A slim chance for understanding

[pjthompson]

You think political discussions are touchy? Try talking about the issue of obesity. There are firebrands on either side of the fat/thin divide who turn into blowtorches at the drop of a donut.

The issue, however, is far more complicated than the zealots would have you believe. That doesn't preclude some politicians from trying to make obesity political. Some legislators are even trying to make it illegal for restaurants to serve fat people, but the cost/benefit ratio of ending obesity is, like obesity itself, a far more complicated issue. Turns out, it may cost more in the long run to keep large folks alive.

I recommend reading the entire Slate article referenced above for it's sane and balanced approach to the subject. I particularly appreciated this, which appears near the end of the article:

But these estimates are more than meaningless—they actually make the problem worse. A second study, published in the American Journal of Public Health on Jan. 30, looked at the relationship between body image and health. The authors compared people of similar age, gender, education level, and rates of diabetes and hypertension, and examined how often they reported feeling under the weather over a 30-day period. It turned out that body image had a much bigger impact on their health than body size. In other words, two equally obese women would have very different health outcomes, depending on how they felt about their bodies. Likewise, two women with similar insecurities would have more similar health outcomes, even if one were fat and the other thin.

These results suggest that the stigma associated with being obese—feeling fat—is a major contributor to obesity-related disease and ill health. This would account for the strong association between body-mass index and depression (especially among women), and the high rates of morbidity and mortality that ensue. Sure enough, racial and cultural subgroups with more moderate attitudes toward obesity seem to experience more moderate health effects. Overweight and obese African-Americans, for example, are much less vulnerable to weight-related illness—even among women who are 5 feet 5 inches and 250 pounds.

I'd also recommend this article for a nuanced analysis of just exactly what makes people fat. Yes, environment, especially the privileged environment of the last twenty years—but it's about 77 percent hereditary as to whether you will be predisposed towards being a thin person or a fat person. Predisposed. That doesn't mean someone with bad genes can't maintain a healthy lifestyle, that they are completely helpless when it comes to gaining weight, but it does mean they're going to have to be constantly vigilant. And as the author of this article points out, thin people need to put away their holier than thou attitudes towards fat people. Turns out they have almost as little to do with their thin waistlines as obese people have to do with theirs.

Comments

[sartorias.livejournal.com]

So very true. I realized when my daughter, at five, had larger wrists than I do that she was likely to be built along the maternal family lines on her dad's side. When she hit puberty and gained thirty pounds in about six months (eating and exercising exactly as she had all along) I knew.

i was very, very careful about making sure to hold off the skinny-side relatives, and to teach her about food choices and exercise. She has, at 26, a comfortable body image, though she's shorter than me by two inches and outweighs me by fifty pounds, and I've got the usual menopausal extra ten. But I note that she has NO trouble attracting guys, or hanging out with her girlfriends of whatever size, or all the other young people things. She just shrugs all the media-hype off.

She did have one girlfriend who would nitpick at her for her size--but this girl thought she herself was a rhino if her weight got an ounce over one hundred, and she was a little taller than me at five seven. My daughter felt sorry for her and her food issues--every meal was an angst-fest.

[pjthompson]

You did a marvelous job showing her it was not about how much she weighed but about who she was inside. And that makes all the difference, both in keeping a comfortable and healthy body size and the kind of self-image that allows her to persevere in a world that's, frankly, buggy nuts about the weight issue.

[sartorias.livejournal.com]

Here's another factoid--all those maternal relatives who were big people lived well into their nineties, except for one fellow who had a heart attack at sixty, but he was a five pack a day smoker.

[pjthompson]

Yep. Even at my last "healthy" weight--when my bp, cholesterol, sugars were all low and in the healthy range and when I was working out on a daily basis and eating all the right things--I was still over the insurance industry weight guidelines. And I also have had several "women of girth" in my family who lived into their nineties. It *is* lifestyle that's important, but like everything else concerning this issue, it's not a simplistic formula.

