Group items tagged

CCTV appeared to show her, dressed in a hijab, walking near a metro station with a head in her hands.Russian media reported that she pulled the head out of a bag and began screaming that she would blow herself up after a police officer asked to see her identity documents.

"I am a terrorist. I am your death".

Investigators told the Presnensky district court they had not found anyone else involved in the case. But prosecutors also said they believed that Bobokulova had been "incited" to commit the crime.

Moscow residents have left flowers and children's toys outside the Oktyabrskoye Polye metro station, where Bobokulova was arrested, and outside the murdered child's home.

Doris knew nothing about raising children, nor much cared. The witheringly wry, worldly heiress was among the most celebrated women of her day, a six-foot glamour queen hounded by paparazzi, who brushed elbows with every midcentury icon from Jackie Kennedy to Elvis Presley, pronouncing Greta Garbo "boring" and, after dating Errol Flynn, theorizing that bisexual men made the best lovers: "I should know," she declared. "I've done exhausting research on the subject." As a child – and sole inheritor of her father Buck's $100 million fortune – she'd become famous as "the richest little girl in the world." She'd been raised by nannies in a chilly, silent Fifth Avenue mansion, with her parents taking little part in her upbringing; family lore holds that her father, on his deathbed in 1925, told 12-year-old Doris, "Trust no one." Now saddled with her pesky nephew Walker, watching him toss ketchup-covered tampons into her pool, Doris Duke regarded him with pity. He was desperate for love and attention, much like herself as a child. But Doris had her own fabulous life to live, and so she shipped Walker off to boarding school. "We were all too self-centered to be bothered with a problem child," she would later tell her cousin Angier St. George Biddle "Pony" Duke.

His grandmother's will had stipulated that if Walker left no heirs, upon his death his trust would be funneled into the Duke Endowment, a $2.8 billion foundation established by Buck Duke that nourishes, among other institutions, Duke University. The idea repulsed Walker: The very name that had given him such unearned bounty also stood for everything he felt he'd been deprived. "He despised Duke!" says longtime friend Mike Todd. "Duke University, Duke Foundation – everything Duke, he hated."

At school the twins had trouble connecting with classmates, few of whom were allowed over to the Inmans' mansion a second time after gaping at the guns, the explicit art and sometimes an eyeful of Walker, who preferred to be nude. Other kids went to summer camp, but the Inmans went to Abu Dhabi to bid millions at auctions; to Japan, where their father introduced them to friends who were supposedly yakuza; to Fiji, where Dad praised them as they dined on poisonous puffer fish. There were getaways aboard the Devine Decadence, which was docked in New Zealand. One day toward the end of second grade, when their father had yanked them out of school without warning, they told themselves it was for the best.

The past three years have been a struggle for the twins as they've grappled with their past. Before they were able to live with Daisha, they were sent to the Wyoming Behavioral Institute. The twins were suicidal, uncooperative and dangerously underweight. Therapist Jennifer Greenup had never seen such extreme emotional deprivation before. "If even a quarter of what they said happened to them happened, they are severely traumatized children," says Greenup, adding, "Their symptoms are real. Whether it's paranoia, lack of trust or hostility." Eventually the kids were able to move in with Daisha and began bonding, a triumph unto itself. But although they've taken positive steps, Greenup says the scale of their trauma is so great that she can't gauge their progress: "I can't say they're progressing well, because there's nothing to compare it to," she admits.

As for the kids' own plans, Patterson seems to hope for a quiet life. "I hope I don't have to live alone. But I actually don't mind. I'll just sit at Greenfield, fishing by my dad's little tomb, just talking about life," he says. "You can't trust anyone," he adds mournfully, repeating the words he learned from his father, which Walker learned from his aunt Doris, which she learned from her father, Buck Duke.

Republicans are the party of Big Energy and Big Food: they dominate contributions from extractive industries and agribusiness. And they are, in particular, the party of Big Pizza.

pizza partisanship tells you a lot about what is happening to American politics as a whole.

