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.
@26: I am literally unable to get the meal planner on mypyramid.gov to recommend a 1200 calorie diet for a 24-year old woman, even by making her 2 feet tall, completely sedentary, overweight, and trying to move toward a healthier weight. The closest I could come was 1400 calories (seems to be an absolute lower floor) for a 4 foot tall overweight woman who’s trying to lose some pounds. At 5 feet tall, overweight and trying to fix that, it recommends 1800 calories. Meanwhile for me, as an overweight 24-year old 6’1″ male, it recommends 3000. Where are you getting your numbers?
@38: Good for you, but please bear in mind that if you weren’t fat as a kid or a teenager, you’re at a distinct advantage for taking and keeping the weight off. Those who get fat when their bodies are creating new fat cells (as opposed to just filling up the existing ones with fat) will struggle a lot more than you have in taking the weight off. They’ll lose the weight but still have those fat cells, and their bodies will want to fill ’em back up.
I only mention this because there’s a real tendency for those who’ve lost weight to be smug assholes about it. There’s usually more to the story than moral superiority.
46: When you take taxes, bills, and premiums into account, our health care system is one of the most expensive per capita on the planet, as it is right now (look it up). There is a long list of countries where nobody is denied health care, yet the cost per person is less. In other words, denying people health care (or rationing health care based on wealth) doesn’t save money. Just because you’re paying money through something called “premiums” or “bills” rather than something called “taxes” doesn’t mean that you’re magically not paying real money. You’re already paying for someone else’s health care. The difference is that, right now, you’re also paying for someone else’s corporate salary and heftier administrative costs.
That whole paragraph in my last post about “accommodating reality” in your beliefs? It doesn’t just apply to the fat acceptance movement. It applies to anti-health teabaggers also.
“We could just let insurance companies charge people according to their risk. Obese people would pay more in proportion to their higher costs.”
So, David, considering that women are responsible for 85% of the health-care costs in this country (and yes, that includes pregnancies), would you similarly espouse charging them higher rates?
@50 Really? Then why is Slog posting one article advocating being healthy at any size over “being thin” and then obesity statistics as the next? If they’re not calling people who don’t advocate thinness at obese, then why are they being placed side by side? What is the connection?
@45 BMI isn’t an accurate indicator of healthy size and that’s why doctors don’t use it – they use growth charts instead. Everyone has a different body size and what’s important is that they stay in a healthy range for THEIR SHAPE, not fit a skinny mold.
55: The first article is a fat acceptance person accusing the medical community of being anti-fat. The second is an article about the health care costs (which can serve as a measurement of health problems) caused by obesity. It’s pointing out the tendency of the fat acceptance movement to defend actual unhealthy obesity rather than defending the notion that being heavy is okay AS LONG AS YOU’RE HEALTHY. They’re forgetting the “healthy” part.
This does nothing to counter the actual belief that being heavy and healthy is okay.
@56 “It’s pointing out the tendency of the fat acceptance movement to defend actual unhealthy obesity rather than defending the notion that being heavy is okay AS LONG AS YOU’RE HEALTHY.”
What the fuck are you talking about?
“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….”
Right. They’re totally advocating unhealthy obesity.
From the wikipedia entry on “Health at Every Size”
http://en.wikipedia.org/wiki/Health_at_E…
“Health at Every Size (HAES) is an approach to health that focuses on intuitive eating and pleasurable physical activity rather than dieting and weight loss.
…
An increasing number of health professionals are adopting a HAES perspective[2]. HAES advocates generally do not believe that the same narrow weight range (or BMI range) is maximally healthy for every individual. Rather, the HAES approach is that as individuals include physical activity in their lives, and eat in response to physical cues rather than emotional cues, they will settle towards their own, personal ideal weights. These weights, however, can be higher or lower than those described by standard medical guidelines.”
