Preventive Medicine Column

Dr. David L. Katz

The First Lady’s indulgence in a >1500 calorie lunch of burger, fries, and shake is a matter of public record and likely familiar to you.  Also a matter of public record, though perhaps not familiar to you, is my reaction, as quoted by ABC News: “I invite only those whose diets are housed with no walls of glass to hurl a burger in the first lady’s direction on the basis of this one lunch.”

This truly is how I feel.  The First Lady is human, and to my knowledge, has never claimed to be otherwise.  The fact that the guy she married happened to turn into the President of the United States did not magically endow her with a new set of taste buds.  She lives in the same obesigenic world as the rest of us, where she has to work hard to eat well and be active.

All signs indicate the First Lady loves her husband, and there is thus every reason to suspect she might experience some daily stress associated with his job and the various, not always pleasant, reactions to it.  Maybe the First Lady was just having one of “those days,” and needed lunch therapy.  Most of us have been there.  We are all well advised to chew carefully on the litany of our questionable lunches before rushing to judgment about anyone else’s.

But I do, nonetheless, have a beef with the First Lady’s lunch.  Several, in fact- and here they are:

Making perfect the enemy of good is a mistake. Whether First Lady of the United States, or first lady or man of your household, it is important to try to eat well and be active, for the sake of your own health, and to serve as a role model to those you love.  It is not necessary to be perfect in this effort to be a good role model.  Before reacting to any given lunch, we really need to know the overall context.  If that context is effort nearly every day to fit in physical activity and eat well, any one lunch should not get too much scrutiny.

Mistaking outcomes for effort is a mistake. Someone struggling with their own weight or exercise or diet could nonetheless be a role model for healthy living, just as some of the best counselors for overcoming substance abuse are ‘recovering’ addicts.  The requirement for being a good advocate and coach is not perfect performance, but dedication to the process.  That the First Lady works hard not only to advocate for healthful eating, but to practice it herself, does not diminish the value of her counsel.

Forgetting that high profile does not mean high proficiency is a mistake; the First Lady is not a nutrition expert, she’s just someone in the spotlight, trying to do the right thing. Katie Couric’s support of colonoscopy did more to promote the practice than years of advocacy by trained experts in cancer screening.  So be it.  But let’s remember that being a celebrity does not confer content expertise- it simply means that what you do and say will always be in the spotlight.  As an uber-celebrity, the First Lady’s every choice of food or fashion is apt to generate considerable attention.  But she is not a health expert- and we should not mistake fame for expertise.

Thinking that personal responsibility and public policy are either/or choices is a mistake. One of the roiling controversies among obesity control experts and expert wannabes is how fully the epidemic may be accounted for by either personal responsibility or public policy.  At the extremes, advocates for personal responsibility seem to suggest that those with no boots should lift themselves up by their bootstraps; staunch environmental determinists seem to imply that the way to better health should not only be paved for us, but we should be carried down it as well.  My view is that we need policies, programs, and practices to empower us- and once empowered, we must all take responsibility to use the resources at our disposal.  Power means responsibility; responsibility requires empowerment.  The First Lady is not solely responsible for eating well and being active- she, too, should be the beneficiary of policies and programs that make it easier.  Which leads directly to my final ‘beef’…

And then, there’s the actual beef- along with the white flour bun and fries and soda-; we could do much better! We might think about the First Lady’s lunch in the context of a famous ad for Lays’ potato chips: betcha’ can’t eat just one!  Many of the most readily accessible options in the modern food supply are foods that are extremely palatable, and all but engineered to lead us to temptation, overcome our resistance, and compel us to eat more than we should.  It does not have to be that way.

My wife has a wonderful recipe* for a burger of lean ground turkey blended with lentils and served on a whole-grain bun. In my view, the key to restraint is not eating less than you want, but eating foods that get you to satisfaction on fewer calories.  I absolutely love the burgers my wife makes, but …I can’t eat more than one, much as I want to!  They are just so filling, due in part to a high fiber content from the lentils and whole grain.  In an age of epidemic obesity, “betcha’ can’t eat just one” is a peril to us all.  What we need is many more ‘bet you can’t eat more than one!’ products- products that fill us up on fewer calories.  Catherine’s turkey-lentil burgers are a delicious example; I call on the food industry to come up with countless others.  If the Shake Shack offered such a burger, the First Lady might have had her dietary indulgence, and stuck to her calorie-controlled program, too.

Clearly, there is no such thing as a free lunch- even if you are First Lady of the United States.  There is, instead, food for thought for us all to chew on as we consider what it will take to make meals we love that love us back the law of the land- from sea to shining sea.




Dr. David L. Katz;