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"  MeMe Roth is about to get kicked out of a candy store. We&amp;#039;re a few feet inside the door of Hershey&amp;#039;s Times Square, a megashrine to chocolate with a 16-story facade of giant peanut butter cups and Peppermint Patties, and the smell alone is giving me a massive head rush. Roth is being filmed by a Japanese news crew, but before they can start rolling, a security guard makes a beeline toward her and barks, &amp;quot;You can&amp;#039;t bring cameras in here!&amp;quot; No matter, there are plenty of other ways to illustrate America&amp;#039;s horrible eating habits to the country with the lowest rate of heart disease in the world. In the past hour, Roth, an antiobesity activist, has already made examples of McDonald&amp;#039;s (&amp;quot;They call them Happy Meals, but they won&amp;#039;t be so happy when they get juvenile diabetes,&amp;quot; she said, pointing out a room full of elementary school kids chowing down on burgers and fries) and Starbucks (&amp;quot;People say they&amp;#039;re getting coffee, but then they come out with these milk shakes with whipped cream on top. That&amp;#039;s not coffee&amp;quot;). Later in the day, Roth plans to parachute into the headquarters of the YMCA of Greater New York to demand that they ban junk food at their child-care centers and terminate the $11.6 million national sponsorship of an exercise and health initiative by PepsiCo (tossing all the vending machines selling Pepsi products while they&amp;#039;re at it). Roth is a little apprehensive because she was thrown out of a Y in 2007\u2014and not because she wasn&amp;#039;t a member. She was living in Pennsylvania and had been pressuring the organization with letters and phone calls for several months when, one day, arriving at her local branch to work out, she grew incensed at the sight of employees giving away ice cream sundaes. &amp;quot;I called the local president and said, `You have one hour to offer something healthy with them or get rid of them.&amp;#039; Then I went back and threw out the toppings,&amp;quot; Roth says, deploring the hypocrisy of an organization whose mission is to promote physical health and yet provides high-calorie freebies. The Y called the police, who escorted her out of the building. Undeterred, Roth, a former VP at Edelman public relations, unleashed a hailstorm of press releases about the incident, noting the &amp;quot;full-fat ice cream&amp;quot; and &amp;quot;an overrepresentation of obesity among employees and volunteers.&amp;quot; Back in Times Square, I ask if she thinks something similar will happen at the New York YMCA. &amp;quot;I hope not,&amp;quot; she says. &amp;quot;You know, I don&amp;#039;t really like confrontation. It stresses me out.&amp;quot; Which is altogether surprising since, as the founder of the National Action Against Obesity, Roth is forever courting controversy. Running her one-woman outfit from her home for the past three years, she has generated headlines by calling for a boycott of Girl Scout cookies (a youth organization shouldn&amp;#039;t profit from sweets), criticizing Olympic swimmer Michael Phelps for endorsing Frosted Flakes, and likening giving kids junk food to child abuse. &amp;quot;People say, `My kid will feel deprived.&amp;#039; Are you depriving them when you keep them away from alcohol and drugs?&amp;quot; she says. In a publicized annual campaign, she urges married women to try on their wedding dresses as an incentive to stay slim. &amp;quot;The average couple puts on 25 pounds each in the first five years ofmarriage. Now, you can choose to grow old and fat together, but women pay a higher price,&amp;quot; she cautions, suggesting that men get away with putting on extra weight without becoming less attractive to their spouses (a theory grounded more in perception than actual data). Having babies and settling into a nice pair of mom jeans doesn&amp;#039;t fly either; &amp;quot;I really resent the women whose kids are in grade school and are still going on about the baby weight,&amp;quot; Roth says. &amp;quot;It&amp;#039;s so passive-aggressive to the kids, as if they&amp;#039;re to blame for the mom being overweight!