Let’s be honest. Thin people feel superior to people who are overweight. The prejudice is so deep seated that it has affected the practice of medicine. Rarely a week goes by without some scientific paper claiming to link obesity with various dreadful health problems; yet most are shoddy and poorly done, and almost all are debunked.
Why do thin people feel superior? The causes are economic and philosophical. Simply put, being overweight is associated with being poor. In addition, Americans have a deeply embedded strain of Puritanism that holds that those who have misfortunes somehow deserve them.
Many American predilections are grounded in economic status, and weight is no different. When poor people were thin because they didn’t have enough to eat, being overweight was a sign of status. Similarly, when poor people were tanned because of working outside, white skin was a sign of status. When poor women couldn’t afford anesthesia for childbirth, access to chloroform was a sign of status.
That’s changed now. Thin is a sign of wealth, a tan in midwinter (from a tropical vacation) is a sign of wealth, and preference for “natural” childbirth is also closely associated with upper income levels.
Achieving and maintaining the favored body type requires access to healthy food and special diet foods. It also requires exercise equipment or membership in a gym or, most exclusive of all, a personal trainer. All these things cost money, so weight has come to be viewed, accurately, as a sign of economic class.
Much of this is perceived only on the unconscious level. Nonetheless, it leaves thin people feeling superior to those who are overweight, because, economically, they often are superior. Weight has become a proxy for social class.
America was founded by Puritans and Puritanism is a strong strain in our thinking, hence the otherwise irrational impulse to regulate the private behavior of others, particularly others who are poor. Americans take almost fiendish delight in pointing out the “deserved” consequences of smoking, over eating, and marijuana use. They have stigmatized those behaviors in every possible way.
In my town, smoking is banned everywhere, including out of doors. Many cities are busily promulgating laws to regulate the composition of food served in restaurants. Users of marijuana, even those using it for medicinal purposes, are routinely prosecuted and may be jailed.
It is not a coincidence that smoking, over eating, and recreational marijuana use are more common among the poor. That is what leads, in part, to the zeal for stigmatizing, banning and punishing such behavior. Smoke a cigarette and you are forced outside into the cold; put transfats into your restaurant fare and you may face a fine from your city or town. Smoke marijuana and you may go to jail. On the other hand, steal $50 billion and force people into financial ruin and suicide, and you get house arrest in your Manhattan co-op while awaiting your trial.
Being poor is, in and of itself, almost always viewed as the “fault” of the people who are poor. This is an echo of the Calvinist belief in predestination, a convenient belief that those who prosper in this life do so because they are destined for an even better life after death. Therefore, overweight is routinely viewed as a visible sign of personal sloth, and worthy of serious negative consequences. The health problems of the overweight are simply just punishment for their inability to exert self-control.
There are literally hundreds of studies that claim to show that overweight is a major killer. Except that it’s not. The science is shoddy because the outcomes are predetermined by prejudice.
Of course morbid obesity is a serious health problem with potentially deadly consequences. However, simply being overweight is not only safe, but actually appears to be protective compared to “ideal” weight. That’s what the data really show.
Walk down the hallways of any hospital and look into the rooms. Very few people are there because of weight related health problems. We know this to be true in our own lives. All of us know many people who are overweight, but they are hardly dropping dead on a regular basis.
Thin is in, because it is viewed as a sign of economic status, and an indication of personal rectitude. The prejudice against the overweight is not justified by the scientific data, nor by the fact that weight is now a proxy for wealth. Like any prejudice, it is not justified at all.
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Insightful social commentary there. What kind of a parallel universe do you live in?
This is on my mind a lot as in my family there seems to be no correlation between overweightedness and lifespan. My skinniest relatives have the most hypertension and diabetes!
Didn't you learn anything from Kate Harding's article last month in Salon? Stuff like this always brings out the nasty comments from the whole 5% that lost weight by "getting off their asses" and exercising/eating right/ insert whatever here, and the rest of us fatties are just too lazy, stupid, whatever.
Meanwhile, the studies that show genetics are what determine your body shape are coming out and standing the test of time. While I could probably lose some weight and be a thinner version of what I am today, I will never be Gwenythe Palthrow thin. Eh... I've learned to live with it. I wish everyone else would.
"Will you have a talk with my doc? Weight is the only thing she wants to focus on."
I'm not surprised. That is the medical "sin" du jour, despite a lack of scientific evidence to support that reaction.
"Meanwhile, the studies that show genetics are what determine your body shape are coming out and standing the test of time."
That's what make the prejudice against over weight people particularly unfair. The underlying assumption is that everyone could be thin if only they tried harder.
"That vice, along with obesity, only becomes the primary killer in a society affluent enough to keep the other killers at bay."
That's true, but obesity is not a primary killer in America. The scientific evidence is pretty clear on that point.
"I have a few friends whose sense of superiority is more of the moral variety - they expend much energy to be thin, exercising and exerting discipline over their eating. They then believe themselves to those who do NOT exercise such discipline and effort. They're pretty poor themselves, so socio economic status is not entering into it."
I did not mean to imply that only wealthy thin people look down on those who are overweight. My claim is that weight has become a proxy for economic class, and even those who are poor aspire to the societal ideal.
It's become acceptible to many people to be cruel to overweight people, "for their own good".
I say this as a formerly thin person. But in my mid 40s, my metabolism slowed to a crawl and I gained weight.
