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News & ArtsMonday, November 23, 2009
Health / News Health at Every Size
Posted by Dan Savage on Mon, Nov 23, 2009 at 9:07 AM
This just in...
A new study has found that almost 10 percent of people who are classified medically as obese believe they have a healthy body size and do not need to lose weight—despite the fact that many have high blood pressure, elevated cholesterol and diabetes.... “Perception affects behavior,” said Tiffany Powell, a cardiology fellow at the University of Texas Southwestern Medical Center at Dallas who reported the findings November 17 at the American Heart Association’s Scientific Sessions 2009. Obese patients who misperceived their body size were less likely to see a physician, she said: 44 percent had not seen a doctor in the past year, compared with 26 percent of obese patients who thought they needed to lose weight. For someone to become motivated enough to improve diet and exercise habits, she said, “they have to understand that obesity is not benign.”
Denialists won't be able to argue that this study's sample size is too small: the data is from the Dallas Heart Study, which involves 6000 subjects. But perhaps the methodology is flawed...
After asking participants to classify their body size as below normal, normal or above normal, the researchers found that about one of every eight people who were obese rated his body size as normal...
Obesity is rapidly becoming the norm in places like Dallas County.
4
Money means eating well - staus means not looking starving -
modern life means less moving around.
World wide problem in Euro countries - too much fat.
Everybody needs to adjust eating habits ... eat less and eat healthy.
modern life means less moving around.
World wide problem in Euro countries - too much fat.
Everybody needs to adjust eating habits ... eat less and eat healthy.
5
@4: It costs next to nothing to grow a garden, and if you don't own land there are lots of community gardens you can participate in. I agree that poverty plays a huge part in obesity, but mostly combined with ignorance.
6
Dear poor people: if you'd like to lose weight, just start a garden in your spare time, in between your three minimum-wage jobs and picking your kids up from school. Sincerely, Helpful Slog Commenters.
7
@5: well, it costs me a lot to grow a garden: gas to go get manure, mulch, plant starts, & the time to dig, amend, plant, repair trellises, weed (fucking morning glory vines), & pest control. not to mention the water bill. it is certainly cheaper to just go buy tomatoes, esp. in the PNW.
8
@6 --....Three minimum-wage jobs does not leave someone in poverty. And this generation is the first to ever have children at school while their parents work?? Stupid use of hyperbole.
Being poor could also mean it's more important than ever to use your limited resources more wisely.
Being poor could also mean it's more important than ever to use your limited resources more wisely.
9
While poverty may put up barriers to eating better, it's not impossible. Also many of the obese today cannot blame poverty. When I see the 350 lbs man, and his 280 lbs wife, and the butterball child coming out of Five Guys Burgers, and walk next door the Cold Stone Creamery, it's not because they're poor. More and more people have bad diet and exercise habits.
10
Perhaps 10% of those considered obese due to the BMI standard consider themselves healthy because they are healthy?
If you have an unusual body type (including significant muscle mass), a BMI calculation will label you obese while having a low body fat percentage, and not really being at higher risk for the parade of horribles you mention.
One of my friends went to a service academy while her BMI labeled her morbidly obese. Turns out being a powerlifter means you have a little bit of muscle mass that skews the calculation.
Hell, just look at the illustrated BMI categories photostream on Flikr to see how things go awry when you try to use a statistical measuring device to judge individual people as deficient.
If you have an unusual body type (including significant muscle mass), a BMI calculation will label you obese while having a low body fat percentage, and not really being at higher risk for the parade of horribles you mention.
One of my friends went to a service academy while her BMI labeled her morbidly obese. Turns out being a powerlifter means you have a little bit of muscle mass that skews the calculation.
Hell, just look at the illustrated BMI categories photostream on Flikr to see how things go awry when you try to use a statistical measuring device to judge individual people as deficient.
11
10, The article specifically says that many of the people who are in denial of their own obesity, have health problems such as high blood pressure, elevated cholesterol and diabetes.
14
Gardening is very time and labor intensive. If you're doing it as a hobby, it's quite enjoyable. If your food depends on it as anything other than "Hey! I grew these tomatoes!" then it's a serious commitment.