&amp;quot; Roth is particularly well-known for saying things that few others would dare speak aloud, much less on national TV. Last year on Fox News, after Jordin Sparks won American Idol, Roth called the size 12 teenager overweight and a bad role model. When photos of Jennifer Love Hewitt&amp;#039;s dimpled butt in a bikini appeared in the tabloids, Roth proclaimed it a wake-up call for American women\u2014if Love Hewitt has cellulite, imagine how bad the rest of us look! Although her work on childhood nutrition has won her supporters such as Chevy Chase (the actor-turned-children&amp;#039;s-health-activist) and Dr. Michael Roizen, the best-selling author of RealAge, comments such as these have angered advocates for the overweight population. &amp;quot;She promotes prejudice and encourages stigmatization,&amp;quot; says Dana Schuster, president of the Association for Size Diversity and Health, an organization devoted to the acceptance and well-being of overweight men and women. &amp;quot;It&amp;#039;s hard for me to understand why she&amp;#039;s such a zealot and so judgmental.&amp;quot; The crux of Roth&amp;#039;s campaign is that obesity is a health issue\u2014&amp;quot;I&amp;#039;m tired of debating it; being overweight is bad,&amp;quot; she says\u2014and in that regard, Roth certainly isn&amp;#039;t the only person freaking out about our nation&amp;#039;s expanding waistline. &amp;quot;Obesity is the terror within,&amp;quot; said former Surgeon General Richard Carmona in 2006, shortly before the end of his term. &amp;quot;Unless we do something about it, the magnitude of the dilemma will dwarf 9/11 or any other terrorist attempt.&amp;quot; (Carmona later accused the Bush administration of muzzling him on issues like stem cell research for political reasons.) In 1998, the National Institutes of Health reviewed all the medical evidence and definitively concluded that being overweight, as defined as having a BMI of 25 or higher, carries a greater risk for developing hypertension, high blood cholesterol, type 2 diabetes, and coronary heart disease. (BMI is calculated by the formula [weight (lb)] / [height (in)]2 x 703 and is a crude tool that doesn&amp;#039;t account for age, sex, or body composition, but the NIH believes that it correlates significantly enough with total body fat content to be a good initial screening tool.) According to the Centers for Disease Control and Prevention (CDCP), nearly 62 percent of American women are overweight and 35 percent are technically obese, with a BMI of 30-plus\u2014higher than the same measures in men. According to an epidemiology report published in July 2008, if current trends continue, 58 percent of American women will be obese by the year 2030, compared with 48 percent of American men, while 87 percent of all women will be overweight. Overweight and obesity exist on a continuum, and one of the problems, Roth believes, is that women are in denial. &amp;quot;Unless they&amp;#039;re morbidly obese, most people don&amp;#039;t think they&amp;#039;re in trouble,&amp;quot; she says. And that&amp;#039;s where Roth&amp;#039;s forthright\u2014some would say obnoxious\u2014tactics come in. In an age when it&amp;#039;s politically correct to celebrate &amp;quot;real women&amp;quot; who &amp;quot;have real curves,&amp;quot; to quote the Dove campaign, Roth breaks through the media&amp;#039;s feel-good-about-your-shape mantra and calls a pound a pound. When Redbook declared &amp;quot;We love your body from size 2 to 20&amp;quot; on its cover, Roth called the magazine reckless in yet another press release and rallied for a boycott. Celebrating something that&amp;#039;s harmful to your health is faux-feminism, she asserts: &amp;quot;Euphemisms don&amp;#039;t build self-esteem, [like] calling your body `curvy,&amp;#039; as if saying nice things is going to help.&amp;quot; If you really want to feel good about yourself, start exercising and stop eating so much. As she proclaims on her website&amp;#039;s mission statement, &amp;quot;I am asking America to make the same decision I made...to shelve all excuses and take it upon myself to maintain a healthy body.&amp;quot; Not that it&amp;#039;s easy, not even for Roth. &amp;quot;Why don&amp;#039;t most women do this? It&amp;#039;s damn hard,&amp;quot; Roth admits. &amp;quot;You think double-fudge Milanos don&amp;#039;t signal their sirens&amp;#039; call to me, too? Hah!