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Monday’s rampage in Illinois marked the 15th time this year that four or more people were killed in a shootin

Of the 90,498 gun deaths in 2020 and 2021, 38,796 were homicides. Nearly 21,000 of those victims were Black men.

In 2020, while the overall crime rate nationwide fell, “that was not true for shootings,” Cook said. That year, he said, there was an “unparalleled” surge in people killed by firearms compared with 2019.

Solving more shootings, particularly nonfatal ones, “would interrupt the cycle of retaliation,” Cook said, and might improve local trust in the police. “That would be a productive use of money,” he said.

Police nationwide in 2020 “cleared” about half of all homicides, according to the FBI, which usually means that someone was arrested and charged or the case was closed another way, including the death of the attacker.

But three decades of research has established that people with mental illness are responsible for just a small percentage of interpersonal and gun violence.

“Anybody who shoots somebody else has a mental health challenge. Period,” Texas Gov. Greg Abbott (R) said shortly after the Uvalde shooting in May.

It’s clear that many other factors are more closely associated with gun violence than mental illness. They include experiencing trauma and violence during childhood, being young and male, living in neighborhoods where violence is more prevalent, poor impulse control, poor anger control, and perhaps most of all, easy access to a firearm.

There is one major, well-established connection between mental illness and gun violence: suicide.

officials must help create environments where there is less trauma in the home, support families and strengthen services for children in schools.

In 1994, Duke University gun violence researcher Jeffrey W. Swanson calculated that if all active psychotic and mood disorders were eliminated overnight, interpersonal violence would be reduced by just 4 percent

“We don’t have gun control as much as we have people control,” he said. “We try to figure out the people who are so dangerous that we have to limit their access to guns.”

In many other countries, guns are tightly restricted, but the United States has taken a different route, he said.

people in Florida with serious mental illnesses, including some who were committed to a psychiatric facility involuntarily or for a short-term emergency hold, 0.9 percent were arrested for a violent crime involving a gun within seven years — about the same rate as the general population.

The 1998 MacArthur Violence Risk Assessment Study, which followed 951 people who had been released from three psychiatric facilities, found that 23 committed 67 acts of interpersonal gun violence — a rate of 2 percent — in the next year. Just 19 of those acts, committed by nine people, were against strangers.

The consistent invocations of mental health after massacres such as those in Buffalo, Uvalde and Highland Park are ways for officials to distance themselves from the horror of the event, to explain the unfathomable,

“It’s a tragedy that demands explanation, and the stigma of mental illness is something that fuels pseudo-explanations,” she said. “It’s a fake explanation. Why has this man done this terrible thing? The answer is because he’s mentally ill. How do you know he’s mentally ill? Because he’s done this terrible thing.”

Surprisingly, Iran is not happy with Azerbaijan’s victory. As openly as the Iranians ever do, they’ve threatened to use force against any changes to the borders of Armenia. Iran, a millenniums-old civilization central to a whole continent, cannot tolerate being walled off behind a chain of Turkish dependencies. India, similarly, is on Armenia’s side and has been sending a regular supply of weapons. One spur for such support, no doubt, is Pakistan’s joining the Azeri-Turkish alliance. In the jargon of American lawyers, this opens a whole new can of worms.

Then there’s Russia, whose absence from the denouement in Nagorno-Karabakh was striking. Even after the 1990s, Moscow still remained by far the biggest supplier of weapons to both Armenia and Azerbaijan. Their economies and societies, above all the elites and their corruption networks, were until very recently molded together. What we are seeing now, as both nations slip out of Russia’s orbit, might be the second round of Soviet collapse.

Once again, Armenia started the shift. In spring 2018 a tremendously hopeful uprising, reminiscent of 1989 in Central Europe, forced the post-communist elites to surrender power. Vladimir Putin was visibly displeased to meet Nikol Pashinyan, the anticorruption journalist and street rebel elected Armenia’s premier by an overwhelming majority. Mr. Pashinyan admittedly had neither political team nor experience; he is learning statesmanship on the job, often at great expense to his nation. Yet he managed to significantly reduce corruption, helping to unlock the legendary entrepreneurship of Armenians. Amid all the grim news, the Armenian economy, led by the I.T. sector, is registering impressive growth.

History has a habit of serving the same lessons with changed variables. In 1988, it was the dreamer Gorbachev stumbling over Nagorno-Karabakh that unwittingly shattered the world order. Today, Mr. Putin could become the second, much darker incarnation of the Kremlin aggrandizer going awry on all fronts. The consequences — from emboldening international aggression to reanimating the West under the banner of NATO — will be profound. As events in Nagorno-Karabakh show, the fragile post-Cold War order is giving way to something else entirely.

The Caucasus might seem strange and distant. Yet it might prove the wedge that turns the fortunes of world order. Trieste, Smyrna, Sarajevo, Danzig and Crimea were all such places. Let us not have to relearn history at the cost of yet another ethnic cleansing

According to some reports, he never expected to win in 2016. But even then, in the run-up to the election, Trump’s opponents were already calling him a fascist. I counseled against such usage at the time, because Trump, as a person and as a public figure, is just so obviously ridiculous; fascists, by contrast, are dangerously serious people, and in many circumstances, their leaders have been unnervingly tough and courageous. Trump—whiny, childish, unmanly—hardly fits that bill. (A rare benefit of his disordered character is that his defensiveness and pettiness likely continue to limit the size of his personality cult.)

Unfortunately, the overuse of fascist (among other charges) quickly wore out the part of the public’s eardrums that could process such words.

ere I want to caution my fellow citizens. Trump, whether from intention or stupidity or fear, has identified himself as a fascist under almost any reasonable definition of the word.

He is also constrained by circumstance: The country is not in disarray, or at war, or in an economic collapse

starting in the mid-2010s, those beloved blue skies began to disappear. First, the smoke came in occasional bursts, from wildfires in Canada or California or Siberia, and blew away when the wind changed direction. Within a few summers, though, it was coming in thicker, from more directions at once, and lasting longer.

Sometimes there were weeks when you were advised not to open your windows or exercise outside. Sometimes there were long stretches where you weren’t supposed to breathe the outside air at all.

Now lots of Bryant’s clients wanted to talk about climate change. They wanted to talk about how strange and disorienting and scary this new reality felt, about what the future might be like and how they might face it, about how to deal with all the strong feelings — helplessness, rage, depression, guilt — being stirred up inside them.

As a therapist, Bryant found himself unsure how to respond

while his clinical education offered lots of training in, say, substance abuse or family therapy, there was nothing about environmental crisis, or how to treat patients whose mental health was affected by it

Bryant immersed himself in the subject, joining and founding associations of climate-concerned therapists

eventually started a website, Climate & Mind, to serve as a sort of clearing house for other therapists searching for resources. Instead, the site became an unexpected window into the experience of would-be patients: Bryant found himself receiving messages from people around the world who stumbled across it while looking for help.

Over and over, he read the same story, of potential patients who’d gone looking for someone to talk to about climate change and other environmental crises, only to be told that they were overreacting — that their concern, and not the climate, was what was out of whack and in need of treatment.

“You come in and talk about how anxious you are that fossil-fuel companies continue to pump CO2 into the air, and your therapist says, ‘So, tell me about your mother.’”

In many of the messages, people asked Bryant for referrals to climate-focused therapists in Houston or Canada or Taiwan, wherever it was the writer lived.

his practice had shifted to reflect a new reality of climate psychology. His clients didn’t just bring up the changing climate incidentally, or during disconcerting local reminders; rather, many were activists or scientists or people who specifically sought out Bryant because of their concerns about the climate crisis.

could now turn to resources like the list maintained by the Climate Psychology Alliance North America, which contains more than 100 psychotherapists around the country who are what the organization calls “climate aware.”

But treating those fears also stirred up lots of complicated questions that no one was quite sure how to answer. The traditional focus of his field, Bryant said, could be oversimplified as “fixing the individual”: treating patients as separate entities working on their personal growth

It had been a challenging few years, Bryant told me when I first called to talk about his work. There were some ways in which climate fears were a natural fit in the therapy room, and he believed the field had coalesced around some answers that felt clear and useful

Climate change, by contrast, was a species-wide problem, a profound and constant reminder of how deeply intertwined we all are in complex systems — atmospheric, biospheric, economic — that are much bigger than us. It sometimes felt like a direct challenge to old therapeutic paradigms — and perhaps a chance to replace them with something better.

In one of climate psychology’s founding papers, published in 2011, Susan Clayton and Thomas J. Doherty posited that climate change would have “significant negative effects on mental health and well-being.” They described three broad types of possible impacts: the acute trauma of living through climate disasters; the corroding fear of a collapsing future; and the psychosocial decay that could damage the fabric of communities dealing with disruptive changes

All of these, they wrote, would make the climate crisis “as much a psychological and social phenomenon as a matter of biodiversity and geophysics.”