Why should pizza, of all things, be a divisive issue

The immediate answer is that it has been caught up in the nutrition wars

the pizza sector has chosen instead to take a stand for the right to add extra cheese.

The rhetoric of this fight is familiar. The pizza lobby portrays itself as the defender of personal choice and personal responsibility. It’s up to the consumer, so the argument goes, to decide what he or she wants to eat, and we don’t need a nanny state telling us what to do.

it doesn’t hold up too well once you look at what’s actually at stake in the pizza disputes.

what do contributions in the last election cycle say? The Democrats are, not too surprisingly, the party of Big Labor (or what’s left of it) and Big Law: unions and lawyers are the most pro-Democratic major interest groups.

Nutrition, where increased choice can be a bad thing, because it all too often leads to bad choices despite the best of intentions, is one of those areas — like smoking — where there’s a lot to be said for a nanny state.

diet isn’t purely a personal choice, either; obesity imposes large costs on the economy as a whole.

But you shouldn’t expect such arguments to gain much traction

For one thing, free-market fundamentalists don’t want to hear about qualifications to their doctrine

Also, with big corporations involved, the Upton Sinclair principle applies: It’s difficult to get a man to understand something when his salary depends on his not understanding it

nutritional partisanship taps into deeper cultural issues.

At one level, there is a clear correlation between lifestyles and partisan orientation: heavier states tend to vote Republican, and the G.O.P. lean is especially pronounced in what the Centers for Disease Control and Prevention call the “diabetes belt” of counties, mostly in the South, that suffer most from that particular health problem

At a still deeper level, health experts may say that we need to change how we eat, pointing to scientific evidence, but the Republican base doesn’t much like experts, science, or evidence. Debates about nutrition policy bring out a kind of venomous anger — much of it now directed at Michelle Obama, who has been championing school lunch reforms — that is all too familiar if you’ve been following the debate over climate change.

It is, instead, a case study in the toxic mix of big money, blind ideology, and popular prejudices that is making America ever less governable.

Moshe, according to his grandfather, wants to be a rabbi like his father, Gabi. His parents had moved to Mumbai seven years before the attack to work at Chabad House. Their life in Mumbai had revolved around Jewish people visiting the city and other parts of India.

But Vance got some help along the way. He tells us that his public schools were decent enough and, when he got motivated, his teachers helped him succeed. He notes that his trajectory changed when he was admitted to Ohio State University, which he was able to attend because of generous federal loans and grants.

the turning point in the book and his life takes place when he decides to enlist in the Marine Corps. He describes how the armed forces taught him discipline, hard work, high expectations and good values.

This is federal bureaucracy engaged in shaping mores and morals, the ultimate example of government as nanny. When so much of what government does is under siege, it is odd that Vance seems to minimize the role that government can play in providing opportunities for others like him.

The other, larger gap in Vance’s book is race. He speaks about the causes of the anxiety and pain of the white working class, but he describes the causes almost entirely in economic terms.

there is surely something else at work here — the sense that people who look and sound very different are rising up.

Vance touches on this sideways, when speaking about the almost pathological suspicion his hillbillies have for Barack Obama. Vance explains that it is because of the president’s accent — “clean, perfect, neutral” — his urban background, his success in the meritocracy, his reliability as a father. “And,” one wants to whisper to Vance, “because he’s black .”

The white working class has always derived some of its status because there was a minority underclass below it. In his seminal work, “American Slavery, American Freedom,” Edmund Morgan argues that even before the revolution, the introduction of slavery helped dampen class conflict within the white population.

The rage that is fueling the Trump phenomenon is not just about stagnant wages. It is about a way of life under siege, and it risks producing a “politics of cultural despair.” That phrase was coined by Fritz Stern to describe Germany a century ago.

The key to avoiding that fate is not a series of public policies — whether tariffs or tax credits — but enlightened politics, meaning leadership that does not prey on people’s fears and phobias.

