The most recent entry by Saleton is an attempt to appease that is not based on science. There is no evidence of 2 types of obesity (with some exceptions of very rare genetic disorders), there is just obesity that is caused by a complicated mix of genetic and environmental factors.

Saleton's recent writings and the many replies are stuck in the "who is to blame" loop. This is completely pointless. What we should be doing is evaluating ways to solve the problem.

I read epidemiological and medical research for a living and teach a class in health promotion and disease prevention and here is what I have gleaned from about 10 years of reading this research.

1) There is clearly genetic differences in the propensity to pack on extra weight and where you gain the weight. I, for instance, will never have thin thighs no matter how much I weigh. I have learned to accept this.

2) Krappy food, especially in America, is rediculously cheap.

3) When it comes to price, quality and quantity are inversely related. See, for example, the portion size at your average 4 star

The focus needs to be on health and not looks. One thing you left off is the ability to adapt to foods one says they don't like.

Most people believe their taste buds control them and not the other way around. Given time and creativity one can change what they eat and WELCOME the change. In other words they will ENJOY veggies and low fat foods AND find sugars and fat foods LESS desireable (notice I say less).

I have a very healthly diet and I LOVE what I eat. People think I'm making this up because they have fooled themselves into believing the crap about 'all things that are bad for you taste the best'.

If someone asks me if I want an apple or a cookie I WANT the apple. But NOT because I'm force to because of some diet but because I trained my taste buds to WANT the apple. YES, I will have a cookie but I now find them too sweet so I only eat a few bites and I had enough.

YES, this takes time but it does work.

I agree that we need to focus on health rather than weight-focusing on weight leads to another set of problems, particularly for young girls.

Nevertheless, it is important to remember that we are hard-wired to prefer calorie dense food. As you say, we can and do exercise control over evolutionarily determined preferences. However, it has become increasingly difficult for poor/low income people to do so given the environment.

There are studies that show that in low-income (often prediminently black) neighborhoods, the number of convenience stores outnumber grocery stores. So, developing that preference for apples over cookies becomes very difficult when apples are not easily available for purchase.

Other barriers: soda is far,far cheeper than milk and in some neighborhoods it is not uncommon to see baby bottles filled with soda rather than milk/water/formula. The resulting tooth decay makes it very difficult to actually chew good-crunchy veggies and fruit (I have seen 2 year olds who needed root canals-no kidding).

Adding insult to injury- Portion size is out of control. If you compare the calorie count of McD's hamburger/cheeseburger (the typical portion size when McD opened) to the calorie count for a QP or Big Mac, you will get some idea of how radical the change has been (don't get me started about the jumbo packages of candy at the movie theatres). And that is just for junk food. Even healthy food will make you fat if you eat too much of it. Compare the size of your dinner plate to a dinner plate that you find in an antique store-I predict that your plates will be at least 25% bigger. Experimental data show that the amount of food you need to feel "satisfied" is directly proportional to how much you have in front of you in the first place.

I think we need a little more compassion for people who have weight problems. Metabolism is about 60% genetically determined and if you start out with a propensity to pack on the pounds and then live in an environment that affords you every opportunity to do so, the cards are stacked against you.

Although McDonald's is less expensive than a meal of fresh salmon and organic vegetables, it is quite possible to have a healthy diet on less than you would spend on prepared foods.

I had a $20/week grocery budget in the 1990's and was eating a lot healthier than my fast food eating counterparts who were spending twice as much on food as I was. Soda may be cheaper than milk, but water is free. Mac & cheese may be cheaper than fresh vegetables, but dried beans are the cheapest of all. A diet of dried beans, tuna, frozen and canned vegetables and plain oatmeal is definitely cheaper than a diet of prepared foods, but the results will take more work and will not taste as good as a Big Mac. I almost never had junk food, since unlike the 'poor' people you are pitying, I couldn't afford it.

"there is just obesity that is caused by a complicated mix of genetic and environmental factors."

Sounds like Fatty is still making excuses while she downs another cheeseburger.