. So the sight of the food piques your hunger even more than it was before. The smell of the food piques your hunger more. The taste of the food piques your hunger more because you already start making insulin. As you're more hungry you'll consume more food.
Slide 3: Diet Soda
What does that have to do with diet soda? Simply this. When you drink diet soda you are tasting sweet, and your pancreas says sweet stuff is coming and immediately starts making insulin which lowers your blood sugar and makes you hungrier. Then as a result of being hungrier you eat more other food. When you drink the diet drinks you eat more other food. How could you get around this problem? Instead of drinking say, a sweetened drink of any kind with your food, you can drink water which will not make your pancreas start producing insulin and will not make you eat more food. Plus, water also has no calories at all.
Slide 4: The Role of TV
While we are on this subject of you seeing food, and smelling food, and tasting food and then making insulin which makes your appetite even greater let's talk a little bit about television. See, up through the middle of the 20th century there really was no television. Then for a couple of decades the television picture was in black and white or it was in very primitive color. Things didn't look all that great on the television. Food advertising on television was not a problem. But then starting with the 1970s, '80s, '90s, we got better and better televisions with bigger and bigger pictures that were more and more realistic. Now, when you sit down in front of your television at night what do you see? You see incredibly realistic pictures of delicious food being advertised, lovely scrumptious looking stuff being advertised. You see that food, and your pancreas says, " Ooh, food is coming," and starts making insulin. Your blood sugar levels plummet and you say, " Wow, I am hungry." Then you get up and start calling that pizza place on the telephone to order pizza, which is of course why they advertise the pizzas at night on the television, so you'll do that. Even if you don't go and dial up and order pizza you'll probably go looking in the refrigerator for something to eat or looking out in the snack area for your snack chips and you'll consume food that you won't even have thought of consuming if someone hadn't just waved food in your face and made you hungry.
Slide 5: Surrounded by Food!
All the readily available fast food places do that too, all the food dispensers, all of the food trademarks that are up everywhere. You see golden arches, you see particular signs, you recognize that Mrs. Field cookie sign, or that Hardee’s sign or that White Castle burger sign, and you've associated those with eating food too, and your pancreas starts making insulin and you're like, " I am hungry. May be I'll pull over and get some food." You wouldn’t have been hungry if you hadn't seen the logo or the sign. What we've got is all of these things provoking hunger in us that isn't real hunger. We are not actually deprived of food, but we are being persuaded we are hungry by the sight of all this food around us all the time. That’s something grandpa didn't have to deal with, being constantly surrounded by temptations to eat food, and many people give in to those temptations and go ahead and eat the food.
Anorexia Nervosa
Module 8, Video 5
Slide 2: Anorexia Nervosa
So on the one hand, you've got the majority of Americans having a problem with being overweight. And then you've got this minority of people who are clear the other direction. They're way underweight. Now we're talking about people with Anorexia Nervosa, and other eating disorders. Where the person is not taking in enough food to maintain health. Anorexia Nervosa is an odd thing to have in the middle of a culture where obesity is our biggest problem. And yet, there are anorectics around and those anorectics occasionally become ill and die of anorexia. And it raises a whole issue of why is anorexia occurring? Why is it that people are literally starving themselves to a dangerous level in order to appear deathly thin?
Slide 3: Standards of Beauty
One factor that plays a role in Anorexia for at least some people, is the societal standard of beauty. Just what does our society consider an example of a beautiful person? What is the best way to look incredibly beautiful? Now our examples of beautiful males, of very good- looking males, tend to involve people who are very well built, broad shoulders, fairly muscled, have a 6- pack. Those kinds of things can't be obtained by starving yourself. You actually have to engage in exercise and work out to get that kind of a build. Of course that does lead some males to do things like use steroids, but it doesn't tend to lead them to be anorectic. On the other hand, our society standard of beauty for females is another matter. Because our standard of beauty for females is people who are stick- thin; very tall, willowy and incredibly thin people. This is what our models look like. This is what the standards of beauty our actresses are presenting look like. And this is a standard of beauty many girls grow up seeing as this is what an attractive female should be like. Now it hasn't always been like this. The stick- thin model trends started in the 1970's and wasn't really common before that. Clothing designers started realizing in the 1970's that they could drape clothing more smoothly and give clothing more flowing lines on very, very thin people, where the people's figure wouldn't interfere with the lines of the clothing. And so, the first really famous thin model was Twiggy. Who would actually be considered slightly heavy by today's model standards, but was much thinner than models up to that point. And after that, fashion designers moved to thinner and thinner models to this point, that your average fashion design model has got to be about 5 foot 9 and weigh less than 100 lbs. And boy, that is thin.