Many of these predictions have since been borne out

Studies have found rates of PTSD spiking in the wake of disasters, and in 2017 the American Psychological Association defined “ecoanxiety” as “a chronic fear of environmental doom.”

Climate-driven migration is on the rise, and so are stories of xenophobia and community mistrust.

According to a 2022 survey by Yale and George Mason University, a majority of Americans report that they spend time worrying about climate change.

Many say it has led to symptoms of depression or anxiety; more than a quarter make an active effort not to think about it.

There was little or no attention to the fact that living through, or helping to cause, a collapse of nature can also be mentally harmful.

In June, the Yale Journal of Biology and Medicine published a paper cautioning that the world at large was facing “a psychological condition of ‘systemic uncertainty,’” in which “difficult emotions arise not only from experiencing the ecological loss itself,” but also from the fact that our lives are inescapably embedded in systems that keep on making those losses worse.

Climate change, in other words, surrounds us with constant reminders of “ethical dilemmas and deep social criticism of modern society. In its essence, climate crisis questions the relationship of humans with nature and the meaning of being human in the Anthropocene.”

This is not an easy way to live.

Living within a context that is obviously unhealthful, he wrote, is painful: “a dimly intuited ‘fall’ from which we spend our lives trying to recover, a guilt we can never quite grasp or expiate” — a feeling of loss or dislocation whose true origins we look for, but often fail to see. This confusion leaves us feeling even worse.

When Barbara Easterlin first started studying environmental psychology 30 years ago, she told me, the focus of study was on ways in which cultivating a relationship with nature can be good for mental health

A poll by the American Psychiatric Association in the same year found that nearly half of Americans think climate change is already harming the nation’s mental health.

the field is still so new that it does not yet have evidence-tested treatments or standards of practice. Therapists sometimes feel as if they are finding the path as they go.

Rebecca Weston, a licensed clinical social worker practicing in New York and a co-president of the CPA-NA, told me that when she treats anxiety disorders, her goal is often to help the patient understand how much of their fear is internally produced — out of proportion to the reality they’re facing

climate anxiety is a different challenge, because people worried about climate change and environmental breakdown are often having the opposite experience: Their worries are rational and evidence-based, but they feel isolated and frustrated because they’re living in a society that tends to dismiss them.

One of the emerging tenets of climate psychology is that counselors should validate their clients’ climate-related emotions as reasonable, not pathological

it does mean validating that feelings like grief and fear and shame aren’t a form of sickness, but, as Weston put it, “are actually rational responses to a world that’s very scary and very uncertain and very dangerous for people

In the words of a handbook on climate psychology, “Paying heed to what is happening in our communities and across the globe is a healthier response than turning away in denial or disavowal.”

But this, too, raises difficult questions. “How much do we normalize people to the system we’re in?” Weston asked. “And is that the definition of health?

Or is the definition of health resisting the things that are making us so unhappy? That’s the profound tension within our field.”

“It seems to shift all the time, the sort of content and material that people are bringing in,” Alexandra Woollacott, a psychotherapist in Seattle, told the group. Sometimes it was a pervasive anxiety about the future, or trauma responses to fires or smoke or heat; other times, clients, especially young ones, wanted to vent their “sort of righteous anger and sense of betrayal” at the various powers that had built and maintained a society that was so destructive.

“I’m so glad that we have each other to process this,” she said, “because we’re humans living through this, too. I have my own trauma responses to it, I have my own grief process around it, I have my own fury at government and oil companies, and I think I don’t want to burden my clients with my own emotional response to it.”

In a field that has long emphasized boundaries, discouraging therapists from bringing their own issues or experiences into the therapy room, climate therapy offers a particular challenge: Separation can be harder when the problems at hand affect therapist and client alike

Some therapists I spoke to were worried about navigating the breakdown of barriers, while others had embraced it. “There is no place on the planet that won’t eventually be impacted, where client and therapist won’t be in it together,” a family therapist wrote in a CPA-NA newsletter. “Most therapists I know have become more vulnerable and self-disclosing in their practice.”

“If you look at or consider typical theoretical framings of something like post-traumatic growth, which is the understanding of this idea that people can sort of grow and become stronger and better after a traumatic event,” she said, then the climate crisis poses a dilemma because “there is no afterwards, right? There is no resolution anytime in our lifetimes to this crisis that we nonetheless have to build the capacities to face and to endure and to hopefully engage.”

many of her patients are also disconnected from the natural world, which means that they struggle to process or even recognize the grief and alienation that comes from living in a society that treats nature as other, a resource to be used and discarded.

“How,” she asked, “do you think about resilience apart from resolution?”

she believed this framing reflected and reinforced a bias inherent in a field that has long been most accessible to, and practiced by, the privileged. It was hardly new in the world, after all, to face the collapse of your entire way of life and still find ways to keep going.

Torres said that she sometimes takes her therapy sessions outside or asks patients to remember their earliest and deepest connections with animals or plants or places. She believes it will help if they learn to think of themselves “as rooted beings that aren’t just simply living in the human overlay on the environment.” It was valuable to recognize, she said, that “we are part of the land” and suffer when it suffers.

Torres described introducing her clients to methods — mindfulness, distress tolerance, emotion regulation — to help them manage acute feelings of stress or panic and to avoid the brittleness of burnout.

She also encourages them to narrativize the problem, including themselves as agents of change inside stories about how they came to be in this situation, and how they might make it different.

then she encourages them to find a community of other people who care about the same problems, with whom they could connect outside the therapy room. As Woollacott said earlier: “People who share your values. People who are committed to not looking away.”

Dwyer told the group that she had been thinking more about psychological adaptation as a form of climate mitigation

Therapy, she said, could be a way to steward human energy and creative capacities at a time when they’re most needed.

It was hard, Bryant told me when we first spoke, to do this sort of work without finding yourself asking bigger questions — namely, what was therapy actually about?

Many of the therapists I talked to spoke of their role not as “fixing” a patient’s problem or responding to a pathology, but simply giving their patients the tools to name and explore their most difficult emotions, to sit with painful feelings without instantly running away from them

many of the methods in their traditional tool kits continue to be useful in climate psychology. Anxiety and hopelessness and anger are all familiar territory, after all, with long histories of well-studied treatments.

They focused on trying to help patients develop coping skills and find meaning amid destabilization, to still see themselves as having agency and choice.

Weston, the therapist in New York, has had patients who struggle to be in a world that surrounds them with waste and trash, who experience panic because they can never find a place free of reminders of their society’s destruction

eston said, that she has trouble with the repeated refrain that therapist and patient experiencing the same losses and dreads at the same time constituted a major departure from traditional therapeutic practice

“I’m so excited by what you’re bringing in,” Woollacott replied. “I’m doing psychoanalytic training at the moment, and we study attachment theory” — how the stability of early emotional bonds affects future relationships and feelings of well-being. “But nowhere in the literature does it talk about our attachment to the land.”

Lately, Bryant told me, he’s been most excited about the work that happens outside the therapy room: places where groups of people gather to talk about their feelings and the future they’re facing

It was at such a meeting — a community event where people were brainstorming ways to adapt to climate chaos — that Weston, realizing she had concrete skills to offer, was inspired to rework her practice to focus on the challenge. She remembers finding the gathering empowering and energizing in a way she hadn’t experienced before. In such settings, it was automatic that people would feel embraced instead of isolated, natural that the conversation would start moving away from the individual and toward collective experiences and ideas.

There was no fully separate space, to be mended on its own. There was only a shared and broken world, and a community united in loving it.

More than one million people have died from Covid, a once unimaginable figure

An increase in drug deaths, combined with Covid, has led overall life expectancy in America to decline to a degree not seen since World War II.

Police killings of unarmed Black men continue long past vows for reform.

“You can’t underestimate the need for belonging,” she said. When something terrible happens, people want to connect with their “in-group,” she said, where they feel they belong, which can push people further into partisan camps.

Rabbi Mychal B. Springer, the manager of clinical pastoral education at NewYork-Presbyterian Hospital, has found herself returning to an ancient Jewish writing in the Mishnah, which says that when God began creating, God created a single person.

“The teaching is, each person is so precious that the whole world is contained in that person, and we have to honor that person completely and fully,” she said. “If a single person dies, the whole world dies, and if a single person is saved, then the whole world is saved.”

We can only value life if we are willing to truly grieve, to truly face the reality of suffering

“It’s not that we don’t care. We’ve reached the limit of how much we can cry and hurt,” she said. “And yet we have to. We have to value each life as a whole world, and be willing to cry for what it means that that whole world has been lost.”

