According to the National Institutes of Health, the man on the left in this photo is obese. I wouldn’t doubt the one on the right is, too.
I don’t really have time to write an in-depth post on this today, but Ezra has a good post today about an article in The New Republic by Paul Campos that was just brought out from behind the subscription wall (you do need to register to read it).
The gist of the article is that the “obesity crisis” is largely manufactured, and what’s behind it is both a diet industry that funds a lot of the research and stands to make a lot of money offering “solutions” as well as just plain visceral disgust of seeing fat people:
Obesity research in the United States is almost wholly funded by the weight-loss industry. For all the government’s apparent interest in the fat “epidemic,” in recent years less than 1 percent of the federal health research budget has gone toward obesity-related research. (For example, in 1995, the National Institutes of Health spent $87 million on obesity research out of a total budget of $11.3 billion.) And, while it’s virtually impossible to determine just how much the dieting industry spends on such research, it is safe to say that it is many, many times more. Indeed, many of the nation’s most prominent obesity researchers have direct financial stakes in companies that produce weight-loss products. (When they are quoted in the media, such researchers routinely fail to disclose their financial interests in the matters on which they are commenting, in part because journalists fail to ask them about potential conflicts.) And the contamination of supposedly disinterested research goes well beyond the effects of such direct financial interests. As Laura Fraser points out in her book Losing It: False Hopes and Fat Profits in the Diet Industry, “Diet and pharmaceutical companies influence every step along the way of the scientific process. They pay for the ads that keep obesity journals publishing. They underwrite medical conferences, flying physicians around the country expense-free and paying them large lecture fees to attend.”
This situation creates a kind of structural distortion, analogous to that which takes place in the stock market when analysts employed by brokerage houses make recommendations to clients intended to inflate the price of stock issued by companies that in return send their business to the brokerages’ investment-banking divisions. In such circumstances, it’s easy for all the players to convince themselves of the purity of their motives. “It isn’t diabolical,” eating-disorders specialist David Garner told Fraser. “Some people are very committed to the belief that weight loss is a national health problem. It’s just that, if their livelihood is based in large part on the diet industry, they can’t be impartial.” Fraser writes that when she asked one obesity researcher, who has criticized dieting as ineffective and psychologically damaging, to comment on the policies of one commercial weight-loss program, he replied, “What can I say? I’m a consultant for them.”
What makes this structural distortion particularly insidious is that, just as Americans wanted desperately to believe that the IPO bubble of the ’90s would never burst–and were therefore eager to accept whatever the experts at Merrill Lynch and on The Wall Street Journal’s editorial page had to say about the “New Economy”–they also long to believe that medical experts can solve the problem of their expanding waistlines. The reason for this can be summed up in six words: Americans think being fat is disgusting. That psychological truth creates an enormous incentive to give our disgust a respectable motivation. In other words, being fat must be terrible for one’s health, because if it isn’t that means our increasing hatred of fat represents a social, psychological, and moral problem rather than a medical one.
The convergence of economic interest and psychological motivation helps ensure that, for example, when former Surgeon General Koop raised more than $2 million from diet-industry heavyweights Weight Watchers and Jenny Craig for his Shape Up America foundation, he remained largely immune to the charge that he was exploiting a national neurosis for financial gain. After all, “everyone knows” that fat is a major health risk, so why should we find it disturbing to discover such close links between prominent former public health officials and the dietary-pharmaceutical complex?
None of this is to suggest that the war against fat is the product of some sort of conscious conspiracy on the part of those whose interests are served by it. The relationship between economic motives, cultural trends, social psychology, and the many other factors that fuel the war on fat is surely far more complex than that. But it does suggest that the conventional wisdom about fat in the United States is based on factors that have very little to do with a disinterested evaluation of the medical and scientific evidence, and therefore this conventional wisdom needs to be taken for what it is: a pervasive social myth rather than a rational judgment about risk.
Basically, what Campos is arguing is that fatness matters less than fitness when the data are crunched, and that the one-size-fits-all measures like BMI or weight charts do more harm than good because weight is used as a proxy for health, regardless of other factors.
In addition, we’re an incredibly schizophrenic society when it comes to weight and fat. We’re told how sinfully rich desserts are, but cautioned against appearing as though we actually ate them. The messages start early: young kids are developing more and more eating disorders as they absorb culturally fucked-up messages about fat. Teenage girls who frequently read magazine articles about dieting are more likely to use extreme forms of weight loss, such as vomiting, later on than girls who don’t. At the same time, the media gets a bug up its ass frequently about The Childhood! Obesity! Epidemic! and runs scaremongering stories like this one — reporting a study in which researchers reported a link between teenage obesity and middle-aged death. Oh, and a second study about weight loss in teens using Meridia (hey! there’s that diet-industry involvement again. I suppose the 14 pounds lost on Meridia beats the average on Xenical. You remember Xenical — “I lost 6 pounds on Xenical, and all I got was this oily anal leakage”).
I do need to wrap this up, but be sure to read the comments at Ezra’s. The fat-bashing starts early, and the “But — but — diabetes!” comments aren’t too far behind. And then go read Amanda’s and Scott’s and Shakes’ posts on the subject.