My family--particularly my mother and sister--freaked out. Really freaked out, to the point that it was truly offensive. I love them dearly, but the pride they derive from being slender is...well, it's kind of bizarre.
While I understand and agree that poverty and obesity are often linked, and believe that it is more difficult to be healthy when money is hard to come by, it is inaccurate to say that being healthy and being thin requires money. It is possible to eat a nutritional, healthy diet on the cheap, but often it requires more work for food preparation.
And it is certainly possible to get good amounts of exercise without expensive gym memberships, trainers, and exercise equipment. Many of my friends are serious runners--running is a sport whose only cost is the occasional new pair of shoes. Walking is an option for just about everyone; biking can provide exercise AND save money if it cuts down on car trips. Many communities have free or cheap rec centers with good exercise facilities.
Of course genetics play a role, and poverty often plays a significant role as well, but it is simply untrue that being thin, and pursuing a lifestyle conducive to thinness, requires significant money.
'Achieving and maintaining the favored body type requires access to healthy food and special diet foods.'
Not true, Dr. A! Have you recently checked the prices of frozen vegetables, rice, and leanish cuts of meat? I am sure you have visions of your sisters stuck in the ghetto, far from grocery stores, but there is such a thing as a bus system. For about $4, most people in this country can make a round trip to a grocery store. Of course, the less processed the food, the longer the cooking time, but most people can carve this time out. I manage to work 40 hours a week at a low wage, stay skinny, and support the diet of a chubby and wonderful man, who is growing skinnier on my diet.
As you imply, who cares? Most health problems are not weight related, according to your post, so the poor people without access to fresh ingrediants are fine. What is your complaint, exactly? Once again, I really like your point of view most of the time, but this post seems to simply be in favor of overweight people.
"For quite a while now it has seemed that morality about things like lying, cheating, stealing have been replaced with treating overweight as a sin. You see various foods described as sinful and decadent. How did that happen?"
It's kind of bizarre, actually.
No, it costs considerably more than that. Being an "avid runner" requires time--leisure time--genuine leisure time, devoid of any more pressing concerns, like fixing something in your home or your car, preparing or shopping for food for your family, working, studying, cleaning, eating, sleeping.
Exactly what the working poor (the vast, vast VAST majority of poor people in America work hard, every single day) is leisure time.
"I say this as a formerly thin person. But in my mid 40s, my metabolism slowed to a crawl and I gained weight."
That's exactly what happened to me. I had been thin my entire life, and I'm ashamed to say, looked askance at others who were not. I learned the hard way that gaining weight is no one's "fault."
I've also been sensitized to the weight issue by my teenage daughter and her friends who place far too much emphasis on weight. It has really made me question the messages that we sent to young girls.
"While I understand and agree that poverty and obesity are often linked, and believe that it is more difficult to be healthy when money is hard to come by, it is inaccurate to say that being healthy and being thin requires money."
I didn't mean to imply that you must have money in order to be thin. There are plenty of people who are thin who don't have a lot of money. It's just a lot easier if you do, and that's part of the reason why weight has become a proxy for economic class.
Uh, last I checked smoking, heroine, and meth give access to being thin too. If you had lived near the ghetto that I used to live in, which is populated by extremely poor people, you would note that there are a lot of thin poor people!
What data? Could you post what actual studies you're talking about one way or another? It seems important to the piece to know what science you're calling out for bad methodology and what you're approving of.
Exercise is the fountain of youth as anyone who is 90 , but looks 65, knows well. Such people have always exercised all their lives and have never been overweight. Many fat people claim to have tried every diet, but none work, and often want to blame their overweight on "genes". But, as you probably know, a recent study of the Old Amish, who use no electricity or cars, found those with the "fat gene", yet they weren't obese or overweight. Why? Because they get so much exercise!!! I must have said this dozens of times to my college students, that no one who progresses to walking five miles a day will be overweight. My daughter dropped 20 pounds when she started riding her bicycle to work, a ride of eight miles up and down hills round trip, five times a week. She was normal weight before and had no intention of losing weight, but the amount of exercise she got changed her weight, anyway.
And say what you will about overweight, it's still a very basic matter of burning more calories than you consume and little else. Those who are overweight may be malnourished as many are, but too many simply consume too many calories and fail to burn enough calories. It's fairly basic, really.
Me too. My older daughter is naturally curvey--not overweight, just curvey. Big breasts, tiny wasp waist, full hips.
When we lived in Los Angeles, she felt like a full-on freak of nature. She felt obese. She felt hideous. (She is the farthest thing from hideous; in fact, she's quite beautiful.)
When we moved to Berkeley, where there was a lot more diversity, her body image changed dramatically.
I'm about 30 pounds overweight. It happened magically, almost overnight.
On most days, I eat a single meal. One meal. I probably consume a maximum of 1,000 calories a day, if that. My basic basal rate should take care of most, if not all of that, and it doesn't. I don't know why it doesn't, but it doesn't. Same thing happened to my father.
When I was younger, I was quite slender. Now I'm not. Nothing has changed in my eating, or exercise, except age.
You don't know what you're talking about.
"Why do thin people feel superior? The causes are economic and philosophical. Simply put, being overweight is associated with being poor. In addition, Americans have a deeply embedded strain of Puritanism that holds that those who have misfortunes somehow deserve them."
For years now the statistics around the world have indicated that the nation which is argueably the most powerful and amongst the wealthiest in the world also has the largest percentage of population who are over weight. How is it that these statistics have bucked the trend of what you appear to be suggesting? If you are right then I certainly would want to be supportive of those who are needing support against those who are superior. However, I genuinely do not understand.