&amp;quot; I&amp;#039;m waiting for Roth at a Juan Valdez caf\u00E9, and my stomach is rumbling. It&amp;#039;s been four hours since I ate a bowl of cereal for breakfast, and normally under these circumstances I&amp;#039;d get a muffin to tide me over until lunch. But in anticipation of Roth&amp;#039;s arrival, I limit my order to iced coffee with milk and sit down at a table by the window. (&amp;quot;People don&amp;#039;t like meeting me, and they&amp;#039;re afraid to eat with me,&amp;quot; Roth had warned over the phone.) A few minutes later, a barista puts out a plate of cut-up lemon loaf with icing. I try to stay glued to my chair, but then Roth phones to say she&amp;#039;s running late, and I seize the opportunity to rush over and grab two cubes of pastry and shove them in my mouth. By the time Roth arrives, wearing a black linen suit cinched tight with a wide black belt, I&amp;#039;ve disposed of the telltale toothpicks. Roth, who is 39 and has two children, Mason, 10, and Julia, 7, is enviably slender, yet not so skeletal that I can dismiss her out of hand for being deranged by an eating disorder. At 5&amp;#039;6&amp;quot; she keeps her weight between 120 and 125 pounds. She weighs herself every day and says, &amp;quot;The alarms sound when I hit 125!&amp;quot; She also exercises for at least 45 minutes every single day, rain or shine, usually by running four miles and doing some strength work, but since she never knows exactly what time she&amp;#039;s going to squeeze it in, she works in her gym clothes so that she&amp;#039;ll be ready to spring into action. (Her stamina is staggering; one day I accompanied her to an adult gymnastics class\u2014&amp;quot;Gymnastics is a secret weapon&amp;quot; of strength and conditioning, she says\u2014and after a half hour of somersaults and cartwheels, I slumped onto a mat to catch my breath while Roth effortlessly performed front handsprings and aeriels.)  The first thing Roth does at Juan Valdez is show me a photograph of herself, her daughter, her mother, and her grandmother, four generations of women sitting together. Roth looks slim, but Roth&amp;#039;s mother is clearly overweight and her grandmother is obese, as in housecoat-and-slippers, needs-a-wheelchair obese. Roth tells me that at 5&amp;#039;0&amp;quot; and 300 pounds, her grandmother is diabetic and has to be hooked up to oxygen because the extra weight on her chest impedes her breathing. And it&amp;#039;s not just the women in her family: Her father, a former triathlete, is also pushing 300. &amp;quot;People say, `Who is she to talk about obesity?&amp;#039; Well, I&amp;#039;ve seen what it can do firsthand,&amp;quot; Roth says. Immediately, I find her much more sympathetic, her determination to stay thin not just vanity but a fear of following in her mother and grandmother&amp;#039;s path. &amp;quot;The day I stop being disciplined about food and exercise is the day I become as fat and sickly as the rest of my family,&amp;quot; she says. Roth grew up in Atlanta, the middle child between two brothers who, as adults, also share her determination not to let themselves get heavy. Roth says she was never overweight, but by the time she was a teenager, she knew she&amp;#039;d have to exercise more than her peers not to become fat. During her freshman year in college, at the University of Georgia, she stopped eating during social occasions and improvised a healthy diet\u2014less meat, more veggies. She subsequently dropped eight pounds and has more or less maintained that weight since. She met her husband, Ben Roth, while they were both interning at IBM, and they married in 1997. He runs a boutique marketing firm and supports her activism as well as her philosophy.  Roth eats very sparingly, about 1,600 calories a day\u2014on the low end of most calculations of what someone her height would need to maintain a weight of 123\u2014a diet of mostly vegetables and legumes with the occasional chicken or seafood. She also avoids red meat and tries to minimize processed food and sweeteners, and shuns refined sugar and flour, empty calories that raise blood glucose and insulin levels. &amp;quot;I probably eat less and less frequently than most people, but what works for me won&amp;#039;t necessarily work for everyone,&amp;quot; she says diplomatically. Black bean burritos seem to be her favorite staple. Roth says that the only time she let herself go occurred as a new mom, but that seeing another mother of a toddler looking great in jeans on the playground snapped her out of it. &amp;quot;Just that extra 10 to 15 pounds, as modest as that sounds, had a profound effect upon my personality, sexuality, confidence. Once it was gone, I lit right back up! That&amp;#039;s also when I realized Ben isn&amp;#039;t my husband, but rather my permanent boyfriend.