The mountain of calamities, and the paralysis over how to overcome it, points to a nation struggling over some fundamental questions: Has our tolerance as a country for such horror grown, dusting off after one event before moving on to the next? How much value do we place in a single human life?

Valuing life and working for healing means going outside of one’s self, and one’s own group, she said.

“This will require collective action,” she said. “And part of the problem is we are very divided right now.”

American culture often prizes individual liberty above collective needs. But ultimately humans are born to care about others and to not turn away,

“Human beings are born for meaning,” she said. “We have very, very large souls. We are born for generosity, we are born for compassion.”

What is standing in the way of a proper valuation of life, she said, is “our very, very disordered relationship with death.”

n the United States, denial of death has reached an extreme form, she said, where many focus on themselves to avoid the fear of death.

That fear cuts through “all tendrils of conscience, and common good, and capacity to act together,” she said, “because in the final analysis we have become animals saving our own skin, the way we seem to save our own skin is repression and dissociation.”

The United States is an outlier in the level of gun violence it tolerates. The rate and severity of mass shootings is without parallel in the world outside conflict zones.America has “a love affair with violence,”

Violence is an almost a normal part of life in the United States, she said, and valuing life takes consistently asking how am I committed to nonviolence today? It also means giving some things up, she said — many people think of themselves as nonviolent, but consume violence in entertainment.

“The question that should scare us is, what will it take to make us collectively bring about this change?

“Maybe this is our life’s work,” she said. “Maybe this is our work as humans.”

“But when I slow down I realize there is something alive in our culture that has harmed those people,” she said. “Whatever that something is, it is harming all of us, we are all vulnerable to it, it wields some sort of influence upon us, no matter who we are.”

Caldwell’s words are worth remembering because they describe—perhaps more eloquently than anyone else in the west—not just why Putin built a following abroad, but also how he became (at least for a time) popular at home

He is the elected leader of Russia—a rugged, relatively poor, militarily powerful country that in recent years has been frequently humiliated, robbed, and misled. His job has been to protect his country’s prerogatives and its sovereignty in an international system that seeks to erode sovereignty in general and views Russia’s sovereignty in particular as a threat.

if we were to use traditional measures for understanding leaders, which involve the defense of borders and national flourishing, Putin would count as the pre-eminent statesman of our time. On the world stage, who can vie with him? Only perhaps Recep Tayyip Erdoğan of Turkey.

I’ve long thought about an argument in Victor Hugo’s Les Misérables

the available evidence indicates he’s been broadly popular in Russia for two decades. One wonders how long this popularity can hold as Russian forces struggle on the battlefield, but the bottom line is still clear—tens of millions of people (including some of the most influential people in the west) have admired an objectively evil man. Why? 

Throughout history we see familiar patterns, in times of stress and confusion, people cry out for salvation and strength. Success—including military success—builds a bond with the people. The victorious ruler connects not just with human pride, but also with profound human longings for protection, purpose, and identity.

One of the most fateful passages of scripture is found in 1 Samuel 8, the moment the people of Israel demand a king. Dissatisfied with the leadership of Samuel’s dissolute sons, they demanded a king “to judge us like all the nations.” 

“There shall be a king over us, that we also may be like all the nations, and that our king may judge us and go out before us and fight our battles.”

he did what Kemal Atatürk had done in Turkey in the 1920s. Out of a crumbling empire, he rescued a nation-state, and gave it coherence and purpose. He disciplined his country’s plutocrats. He restored its military strength. And he refused, with ever blunter rhetoric, to accept for Russia a subservient role in an American-run world system

Marius’s case for Napoleon feels relevant as Vladimir Putin longs for the glories of the Russian imperial past:

Putin inherited the husk of an empire, and in war after war, for year after year, he triumphed. He expanded the zone of Russian control. He replaced the lost Soviet identity with a renewed commitment to Russian greatness. While Putin’s victories weren’t as dramatic as Napoleon’s—Georgia and Crimea can’t compare to Jena and Austerlitz—war provides a terrible purpose, and victory creates remarkable pride. 

The sobering reality is that we cannot look at Russia and simply shake our heads at “those people,” secure in the knowledge that we’re fundamentally different

we’re still not far removed from a violent attempt to overturn an American election, led by a mob waving blue flags stamped with their leader’s name. 

There are those who see the ways in which human beings abuse liberty, or squander it in disorder and decadence, and are drawn to the order and direction of authoritarianism. In this formulation, freedom itself is the problem. It doesn’t provide purpose. 

“Because we live in the past when we are online,” Sacasas suggests, “we will find ourselves fighting over the past.”

my hunch is that people feel stuck or move on because online, these events feel like things that have happened, rather than something that is happening.

“What we’re focused on is not the particular event or movement before us, but the one right behind us,”

“As we layer on these events, it becomes difficult for anything to break through. You’re trying to enter the information environment and the debate, and you find layer upon layer of abstraction over the initial point of conflict. You find yourself talking about what people are saying about the thing, instead of talking about the thing. We’re caking layers of commentary over the event itself and the event fades.” This is, if you ask me, a decent description of the last five years of news cycles.

So, what’s changed? Why do we feel more stuck now?

“I think it also has to do with the proportion of one’s daily experience to dispatches from the past,” Sacasas said. Pre-internet, “the totality of my day wasn't enclosed by this experience of media artifacts coming to me.”

the smartphone-bound, reasonably-but-not-terminally online people—the amount they spend engaged with the recent past has increased considerably, to the point that some are enclosed in this online world and develop a disordered relationship to time.

Constantly absorbing and commenting on things that have just happened sounds to me like a recipe for feeling powerless.

“That feeling of helplessness comes out of the fact that all our agency is being channeled through these media,” he said. “We have these events that are ponderously large, like climate change or gun control, and to view them only through the lens of what happened or the abstraction of what people are saying strips away the notion of our agency and makes it all feel so futile.”

the social-media platforms we live on push us toward contribution, and they make it feel necessary. Yet what is the sum total of these contributions? “If I'm cynical,” Sacasas said, “what I think it generates is something akin to influencer culture. It creates people who will make money off of channeling that attention—for better or for ill. Everyone else is stuck watching the show, feeling like we’re unable to effectively change the channel or change our circumstances.”

ubiquitous connectivity and our media environments naturally lend themselves toward an influencer-and-fandom dynamic. If the system is built to inspire more and more layers of commentary, then that system will privilege and reward people who feed it

On an internet that democratizes publishing, what this might mean is that all media takes on the meta-commentary characteristics of political or sports talk radio.

When the Depp-Heard trial began gaining traction online in April, Internet users around the world recognized a fresh opportunity to seize and monetize the attention. Christopher Orec, a 20-year-old content creator in Los Angeles, has posted a dozen videos about the trial to his more than 1.4 million followers on Instagram across several pages. “Personally, what I’ve gained from it is money as well as exposure from how well the videos do,” he said. You can “go from being a kid in high school and, if you hop on it early, it can basically change your life,” Orec said. “You can use those views and likes and shares that you get from it, to monetize and build your account and make more money from it, meet more people and network.”

if you were going to design a nightmare scenario, it might look a bit like what is described in this Washington Post story from last Thursday:

Like the Depp-Heard coverage, the forces that Sacasas describes can be deeply cynical and destructive. They’re also almost always exhausting for those of us consuming them

Examining and discussing and understanding the past is important, and our technologies are enormously helpful in this respect.

Sacasas compared the way our media ecosystem works—and all these feedback loops—to a novelty finger trap. “Almost every action generates more difficult conditions—to struggle is to feed the thing that’s keeping you bogged down.”

As politicians—especially those on the far right—transition into full time influencers, they no longer need to govern even reasonably effectively to gain power. They don’t need to show what they’ve done for their constituents. Simply culture warring—posting—is enough. The worse the post, the more attention it gets, and the more power they accrue.

There's a reason Marjorie Taylor Greene raised $9 million and Sarah Palin has only raised $600,000. MTG has recognized something Palin used to know. Her job is to say something terrible every day so we do all her viral marketing for her.

One outcome of elected officials adopting the influencer model is a politics that is obsessed with, and stuck in, the past. I don’t just mean a focus on making America “great again,” but a politics that is obsessed with relitigating its recent past.

we are forever talking about Hillary’s emails or Hunter Biden’s laptop or Merrick Garland’s thwarted Supreme Court seat or the legitimacy of the previous election.

How do we break the cycle? Is silence our best weapon to starve the attention? That feels wrong. I don’t have answers, but Sacasas has given me a valuable guiding question: How do we train our attention on our present and future, when so much of our life is spent ensconced in dispatches from the recent past?

titled “Tightness-Looseness Across the 50 United States,” the study calculated a catalog of measures for each state, including the incidence of natural disasters, disease prevalence, residents’ levels of openness and conscientiousness, drug and alcohol use, homelessness and incarceration rates.