Slide 4: Standards of Beauty
Now if we look at standards of beauty from the past, some interesting things come out. For example, if you look at standards of beauty among Renaissance artists, you look at people like Rubens, for example. There's a word for females that are carrying a little bit of extra weight, and that's Rubenesque. Because Ruben's figures were often Rubenesque. But so were Raphael's figures. A lot of people depicting very beautiful women as somewhat heavy if they were making pictures of goddesses for example, they would depict those goddesses as being voluptuous; having a little bit of fat, having curves. That was the standard of beauty in those days. But of course in those days, well- fed women tended to be wealthy women, healthy women. People who were in really good shape. And under- fed people looked scrawnier and thinner, and that was associated with a negative aspect of beauty. But as we moved on in the 20th Century, we still liked females to be more voluptuous, more shapely. If you look at the movie stars of the 1940's and 50's, they were very voluptuous women. They were women who had curves. They were women who had just a little body fat on them. They were women who had actual thighs. And they were considered extremely attractive for being that way. I always think of Marilyn Monroe in this regard. Because Marilyn Monroe was considered one of the most beautiful women of her generation. And yet Marilyn Monroe was only 5 foot 5 and a half inches tall. And at her very lightest, weighed 118 lbs. And weighed up to 140 at other points in her life. When she died, and they cleaned out her closet of her clothing, the things she was currently wearing, she had clothing that ranged between sizes 8 and 12. She would have been considered much too large for today's modeling jobs, where the average model wears a size 0. So certainly standards of beauties have changed. And standards of beauty are reflected in the kind of models that you see.
Slide 5: Fashion Dolls
And then there were fashion dolls like Barbie. Barbie is an interesting enigma, because nobody actually knows what Barbie's measurements are, or how much Barbie weighs, because nobody knows how tall Barbie is. Mattel has never specified Barbie's height. Probably quite deliberately. Although if you stand her up beside Ken, she is shorter than Ken. So she ... Assuming Ken is a decently, normally- sized human being, Barbie's probably a fairly average size woman in height. But nobody really knows how tall Barbie is supposed to be. But given Barbie's figure, she's ridiculously thin. Now, Barbie used to be thinner than she currently is. From about 2000 onward, Mattel heard the complaints of people saying, Barbie was so thin she was promoting anorexia, and Mattel made Barbie's waist just a little bit wider. So Barbie's not as thin as she used to be. But Barbie's still ridiculously thin. Barbie's waist- to- hip ratio is somewhere in the neighborhood of . 55. Which is a very unusual ratio in human beings. But Barbie's more of an enigma in this other way. Very interesting thing about Barbie. We don't know Barbie's height, like I say. So it's kind of hard to calculate Barbie's measurements. But if Barbie was 6 foot 1, she would have a chest size, her breast measurements would be about 39 inches. And her waist would only be 19 inches; the old style Barbie would. So she'd have a 39 inch chest and 19 inch waist. And physiologists will tell you in human beings, that is darn near impossible; not in any natural way. Because to slim your waist down to just 19 inches, you would have to lose body fat from all over your body. And breasts are made of fat. If a woman thinned down to a point where her waist was that thin, her breasts would be much smaller than that. Of course you know how fashion models deal with that problem. They slim their waist down that thin and then they get breast implants to have enormous- looking breasts with that small waist. Which is a very artificial way, of course, to look attractive as a female. And that's the standard beauty that girls grow up seeing in United States today.