15
13,
BMI provides a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems.
http://www.cdc.gov/healthyweight/assessi…
16
From the article Dan linked about Dallas County:
"State demographer Karl Eschbach, the study's author, predicts that by 2040, 46 percent of Dallas County adults will be obese if no big prevention push is mounted."
From the King County website:
"In 2001, 52% of King County residents age 18 and over (about 680,000 of the county’s 1.3 million adults) were either overweight or obese. In 1987, the first year for which data are available, 37% (about 395,000) were overweight or obese."
Yes, there is a difference between overweight and obese, but those numbers are from 2001 and obesity was trending up. King County has no place acting skinnier-than-thou.
"State demographer Karl Eschbach, the study's author, predicts that by 2040, 46 percent of Dallas County adults will be obese if no big prevention push is mounted."
From the King County website:
"In 2001, 52% of King County residents age 18 and over (about 680,000 of the county’s 1.3 million adults) were either overweight or obese. In 1987, the first year for which data are available, 37% (about 395,000) were overweight or obese."
Yes, there is a difference between overweight and obese, but those numbers are from 2001 and obesity was trending up. King County has no place acting skinnier-than-thou.
17
You've never actually grown a garden, have you? The tools are fucking expensive. And how many poor people have backyards or own their homes and thus aren't beholden to a landlord?
It costs next to nothing to grow a garden
You've never actually grown a garden, have you? The tools are fucking expensive. And how many poor people have backyards or own their homes and thus aren't beholden to a landlord?
18
@15
From your CDC link:
How reliable is BMI as an indicator of body fatness?
The correlation between the BMI number and body fatness is fairly strong; however the correlation varies by sex, race, and age. These variations include the following examples:
At the same BMI, women tend to have more body fat than men.
At the same BMI, older people, on average, tend to have more body fat than younger adults.
Highly trained athletes may have a high BMI because of increased muscularity rather than increased body fatness.
It is also important to remember that BMI is only one factor related to risk for disease. For assessing someone's likelihood of developing overweight- or obesity-related diseases, the National Heart, Lung, and Blood Institute guidelines recommend looking at two other predictors:
The individual's waist circumference (because abdominal fat is a predictor of risk for obesity-related diseases).
Other risk factors the individual has for diseases and conditions associated with obesity (for example, high blood pressure or physical inactivity).
Did this study use more than BMI to classify them?
btw. My BMI has always classified me underweight.
From your CDC link:
How reliable is BMI as an indicator of body fatness?
The correlation between the BMI number and body fatness is fairly strong; however the correlation varies by sex, race, and age. These variations include the following examples:
At the same BMI, women tend to have more body fat than men.
At the same BMI, older people, on average, tend to have more body fat than younger adults.
Highly trained athletes may have a high BMI because of increased muscularity rather than increased body fatness.
It is also important to remember that BMI is only one factor related to risk for disease. For assessing someone's likelihood of developing overweight- or obesity-related diseases, the National Heart, Lung, and Blood Institute guidelines recommend looking at two other predictors:
The individual's waist circumference (because abdominal fat is a predictor of risk for obesity-related diseases).
Other risk factors the individual has for diseases and conditions associated with obesity (for example, high blood pressure or physical inactivity).
Did this study use more than BMI to classify them?
btw. My BMI has always classified me underweight.
19
Also, the "obesity is a result of ignorance" argument is usually put forward by the monied class to mitigate guilt and eliminate their need to take action. There is a larger (heh) reason a strong correlation between low income and obesity exists.
Even if poor people had the time to garden their own food, they would likely lack money for start-up supplies. And public space is not available to everyone; pea patches routinely have waiting lists.
Of course, education should play a role in fighting obesity. But just saying "fat people didn't pay attention in school" doesn't help anything.
Even if poor people had the time to garden their own food, they would likely lack money for start-up supplies. And public space is not available to everyone; pea patches routinely have waiting lists.
Of course, education should play a role in fighting obesity. But just saying "fat people didn't pay attention in school" doesn't help anything.
20
It's telling that the article doesn't specify how many of those people have health problems, or how that tracks with those health problems in the general population. Or weren't you aware that skinny people can also have high blood pressure/cholesterol and diabetes?
The article specifically says that many of the people who are in denial of their own obesity, have health problems such as high blood pressure, elevated cholesterol and diabetes.
