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.
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Date: 2007-10-07 12:41 am (UTC)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.
THANK YOU! totally agreed. I just found out that a friend of mine who has a serious body dysphoria problem got a lap-band yesterday. (He's 5'9'', 230lbs!) I was really upset about this, and some of my buds didn't understand my reaction, which lead to me feeling really isolated. I needed to hear some positive words!
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Date: 2007-10-07 08:38 am (UTC)One of the things that pisses me off on an almost daily basis at work is having to listen to our hold messages at the clinic, which are often pimping expensive procedures at the bariatric institute and the plastic surgery department (gotta make those sales! health care institution? what?) Listening to that shit couched in terms that implicitly base them on the trust people have in the institution as a famous hospital system that wouldn't possibly recommend unhealthy things just makes me want to start ranting every single time. Friday it was all about why women might want boob jobs. *graar*