Gelfand said:Some groups have much stronger norms than others; they’re tight. Others have much weaker norms; they’re loose. Of course, all cultures have areas in which they are tight and loose — but cultures vary in the degree to which they emphasize norms and compliance with them.

states in New England and on the West Coast were the loosest: California, Oregon, Washington, Maine, Massachusetts, Connecticut, New Hampshire and Vermont.

In both 2016 and 2020, Donald Trump carried all 10 of the top “tight” states; Hillary Clinton and Joe Biden carried all 10 of the top “loose” states.

“Rule Makers, Rule Breakers: How Tight and Loose Cultures Wire the World” in 2018, in which she described the results of a 2016 pre-election survey she and two colleagues had commissioned

The results were telling: People who felt the country was facing greater threats desired greater tightness. This desire, in turn, correctly predicted their support for Trump. In fact, desired tightness predicted support for Trump far better than other measures. For example, a desire for tightness predicted a vote for Trump with 44 times more accuracy than other popular measures of authoritarianism.

The 2016 election, Gelfand continued, “turned largely on primal cultural reflexes — ones that had been conditioned not only by cultural forces, but by a candidate who was able to exploit them.”

Along the same lines, if liberals and conservatives hold differing moral visions, not just about what makes a good government but about what makes a good life, what turned the relationship between left and right from competitive to mutually destructive?

Cultural differences, Gelfand continued, “have a certain logic — a rationale that makes good sense,” noting that “cultures that have threats need rules to coordinate to survive (think about how incredibly coordinated Japan is in response to natural disasters).

cultures that don’t have a lot of threat can afford to be more permissive and loose.”

The tight-loose concept, Gelfand argued,is an important framework to understand the rise of President Donald Trump and other leaders in Poland, Hungary, Italy, and France,

The gist is this: when people perceive threat — whether real or imagined, they want strong rules and autocratic leaders to help them survive

My research has found that within minutes of exposing study participants to false information about terrorist incidents, overpopulation, pathogen outbreaks and natural disasters, their minds tightened. They wanted stronger rules and punishments.

The South dominated the tight states: Mississippi, Alabama Arkansas, Oklahoma, Tennessee, Texas, Louisiana, Kentucky, South Carolina and North Carolina

Looseness, Gelfand posits, fosters tolerance, creativity and adaptability, along with such liabilities as social disorder, a lack of coordination and impulsive behavior.

If liberalism and conservatism have historically played a complementary role, each checking the other to constrain extremism, why are the left and right so destructively hostile to each other now, and why is the contemporary political system so polarized?

Gelfand writes that tightness encourages conscientiousness, social order and self-control on the plus side, along with close-mindedness, conventional thinking and cultural inertia on the minus side.

Niemi contended that sensitivity to various types of threat is a key factor in driving differences between the far left and far right.

She cited research thatfound 47 percent of the most extreme conservatives strongly endorsed the view that “The world is becoming a more and more dangerous place,” compared to 19 percent of the most extreme liberals

Conservatives and liberals, Niemi continued,see different things as threats — the nature of the threat and how it happens to stir one’s moral values (and their associated emotions) is a better clue to why liberals and conservatives react differently.

Unlike liberals, conservatives strongly endorse the binding moral values aimed at protecting groups and relationships. They judge transgressions involving personal and national betrayal, disobedience to authority, and disgusting or impure acts such as sexually or spiritually unchaste behavior as morally relevant and wrong.

Underlying these differences are competing sets of liberal and conservative moral priorities, with liberals placing more stress than conservatives on caring, kindness, fairness and rights — known among scholars as “individualizing values

conservatives focus more on loyalty, hierarchy, deference to authority, sanctity and a higher standard of disgust, known as “binding values.”

As a set, Niemi wrote, conservative binding values encompassthe values oriented around group preservation, are associated with judgments, decisions, and interpersonal orientations that sacrifice the welfare of individuals

Just as ecological factors differing from region to region over the globe produced different cultural values, ecological factors differed throughout the U.S. historically and today, producing our regional and state-level dimensions of culture and political patterns.

Niemi cited a paper she and Liane Young, a professor of psychology at Boston College, published in 2016, “When and Why We See Victims as Responsible: The Impact of Ideology on Attitudes Toward Victims,” which tested responses of men and women to descriptions of crimes including sexual assaults and robberies.

We measured moral values associated with unconditionally prohibiting harm (“individualizing values”) versus moral values associated with prohibiting behavior that destabilizes groups and relationships (“binding values”: loyalty, obedience to authority, and purity)

Increased endorsement of binding values predicted increased ratings of victims as contaminated, increased blame and responsibility attributed to victims, increased perceptions of victims’ (versus perpetrators’) behaviors as contributing to the outcome, and decreased focus on perpetrators.

For example, binding values are associated with Machiavellianism (e.g., status-seeking and lying, getting ahead by any means, 2013); victim derogation, blame, and beliefs that victims were causal contributors for a variety of harmful acts (2016, 2020); and a tendency to excuse transgressions of ingroup members with attributions to the situation rather than the person (2023).

What happened to people ecologically affected social-political developments, including the content of the rules people made and how they enforced them

Numerous factors potentially influence the evolution of liberalism and conservatism and other social-cultural differences, including geography, topography, catastrophic events, and subsistence styles

Joshua Hartshorne, who is also a professor of psychology at Boston College, took issue with the binding versus individualizing values theory as an explanation for the tendency of conservatives to blame victims:

I would guess that the reason conservatives are more likely to blame the victim has less to do with binding values and more to do with the just-world bias (the belief that good things happen to good people and bad things happen to bad people, therefore if a bad thing happened to you, you must be a bad person).

Belief in a just world, Hartshorne argued, is crucial for those seeking to protect the status quo:It seems psychologically necessary for anyone who wants to advocate for keeping things the way they are that the haves should keep on having, and the have-nots have got as much as they deserve. I don’t see how you could advocate for such a position while simultaneously viewing yourself as moral (and almost everyone believes that they themselves are moral) without also believing in the just world

Conversely, if you generally believe the world is not just, and you view yourself as a moral person, then you are likely to feel like you have an obligation to change things.

I asked Lene Aaroe, a political scientist at Aarhus University in Denmark, why the contemporary American political system is as polarized as it is now, given that the liberal-conservative schism is longstanding. What has happened to produce such intense hostility between left and right?

There is variation across countries in hostility between left and right. The United States is a particularly polarized case which calls for a contextual explanatio

A central explanation typically offered for the current situation in American politics is that partisanship and political ideology have developed into strong social identities where the mass public is increasingly sorted — along social, partisan, and ideological lines.

I then asked Aaroe why surveys find that conservatives are happier than liberals. “Some research,” she replied, “suggests that experiences of inequality constitute a larger psychological burden to liberals because it is more difficult for liberals to rationalize inequality as a phenomenon with positive consequences.”

Steven Pinker, a professor of psychology at Harvard, elaborated in an email on the link between conservatism and happiness:

t’s a combination of factors. Conservatives are likelier to be married, patriotic, and religious, all of which make people happier

They may be less aggrieved by the status quo, whereas liberals take on society’s problems as part of their own personal burdens. Liberals also place politics closer to their identity and striving for meaning and purpose, which is a recipe for frustration.

Some features of the woke faction of liberalism may make people unhappier: as Jon Haidt and Greg Lukianoff have suggested, wokeism is Cognitive Behavioral Therapy in reverse, urging upon people maladaptive mental habits such as catastrophizing, feeling like a victim of forces beyond one’s control, prioritizing emotions of hurt and anger over rational analysis, and dividing the world into allies and villains.

Why, I asked Pinker, would liberals and conservatives react differently — often very differently — to messages that highlight threat?

It may be liberals (or at least the social-justice wing) who are more sensitive to threats, such as white supremacy, climate change, and patriarchy; who may be likelier to moralize, seeing racism and transphobia in messages that others perceive as neutral; and being likelier to surrender to emotions like “harm” and “hurt.”

The authors used neural imaging to follow changes in the dorsomedial prefrontal cortex (known as DMPFC) as conservatives and liberals watched videos presenting strong positions, left and right, on immigration.

there are ways to persuade conservatives to support liberal initiatives and to persuade liberals to back conservative proposals:

While liberals tend to be more concerned with protecting vulnerable groups from harm and more concerned with equality and social justice than conservatives, conservatives tend to be more concerned with moral issues like group loyalty, respect for authority, purity and religious sanctity than liberals are. Because of these different moral commitments, we find that liberals and conservatives can be persuaded by quite different moral arguments

For example, we find that conservatives are more persuaded by a same-sex marriage appeal articulated in terms of group loyalty and patriotism, rather than equality and social justice.