Slide 6: Male/Female Differences
Now as your textbook points out, in considering being very, very thin in the ideal way to appear, females are probably not in accord with males. That is, if you ask males what they consider the ideal female figure, and then you ask females what they consider the idea female figure, males' ideal female figure is not as thin as what females consider the ideal female figure. Males would actually like the females in their lives to be a little bit heavier than the females think they ought to be. So males' view of how the females in their lives should look, is actually closer to normal human dimensions, than what females think that they ought to look like. What we can say is females have a distorted view of how they should look. In that they think the ideal female figure is a figure that most males would report as too thin. And most males would like to see that figure a little bit heavier. So if you're trying to diet yourself down to some ideal figure, that is ridiculously low like that, it's not surprising it would encourage at least some people to be anorexic.
Module 8, Video 1
Slide 2: Dissociative Identity Disorder
Now, if you want an example of how psychological views of a disorder might change over time to where the disorder almost becomes unrecognizable compared to the original one, you can't do any finer than with what was originally called multiple personality disorder. Multiple Personality Disorder is one of those things that media just loves as the plots of books, as the plots of movies, as the plots of television shows. People love the idea of a person who has multiple identities inside of the same body, and assumes different identities at different times. There have been a number of movies that have used this as a plot device. For example, “The Three Faces of Eve,” or the movie “Sybil” involve characters in which people have different personalities, and they're very different people at different times. Now, if you go back to earlier versions of the DSM, what is now called the Dissociative Identity Disorder, used to be very narrowly defined. They talked about people who had distinctively different personalities that were inside of the same body. They would move from one personality to another without their conscious control. Those personalities, they assumed fully when they had them. Some of the personalities were not aware of the other personalities. It's the kind of thing that's very colorful. It's the kind of thing that gets a lot of people's imaginations going. So of course, it's a great basis for a plot device in a story or in a movie. The thing is there was great debate entirely over just how common this was. At that time, we said, " Well, it was the single rarest of disorders.” That if you look in terms of people whose walk and talk, and handwriting, and names and entire set of memories changed when they change personalities, there were only a handful of such cases that have been documented over the years at least with any kind of detail. It's seemed like an incredibly rare disorder.
Slide 3: Dissociative Identity Disorder
Then more recently in the DSM V, there's been this shift in the description of Dissociative Identity Disorder. As was the case with Autism Spectrum Disorder, where they said, " Instead of talking about one disorder, let's talk about a range of disorders from milder to more severe." They started doing the same thing with Dissociative Identity Disorder where they said, " Okay, you have these very rare conditions where people abruptly become another personality, and all of their mannerisms and their memories, and their handwriting, and the way the walk all changes." You have that one group of people where those qualities all change, and they seem like distinctively different people. They're very rare, not many cases like that at all. Then you have a continuum down from there, from those people who absolutely become very different personalities to those people whose personalities change dramatically but they're not necessarily such different personalities. Then ranging down from there to those people who just don't have one set personality, but rather have personalities that shift around all the time. Well, if you have a continuum of diagnosis for Dissociative Identity Disorder, and let it range on down to the people who have very changeable personalities which aren't set in one place all the time, well then the number of people who have this disorder becomes much, much larger because you're including in the diagnosis people who didn't used to be included in the diagnosis. We've gone from a disorder that you hardly ever see, and that nobody much has been diagnosed with. We've shifted that disorder's criteria to say, " You can have lesser symptoms, and still be classified with that disorder," and because of this, now they're classifying way more people with Dissociative Identity Disorder, people who are fringing on what we'd have called Dissociative Identity Disorder before how are now classified as having Dissociative Identity Disorder. It's a case of changing the way the diagnosis is done, which includes a lot more people.
