I hate to admit it, but I was wrong.
Back in April of 2010 I wrote a blog entitled “Life, Liberty, and the Pursuit of Fatness” discussing the fat acceptance movement. I questioned its motives, pointed the finger at what I thought were its unreasonable claims, and flat out refused to believe that being fat could be healthy. You see, like most people who have grown up in the “fat is bad” era, when I heard news reports claiming we are drowning in a nationwide obesity crisis (talk about a loaded expression), I jumped on the lifeboat.
It took a good amount of critical research, reading between the lines, and turning a deaf ear to the popular media fat-bashing machine before I would be willing accept the possibility that all my nutritional indoctrination might be wrong. But wrong I was.
A lot of current claims about the obesity crisis are based on misinformation. In 2002, Richard Carmona, the former surgeon general described obesity as “the terror within, a threat that is every bit as real to America as the weapons of mass destruction.” And how could it not be when the Center for Disease Control reported that more than 400,000 Americans die from being overweight or obese? This shocking statistic became the headline for thousands of popular media articles and pumped millions of dollars into scientific research aimed at curing obesity.
But in 2005, an updated report from the CDC acknowledged that the previous analysis suffered from computation errors and reduced the estimate fifteen-fold, taking the 400,000 deaths down to 26,000. Further separating “overweight” and “obese” individuals from “extremely obese” individuals (BMI over 35) decreases the number even more, as most deaths are clustered in the BMI over 35 category. When “overweight” individuals (BMI 25-30) are compared to “normal” weight individuals (BMI 18.5-24) an even more interesting statistic surfaces. Overweight individuals actually live longer than normal weight people.
Research from a Canadian national health survey following more than 11,000 adults looked at the relationship between BMI and longevity. Compared to people who fell into the normal-weight category:
– Those classified as underweight were 73% MORE likely to die
– Those classified as extremely obese were 36% MORE likely to die
– Those classified as obese had about the SAME risk of death
– Those classified as overweight were 17% LESS likely to die
Eric Oliver, a political scientist at the University of Chicago says the obesity epidemic is really “a relatively small group of scientists and doctors, many directly funded by the weight loss industry, (who) have created an arbitrary and unscientific definition of overweight and obesity. They have inflated claims and distorted statistics on the consequences of our growing weights, and they have largely ignored the complicated health realities associated with being fat.”
“So what?” you may be thinking. “Just because people are living longer doesn’t mean they are living healthier lives. Everyone knows fat people are unhealthy.”
While weight is a causal factor in a couple diseases, say osteoarthritis or sleep apnea, there isn’t much evidence that excess body fat itself causes disease. Instead other variables might be at play. For example, most overweight individuals report weight cycling at some point during their lives. A single weight cycle, think a failed crash diet, has been shown to damage blood vessels and increase the risk for cardiovascular disease. Rat studies indicate that obese rats that have weight cycled have very high blood pressures compared to rats that have maintained a consistent weight.
Additionally, there is a weak association among obesity and hypertension in cultures where dieting is uncommon. Could the “cure” for hypertension actually be the “cause?”
Research also finds that overweight people report feeling more stress and anxiety, both of which are a risk factor for diabetes and cardiovascular disease. In countries where there is less stigma attached to weight, overweight individuals are not prone to the same diseases associated with obesity in the United States. Additionally, when researchers looked at a group of more than 170,000 U.S. adults, they found the differences between actual weight and perceived ideal weight was a better indicator of mental and physical health than BMI. In other words, feeling fat has a stronger implication for health than being fat.
Research indicates that activity level, combined with other lifestyle choices like sleep and social habits, are more related to health than body fat percentage. For example, one study found that obese men classified as “fit” based on a treadmill test have similar death rates as lean men classified as “fit.” The obese fit men actually had death rates one-half those of the lean but unfit men.
What about type 2 diabetes? This disease, characterized by a reduced sensitivity to insulin, is much more common among obese individuals, and thus, obesity is often blamed for its emergence. But is it possible that insulin resistance causes obesity? In this classic which came first scenario, research suggests that high levels of insulin appear before weight gain in future diabetics. This finding is consistent with the “thrifty genotype” theory, which views insulin resistance as a helpful adaptation for storing more fat during times of famine. Because fat cells do not develop insulin resistance as readily as other cells, they allow glucose and nutrients to enter, promoting excess fat storage and weight gain. The added weight gain further increases insulin resistance and the cycle continues. So is weight loss the answer?
I’ll give you a second to guess what my answer is going to be (cue the Jeopardy music).
What is a resounding NO!?! A review of controlled weight loss studies for type 2 diabetes shows that initial improvements were short-lived, and study participants returned to their starting values within eighteen months, even when they maintained their weight loss. In another study, women who underwent liposuction resulting in an average loss of twenty pounds of body fat did not show improvements in insulin sensitivity. What have been shown to improve diabetes time and time again are changes in nutrition and increased activity, even without any resulting weight loss.
