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January 09, 2003
Love Your Body
The New Republic has an article (you'll need free registration, but 'cypherpunks' works) questioning whether any of us are dying from being fat. As one of those people with a Pooh-type body shape, I've been vaguely aware for some time that the evidence was not entirely clear that being overweight was, in itself, a significant health risk.
But what about all that research?
University of Virginia professor Glenn Gaesser has estimated that three-quarters of all medical studies on the effects of weight on health between 1945 and 1995 concluded either that "excess" weight had no effect on health or that it was actually beneficial. And again, this remains the case even before one begins to take into account complicating factors such as sedentary lifestyle, poor nutrition, dieting and diet drugs, etc. "As of 2002," Gaesser points out in his book Big Fat Lies, "there has not been a single study that has truly evaluated the effects of weight alone on health, which means that 'thinner is healthier' is not a fact but an unsubstantiated hypothesis for which there is a wealth of evidence that suggests the reverse."
Of course, it's easy to sell books by telling people that it's all right to be tubby. The alternative view, of course, is that being overweight takes years off your life.
But this is a largely uncorrected study of the sort decried by the previous article. So, what's the real problem? The New Republic argues that it's largely the diet industry, and appetite suppressants in particular. Perhaps that is part of the tale. Certainly, I suggest you avoid diet products. They are unlikely to do you any good and in some cases they may be dangerous. But further down the TNR article is this:
Quite simply, when researchers factor in the activity levels of the people being studied, body mass appears to have no relevance to health whatsoever--even among people who are substantially "obese." It turns out that "obese" people who engage in moderate levels of physical activity have radically lower rates of premature death than sedentary people who maintain supposedly "ideal-weight" levels.
In other words, activity level is a highly significant predictor of premature death, and weight and BMI aren't. Now, overweight people tend to do less exercise, and find it harder to find exercise regimes to suit them. But if the answer's to exercise more, why the obsession with weight?
And what of our activity levels? They're not high. Those of us reading Pepys' Diary as a weblog have been struck by the extent to which Pepys' normal day, and that of everyone else he knew, consisted of walking around central London doing business with people. And he would have led a sedentary lifestyle compared to most of his contemporaries. "Moderate exercise" means the equivalent of half an hour brisk walking a day. Most of us don't do that; the article suggests only 20% do, but my guess is that this figure is high. Certainly I noticed a huge improvement in my physical fitness after only a couple of months of playing the dancing game, and I was already doing quite a lot of not very brisk walking and cycling. (via the Sideshow)
Posted by Alison at January 9, 2003 06:55 PM
Comments
If this is so then I might well be dancing on a few graves one day. Since I have neither a car or driving license walking and cycling are my preferred methods of transport. I probably don't get about as much as Samuel Pepys' did but I'm a heck of a lot closer than the the bulk of the population.
Posted by: Kim Huett at January 9, 2003 08:24 PM
is "the dancing game" DDR aka Dance Dance Revolution? I played it when I got a free-play card at Gameworks in Seattle (as part of a very lame job fair) and liked it!
Posted by: Anita Rowland at January 10, 2003 07:38 PM
Yes, absolutely. You've not been paying attention, have you? Try:
http://www.kittywompus.com/macadamia/2002/09/14.html
which is I think the post where I first wrote about it.
Posted by: Alison Scott at January 10, 2003 08:47 PM
There's another confounding factor not mentioned here: The prejudice doctors have against fat people. In the same way that there are some doctors who seem to think all illness or injury in smokers is caused by smoking, there are doctors who behave in the same way when the patient is fat. I've heard some pretty awful stories about horrible malpractice by doctors who were just determined to neglect patients because they were overweight.
I noticed a few years ago that some doctors were doing a lot of whining about how hopeless it was to try to treat "obese" patients - there were a plethera of "reasons" for this diagnosis, including the belief that anyone who was fat was too negligent of their own health-care, and too dishonest about their condition, to be relied on to take care of themselves or report honestly on any health matters.