Obesity in America, Part 1: Little Exercise, Lots of Food
Module 8, Video 2
Slide 2: Lack of Exercise
One of the things you might have garnered from reading this chapter is that Americans are very heavy people, we are among the heaviest people in the world. We weren't always that heavy, as the charts in your textbook point out. Americans were thinner just a few decades ago than we are now, but we are gradually getting heavier and heavier. Every new decade seems to be the heaviest Americans ever. You get into this whole issue of why is that? Why are we gradually growing fatter and fatter? It's a good question. Now, there are a number of possibilities behind Americans growing fatter. We could for example point out the fact that manual labor jobs are very scarce these days. Most people don't do back breaking labor all the time. Certainly then you are getting a lot of exercise at work. It's true that we've had fewer and fewer jobs where people get exercise at work over the last few decades. Not having manual labor might be contributing to the job, not working all the time. It's also possible that our changes in leisure time activities have had an effect on our general level of obesity. The preferred leisure time activities of Americans today often involve doing a lot of sitting down. We have cable TV networks and satellite TV networks with 500 channels, and Netflix and Hulu to send us things, to sit and watch on TV. We have video games galore to play. In addition to that, there are social media and the internet to explore. That means a lot of time, in leisure time, just sitting and not exercising. Whereas in the past Americans did more exercising in leisure time. Americans did more outside activities, they played more outside games, and just generally got more exercise than they do today.
Slide 3: Larger Meals
Neither of those things can be totally responsible for why Americans are among the fattest people on Earth, because that's true of many other countries too. Many other countries also don't do much manual labor. Many other countries also have internet and many TV channels and video games to play. Why is it that Americans are so heavy? Putting aside our activity levels you might then turn to what kind of food do we consume, and how much food we consume? There we are probably getting closer to the roots of the whole problem. Americans seems to eat more food than many other people do. We seem to eat larger meals and we seem to eat more between meals than many other people do. That chart in your textbook is a real eye opener showing how Americans consume more than 3,000 calories a day whereas the residents of many other countries consume far fewer calories a day. We are eating larger meals, larger portions in our meals and just taking in more calories during the day.
Slide 4: Big Portions
The food portions issue comes into play when you consider that a lot of restaurants for example have discovered that you will make more money if you sell larger portions, charge more for those larger portions and then you are getting more money out of each customer in the same amount of time. A customer doesn't feel cheated because the portions are so large they can stuff themselves, they still have food to take home. At the same time the restaurant is making more money with each sitting of diners because they are getting more money for each meal out of the diners. When you have more food in front of you, you tend to eat more food. Studies have indicated that if we put larger portions in front of people and say to people “eat what you want,” the larger portion we put in front of the person the more food they'll tend to eat overall. It's possible just by scaling up our portions we have contributed to people eating more in a given setting.
Slide 5: Proximity to Food
Of course we don't just eat during meals, there is also eating between meals. Americans probably do more snacking between meals than a lot of other people do. We have fast food restaurants all over the place. In addition to fast food restaurants we have little corner markets into which you can go in and buy all sorts of snacks and drinks and things to take out in the middle of the day. So that you have constantly got this proximity of food, tempting people to come in and grab something fun to eat. Come in and get something good to eat. Offering us all sorts of tempting treats, all sorts of tempting drinks, and those things drunk throughout the day would add up to quite a few calories.