What’s most unfortunate about our culture’s association between body size and health is that it paves the way for fat bashing, prejudice, and discrimination. We demonize fat, and as a result, view the people carrying it around as vessels for evil. In our quest to cure obesity, we ostracize a segment of the population. We confer them with labels like lazy, sick, bad, stupid, and unhealthy. We spend so much time trying to rid the world of “fatties” that we lose sight of what is really important: health. If we could refocus our attention on finding health at any and every size, and let go of the notion that only “average” or “normal” weight people can be healthy we could start to see actual improvements in blood pressure, cholesterol, diabetes, and a slew of other conditions previously linked primarily with weight.
In the end, by focusing so much on weight, we are preventing people from finding what every weight-loss venture promises to deliver: a long, happy, and healthy life.
Note: For further reading please check out the book Health and Every Size by Linda Bacon or refer to her blog at www.healthateverysizeblog.wordpress.com. Another great resource that promotes health and every size is thefatnutritionist.com. If you would like more information on the research I am referencing please comment or send me a message.
6 comments
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April 12, 2012 at 7:53 pm
Angela Elain Gambrel
I still do not believe you can be obese and healthy. I agree extremes are dangerous either way, but the few studies you cite are not statistically significant to convince me to throw out decades of health research and studies.
April 12, 2012 at 9:27 pm
danapod
This blog post doesn’t quite get at the heart of the isssue (more to come later on that), but essentially what I really want to convey is that fat in and of itself is not unhealthy. It is the unhealthy habits (poor food choices, not enough exercise, etc) that are bad. Both fat and thin people alike make these unhealthy choices, and thus, according to pretty much everything I’ve read, both are equally at risk for things like heart disease, high choleterol, and other typically weight related illnesses. Extremem obesity is unhealthy in that it is very unlikley for someone to become extremely obese without these unhealthy habits, but most overweight/fat people should not be lumped in the with the extremely obese. I urge you to check out the book The Obesity Myth by Paul Campos. It goes into a lot of the research (much more than I can talk about in one blog post) behind obesity.
Some people are genetically determined to be fatter, even with healthy habits, and I hate to see them face discimination because of the size of their body. Additionally, what are most damaging are the endless cycles of weight loss and gain that people try to go on in attempt to get thin. They not only cause physical damage to the body they also set the body’s natural weight set point above where it used to be, that is, weight cycling makes you fatter. When dieting has been shown time and time again to fail, the best thing people can do is ditch the one-size-fits-all mentality for body shape, love who they are, and learn to trust their body’s hunger signals. Usually this will result in people finding their set weight point, even though for many people that healthy set weight point still leaves them fat.
Thanks for your commment!
April 15, 2012 at 12:14 am
nicole marie story
I absolutely agree that Fat, in and of itself, is not the culprit to un-health. There is so much more. I am curious – why are you having these change in thoughts? Because you are pregnant? Or because you’ve simply grown in your Fat thought jurisdiction. Note: I’ve enjoyed a few glorious glasses of wine with my family, so I want my comment to reflect as happily and smartly as possible – and please accept my apologies if it doesn’t. But I really see a shift in your thought process, and I’m wanting to know of why that exists. If that’s to personal for you to share, then please, do not. And if I’ve missed an explanation, then please, just tell me to go away and read better. But I’m very intrigued!!! 😀
April 15, 2012 at 6:47 pm
danapod
You’re right in that there has been a slight shift in my thought process, although it’s not quite as great as it might reflect in my blog. I’ve always been very big on social justice issues. Inequality/prejudice/discrimination for any reason have always been distasteful to me. I’ve read a lot about discrimination towards various groups, including fat people, but I always thought fat people were different from other groups in that they somehow chose to be fat, or at least made poor health decisions.
I picked up a couple book a few months back that look at the research behind obesity. I’ve alwasy been willing to change my viewpoint when presented with new information…a true scientist at heart I like to think, and what I read and discovered from reading those books altered my perspective on being fat. My biggest take-away message I got was this: being fat in and of itself (except in extreme forms) is not unhealthy. Poor eating and exercise habits are unhealthy, but both thin and fat people alike have those. You can’t make assumptions about a person’s diet and lifestyle by weight alone. Pointing to a person who is fat and assuming they must make poor health choices does a disservice to that person. I also learned a lot about the changing standards for beauty throughout the decades, the politics surrounding the food we consume, the dieting industry and how it benefits from failure, the detriments of weight cycling, the biology behind why we as people are geared toward fatness and how our bodies actively try to prevent weight loss. I learned too much new information that I could no longer make a blanket statement that fat is bad. It’s a complex issue, one I hope to delve into further in future blog posts.
So while I still believe following a healthy, moderate diet is important and exercise is great; I can no longer say that weight loss is the solution to becoming healthy nor that fat is the evil I once it thought it was. We obscure the real issue (health) by putting all of our focus on weight, and while doing so we create a society that is prejudice toward fat people.
I’m alwasy learning though, so I don’t claim to know all the answers or to even be 100% right. I am just going off what the best possible evidence indicates; my beliefs are malliable and subject to change should new and better information presents itself. 🙂
Dana
April 15, 2012 at 12:18 am
nicole marie story
* too 🙂
May 26, 2012 at 4:54 pm
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