“political arguments reframed to appeal to the moral values of those holding the opposing political position are typically more effective

We find support for these claims across six studies involving diverse political issues, including same-sex marriage, universal health care, military spending, and adopting English as the nation’s official language.”

In one test of persuadability on the right, Feinberg and Willer assigned some conservatives to read an editorial supporting universal health care as a matter of “fairness (health coverage is a basic human right)” or to read an editorial supporting health care as a matter of “purity (uninsured people means more unclean, infected, and diseased Americans).”

Conservatives who read the purity argument were much more supportive of health care than those who read the fairness case.

Liberals who read the fairness argument were substantially more supportive of military spending than those who read the loyalty and authority argument.

In “Conservative and Liberal Attitudes Drive Polarized Neural Responses to Political Content,” Willer, Yuan Chang Leong of the University of Chicago, Janice Chen of Johns Hopkins and Jamil Zaki of Stanford address the question of how partisan biases are encoded in the brain:

society. How do such biases arise in the brain? We measured the neural activity of participants watching videos related to immigration policy. Despite watching the same videos, conservative and liberal participants exhibited divergent neural responses. This “neural polarization” between groups occurred in a brain area associated with the interpretation of narrative content and intensified in response to language associated with risk, emotion, and morality. Furthermore, polarized neural responses predicted attitude change in response to the videos.

The four authors argue that their “findings suggest that biased processing in the brain drives divergent interpretations of political information and subsequent attitude polarization.” These results, they continue, “shed light on the psychological and neural underpinnings of how identical information is interpreted differently by conservatives and liberals.”

While liberals and conservatives, guided by different sets of moral values, may make agreement on specific policies difficult, that does not necessarily preclude consensus.

or each video,” they write,participants with DMPFC activity time courses more similar to that of conservative-leaning participants became more likely to support the conservative positio

Conversely, those with DMPFC activity time courses more similar to that of liberal-leaning participants became more likely to support the liberal position. These results suggest that divergent interpretations of the same information are associated with increased attitude polarizatio

Together, our findings describe a neural basis for partisan biases in processing political information and their effects on attitude change.

Describing their neuroimaging method, the authors point out that theysearched for evidence of “neural polarization” activity in the brain that diverges between people who hold liberal versus conservative political attitudes. Neural polarization was observed in the dorsomedial prefrontal cortex (DMPFC), a brain region associated with the interpretation of narrative content.

The question is whether the political polarization that we are witnessing now proves to be a core, encoded aspect of the human mind, difficult to overcome — as Leong, Chen, Zaki and Willer sugges

— or whether, with our increased knowledge of the neural basis of partisan and other biases, we will find more effective ways to manage these most dangerous of human predispositions.

What happened in 2012, when the oldest Gen-Z babies were in their middle teens? That was the year Facebook acquired Instagram and young people flocked to the latter site. It was also “the beginning of the selfie era.”

Mr. Haidt’s research, confirmed by that of others, shows that depression rates started to rise “all of a sudden” around 2013, “especially for teen girls,” but “it’s only Gen Z, not the older generations.” If you’d stopped collecting data in 2011, he says, you’d see little change from previous years. “By 2015 it’s an epidemic.” (His data are available in an open-source document.)

Mr. Haidt imagines “literally launching our children into outer space” and letting their bodies grow there: “They would come out deformed and broken. Their limbs wouldn’t be right. You can’t physically grow up in outer space. Human bodies can’t do that.” Yet “we basically do that to them socially. We launched them into outer space around the year 2012,” he says, “and then we expect that they will grow up normally without having normal human experiences.”

Social media and selfies hit a generation that had led an overprotected childhood, in which the age at which children were allowed outside on their own by parents had risen from the norm of previous generations, 7 or 8, to between 10 and 12.

That meant the first social-media generation was one of “weakened kids” who “hadn’t practiced the skills of adulthood in a low-stakes environment” with other children. They were deprived of “the normal toughening, the normal strengthening, the normal anti-fragility.

Now, their childhood “is largely just through the phone. They no longer even hang out together.” Teenagers even drive less than earlier generations did.

Mr. Haidt especially worries about girls. By 2020 more than 25% of female teenagers had “a major depression.” The comparable number for boys was just under 9%.

The comparable numbers for millennials at the same age registered at half the Gen-Z rate: about 13% for girls and 5% for boys. “Kids are on their devices all the time,”

Most girls, by contrast, are drawn to “visual platforms,” Instagram and TikTok in particular. “Those are about display and performance. You post your perfect life, and then you flip through the photos of other girls who have a more perfect life, and you feel depressed.

He calls this phenomenon “compare and despair” and says: “It seems social because you’re communicating with people. But it’s performative. You don’t actually get social relationships. You get weak, fake social links.”

Mr. Haidt says he has no antipathy toward the young, and he calls millennials “amazing.”

To illustrate his point about Gen Z, Mr. Haidt challenges people to name young people today who are “really changing the world, who are doing big things that have an impact beyond their closed ecosystem.”

He can think of only two, neither of them American: Greta Thunberg, 19, the Swedish climate militant, and Malala Yousafzai, 25, the Pakistani advocate for female education

I’m predicting that they will be less effective, less impactful, than previous generations.” Why? “You should always keep your eye on whether people are in ‘discover mode’ or ‘defend mode.’ ” In the former mode, you seize opportunities to be creative. In the latter, “you’re not creative, you’re not future-thinking, you’re focused on threats in the present.”

University students who matriculated starting in 2014 or so have arrived on campus in defend mode: “Here they are in the safest, most welcoming, most inclusive, most antiracist places on the planet, but many of them were acting like they were entering some sort of dystopian, threatening, immoral world.”

56% of liberal women 18 to 29 responded affirmatively to the question: Has a doctor or other healthcare provider ever told you that you have a mental health condition? “Some of that,” Mr. Haidt says, “has to be just self-presentational,” meaning imagined.

This new ideology . . . valorizes victimhood. And if your sub-community motivates you to say you have an anxiety disorder, how is this going to affect you for the rest of your life?” He answers his own question: “You’re not going to take chances, you’re going to ask for accommodations, you’re going to play it safe, you’re not going to swing for the fences, you’re not going to start your own company.”

Whereas millennial women are doing well, “Gen-Z women, because they’re so anxious, are going to be less successful than Gen-Z men—and that’s saying a lot, because Gen-Z men are messed up, too.”

The problem, he says, is distinct to the U.S. and other English-speaking developed countries: “You don’t find it as much in Europe, and hardly at all in Asia.” Ideas that are “nurtured around American issues of race and gender spread instantly to the U.K. and Canada. But they don’t necessarily spread to France and Germany, China and Japan.”

something I hear from a lot of managers, that it’s very difficult to supervise their Gen-Z employees, that it’s very difficult to give them feedback.” That makes it hard for them to advance professionally by learning to do their jobs better.

“this could severely damage American capitalism.” When managers are “afraid to speak up honestly because they’ll be shamed on Twitter or Slack, then that organization becomes stupid.” Mr. Haidt says he’s “seen a lot of this, beginning in American universities in 2015. They all got stupid in the same way. They all implemented policies that backfire.”

Mr. Haidt, who describes himself as “a classical liberal like John Stuart Mill,” also laments the impact of social media on political discourse

“Social media is incompatible with liberal democracy because it has moved conversation, and interaction, into the center of the Colosseum. We’re not there to talk to each other. We’re there to perform” before spectators who “want blood.”

Is there a solution? “I’d raise the age of Internet adulthood to 16,” he says—“and enforce it.”

By contrast, “life went onto phone-based apps 10 years ago, and the protections we have for children are zero, absolutely zero.” The damage to Generation Z from social media “so vastly exceeds the damage from Covid that we’re going to have to act.”

Gen Z, he says, “is not in denial. They recognize that this app-based life is really bad for them.” He reports that they wish they had childhoods more like those of their parents, in which they could play outside and have adventur

“It’s shoot first, ask questions later,”

Each one of these incidents resulted from unique events. But activists and researchers say they stem from a convergence of bigger factors — increased fear of crime and an attendant surge in gun ownership, increasingly extreme political messaging on firearms, fearmongering in the media and marketing campaigns by the gun industry that portray the suburban front door as a fortified barrier against a violent world.

“The gun lobby markets firearms as something you need to defend yourself — hammers in search of nails,”

The perception that crime, especially violent gun crime, has increased is not a manufactured myth. National murder rates have climbed by about a third since 2019, according to government data, even accounting for modest declines in fatal shootings over the past 18 months.

Gun purchases rose during the pandemic and the unrest and racial-justice protests after the murder of George Floyd. Nearly 20 percent of American households bought a gun from March 2020 to March 2022, and about 5 percent of Americans bought a gun for the first time,

More than 30 states also have “stand your ground” laws. Some have recently strengthened their “castle doctrine” laws, making it more difficult to prosecute homeowners who claim self-defense in a shooting.

