Round and Round and Round

This is an important article not just because of its content, but also because of its publication on Slate.com, which is generally regarded as reliable (they still seem to have journalistic standards), and widely read:

http://www.slate.com/articles/health_and_science/medical_examiner/2015/03/diets_do_not_work_the_thin_evidence_that_losing_weight_makes_you_healthier.html?wpsrc=nymag#

The author, Harriet Brown, has a book out called

Body of Truth: How Science, History, and Culture Drive Our Obsession with Weight–and What We Can Do about It

which I have just ordered. I thought about ordering copies for my endocrinologist and my regular doctor. They’re both, as I’ve said often, pretty good on the subject of my weight, though I do wonder now and again whether my standards are low. Well, no, I know my standards are low–I’ll follow any doctor anywhere who doesn’t start talking to me like I’m an idiot and begin every conversation with a stern lecture on my weight. But I have other evidence in both their cases that they actually see me as a human being, and, in spite of what I suspect is overwhelming cultural and academic (as in, med. school) pressures, do manage to respect my right to determine my relationship to my body.

Objectivity is a false–that is, un-achievable–standard in scientific research, since humans conduct research and there’s pretty much no such thing as a human without some sort of programming, predisposition, or agenda. But it is also the standard for all sorts of information gathering and formation for very good reasons. Hence the institution of the peer-review, though even that is not free of agendas and prejudices. And, given that weight has carried (and I use the verb fully aware of the bitter pun involved) so much stigma for so many thousands of years, I think it’s pretty much safe to say that very little of the research done on weight and health is anywhere near “clean.” Which invalidates pretty much all of it (I hadn’t known about the treatment in which parts of the hypothalamus were actually burned (like witches?) away in order to control the brain’s impulse to eat, though I do remember that there were fairly dire dental consequences to the whole wiring-the-jaw-shut treatment), and the extent to which it is still treated violently as a first-resort treatment is not-insubstantial evidence thereof. In every other area of medicine, other than cosmetic surgery, which doesn’t generally deal with organs, the first line treatment is not to either excise healthy tissue or feed poisons to the person. But in the treatment of obesity, bariatric surgery is the amputation of healthy organs. Weight loss drugs are invariably dangerous to the heart or the liver (though, to be fair, acetaminophen is also hell on the liver and we sell it over the counter…). Meth, which is a hugely effective weight loss drug, is flat-out fatal as well as being illegal.

So perhaps the whole basis of the treatment of obesity–that it is, in itself, a disease–needs to be scrapped. You know that truism about crazy consisting of doing the same thing over and over and expecting different results… Maybe the bariatric physicians of the world could find something more useful and less abusive (if also less renumerative) to do with their big brains, like actually finding out how the body, genetics, psychology, neurology, and food interact. Maybe all sorts of things would change. Maybe they’d find a cure for MRSA or cancer along the way. The whole subject is kind of like the Amazon Forest of medical research–no knowing what wonders lurk undiscovered there.

Meanwhile, there is mounting (peer-reviewed and carefully collected, not to mention the overwhelming anecdotal testimony) evidence that yelling at fat people only makes them more miserable and, often, fatter. So, while I do blame the mega-million dollar weight loss industry (check out the stats in the article on the increase in bariatric surgery–and I don’t even know whether they figure in that portion of the industry into the profit-numbers for the weight loss industry) for some of this, it’s clearly a chicken-and-egg question. And it’s time that a critical mass (yeah, another bitter pun) of people start trying to stop that wheel from turning. So I’m going to suggest that y’all invest in copies of the book, or print out the Slate article about it and take them to every doctor you see. They’re not going to stop pathologizing us until we start refusing to be pathologized. I realize that, yet again, this places the responsibility for ending bad practices/bad thinking on the victims of that bad thinking, but that seems to be the way of things. The folks who have been hurt are the ones who have to stand up. It sucks, but it is how change happens. I am not claiming fat people as an oppressed minority. Even if we are, we’re subject to such localized, in-plain-sight invisible, and cross-boundary prejudice that it’d be awfully hard to track, and therefore hard to organize around. Attempts so far have largely resulted in not much change, though I’d like to think that Health at Any Size is beginning to gain some traction.

Anyway, I’m going to post this and go take a walk because it’s pretty outside and I find the relative height of the path around the local reservoir (maybe the highest point in this lower-than-Kansas-flat state) oddly cheerful-making.

round_rock

2 thoughts on “Round and Round and Round

  1. Thanks for posting! Hadn’t seen this article. Hope you enjoyed your walk.

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