Where are they forgetting the healthy part?
oh and btw, they’re not protesting medical professionals, they’re pushing back at public opinion and public health care policy. You know, the people who blame an inability to stop eating on being fat, that subsidizes HFCS, has an out of date food pyramid, pays billions of dollars to quick fix diets and pills, pays pennies for shitty fatty food in public schools, calls Jordan Sparks fat, etc.
Oh come on, Dan. Leave the fatties alone. Seriously, they don’t get enough of this bullshit on the schoolyard? Fat isn’t always a sign of poor health; I personally know fat people healthier than myself. The fact is that our culture brands fat people as somehow immoral, and for people who don’t have the fortune of being able to lose the weight, the discrimination, the foul looks, they’re not really fair, are they?
For example, the message in our culture is that you’re not just a target for mockery and self congratulatory judgmentalism if you don’t toe the waistline, you’re a bad person.
But there is no “Fat Agenda.” No group of people is going around trying to get people to eat at McD’s every day. There is no big Fat Conspiracy driving people’s waistlines outward.
There are bad people out there. People who think it’s okay to bomb abortion clinics and cut women’s health care. People who pray for the President’s death. Fat hate is just a big waste of time, as far as I’m concerned.
Some people should probably consider working to lose weight and everyone should try to be their best, but isn’t that their own fucking business?
Would you like to know what is causing obesity in america? It’s not laziness, lack of intelligence or self control on the part of those who are overweight.
Fact: by 6th grade, kids no longer have recess, or even a lunch period that takes place outside.
Fact: High schools require only one semester of gym class in the four years spent there.
Also speaking of schools, school lunches are not only packed with calories, but lunch periods last, at best, 20 minutes or so. Studies have shown that rushing meals leads to weight gain.
Kids are, further, under more pressure than ever before, academically speaking, often coming home with hours of homework a night.
Is it any fucking wonder people are overweight? If our KIDS don’t have time to go play outside, how the hell are most working adults going to manage it?
I swear to god I just don’t get it. I mean fat people look like s%@t. I don’t think that is hard to refute. Fat people should be ashamed of themselves period. It doesn’t take too much effort to look in the mirror and say you know what this weight is getting out of control. Maybe I should either stop eating so much or excersise. There is a guy I work with that wheezes whenever he talks because he’s so fat. I once bought him a bag of oversize marshmallows one day hoping he would choke on them. I wish it was okay to throw rotten tomatoes and cabbage at fat people.
I’m fat. I’m five feet and weigh 175 pounds. Whoa, unhealthy right? Wrong. My cholestrol level is normal, my hear rate is within healthy range and I show no sign of diabetes. Why? Because I’m healthy. I use a bike or walk everywhere, I do aikido twice a week. I do physical labor. I’m tired of people going on about the dangers of being overweight like it’s a threat to humanity.
Not everyone is supposed to look like a model and everyone comes in different sizes and shapes. I’m not in the mood to be lectured because I don’t look like I take care of myself. I do, a lot of this genetics too. Ever see a Samoan? How about them lithe Norwegians?
There is a british athletic (I forgot his name) who is morbidly obese at over 280 pounds but has a resting pulse of a runner and competes in triathalons. Not everyone you sneer at as fat is unhealthy. There are plenty of thin people suffering from health problems too.
Now excuse me while I go bicycle a mile to the store.
@59 Where are you getting your info?
At my high school lunch lasts 30 minutes, and you are required to take four half-year courses of health and fitness to graduate.
Three of those courses can be replaced by either participation in an official school sports team or in an outside activity approved by the H&F department.
But, yeah. The lunches do have an insane amount of calories
@31 You want a cookie because you lost weight? Here ya go..nomnomnomnom.