It's telling that the article doesn't specify how many of those people have health problems, or how that tracks with those health problems in the general population. Or weren't you aware that skinny people can also have high blood pressure/cholesterol and diabetes?
21
18, again even with it's limitations, BMI is still a reliable measurement for most people. Unless you are a major body builder of some sort, BMI is going to work for you. Most people found to be obese by BMI standards are nowhere close to being body builders, or athletic in any sense..
22
20, It still says people with medical problems stemming from their obesity are still in denial about their weight. Most people found to be obese by BMI standards are obese. Pretesting they are in some odd exception to the rule doesn't make it so.
23
And, by the way, this woman is obese, so is this woman, and this woman is less than half a pound away from qualifying. If you think any of these women are about to keel over, there's something seriously fucking wrong with you.
24
@9: "Butterball child" sounds delicious. Can I find them in my local NW food store's frozen foods section next to the Butterball Turkeys or are they a regional favorite available only in Baltimore? Are they grown in factory farms? I prefer organic, cageless free range.
25
@22,
Unless of course it's not stemming from obesity. What about people with childhood diabetes or who have a genetic predisposition to any of those problems? You define credulous hack.
Unless of course it's not stemming from obesity. What about people with childhood diabetes or who have a genetic predisposition to any of those problems? You define credulous hack.
26
23, They all should consider losing weight. While they bodies have been able to stand up to the strain of their weight thus far, statistically, chances are, they will break down faster, and have more health problems as they grow older than normal weight person.
27
Poor people don't need their own gardens to eat well. I've been extremely poor, below the poverty line, but knew enough about nutrition to buy whole grains and beans in bulk and fruits and vegetables in season. An additional understanding of spices and cooking allowed me to eat delicious, healthy food.
28
25, You don't know what you are talking about. Juvenile diabetes is not the same as adult onset diabetes which is often part of, caused by being obese. Look up the difference between type1 (juvenile diabetes) and type 2 (adult onset diabetes)
29
@23 -- You apparently are illustrating the study's conclusion? Do you not know what thin looks like?
Those women are indeed fat, obese, chubby-wubby, call it what you will.
I don't know anything about their moral rectitude however.
Those women are indeed fat, obese, chubby-wubby, call it what you will.
I don't know anything about their moral rectitude however.
30
There are online sites that let you choose clothes that actually fit your form, if that helps.
Puff skirts are back this year, and the media message from France for fashion is legs, legs, legs.
That said: the best thing anyone can do is avoid yo-yo dieting and get mild to moderate exercise, gradually working up to it - drastic changes can really stress your body out.
Puff skirts are back this year, and the media message from France for fashion is legs, legs, legs.
That said: the best thing anyone can do is avoid yo-yo dieting and get mild to moderate exercise, gradually working up to it - drastic changes can really stress your body out.
31
I think it's rather cute, really. Dan will defend to the death anyone's right to put anything in any orifice except food in the mouth.
He's the Nancy Reagan of weight. Telling people who are obese to "just say no" while ignoring piles of data of what is behind the rates (sub-standard or no education in schools about nutrition, poverty, food insecurity, etc.)
I will say this post gave me a good laugh with the "it costs next to nothing to grow a garden" comment.
He's the Nancy Reagan of weight. Telling people who are obese to "just say no" while ignoring piles of data of what is behind the rates (sub-standard or no education in schools about nutrition, poverty, food insecurity, etc.)
I will say this post gave me a good laugh with the "it costs next to nothing to grow a garden" comment.
32
@17 - you can rent them really cheap from the Phinney Neighborhood Center. And, fwiw, gardening is good exercise.
34
33, You have to remember, while she may have been a 16 in the 1950s, she'd be a 6 or 8 in today's sizes. You could fit two of her in a current day size16.
35
I love these threads, 'cuz it says "you're a huge obese monster because you eat all the wrong foods, don't go to the gym and sit on your butt all day" with the utter certainty of a 17th century preacher.
'cuz if you go to the gym, eat the right things and walk everywhere, there is 0% chance that you'll be heavy in any sense.
'cuz if you go to the gym, eat the right things and walk everywhere, there is 0% chance that you'll be heavy in any sense.
36
@33 Ha! La divina was 35-22-35 and weighed around 120 pounds at 66 inches tall. Not obese then or now.
Wonderfully curvy and like jello on springs.....