Obesity in America, Part 2: Soft Drinks, Profits, and Corn Syrup
Module 8, Video 3
Slide 2: Soft Drinks
But my favorite villain in American obesity, the one that I think is more responsible than any one single factor is soft drinks. Most specifically soda or pop depending on which coast you live on. You'll call it one or the other. Soft drinks originally came about, the soft drink industry really got started with medicinal tonics that were made up in drugstores and given to people in order to cure them of malaise or tiredness or stomach problems. Coca Cola, for example, was originally a medicinal preparation that contained cocaine to pep people up. You'd go to your druggist. They'd take a little syrup of Coca Cola. They'd mix it with some carbonated water, and you would drink it, and it was supposed to pep you up, which undoubtedly I imagine it did, even though it only had minuscule amounts of cocaine in it. When in the late 1800's it became obvious that having cocaine was probably not the best thing, Coca Cola dropped the cocaine and replaced it with equivalent amounts of caffeine. But it was still considered a medicinal drink for some time, and Pepsi Cola, Dr. Pepper, both of those were stomach tonics that were supposed to excite your digestive system and get it to working better and less sluggishly. The word “pep” in both of those refers not to making people more peppy but rather to the word pepsin, referring to its supposed effects on your stomach. These drinks were originally medicinal drinks, and druggists could sell them for medicinal drinks, but they were also tasty and people would sometimes buy them to enjoy the taste. But eventually they got into bottling these drinks and selling them already prepared in bottles. Bottled sodas is something you might want to take along on a picnic, that you might want to indulge in now and then, became advertised more and more frequently and became a bigger part of the American diet. As we got into the 50's and 60's, bottlers were really pushing the idea of drinking soda as opposed to other things. But even then, soda wasn't consumed that heavily. You had to carry bottles around and you had to return the bottles afterward, and it was all kind of a hassle. What really brought soda into its own was the fast food industry.
Slide 3: Profits
You see, there's not a huge profit in bottling soda and transporting it to places and selling it. Oh, there's certainly a profit there. There's no question about that. But it costs money to transport things in glass across the country. The water that the soda itself is made out of is quite heavy, too. The shipping gets to be pretty expensive. On the other hand, it's a whole lot cheaper to ship the syrup that you make the soda from and then mix that syrup with water and carbon dioxide on the spot, and create fountain drinks, and fountain drinks dispensers became more and more common in part with the advent of fast food restaurants. Fast food restaurants were one place were you'd be distributing a whole lot of soda over a short period of time, making it right there on the spot, very economical and a really good way for fast food restaurants to pad their bottom line. When original fast food restaurants, places like McDonald's and Henry's and other hamburger joints like that first came into being, what they tended to serve was burgers and fries and shakes, and those were the big sellers at the time. But the trouble with those particular things is the mark up on them is not terrific. You have to sell a lot of burgers and fries and shakes to make a whole lot of money out of a fast food restaurant 'cause you're not making that much for each item you sell. Now, carbonated drinks are another matter. You can buy the fountain syrup very cheaply in bulk, mix up the carbonated drink right there on the spot and sell the drink for a fairly hefty amount of money and make a tremendous mark up. So you can put 30 cents worth of ingredients into a paper cup and sell it for $ 1.80, and that's a pretty tremendous gain. So although you're not making a lot selling the food, you could make a whole lot selling the drinks, but to do that, you got to persuade the people that the drinks are what they want to drink. They want to order that and drink it. That's the ideal thing for them, and so you push and market the soda very heavily. Everybody wants to drink this soda. This soda is really great because that's where you're making the money is from selling the soda. Selling the food, not so profitable. Selling the soda, enormously profitable.
Slide 4: Profits
Now you can go into a fast food restaurant and order your fast food with milk or order your fast food with juice and what you'll find is that they charge quite a lot for those things and gave you much smaller portions because they really don't want to encourage you to buy those. There's not a huge profit in those things. The huge profit is in selling the soda, and if you are gonna buy them, well they've got to mark the price up enough they make some money on those so they come off fairly expensive for a much smaller portion, and they know that many of the customers will say, " Well, that's too small a portion. I'll just order the soda and I'll have a bigger drink," and that's what they're counting on. That's where the money comes from. So there's a tendency to push people to drink soda and sodas become a very, very big thing, a huge market in the United States. Lots of people drink sodas with every meal and drink sodas between meals now, something that didn't happen in the middle part of the 20th century.
