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Simple Sunday —

February 12, 2012

This post began as a response to Tom’s comment, but I began to realize that this should be addressed at our skeptics, including Dr. Peter, whose comment I am planning to respond to on Monday, as I have decided that I don’t have to get all research-y on the weekends. That’s for workdays. Weekends are for fucking around.

So, Tom contends that my estimate of 112,000 annual obesity deaths is incorrect because of what he found on Surgeon General’s Call to Action to Prevent Overweight and Obesity, which says “An estimated 300,000 deaths per year may be attributable to obesity.” The problem is, they don’t actually cite the research behind their claim. And if you can’t read the underlying research and know HOW they are counting those 300,000 deaths, then it’s awfully hard to say with any certainty whether my data or his data is more accurate.

My data comes from NHANES data, where Dr. Katherine Flegal and her team have taken anthropometric measurements, along with a full health exam, of tens of thousands of adults since 1971. It’s the only research of its kind and it’s the gold standard for research on obesity and health because it’s one of the few studies with such a huge amount of quantifiable data, as opposed to research that relies on surveys or medical record digs.

Tom hasn’t actually found a piece of research, he has found an uncited claim by the Surgeon General, which I will be certain to bring to their attention, so thanks. As for Tom’s concern for the 112,000, I wasn’t saying their deaths were acceptable. I was comparing previous studies from the CDC which grossly exaggerated the mortality rates for obesity AND overweight. So, yes, if they are making claims about the net mortality rate of obesity and overweight being 400,000 annual deaths, then I can compare the net total from the NHANES data, which is around 26,000 deaths, and you can read exactly how they got that right here in the research results.

But yes, the lives of those 112,000 do matter, but what you do not know is the reason for their deaths. Take, for example, the recent death of Heavy D, after which people speculated on how the fatness killed him. The reality was that Heavy D was both a cigar smoker and a chronic weight cycler, who lost over 100 pounds at least three times since 2003, not withstanding the other diets and diet pills he took in order to rid himself of his weight. At the time of his death he was on his fourth weight loss attempt in a decade.

So, yeah, I care about the people who are so desperate to not be fat that they are weight cycling themselves to death. I care about sharing with people that they can be healthy if they eat healthy foods and exercise, even if they scale doesn’t plummet. These are the things that I, and my awesome team of co-bloggers, do every day on Fierce, Freethinking Fatties. And people have the audacity to accuse us of enabling obesity and encouraging people to be unhealthy.

People act as though if you are not actively promoting weight loss as the cure for everything, then you must be promoting unhealthy behaviors. But behaviors and bodies are not the same thing. At our gym, there’s a woman who teaches the TRX class and who tears it up, and she appears fat. And in the weight room there are two trainers, both look heavy, one is a monumental bald white guy who you could not distinguish from a sedentary fatty if your life depended on it.  At the YMCA, when I tried the spinning class, the woman who taught us there appeared fat, and she cranked those gears at a terrifying rate. And she did it twice a day for an hour at least three days per week, at this particular YMCA.

These are my observations from a small, Midwestern town, and I guarantee that I am not the only one seeing these amazing fatties who are fit as a fiddle, yet still have to put up with the assumptions of others. And why? Because instead of focusing on a national campaign of health, we have become unwitting participants in a War on Fat.

While I absolutely LOVE discussing this issue, since I enjoy hashing out all kinds of uncomfortable topics, not all fat people are interested in being the subject of a national campaign. And when you compare the morbidity and mortality risk of obesity — a physical state, not a behavior mind you — and something like alcohol consumption, you begin to see that this has absolutely nothing to do with health, and everything to do with our puritanical outrage and the need for folk devils in a time of great uncertainty and fear.

Let’s say obesity kills 112,000 people, or 4.6% of total deaths, per year in the United States. Well, alcohol consumption kills 85,000, and is responsible for 3.5% of deaths (PDF), and we just finished our dual annual Get Shitfaced and Drive Somewhere Holidays, New Years and the Superbowl. And that’s not even considering the dumbasses who have it even worse when they go for a stroll.

And when’s the last time you heard someone take to a message board and say, “When I go to the store, I see those alkies loading up their carts with case after case of Stag and bottles of Tequila. It’s just disgusting!” I’ve been a drinker. When we used to hang out at Krieger’s every Wednesday night, people weren’t scowling at the drinkers around the bar. Nobody walked up and said, “You know your liver’s not going to last very long if you keep this up.” After all, we were just stupid college kids, and that’s what college kids do, right? And if there is any moral judgement, society dismisses it as puritanical nonsense. “What are we gonna do, have prohibition again?”

So, how can one of these health issues be a dire, urgent national emergency that requires our vigilance and a significant portion of our public awareness campaigns, while the other is practically our national past time? How is 4.6% significantly worse than 3.5%? And don’t give me this Quality of Life crap, because most obese people are not morbidly obese. They are smaller than me and I’m pretty fucking active, limber and comfortable.

And besides, have you ever lived with an alcoholic? Talk about a shitty quality of life.