Complaining about political correctness is patriotically correct. The patriotically correct must use the non-word “illegals,” or “illegal immigrant” or “illegal alien” to describe foreigners who broke our immigration laws. Dissenters support “open borders” or “shamnesty” for 30 million illegal alien invaders. The punishment is deportation because “we’re a nation of laws” and they didn’t “get in line,” even though no such line actually exists. Just remember that they are never anti-immigration, only anti-illegal immigration, even when they want to cut legal immigration.

Black Lives Matter is racist because it implies that black lives are more important than other lives, but Blue Lives Matter doesn’t imply that cops’ lives are more important than the rest of ours. Banning Islam or Muslim immigration is a necessary security measure, but homosexuals should not be allowed to get married because it infringes on religious liberty. Transgender people could access women’s restrooms for perverted purposes, but Donald Trump walking in on nude underage girls in dressing rooms before a beauty pageant is just “media bias.”

Terrorism is an “existential threat,” even though the chance of being killed in a terrorist attack is about 1 in 3.2 million a year. Saying the words “radical Islam” when describing terrorism is an important incantation necessary to defeat that threat. When Chobani yogurt founder Hamdi Ulukaya decides to employ refugees in his factories, it’s because of his ties to “globalist corporate figures.” Waving a Mexican flag on U.S. soil means you hate America, but waving a Confederate flag just means you’re proud of your heritage.

Those who disagree with the patriotically correct are animated by anti-Americanism, are post-American, or deserve any other of a long list of clunky and vague labels that signal virtue to other members of the patriotic in-group.

Poor white Americans are the victims of economic dislocation and globalization beyond their control, while poor blacks and Hispanics are poor because of their failed cultures. The patriotically correct are triggered when they hear strangers speaking in a language other than English. Does that remind you of the PC duty to publicly shame those who use unacceptable language to describe race, gender or whatever other identity is the victim du jour?

The patriotically correct rightly ridicule PC “safe spaces” but promptly retreat to Breitbart or talk radio, where they can have mutually reinforcing homogeneous temper tantrums while complaining about the lack of intellectual diversity on the left.

There is no such thing as too much national security, but it’s liberals who want to coddle Americans with a “nanny state.”

Blaming the liberal or mainstream media and “media bias” is the patriotically correct version of blaming the corporations or capitalism. The patriotically correct notion that they “would rather be governed by the first 2,000 people in the Boston telephone directory than by the 2,000 people on the faculty of Harvard University” because the former have “common sense” and the “intellectual elites” don’t know anything, despite all the evidence to the contrary, can be sustained only in a total bubble.

Every group has implicit rules against certain opinions, actions and language as well as enforcement mechanisms — and the patriotically correct are no exception. But they are different because they are near-uniformly unaware of how they are hewing to a code of speech and conduct similar to the PC lefties they claim to oppose.

The modern form of political correctness on college campuses and the media is social tyranny with manners, while patriotic correctness is tyranny without the manners, and its adherents do not hesitate to use the law to advance their goals.

After she moved to New York, Jones worked with a group of her fellow high school graduates to start a scholarship fund for young African-American women to go to college. She also was active in her public housing building's tenant patrol until she was 106.

"Ms. Jones was the very last American from the 1800s," said Young, whose group tracks and maintains a database of the world's longest-living people.

the roughly 90 million Americans who are formally considered obese — that’s about 30 percent of the population — aren’t just in imperfect health. They’re downright ill, and we need to heal them.