Wonderfully curvy and like jello on springs.....
37
BMI is a tool designed to provide statistical information when analyzing large population groups and was never intended to be used as a tool to determine the relative health of individuals. So, while there may be SOME individual correlation between BMI and obesity, relying on it as the sole determiner is probably not the best idea.
Also, it's not surprising to me that many of these people would be in denial about their obesity; when you spend most of your time around other people who tend to have the same general body type as you (and according to recent studies a significant percentage - if not an outright majority - of of Americans could be classified as either overweight or obese), you begin to think of that as "normal".
Also, it's not surprising to me that many of these people would be in denial about their obesity; when you spend most of your time around other people who tend to have the same general body type as you (and according to recent studies a significant percentage - if not an outright majority - of of Americans could be classified as either overweight or obese), you begin to think of that as "normal".
38
I don't care if you're rich or poor. Walking/running is fucking free. Get off your fat lazy ass and go do something for fuck sake. Maybe instead of lumbering your rich ass 10 feet to your Escalade or hoisting your poor ass onto the wheelchair lift of the Metro you should walk to wherever it is you're going. Ate BK and three bags of Doritos for lunch? Better make that a run.
If you're not going to do it for yourself maybe you can at least do it for your community. After all we are the ones who are forced to look at your disgusting front butt hanging over your sweatpants and out the bottom of your shirt.
If you're not going to do it for yourself maybe you can at least do it for your community. After all we are the ones who are forced to look at your disgusting front butt hanging over your sweatpants and out the bottom of your shirt.
40
@35" 'cuz if you go to the gym, eat the right things and walk everywhere, there is 0% chance that you'll be heavy in any sense. "
Yeah --- pretty much true, tho nothing sure except death and taxes. If after a year, people who are going to the gym for 5-6 hours of excercise a week, good food, and walking are still obese, then they are one of the tiny number of people with some unusual health issue.
But you won't know if you are one of those anomolies unless you do the whole exercise and eating routine...
Yeah --- pretty much true, tho nothing sure except death and taxes. If after a year, people who are going to the gym for 5-6 hours of excercise a week, good food, and walking are still obese, then they are one of the tiny number of people with some unusual health issue.
But you won't know if you are one of those anomolies unless you do the whole exercise and eating routine...
43
@31, he's defended people's right to be fat, too. There's been a couple of podcasts where he's pointed out that being fat isn't ideal heath-wise, but that one could say the same of many other behaviors (for instance gay people have a higher risk of suicide/psychological disorders, so their lifestyle is "less healthy"), and that doesn't mean people don't have the "right" to pursue those behaviors.
Anyway this post is critiquing the fat acceptance movement, not individual chubby/overweight people. Fat acceptance argues that you can be "healthy at every size," this is a counterargument. It's not an argument about anyone's "right" to eat.
Anyway this post is critiquing the fat acceptance movement, not individual chubby/overweight people. Fat acceptance argues that you can be "healthy at every size," this is a counterargument. It's not an argument about anyone's "right" to eat.
44
33, To add, it turns out it's a myth that she was a 16, and she had a bmi of 21, which falls into the normal range.
http://women.timesonline.co.uk/tol/life_…
http://women.timesonline.co.uk/tol/life_…
45
34, 36, 44 - Have you guys got your sarcasm meter toggled to the 'off' position today?
My post was intended to harpoon (sorry) some hysteria over body size and what is or isn't considered 'obese'. Of Course Miss Monroe wasn't 'obese', in any sense of the word. I believe @23's post was making something of the same point.
Still, I guar-an-tee you that, if Marilyn were alive today -- still scrumptiously in her early 30's, say -- you'd have jackasses on the internet howling about how FAT she is. It's the way of it -- the way of virtual life, that is. In person she'd still knock their socks off, I betcha.
My post was intended to harpoon (sorry) some hysteria over body size and what is or isn't considered 'obese'. Of Course Miss Monroe wasn't 'obese', in any sense of the word. I believe @23's post was making something of the same point.
Still, I guar-an-tee you that, if Marilyn were alive today -- still scrumptiously in her early 30's, say -- you'd have jackasses on the internet howling about how FAT she is. It's the way of it -- the way of virtual life, that is. In person she'd still knock their socks off, I betcha.