Just one thought that comes from China. Confucious said "If you cannot convince them, confuse them". I am confused.
Sorry Amy, I am sure you can accept that comment as a joke, cant you?
"Obesity and overweight lead to diabetes, high blood pressure, and joint problems, on and on. Are you going to deny this?"
That's true for people who are morbidly obese. However, the data shows that people who are simply overweight consistently live longer than those who are thin.
"When we moved to Berkeley, where there was a lot more diversity, her body image changed dramatically."
Thank goodness. The obsession that girls and women have with weight is unhealthy both physically and psychologically.
"For years now the statistics around the world have indicated that the nation which is argueably the most powerful and amongst the wealthiest in the world also has the largest percentage of population who are over weight."
That's hardly surprising, isn't it?
In most countries, people are thin because they are malnourished. I never mentioned that in this post because starvation is unusual in first world countries. Take out the countries where people are starving and look again.
I know plenty of thin people with diabetes, so they can't really blame that all on weight can they.
I also believe way back when, being heavy was a sign of wealth as it meant you had enough money to be well fed. Also being pale was a sign of wealth as it meant you had other people to do the work for you and you didn't have to go outside.
Funny how someone else always decides what's in or not and everyone just drones along.
I must say though, I fell more prejudice from heavy people towards me, then I ever have shown them. Genes work both ways.
"I hope Dr. Amy, your article was really meant to open eyes and not just garner a miasma of responses, which it obviously has and will."
So often people never stop to consider why they believe what they believe. Many well intentioned people are unaware of the role stereotypes can play in our thinking. Hopefully, this piece will cause them to consider the source of their beliefs.
Dr. Amy, I have a totally unscientific explanation for why poor people tend to have difficulty with overweightedness. If you go awhile without food in the cabinet, and then the check comes in, you really EAT. I know this is not scientific but I do know that the metabolism gets ready to really store it up when food arrives. Add to that the fact that white flour based products are much cheaper than fresh foods.
My best friend from school was poorer than poor, and she did this. She maybe only ate one meal a day, but then boy did she eat! I know this is not good on the system. Just my two cents...
I see your view that this comes from a Puritan culture, but I do not agree that thin people feel superior.
Also, when I was a teenager, so many decades ago and in a southern climate, it was not considered attractive to be so thin. The muscular/voluptuous cheerleader-type was the ideal. Twiggy came along awhile later.
My weight has changed a few times in the past decade or so, in both directions, from being a bit heavy, as well as losing (involuntarily) too much weight. Every time I balanced it back out, I was not thinking about my weight, but only about my health, changing my diet, etc., so that I would feel better. Each time I either gained or lost, as needed, but only as a by-product, not as a primary goal.
Doctors should spend less time worrying about their patients' weight (which might be a correlation, rather than a cause of "disease") and more helping them just to be healthy.
And... I'm not wealthy, by any means.
"I never mentioned that in this post because starvation is unusual in first world countries. Take out the countries where people are starving and look again."
You know I see exactly how some use statistics. If we want to be sure of convincing others of our point of view we must be selective in which statistics we use and which ones we will ignore. I guess that is much the same as when some people "debate" they select which part of the conversation they want to hear from the other person and hich part they ignore.
Is this a scientific approach if you do not take the full spectrum of possibilities? However, should this be the case, my position would not be much different. Lets adjust my statement a little:
"For years now the statistics around the world have indicated that the nation which is argueably the most powerful and amongst the wealthiest in the (first) world also has the largest percentage of population who are over weight (in the first world)."
Does that help you a little? Not so sure that it is very honest deciding which statistics to ignore, it may impress those who do not pay attention to detail, but those who are less naive may see things a little different.
Where did you get this definition? That's not accurate. Having spent my college years as a Calvinist, that's not what predestination is about at all. I think John Calvin would be quick to correct you as would most modern Calvinists who still follow his teachings and believe in the 5 points.
Calvinism is not about glorifying the rich. In fact, a primary teaching of Calvinism is to despise the present life and all worldly possessions and cling to the future hope of heaven. John Calvin writes on this in Chapter IX (Of Meditating on the Future Life) of his book, Institutes of the Christian Religion:
"Whatever be the kind of tribulation with which we are afflicted, we should always consider the end of it to be, that we may be trained to despise the present, and thereby stimulated to aspire to the future life. For since God well knows how strongly we are inclined by nature to a slavish love of this world, in order to prevent us from clinging too strongly to it he employs the fittest reason for calling us back, and shaking off our lethargy....Hence our stupidity; our minds being so dazzled with the glare of wealth, power, and honours, that they can see no farther."
Anyway, probably beside the point. Just saying...
I do get tired of everyone blaming the Puritans for all of our American contradictions -- it would seem to me they have less influence on contemporary culture than the Evangelical movement of the past 100 years (which isn't all that different in some of it's desire to prescribe lifestyle to others).
It is true that, in this country, one has to be particularly dedicated to find cheap, healthy food. It's a lot easier, when you work 12 hour shifts and have kids, to pick up pre-packaged cheap food than to spend the time on long preparations.
Check out Erinreich's book "Nickeled and Dimed" for a really good explanation of this.
But if exercise and a decent diet produces cardiovascular health, and you end up thin, a bonus. Imagine being thin at 150 (male) and then having to tote around a 20 pound bag. No thanks. I'll pass on that for my next 14teener.
