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When a French warship bristling with cannons sailed into the port of the Haitian capital in 1825, an emissary from King Charles X came ashore and delivered an astonishing demand: France wanted reparations from the people it had enslaved.

The demand was for 150 million French francs, to be turned over in five annual payments, far more than Haiti could pay.

So France pushed Haiti to take a loan from a group of French banks to start paying. That Sisyphean weight came to be known as the double debt.

Every franc shipped across the Atlantic to an overseas bank vault was a franc not circulating among Haiti’s farmers, laborers and merchants, or not being invested in bridges, schools or factories — the sort of expenditures that help nations become nations, that enable them to prosper.

For a decade, a quarter of Haiti’s total revenue went to paying debts controlled by National City Bank and its affiliate, according to nearly two dozen annual reports prepared by American officials and reviewed by The Times.

After half a century of crushing payments tied to the double debt, Haitians celebrated the news that at last the country would have its own national bank, the sort of institution that in Europe had financed railroads and factories.

“Isn’t it funny,” one Haitian economist wrote, “that a bank that claims to come to the rescue of a depleted public treasury begins not by depositing money but by withdrawing everything of value?”

When the American military invaded Haiti in the summer of 1915, the official explanation was that Haiti was too poor and too unstable to be left to its own devices. Secretary of State Robert Lansing made little effort to mask his contempt for the “African race,” casting the occupation as a civilizing mission intended to end “anarchy, savagery and oppression.”

“I helped make Haiti and Cuba a decent place for the National City Bank boys to collect revenues,” the general who led the U.S. forces in Haiti, said years later, describing himself as a “racketeer for capitalism.”

For decades to come, the United States was the dominant power in Haiti, dissolving parliament at gunpoint, killing thousands and shipping a big portion of Haiti’s earnings to bankers in New York while the farmers who helped generate the profits often lived near starvation.

“Neocolonialism through debt,” is how Thomas Piketty, one of the economists we spoke with, put it. “This drain has totally disrupted the process of state building,” he said.

“They were betrayed by their own brothers, and then by foreign powers.”

In an 1875 loan, the French bankers took a 40 percent cut off the top.

The double debt has largely faded into history. Generations of French profited richly from the financial exploits of their forebears, but that is rarely taught in classrooms.

“This is part of my family history I never knew,” said one sixth-generation descendant of Napoleon’s first wife.

Even in Haiti, the full story was long unknown. Then in 2003, President Jean-Bertrand Aristide stunned Haitians by denouncing the debt imposed by France and demanding reparations.

Mr. Biden appeared content to keep North Korea on the back burner, even though President Barack Obama told Mr. Trump in November 2016 that North Korea should be Washington’s top national security priority. Mr. Biden has yet to name a candidate to be ambassador to South Korea. The special envoy for North Korea, Sung Kim, is a veteran diplomat who has dealt with these issues before, but he is doing the job part-time — he is also ambassador to Indonesia.

China and Russia blocked the proposal last week in the U.N. Security Council. And Kim Jong-un, the leader of North Korea, appears unfazed by the threat of more U.N. and Treasury Department sanctions — he fired off two cruise missiles on Tuesday and two more ballistic missiles on Thursday, for a total of six weapons tests this month, equal to the number for all of last year.

Siegfried Hecker, a nuclear scientist at Stanford University who has visited North Korea, estimated the country very likely has enough nuclear material for about 45 warheads, an increase of about 20 since the end of the Obama administration. He also gave an upper-end number of 60.

But the leaders of those two East Asian nations are divided in their approach and remain embroiled in bitter disputes over separate issues of history and war. Japanese officials are critical of Mr. Moon’s North Korea policy. In November, Wendy Sherman, the deputy secretary of state and an experienced negotiator on North Korea and Iran, hosted a meeting with her South Korean and Japanese counterparts in Washington, but long-running hostilities resulted in an awkward news conference.

One of the biggest dilemmas is how to work with China to curb North Korea’s weapons program. The Chinese leader, Xi Jinping, and his colleagues are balancing various goals: They want to end the disruption caused by Mr. Kim’s weapons while also seeking to avoid a failed state on their border or Pyongyang growing close to Washington or Seoul.

China is by far North Korea’s biggest trading partner. Although it has approved of U.N. sanctions on occasion, it and Russia began asking in 2019 for partial relief of the Obama- and Trump-era sanctions. For a period, it was enforcing those sanctions, but then it began helping North Korea circumvent them as Beijing-Washington relations deteriorated.