[sartorias.livejournal.com]

*nods*

[(Anonymous)]

Obesity is such a fuzzy concept - use body/mass index, and athletes with minimal fat come out as "obese". I also threw a hissy when a local gym insisted that women should aim for a fat level of less than 10% because that was what was appropriate for men. It makes the whole thing so confusing that many people simply don't know where they stand. My neighbour/oldest friend has a far higher fat level than I do (and is also UK size 18/20 to my size 14), but on every other measure (blood pressure, cholesterol etc) she is far fitter than I am. Everything really is more complicated, isn't it?

[pjthompson]

I agree, O Anonymous One. :-) The media loves to simplify everything ("sound bites"--haha) and unfortunately that tends to get filtered down to the way the populace thinks about things. And how we think about things seems to be the crucial factor in many of the issues concerning fat, health. And, well, everything I suppose.

[sollersuk.livejournal.com]

Anonymous One is me - lj arbitrarily decided to log me out and I didn't notice.

Here's an interesting thought garnered from the work on the bodies in the Spitalfields crypt: before the early 19th century women did not suffer from osteoporosis. Their bone density started lower than modern, but didn't take the nosedive between 40 and about 55 that modern women do - just a slow, gentle slope, so in their 70s and 80s they had higher bone densities than modern women in their 50s. We couldn't come to a conclusion on why this was. One possibility was that they were obese - but that doesn't seem to have happened at an early enough age. My suggestion (and nobody has disproved it so far) was that the change happened at the date when women stopped drinking small beer for breakfast.

*opens another bottle of beer*

[pjthompson]

I like that theory! ::will uncork one myself when I get home from work::

But seriously, it probably is something just as basic as that, some habit they had in the old days that we don't. Not all of them were injurious to one's health.

[windsong5.livejournal.com]

Wow. I think that's interesting how people feel about their body is what really steers them towards disease. It's amazing how much power our minds have.
I like the part about being predisposed. We can't, and shouldn't, blame our genes for everything. The time comes when we must be responsible for ourselves.
An intersting study about thin people. You don't have to be "fat" to be obese. There are some slender people out there that have more fat than muscle, it just gets deposited deeper in. Around their internal organs.
To discriminate someone because of their weight is wrong. Especially if it really is a case of mind over matter.

[pjthompson]

We can't, and shouldn't, blame our genes for everything. The time comes when we must be responsible for ourselves.

I completely agree with this. Even if we've been victimized by something, a time comes when you have to lay that aside and be responsible for your own life.

To discriminate someone because of their weight is wrong. Especially if it really is a case of mind over matter.

I don't think obesity is a question of mind over matter. How one treats it, views it, lives with it definitely is, but we have to recognize the physical part of the equation. We can't escape it completely, but we can learn to work around it.

[safewrite.livejournal.com]

As a woman whose parents sent me to dance class as a pre-teen so that I would, "be able to be elegant about my size" I think you post was appropos. There was a study, cited here, that states that there is a direct link between size and earning power. I lost a number of sizes and saw my own income rise.

FWIW I am a low-carb dieter. I went from a size 24 to an 18 (in six months!) and have stayed slimmer for five years. Studies that say Atkins and South Beach do not work are not giving us the whole picture: I was and am at high risk for adult onset diabetes. A low carb lifestyle has buffered me against that risk. Diet and exercise work and I have a healthy body image. According to a recent survey of 2,000 guys for GLAMOUR magazine, 22% of men find a queen-sized woman to be the sexiest.

[pjthompson]

that states that there is a direct link between size and earning power. I lost a number of sizes and saw my own income rise.

I've seen it happen in my own life, too.

FWIW I am a low-carb dieter.

I'm a South Beach girl. I lost 35 pounds last year, though I backslid a bit over the holidays. Not too bad, but I'm on my way down again. I think being conscious of good carb/bad carb is a good survival skill. I'm also at high risk for adult diabetes--and it was a (thankfully) false positive on a diabetes test that finally got me to take responsibility for myself.

Diet and exercise work and I have a healthy body image.

