Yesterday someone named Monty posted a reply to my post “Why Health at Every Size” that said, in part:
I just worry that your are confusing the two and have convinced yourself that 284 is healthy. I guess I would challenge you to post your numbers (cholesterol, Blood pressure, etc) and prove to the scientific community that larger people can have perfectly healthy numbers. That would make it easier to shut these fat-haters up!
He/she prefaced this with a paragraph that I found even more paternalistic and insulting. You can read my answer on that post, but what it made me want to talk about is the double edged sword of proof as it relates to us fatties.
Obviously, the fact that I am healthy is not enough proof for the scientific community (nor should it be) – but I have to wonder what would be enough? So grounded are they in the apocryphal idea that health and weight are causally linked that it seems like no amount of evidence will sway them. I know that because we keep reading things like “[random health problem] is caused by obesity” even though there is zero evidence to support those statements. The bigger problem to me is that this has lead to a climate where instead of trying to figure out what would make everyone healthier, everyone is trying to find the magic bullet that will make everyone thin.
You would think that after all of this time and effort, the fact that they have failed to prove that weight causes health issues, or that intentional weight loss works, would have lead scientists to start looking for another answer, or at least a new question. Unfortunately very few people seem to be interested in doing any research to see if the issue might be something other than weight perhaps because they are too busy trying to shout “don’t you know fat is unhealthy” above the noise of the actual evidence.
Maybe it’s because convincing people that being thin will make them healthy has become a $60,000,000,000 a year industry. Who wants to give up sixty billion bucks to research the health effects of being constantly told that you are sick, unattractive, lazy etc. Or to research why it is that in countries with no stigma about obesity there seem to be no greater negative health outcomes. That would be too much work. Just keep telling the fatties to lose weight. It’s a great business plan since intentional weight loss (whether you call it a diet, lifestyle change, eating program, medically supervised, or something else) fails 95% of the time within 5 years. (Even if you see a doctor, even if you lift weights to increase your base metabolic rate, even if you only lose one pound per week…) This revolving door affords the industry a never ending supply of clients. They seem to think that diet programs are like toilet paper – you’ll need them every day until you die.
So it seems that no number of healthy fat people would satisfy the scientific community that you can be fat and healthy, especially in light of the VFHT (Vague Future Health Threat) Maybe some scientist would like to explore the possibility that it’s not the obesity that “catches up to us”, but the stress of a lifetime of constant social stigma, discrimination, and assertion that we are unhealthy lazy slobs, that causes health problems later in life for some obese individuals.
On the other side of that equation are these diets we keep hearing so much about. They work less than 5% of the time. But the general consensus of the scientific community seems to be “They only work a tiny percentage of the time, but that’s proof that they work so go get ’em tiger. And if you find yourself in the 95% of people who don’t lose weight – it’s so obviously and scientifically your fault. 5% of people can’t be wrong!”.
So every scientist and researcher interested in this subject has the opportunity to study the 1 in 3 healthy obese people and try to figure out why they are healthy. Or to study cultures where obesity is not stigmatized and negative health outcomes do not appear to be realized. Or they could do the million and first study about weight loss and the less than 5% of people who’ve been able to maintain weight loss for more than 5 years. And most of them choose the latter! I don’t think I’m particularly interested in the opinions of people who call themselves scientists and yet continuously make that choice.
All scientists make mistakes, disprove their own hypotheses through their research, and realize that they were wrong. That’s what science is about. It just seems like the ones who aren’t part of a $60 Billion industry are a little quicker to be honest (and, you know, scientific about it), and make a course correction. I don’t know about you but 5% is within the margin of error of most studies and that’s just not enough proof for me. What I do keeps me healthy and Monty may be worried about me (“bless his/her heart” as we say in the South), but I am not worried at all.