&amp;quot; Roth then hastens to add, &amp;quot;It has to be said that he&amp;#039;s never complained about my body at any weight. Like most hubbies, he&amp;#039;s just glad to be there if and when the clothes come off.&amp;quot; But being overweight doesn&amp;#039;t just put a burden on your body, mind, and marriage, it also burdens society. According to Eric Finkelstein, a health economist who evaluates obesity prevention programs for the CDCP, &amp;quot;About 9 percent of our health care costs go to diseases that are attributable to overweight and obesity.&amp;quot; (In comparison, Finkelstein says that roughly the same amount goes to diseases attributable to smoking tobacco.) Reducing obesity has also been targeted as a way to cut energy costs, since it takes more fuel to transport heavier loads. (&amp;quot;I&amp;#039;d rather get the free movies back on the airplanes and have everyone lose 10 pounds,&amp;quot; Roth says.) Obesity has even become something of a national security issue. As former Surgeon General Carmona wondered, &amp;quot;Where will our soldiers and sailors and airmen come from? Where will our policemen and firemen come from if the youngsters today are on a trajectory that says they will be obese, laden with cardiovascular disease, increased cancers, and a host of other diseases when they reach adulthood?&amp;quot; Similar fears about her own children&amp;#039;s health turned Roth to activism in the first place. In 2005, after noticing that her son was repeatedly being served a bagel with cream cheese and Pringles at his elementary school, Roth complained to the parent-teacher organization that created the lunch plans. She got a frosty response: &amp;quot;Please consider moving,&amp;quot; e-mailed back one PTO member. So Roth decided to use her experience in public relations to, well, go public. &amp;quot;I remember the exact moment of jogging around Taylor Park in Millburn, New Jersey, and asking myself, Can I really issue a press release about what&amp;#039;s going on in my own children&amp;#039;s school? I decided not to wuss out and went for it.&amp;quot; The New York Post picked up the story, and Roth got booked on TV and radio gigs. (She has since relocated to New York City, where, she says, nutrition standards in public school are among the best in the country and she no longer has to deal with those &amp;quot;undersexed PTO-fraus.&amp;quot;) In 2006, she dubbed her mission the National Action Against Obesity. A year later, Roth got a certificate through a six-month program at the Institute of Integrative Nutrition and now has a private counseling business that helps support the activist work, which is completely volunteer.  Roth and others who have declared war against obesity blame a huge abundance of highly caloric food, as well as shifting customs in which eating everywhere, all the time\u2014in our car, in bookstores, in movies theaters\u2014is now the norm. Obesity running in families, they argue, has more to do with inheriting bad habits than any kind of fat gene. &amp;quot;There is not a lot of evidence [for obesity] on the genetics side, but there is lots of evidence on the environmental and behavioral side,&amp;quot; says Barry Popkin, a professor of global nutrition at the University of North Carolina and author of The World Is Fat. Marion Nestle, a nutrition and public health professor at New York University and author of What To Eat concurs: &amp;quot;Genetics is important, of course, but probably accounts for only a small fraction of obesity. Overeating is much, much more important.