From a puff piece on the fat acceptance movement in the NYT last week:

Heavier Americans are pushing back now with newfound vigor in the policy debate, lobbying legislators and trying to move public opinion to recognize their point of view: that thin does not necessarily equal fit, and that people can be healthy at any size…. “I get so angry when I feel people pushing a weight-loss agenda,” said Linda Bacon, a nutrition professor at City College of San Francisco and author of “Health at Every Size,” a book published last year whose title has become the rallying cry of the fat pride community. “What we’re doing in public health care policy is harmful. We give a direct and clear message that there’s something wrong with being fat.”

And in today’s NYT:

While Congress searches for ways to slow the growth of health care spending, a new study suggests that its efforts may be overwhelmed by the surging prevalence of obesity. The report, to be issued Tuesday, projects that if current trends continue 103 million American adults will be considered obese by 2018. That would be 43 percent of adults, compared to 31 percent in 2008, according to the research by Kenneth E. Thorpe of Emory University, an authority on the cost of treating chronic disease.

Mr. Thorpe concluded that the prevalence of obesity is growing faster than that of any other public health condition in the country’s history. Health care costs related to obesity—which is associated with conditions like hypertension and diabetes—would total $344 billion in 2018, or more than one in five dollars spent on health care, if the trends continue. If the obesity rate were held to its current level, the country would save nearly $200 billion a year by 2018, according to the study.

Mr. Thorpe said in an interview that the health care bills in Congress limit their attack on obesity to a few community-centered pilot programs with insufficient funding. Congress has steered clear of measures that might have a more direct impact, like taxing sugary sodas and fat-laden snacks.

72 replies on “Health at Every Size”

  1. You know what, maybe it’s just me but I see many many more skinny old people than I do fat old people. When was the last time you seen someone over 85 years old who was really fat? Now compare that with someone over 85 who was slender.

  5. @1 Actually, when I think about the size progression of family members, it seems like they were all heavier in their 50’s and 60’s than they were in their 70’s and 80’s. I always chalked it up to the fact that old people shrink.

  7. A modest proposal: mandate that it is illegal for insurance companies to fully cover treatments for chronic diseases that affect over x% of the population. Force insurers to charge significant copays for Statins and high blood pressure meds. Stop forcing the rest of us to pay for what is more or less a routine living expense by virtue of living in a country where health coverage is provided through nearly unregulated local monopolies.

  9. I’m gonna start a “Slob Pride” movement. Sure there are advantages to bathing and cleaning up. Yes there are disease links to having a house filled with rotting garbage. But people die every day in clean homes. In fact, a pile of dirty towels on the floor may save your life if you slip and fall in the bathroom!

    Think of all the water saved by all those missed showers and laundry days. And it will help fight overpopulation because filthy people with terrible B.O. probably won’t get laid.

  11. Another modest proposal: Stop the federal corn subsidies that have created a glut of corn products in our food supply. (Hello corn syrup!) Use the money to support small farms, instead. Lots of small farms = greater food security, better quality food and less dependency of fossil fuel for production.

    Less corn = less obesity = lower costs for health care.

    See Michael Pollan’s Ominvore’s Dilemma for details.

  12. Health used to be measured by some basic standards: Being able to do a modest number of push-ups or sit-ups, touching your toes, being able to jog on a track or treadmill for 10 minutes without being heavily winded. Nothing crazy, just basic fitness. If you aren’t fit enough to do 5 push-ups, are you really healthy? If you can’t touch (or see) your toes, is that health? I’m all for adjusting our standards when necessary, but…

  15. Maybe if our government would stop the BS propaganda in favor of low-fat, high-carb diets, people would have a chance to drop some of those excess pounds. Worked for me and a few dozen people I know. They don’t have to tax anything sugary, just get the truth out there.

  16. I’m going to laugh till I cry when these “fat acceptance” gastropods start dropping dead from coronaries or are forced to get their legs amputated.

  17. @15 yeah, its the governments fault. Maybe they should have a campaign that says “Stop eating so much unhealthy shit you fat fucks”. Would that make you happy?

  18. The NYT article ends with a comment from Ms. Bacon saying “We’re all in this life raft together.” Do you think that a life raft filled with people is really a good image for a plus size person to bring up? Let’s take this life raft metaphor a step further. If I’m in a life raft with a bunch of people am I going to let one person chow down a bunch of those rations? No, everyone’s going to get the same amount of food to eat. If someone’s eating 2x a much as the next person they use up the supplies and if one person’s too big the whole thing will get unbalanced and we could all go down! Let Ms. Bacon eat what I do in the same amounts for a few years (and exercise as much as I do). I’ll bet we’re pretty much the same size at the end of that time…

  19. I feel so confused by exactly what their goal is, some of it I kind of understand although completely disagree with e.g. forcing airlines to install loveseats to offer them at no additional cost but others are kind of like WTF?

    The negative health effects of being obese are well-known, scientifically proven and even very logical in nature. A few of them are kind of abstract like cancer but most of them are kind of like, uh, duh, of course weighing 300 pounds is bad for your knees.

