The Obesity Myth
Oct. 6th, 2007 05:11 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
moominmuppetSome stuff I've read and watched in the past week:
The Obesity Myth is a great intro to the major problems with how fat is handled in American medicine. It's nowhere near long enough to get into the nitty-gritty as much as I would've liked, but that's also one of its strengths; at just over 200 pages, it's a good framework for starting to understand further critique on various points. Although he does go off on a few random tangents (Clinton/Lewinski), the book starts out covering the science of fat (and exactly how little evidence there is that fat itself, as opposed to other factors such as activity level and the effects of yo-yo dieting, really has major health effects), and then segues into the manner in which the current medicalization of our fear of fat gives a somehow respectable patina to the ridiculous discrimination and flat-out nastiness that fat people encounter every day (do you know that there are now companies that are refusing to hire the overweight? That wasn't in the book, but it's something that pisses me off no end). I ended up ordering two copies to buy (used, since it's sadly out-of-print), just so I have an extra to lend out. I'd recommend picking up a copy if you're tired of well-meaning but pushy family members trying to throw you at every fad diet that comes down the line. Hell, give a copy to your doctor next time they hassle you (better yet, get a different doctor). As I told my mom when I was reading it (it was great discussion material), I have a long-standing policy of absolutely refusing to feed the diet industry, or let them make their money off my back. It's deeply political for me, even aside from the general uselessness of those approaches. There's plenty I can do to improve my health. I need to quit smoking, and I should be more physically active. I'm not going to argue either of those points. There's abundant data to back them both up. But sending our society on a misguided and flatly useless wild goose chase about fat poundage, rather than focusing on those issues, is absolutely counterproductive. It leads to approaches to weight loss that don't improve health, even in the few cases in which people actually manage to keep the weight off (a miniscule proportion), and it discourages people from getting more healthy, because they feel if they're not seeing a weight drop, they can't be getting the positive effects (despite the research saying exactly the opposite). Caloric restriction is not the way to go. Diet pills and other dangerous approaches are even worse. Yes, various body types come with some increase in health risks for some illnesses. I'm more likely to have bad knees. I'm less likely to have osteoporosis or lung disorders or the most dangerous forms of breast cancer (he talks a lot about diabetes -- the results there are much cloudier than you've been lead to believe -- again, activity level and a healthy diet make the big difference, regardless of body size). Artificially changing our bodies is rarely the way to handle these varied risks, any more than trying to change someone's height or race is going to be the successful way to deal with risks that correlate to those factors. Campos makes very good arguments that a) the data is not what we've been told (definition of an obesity expert for most of our govermental panels that put out these scare messages? Someone who runs a weight-loss clinic), b) artificially trying to make a fat person into a thin person probably won't have the effects we're looking for, even if it's possible, and c) we simply don't know how to do that. Not unless 95% failure rates and steadily increasing rates of both dieting and extremely high weight are signs that we've got a plan. Recommended reading. Highly recommended.
The Obesity Myth is a great intro to the major problems with how fat is handled in American medicine. It's nowhere near long enough to get into the nitty-gritty as much as I would've liked, but that's also one of its strengths; at just over 200 pages, it's a good framework for starting to understand further critique on various points. Although he does go off on a few random tangents (Clinton/Lewinski), the book starts out covering the science of fat (and exactly how little evidence there is that fat itself, as opposed to other factors such as activity level and the effects of yo-yo dieting, really has major health effects), and then segues into the manner in which the current medicalization of our fear of fat gives a somehow respectable patina to the ridiculous discrimination and flat-out nastiness that fat people encounter every day (do you know that there are now companies that are refusing to hire the overweight? That wasn't in the book, but it's something that pisses me off no end). I ended up ordering two copies to buy (used, since it's sadly out-of-print), just so I have an extra to lend out. I'd recommend picking up a copy if you're tired of well-meaning but pushy family members trying to throw you at every fad diet that comes down the line. Hell, give a copy to your doctor next time they hassle you (better yet, get a different doctor). As I told my mom when I was reading it (it was great discussion material), I have a long-standing policy of absolutely refusing to feed the diet industry, or let them make their money off my back. It's deeply political for me, even aside from the general uselessness of those approaches. There's plenty I can do to improve my health. I need to quit smoking, and I should be more physically active. I'm not going to argue either of those points. There's abundant data to back them both up. But sending our society on a misguided and flatly useless wild goose chase about fat poundage, rather than focusing on those issues, is absolutely counterproductive. It leads to approaches to weight loss that don't improve health, even in the few cases in which people actually manage to keep the weight off (a miniscule proportion), and it discourages people from getting more healthy, because they feel if they're not seeing a weight drop, they can't be getting the positive effects (despite the research saying exactly the opposite). Caloric restriction is not the way to go. Diet pills and other dangerous approaches are even worse. Yes, various body types come with some increase in health risks for some illnesses. I'm more likely to have bad knees. I'm less likely to have osteoporosis or lung disorders or the most dangerous forms of breast cancer (he talks a lot about diabetes -- the results there are much cloudier than you've been lead to believe -- again, activity level and a healthy diet make the big difference, regardless of body size). Artificially changing our bodies is rarely the way to handle these varied risks, any more than trying to change someone's height or race is going to be the successful way to deal with risks that correlate to those factors. Campos makes very good arguments that a) the data is not what we've been told (definition of an obesity expert for most of our govermental panels that put out these scare messages? Someone who runs a weight-loss clinic), b) artificially trying to make a fat person into a thin person probably won't have the effects we're looking for, even if it's possible, and c) we simply don't know how to do that. Not unless 95% failure rates and steadily increasing rates of both dieting and extremely high weight are signs that we've got a plan. Recommended reading. Highly recommended.
![[identity profile]](https://www.dreamwidth.org/img/silk/identity/openid.png){kind=small}
thanks for the notes here
Date: 2007-10-06 11:17 pm (UTC)I didn't realize that you smoke. I do also. I'd also like to be able to not. Something, I picked up when I was in my early twenties and trying not to be anorexic/bulemic. I don't usually have much it feels useful to say on the fat rants because my experiences are so odd, it's hard to find good placement for them in the general posts. I have pretty strong opinions about dieting, not just money, but long term health.
More lately, I think about age as much as weight and just the way there's still pressure to to see value in a certain way. Also, what things are providing the force behind the pressure. And then that leads to other general thoughts about pressure, mostly towards women because those are the ones I feel.
Re: thanks for the notes here
Date: 2007-10-07 08:45 am (UTC)I don't, but I'll go take a look as soon as I finish this comment. I was talking to my mom during my trip to CA about why I'm so torn about whether to follow my initial goal of getting a nursing degree so I can eventually work in women's health care in the clinics. I have such a love/hate relationship with medicine (my ideals vs how its practiced here) that I'm not sure I can manage to stomach getting through the system to get where I want in order to provide the kind of care I want to provide.
I have pretty strong opinions about dieting, not just money, but long term health.
*nod* Definitely. A lot of why I refuse to give them my money is because I think they're selling me something that's fundamentally unhealthy (and the research seems to back that up) under the pretense of "helping me get healthy".
More lately, I think about age as much as weight and just the way there's still pressure to to see value in a certain way. Also, what things are providing the force behind the pressure. And then that leads to other general thoughts about pressure, mostly towards women because those are the ones I feel.
*nod* Create a system that gets us wasting all our energy obsessing about our bodies, whether in terms of unrealistic appearance goals for weight or for age, really helps with keeping us from putting that energy where it's actually going to do us some good, and change the world around us. I think it's perfectly insidious.