Too many bi-pass operations, too much high blood pressure, much due to sedentary, bad diet. Drag out as many statistics as you want. Some of us have our own statistical base from a bunch of years of observation.
Find exercise unappealing? So make a case against the benefits, eh?
If people must eat fast food rather than prepare it (and it does not take hours to prepare a decent meal, believe me.... it can easily be done in the time it takes to get in the car and go through the drive through and get home) then why not go to Subway instead? But, no, hamburgers and french fries and subs and pizzas are the norm. And snacking throughout the day is the norm.
I am 53 and, despite decent genetics, could not be slim were I to eat whatever I wished and not exercise regularly. I simply could not. My husband is 25 lbs overweight because he will not exercise and he eats much larger portions than I do and he sneaks snacks. That is his choice. I prepare his meals, but he knows what he is doing. Were he to make a few changes, he could lose those pounds and he knows that and admits it.
When I see the hugely overweight I do not hate them but I also do not imagine that they are all helpless and cannot take charge of their own eating or lifestyle habits. I must assume that they are comfortable, in some way, with who they are, or that they have chosen not to deal with the issues that have gotten them to that point. My sister's partner is very heavy. She grew up very poor and ate to self-medicate. She knows this, she has been in therapy. She refuses to change for her own reasons. My sister can no longer help her if she refuses to help herself. She is unhappy but until she wishes to change her habits then she will be very heavy and unhappy with her weight.
I see middle class, rich and poor people who are fat. I do think that the poor who fill their baskets with processed food and junk think that it is cheaper and easier and often need to be educated but I also think that many people can get into lazy, easy habits with food and exercise and that once the weight goes on and on it becomes a sort of self-fulfilling prophecy and becomes that much harder to get rid of. Ten is hard, 20 is harder, 50 is even harder and so on.
Defending fat has become some sort of political stance that I just don't get. It's like it's P.C. or something and you can't say: No, I don't think it's okay to be fat without being called a bigot or an asshole. When the heck did that happen?
For this, I commend you. Not only does your article explore WHY thin people feel superior--your comments section is certainly ample proof THAT they do. Astonishing.
Dear thin people: Get over yourselves.
Signed, a thin girl who knows how damn lucky she is to be so.
When I joined the Air Force back in 1978, I was considered over-weight because I weighted more then the AF weight standard for my height, of 5'9". My max. weight was suppose to be 180 lbs. I weighted 190, and felt normal. They made a big deal about it though, because that was their rule. Never-mind that the previous few years I played college football, and weighted a whopping 220 +/- 10 lbs, and was able to run the 40 yd. dash in 4.9 seconds. It was all irrelevant. I finally got a weight waiver, but it was a challenge. I was always a stocky male, as was my dad, and my grandpa.
About 5+ years ago, when I first was diagnosed with severe spinal cord compression, a low-grade glioma, (In the left cerebellum, pons, peduncle and medulla.) and other neurological issues, I considered myself active, as I managed restaurants, and participated in many physical activities like softball, volleyball, hockey (Deck hockey, no skates, like lacrosse with hockey sticks.) and went camping, hiking and other outdoorsy activities.
But that changed 5 years ago, and had an impact on my weight. The worse thing, besides the obvious, was when I was given mega doses of dexamethasone, a steroid, (It was to shrink the edema of my spinal cord and brin tumor.) whose side-effects are mind boggling. The worst was the weight-gain, which was a lot over a relatively short period of time. I gained about 50 pounds in a 3-4 month period. The challenge has been to loss that since. I now live on Social Security Disability, at the poverty level, which doesn't allow me the ability to buy all this "healthy food". I get a lot of my food at a local food bank which doesn't provide a lot of those "Healthy foods". I had a primary care doc at the VA for about a year, who I fired about 2 years ago, and his comment was to eat healthy, buy all this high priced produce, etc, etc. Both the docs before and after him said don't worry about my weight for now, as we had more pressing concerns. (I still have the brain tumor, because of location, location, location.) And I can't leave out the symptoms associated with the tumor, which limit my physical activity. But my weight does concern me, and it is an ongoing battle. I feel like I am stuck between a rock and a hard spot.
An interesting study called "Project Implicit" studies our unconscious prejudices. The research, done by Mahzarin Banaji, Richard Clarke Cabot Professor of Social Ethics at Harvard University, in collaboration with William Cunningham and Marcia Johnson at Yale University, suggests our conscious brain can lead us away from the prejudices of our unconscious mind. And it discusses our prejudice for overweight folks. It is quite interesting. Here are the links:
http://projectimplicit.net/generalinfo.php and this story,
http://www.hno.harvard.edu/gazette/2003/07.17/15-prejudice.html
Thanks for the post. Rated
"Some of us are not ever to be thin."
That the reality that those who are thin often refuse to acknowledge.
"I wish more doctors were better trained to understand exactly what the relationship is between weight and health and lifestyle, and better trained to be good doctors even when the person they're treating is overweight or obese or even morbidly obese."
I agree. It has become "conventional wisdom" that overweight inevitably causes health problems though that is not supported by the existing scientific evidence. Doctors would do well to read the evidence and ignore the hype.
"I will, I know, completely piss people off with this, but I just don't understand why this continued defense of fat."
I'm not defending fat. I'm defending science. It's simply not as bad as people (particularly thin people).
And I'm offering an explanation for why the science has become obscured by emotion. Weight is proxy for economic class, and Americans are very Puritanical is their zeal to regulate private behavior.