The speech might have been rambling and emotional but its motivation was clear. And it immediately created a quandary for many West-blamers and Putin-understanders. How would you square your belief in national sovereignty and the effective declaration by the Russian president that Ukraine shouldn’t have any?

On the left Russia stood as a flawed bulwark against imperialism, on the right against the supranational machinations of the New World Order (the EU, Nato, the UN, whatever).

I don’t call these western apologists for Putin traitors, or fifth columnists, or paid agents of Russia. They’re none of those things. I note that as of today, courtesy of Putin, these people all look foolish.

But if the Moscow autocrat follows through the logic of his own words, then things may get very difficult for us all. A price will be paid, economically certainly and possibly in something more precious.

It will be Putin’s doing but there will be an increasing number of voices raised blaming our own governments and institutions. Voices that must be heard but must be countered.

But Ukrainians never thought that the alliance and the allies were different."Zelenskyy told NATO that his country still needs more military equipment, specifically tanks and fighter jets, and chided them for not establishing a no-fly zone.

Biden has committed $2 billion in military assistance to Ukraine since the start of his presidency, including an $800 million military package last week.

The NATO summit was followed by a meeting with leaders of the Group of Seven leading industrial nations and an address to European Union leaders, the White House said.

The U.S. also said that international organizations and multilateral corporations should no longer conduct their activities with Russia in a business-as-usual manner, the second official said. “Our purpose here is to methodically remove the benefits and privileges Russia once enjoyed as a participant in the international economic order,” the official said.The new sanctions include 328 Duma members; Herman Gref, the head of Russia’s largest financial institution Sberbank and a Putin adviser since the 1990s; member of the Russian elite Gennady Timchenko, his companies and his family members; 17 board members of the Russian financial institution Sovcombank; and 48 large Russian defense state-owned enterprises

As the biggest conflict in Europe since World War II enters its second month, the discussions here could be among the most consequential of Biden’s presidency. When Biden was asked as he was leaving the White House for Brussels how likely he thought the threat of chemical warfare was, he said, “I think it’s a real threat.”  

“We are united in condemning the Kremlin’s unprovoked aggression and in our support for Ukraine sovereignty and integrity," NATO Secretary-General Jens Stoltenberg said ahead of the meeting. The group would also discuss efforts to strengthen the military alliance's defenses in the short and the long term, he said.

Biden plans to travel to Poland on Friday to offer support as it deals with millions of refugees who are fleeing the conflict and to thank U.S. troops stationed there.

yet it is one the government’s opponents are always reluctant to admit because its logical corollary is that there will always be an incentive for those not included under the cap to try their luck in the Channel — unless they perceive a high risk of deportation. You cannot stop the boats while taking in the passengers.

Sunak’s policy, despite its logic, faces a tortuous road ahead. To ministers’ surprise, they won their case on the Rwanda scheme in British courts last year, only to have the first flight blocked in the middle of the night by an ECHR judge.

Yet as the home secretary recently suggested, the government still believes it can get its way. The ECHR, despite its reputation for inflexible and expansionist application of human rights law, can be expedient when its institutional reach is under threat

In 2012, for example, after an unmanageable surge of cases that provoked European governments’ wrath, the ECHR agreed to limit itself to intervening only where it believed national courts had not done their jobs properly. Its caseload quickly shrank.

With the UK outside the EU and therefore able to leave the ECHR with relative ease, the court’s survival instinct has kicked in. Its officials are said to have been taken aback by the hostility to its Rwanda injunction last June and are in a mood to compromise to avoid the risk of losing the UK altogether

Even assuming the legislation takes full effect, it may not work. Migrant arrivals are expected to reach 65,000 this year. The asylum backlog stands at 166,000 and counting, hotels are full to bursting and the government hasn’t yet sent a single person to Rwanda, which in turn hasn’t built the capacity to house more than 200. No wonder most think the policy is doomed.

Between the prospect of being deported, housed in unappealing lodgings such as barges and RAF bases rather than hotels, and caught by the French, who are being given large sums of money to step up their coastal policing, the government is hoping it can make trying to cross the Channel sufficiently unattractive

There has been a sharp drop in the number of Albanians arriving on our beaches since the government signed a co-operation agreement with Tirana, stepped up deportations and publicised both.

evidence from Canada in 2016, where a publicity campaign highlighting the deportation of failed asylum seekers from Hungary led to a dramatic drop in arrivals.

