13 Ways of Looking at Obesity

1)      Before 1983, obesity was defined as being greater or equal to one’s ideal body weight, or a hundred pounds over one’s ideal body weight. Since 1983: A body mass index of over 30.  A waist size over 35 inches for women, 40 for men.  Body fat percentage over 25 percent for men, 32 percent for women. An estimated 66% of Americans are overweight, 33% obese.

2)      Obesity is linked to high cholesterol, high blood pressure, high blood sugar, cancer, gallstones, osteoarthritis, gout, sleep apnea, asthma, heart disease, strokes, polycystic ovarian syndrome, hyperinsulinemia, dyslipidemia, congestive heart failure, enlarged heart, pulmonary embolisms, gastro-esophageal disease, fatty liver disease, hernias, erectile dysfunction, urinary incontinence, chronic renal failure, lymph edema, cellulitis, and depression. On average, obesity reduces life expectancy by six or seven years. The total economic cost in the United States is estimated at $270 billion per year.

3)      
 
Obesity is like: tobacco, drunk driving, brains on drugs, breast cancer, forest fires, throwing away recyclables in the regular trash. Public service announcements will alleviate the problem.

4)      “[Self-medicating practices like drinking, video games, and overeating] provide opportunities to become absorbed in the present, opportunities that suffuse people with the pleasure of engaged appetites and enable  people to feel more resilient in the everyday…. We will learn nothing about how to cure self-induced ill health from appetitive excess if we don’t understand its mental health function.  Sure, addictive behavior is associated with depression, but it also discharges stress.  Legislating more consciousness won’t fix it.  Shaming patients won’t fix it: they’ve already learned to dread ‘health’ as a pleasure buzzkill.  Knowledge is not really power where the appetites are concerned.” – from ”Risky Bigness: On Obesity, Eating, and the Ambiguity of ‘Health’” by Lauren Berlant, in Against Health: Biopolitics, Medicine, Technoscience, and Health in the 21st Century (NYU Press 2010).

5)  


Is this entertainment , a source of motivation, or the source of unrealistic expectations?

6)      “The best ways to measure health involves noticing how you feel in your body. Do you have energy? Are you less stressed? How are you sleeping? How is your mood? Weight and body mass index (BMI) simply are poor predictors of health and longevity. A study comparing the Health at Every Size approach to a diet approach showed that both groups initially had similar improvements in metabolic fitness, activity levels, psychological measures and eating behaviors, though only the dieters lost weight. But after two years, dieters had regained their weight and lost the health improvements, while the Health at Every Size group sustained their health improvements.” – Marsha Hudnall, M.S., R.D., in an interview with Darryl Roberts for Huffington Post

7)   

  

Obesity is the result of a lack of portion control a poor choices.

8)      “As many of [Barbara] Ehrenreich’s working poor could attest, poverty and ill health are often part of a vicious cycle. The challenges of eating healthfully don’t simply disappear when you gain access to groceries. You need a clean place to cook, some basic tools, and reliable sources of water and heat. Moreover, you need to know what to do with the legumes, grains, vegetables, and budget cuts of meat that form the staples of wholesome, economical meals. A recent Columbia University study in nutrition education points out the not-surprising fact that it’s not enough to give people data about the risks of obesity. To create real changes in the way Americans eat, we need to link data with actual behavioral practice and environmental support.” – from “Obesity Epidemic: Spurring a Revolution,” by Linda Novick O’Keefe on Huffington Post.

9) 

  The fat acceptance movement.

10)   “In a study of large Canadian men and women, Joanisse and Synnott (1999) identify three categories of strategies that people use to respond to and resist the stigmatization of obesity.  The first category, which the authors term passive resistance, includes internalization and anger.  Internalizers accepted the negative view of being overweight and continued to try to lose weight, while the angry respondents rejected the negative view, but rather than fight back, tended ‘to seethe internally.’  Second, respondents used four techniques of active resistance, including verbal assertion, physical aggression, flamboyance, and activism.  Verbal assertion involved responding verbally to others’ prejudice and discrimination, while physical aggression usually consisted of minor acts of vandalism.  Respondents who used flamboyance proudly and flagrantly displayed their size, for example, by wearing brightly colored clothing.  Activism involved joining advocacy groups.  Finally, respondents described two strategies of reflective resistance, self-acceptance, and enlightenment, whereby they realized they could still live happy, productive lives despite their weight.” – from Women and Dieting Culture: Inside a Commercial Weight Loss Group by Kandi Stinson (Rutgers UP, 2001)