"Not only does your article explore WHY thin people feel superior--your comments section is certainly ample proof THAT they do."
Unfortunately, that's true. My primary argument is about the science, but I would like to add an additional one for those who are still insisting that "fat" is something to be despised: how about a little compassion for those who are already struggling with unreasonable society expectations?
"About 5+ years ago, when I first was diagnosed with severe spinal cord compression, a low-grade glioma, (In the left cerebellum, pons, peduncle and medulla.) and other neurological issues, I considered myself active, as I managed restaurants, and participated in many physical activities like softball, volleyball, hockey (Deck hockey, no skates, like lacrosse with hockey sticks.) and went camping, hiking and other outdoorsy activities.
But that changed 5 years ago, and had an impact on my weight. The worse thing, besides the obvious, was when I was given mega doses of dexamethasone, a steroid, (It was to shrink the edema of my spinal cord and brin tumor.) whose side-effects are mind boggling. The worst was the weight-gain, which was a lot over a relatively short period of time. I gained about 50 pounds in a 3-4 month period. The challenge has been to loss that since. I now live on Social Security Disability, at the poverty level, which doesn't allow me the ability to buy all this "healthy food". I get a lot of my food at a local food bank which doesn't provide a lot of those "Healthy foods"."
Thank you for your eloquent testimonial.
Many medications cause weight gain, particularly steroids, and it is hardly a person's "fault" if they weight on a medically necessary treatment.
Absolutely. It happened to my daughter, and I don't know if it's true, but it appears to me that weight gained via medication is more difficult to lose.
As an aside, I never quite understood why people say the poor cannot afford healthy foods. You don't have to go to Whole Foods to buy healthy foods. You can buy oatmeal from the bulk bins in any supermarket. You can buy lentils and beans from the bulk bins- great and cheap sources of protein and fiber. You can find a great variety of vegetables for cheap in a typical asian supermarket. Tap water is free.
Say you are in the Frankfurt Airport and you need to find the gate to the flight to the USA. Just find and follow the big butts.
(800,000,000 million people at last count classified as hungry.)
""I wish more doctors were better trained to understand exactly what the relationship is between weight and health and lifestyle"
This is a bit specious. There is a limit to "training" and often there are no absolutes. The jury is still out on cholesterol, effect on joints from exercise, etc. But a major problem is that big pharmy screws the facts for benefit.
"Critical examinations of studies and news on food, weight, health and healthcare that mainstream media misses. Debunks popular myths, explains science and exposes fraud that affects your health. Plus some fun food for thought. For readers not afraid to question and think critically to get to the truth."
The blog is an excellent read, and a repository of links to almost all major studies on the impact of being overweight or obese. This quote is from a post on heart disease (http://junkfoodscience.blogspot.com/2007/10/obesity-paradox-13-take-heart.html)
"What is most amazing is how long it has been known that body fat doesn’t cause heart disease or premature death, yet how vehemently people hold onto this belief. “The notion that body fat is a toxic substance is now firmly a part of folk wisdom: many people perversely consider eating to be a suicidal act,” wrote Dr. William Bennett, M.D., former editor of The Harvard Medical School Health Letter and author of The Dieter’s Dilemma. “Indeed, the modern belief that body fat is a mortal threat to its owner is mainly due to the fact that, for many decades, the insurance companies had the sole evidence, and if it was wrong they would presumably have had to close their doors.” That can still be said today, although the obesity interests have since grown considerably larger.
But the evidence that fatness is not especially harmful has been shown from research that dates back to the 1950s — more than a half a century ago. While many remain incredulous, the soundest body of evidence has shown, and continues to show, that being fat is not a risk factor for heart disease or a cause of premature death, even controlling for the effects of smoking or cancer."
I encourage anyone who is interested to read the whole post and peruse the blog. You'll be surprised at the difference between conventional wisdom and actual science.
Some years ago one of my co-workers decided that he wanted to get "in shape." He ate like a ballerina and exercised two or three hours a day. He lost his gut and looked great. But it was like his entire life revolved around looking great, and he just couldn't keep it up. He started eating normally and cut back to an hour a day exercise. He put back on about 25 pounds, and probably ended up weighing what he should have weighed in the first place.
Also, in a society in which 2/3 of the population is overweight and 1/3 is obese, I don't think you can claim that fat is a proxy for socioeconomic status. Yes, there is a correlation between weight and SES, but I certainly wouldn't call weight a proxy for socioeconomics...Plenty of individuals on the higher end of the wealth and income spectrum struggle with overweight and obesity.
Are you a candidate? If so, why have you chosen not to get the surgery, just out of curiosity? It's no quick fix, sure, but I've known people who have dropped over 100 pounds after gb.
Weight, Mortality, Years of Healthy Life, and Active Life Expectancy in Older Adults (http://www3.interscience.wiley.com/journal/119386968/abstract)
PARTICIPANTS: Five thousand eight hundred eighty-eight adults aged 65 and older at baseline.
RESULTS: Women who are healthy and of normal weight at age 65 have a life expectancy of 22.1 years. Of that, they spend, on average, 9.6 years as overweight or obese and 5.3 years in fair or poor health. For both men and women, being underweight at age 65 was associated with worse outcomes than being normal weight, whereas being overweight or obese was rarely associated with worse outcomes than being normal weight and was sometimes associated with significantly better outcomes.
