West Virginia's status as the third-fattest state, confirmed in a recent report from the Trust for America's Health, gives new meaning to the phrase "Mountain Mama" in John Denver's Blue Ridge paean "Country Roads." For the morbidity and mortality experts at the Centers for Disease Control and Prevention, it also poses a puzzle: Why are West Virginians so fat?
I'll hazard a guess and say it's because they eat too much. But the CDC is not satisfied with layman's explanations. A few months ago, it sent a crack team of investigators to hunt down the source of West Virginia's obesity outbreak.
According to The New York Times, the CDC's "disease detectives" spent three weeks in Gilmer County and Clarksburg, asking the tough questions that needed to be asked. At local schools they demanded to know if "at least one or two appealing fruits and vegetables" were offered every day in the cafeteria, and if the administration would consider replacing regular sour cream with a low-fat version.
In local workplaces, they asked whether fruit juice and bottled water were available in the vending machines, and whether employees could get extra time for their lunch breaks if they promised to spend it walking. They surveyed the produce and milk selections in "random grocery stores and restaurants." They looked for sidewalks and checked them for cracks.
Upon hearing about the CDC's epidemiological odyssey, Florida State University statistics professor Daniel McGee "burst out laughing," the Times reported. "My God," he said, "what a strange thing to do." Another statistician, the University of Wisconsin's David DeMets, was similarly dismissive, saying "we get a lot of false positives from that kind of investigation," since there's no way to tell whether any given factor contributes to obesity or, if so, to what extent.
Yet the CDC, which began life as an agency devoted to fighting malaria in the South and today is determined to eradicate obesity there, is simply following the logic of its own rhetoric.
Faced with a nationwide "epidemic" that is especially pronounced in Southern states, it is looking for the vectors that transmit the "disease."
Once the government understands these vectors, the CDC assumes, it can control obesity, just as malaria can be controlled by draining mosquito-breeding swamps and cholera can be controlled by removing the pump handles from contaminated wells. This approach would make perfect sense if obesity were caused by microorganisms. But since obesity is caused by certain patterns of behavior, themselves subject to myriad influences, this is one case the disease detectives are not likely to solve.