I was stick-thin growing up, but by the end of college i was borderline over-weight. When i tried to eat less, I gained weight. Then I learned how to LINDY-HOP and after a year of my social life revolving around fun that also happens to be great exercise, I lost ~23 pounds. GO FIGURE!
the problem with many of the posts on this site about this subject, especially from Dan, is the lack of knowledge. simplification of the problem results in your simplistic solutions and of course, the bonus of mocking the overweight.
obesity is connected with cash. bad food is cheaper. areas in the US have what are called “food deserts” which severely limit the abilities of low-income people to even purchase reasonably priced healthy foods. for these people, the hip urban market with overpriced organic vegetables is not around (if they could even afford it).
yes, it’s ironic that lack of access to food helps to cause obesity. check it out.
http://www.ers.usda.gov/Publications/AP/…
http://infillphiladelphia.org/food-acces…
don’t worry, you can go on and keep hating on the fat people after you finish reading.
Aside from the question of how much obesity has increased, the BMI is an utterly horrendous tool to be using with such alleged precision.
The problem with BMI is it WAS NEVER INTENDED TO BE USED ON INDIVIDUALS, and now it is. First, off, it was designed as a relative measure for means of sedentary populations. As in, people who get zero exercise, which is already an unhealthy state. Applying it to people who actually exercise(and are carrying extra pounds of muscle) has little value.
Secondly, the measure is fatally flawed in that it uses the square of height, while human beings are three dimensional. That means it allows short people to be proportionately much heavier than tall people. So if you’re five feet tall, you can be downright chubby before it says you’re overweight, and if you’re 6’4″ you have to be gaunt or you are considered obese(unless you have an exceptionally narrow frame). So what, I should stop playing sports so I can qualify for cheaper health insurance? What kind of perverse incentive is that?
@21- Nonsense. You just need to clench and relax your anal sphincter enough times a day and you’ll be fine.
As one of those rare chubby chicks who has an actual glandular issue, takes meds, whole ball of wax, I’ll tel you this. Dan is both right, & not right.
Dan is right: *usually* fat = unhealthy, or at the very least, obesity = unhealthy. We Americans are the most obese country going. It’s a massive problem. (It’s also clearly one of Dan’s phobias.)
Dan is wrong: it’s not *always* the case. Fat isn’t always unhealthy, nor is every fat person you see on their way to a Kentucky Fried Chicken.
There’s a whole slew of reasons Americans (or fat Americans) are fat, some of which are mentioned above by other posters. There’s the rare bunch of us w/ a medical issue. There’s our increasingly sedentary lifestyle. We fuel ourselves with increasingly processed/salty/fried foods. Unhealthy foods are cheaper & easier to access; we’re not encouraged either by most schools or most jobs to make time to take walks/get fit; & we’ve gotten lazy. Our favorite forms of entertainment involve going out somewhere & watching things; going out & eating; or staying in & doing both. We don’t get enough sleep. Most of us are stressed out & can’t afford our lifestyles. I’d be surprised as hell if at least one of these didn’t apply to most of us reading this, especially those of us w/ weight issues.
& if you’re in that slender majority (pun intended) for whom none of that is true, I’m not talking about you. Enjoy your healthy lifestyle.
I just got back from Belgium & Germany. Lotsa folks over there don’t have cars. They walk & bike everywhere. Anytime I went out, the distance was measured by how long it took to walk there.
I lost 20 pounds before going on my 2-week trip (sadly, much more to go). When in the home of so many delicious things, I relaxed & did a sweet backstroke up a river of Belgian chocolate, spaetzle, schnitzel & beer. I felt fat coming home & figured I’d gained about half of it back. No. I only gained three pounds. Because I walked everywhere.
So the new diet? It’s the shut yer fat mouth & move yer fat ass diet. & it’s working for me, I’m on the way back down. (Mind you, I’d already started a lot of other healthy habits, with the water, veggies, etc.) I throw a lot more walking into my day than I did before the trip overseas.
(Lastly, not trying to have the weight loss smug tone! Just trying to share what’s working so far. Burroughs said that being addicted to food was worse than drugs, because food you can’t just quit cold turkey.. I’m worried about backsliding, all the time. But you can change your habits.)