CONCLUSION: Similar to middle-aged populations, older adults are likely to be or to become overweight or obese, but higher weight is not associated with worse health in this age group. Thus, the number of older adults at a "healthy" weight may be much higher than currently believed.
Is the obesity epidemic exaggerated? (http://assets0.pubget.com/pdf/18244992.pdf):
... the association of overweight and obesity with higher risks of disease is equally unclear, partly because of the multifactoral character of these diseases. Increases in overweight and obesity have been paralleled by falls in US total cardiovascular mortality and mortality from coronary heart disease and stroke, as well as in prevalence of hypertension and hypercholesterolaemia.
Several factors justify scepticism about the link between non-insulin dependent diabetes mellitus and overweight and obesity. They include the absence of compelling direct evidence
that excess fat is the cause of insulin resistance, the fact that the link fails four of the Austin Bradford Hill criteria for causality, and that increased physical activity and dietary changes reduce diabetes risk in advance of, or in the absence of, weight loss.
There is considerable evidence that most fat adults were not fat children. Moreover, the thousand families cohort study found both little consistency between childhood overweight and adult obesity and no net increase in adult risk of disease for overweight children or teenagers. Nor did childhood thinness protect against either adult obesity or coronary vascular disease.
Some in the public health community believe that deliberate exaggeration or, indeed, misrepresentation of the risks of diseases or certain behaviours or our capacity to prevent or treat them on a population-wide basis is justified, if not demanded, in the interests of health. Since many of the exaggerations come from people who understand the scientific uncertainties around overweight and obesity, it seems that these individuals have adopted such an approach to the obesity epidemic. The unwelcome implications of this for science policy and for evidence based medicine dwarf those of any obesity epidemic, real or imagined.
The burden of mortality of obesity at middle and old age is small. A life table analysis of the US Health and Retirement Survey (http://www.ncbi.nlm.nih.gov/pubmed/18584293):
The evidence of effect of overweight and obesity on mortality at middle and old age is conflicting. The increased relative risk of cardiovascular disease and diabetes for overweight and obese individuals compared to normal weight is well documented, but the absolute risk of cardiovascular death has decreased spectacularly since the 1980s...
The highest life expectancy at age 55 was found in overweight (BMI 25-29.9), highly educated non smokers: 30.7 (29.5-31.9) years (men) and 33.2 (32.1-34.3) (women), slightly higher than a BMI 23-24.9 in both sexes... Obesity and low normal weight decreased population life expectancy respectively by 0.8 (0.2-1.3) and 0.8 (0.0-1.5) years for men and women in a contemporary, US population. The burden of mortality of obesity is limited, compared to smoking and low education.
I have known many overweight people and the vast majority were miserable. I have one friend who is morbidly obese and says she is fine with it, although she is already suffering from diabetes. Her family and friends are concerned about her health -- we want her to stay around for a long time. But it is her choice and I accept that.
I've never been more than 20-25 pounds overweight and it took a lot of time and will power to lose that weight. I did it sensibly, adopted a healthier lifestyle, and it's never come back. That doesn't make me superior to anyone else, but it sure as hell has made me happier.
Thin bashing isn't any more appealing than fat bashing.
One theory goes that women who have early hysterectomies have immediately gained weight.
A layer of fat and you can turn down the thermostat! It's like whales; all that fat holds the heat in. It's a good thing, especially in the winter and somehow relates to the cycle of nature preparing for hibernation like bears. But here I go with Nature again. She is an excellent example for many things we don't understand about ourselves. Such as gaining weight in autumn (holiday feasts), the long winter's nap and naturally slimming down in the spring. Has nobody noticed that?
That said, I do feel you can carry a few extra pounds as long as you are getting regular excercise. If you are sitting around doing nothing, being heavy is the least of your problems. Use it or lose it.
These people were extremely fit, dancing grueling performances and practicing every day for hours, but it was before the time when dancers had to be super thin, or particularly young. If you look at the photos, they are NOT thin. The women have hips and boobs and bellies. They are beautiful but not skinny.
In the video Ballet Russe which shows dancers from the later version of the Ballet Russe, not Diaghilev's, the ones still living now in their 80's. Some of these folks have been dancing all their lives, but only one of them is thin, a man who specifically works out at the gym to retain this body.
1) I'm very thin but I DO NOT feel superior. I put so much effort to keep myself thin and healthy. I write down everything I eat to track down calories. I would LOVE to gulp down double choclate brownie evryday but I can NOT
2) Fat are only poor people. They are definetely depressed and lazy people. Is Queen Latifa poor or Anteha Franklin?
3) 15 almonds is the way much cheaper than a bag of chips or french fries.
You can prepare ypur food at home for lunch. That lunch is much cheaper than BIG greasy Mc Donalds.
4) I prepare my lunch and snacks at home and carry them with me. Yes they are heavy, but that's I don't have big ass. And because I'm not lazy.
5) For exercise you need to spend money. Just walk. It is MUCH cheaper than gas
1) I'm very thin but I DO NOT feel superior. I put so much effort to keep myself thin and healthy. I write down everything I eat to track down calories. I would LOVE to gulp down double chocolate brownie everyday but I can NOT
2) Fat are only poor people. They are definitely depressed and lazy people. Is Queen Latifah or Aneta Franklin poor?
3) 15 almonds is the way much cheaper than a bag of chips or French fries.
You can prepare your food at home for lunch. That lunch could be much cheaper than BIG greasy Mc Donald’s.
4) I prepare my lunch and snacks at home and carry them with me. Yes! they are heavy, but that's why I don't have big ass. And because I'm not lazy.