&amp;quot; Even scientists who research the biological underpinnings of obesity acknowledge that nurture seems to be trumping nature. &amp;quot;The environment has increased in importance because we have everything working against us now,&amp;quot; says Sarah F. Leibowitz, PhD, head of the Laboratory of Behavioral Neurobiology at Rockefeller University in New York City. &amp;quot;There are still people who are more prone, but diet is certainly the major factor. One of the things we&amp;#039;ve been looking at is the effect on the brain of early exposure in the womb to high-fat diets, and clinical studies demonstrate that a fat-rich diet during pregnancy or introduced during early infancy can produce obesity in adulthood. It&amp;#039;s getting worse with every generation because the mothers are eating more and getting heavier.&amp;quot; However, geneticists argue that people inherit not just a family propensity to being overweight but also an evolutionary instinct to consume and store as many calories as possible. &amp;quot;There is a basic drive to eat that is unconscious, and then there&amp;#039;s the conscious wish to eat less, and in a vast majority of cases, the basic drive wins out over time,&amp;quot; says Jeffrey M. Friedman, PhD, of Rockefeller University, whose lab identified leptin, a hormone made by the body&amp;#039;s fat cells that signals satiety to the brain. Moreover, there&amp;#039;s a range of individual differences in our energy-regulating mechanisms, and Friedman theorizes that obese people have higher leptin levels because they&amp;#039;re actually resistant to it, just as people with diabetes can be resistant to insulin. &amp;quot;We have to understand that people are different and accept their differences,&amp;quot; he says. &amp;quot;The experience of someone who is obese is totally unlike the experience of someone who is just trying to lose 10 or 15 pounds.&amp;quot; I tell Friedman about Roth and how she often touts that she &amp;quot;comes from a long line of obesity,&amp;quot; and he says, &amp;quot;She may feel that she&amp;#039;s exercising willpower and is thin when she was meant to be heavy, but that makes the assumption that her drives are equivalent in potency to everyone else&amp;#039;s. She probably just didn&amp;#039;t inherit her family&amp;#039;s fat gene.&amp;quot; Moreover, Friedman notes, &amp;quot;There&amp;#039;s an element of demagoguery here. Telling obese people that they just need to be a normal weight isn&amp;#039;t going to motivate them. The people who get stigmatized the most are the people who can do the least about it.&amp;quot; And in fact, proponents of fat acceptance say that the overweight are being scapegoated. Although the movement began in 1969 with the National Association to Advance Fat Acceptance, the current wave of fat liberation is taking place on blogs such as Big Fat Deal and The F-Word. (Roth has squared off against both blogs&amp;#039; authors on TV several times.) The fat-acceptance movement contends that overweight people can be perfectly healthy, just as normal-weight people can be unhealthy. &amp;quot;Obesity in and of itself is not a disease, so we&amp;#039;re barking up the wrong tree,&amp;quot; says the Association for Size Diversity and Health&amp;#039;s Dana Schuster. &amp;quot;The real health issues that we have are about sedentary lifestyles and not enough access to good nutrition.&amp;quot; Schuster also points out that communities with the highest obesity rates also tend to be low-income. &amp;quot;Their choices are very limited, as are their health care options, so let&amp;#039;s focus on health and not demonize a particular part of the population.&amp;quot; As an article published in The American Journal of Clinical Nutrition notes, poverty leads to obesity because the most highly caloric foods\u2014containing refined grains, added sugars, and fats\u2014are often the cheapest to buy, and these highly palatable but energy-dense foods invariably lead to overeating. Such diets are simply more affordable than ones based on lean meats, vegetables, and fruits. Finally, Schuster argues that Roth&amp;#039;s approach is just counterproductive: &amp;quot;What motivates people is a sense of value about themselves, and shaming and blaming pushes people away from self-care, not toward it,&amp;quot; she says, adding, &amp;quot;I guarantee you that if you make a certain food evil or wrong or bad, it will be the food that calls out most loudly from the grocery store.