“People become paranoid and over-worried — and then comes an unannounced knock on their door,”

But several large-scale studies have suggested that the laws have few benefits, increase the likelihood of gun violence and might discriminate against minority groups, especially Black people.

The effect of self-defense laws protecting homeowners and gun owners is fiercely debated, with proponents arguing that their mere presence deters criminal behavior or civil disorder

shootings in which white people shot Black people were nearly three times as likely to be found “justified” compared with cases where white people shot other white people.

A 2023 analysis of recent academic research by the nonpartisan RAND Corporation found no evidence that such laws had the deterrent effect that their sponsors claimed, and there was some indication, while not conclusive, that the laws might account for some increases in gun violence.

weapons were actually more likely to be used in suicides, discharged accidentally, stolen or brandished in domestic disputes, than used to fend off an external attack.

The National Rifle Association and other gun-rights groups have long disputed such assessments, citing surveys that show far greater use of weapons for legitimate self-defense.

About a third of the roughly 16,700 gun owners surveyed in a study led by William English, a Georgetown University business school professor, said they had used their guns for self-defense, prompting Mr. English to estimate that as many as 1.6 million people in the country had defended themselves with a weapon that year.

The ordinary fixes—the kind that draw on people’s will, and require eating less and moving more—rarely have a large or lasting effect. Indeed, America itself has suffered through a long, maddening history of failed attempts to change its habits on a national scale: a yo-yo diet of well-intentioned treatments, policies, and other social interventions that only ever lead us back to where we started

Through it all, obesity rates keep going up; the diabetes epidemic keeps worsening.

The most recent miracle, for Barb as well as for the nation, has come in the form of injectable drugs. In early 2021, the Danish pharmaceutical company Novo Nordisk published a clinical trial showing remarkable results for semaglutide, now sold under the trade names Wegovy and Ozempic.

Patients in the study who’d had injections of the drug lost, on average, close to 15 percent of their body weight—more than had ever been achieved with any other drug in a study of that size. Wadden knew immediately that this would be “an incredible revolution in the treatment of obesity.”

Many more drugs are now racing through development: survodutide, pemvidutide, retatrutide. (Among specialists, that last one has produced the most excitement: An early trial found an average weight loss of 24 percent in one group of participants.

In the United States, an estimated 189 million adults are classified as having obesity or being overweight

The drugs don’t work for everyone. Their major side effects—nausea, vomiting, and diarrhea—can be too intense for many patients. Others don’t end up losing any weight

For the time being, just 25 percent of private insurers offer the relevant coverage, and the cost of treatment—about $1,000 a month—has been prohibitive for many Americans.

The drugs have already been approved not just for people with diabetes or obesity, but for anyone who has a BMI of more than 27 and an associated health condition, such as high blood pressure or cholesterol. By those criteria, more than 140 million American adults already qualify

if this story goes the way it’s gone for other “risk factor” drugs such as statins and antihypertensives, then the threshold for prescriptions will be lowered over time, inching further toward the weight range we now describe as “normal.”

How you view that prospect will depend on your attitudes about obesity, and your tolerance for risk

The first GLP-1 drug to receive FDA approval, exenatide, has been used as a diabetes treatment for more than 20 years. No long-term harms have been identified—but then again, that drug’s long-term effects have been studied carefully only across a span of seven years

the data so far look very good. “These are now being used, literally, in hundreds of thousands of people across the world,” she told me, and although some studies have suggested that GLP-1 drugs may cause inflammation of the pancreas, or even tumor growth, these concerns have not borne out.

adolescents are injecting newer versions of these drugs, and may continue to do so every week for 50 years or more. What might happen over all that time?

“All of us, in the back of our minds, always wonder, Will something show up?  ” Although no serious problems have yet emerged, she said, “you wonder, and you worry.”

in light of what we’ve been through, it’s hard to see what other choices still remain. For 40 years, we’ve tried to curb the spread of obesity and its related ailments, and for 40 years, we’ve failed. We don’t know how to fix the problem. We don’t even understand what’s really causing it. Now, again, we have a new approach. This time around, the fix had better work.

The fen-phen revolution arrived at a crucial turning point for Wadden’s field, and indeed for his career. By then he’d spent almost 15 years at the leading edge of research into dietary interventions, seeing how much weight a person might lose through careful cutting of their calories.

But that sort of diet science—and the diet culture that it helped support—had lately come into a state of ruin. Americans were fatter than they’d ever been, and they were giving up on losing weight. According to one industry group, the total number of dieters in the country declined by more than 25 percent from 1986 to 1991.

Rejecting diet culture became something of a feminist cause. “A growing number of women are joining in an anti-diet movement,” The New York Times reported in 1992. “They are forming support groups and ceasing to diet with a resolve similar to that of secretaries who 20 years ago stopped getting coffee for their bosses.

Now Wadden and other obesity researchers were reaching a consensus that behavioral interventions might produce in the very best scenario an average lasting weight loss of just 5 to 10 percent

National surveys completed in 1994 showed that the adult obesity rate had surged by more than half since 1980, while the proportion of children classified as overweight had doubled. The need for weight control in America had never seemed so great, even as the chances of achieving it were never perceived to be so small.

Wadden wasn’t terribly concerned, because no one in his study had reported any heart symptoms. But ultrasounds revealed that nearly one-third of them had some degree of leakage in their heart valves. His “cure for obesity” was in fact a source of harm.

In December 1994, the Times ran an editorial on what was understood to be a pivotal discovery: A genetic basis for obesity had finally been found. Researchers at Rockefeller University were investigating a molecule, later named leptin, that gets secreted from fat cells and travels to the brain, and that causes feelings of satiety. Lab mice with mutations in the leptin gene—importantly, a gene also found in humans—overeat until they’re three times the size of other mice. “The finding holds out the dazzling hope,”

In April 1996, the doctors recommended yes: Dexfenfluramine was approved—and became an instant blockbuster. Patients received prescriptions by the hundreds of thousands every month. Sketchy wellness clinics—call toll-free, 1-888-4FEN-FEN—helped meet demand. Then, as now, experts voiced concerns about access. Then, as now, they worried that people who didn’t really need the drugs were lining up to take them. By the end of the year, sales of “fen” alone had surpassed $300 million.

It was nothing less than an awakening, for doctors and their patients alike. Now a patient could be treated for excess weight in the same way they might be treated for diabetes or hypertension—with a drug they’d have to take for the rest of their life.

the article heralded a “new understanding of obesity as a chronic disease rather than a failure of willpower.”

News had just come out that, at the Mayo Clinic in Minnesota, two dozen women taking fen-phen—including six who were, like Barb, in their 30s—had developed cardiac conditions. A few had needed surgery, and on the operating table, doctors discovered that their heart valves were covered with a waxy plaque.

Americans had been prescribed regular fenfluramine since 1973, and the newer drug, dexfenfluramine, had been available in France since 1985. Experts took comfort in this history. Using language that is familiar from today’s assurances regarding semaglutide and other GLP-1 drugs, they pointed out that millions were already on the medication. “It is highly unlikely that there is anything significant in toxicity to the drug that hasn’t been picked up with this kind of experience,” an FDA official named James Bilstad would later say in a Time cover story headlined “The Hot New Diet Pill.

“I know I can’t get any more,” she told Williams. “I have to use up what I have. And then I don’t know what I’m going to do after that. That’s the problem—and that is what scares me to death.” Telling people to lose weight the “natural way,” she told another guest, who was suggesting that people with obesity need only go on low-carb diets, is like “asking a person with a thyroid condition to just stop their medication.”

She’d gone off the fen-phen and had rapidly regained weight. “The voices returned and came back in a furor I’d never heard before,” Barb later wrote on her blog. “It was as if they were so angry at being silenced for so long, they were going to tell me 19 months’ worth of what they wanted me to hear. I was forced to listen. And I ate. And I ate. And ate.”

For Barb, rapid weight loss has brought on a different metaphysical confusion. When she looks in the mirror, she sometimes sees her shape as it was two years ago. In certain corners of the internet, this is known as “phantom fat syndrome,” but Barb dislikes that term. She thinks it should be called “body integration syndrome,” stemming from a disconnect between your “larger-body memory” and “smaller-body reality.

In 2003, the U.S. surgeon general declared obesity “the terror within, a threat that is every bit as real to America as the weapons of mass destruction”; a few months later, Eric Finkelstein, an economist who studies the social costs of obesity, put out an influential paper finding that excess weight was associated with up to $79 billion in health-care spending in 1998, of which roughly half was paid by Medicare and Medicaid. (Later he’d conclude that the number had nearly doubled in a decade.

