A Round of APPLAUSE

I am just plain going to copy the whole gorgeous article from the NYT:

Our Absurd Fear of Fat

By PAUL CAMPOS
Published: January 2, 2013 180 Comments

ACCORDING to the United States government, nearly 7 out of 10 American adults weigh too much. (In 2010, the Centers for Disease Control and Prevention categorized 74 percent of men and 65 percent of women as either overweight or obese.)

But a new meta-analysis of the relationship between weight and mortality risk, involving nearly three million subjects from more than a dozen countries, illustrates just how exaggerated and unscientific that claim is.

The meta-analysis, published this week in The Journal of the American Medical Association, reviewed data from nearly a hundred large epidemiological studies to determine the correlation between body mass and mortality risk. The results ought to stun anyone who assumes the definition of “normal” or “healthy” weight used by our public health authorities is actually supported by the medical literature.

The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals. If the government were to redefine normal weight as one that doesn’t increase the risk of death, then about 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead.

To put some flesh on these statistical bones, the study found a 6 percent decrease in mortality risk among people classified as overweight and a 5 percent decrease in people classified as Grade 1 obese, the lowest level (most of the obese fall in this category). This means that average-height women — 5 feet 4 inches — who weigh between 108 and 145 pounds have a higher mortality risk than average-height women who weigh between 146 and 203 pounds. For average-height men — 5 feet 10 inches — those who weigh between 129 and 174 pounds have a higher mortality risk than those who weigh between 175 and 243 pounds.

Now, if we were to employ the logic of our public health authorities, who treat any correlation between weight and increased mortality risk as a good reason to encourage people to try to modify their weight, we ought to be telling the 75 million American adults currently occupying the government’s “healthy weight” category to put on some pounds, so they can move into the lower risk, higher-weight categories.

In reality, of course, it would be nonsensical to tell so-called normal-weight people to try to become heavier to lower their mortality risk. Such advice would ignore the fact that tiny variations in relative risk in observational studies provide no scientific basis for concluding either that those variations are causally related to the variable in question or that this risk would change if the variable were altered.

This is because observational studies merely record statistical correlations: we don’t know to what extent, if any, the slight decrease in mortality risk observed among people defined as overweight or moderately obese is caused by higher weight or by other factors. Similarly, we don’t know whether the small increase in mortality risk observed among very obese people is caused by their weight or by any number of other factors, including lower socioeconomic status, dieting and the weight cycling that accompanies it, social discrimination and stigma, or stress.

In other words, there is no reason to believe that the trivial variations in mortality risk observed across an enormous weight range actually have anything to do with weight or that intentional weight gain or loss would affect that risk in a predictable way.

How did we get into this absurd situation? That is a long and complex story. Over the past century, Americans have become increasingly obsessed with the supposed desirability of thinness, as thinness has become both a marker for upper-class status and a reflection of beauty ideals that bring a kind of privilege.

In addition, baselessly categorizing at least 130 million Americans — and hundreds of millions in the rest of the world — as people in need of “treatment” for their “condition” serves the economic interests of, among others, the multibillion-dollar weight-loss industry and large pharmaceutical companies, which have invested a great deal of money in winning the good will of those who will determine the regulatory fate of the next generation of diet drugs.

Anyone familiar with history will not be surprised to learn that “facts” have been enlisted before to confirm the legitimacy of a cultural obsession and to advance the economic interests of those who profit from that obsession.

Don’t expect those who have made their careers on fomenting panic to understand that our current definition of “normal weight” makes absolutely no sense.

Paul Campos is a professor of law at the University of Colorado, Boulder, and the author of “The Obesity Myth: Why America’s Obsession With Weight Is Hazardous to Your Health.”

I’m also going to repost a very intelligent response from “Vincent:”

Argh. The study authors were clear about their conclusions, but this op-ed muddles the results for NYT readers.

Flegal: overweight people may have lower mortality because they get better medical care, because they show symptoms of disease earlier or because they’re screened more regularly for chronic diseases stemming from their weight, such as diabetes or heart problems. She also proposes that perhaps being thin doesn’t make you sick, but instead being sick can make you thin. In this study, people who lose weight because of diseases such as cancer contribute to earlier death among the ‘low BMI’ category.

It’s also worth mentioning that Flegal’s analysis includes WHO international reports – and it’s fairly intuitive that in developing nations, having a low BMI is often linked to chronic illnesses and STARVATION as well as higher mortality.

That being said – fat stigma is too pervasive and everyone should be accepted with judgment, fat or thin. Someone who eats well and exercises often will be healthy, regardless of how she looks. Have a thorough enough conversation with anyone who is obese and you’ll find that the myth of the obese as lazy and guilty for their weight is hollow. The prevalence of inexpensive high-calorie low-nutrient foods, the high cost and inaccessibility of produce, and family diet predict weight more than so-called willpower.

But we shouldn’t be so quick to accept specious arguments because they make us feel good.

He raises some good points. There are a great many issues bundled up in and crowded behind the NYT op-ed, but it’s still a remarkable moment, specifically because it has the weight of the NYT and JAMA behind it. Of course the media, bless their hearts, are going to goofily simplify the issue. It’s what they do, and all too often what they think we want them to do. Even the still-pretty-darn-good NYT.

But this is the beginning of a discussion that NEEDSNEEDSNEEDS to start happening precisely because there is so much bullying and abuse of fat people going on out there in the righteous name of science. Now, I am very pro-science, but like any other source of authority, it can be turned into a mighty shilliligh with which to batter the bejeebers out of someone. And it has, all too often. It is being used that way as I type, all over the country and to many, many individual humans.

There are a bunch of issues that get bundled up in discussions of obesity. There is aesthetics. There is economics. There is culture. There is medicine. There is taste. There is history. There is politics. There is feminism. There is religion. And I could go on gleefully making up fun combos of all these. It would be positively shakespearean. But this post is long enough for the moment. And offers some real reasons to rejoice and be glad. Which seems like enough for one day.

2 thoughts on “A Round of APPLAUSE

  1. Marcy Wieseman says:

    Happy First Year Anniversary! 

    ________________________________

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s