    Except for some circumstances like airplanes I really don’t care if they eat a vat of macaroni soup every night but to act like being fat isn’t inherently unhealthy and that society doesn’t have good reasons to discourage it is so staggeringly delusional that it hurts my head to think about it.

    Here is a fattie making Macaroni Salad:
    http://www.youtube.com/watch?v=u4zw99Vso…

  20. uh… there is something wrong with being fat. We should be sending that message. It’s unhealthy, just like smoking and health care penalizes people for being smokers.

  21. Clearly, you folks need to buy my mega-dose fish oil supplement. You can have 30 orgasms a day and lose weight too. Oh, and buy my book.

  23. If you have a decent diet, get at least the suggested minimum of exercise, and your doctor feels that you’re doing an adequate job of maintaining your health, but are still not particularly thin, then that should be okay. I don’t think we should judge people who put in the effort to be healthy, because it can be long process for some people and we should encourage the right behaviors.

    The problem is that these “fat acceptance” folks find fault with the very idea of pushing and strongly encouraging people to pursue healthy behaviors. That is wrong. You can be reasonably healthy without being skinny, but only up to a point.

  24. So people are getting upset that health care reform is including some tough measures to actually include public health according to the best epidemiological data we have… but no one seems to be up in arms over the fact that the House bill would require providers to cover Christian Scientist prayer “treatment” as a legitimate medical expense.

    Freedom of Calories is the new Freedom of Religion. Somebody get in there and revise the Constitution.

  25. The fat shaming in these comments is pathetic. NOT BEING THIN DOESN’T MEAN YOU’RE OBESE. How big are you guys? Do you fit the aesthetic standards of the multi billion dollar diet industry?

    I used to live with a girl who was stick thin. Ate candy and ramen and smoked pot all day. People called her beautiful, said she should be a model, men fell over her. I also am part of a triathlon team. I compete with people who do not fit the skinny mold in the slightest, and they kick my 105lb ass. Their size prompts “fat,” “ugly,” and “gross.”

    Just like the first article says, being skinny should not be our goal, being HEALTHY should be. But we don’t give a shit about that, and neither do the commenters in this thread – it’s about fitting a standard of beauty, not being appropriately healthy.

  26. @23,

    It depends on who they are, but most don’t have a problem with encouraging people to exercise and eat reasonably well. What they have a problem with is pushing crash diets (which the government does promote. 1200 calories/day is what the government recommends, and that definitely qualifies.) and losing weight at all costs.

    What most of the judgmental fucks here, including Dan most of all, don’t know or pretend not to know is that any fat person has been struggling with their weight all their life. The advice that the government and the medical establishment give out does more harm than good. Most people don’t have the discipline, time, or resources to be thin, but they may be able to make small changes for the better. It’s called harm reduction, and all you assholes (especially you, DAN) who insult teh fattiez for not being fuckable are part of the problem.

  28. 26, the government recommendations are as follows

    2500 calories a day for men

    2000 calories a day for women (2,500 in third trimester of pregnancy)

    1800 calories a day for children aged 5-10

  29. 28, the problem is many people will take in 2000 calories in a single meal without even realizing it because most people don’t put much thought into what they are eating.

  31. @17, the government actively contributes to the lies being told re: carbohydrates being the solution, cutting fat being the cure. I believed the lie for a long fucking time and struggled with my weight as a result. I ate less than my skinny friends and worked my ass off with exercise and couldn’t lose weight because I thought I was doing it right, the way they recommended.

    Got the truth, lost the weight. The implication that “fat” people are just lazy is wrong and unfair. A lot of them don’t know what the hell else to do because they follow the guidelines they’ve been told to trust and it still doesn’t work. I eat more now and don’t have to exercise as hard to maintain because I don’t believe the BS anymore.

    It may not be the solution for everyone, but it worked for me and a lot of people that I know, so I’m sure it can help many others. Jumping to the conclusion that fat people = lazy fuckers who do nothing for their health is not really going to help.

    And you wouldn’t laugh if it was someone you loved. It’s a lifelong struggle for many good people, and it’s not for lack of trying to “fix” it. Of course, you may not deign to love someone so imperfect, so perhaps you’ll never get it.

  32. @ 25 and 26 I don’t think anyone is saying to have to be stick thin to be healthy, of course moderately “overweight” people can be very fit and healthy. But obese is a different thing. We shouldn’t be telling people it’s ok to be 50 lbs overweight, it’s just not. My dad and all of his brothers have diabetes now, they’re all fat too. I see that and it helps me choose to exercise and choose healthier food. I’ve seen enough of what fat people eat, if “struggling with your weight” includes struggling with the big mac you just ordered – give me a break. Come back when you made some attempt to walk 20 minutes a day and eat a little bit healthy. You can still be fat and do that, but you really can’t get THAT fat.

  34. I’ve always considered obesity a self-inflicted condition, you know, barring that infinitesimal percentage of fatties that have a gland problem and make actual efforts to be healthy. But I don;t get the feeling that Mrs. Bacon is advocating for them so much as trying to assure herself.

