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Let's Ask Marion: Are We Getting Bigger, Or Is The Obesity Epidemic A Big Myth?
Submitted by KAT on Fri, 01/25/2008 - 11:25pm.
(With a click of her mouse, EatingLiberally’s kat corners Dr. Marion Nestle, NYU professor of nutrition and author of Food Politics and What to Eat:)
Kat: Tuesday's New York Times had a piece about the fat acceptance movement and some of its more voluble proponents, who are blogging away in the "fatosphere" about America's obsession with obesity. They challenge many commonly held assumptions about fat and encourage those who are overweight to stop castigating themselves and come to terms with the fact that people come in all shapes and sizes, and dieting and exercise may just be an exercise in futility for some folks.
It seems reasonable to me that someone who's overweight but active could well be healthier than a person who's skinny but sedentary. And there's no disputing the fact that our culture's veneration of thinness is tiresome and tyrannical. But, as the Times noted, many of the bloggers dismiss the obesity epidemic as just "hysteria," and an excuse to vilify fat people.
Meanwhile, manufacturers are recalibrating everything from infant car seats to amusement park rides to accommodate Americans' ever widening girth. It seems pretty clear that there's more to more of us than there used to be. What do you say to people who insist that that the obesity epidemic is a myth?
Dr. Nestle: I tread very carefully in these waters. Obesity is one topic for which the difference between populations and individuals really matters. It is one thing to talk about an obesity epidemic in a population, and quite another to talk about an individual who happens to be overweight. This difference is especially acute if that individual is someone who has been battling excess pounds for decades, knows everything there is to know about diets and dieting, and is fed up to here with having to confront overt discrimination and rude personal comments on a daily basis.
So let's start with populations. Across the entire population of the United States and most other countries in the world, body weights are going up and are higher on average than they were 25 years ago. They have increased or are increasing among populations of all ages, social groups, and classes. That's why we have larger clothing sizes, hospital beds, movie theater seats, and coffins. Populations that are overweight are at higher risk for several chronic diseases, and populations that are most overweight have even higher risks.
Now let's talk about individuals. A person who is overweight has a higher risk for, say, type 2 diabetes, but not everyone who is overweight will develop this condition. An overweight person who is physically active and eats a healthier diet is less likely to develop symptoms of type 2 diabetes than a person of the same level of overweight who is sedentary and eats a lot of junk food. But these are individuals and we are talking about risk. Both overweight people may develop type 2 diabetes or neither may develop it. Both are at higher risk than a person who is not overweight, especially if that person is physically active and eats healthfully.
The chance of getting type 2 diabetes is small, but it increases with increasing bodyweight, sedentary behavior, and poor diets. So I say the obesity epidemic is real for populations, but for individuals it depends on who they are and what they do. Eating healthfully and being active are good things to do at any weight. I think we should treat individuals as individuals, respect personal differences and personal choices, and do everything we can to change the food environment. Right now, the food environment encourages everyone to overeat. Let's do what we can to change the food environment so it is easier for everyone to be active and make more healthful food choices. How's that for a concept?
What a wonderfully reasonable, refreshingly measured perspective on a very contentious topic!
Only people who refuse to see reality can deny an obesity epidemic. And obesity doesn't just happen like, say, a broken ankle when you fall wrong. Yes, popular media boosts unrealistic body shape expectations, but that doesn't explain the expansion of people's waistlines. Rather than promoting obesity acceptance, we'd be better off promoting healthy eating habits and turning off the TV with its steady diet of ads for unhealthy food interrupted by "entertainment" featuring skinny women. Make no mistake; fat people aren't the only ones who pay for obesity-related disease. We're all paying for it through rising insurance rates and government health plans to address the demands of obesity-related diseases.
Janet - you aren't taking into account an increasing population (there are more people in the world now than there were 20 or 30 years ago), or the fact that a lot of that population is aging (and we gain weight as we age, and then lose as we get even older). You also aren't taking into account that the BMI (which is a total bust as far as being able to tell if someone is healthy or not) had its standards for overweight and obese lowered 10 years ago, which made millions of people overweight and obese overnight without gaining a pound. You aren't taking into consideration that correlation is NOT causation. Just because SOME fat people get diseases does NOT mean the disease is CAUSED by their fat. Thin people get the same diseases as fat people but they aren't told their thinness caused it, only the fat are vilified for being unhealthy, because the myth that "fat is a choice" is perpetuated by people who are making a ton of money off keeping us striving to meet an unattainable goal. The fat people (those headless fat people who don't fit in chairs and are assumed to weigh over 300 or 400 lbs) that are shown as emphasis of how OMG FAT the country is getting, are probably less than 2% of ALL the obese people in the country. There are a lot of fat people who are healthy, but really, is it any of your business if they aren't healthy? Is it any of your business if those thin people aren't healthy? And you can't use the excuse that fat people are driving up the health care costs for everyone. What is driving up the health care costs are all those HMOs and insurance plans who demand that doctors run test after test after test to PROVE that a patient needs a particular type of care, instead of relying on the doctor's knowledge. HMOs and insurance companies aren't in business to help us cover health costs, they're in business to make money and they could care less about your health or mine or anyone else's. Keep buying into the obesity epidemic hysteria. If you're a naturally thin person, you will never have to worry about being denied care, nor will you have to worry about getting fat. But if you're a naturally fat person, you'll be bombarded, day after day after day, with the supposed facts that your fat is going to kill you, you are ugly, you are stupid, you have no willpower, and if you would just try hard enough and starve yourself long enough, and spend 5 hours a day exercising, you can get and stay thin for the rest of your life. Sorry, that one size fits all solution doesn't work. Been there done that. I'll stay fat, healthy, and happy, thank you very much.
And you can't use the excuse that fat people are driving up the health care costs for everyone. What is driving up the health care costs are all those HMOs and insurance plans who demand that doctors run test after test after test to PROVE that a patient needs a particular type of care, instead of relying on the doctor's knowledge.
Obesity issues are certainly one of the things driving up healthcare costs. That isn't to say it is the only thing but to deny it is ridiculous. The bigger issue is that Americans simply a lot of garbage and too much of it.
Stupid lawsuits are also driving up costs but thats a different post.
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