Slide 5: Corn Syrup
One other thing about fountain drinks and sodas that's very interesting and contributes to this whole obesity thing, though, and that is that in the United States sodas are mostly made with high fructose corn syrup as their sweetener, not sugar. Now high fructose corn syrup certainly tastes sweet. High fructose corn syrup is about 2/ 3 of the price of sugar so in terms of just saving money, it's much cheaper to make soda with high fructose corn syrup. But corn syrup does not stimulate the same taste response that actual sugar does, that sucrose does. It's not quite as satisfying to people as sucrose is. If you want to test that out, just find yourself a bottle of a well-known soda, brand name soda that's made with sugar and contrast that with a bottle of the same soda made with corn syrup, and you'll see that the sugar soda is more delicious and more satisfying. Corn syrup is not quite so satisfying. Because the corn syrup is not quite so satisfying, there's probably a tendency for people to drink more of it because it isn't as satisfying to consume. So there's a tendency to drink more soda when it's sweetened with corn syrup than when it is sweetened with sugar. So why you say do we sweeten sodas with corn syrup besides the money issue? Sure, the Benjamins are always important. It's always all about the Benjamins, and money would be enough by itself to use corn syrup to make soda, but sugared sodas do taste better. Why are they sweetening them with corn syrup?
Slide 6: Shelf Life vs. Satisfaction
Well, there's a second reason for this, and that has to do with the shelf life of the syrup that they make soda out of. Those big bags of syrup that you put in a fountain drink dispenser? Soda sweetened with corn syrup has a longer shelf life than soda sweetened with sucrose, with table sugar. And so in terms of being able to stack up a pile of these things and keep them for awhile without them getting a stale taste to them, you do better with corn syrup over the long run, and that longer shelf life means less spoilage, less loss by the people who are dispensing it, and that also means more money. So frankly, even though we would enjoy soda better if it was made with sugar, we instead make sodas with corn syrup. Now, a lot of other countries make their sodas with sugar, and that may indeed make a difference. We may be consuming more soda because it's made with corn syrup than if we were making that soda with sugar. It's hard to say although studies seem to indicate that would be the case.
Obesity in America, Part 3: Insulin, Diet Soda, and Food Cues
Module 8, Video 4
Slide 2: Pancreatic Responses
Now you're saying yes but I drink diet soda so that has no calories, so how is that contributing to obesity? What's true the soda itself is not caloric when you drink diet soda. But when you drink diet soda, when you consume sweet foods it tastes like it's got sugar in it to your body, and your body has this interesting goes on that has do with the anticipation of food coming. You see, for many, many years now you've seen food, you smelled food, you've tasted food, and then sugar started pouring into your blood stream from digestion and your pancreas started making insulin to deal with that sugar. You taste food, you smell food, you see food. The pancreas makes insulin to deal with the sugar. Without very many pairings at all, just the sight of food, the smell of food or the taste of food will already start putting the pancreas into action, making insulin to deal with the sugar it expects to be coming. But when you dump insulin into your blood stream insulin pulls down your blood sugar levels, that's what it's for. It's pulling down your blood sugar levels in anticipation with the sugar that's coming. But that also means it makes you hungrier. As soon as you see food, as soon as smell food, as soon as you taste it, you start making insulin, ven before that food started entering your blood stream, and that starts making you hungrier. So the sight of the food piques your hunger even more than it was before. The smell of the food piques your hunger more. The taste of the food piques your hunger more because you already start making insulin. As you're more hungry you'll consume more food.
Slide 3: Diet Soda
What does that have to do with diet soda? Simply this. When you drink diet soda you are tasting sweet, and your pancreas says sweet stuff is coming and immediately starts making insulin which lowers your blood sugar and makes you hungrier. Then as a result of being hungrier you eat more other food. When you drink the diet drinks you eat more other food. How could you get around this problem? Instead of drinking say, a sweetened drink of any kind with your food, you can drink water which will not make your pancreas start producing insulin and will not make you eat more food. Plus, water also has no calories at all.