Dances With Fat 
Nice of him to be so “concerned” about you. I always love it when “well meaning” fundamentalist Christians are “concerned” about the fate of my queer little soul. It really upsets them when I tell them that I want nothing to do with a God who would hate his own gay creation for being the way he made it. They love that–ha!
I have a double-aged sword in this bigoted society that we live in. Maybe even triple-edged. Gay, fat, and have struggled with depression throughout my life.
I’m thinking I may have found a guy who likes me anyway–keeping my fingers crossed!
Glad I stumbled across this. I don’t think you need to change at all!
Oh Ragen, you are soooo astute. It is no coincidence that the “zillion dollar” industry to make us thin is in cahoots with the prevailing message that we are health risks if we don’t fit into the charts that deem us healthy. John Berger wrote in the “Way of Seeing, “The spectator-buyer is meant to envy herself as she will become if she buys the product. She is meant to imagine herself transformed by the product into an object of envy for others, an envy which will then justify her loving herself. One could put this another way: the publicity image steals her love of herself as she is, and offers it back to her for the price of the product.” No thanks, I’ll spend my money in other ways thank you. . . . . . . . . .
Where did you get that number that 1 in 3 obese people are healthy?
Oh, dear…that reads kind of snarky. I don’t mean to say it can’t be right, I just want to be able to use that number and say where it came from. I’m a nerd, too!
No worries, I’ve read it a bunch of places but this is a good study that found that number.
Nerds Unite!
~Ragen
Thanks!
ROFLOL at 5% can’t be wrong!
Where are these countries, of which you speak? I’ve got a valid passport and nothing to do!
I am immersed in weight research right now, and it’s so tiresome to talk to just about anyone about it and be told it’s “calories in/calories out” or “people just don’t move enough”. When I go, “well, it’s more complicated than that” I get told, no it’s not, by people who haven’t done one tenth of the research I have.
Also, the assumption that fat = unfit used to annoy the crap out of me. I’ve always been a big walker. I walk everywhere and can walk for hours and hours. Not only do I walk fast, but I have serious endurance. I live in Germany, where going for hikes in the forest on Sundays is part of the culture. I used to get very tired of people turning to me and asking if I was OK – because of course, as a fatty I couldn’t possibly cope with a hike – when as far as I was concerned, they were slowing me down.
However… in fairness, I do have to add that there IS a relationship between fat and health, in that the behaviours that can get you into trouble with diabetes, metabolic syndrome and the like are oftentimes the same ones that make you fat. So there definitely CAN be a relationship between the two. Although the correct thing to do in that case is to look at fixing the diabetes, or getting the cholesterol down or whatever. Also, because of the role that fat plays in oestrogen regulation, being very overweight can put you at risk for breast cancer.
I’m currently undergoing treatment for cancer (not breast cancer) and after I read about the relationship between fat and various types of cancer, I have wondered how much being overweight contributed to what happened to me. Or, to be more precise, how much the behaviours that made me fat in the first place contributed to the cancer. It’s a very hard thing to discuss, because what happens normally is that even bringing the subject up opens a space where people feel free to sit in judgement of you.
Hi Alexie,
Thanks for the comment. It’s awesome that you’ve stayed so fit and done so much research, and I’m sorry that you’re having to deal with cancer.
It’s not that I don’t think there is a relationship between fat and health, it’s just that the only proven relationship between fat and health that I’ve seen is correlational, not causational and it’s not a 100% correlation. According to some studies, it’s barely a 50% correlation http://archinte.ama-assn.org/cgi/content/full/168/15/1617. When I researched excess estrogen and cancer relationships I found the same thing – the research that I found should a correlational link, but not a causational one. (If you know of research that shows a causal link I would love to take a look at it!)
Thanks for the awesome comment and very best of luck to you!
~Ragen
Well put! Thank you. Thank you.
Thanks Sonora!
~Ragen
Ragen,
Once again, I’m just sitting in deep appreciation of your knowledge base, your passion and your voice. Not to mention the power of snark! 🙂 Thanks for another thought-provoking post.