  38. as a stick thin high school kid that suddenly ballooned out to over 220 in his late 20’s I can say, you may be proud of being fat, but you’re sure as fuck not comfortable.

    trying to tackle the san francisco hills with an extra 60 pounds was not fun. oh and the sweat… christ the sweat.

    I’m a lazy bastard, and don’t like rigorous excercise, so i took the slow path and just walked around for at least 2 hours a day. On my work lunch break and after work. took me the better part of a year but i lost it.

    i can tell you which of the two states i enjoyed being better. This isn’t a Hollywood beauty versus reality thing, this is just plain reality. Nature didn’t evolve fat humans, we invented them.

  39. Of course one reason this sort of story is coming up right now is because the Insurance Industry is fighting a last-ditch effort in the Senate to kill health care reform. The argument that costs will spiral out of control because all the fat fat fatties refuse to stop eating is one of many talking points that are being played up by those who wish to kill any sort of universal coverage. Because Americans have shown themselves to be willing to demonize the overweight, the “personal responsibility” angle here is likely to find some traction.

    It doesn’t mean that there is no substance to it — Americans are as a group far more likely to have weight problems and other health problems associated with poor diet and limited physical activity. But it is certainly no coincidence that articles like this that blame increasing health care costs on unattractive people are hitting the pages of the NYT today.

  41. 38, Losing weight slowly is the way to do it if you want to keep it off. People who lose weight too quickly almost always gain it back. One problem is so many people give up on improved exercise and dietary habits when they haven’t lost 20 pounds in 2 weeks. People should aim to lose about 4-6 pounds a month until they reach their goal. Good for you for sticking with it.

  43. 39, I’m against rationing health care to obese people. A better solution is to tax unhealthy foods, and apply those funds to caring for obese people.

  44. @28: Those government recomendations, though, are for maintaining a healthy weight if you are already physically active on a regular basis and of average height and body type. You have to realize that for the average person, who doesn’t get all that much exercise, 1800 calories is MORE than enough. I don’t think people realize just how little food is necessary to sustain a healthy life. I believe very few people choose to actually eat that little and those that do generally just do so by habit and not out of conscious decision.

    Obviously the solution to getting healthier is more exercise and quality food in moderated proportions, but not everyone lives a life that allows that. For desk jockies, the standard 2000 calories is actually too much.

  45. Obese means a BMI of greater than 30. No one is healthy if they are obese. This is coming from someone who topped out at a BMI of 32 and has lost 40lbs this year because it was starting to effect my health.

  46. We could just let insurance companies charge people according to their risk. Obese people would pay more in proportion to their higher costs.

    Or we could demand that everyone pay the same, create a massive new entitlement that allows many more people to get their health care on somebody else’s dime, and paper over the perverse incentives in such a system with a few entirely symbolic, ineffective public service campaigns that waste a few more tax dollars.

    At least the rise in obesity will give progressives a useful excuse when Obamacare explodes the budget: “It was the fat people that did it.”

  47. All this business about some kind of diabolical food making people fat is an out an out crock. All that matters is energy balance. Calories in versus calories out. Nothing magical happens in your body. It’s all governed by the laws of thermodynamics.

    Wanna lose weight? Eat less. Exercise more. Or both. Don’t want to do either? I could care less – just STFU, make peace with your fat, and don’t expect the rest of us to give any credence to your claims that the sky is green and the grass is blue when the subject of the health effects of obesity come up.

    Thanks.

  48. I’m not particularly skinny or thin, but I exercise vigorously three hours a week and I’ve stopped buying junk food. I’ve lost five pounds in four months. My BMI is 22.0 and I feel great.

    Exercise also helps fight depression. For me, it’s less about demonizing fat people and more about the benefits of eating well and exercising- which lead to being a healthy weight.

  50. Nobody here has argued that obesity is the same thing as “not being thin.” Yes, some people are healthy with a little extra padding, some are healthy with a six-pack, etc etc. Nobody, however, is healthy if they’re full-blown obese. Acknowledging that isn’t “anti-fat;” it’s just realistic. The health effects of obesity are real whether it hurts anyone’s feelings or not.

    Take smoking, for instance. My belief that smoking causes lung cancer isn’t based on a hatred of smokers. It’s based on the fact that there is a traceable and statistically significant link between smoking and the occurrence of lung cancer. No matter how awesome and wonderful my smoking friends are, that isn’t going to become untrue.

    Advertising agencies may be guilty of being unfairly biased against larger people; the medical community, however, is not. It’s their responsibility to report facts as they discover them. When they find evidence that obesity leads to diabetes, or heart disease, or skeletomuscular problems, they can’t just bury their heads in the sand because the fat acceptance movement won’t like those facts. It’s the fat acceptance movement’s job, rather, to adjust their worldview to accommodate facts. Maybe focus on the idea that there’s nothing wrong with being large and HEALTHY (when that’s the case) rather than trying to insist that there’s no such thing as large and unhealthy. The latter is dishonest and irresponsible.

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