8.7: A DIFFERENT VIEW- Obesity - a manifestation of fat-phobia and a distraction from the real issues!

The other side of this debate maintains that the dangers of increased size (or increased fatness) have been greatly exaggerated.

Scientists and activists on this side of the debate make several arguments: that estimates of the negative health impacts of increased size are flawed, and health benefits to larger size are ignored. They point to evidence that it is possible to be fat and fit (or thin and unfit). They suggest that a widespread cultural prejudice against fat people has influenced the research and the reporting on this issue. Some of them say that the influence of the diet industry on research has introduced bias (although personally, I'm not convinced by that argument -- I think the sugar and dairy industries have at least as much influence on research as the diet industry does).

Among the arguments that obesity skeptics make are:

• In the same period that average weight in the US has increased, deaths from heart disease and stroke have decreased and life expectancy has grown.
• In a major study by the CDC on life expectancy, people in the "overweight" category had a LONGER life expectancy than people in the "normal" weight category. People in the "underweight" category were at as much risk for early death as people in the "morbidly obese" category.
• While people who are overweight are at greater risk for diabetes and high blood pressure, they are at lower risk for osteoporosis and some other conditions. (Oesteoporosis is a far less deadly disease, it should be noted.) In addition, obese people diagnosed with Type 2 diabetes tend to live longer than "normal weight" or "underweight" people with the same disease (the "obesity paradox").
• The true risk factors for diabetes and high blood pressure - sedentary lifestyle, poor nutrition, stress, lack of sleep - are associated with obesity too. But it's not the fat that causes the problem, it's the behaviors associated with fat. A fat person who gets regular exercise, good nutrition and manages stress has a similar health profile to a thin person who does these things.
• By stigmatizing fat, we make fat people's health worse. Some studies show that it makes people sick. Depression occurs at higher rates in fat children- is that caused by the fat, or by the way society treats fat people?
• Anti-fat bias is rampant in the medical establishment. Many people postpone a visit to the doctor, for example, because they don't want to get on the scale or get criticized by their doctor. Some studies have shown that many doctors say that they dislike treating fat patients - and this could affect the quality of patient care.
• Weight loss and weight cycling (going up and down in weight) have health risks of their own. Most fat people have experienced weight cycling, which puts a strain on the cardiovascular system.
• Most people who lose weight regain it within 2 years. Food and exercise are not the only things that affect weight - our metabolism (how we burn energy) plays a major role, and the body naturally shifts metabolism to use less energy when less food is available, for example, when dieting.This makes it very difficult to maintain weight loss over the long run.
• Interventions for obese (fat) people that do not focus on weight loss, but instead focus on improving overall health, have better and more long-lasting results than interventions that focus on weight loss. A focus on weight is not necessary for an improvement in health. In addition, a large study recently showed that increasing physical activity improves the health of fat people more than weight loss does.
• Many obesity skeptics agree that extreme obesity (say, a BMI over 45) can carry significant health risks. They do not deny ALL risks of obesity. Yet the vast majority of obese people are in the BMI 30-40 range, and the health risks of that level of obesity are questioned.

Lindo Bacon, a respected nutritionist and scientist who taught many years at CCSF has been a leader in making the scientific case for another approach to size. Lindo calls their approach (and book) Health At Every Size. Their article "Weight Science" was influential in unlinking weight and health -- while the connections between health and physical activity, good nutrition, sleep, and stress are all supported by their research. . (Optional -- if you want to read it -- Weight Science: Evaluating the Evidence for a Paradigm Shift (click here) (or you can access the article as a PDF too)

I have summarized "Weight Science" in a slide show, below - OPTIONAL. If you click on "WeightScienceSlides.PDF" you can view the slides in the Lesson, or download them to view on your own.

Download Weight Science.pdf

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