It all depends on what’s required to deter people from crossing. The aim, after all, isn’t to run a constant, high-volume travel service to Kigali, but to stop people from getting on boats in the first place. This may already be working

This leaves the final piece, which is the expansion of “safe and legal routes” to the UK. It has taken months of awkward media interviews, select committee hearings and the threat of a backbench rebellion, but the government has finally accepted it needs a better system for taking in legitimate refugees.

One way is a broader, Ukraine-style scheme, so households can bring in refugees if they agree to take them in

Another is to allow for more extended family reunifications for refugees who have relatives here

And another would be to expand the practice of assessing and accepting people at UN camps, like the Syrian resettlement scheme

After years of ineffectual government under Theresa May and Boris Johnson, we have become used to the idea that ministers never have any ability or intention of keeping their promises

For decades — and particularly since the 2008 recession — politicians in both parties have mounted a strident campaign against government funding for the liberal arts. They express a growing disdain for any courses not explicitly tailored to the job market and outright contempt for the role the liberal arts-focused university has played in American society.

Former Gov. Scott Walker’s assault on higher education in Wisconsin formed the bedrock of many later conservative attacks. His work severely undermined a state university system that was once globally admired. Mr. Walker reportedly attempted to cut phrases like “the search for truth” and “public service” — as well as a call to improve “the human condition” — from the University of Wisconsin’s official mission statement

But blue states also regularly cut higher education funding, sometimes with similar rationales. In 2016, Matt Bevin, the Republican governor of Kentucky at the time, suggested that students majoring in the humanities shouldn’t receive state funding. The current secretary of education, Miguel Cardona, a Democrat, seems to barely disagree. “Every student should have access to an education that aligns with industry demands and evolves to meet the demands of tomorrow’s global work force,” he wrote in December.

Federal funding reflects those priorities. The National Endowment for the Humanities’ budget in 2022 was just $180 million. The National Science Foundation’s budget was about 50 times greater, having nearly doubled within two decades.

What were students meant to think? As the cost of higher education rose, substantially outpacing inflation since 1990, students followed funding — and what politicians repeatedly said about employability — into fields like business and computer science. Even majors in mathematics were hit by the focus on employability.

Universities took note and began culling. One recent study showed that history faculty across 28 Midwestern universities had dropped by almost 30 percent in roughly the past decade. Classics programs, including the only one at a historically Black college, were often simply eliminated.

Higher education, with broad study in the liberal arts, is meant to create not merely good workers but good citizens

this is a grim and narrow view of the purpose of higher education, merely as a tool to train workers as replaceable cogs in America’s economic machine, to generate raw material for its largest companies.

Citizens with knowledge of their history and culture are better equipped to lead and participate in a democratic society; learning in many different forms of knowledge teaches the humility necessary to accept other points of view in a pluralistic and increasingly globalized society.

In 1947, a presidential commission bemoaned an education system where a student “may have gained technical or professional training” while being “only incidentally, if at all, made ready for performing his duties as a man, a parent and a citizen.” The report recommended funding to give as many Americans as possible the sort of education that would “give to the student the values, attitudes, knowledge and skills that will equip him to live rightly and well in a free society,” which is to say the liberal arts as traditionally understood. The funding followed.

The report is true today, too

the American higher education system is returning to what it once was: liberal arts finishing schools for the wealthy and privileged, and vocational training for the rest.

Reversing this decline requires a concerted effort by both government and educational actors

renewed funding for the liberal arts — and especially the humanities — would support beleaguered departments and show students that this study is valuable and valued.

At the university level, instituting general education requirements would guarantee that even students whose majors have nothing to do with the humanities emerged from college equipped to think deeply and critically across disciplines.

Liberal arts professors must also be willing to leave their crumbling ivory towers and the parochial debates about their own career path, in order to engage directly in public life

the major finding of the survey “is that democratic norm violations of the sort many Republicans ran on are an electoral loser.”

Republican candidates, Westwood added, “running on platforms that supported democratic norm violations were standing behind a policy that seems to only resonate with Trump and a small minority of Republican voters.