Brian Elbel, a population-health expert at New York University’s school of medicine, examined fast-food receipts from four chains in New York both before the city law went into effect and after, to see if customers were altering their orders to reduce the calories they consumed per visit to the restaurants. He found no meaningful difference, and his subsequent research in Philadelphia, which in 2010 implemented a mandate like New York’s, echoes and bolsters that conclusion. “It’s becoming increasingly clear that nothing big is happening for a large group of people,”

New York City commissioned a broader survey than Elbel’s, looking at thousands of receipts from 11 chains. At three of them — Au Bon Pain, KFC and McDonald’s — there was proof of calorie reductions after the law. But at seven there wasn’t, and at Subway, which was promoting footlong sandwiches for $5 during the post-law survey period, calorie consumption per visit actually increased.

the principal reasons for the remarkable decrease in smoking in New York City and elsewhere over the last few decades weren’t ominous commercials and warning labels. They were taxes and the bans on indoor smoking. People kicked the habit when it became onerous, in cost and convenience, not to

. “The people who tend to be most responsive to information may be those we least aim to target.”

Starbucks customers ordering sugary, creamy coffee beverages kept on doing so, seemingly because they had already figured that the drinks were fattening and had made a flabby peace with that. But customers indeed adjusted their food orders upon realizing that a pastry could easily exceed 400 calories. They hadn’t bargained on, or planned for, that. “What really matters is what your prior beliefs are,”

education and information could be effective in influencing a discrete, relatively easy behavior, like persuading someone to get vaccinated. “But when it’s habitual and even addictive behavior, you’re in a whole new ballgame,

“Calorie reductions were highest in high-income, high-education neighborhoods (where we believe obesity rates to be lower),

that — not any itch to play nanny — is why he and Mayor Michael Bloomberg support such measures as new taxes on sodas, which may never happen, and a ban on sugary drinks over 16 ounces

We’re not as plump as we are because we’ve never had our eyes opened to the wages of a Whopper. We’re this way because it’s all too easy, in a pang of hunger and collapse of resolve, to turn a blind eye to the toll

“Their reaction is, ‘Let me enjoy what I want to eat, and stop telling me what to do.’ And it’s one of the few things that less well-off people have: they don’t have to cook.”

The ubiquity, convenience and habit-forming appeal of hyperprocessed foods have largely drowned out the alternatives: there are five fast-food restaurants for every supermarket in the United States; in recent decades the adjusted for inflation price of fresh produce has increased by 40 percent while the price of soda and processed food has decreased by as much as 30 percent; and nearly inconceivable resources go into encouraging consumption in restaurants: fast-food companies spent $4.2 billion on marketing in 2009.

overconsumption of fast food “triggers addiction-like neuroaddictive responses” in the brain, making it harder to trigger the release of dopamine. In other words the more fast food we eat, the more we need to give us pleasure; thus the report suggests that the same mechanisms underlie drug addiction and obesity.

This addiction to processed food is the result of decades of vision and hard work by the industry. For 50 years, says David A. Kessler, former commissioner of the Food and Drug Administration and author of “The End of Overeating,” companies strove to create food that was “energy-dense, highly stimulating, and went down easy. They put it on every street corner and made it mobile, and they made it socially acceptable to eat anytime and anyplace. They created a food carnival, and that’s where we live. And if you’re used to self-stimulation every 15 minutes, well, you can’t ru

Real cultural changes are needed to turn this around. Somehow, no-nonsense cooking and eating — roasting a chicken, making a grilled cheese sandwich, scrambling an egg, tossing a salad — must become popular again

HOW do you change a culture? The answers, not surprisingly, are complex. “Once I look at what I’m eating,” says Dr. Kessler, “and realize it’s not food, and I ask ‘what am I doing here?’ that’s the start. It’s not about whether I think it’s good for me, it’s about changing how I feel. And

we change how people feel by changing the environment.”

Obviously, in an atmosphere where any regulation is immediately labeled “nanny statism,” changing “the environment” is difficult. But we’ve done this before, with tobacco.

Political action would mean agitating to limit the marketing of junk; forcing its makers to pay the true costs of production; recognizing that advertising for fast food is not the exercise of free speech but behavior manipulation of addictive substances; and making certain that real food is affordable and available to everyone.