11)   Of Americans with normal BMIs (under 25), as many as 20 to 30 percent have unhealthy body fat percentage.  Much like their higher body-weight counterparts, they have altered blood lipid profiles, four times the risk of metabolic syndrome (which includes hypertension and high blood pressure), and higher amounts of leptin (a hormone responsible for appetite regulation). (Mayo Clinic; Wall Street Journal)

12)   “For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more. While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. This translates into a sobering reality: once we become fat, most of us, despite our best efforts, will probably stay fat.” Tara Parker-Pope, “The Fat Trap,” The New York Times.

13)   “Tara picture though is definitely the incredibly strict life that typifies society’s eye view of “dieting”.  But even if severity’s what’s required, why can’t people just stay hard core?  Superficially you might think people would in fact be able to remain hard core, because people really, really, really want to keep the weight off and I imagine this confuses many folks, including Tara.

“How badly do people want this?  In a now classic study, Rand and MacGregor revealed that formerly obese, bariatric surgical patients would rather be of normal weight and deaf, dyslexic, diabetic, legally blind, have very bad acne, have heart disease or one leg amputated, than return to being severely obese. If you felt that way about something, for whatever the reason, don’t you think you’d do whatever it took to keep that weight off, even if it were a hardship?” – Yoni Freedhoff, a Canadian bariatric doctor, in a blog response to “The Fat Trap.”

I wanted to put together something that displays many of the discussions currently going on around the issue of obesity, in part because I don’t this site to seem dismissive of the rampant health concerns that are linked with excess weight.  The above quotes, pictures, and clips are meant to show the many definitions of obesity, how varying the viewpoints about obesity are, and how many contradictory views come up.

If you look closely, though, there are patterns.  The one I find most interesting is the concept of culpability and control:  Yes, behaviors need to change to have a healthier lifestyle.  We say the debate is how to respond to the obesity epidemic, when, in fact, we’re asking a more basic question: how much control is in the hands of the individual, and what is standing in their way of making healthier decisions?  How we answer this question affects our actual reaction to obese people—if I see it as purely personal, then I can judge or moralize, react to obesity as unattractive and a sign of a personal defect.  If I see it as societal or part of some larger issue, then obesity becomes an issue of marginalization, and judging a person based on size becomes akin to judging her based on race or sexual orientation.  Responding to the “obesity epidemic” depends on finding where in between the two extremes the cause (or causes) fall.

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4 thoughts on “13 Ways of Looking at Obesity

  1. Just for fun, I looked up some longitudinal studies on obesity after reading this post (and this isn’t a criticism of your viewpoint or intent, just curiosity it inspired). The longest study I could find that started from infancy stopped studying participants at age 26. That doesn’t really strike me as enough to base a life expectancy calculation on. I know you didn’t make it, but I take issue with it because it’s nearly always used to hold individuals culpable. Like taking away a helmet requirement for motorcyclists.

    • Kat says:

      I agree that the studies of obesity that we currently have are incredibly insufficient, and often focus too much with the assumption that the individual has more control than they do. I’d really like to see a study done that looks at how changes in outside factors– ie, work hours, stress at home– affect weight and health. Many of the people I’ve seen undergo drastic weight loss or other changes in their health started by modifying their life to reduce stress.

      Or, what I find more interesting, a number (if not the majority of) the newer trainers I’ve worked with have mentioned that they gained a noticeable amount of weight in the first months of starting as a trainer (a time that includes long hours and a lot of stress)– even a girl who usually struggled to maintain her weight gained eight pounds. These aren’t people who have a lack of knowledge about diet and fitness, which I think very much shows that the problem isn’t necessarily the individual’s inability to make healthy choices or put their health first; the general change in American lifestyle since the Industrial Revolution has put us in an environment where our bodies override our ability to control what we eat. If we keep looking at what actions people can take to be healthier and better, we end up treating the symptom and not the cause… And make people feel like shit about themselves.

      Also, believe me, I can’t begin to tell you how much I appreciate your insight. 🙂

  2. alexandria says:

    intentional or unintentional reference to this essay i love:

    http://www.bhreview.org/piece/thirteen-ways-of-looking-at-fat/

    ?

    great post, kat.

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