Weighting Around

Go here and read this: http://www.salon.com/2014/03/31/is_being_thin_more_deadly_than_being_obese/?utm_source=facebook&utm_medium=socialflow

Here’s the end of the article:

Here in the US, many of the same social problems that cause thinness are often also at the roots of being overweight. Obesity rates, for instance, are higher among low-income children.  And while being underweight is a significant health risk, obesity and its often-fatal effects are still affecting a far broader population. A 2013 study in the American Journal of Public Health found that obesity is a contributing factor in nearly one in five deaths among black and white Americans.  The study’s lead author said at the time that “We expect that obesity will be responsible for an increasing share of deaths in the United States, and perhaps even lead to declines in U.S. life expectancy.” In 2008, obesity-related medical costs in the US were $147 billion. 

In plenty of places in the world, it’s hunger, not abundance, that’s the gravest threat. The BMI is a pretty crappy indicator of overall wellness anyway.  But in the quest to improve public health, the consequences of obesity don’t need to be minimized to make a point about the dangers of being underfed. Just because we’re finally making some small inroads in the quest to stave off the health problems that come with obesity it doesn’t automatically follow that we’re setting ourselves up for a whole new raft of thinness-related ones. It’s just about evening the scales – not tipping them.

Poor article. It can’t quite decide what to make of its argument. But it does get points for noting that the same factors that cause obesity can be factors in underweight-ity (interesting that there isn’t a common-parlance term for that, isn’t it?).

I am all for feeding children healthier foods than we have. We definitely need to deal with the urban food-desert issue. I believe that there are levels of obesity that are, just on the basis of structural (by which I mean skeletal) facts, are damaging, tough to deal with, and mighty uncomfortable. I feel better, much, when I’m exercising regularly (and, according to the NYT, walking is very good for thinking generally, and writerly thinking in particular). But I also believe that statistics and our obsession with them are problematic. Like BMI, statistics are tools for reading trends–and like BMI are often used to read trends they don’t actually apply to. Being fat doesn’t kill you any more than being skinny does. Being poor, having access to crappy (if any) medical care, never moving your body, smoking, drug/alcohol addiction, genetic factors, and being malnourished kill you, whether you’re too fat or too thin. These studies, even interesting ones, even the meta-studies that tabulate and examine bunches of other studies, switch sides too often to be intellectually reliable. Often they represent the best tools we have for looking at things, which is fine, except when the scientists involved forget the contexts and/or whole pictures. And the human factor–study-schmuddy, humans remain tremendously complex units, whose complexities often render statistical studies almost meaningless on the individual level. Everyone knows someone who smoked and drank his/her way through a long, long life. And skinny/healthy people get heart disease and cancer, too. 

I got to thinking about this sort of stuff while listening to Harry Shearer last night when driving to the airport to pick my husband up from his Great Haggis Hunt (also known as The 15th c. Conference in Aberdeen). Shearer was doing his bit with lists of this and that marker of national standards. He has kind of a thing for tracking how far we’ve fallen in this or that category–for how much we are not “The Greatest Country” in the world. It’s tonic–I do think we suffer considerably from the crippling effects of jingoistic insistence on believing we’re The Greatest rather than putting our collective shoulders to the wheel and making our schools better, our medical system both more humane and more competent, our infrastructure safer and stronger…you know the list. But those things are also just more number-crunching. Sure, the Scandanavian countries and Switzerland all run better. Duh. They’re smaller, less economically divided (for all that they have plenty of hugely wealthy people), and have populaces that understand the role of taxation in the universal good. We’re huge, messy, and full of folks who haven’t caught up to 19th century scientific advances and think taxation is The Root of All Evil. We’re still mired in the Puritanism that formed us and the racism that we can’t seem to get beyond. Our 50 years of Glory after WWII were an historical fluke that was really, as many have noted (and as I will keep noting until it sinks in) only Glory for folks with middle-class or better incomes, most of whom were white and male. We had a kind of Florentine Renaissance period of scientific and artistic zinginess. It was very cool. But the wheel of history turns and turns and empires go splat. Somehow or other, folks mostly keep on keeping on, some stuff gets done that should, some stuff that needs work languishes un-worked-on, but the country keeps going. Look, for crying out loud, at Italy. Even in its glory days (the Renaissance, roughly speaking), it was a mess of warring city states who were still depending on Roman aqueducts to get water into their cities (still are, in some cases, for that matter). It’s an entire nation that has never, to my knowledge, had a competent government. So, while I find Shearer’s Roll of Shame on Us worthwhile in some ways, and admit that some of the stuff it tracks is important, it seems to me that he’s ultimately just doing the same thing with statistics that the medical profession does–mistaking numbers for reality, and focusing way too much energy on simplistic analyses of complex situations. Which tends to lead to vague thinking and grumpiness. Of which I am often as guilty as the next person. 

Meanwhile, back to actual fat-matters: I was doing really well with Victoza. My insurer (for reasons that anyone who’s read more than 3 of these blogs can supply for him/herself) forced me to shift to either Byetta (twice a day rather than once–which I’m a little too ditzy to track) or Bydureon (once a week, much bigger needle, slightly complicated and messy mix-it-yourself process). I went with the Bydureon and have found it thoroughly loathsome to deal with. So I’ve filed a request to be allowed back on Victoza which involves my doc applying for “prior authorization.” My understanding is that these things are generally refused. But fingers crossed. If it doesn’t work, the next step is writing the insurance commissioner, which here in tiny Delaware, is reputed to sometimes be effective. It’d be lovely if my bloody insurer were more concerned with my health than with whether they’ve cut a deal with Novo Nordisk (makers of Victoza) or Astra Zeneca (makers of the two others, and located–I suspect not coincidentally–here in DE). Another noble moment for for-profit medical insurance. I’ll keep you posted. 

Speaking of Delaware, here’s a fine, fat, fluffy chicken:

round chicken

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