In other words, rather than Jews denying their alcoholism, the alcoholism movement is practicing massive denial of social factors in alcoholism. We commonly read reviews of the literature which declare that research findings with regard to social differences run exactly counter to standard wisdom in the field. Thus, "The stereotype of the typical 'hidden' female alcoholic as a middle-aged suburban housewife does not bear scrutiny. The highest rates of problem drinking are found among younger, lower-class women ... who are single, divorced, or separated" (Lex, 1985:96-97). Unemployed and unmarried women are far more likely to be alcoholics or heavy drinkers (Ferrence, 1980). Why are such findings regularly denied? In part, middle-class women (like Betty Ford) are eagerly sought as alcoholism patients because of their ability to pay for therapy and because their prognosis is so much better than that for lower-SES or derelict women.

Perhaps also in America this denial comes from a pervasive ideology that minimizes class distinctions. It is seen as an additional and unwarranted burden to the oppressed to announce that low-SES women are far more likely to be obese (Goldblatt et al., 1965), that low-SES men are far more likely to have a drinking problem (Cahalan and Room, 1974), and that the greater likelihood for lower-SES people to smoke has become increasingly pronounced as more middle-class smokers quit (Marsh, 1984). In general, social class is correlated with people's ability and/or willingness to accept and act upon healthful recommendations. The health belief model finds that health behaviors depend on the person's sense of self-efficacy, the value the person places on health, and the person's belief that particular behaviors really make a difference to health outcomes (Lau et al., 1986).

The alternative to discussing such issues in terms of values is usually to ascribe addiction, alcoholism, and obesity to biological heritage. But what are the consequences of believing, as Vaillant (1983) claimed (with so little evidence), that low-SES people are more often alcoholic because their parents' alcoholism has propelled them downward economically and socially, and that they harbor a biological inheritance likely to perpetuate this trend? What should we make of the high incidence of alcoholism, drug addiction, cigarette smoking, and obesity among black Americans? Should we believe they have inherited these tendencies, either separately or as one global addiction factor? This thinking offers little chance for improving the lot of those who suffer the worst consequences of addiction.

In addition to less secure values toward health, lower socioeconomic status seems to be associated with the failure to develop effective strategies for managing consumption. The best illustration of this is the presence of high abstinence and abuse levels in the very same groups. For example, in the United States, the higher a person's SES, the more likely a person is both to drink at all and to drink without problems (Cahalan and Room, 1974). Low SES and minority racial status make people both more likely to abstain and more likely to require treatment for alcoholism (Amor et al., 1978). It is as though, in the absence of a confident way of drinking, people strive to avoid alcohol problems by not drinking at all. This strategy is highly unstable, however, because it depends mainly an the person's ability to remain outside drinking or drug-using groups throughout his or her lifetime.

It seems often that the secrets of healthful behavior are limited to those who already possess them. Many middle- and upper-middle-class people appear to gain this knowledge as a birthright, even when they endorse disease theories of alcoholism. Despite Vaillant's (1983) emphasis on the uncontrollable nature of alcohol abuse, an illustration accompanying the Time magazine piece on Vaillant's book showed the Valliant family taking wine with a meal. The caption read: "Wine is part of the meal an special occasions for the Vaillants and Anne, 16, and Henry, 17. 'We should teach children to make intelligent drinking decisions'" ("New Insights into Alcoholism," 1983:64). In his book, Vaillant (1983:106) advised that "individuals with many alcoholic relatives should be ... doubly careful to learn safe drinking habits," although he nowhere discussed how this is to be done.

When I observe public health officials, academicians, and the largely managerial class of people I know, I find almost none smokes, most dedicate themselves to physical fitness and exercise, and hardly any have time for drinking or taking drugs in a way that leads to unconsciousness. I haven't attended a party in years where I have seen anyone get drunk. I am perplexed when these same people make public health recommendations or analyze addictions in a way that removes the locus of control for addictive behavior from the individual and places it in the substance - as when they concentrate on preventing people ever from taking drugs, treat alcoholism and comparable behaviors as diseases, and explain overweight as an inherited trait - all exactly opposite to the approach that works in their own lives. This anomaly marks the triumph of the very values and beliefs that have regularly been shown to lead to addiction; it is a stunning case of bad values chasing out good.

The explanation for this perverse triumph starts with the success of a majority of people with the worst substance abuse problems in converting the majority population to their point of view. For example, Vaillant (1983) explained how several alcoholics educated him about alcoholism, thereby reversing the point of view he previously held (Vaillant, 1977) and placing him in conflict with most of his own data. This triumph of bad values is due also to the dominance of the medical model in treatment for psychological problems in the U.S. - and especially the economic benefits of this model of treatment, residual superstitions about drugs and the tendency to convert these superstitions into scientific models of addiction (Peele, 1985), and a pervasive sense of loss of control that has developed in this country about halting drug abuse.

Do Human Beings Regulate Their Eating Behavior and Weight?

The idea that people regulate their consumption in line with personal and social values is perhaps most disputed in both popular and scientific circles in the case of obesity. People we know all the time strive but fail to achieve a desired weight. Strong evidence has been presented and widely publicized that weight and obesity are genetically determined. If this is the case, then the attempt to restrain eating to achieve a healthy, but biologically inappropriate, weight is doomed and is likely to lead to eating disorders like bulimia and anorexia that are rampant among young women. This view of the futility of conscious restraint of eating has been most emphatically presented by Polivy and Herman (1983).

Yet there are also strong commonsensical indications that weight is closely associated with social-class, group, and individual values: after all, the beautiful people one watches in movies, television, and performing music seem very much thinner (and better looking) than average. In this section, I examine the idea that weight and eating behavior are under cultural and individual control by tracing the work of three prominent researchers and their followers: (1) psychiatrist Albert Stunkard, who established that weight is greatly influenced by social group and yet who has sought to prove that weight is a biological inheritance; (2) social psychologist Stanley Schachter (and several of his students), who have striven to show through experimental research that eating behavior is irrational and biologically determined; and (3) physical anthropologist Stanley Garn, who depicts human weight levels as largely malleable and adaptable to social standards.