In 2004, Finkelstein attended an Action on Obesity summit hosted by the Mayo Clinic, at which numerous social interventions were proposed, including calorie labeling in workplace cafeterias and mandatory gym class for children of all grades.

he message at their core, that soda was a form of poison like tobacco, spread. In San Francisco and New York, public-service campaigns showed images of soda bottles pouring out a stream of glistening, blood-streaked fat. Michelle Obama led an effort to depict water—plain old water—as something “cool” to drink.

Soon, the federal government took up many of the ideas that Brownell had helped popularize. Barack Obama had promised while campaigning for president that if America’s obesity trends could be reversed, the Medicare system alone would save “a trillion dollars.” By fighting fat, he implied, his ambitious plan for health-care reform would pay for itself. Once he was in office, his administration pulled every policy lever it could.

Michelle Obama helped guide these efforts, working with marketing experts to develop ways of nudging kids toward better diets and pledging to eliminate “food deserts,” or neighborhoods that lacked convenient access to healthy, affordable food. She was relentless in her public messaging; she planted an organic garden at the White House and promoted her signature “Let’s Move!” campaign around the country.

An all-out war on soda would come to stand in for these broad efforts. Nutrition studies found that half of all Americans were drinking sugar-sweetened beverages every day, and that consumption of these accounted for one-third of the added sugar in adults’ diets. Studies turned up links between people’s soft-drink consumption and their risks for type 2 diabetes and obesity. A new strand of research hinted that “liquid calories” in particular were dangerous to health.

when their field lost faith in low-calorie diets as a source of lasting weight loss, the two friends went in opposite directions. Wadden looked for ways to fix a person’s chemistry, so he turned to pharmaceuticals. Brownell had come to see obesity as a product of our toxic food environment: He meant to fix the world to which a person’s chemistry responded, so he started getting into policy.

The social engineering worked. Slowly but surely, Americans’ lamented lifestyle began to shift. From 2001 to 2018, added-sugar intake dropped by about one-fifth among children, teens, and young adults. From the late 1970s through the early 2000s, the obesity rate among American children had roughly tripled; then, suddenly, it flattened out.

although the obesity rate among adults was still increasing, its climb seemed slower than before. Americans’ long-standing tendency to eat ever-bigger portions also seemed to be abating.

sugary drinks—liquid candy, pretty much—were always going to be a soft target for the nanny state. Fixing the food environment in deeper ways proved much harder. “The tobacco playbook pretty much only works for soda, because that’s the closest analogy we have as a food item,

that tobacco playbook doesn’t work to increase consumption of fruits and vegetables, he said. It doesn’t work to increase consumption of beans. It doesn’t work to make people eat more nuts or seeds or extra-virgin olive oil.

Careful research in the past decade has shown that many of the Obama-era social fixes did little to alter behavior or improve our health. Putting calorie labels on menus seemed to prompt at most a small decline in the amount of food people ate. Employer-based wellness programs (which are still offered by 80 percent of large companies) were shown to have zero tangible effects. Health-care spending, in general, kept going up.

From the mid-1990s to the mid-2000s, the proportion of adults who said they’d experienced discrimination on account of their height or weight increased by two-thirds, going up to 12 percent. Puhl and others started citing evidence that this form of discrimination wasn’t merely a source of psychic harm, but also of obesity itself. Studies found that the experience of weight discrimination is associated with overeating, and with the risk of weight gain over time.

obesity rates resumed their ascent. Today, 20 percent of American children have obesity. For all the policy nudges and the sensible revisions to nutrition standards, food companies remain as unfettered as they were in the 1990s, Kelly Brownell told me. “Is there anything the industry can’t do now that it was doing then?” he asked. “The answer really is no. And so we have a very predictable set of outcomes.”

she started to rebound. The openings into her gastric pouch—the section of her stomach that wasn’t bypassed—stretched back to something like their former size. And Barb found ways to “eat around” the surgery, as doctors say, by taking food throughout the day in smaller portions

Bariatric surgeries can be highly effective for some people and nearly useless for others. Long-term studies have found that 30 percent of those who receive the same procedure Barb did regain at least one-quarter of what they lost within two years of reaching their weight nadir; more than half regain that much within five years.

if the effects of Barb’s surgery were quickly wearing off, its side effects were not: She now had iron, calcium, and B12 deficiencies resulting from the changes to her gut. She looked into getting a revision of the surgery—a redo, more or less—but insurance wouldn’t cover it

She found that every health concern she brought to doctors might be taken as a referendum, in some way, on her body size. “If I stubbed my toe or whatever, they’d just say ‘Lose weight.’ ” She began to notice all the times she’d be in a waiting room and find that every chair had arms. She realized that if she was having a surgical procedure, she’d need to buy herself a plus-size gown—or else submit to being covered with a bedsheet when the nurses realized that nothing else would fit.

Barb grew angrier and more direct about her needs—You’ll have to find me a different chair, she started saying to receptionists. Many others shared her rage. Activists had long decried the cruel treatment of people with obesity: The National Association to Advance Fat Acceptance had existed, for example, in one form or another, since 1969; the Council on Size & Weight Discrimination had been incorporated in 1991. But in the early 2000s, the ideas behind this movement began to wend their way deeper into academia, and they soon gained some purchase with the public.

“Our public-health efforts to address obesity have failed,” Eric Finkelstein, the economist, told me.

Others attacked the very premise of a “healthy weight”: People do not have any fundamental need, they argued, morally or medically, to strive for smaller bodies as an end in itself. They called for resistance to the ideology of anti-fatness, with its profit-making arms in health care and consumer goods. The Association for Size Diversity and Health formed in 2003; a year later, dozens of scholars working on weight-related topics joined together to create the academic field of fat studies.

As the size-diversity movement grew, its values were taken up—or co-opted—by Big Business. Dove had recently launched its “Campaign for Real Beauty,” which included plus-size women. (Ad Age later named it the best ad campaign of the 21st century.) People started talking about “fat shaming” as something to avoid

By 2001, Bacon, who uses they/them pronouns, had received their Ph.D. and finished a rough draft of a book, Health at Every Size, which drew inspiration from a broader movement by that name among health-care practitioners

But something shifted in the ensuing years. In 2007, Bacon got a different response, and the book was published. Health at Every Size became a point of entry for a generation of young activists and, for a time, helped shape Americans’ understanding of obesity.

Some experts were rethinking their advice on food and diet. At UC Davis, a physiologist named Lindo Bacon who had struggled to overcome an eating disorder had been studying the effects of “intuitive eating,” which aims to promote healthy, sustainable behavior without fixating on what you weigh or how you look

The heightened sensitivity started showing up in survey data, too. In 2010, fewer than half of U.S. adults expressed support for giving people with obesity the same legal protections from discrimination offered to people with disabilities. In 2015, that rate had risen to three-quarters.

In Bacon’s view, the 2000s and 2010s were glory years. “People came together and they realized that they’re not alone, and they can start to be critical of the ideas that they’ve been taught,” Bacon told me. “We were on this marvelous path of gaining more credibility for the whole Health at Every Size movement, and more awareness.”

that sense of unity proved short-lived; the movement soon began to splinter. Black women have the highest rates of obesity, and disproportionately high rates of associated health conditions. Yet according to Fatima Cody Stanford, an obesity-medicine physician at Harvard Medical School, Black patients with obesity get lower-quality care than white patients with obesity.

That system was exactly what Bacon and the Health at Every Size movement had set out to reform. The problem, as they saw it, was not so much that Black people lacked access to obesity medicine, but that, as Bacon and the Black sociologist Sabrina Strings argued in a 2020 article, Black women have been “specifically targeted” for weight loss, which Bacon and Strings saw as a form of racism

But members of the fat-acceptance movement pointed out that their own most visible leaders, including Bacon, were overwhelmingly white. “White female dietitians have helped steal and monetize the body positive movement,” Marquisele Mercedes, a Black activist and public-health Ph.D. student, wrote in September 2020. “And I’m sick of it.”

Tensions over who had the standing to speak, and on which topics, boiled over. In 2022, following allegations that Bacon had been exploitative and condescending toward Black colleagues, the Association for Size Diversity and Health expelled them from its ranks and barred them from attending its events.

As the movement succumbed to in-fighting, its momentum with the public stalled. If attitudes about fatness among the general public had changed during the 2000s and 2010s, it was only to a point. The idea that some people can indeed be “fit but fat,” though backed up by research, has always been a tough sell.

Although Americans had become less inclined to say they valued thinness, measures of their implicit attitudes seemed fairly stable. Outside of a few cities such as San Francisco and Madison, Wisconsin, new body-size-discrimination laws were never passed.

In the meantime, thinness was coming back into fashion

In the spring of 2022, Kim Kardashian—whose “curvy” physique has been a media and popular obsession—boasted about crash-dieting in advance of the Met Gala. A year later, the model and influencer Felicity Hayward warned Vogue Business that “plus-size representation has gone backwards.” In March of this year, the singer Lizzo, whose body pride has long been central to her public persona, told The New York Times that she’s been trying to lose weight. “I’m not going to lie and say I love my body every day,” she said.