They absolutely do. And when I do those things, I find the entire world changes around me. ;-) Seriously, my improved body image ripples outward from me and I receive much more positive responses from others as a result.

[jmeadows.livejournal.com]

Wight issues... *sigh* I cannot stand it when people make judgments on others based on their weight. And it goes both ways, too.

I had a friend in high school with an underactive thyroid. She ate next to nothing and worked out, but could not lose weight. It was completely a health issue. (Thankfully people didn't talk about her, because she was way too nice and everyone loved her. I'd have had to murder people in their sleep if they said things.)

I, on the other hand, ate anything within sight, and people asked if I was anorexic or bulimic. :S (Er, no. Just physically active and I got my mom's genes.)

My sister takes after my dad. She's a curvy girl and watches what she eats, but man, let me tell you. If she and I go out together, people are checking *her* out. She's confident about her shape and size, and it *shows*.

The media sucks with trying to put opinions in our heads about what is an acceptable size. *sporks them*

[pjthompson]

It absolutely swings both ways and there's plenty of prejudice to go around, unfortunately. We can't take credit *or* blame for our DNA, it's just the way things are. Then again, like you said, I think the media has a lot to do with the kinds of body image issues that are out there. They reinforce a number of negative stereotypes.

[kmkibble75.livejournal.com]

That's really interesting. I wouldn't have guessed it, but with someone else saying it, it makes perfect sense.

I have a friend who's about 6 foot three and weighs well over three hundred pounds. He smokes, drinks, and eats three course breakfasts at a diner at 3 a.m. when we hang out. The kicker is that the bastard has lower cholesterol and better blood pressure than I do (6-3, 175 lbs.).

Now that I mentioned that, I think my blood pressure just went up. ;-)

[pjthompson]

Now that I mentioned that, I think my blood pressure just went up. ;-)

lol--I can relate to that. But seriously, and I sincerely hope this isn't the case, it could still catch up to your friend down the line and in some other way. Or not. It's a complex mix of factors and no one can say for sure, but the likelihood is, for most of us, that those kinds of weights/eating habits don't do us any favors in the long run.

[kmkibble75.livejournal.com]

No, I'd imagine they don't. He's thrown his back out quite a few times, actually, so I guess that's where it comes back to bite him.

[pjthompson]

And diabetes is always a concern for "people of girth." I hope none of that happens!

[handworn.livejournal.com]

That doesn't make much sense. If people were "programmed" to be fat, past generations would have showed that. Instead, overall, we've all gotten much fatter in about a generation. Cheap, processed food and cheap sugar, in particular, are quite significant factors. But is a lack of willpower in the face of all this "bounty" any prettier for genetic influence?

Just in general, I'm somewhat skeptical of arguments that amount to "people can't help it." Seems to me that it often means "people don't want to help it and we should make them feel good about that."

[pjthompson]

Actually, Matt, I think the point is that if people had access to the kinds of bad food we've had plus the lack of manual labor that is characteristic of much of modern America, the obesity rates would have been much higher in the past. I think the fact that so many of us no longer work in factories or in the field has as much to do with it as anything.

But you go ahead and reduce the argument to whatever makes you feel superior.

[handworn.livejournal.com]

I'm not trying to feel superior. I've had some seriously bad food habits and exercise habits, myself, and have spent my life about twenty pounds overweight, at least. I've just never been tempted to use genes as an excuse.

There's a tendency in modern life to set making people feel good about themselves as the primary goal. When it comes to things like skin color or sexuality, that's fine. That's a positive good. But about things that actually can change, like culture or habits or beliefs, it becomes an agent of the status quo, a catering to people's natural tendency toward inertia and against self-improvement.

It's a matter of which position you approach this from. I don't deny that genes play a role in weight. But this only describes the differing degrees of challenge people face. A person who once was fat but became thin gets enormous respect from me, way more than those with a naturally high metabolism who have never had to struggle with it, just like someone like Barack Obama or John Edwards who built themselves up from poverty gets way more respect from me than someone born into wealth. I don't think trying to take away people's challenges does them any favors.