Warmly,
Ann
Excellent post Ragen.
And if you find yourself in the 95% of people who don’t lose weight – it’s so obviously and scientifically your fault. 5% of people can’t be wrong!”.
That’s why I’ve decided my proving days are over although given the way I tend to think and respond, I sometimes forget it.
The way this is framed as debate is an attempt by those holding the above views to try and hide their irrationality. They are in thrall to proto-anorexia as a lifestyle and cannot face it.
This is the basis of the culture of calorie restriction, people’s minds have been taken over by it, just like people with anorexia have been trying to tell us all this time.
They are dismissed as being mentally ill to cover the consequences of those who pay the ultimate price for this thinking-because of their genetic legacy-distancing it from the acceptable face of normalize pro ana.
Everything else including the money has followed that. Certain cynical operators have manipulated this potency for their own ends for sure, but they depend on its power to enable this.
As for the researcher up thread, I do not accept the-you behave fat-become fat-then develop higher risk of problems-chain of causality.
What we eat and even how much energy we expend is a product of our mentabolic activity, therefore it is our metabolism which affects/ alters our eating, weight, levels of activity.
What causes this should be a focus of study, not how to run around after the fact.
I’ve noticed that those who read only the science pick up it’s inherent underlying bias and find it hard to think outside this.
WARNING: This comment may trigger some readers due to: inaccurate medical information, opinion and myths presented as facts, negative body talk and possible internalized oppression.
I enjoy your blog and can appreciate your efforts/attitudes, but what about Type 2 Diabetes? A condition that require those who have it to take medications and injections, and can cause complications like loss of feet, blindess, death etc. This has definitely been linked to obesity, and CAN be entirely reversed (or at least much better controlled) when the person who has it gets their diet/exercise straight (when weight loss typically follows). Just submitting that as one example where obesity CAN lead to very unpleasant diseases. (There are also more subjective issues, like knee/foot pain.) Not trying to be a skinny beayatch – I’m pleasantly plump m’self – I’m just sayin’.
Hi J,
Thanks for your comment, unfortunately it is rife with misinformation.
The idea that obesity causes type 2 diabetes is completely erroneous. The only thing that can be proven is that obesity and Type 2 diabetes sometimes happen at the same time. Correlation does not imply causation and in this case we’re talking about low-percentage correlations. According to the American Diabetes Association “Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.” Check out this blog for more information.
The idea that diet and exercise are typically followed by weight loss is partially true for the short term but over a five year period dieting has a success rate of less than 5% (typically within the margin of error for the study involved). If someone with type 2 diabetes changes their diet and exercise habits and it helps them manage the disease and they happen to lose weight, then the disease management and weight loss are both side effects of the behavior changes. There is no causal path that least from behavior changes through weight loss to management of diabetes.
While symptoms of Type 2 diabetes can be controlled to some extent through diet and exercise, there is no such thing as “entirely reversing it”, it is a disease.
According to the American Diabetes Association “Most overweight people never develop type 2 diabetes, and many people with type 2 diabetes are at a normal weight or only moderately overweight.” Check out this blog for more information.
The fact that you are pleasantly plump has no bearing on the fact that you are spreading bits of confused misinformation as if they are facts. Further I would prefer you not use the term “Skinny beayatch”on the blog since I find body snarking of any type inappropriate.
As always, if you can site a statistically significant study that supports your position I’ll be happy to read it and reconsider mine. Thanks.
~Ragen
The problem with the diagnosis of Type 2 Diabetes is that it is applied the moment there is one single documented BGL reading above a certain level and is never revoked thereafter. I know of people who keep their blood sugars under pretty good control not even eliminating sugary foods completely, but just making sure to eat fats and proteins along with them. And I know that emotions play a big role in blood sugar levels as well. My wife is supersize, and was diagnosed with diabetes at exactly the same age as her pleasantly plump mother did. The latter is into her 80s.