The nihilists don’t necessarily deny that the planet’s frying but, essentially, they refuse to feel bad about it; they want their sunshine holidays and their 4x4s, come hell or (possibly quite literally) high water, and screw anyone who gets in the way.

We are watching a new front open up in the culture war, and its timing is probably no coincidence

Greta Thunberg’s unique strength when she first emerged as an activist was that, as a child, and one with Asperger’s to boot, she had almost unassailable moral authority

most people recognise that hers is still an innately vulnerable age; not quite a child, not quite grown up, instinctively evoking protective feelings in anyone with an ounce of humanity.

She is still so young, so vulnerable, for someone carrying such an impossible weight of expectation. How would she cope if the world leaders who have paid lip service to her demands don’t ultimately do what she wants?

the violence of the backlash adds a more worrying dimension. If she were my daughter I would be both immensely proud of her, and terrified for her; torn between not wanting her to be bullied into silence, and wanting to hide her away from it all.

A society that cannot bear to be lectured by its children, even when they’ve got a point, while the adults are behaving like spoiled toddlers refusing to clean up their own mess, is one that can never progress. Perhaps our children can finally be children again, when the rest of us grow the hell up.

to have responded promptly and sufficiently would have meant jettisoning an entire structure of political thought developed in these countries over the past half century.

Politics is best understood as public relations for particular interests. The interests come first; politics is the means by which they are justified and promoted

On the left, the dominant interest groups can be very large – everyone who uses public services, for instance

On the right they tend to be much smaller. In the US, the UK and Australia, they are very small indeed: mostly multimillionaires and a very particular group of companies: those whose profits depend on the cavalier treatment of people and planet

I’ve seen how the tobacco companies covertly funded an infrastructure of persuasion to deny the impacts of smoking. This infrastructure was then used, often by the same professional lobbyists, to pour doubt on climate science and attack researchers and environmental campaigners.

these companies funded rightwing thinktanks and university professors to launch attacks on public health policy in general and create a new narrative of risk, tested on focus groups and honed in the media

They reframed responsible government as the “nanny state”, the “health police” and “elf ’n’ safety zealots”. They dismissed scientific findings and predictions as “unfounded fears”, “risk aversion” and “scaremongering”.

Public protections were recast as “red tape”, “interference” and “state control”. Government itself was presented as a mortal threat to our freedom.

The groups these corporations helped to fund – thinktanks and policy units, lobbyists and political action committees – were then used by other interests: private health companies hoping to break up the NHS, pesticide manufacturers seeking to strike down regulatory controls, junk food manufacturers resisting advertising restrictions, billionaires seeking to avoid tax

Between them, these groups refined the justifying ideology for fragmenting and privatising public services, shrinking the state and crippling its ability to govern.

Now, in these three nations, this infrastructure is the government. No 10 Downing Street has been filled with people from groups strongly associated with attacks on regulation and state interventio

Modern politics is impossible to understand without grasping the pollution paradox. The greater the risk to public health and wellbeing a company presents, the more money it must spend on politics – to ensure it isn’t regulated out of existence. Political spending comes to be dominated by the dirtiest companies

The theory on which this form of government is founded can seem plausible and logically consistent. Then reality hits, and we find ourselves in the worst place from which to respond to crisis, with governments that have an ingrained disregard for public safety and a reflexive resort to denial

It is what we see today, as the Trump, Johnson and Morrison governments flounder in the face of this pandemic. They are called upon to govern, but they know only that government is the enemy.

This was (and is) America, after all. The government can't tell you what to do! Every individual gets to make their own decisions!

He also repeatedly mocked Joe Biden for wearing a mask during the teeth of the pandemic.

"Did you ever see a man that likes a mask as much as him?" Trump asked a campaign rally crowd in Pennsylvania in September 2020. "And then he makes a speech, and he always has it -- not always, but a lot of times -- he has it hanging down. Because, you know what, it gives him a feeling of security. If I were a psychiatrist -- right? I'd say, this guy's got some big issues. Hanging down."

