Anyone on a diet reads the back of the package looking for calories per serving. But underneath the calorie count, you’ll find a list of nutrients (phosphorus, vitamin D, magnesium) and the % Daily Value of each. This percentage is based on the Recommended Daily Allowance (RDA), aka the Minimum Daily Requirement. The terms are confusing.

While Weight Watchers and Jenny Craig won’t show us their data (company executives argued to the Federal Trade Commission that disclosing effectiveness data would discourage Americans from dieting), university researchers have published theirs. In the controlled studies that have followed dieting participants for 2 years—most studies last only 6 months because they’re less expensive to complete and the results look better—the average weight loss is a mere 2 pounds (http://www.ncbi.nlm.nih.gov/pubmed/18377114).

Even if you’ve never put yourself on a diet, you’ve probably spent time with someone who has, and it’s no damn fun. In fact, it’s incredibly stressful. You’re taking an official, often fee-paying step toward what you believe is a better silhouette, and perhaps even better health. What’s so stressful?

Before I go on in future blogs to discuss our misguided societal obsession with obesity, I want to turn my attention to the overlooked problem of being underweight. While extreme obesity is clearly a health risk, the thinnest among us may be at higher risk of early death as well.

If you’re reading this, you made it. On New Year’s day, underage drinking-related ER visits were more than 300% higher than on an average day in the last year. New Year’s is far more dangerous than July 4th (about 75% more ER visits than average) or Memorial Day (about 25% more).

How do we define a successful diet? It’s all in the eye of the beholder, and in this case, the beholder’s era. According to the epidemiologist Traci Mann, for more than half a century, we have used the Metropolitan Life Ideal Weight Table, an actuarial exercise in insurance prediction, to standardize our measurements and categorize Americans as small, medium, or large- framed.

We excel at obesity.  Americans lead the world, collecting pounds like heavy Olympic medals hung from our necks during the national anthem. The US obesity prevalence has doubled in the past thirty years. There is a long list of partial explanations that add up. We have a ridiculously successful fast food industry. There’s a powerful corn lobby pushing high-calorie syrupy sweeteners. Our dinner plates are large and our portions fill them (the all-you-can-eat phenomenon). Our food selection is fat-laden. We are sedentary and the low (internationally-speaking) price of gas keeps us car-bound. The population decline in cigarette smoking has led to weight gain (even good news brings bad news!) We are amateurs at self-control.

We like to think of our health behaviors—I will go to the gym five times this week, I will quit smoking next week—as independent actions, subject to our will. Indeed, THEVISUALMD.COM divides Wellness into 9 Rules and presents them as if each rule stands alone. But the domains of Wellness interact. Our behaviors are inter-dependent, for better and for worse. The body is a masterpiece of equilibrium, of action and reaction.

Over the next year, TheVisualMD will produce the 9 Visual Rules of Wellness, a beautiful and accurate display of imaging and scientific writing that will show how our behaviors—eating, sleeping, smoking, drinking, exercising—drive and damage our bodies and health. As a physician and researcher interested in behavioral medicine, I will blogging about patients and topics across these 9 Rules. Let me begin my first entry with some questions about a name.