48
@47: I love how this is a referendum on me, I love the attention.
I'm pretty sure I exercise more often than most folks on Slog. I'm certainly stronger than the vast majority of people here, that's for sure.
Which is why Lindy needs to watch out, I'm still going to duel her on the roof of the Stranger HQ tower for unspecified reasons.
I'm pretty sure I exercise more often than most folks on Slog. I'm certainly stronger than the vast majority of people here, that's for sure.
Which is why Lindy needs to watch out, I'm still going to duel her on the roof of the Stranger HQ tower for unspecified reasons.
49
10% of people living in denial is something to crow about?
Oooooookay...
I can understand how there's a higher margin of people who state that their body size is 'normal' - it's all about just looking around at the waist size of your neighbors.
Oooooookay...
I can understand how there's a higher margin of people who state that their body size is 'normal' - it's all about just looking around at the waist size of your neighbors.
51
Most of you are conflating two separate things: Health at Every Size and the Fat/Size Acceptance movement. FA suggests that all human beings, including fat people, are worthy of respect and dignified treatment, however repulsive certain people may find their appearances or “lifestyles.” (Kind of like how, for example, LGBT folks, people of color, Republicans, etc., deserve respectful, dignified treatment no matter repulsive certain people may find them or their lifestyles.) You’re not required to marry one; it would be nice, however, if you didn’t attack them in the streets, deny them jobs and housing, etc.
HAES is a lifestyle approach that’s available to people of any size, fat or thin. It focuses on eating healthy food, exercising, not smoking, and leading a healthy lifestyle without focusing on weight or weight loss. Instead health is measured by the same markers that all people’s health should be measured by: blood pressure, cholesterol and triglycerides, blood sugar, physical fitness (as in being able to walk or exercise for sustained periods) etc. People with poor eating and exercise habits to begin with may lose weight after adopting HAES, but not everyone will. Everyone who stick to it will, however, most likely improve in the other areas mentioned—perhaps substantially. It’s especially good for people with a history of eating disorders or body image issues—it allows them to work on being healthy, rather than having success or failure rest on whether they’ve achieved skinniness or not.
HAES is a lifestyle approach that’s available to people of any size, fat or thin. It focuses on eating healthy food, exercising, not smoking, and leading a healthy lifestyle without focusing on weight or weight loss. Instead health is measured by the same markers that all people’s health should be measured by: blood pressure, cholesterol and triglycerides, blood sugar, physical fitness (as in being able to walk or exercise for sustained periods) etc. People with poor eating and exercise habits to begin with may lose weight after adopting HAES, but not everyone will. Everyone who stick to it will, however, most likely improve in the other areas mentioned—perhaps substantially. It’s especially good for people with a history of eating disorders or body image issues—it allows them to work on being healthy, rather than having success or failure rest on whether they’ve achieved skinniness or not.
52
I think fat folks are GREAT. We need more of them; the bigger, the fatter, the better. Give me a short, fat, sensual life over a long lean life any day. Jelly bellies are the smart ones: just think, they willingly sacrifice the last 10 to 15 years off their lives because those are the drooling, incontinent, cancer ridden years. Who wants a decade and a half of senile dementia anyway? Live lazy, eat lots, die early and leave a disgustingly bloated corpse.
Every meal should be a Thanksgiving meal with lotsa pies.
This message brought to you by the High Fructose Corn Syrup Consortium.
Every meal should be a Thanksgiving meal with lotsa pies.
This message brought to you by the High Fructose Corn Syrup Consortium.
54
23: Whether or not those women are "attractive" has nothing to do with whether or not they're healthy. A large woman can be as well groomed and fashionable as possible, but her arteries still have a higher chance of being clogged.
It's really simple, guys: if someone is large despite having a healthy diet and exercise routine, then fine; they're just naturally large and probably have nothing to worry about. If someone is large because they eat fatty foods and get very little exercise, then they are likely going to have health issues down the line.
Because the vast majority of obese people are obese due to poor health habits, we get these very REAL statistical links between obesity and poor health. Denying the links between unhealthy habits, obesity, and poor health does not cause such links to cease to exist, nor does it do any good at all for the self-esteem of obese people. Exaggerating the portion of "obese" people who are healthy or whose obesity is due to chronic medical conditions rather than unhealthy habits is dishonest and, once again, doesn't change the reality that poor health habits will affect your health. Focusing on whether or not an obese person can be found attractive by however many people is absolutely irrelevant.