Slide 4: The Role of TV
While we are on this subject of you seeing food, and smelling food, and tasting food and then making insulin which makes your appetite even greater let's talk a little bit about television. See, up through the middle of the 20th century there really was no television. Then for a couple of decades the television picture was in black and white or it was in very primitive color. Things didn't look all that great on the television. Food advertising on television was not a problem. But then starting with the 1970s, '80s, '90s, we got better and better televisions with bigger and bigger pictures that were more and more realistic. Now, when you sit down in front of your television at night what do you see? You see incredibly realistic pictures of delicious food being advertised, lovely scrumptious looking stuff being advertised. You see that food, and your pancreas says, " Ooh, food is coming," and starts making insulin. Your blood sugar levels plummet and you say, " Wow, I am hungry." Then you get up and start calling that pizza place on the telephone to order pizza, which is of course why they advertise the pizzas at night on the television, so you'll do that. Even if you don't go and dial up and order pizza you'll probably go looking in the refrigerator for something to eat or looking out in the snack area for your snack chips and you'll consume food that you won't even have thought of consuming if someone hadn't just waved food in your face and made you hungry.
Slide 5: Surrounded by Food!
All the readily available fast food places do that too, all the food dispensers, all of the food trademarks that are up everywhere. You see golden arches, you see particular signs, you recognize that Mrs. Field cookie sign, or that Hardee’s sign or that White Castle burger sign, and you've associated those with eating food too, and your pancreas starts making insulin and you're like, " I am hungry. May be I'll pull over and get some food." You wouldn’t have been hungry if you hadn't seen the logo or the sign. What we've got is all of these things provoking hunger in us that isn't real hunger. We are not actually deprived of food, but we are being persuaded we are hungry by the sight of all this food around us all the time. That’s something grandpa didn't have to deal with, being constantly surrounded by temptations to eat food, and many people give in to those temptations and go ahead and eat the food.
Anorexia Nervosa
Module 8, Video 5
Slide 2: Anorexia Nervosa
So on the one hand, you've got the majority of Americans having a problem with being overweight. And then you've got this minority of people who are clear the other direction. They're way underweight. Now we're talking about people with Anorexia Nervosa, and other eating disorders. Where the person is not taking in enough food to maintain health. Anorexia Nervosa is an odd thing to have in the middle of a culture where obesity is our biggest problem. And yet, there are anorectics around and those anorectics occasionally become ill and die of anorexia. And it raises a whole issue of why is anorexia occurring? Why is it that people are literally starving themselves to a dangerous level in order to appear deathly thin?
Slide 3: Standards of Beauty
One factor that plays a role in Anorexia for at least some people, is the societal standard of beauty. Just what does our society consider an example of a beautiful person? What is the best way to look incredibly beautiful? Now our examples of beautiful males, of very good- looking males, tend to involve people who are very well built, broad shoulders, fairly muscled, have a 6- pack. Those kinds of things can't be obtained by starving yourself. You actually have to engage in exercise and work out to get that kind of a build. Of course that does lead some males to do things like use steroids, but it doesn't tend to lead them to be anorectic. On the other hand, our society standard of beauty for females is another matter. Because our standard of beauty for females is people who are stick- thin; very tall, willowy and incredibly thin people. This is what our models look like. This is what the standards of beauty our actresses are presenting look like. And this is a standard of beauty many girls grow up seeing as this is what an attractive female should be like. Now it hasn't always been like this. The stick- thin model trends started in the 1970's and wasn't really common before that. Clothing designers started realizing in the 1970's that they could drape clothing more smoothly and give clothing more flowing lines on very, very thin people, where the people's figure wouldn't interfere with the lines of the clothing. And so, the first really famous thin model was Twiggy. Who would actually be considered slightly heavy by today's model standards, but was much thinner than models up to that point. And after that, fashion designers moved to thinner and thinner models to this point, that your average fashion design model has got to be about 5 foot 9 and weigh less than 100 lbs. And boy, that is thin.
