The Washington PostDemocracy Dies in Darkness

This Appalachian town was America’s ‘fattest city.’ Here’s how it slimmed down.

There’s no quick fix. Success in fighting obesity takes a lot of little things — but they add up.

Marshall University in Huntington, W.Va., offers the Rolling Thunder Bike Share Program to encourage students to ride bikes instead of using cars. (Michael S. Williamson/The Washington Post)

In 2008, a study by the Centers for Disease Control and Prevention called Huntington, W.Va., the fattest city in America. The story was national news, a cautionary tale for a country whose waistline seemed to expand a bit more each year.

Soon Jamie Oliver, the British celebrity chef, helicoptered in to film a new reality show, “Food Revolution,” in which he attempted to teach Huntingtonians how to improve their diet. The show was full of manufactured drama: Oliver told a weeping mother she was killing her kids with junk food, took a skeptic to the mortuary to show him the surge in double-wide coffins and dropped his jaw at a class full of elementary school students who couldn’t identify a tomato. Viewers gawked; “Food Revolution” won an Emmy.

In the decade since, Huntington has made news for its opioid problem, but what about its diet? The CDC’s latest metropolitan health survey found that the city’s rate of obesity among adults had dropped a whopping 13 points, from 45.5 to 32.6 percent, even as the overall rate in West Virginia remained the highest in the nation. Huntington was no longer America’s fattest city. What happened in Huntington, a city of 47,000 at the intersection of the Rust Belt and Appalachia, offers important lessons for how the nation deals with its obesity problem — which today afflicts nearly 40 percent of adults and 1 in 6 children.

Former U.S. Food and Drug Administration Commissioner Dr. David A. Kessler discusses the issue of obesity in America saying. (Video: Washington Post Live)

Americans love the quick fix. “Look Younger in Minutes!” “Bikini Ready in 7 Days!” But there is no quick fix for obesity. It poses a complicated challenge that is connected to problems from chronic disease and dementia to the early onset of puberty. Instead, this is what’s happening in Huntington: slow, incremental, uneven change in the culture of a community — from where people shop for food to what their kids are served in school to what their mayor and their pastors have to say about choices at mealtime.

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In 2010, we went to Huntington in Oliver’s wake, looking for evidence of the food revolution the chef had promised. For more than a year, we tracked the ups and (mostly) downs of a “fresh market,” which sold nothing but seasonal produce. But the town wasn’t ready for it. We’ll never forget the man who strolled up to the market one day and asked for bananas, then for cigarettes, and grumbled that he could get the few items they did have, cheaper, at the discount grocer Aldi.

It took years to figure out what would work. In 2012, a group of women opened the Wild Ramp, a food market that runs on consignment, with 80 percent of sales going to local farmers and artisans who drop their goods off, then come back to pick up their checks. This makes sense in Huntington because farming has always been a marginal proposition in the region’s rocky hills and tight hollows. Most farmers have other jobs to pay the bills and, therefore, little time to stand at a farmers market to sell what they grow. It makes sense, too, because Huntington has never really recovered from the collapse of its manufacturing economy, and the market is billed as economic development rather than some yuppified import from the coasts.

Most of all it makes sense because it is as convenient for shoppers as it is for farmers — something rare in the good-food movement, which has made “convenience” the enemy of a healthy diet, railing against drive-throughs and microwaves. Unlike most farmers markets, the Wild Ramp is open six days a week, it is centrally located, and it has an array of products, from fresh produce and dairy to meat, pasta and salsas.

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Since it launched, the market has returned some $1.3 million to local farmers and producers. This in a town where the per capita annual income is about $21,500. It has become a hub of activity around locally produced food, with educational programs, a festival and a positive presence in a town that needed one. The Wild Ramp will never supplant Walmart or Kroger as Huntington’s grocery mainstay. But it has made the idea of fresh, local food — and the healthier way of eating that evokes — a point of pride for residents, rather than an eat-your-broccoli lecture by outside “experts.”

Meanwhile, a much less visible revolution was underway in the public school cafeterias. The schools were a major part of Oliver’s show, with Rhonda McCoy, the school system’s food service director, playing the villain to the chef’s righteous crusader. Oliver decried the “processed crap” served to students, as well as the thicket of rules that stood in the way of reform.

But it turned out that McCoy was the real reformer. In the years after Oliver left town, she took the recipes he introduced — which students hated and which had too much fat to meet federal standards — and tweaked them to suit local tastes and pass bureaucratic muster. She secured grants to retrofit her kitchens and retrained her cooks, and today more than 80 percent of the food served to students in Cabell County Schools, the district that includes Huntington, is made from scratch.

Huntington’s schools spent more than $67,000 on fresh produce from student and local farmers last year, and they’re on track to buy even more in 2019. It’s a priority, McCoy says, because kids are more likely to eat vegetables if they know that a friend had a hand in growing them. And though the Trump administration last year lowered nutrition standards for grains, flavored milk and sodium in school cafeterias, McCoy continues to run her program under the stricter Obama-era rules.

The story in Huntington isn’t all good news. The city’s obesity rate remains higher than the national average of 29.5 percent. Nearly a quarter of adults 45 or older have diabetes, and 40 percent have high blood pressure, according to the CDC. So when it comes to dietary health, Huntington still has work to do.

But the shift is real, and because it has institutional roots in the community, it is more likely to grow over time. The city now hosts a number of distance runs and has built dozens of miles of bike trails. In 2015, Mayor Steve Williams began a series of “Walks With the Mayor,” in which he and other city officials stroll through neighborhoods to encourage residents to be more active.

“We aren’t the healthiest city yet, but we are moving in the right direction,” Gail Patton, the leader of the group that launched the Wild Ramp, told us recently. “And we are moving in that direction as a result of intentional actions by an army of people, businesses, local government and institutions who want to see things improve.”

For too long, efforts to change America’s diet have focused on individuals, with moralizing messages about the importance of home cooking, spending more time and money on food, and so on.

But dietary change has never been a simple matter of people knowing what to eat and summoning the will to do it. If it were, then the diet industry would be a boon instead of a $66 billion boondoggle. Changing the food culture of a community, let alone a diverse and divided nation of 328 million souls, is a matter of redirecting, reframing and in some cases remaking traditions, habits, expectations and the physical environment — of changing what is normal in people’s lives. That takes time.

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It’s not a new idea but one that has been ignored in our impatient, on-demand society. The cultural anthropologist Margaret Mead captured the challenge in a 1940s National Research Council report, “The Problem of Changing Food Habits”: “To devise . . . a system of education, communication, and change which will link the daily habits of the people to the insight of the laboratory, and at the same time contribute to the development of a culture which produces individuals who are generally better adjusted as well as specifically better fed, is a task which requires a recognition of the total cultural equilibrium.”

In Huntington, change began not in individual homes but in public spaces: schools, churches, food stores, the mayor’s office. Eating better is on Huntington’s mind in a way it wasn’t 10 years ago. That’s progress.

Twitter: @jane_black

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