Hi Dan,
It’s your fat fanbase “weighing in” here.
You juxtapose these two ideas as though they are in conflict — Health at Every Size and Efforts to Improve the Health of the Population.
They are not.
(FYI – Linda Bacon, PhD, is not herself fat. I think if you interviewed her, Dan, you would see you have quite a bit in common in terms of long-term goals — it’s just how to get there that differs).
Health at Every Size doesn’t mean that everyone of every size is healthy. What it means is that pursuing health, rather than a particular size or weight, is a vastly better (more sustainable, more achievable, science-based) approach. Talk to any physician who is an expert in treating obese people, and they will tell you that long-term weight loss, even with medications (of which there are very few safe ones, and they would need to be taken forever, with their side effects, to work) and surgery rarely results in anything more than 20% of a person’s initial weight in the long term.
Eating better, eating fewer calories, being more active — these are things that most human beings in industrialized need to do to to maintain health long-term. It’s not “calories in, calories out” so much as a combination of a genome designed to survive hard physical labor and times of famine and plenty living in an environment where movement is limited and it’s “good n’ plenty” 24/7. Relying on willpower or self-restraint or internal motivation isn’t going to improve health — it’s going to take changes to our food and physical enviroment. I am all for these things, and I’m also all for a “Health at Every Size” approach — focusing on what people need in order to be healthy — so people who have the sky spitting on them 6 months out of the year but don’t have the money to join a gym (and who barely have money to eat — a “famine” and “plenty” cycle practically guaranteed to lead the body to store whatever it can get it’s fat cells on) can afford one, and that the food people can afford contains more essential nutrition and fewer empty calories.
We’re on the same side.
Talk to Linda Bacon.
it strikes me that PART of the problem here (one of many, lest i be accused of over-simplifying) is that the entertainment industry/media/cultural millieu whatever that holds up TOO thin as the only acceptible aesthetic, has over-sensitized people who do not look thin to any criticism the very real obesity epidemic in our country. As many have pointed out, being healthy does NOT mean you have to look like a super-model, but if you are morbidly obese then you are probably not healthy. just to set the record straight, i don’t think the healthcare industry is saying that you need to look like tyra banks- what they’re saying is that if you are several HUNDRED pounds overweight you are probably going to end up w/ heart disease, diabetes, and or knee problems. the definition of “morbid” in medicine, by the way, is essentially any condition that really fucks up a person’s quality of life. you can’t have a proper debate about any of the rest of it, until the bigger people in the convo-some of whome probably ARE healthy and just get on the top shelf whenever anyone says the word fat-at least give up the “you just hate me because im not a twig” argument.
You probably see more thin people aged over 70 because they grew up in an age when obesity was rare, there were no fast food restaurants, processed food and unhealthy snack items. Many more people lived on farms, had fresh food they grew themselves or purchased locally, they walked more, engaged in more labor and physical activities. Few people had the money to overeat, which is why in media then rich people are portrayed as fat.
The 1950s probably marked the end of this period in American history. After that you start seeing more obese people, and in the 1990s, obese children – previously virtually unknown.
That said, it is possible for a somewhat overweight person to be generally healthier and fitter than a given thin person who doesn’t exercise or eat right. But mostly more and more Americans are too fat physically and between the ears.
Also, it’s entirely possible for the not-fat elderly person you see today used to be heavier — and that’s what allowed them to withstand what illnesses they’ve encountered. The “obesity paradox” seems to indicate that having a BMI greater than 25 confers survival benefits. But as people have bouts with serious things, their bodies do what they are supposed to and release the stored energy when they need it. Heavier people tend to have better bone density, too — so being overweight and fit for some is the best bet.
Being as physically fit and eating a healthy diet, avoiding harmful behaviors like smoking, drinking to excess, not wearing a seat belt, etc. — those are things we can all do regardless of what size we end up.
So, unless you’re going to do a thorough risk assessment and prove you’re healthier than I am — stop judging my fat ass.