In May 2020 on a trip to a Ford plant in Michigan, Trump said that he wore a mask away from reporters and cameras, but took it off because he "didn't want to give the press the pleasure of seeing it."

This is (and was) a ridiculous line of thinking when it came to a pandemic. The only way to limit infections -- until the development of the Covid-19 vaccine -- was to stop so many people from getting it.

Not wearing a mask, then, wasn't just about you and your rights. It literally endangered other people.

Anyway, the point here is that Mandel sees his path to the GOP nomination as painting himself as the Trumpiest candidate in the crowded field. And because Trumpism isn't about a set of policy prescriptions but rather focused on tone (owning the libs, mostly), the way to demonstrate fealty to the former President is through stunts like, say, burning a mask.

What's most depressing here -- at least to me -- is that Mandel's transparent ploy will probably work. The video, posted on Tuesday night, already has more than 400,000 views. Trumpists will celebrate it -- and Mandel -- as heroes willing to fight against the nanny state.

But that doesn't matter. Masks are bad because Trump said they were. Which is more than enough justification for Mandel.

It was meant, as the Supreme Court described it in 1975, “to free widowed and divorced mothers from the necessity of working, so that they could remain home to supervise their children.”

Eligibility was determined by states and localities, which found various ways to exclude Black women. With the civil rights revolution in the 1960s, however, more Black mothers were able to receive benefits.

But universal day care programs that would help women work didn’t go anywhere either. In 1971, Congress passed a bill that would have created a national network of high-quality, sliding-scale child care centers, akin to those that exist in many European countries. Urged on by Patrick Buchanan, Richard Nixon vetoed it, writing that it would “commit the vast moral authority of the national government to the side of communal approaches to child rearing over against the family‐centered approach.”

Ever since, efforts to expand government-supported child care have faced furious opposition from the religious right.

At the same time, many on the right, driven partly by concerns about low birthrates, have awoken to the crushing financial burden of parenthood. The public policy debate is thus no longer whether to subsidize child rearing, but how. Mitt Romney’s Family Security Act, for example, would give parents $350 a month for each child under 6, and $250 a month for children between 6 and 17, up to $1,250 per family per month.

With the laissez-faire economic assumptions that dominated America since the Reagan administration discredited, Democrats no longer cower when the right accuses them of fostering big government. As Biden said in his address to Congress on Wednesday, “Trickle-down economics has never worked.”

This doesn’t mean that the American Families Plan is going to happen. With little chance of any Republican support, it would have to be passed through the reconciliation process, so its fate likely lies in the hands of Joe Manchin, the Senate’s most conservative Democrat. Still, it’s amazing that it’s suddenly possible that American parenthood could actually become a less financially brutalizing experience.

There are several reasons our domestic policy has long been uniquely hostile to parents, but two big ones are racism and religious fundamentalism. Essentially, it’s been politically radioactive for the federal government to support Black women who want to stay home with their kids, and white women who want to work.

Ever since, efforts to expand government-supported child care have faced furious opposition from the religious right.

But Schlafly-style conservatives have less power than they used to. Religious fundamentalists have decisively lost the culture war about women working, and about family values more generally; the party of Donald Trump and Matt Gaetz is in no position to lecture anyone about their domestic arrangements.

The public policy debate is thus no longer whether to subsidize child rearing, but how. Mitt Romney’s Family Security Act, for example, would give parents $350 a month for each child under 6, and $250 a month for children between 6 and 17, up to $1,250 per family per month.

With the laissez-faire economic assumptions that dominated America since the Reagan administration discredited, Democrats no longer cower when the right accuses them of fostering big government. As Biden said in his address to Congress on Wednesday, “Trickle-down economics has never worked.”

“Our country has taken a turn, and I believe Covid had a lot to do with it,” said Murray. Families, she said, are acutely aware of the unmanageable stress they’re under, and they’re saying, “I want my country to deal with it.” For the first time in my lifetime, there’s hope that it will.

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.