And of course, there were surgeons who were suddenly blaming the presence of fat for their own surgical failures, claiming it made it too hard to do surgery. (And maybe it does, but that would still be a secondary, not primary, effect of fat-related problems. It was certainly not honest to claim that these people were ill because they were fat.)
Posted by: Avedon at January 11, 2003 06:46 PM
I came here to read about fat - I left having syndicated Pepys' diary to my livejournal account. Did that man do nothing but scrounge meals from others?
On to the fat thing. I'm sure I read a study last year about physical activity and obesity. If you are "moderately active" you have to be three stone overweight before you are as unhealthy as an inactive thin person. Until two/three years ago I was quite fit, then I got even fitter when I was going to the gym regularly. Now I find it hard to climb a few flights of stairs in work. This upsets me more than the weight I am.
Posted by: Ang at January 12, 2003 09:07 AM
Well, I'm one of those people with a medical condition that keeps me in regular touch with dieticians and the like, and there's been a lot of switching back and forth over just what the "right" foods are. It makes it hard to believe the current advice when the skinny dieticians of a decade ago are being contradicted by the skinny dieticians of the here and now.
But it's no wonder people are paying the farmers less than ever. I wonder if there would be a market for a GM wheat with zero-calory flour, of biscuit-making quality, which contained extra caffiene.
Tea and biscuits, Alison?
(And don't forget the low-caffiene Jolt cola, only half the caffiene of regular Jolt cola!)
Posted by: David Bell at January 12, 2003 10:26 AM
Avedon observes:
"I've heard some pretty awful stories about horrible malpractice by doctors who were just determined to neglect patients because they were overweight."
Yeah. It gets worse. A friend of ours is doing her residency work in Seattle. She decided to go to medical school in her late thirties, did the work to get a second undergraduate degree to get her the grades/background to get into medical school, and got into medical school in her early forties. Which I think totally rocks. But she's also fat. And the surgeon who supervised her surgical residency flunked her for being fat. Explicitly. He said it was a handicap she couldn't possibly overcome, irrespective of her other abilities. Fortunately, he said all of this in writing. So our friend is grieving it; the Dean of her Medical School is herself a fat female of middle years, so she feels she has a good shot at making a case.
Posted by: Ulrika O'Brien at January 21, 2003 10:00 PM
I USE TO WEIGH 235LBS.AND I NOW WEIGH 110LB. WHEN I WAS 235LB. I WAS DOING MODERATE EXERISE, NOW I DO NONE. IT WASN'T HARD TO LOSE THE WEIGHT, BUT NOW SLIM (ACTUALLY UNDERWEIGHT) IT'S VERY HARD TO DO MODERATE EXERISE, DUE TO MY LACK OF ENERGY. I'D LOVE TO PUT ON SOME NICE MUSCLES, BUT AGAIN ONCE SMALL, THAT'S ANOTHER TASK THAT'S HARDER THAN LOSING THE WEIGHT. I CAN HONESTLY SAY I FELT BETTER, HAD MORE ENERGY, AND DID MORE EXERISE WHEN I WAS OVERWEIGHT, COMPARED TO BEING SMALL. I AM GLAD THE WEIGHT CAME OFF, BUT IN TRUE HONESTY WHICH ONE IS ACTUALLY BETTER HEALTH?
Posted by: Cilla at June 8, 2003 03:55 PM
I want to say only that why not people think that body is not much important compare to a loving personality,i m a small body person i did not thought in my early age that body would become problem for me bcz my friends keep saying u put some weight but how bcz my body is under size due to constant weight and shape,even i m perfect i m a technical worker, so how do i satisfy my self?. One more thing that people keep saying the heavy body has sex but u know if we don't have good orgasm then what is the need of heavy body with out a climax in love.I find my self perfect care of orgasm.
Regards
Posted by: kash at September 9, 2003 10:22 PM