Both Democrats and Republicans, Westwood said,overestimate the extent to which the other side supports democratic norm violations by up to five times. There is a real risk that damage to our country could occur not because of support for norm violations but as a pre-emptive strike based on the faulty assumption that the other side has abandoned democracy.

the election outcomes are consistent with the interpretation that the candidates most closely associated with Trump suffered a penalty. Voters rejected all the Trump-endorsed secretary of state nominees in important swing states. Republicans unexpectedly lost seats in districts where Republican incumbents who supported Trump’s impeachment had been denied renomination. Republicans closely linked to Trump lost elections in winnable swing states

A publicly released post-election analysis by Neil Newhouse and Jim Hobart, partners at the Republican polling firm Public Opinion Strategies, found, for example, that a far higher percentage of Democrats, 81 percent, believe “Republicans represent a threat to democracy that, if not stopped, will destroy America as we know it,” than Republicans (69 percent) believe the same thing about Democrats

abortion, which worked to the advantage of Democrats, “was more of a factor than the pre-election polls indicated,” with almost as many voters, 31 percent, saying it was a high-priority issue as the 32 percent who identified rising prices and inflation, an issue that benefited Republicans

Almost identical percentages identified concern over democratic backsliding, at 25 percent, a pro-Democratic issue, as the 26 percent who identified jobs and the economy, a pro-Republican concern.

through 2020, a larger percentage of Republicans considered themselves “to be more a supporter of Donald Trump” than “a supporter of the Republican Party.” That came to an end in January 2021, and by this month, 67 percent said they were “more a supporter of the Republican Party,” more than double the 30 percent who said they were “more a supporter of Donald Trump.”

Crime, Greenberg wrote,was a top issue for many Democratic base voters. A quarter of Blacks and half of Hispanics and Asians voters trusted Republicans more than Democrats to address the issue. With Democrats trailing Republicans by 10 points on crime, Democrats have a lot of work to do.There is another word of caution for Democrats. The party’s single most important achievement in 2022 was to maintain control of the Senate, preventing Republicans from blocking Biden’s judicial and executive branch appointments.

n 2024, however, 23 seats in the Democratic caucus will be up for grabs — including two independent seats (Angus King in Maine and Bernie Sanders in Vermont) — making it that much harder for Democrats to keep their thin majority. Eight of these Democratic seats are in purple or red states (Montana and West Virginia, for example), offering multiple opportunities to the Republican Party

In contrast, all 10 of the Republican-held seats up for election in 2024 are in solidly red states.

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.

Henry Highland Garnet — the first African-American to speak in Congress after the passage of the Thirteenth Amendment — even apologized for speaking of various different races, “when in fact there is but one race, as there was but one Adam.”

Fast forward to 2015, when the University of California called the phrase “There is only one race, the human race” a “micro-aggression”; or 2020, when the phrase “All Lives Matter” was deemed evidence of “anti-blackness”

The 21st Century, the brief era of color-blindness behind us, reached back to the 19th to insist that race defines us at our core, can never be overcome, and marks us all either an oppressor or a victim.

Hughes cuts to the chase and calls these reactionaries in progressive clothing “neoracists”. They are. What else would one call them?

They are race-obsessed. They view any human interaction as a racial power-struggle, and compound it with any number of further “intersectional” power-struggles

They see group identity as determinative everywhere; and therefore want to intervene everywhere, to discriminate against whites and successful non-whites in favor of unsuccessful non-whites

Individual rights? They come second to group identity.

The old black-white paradigm to which so many are still attached has been superseded by the kaleidoscope society, in which “race” is almost always mixed, complicated, or one difference among many.

Political power? Blacks, who are about 14 percent of population, are represented proportionally in the House — covering 29 states — and can claim the last two-term president, the current vice president, the House minority leader, the secretary of defense, the chairman of the Joint Chiefs, the mayors of the four most populous cities last year, and more than a fifth of SCOTUS.

So do we do nothing? Not at all. In fact, blaming an abstraction — “white supremacy” — takes us backwards practically and analytically. Hughes advocates for color-blind processes wherever possible: blind grading in schools and colleges; or hiring policies that remove names from applications to deter racism.

the implosion of bad ideas is not the same as the resuscitation of good ones. What Hughes has done in this book is remind us what we already knew: that racism and neoracism are two sides of the same collectivist coin, and that treating everyone regardless of race is the only feasible way forward for a multiracial America, just as it is the only morally defensible regime that can actually counter and erode racial hatred. The proof is in our past progress. But the potential for multi-racial individualism is as unknowable as it is exhilarating.

The big question, then, is how do you bring about widespread, deep-seated cultural change within the organs of government and institutions connected to it?

Can you legislate to change a culture?

Sir Brian Langstaff, the report author, thinks you might be able to – or at least make a start.

He suggests there should be a so-called duty of candour demanded in law for civil servants and others.It would then become a legal obligation to speak up, rather than a cultural expectation to shut up.Whistleblowing would be mandatory.But will it happen, and will it make any difference?