Bear this in mind before you decide that the health of others is this national conversation that we’re supposed to have with you. I want to have this conversation because I think the existing “truths” about obesity and health are highly flawed. And if you disagree, I’m glad to share why you’re wrong. But I do this because I am confident in my understanding, not because I owe anyone an explanation for my body.

Tomorrow we return to regularly scheduled programming.


8 Comments leave one →
  1. February 12, 2012 7:58 pm

    Weren’t you permabanned? If so, please go away, as you are not welcome here.

    If you’re not the person who used to post under this name, ignore me.

  2. Colleen permalink
    February 12, 2012 9:26 pm

    I have enjoyed being enlightened regarding the “obesity epidemic.” As a therapist and former educator I sincerely wish we were as concerned with the “self-esteem,” epidemic that rears its ugly head in the guise of an “eating disorder,” rather than just focus on “obesity.” My research indicates that we have an “anorexic epidemic” occurring as well yet it certainly does not make the bill boards! Just saying.

  3. February 13, 2012 10:26 am

    “People act as though if you are not actively promoting weight loss as the cure for everything, then you must be promoting unhealthy behaviors.”

    This is the crux of the matter!

    It seems like opponents of HAES are willfully blind to the “H” in the acronym. For them, health is impossible without weight loss. You can supply them with an endless number of studies showing how much more successful it is to implement healthy behaviours rather than (usually futilely) try to lose weight if one’s goal is to improve health indicators and they’ll still stubbornly stick to their “thin = healthy” guns.

    I really admire you, Shannon, for continuing to respond to those who condescendingly describe us as “non-compliant” or tell us we “could do better” by losing weight because working out, overcoming the psychological factors behind binge eating (if that is a problem–and for many overweight people it is NOT an issue) and eating healthy foods just isn’t enough.

    It’s really, really hard to fight the tsunami of “lose weight or die”, but we’ve got to. There’s no other solution.

    Long live HAES!

  4. Tom Anderson permalink
    February 13, 2012 3:33 pm

    I find it hard to believe the Surgeon General just rolled a 300,000-sided dice and came up with that number. I’ll pose a simple question
    1. Is there a correlation between body fat levels and increased health problems?
    2. Does decreasing body fat levels reduce these same health problems?

    • February 13, 2012 3:48 pm

      1. Yes, of course there is a correlation. But correlation is not causation and there are many factors that stand between a simple Obesity Causes X Disease conclusion. Poverty, education, stigma, among many, many others.
      2. Yes, decreasing body fat levels reduces these same health problems. But while many people decrease their body fat levels every day through diet and exercise, few reduce their body fat levels for long, and when they regain, they do significant damage to their metabolic health.

      And I’m not asking you to not find it hard to believe, I’m saying that unless you have the research on which this estimate is based, there is no way to validate their claim.


      • Tom Anderson permalink
        February 13, 2012 10:55 pm

        It is not that I don’t have the research, it is that I don’t have the time to run it all down. I run a small business while working at another job, and have three kids. I respect that you have the drive to find plenty of evidence, but I feel that it is pierced together to find a conclusion that supports your hypothesis, and I’ve seen where you manipulate data to do just that. I wish I had the research job you had that allows you do this; I really do respect your efforts.

        You say that “few reduce their body fat for long and when they regain, they do significant damage to their metabolic health.” What about encouraging people to exercise and eat healthy so they don’t gain the body fat that is causational (and not just corollary).

        I would put forth that that poverty, education, and stigma are the corollaries and not the causes; I doubt you’d be able to find proof where poor education or stigma caused these diseases, but if you looked objectively and didn’t hunt for the data to support your hypothesis, I’m sure you could find that increased body fat causes them.

  5. Jackie permalink
    February 15, 2012 9:40 pm

    Tom, Shannon is not hypothesizing anything. Where as the anti-obesity crusaders have a long history of cherry picking for results that support their claim fat is horrible. You know what the cause is Tom, genetics. Not everyone is born to have the same body size and weight. Attacking a fat person for being fat, is no different than attacking a person with dark skin, because they’re dark skinned.

    This is only an issue, because there is a lot of money to be made off of attributing science thought up in the 1700s to fat people. That’s right, the idea that you can tell someone’s health just by looking at them is an ancient and non-scientific judgement. Since it’s so hard to get it through the thick heads of many people who follow the anti-obesity crusaders failed logic that fat is due to genetics, it’s difficult for them to understand when someone like Shannon presents real research to them.

    It seems some people, perhaps like you Tom, will fight tooth and nail to preserve the myth that weight can be controlled. You should be grateful that Shannon took the time out of his day to try and educate you. When all he gets in thanks, is a condescending trollish response, that he’s been piecing together evidence to support himself. That is not what fat activists do, that is what anti-fat researchers do. See the difference Tom.

    Shannon, I appreciate what you did here. It seems though the effort was futile. Tom will just continue going about his life, feeling superior to fat people. Hopefully his children won’t adopt his anti-fat attitude, and be one of the 112,000 children who are hospitalized with a starvation disorder in the future.

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