5) For exercise you need to spend money. Just wal!!!. It is MUCH cheaper than gas
Bad luck sucks and is a part of life. Americans aren't willing to accept this though, so we have to shit on people who are already having a rough time of it.
Aren't we a piece of work?
This is an appalling opinion piece posing as scientific fact. I'm glad you're not my doctor. But then again, doctors are not trained as scientists, which is part of the reason there are so many quacks.
"Why should I even be surprised, if people hate disabled people and Blacks, Hispanics, Jews, Christians, Muslims, women/men and any of a number of human attributes presumed to be innate, or born with why wouldn’t they hate people who represent a negative in a myriad of ways"
What's interesting about weight, though, is that it is often a proxy for class. When the poor were thin because they were undernourished, being overweight was "in."
"Obesity is often a class issue, but in some cases it is a genuine medical issue,"
Your story is an example of the Puritanical instincts of many people. They are sure that overweight must be a person's "fault," not the result of metabolism, medication or hormonal problems.
"bag of bones," and does not want to make love with someone that thin."
After 40 years of being thin, I'm now somewhat overweight. I prefer to think of it as being "famine resistant."
"You will see some but, once you exclude those under 75, there's not many"
That may be true of the morbidly obese, but as the paper that I quoted above demonstrated, it's not true about the overweight.
Hn . . . While personal habits can and do play into someone being overweight, there are actual medical conditions that cause people to gain weight. Thyroid disorders are a big one, my mother has had problems with this most of her life, has tried EVERY diet under the sun and still struggles.
Many people who constantly battle with weight are NOT lazy.
for a start, I call Bullshit on a couple of your leaps -
1) your primary premise that Weight is a proxy for class/social status -
is an opinion based on not much more than a few somewhat-related ideas and anecdotal examples you've linked together
yes, the skinny bitch in the tennis skirt driving the Lexus SUV probably does look down on the obese woman in the carpool line
however, that is hardly evidence to convict an entire category of non-obese people
2) you say the evidence is flimsy at best that excess weight leads to disease and ill health. Perhaps. Perhaps what you mean is that being a few pounds over the recommended BMI is neither harmful nor life-threatening. Maybe.
Maybe significant excess weight reflects a non-healthy diet and lack of exercise, which do, in turn lead to diseases (cancer, high blood pressure, diabetes) that were not part of our society prior to about 50 years ago and are found less rarely in European countries.
Is it because Americans are poor? I don't think so. It may be because most Americans do not eat a diet with enough fruits, vegetables, and legumes/grains.
****
This comment may seem like I am one of the judgemental Thin people. No!
For the record, I am technically Overweight (at least according to BMI and Weight Watchers calculations). I come from a middle-class, working family. Our medical history - both grandmothers in their 90s, still alive, have walked to/from work/grocery/church and gardened, ate and drank wine moderately, never ate fast food, and have always been neither thin nor fat. OTOH, my dad ate a lot of beef and fried food, drank too much, was overweight/borderline obese on & off, smoked, and died of heart disease at 59. My mom who smokes and has never exercised is in her 60s with diabetes, high blood pressure, and who knows what else.
Perhaps these diseases are genetic. But, I for one, will do whatever I can to make the necessary lifestyle changes (yes, I know, a yuppie word if there ever was one) to maintain my health and ward them off as I can. Most doctors I know/see speak more about making lifestyle changes (diet, smoking, exercise) than focussing on losing 15 pounds.
And yet, you as a doctor, think this is only because they have a predisposed prejudice against poor people?
Come on!
I did it to myself.
I was careless and lazy about my eating.
I chose things to eat and amounts that I knew could, indeed would, put weight on me.
I did it to me.
Yes, it was a result of being unhappy and dis-satisfied.
Yes, it was a physical attempt to solve an emotional or social or relationship problem.
But I knew.
I just gave up.
I just didn't care.
Now I am ashamed. Now I care.
I don't like to go out in public except to shop for groceries or go to discount stores where lots of other heavy women shop.
This area where I live is full of heavy women....Some have bad habits, some have poor knowledge, some have given up like me, and of course, some are poor.
Fast food habits may account for much of the obesity.
I feel inferior to other women who have not "let themselves go" ....
I have lovely clothing one, two, three sizes smaller growing old fashioned, except for the classics, in my two filled closets.
I am "only" size 16, elastic waist pants...short or "petite" length, as my legs are short. I am only five foot five..or was, maybe I am shorter now.
My back hurts a lot...is it my spine shrinking like my mother's did or, is it the 75-90 extra pounds I carry?
My bone structure is medium small, I have narrow shoulders. At 130 lbs I am not thin. I have meat on me.
Years ago at age 21, American Airlines told me never to weigh on ounce over 120 lbs. Yes, I was a slim stewardess once.
Thin people MY age have my permission and encouragement " feel superior"...they have usually worked on it and have diligently maintained their bodies.
But for the young, never heavy , as I once was, to feel superior, as I once did, is an exercise in folly...
But I remember when I thought size ten and later size twelve was "heavy"...oh to be size twelve again!
Is it even worthwhile trying, once one has turned sixty, to lose weight and is it even possible?
I am serious here. I don't always feel well.
"But for the young, never heavy , as I once was, to feel superior, as I once did, is an exercise in folly..."
I agree.