Among the many other dramatic effects of the GLP-1 drugs, they may well have released a store of pent-up social pressure to lose weight.

If ever there was a time to debate that impulse, and to question its origins and effects, it would be now. But Puhl told me that no one can even agree on which words are inoffensive. The medical field still uses obesity, as a description of a diagnosable disease. But many activists despise that phrase—some spell it with an asterisk in place of the e—and propose instead to reclaim fat.

Everyone seems to agree on the most important, central fact: that we should be doing everything we can to limit weight stigma. But that hasn’t been enough to stop the arguing.

Things feel surreal these days to just about anyone who has spent years thinking about obesity. At 71, after more than four decades in the field, Thomas Wadden now works part-time, seeing patients just a few days a week. But the arrival of the GLP-1 drugs has kept him hanging on for a few more years, he said. “It’s too much of an exciting period to leave obesity research right now.”

When everyone is on semaglutide or tirzepatide, will the soft-drink companies—Brownell’s nemeses for so many years—feel as if a burden has been lifted? “My guess is the food industry is probably really happy to see these drugs come along,” he said. They’ll find a way to reach the people who are taking GLP‑1s, with foods and beverages in smaller portions, maybe. At the same time, the pressures to cut back on where and how they sell their products will abate.

the triumph in obesity treatment only highlights the abiding mystery of why Americans are still getting fatter, even now

Perhaps one can lay the blame on “ultraprocessed” foods, he said. Maybe it’s a related problem with our microbiomes. Or it could be that obesity, once it takes hold within a population, tends to reproduce itself through interactions between a mother and a fetus. Others have pointed to increasing screen time, how much sleep we get, which chemicals are in the products that we use, and which pills we happen to take for our many other maladies.

“The GLP-1s are just a perfect example of how poorly we understand obesity,” Mozaffarian told me. “Any explanation of why they cause weight loss is all post-hoc hand-waving now, because we have no idea. We have no idea why they really work and people are losing weight.”

The new drugs—and the “new understanding of obesity” that they have supposedly occasioned—could end up changing people’s attitudes toward body size. But in what ways

When the American Medical Association declared obesity a disease in 2013, Rebecca Puhl told me, some thought “it might reduce stigma, because it was putting more emphasis on the uncontrollable factors that contribute to obesity.” Others guessed that it would do the opposite, because no one likes to be “diseased.”

why wasn’t there another kind of nagging voice that wouldn’t stop—a sense of worry over what the future holds? And if she wasn’t worried for herself, then what about for Meghann or for Tristan, who are barely in their 40s? Wouldn’t they be on these drugs for another 40 years, or even longer? But Barb said she wasn’t worried—not at all. “The technology is so much better now.” If any problems come up, the scientists will find solutions.

Stealing wasn’t something I necessarily wanted to do. It just happened to be the easiest way to stop the tension.

The first time I made this connection was in first grade, sitting behind a girl named Clancy. The pressure had been building for days. Without knowing exactly why, I was overcome with frustration and had the urge to do something violent.

I liked Clancy and I didn’t want to steal from her. But I wanted my brain to stop pulsing, and some part of me knew it would help. So, carefully, I reached forward and unclipped the bow. Once it was in my hand, I felt better, as if some air had been released from an overinflated balloon. I didn’t know why, but I didn’t care. I’d found a solution. It was a relief.

Together we went through the box. I explained what everything was and where it had come from. Once the box was empty, she stood and said we were going to return every item to its rightful owner, which was fine with me. I didn’t fear consequences and I didn’t suffer remorse, two more things I’d already figured out weren’t “normal.” Returning the stuff actually served my purpose. The box was full, and emptying it would give me a fresh space to store things I had yet to steal.

“Why did you take these things?” Mom asked me.I thought of the pressure in my head and the sense that I needed to do bad things sometimes. “I don’t know,” I said.“Well… Are you sorry?” she asked.“Yes,” I said. I was sorry. But I was sorry I had to steal to stop fantasizing about violence, not because I had hurt anyone.

Empathy, like remorse, never came naturally to me. I was raised in the Baptist church. I knew we were supposed to feel bad about committing sins. My teachers talked about “honor systems” and something called “shame,” which I understood intellectually, but it wasn’t something I felt. My inability to grasp core emotional skills made the process of making and keeping friends somewhat of a challenge. It wasn’t that I was mean or anything. I was simply different.

Now that I’m an adult, I can tell you why I behaved this way. I can point to research examining the relationship between anxiety and apathy, and how stress associated with inner conflict is believed to subconsciously compel people to behave destructively. I believe that my urge to act out was most likely my brain’s way of trying to jolt itself into some semblance of “normal.” But none of this information was easy to find. I had to hunt for it. I am still hunting.

For more than a century, society has deemed sociopathy untreatable and unredeemable. The afflicted have been maligned and shunned by mental health professionals who either don’t understand or choose to ignore the fact that sociopathy—like many personality disorders—exists on a spectrum.

After years of study, intensive therapy and earning a Ph.D. in psychology, I can say that sociopaths aren’t “bad” or “evil” or “crazy.” We simply have a harder time with feelings. We act out to fill a void. When I understood this about myself, I was able to control it.

It is a tragic misconception that all sociopaths are doomed to hopeless, loveless lives. The truth is that I share a personality type with millions of others, many of whom have good jobs, close-knit families and real friends. We represent a truth that’s hard to believe: There’s nothing inherently immoral about having limited access to emotion. I offer my story because I know I’m not alone.

That’s because real people — and yes, even professional economists — tend to process the parallel rise of prices and wages in quite different ways.

In brief, researchers have found that we tend to internalize the gains due to inflation and externalize the losses. These different processes yield different emotional responses.

Let’s start with higher prices. Sticker shock hurts. Even as someone who closely studies the inflation statistics, I’m still often surprised by higher prices. They feel unfair. They undermine my spending power, and my sense of control and order.

younger folks — anyone under 60 — had never experienced sustained inflation rates greater than 5 percent in their adult lives. And I think this explains why they’re so angry about today’s inflation.

Even though wages tend to rise hand-in-hand with prices, we tell ourselves a different story, in which the wage rises we get have nothing to do with price rises that cause them.

But then my economist brain took over, and slowly it sunk in that my raise wasn’t a reward for hard work, but rather a cost-of-living adjustment

Internalizing the gain and externalizing the cost of inflation protects you from this deflating realization. But it also distorts your sense of reality.

The reason so many Americans feel that inflation is stealing their purchasing power is that they give themselves unearned credit for the offsetting wage rises that actually restore it.

in reality, higher prices are only the first act of the inflationary play. It’s a play that economists have seen before. In episode after episode, surges in prices have led to — or been preceded by — a proportional surge in wages.

While older Americans understood that the pain of inflation is transitory, younger folks aren’t so sure. Inflation is a lot scarier when you fear that today’s price rises will permanently undermine your ability to make ends meet.

Perhaps this explains why the recent moderate burst of inflation has created seemingly more anxiety than previous inflationary episodes.

More generally, being an economist makes me an optimist. Social media is awash with (false) claims that we’re in a “silent depression,” and those who want to make American great again are certain it was once so much better.

in reality, our economy this year is larger, more productive and will yield higher average incomes than in any prior year on record in American history

And because the United States is the world’s richest major economy, we can now say that we are almost certainly part of the richest large society in its richest year in the history of humanity.

The income of the average American will double approximately every 39 years. And so when my kids are my age, average income will be roughly double what it is today. Far from being fearful for my kids, I’m envious of the extraordinary riches their generation will enjoy.

Psychologists describe anxiety disorders as occurring when the panic you feel is out of proportion to the danger you face. By this definition, we’re in the midst of a macroeconomic anxiety attack.

The latest study looked at data from 126,972 people over the study period. It found that in 2015, 4.2 percent of Medicaid enrollees under the age of 17 in Maryland had overlapping prescriptions of three or more different classes of psychiatric medications. That figure rose to 4.6 percent in 2020.

“devastating” because the hardship of rural Americans is real, “terrifying” because the political backlash to this hardship poses a clear and present danger to our democracy, and “baffling” because at some level I still don’t get the politics.

Technology is the main driver of rural decline, Schaller and Waldman argue. Indeed, American farms produce more than five times as much as they did 75 years ago, but the agricultural work force declined by about two-thirds over the same period, thanks to machinery, improved seeds, fertilizers and pesticides

Coal production has been falling recently, but thanks partly to technologies like mountaintop removal, coal mining as a way of life largely disappeared long ago, with the number of miners falling 80 percent even as production roughly doubled.