Slide 4: Standards of Beauty
Now if we look at standards of beauty from the past, some interesting things come out. For example, if you look at standards of beauty among Renaissance artists, you look at people like Rubens, for example. There's a word for females that are carrying a little bit of extra weight, and that's Rubenesque. Because Ruben's figures were often Rubenesque. But so were Raphael's figures. A lot of people depicting very beautiful women as somewhat heavy if they were making pictures of goddesses for example, they would depict those goddesses as being voluptuous; having a little bit of fat, having curves. That was the standard of beauty in those days. But of course in those days, well- fed women tended to be wealthy women, healthy women. People who were in really good shape. And under- fed people looked scrawnier and thinner, and that was associated with a negative aspect of beauty. But as we moved on in the 20th Century, we still liked females to be more voluptuous, more shapely. If you look at the movie stars of the 1940's and 50's, they were very voluptuous women. They were women who had curves. They were women who had just a little body fat on them. They were women who had actual thighs. And they were considered extremely attractive for being that way. I always think of Marilyn Monroe in this regard. Because Marilyn Monroe was considered one of the most beautiful women of her generation. And yet Marilyn Monroe was only 5 foot 5 and a half inches tall. And at her very lightest, weighed 118 lbs. And weighed up to 140 at other points in her life. When she died, and they cleaned out her closet of her clothing, the things she was currently wearing, she had clothing that ranged between sizes 8 and 12. She would have been considered much too large for today's modeling jobs, where the average model wears a size 0. So certainly standards of beauties have changed. And standards of beauty are reflected in the kind of models that you see.
Slide 5: Fashion Dolls
And then there were fashion dolls like Barbie. Barbie is an interesting enigma, because nobody actually knows what Barbie's measurements are, or how much Barbie weighs, because nobody knows how tall Barbie is. Mattel has never specified Barbie's height. Probably quite deliberately. Although if you stand her up beside Ken, she is shorter than Ken. So she ... Assuming Ken is a decently, normally- sized human being, Barbie's probably a fairly average size woman in height. But nobody really knows how tall Barbie is supposed to be. But given Barbie's figure, she's ridiculously thin. Now, Barbie used to be thinner than she currently is. From about 2000 onward, Mattel heard the complaints of people saying, Barbie was so thin she was promoting anorexia, and Mattel made Barbie's waist just a little bit wider. So Barbie's not as thin as she used to be. But Barbie's still ridiculously thin. Barbie's waist- to- hip ratio is somewhere in the neighborhood of . 55. Which is a very unusual ratio in human beings. But Barbie's more of an enigma in this other way. Very interesting thing about Barbie. We don't know Barbie's height, like I say. So it's kind of hard to calculate Barbie's measurements. But if Barbie was 6 foot 1, she would have a chest size, her breast measurements would be about 39 inches. And her waist would only be 19 inches; the old style Barbie would. So she'd have a 39 inch chest and 19 inch waist. And physiologists will tell you in human beings, that is darn near impossible; not in any natural way. Because to slim your waist down to just 19 inches, you would have to lose body fat from all over your body. And breasts are made of fat. If a woman thinned down to a point where her waist was that thin, her breasts would be much smaller than that. Of course you know how fashion models deal with that problem. They slim their waist down that thin and then they get breast implants to have enormous- looking breasts with that small waist. Which is a very artificial way, of course, to look attractive as a female. And that's the standard beauty that girls grow up seeing in United States today.
Slide 6: Male/Female Differences
Now as your textbook points out, in considering being very, very thin in the ideal way to appear, females are probably not in accord with males. That is, if you ask males what they consider the ideal female figure, and then you ask females what they consider the idea female figure, males' ideal female figure is not as thin as what females consider the ideal female figure. Males would actually like the females in their lives to be a little bit heavier than the females think they ought to be. So males' view of how the females in their lives should look, is actually closer to normal human dimensions, than what females think that they ought to look like. What we can say is females have a distorted view of how they should look. In that they think the ideal female figure is a figure that most males would report as too thin. And most males would like to see that figure a little bit heavier. So if you're trying to diet yourself down to some ideal figure, that is ridiculously low like that, it's not surprising it would encourage at least some people to be anorexic.