I should have elaborated that in past years I was vain and "into" my looks much more than I knew at the time...I am someone who can carry a lot of extra weight and still be proportional...and I have the advantages of good bone structure.....I feel badly physically too much of the time...I link that to the extra-extra weight....I have held women from this specific part of the state in scorn for their famed dumpiness and fatness....now I am one of them physically as well as geographically...it is good for the soul to admit one's faults and shortcomings...that is how I was brought up to believe, what I have taught my two (quite successful and happy, well adjusted adults) children , how they are teaching their children and although it is passe in today's ego-centric "I can do no wrong" milieu I still think it worthwhile , "good for the soul" some might say.
What I wonder and hope Dr. Amy will answer is, what is the possibility for someone who is around age 60 to lose a significant amount of weight , say forty or fifty pounds? I just want to feel better in my back and joints...looking nicer in my clothing would be a bonus. I hope my vanity has been modified and that I would never revert to old ways of looking at others for which I sincerely regret.
My gourmet cooking has backfired and my husband has also blown up a good fifty pounds...at over 6 ft. he can also "carry it" but it is taking it's toll on him now too...we were surprised to find love and real romance in our mid fifties...I married a tall, dark and handsome guy with a fairly flat stomach and he married a cute blond grandmother who looked considerably younger than himself though he is two years younger than I am. He stopped smoking so I would go out with him! We want to be strong and healthy and not the couch/computer potatoes we have become.
I still admire and applaud an older woman or man who has maintained their weight at a HEALTHY level...I do not worship at the shrine of thinness, obviously, but I respect the efforts those disciplined folks have put into the lifetime of good habits...what's to feel sorry about that?
I do not, repeat DO NOT, look down on heavy people...I did so years ago, not even aware that I was doing so at the time...I though I had spelled that out.....guess I did not...could YOU have a prejudice or two that could be coloring your own responses to what someone says? Possibly there is an invisible filter you don't know is there that does not allow you to accept what someone shares from their insides, secret even to themselves until fairly recently, and you want to scold that person....
Scold away if you must dear Phaedo, but no one who is around me for five minutes would ever think me to be one who looks down on a heavy person or a poor person or anyone EXCEPT the crude mouth , cursing parents who yank their unwashed, crying children around in stores threatening to do and sometimes actually doing, bodily harm and calling their own child a foul name...THOSE are the people I look down upon and disrespect...when I have rent that sometimes is 50% of our monthly income I know what it is to be poor...there are more and more of those months...but that does not mean I must ACT down and out ,or get sloppy and dirty..)"Sloppy and dirty" are NOT synonyms or "code"for "FAT" by the way...lest you misconstrue that!)
It is only about 8pm here on the west Coast but I am one of the older women you have a difficult time liking and I am getting tired so perhaps I have communicated anything near to what I am thinking or what my attitude is... NOTHING like you indicated....when I was thirty eight...the PERFECT AGE as I recall....I did not at all like women of the late fifties to late sixties age either.. I thought it was because of my own mother! ha! Guess it is just natural...I didn't want to be like them...nit picky, easily offended, overly dramatic, feathers always ruffled, waving fans all over the place...critical of others....I met one though who was a darling and decided to try to model myself after HER! Oh, she was a "large" woman too! WhatI liked about her was her gentle, loving heart and forgiving spirit and matter of fact practical ideas and solutions...I chose her to be my second Mom... the Mom I would have chosen...I like to think I am somewhat like her and she was NOT haughty at all...The mean looks on the faces of those women you see everywhere is probably just aches and pains and hot flashes and a sore back and missing their children who are grown and gone or a husband who is unfaithful or perhaps ill and dying...I bet you a dollar that it is not at all about you or your weight...
In the meantime I am glad I am no longer a vain woman and that I have had the chance to be a better person...I still do not like this area where I live but as it is looking more and more like where we will stay I have another attitude adjustment to make! That is life, when we stop adjusting our hearts and minds, stop admitting where we were mistaken, then it is time to die...
I have told more people than I can count about the difference between obesity and overweight. I've showed them statistics. And I've heard some of the most amazing bullshit in response, like "The insurance companies must be lying on those actuarial tables."
There are a couple of other points I'd like to see you make. For one thing, underweight people are more likely to die than even the obese. For another, what our culture calls "overweight" isn't the same as what a doctor's chart calls overweight. A woman of "normal" BMI is plump by Hollywood standards, and a woman who is medically overweight is a porker - only able to play comic roles - by Hollywood standards.
A lot of comments posted here offer anecdotal evidence that overweight has no association with heart disease, diabetes, etc. Of course, not everyone who has a high BMI will suffer such health problems, but research shows that in the aggregate, the association holds.
"For all the research showing such associations"
My point is that there isn't research showing such associations. The research shows the opposite, but most people continue to assert the "conventional wisdom" even though the scientific evidence does not support it.
This isn't "anecdotal evidence" that overweight people live longer; it's not one study; it's all studies, at all times, all actuarial tables covering vast populations of people. Obese people do indeed have weight-related health problems; those who are merely "overweight" have FEWER health problems and live LONGER. That's what ALL THE RESEARCH shows and that's what Dr. Amy is trying to tell you, but it just went in one ear and out the other, didn't it?
Maybe I should try to make this simple for you:
It goes like this:
Underweight - 2nd shortest life span
"Normal" weight - 2nd longest life span
"Overweight" - longest life span
Obese - shortened life span but not as short as underweight
Morbidly obese - shortest life span
Looks like "overweight" should be rechristened "healthy weight," doesn't it?