&amp;quot; I&amp;#039;ve always believed this too, that if you restrict yourself you&amp;#039;ll wind up bingeing on forbidden foods, which is why I&amp;#039;ve never done so, even as I&amp;#039;ve seen my weight steadily inch up over the past five years. When I agree to try on my wedding dress with Roth, I&amp;#039;m pretty confident it will still fit because I was five months pregnant when I got married. And indeed it does, but just barely. Chastened, I decide to strike refined flour and added sugars from my diet and eat the Roth way. It&amp;#039;s hard at first, but I start to lose weight\u201415 pounds after three months\u2014and Roth sends me encouraging e-mail advising me to eat extra protein to avert &amp;quot;crazy sugar cravings.&amp;quot; The next time I see Roth, several weeks after our Times Square adventure, I ask how she manages to not feel deprived. &amp;quot;I allow myself my `tens,&amp;#039; &amp;quot; she says. She consistently shuns sweets such as birthday cake and ice cream, &amp;quot;sixes, sevens&amp;quot; on her scale of desirability, things she can do without, so that once or twice a year, she can indulge in the things she absolutely adores, her &amp;quot;tens,&amp;quot; such as tiramisu, or her favorite handmade chocolate-coconut Easter eggs, or even, gasp, a Coke: &amp;quot;I&amp;#039;m from Atlanta; I grew up on it.&amp;quot; We&amp;#039;re walking from Roth&amp;#039;s apartment on Manhattan&amp;#039;s Upper West Side to a lunch spot one mile north with her children leading the way on scooters. (Her kids, by the way, seem perfectly at ease with their mother&amp;#039;s strong admonitions about nutrition, yet at one point Mason lets it slip that he tried a Twinkie once with his grandfather, before he knew it was bad for him.) We arrive at a Texas BBQ place that Roth has picked\u2014not what I expected\u2014and she orders rice and bean wraps for her kids and two side dishes, one sweet potatoes, one mixed vegetables, for herself. She drinks water. &amp;quot;People are sometimes disappointed in me because I&amp;#039;m not an Alice Waters foodie-type,&amp;quot; she says. &amp;quot;I&amp;#039;m trying to emphasize the utilitarian aspect of food and keep it in its place. I think we should stop fetishizing it,&amp;quot; she adds, getting warmed up. &amp;quot;I think we need to just put the food away.&amp;quot; While many foodies would deplore the rejection of the sensual joys of eating, public health policy is starting to reflect Roth&amp;#039;s views, as cities ban trans fats and elementary schools forbid cupcakes. Los Angeles just passed a law enacting a one-year moratorium on the opening of new fast food restaurants in South L.A. Roth testified for New York City&amp;#039;s Board of Health last year in favor of the new mandate requiring chain restaurants with more than 15 locations nationwide to list calorie counts on their menu boards, and I can personally vouch that at 490 calories, that apple fritter at Starbucks has lost a lot of its appeal. Roth has allied herself with the Center for Science in the Public Interest\u2014the body that recently pressured Congress to pass the law requiring disclosure on food labels of the presence of allergens such as peanuts, milk, and eggs\u2014where she works on committees for school wellness policies and against junk food marketing to kids. She&amp;#039;s been gathering signatures for a petition against the YMCA and was also invited to be on the board of the Children&amp;#039;s International Obesity Foundation and Women for Family Nutrition. As a result, Roth&amp;#039;s profile is rising, even as her figure stays the same. When she arrived at the headquarters of the YMCA of Greater New York, the Y officials not only recognized her but sat down with her in front of the cameras. She appears on TV and radio shows about once a week, and she&amp;#039;s in a documentary on the obesity crisis called Killer at Large that&amp;#039;s making the film festival rounds. &amp;quot;MeMe Roth is the future,&amp;quot; notes nutrition expert Barry Popkin. &amp;quot;If you look at the three major public health movements of the last 30 years\u2014Mothers Against Drunk Driving, seat belt laws, and antismoking campaigns\u2014all of those started with activism. This is the way change comes in America.&amp;quot; One pound at a time. "^^<http://www.w3.org/2001/XMLSchema#string>
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