The fact remains that, attractive or not, the majority of obese people are at serious risk and need to know it. If someone wants to take those risks because they feel attractive enough already or because health and longevity aren't as important to them as their pleasures, then fine; they get to make that choice. But it has to be an informed choice where they realize what their risks are. It can't be based on deceptive denial that there is a definite link between eating fatty foods, lacking exercise, being obese, and developing related health problems.
More...
It's really simple, guys: if someone is large despite having a healthy diet and exercise routine, then fine; they're just naturally large and probably have nothing to worry about. If someone is large because they eat fatty foods and get very little exercise, then they are likely going to have health issues down the line.
Because the vast majority of obese people are obese due to poor health habits, we get these very REAL statistical links between obesity and poor health. Denying the links between unhealthy habits, obesity, and poor health does not cause such links to cease to exist, nor does it do any good at all for the self-esteem of obese people. Exaggerating the portion of "obese" people who are healthy or whose obesity is due to chronic medical conditions rather than unhealthy habits is dishonest and, once again, doesn't change the reality that poor health habits will affect your health. Focusing on whether or not an obese person can be found attractive by however many people is absolutely irrelevant.
The fact remains that, attractive or not, the majority of obese people are at serious risk and need to know it. If someone wants to take those risks because they feel attractive enough already or because health and longevity aren't as important to them as their pleasures, then fine; they get to make that choice. But it has to be an informed choice where they realize what their risks are. It can't be based on deceptive denial that there is a definite link between eating fatty foods, lacking exercise, being obese, and developing related health problems.
55
Is this surprising? I thought it was more along the lines of "common knowledge."
I don't understand what the issue is. Why bring it up?
I don't understand what the issue is. Why bring it up?
56
Dan hates fat people, Arabs, Muslims, African-American, non-rich gay people... Is there anyone you do like,Dan?
57
@55 Because apparently people aren't making "informed choices" (a liberal euphemism for "agreeing with me") and they must be re-educated.
58
I've conducted a new study, and I've determined that the majority of innumerate / irrational people on Slog think they can understand relatively simple math or logic.
The study at issue says that 12% of people believe that they are healthy despite being classified as "obese" with the BMI metric. Instantly, any discussions of "most" or "generally" or "normally" are irrelevant, because we're talking about roughly one-tenth of the population. It doesn't matter if most people classified as obese have various health issues, because we're specifically talking about the small subset of people who are classified as obese but believe that they are nonetheless healthy. If a large number of these people are, in fact, healthy, then this study doesn't really say what people think it does.
Yes, the article says that some of these people had health issues: somewhere between 35% and 64% of this narrow group. If 50% of the people in this group (chosen as the mean between the two possible outcomes, for lack of a reason to choose otherwise) identified themselves as healthy but have one of the diseases in question, that's only 6% of the overall group, or 360 people out of 6,000. Importantly, it also means that 50% of the people Dan implies are misleading themselves are actually correct.
As an aside, whether it's about bisexual people's choices of long-term partners, racial voting patterns, or public health issues, Dan Savage *is terrible at math*. Perhaps some remedial high school classes are in order?
The study at issue says that 12% of people believe that they are healthy despite being classified as "obese" with the BMI metric. Instantly, any discussions of "most" or "generally" or "normally" are irrelevant, because we're talking about roughly one-tenth of the population. It doesn't matter if most people classified as obese have various health issues, because we're specifically talking about the small subset of people who are classified as obese but believe that they are nonetheless healthy. If a large number of these people are, in fact, healthy, then this study doesn't really say what people think it does.
Yes, the article says that some of these people had health issues: somewhere between 35% and 64% of this narrow group. If 50% of the people in this group (chosen as the mean between the two possible outcomes, for lack of a reason to choose otherwise) identified themselves as healthy but have one of the diseases in question, that's only 6% of the overall group, or 360 people out of 6,000. Importantly, it also means that 50% of the people Dan implies are misleading themselves are actually correct.
As an aside, whether it's about bisexual people's choices of long-term partners, racial voting patterns, or public health issues, Dan Savage *is terrible at math*. Perhaps some remedial high school classes are in order?
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