No, it’s not actually I Hate Fat People week, but it kind of feels like it. A (very questionable) new study says that obesity spreads like a “virus,” and having fat friends can make you fatter. Another says that mothers who work outside the home make their kids fat. According to the Chronicle of Higher Education, obese girls are less likely to go to college. And now Dick Cavett has a thing or two to say about obese people daring to show their faces on television (or just about anywhere). It’s an incredibly hateful piece, and it demonstrates just how bigoted people can be towards overweight people — something further illustrated in a recent Zogby survey which found that 26 percent of Americans believe most people would least want to work with a morbidly obese person.
Cavett writes:
It was only a few years ago that I first noticed an obese person in a commercial. Then there were more. Now, like obesity itself, it has gotten out of hand.
This disturbs me in ways I haven’t fully figured out, and in a few that I have. The obese man on the orange bench, the fat pharmacist in the drug store commercial and all of the other heavily larded folks being used to sell products distresses me. Mostly because the message in all this is that its O.K. to be fat.
As we know, it isn’t.
It isn’t, he says, because of the health risks that come with obesity. There are some people who dispute the very idea that obesity is at all related to health issues, but I’m not part of that camp. Yes, being obese is bad for you. Guess what? Most obese people know that! Some extra fat on your thighs does not, in fact, turn your brain to lard. But being overweight does not automatically translate into being unhealthy, any more than being thin automatically translates into living until you’re 100. There are a whole lot of factors. And from my (admittedly limited) research into this issue, it seems that being sedentary and eating crap is a whole lot worse for you than being fat — that is, a thin or average-sized person who never moves and eats crap every day is going to have bigger problems with heart disease, diabetes, and many of the other issues Cavett lists than a person whose BMI puts them into the overweight category but who exercises regularly and eats a balanced diet.
And, as many overweight — and average-weight — people will tell you, dropping pounds isn’t easy. I’m not overweight, I work out four times a week, I eat fairly well, I walk just about everywhere (including up the stairs to my sixth-floor apartment), I have a normal metabolism and I still can’t lose even very small amounts of weight (a few pounds) without some serious effort. Losing 15 or 20 or 30 pounds is certainly no small job. The narrative of “if you only exercise and eat well you’ll be ‘normal’ sized” is a joke — plenty of people do eat well and do exercise and still have BMIs that put them in the “overweight” or “obese” category. Genetics matter, a lot. And it is pretty difficult to change your genetically-determined weight, on either end of things:
The implications were clear. There is a reason that fat people cannot stay thin after they diet and that thin people cannot stay fat when they force themselves to gain weight. The body’s metabolism speeds up or slows down to keep weight within a narrow range. Gain weight and the metabolism can as much as double; lose weight and it can slow to half its original speed.
Losing significant amounts of weight is just as difficult as gaining significant amounts of weight:
It began with studies that were the inspiration of Dr. Ethan Sims at the University of Vermont, who asked what would happen if thin people who had never had a weight problem deliberately got fat.
His subjects were prisoners at a nearby state prison who volunteered to gain weight. With great difficulty, they succeeded, increasing their weight by 20 percent to 25 percent. But it took them four to six months, eating as much as they could every day. Some consumed 10,000 calories a day, an amount so incredible that it would be hard to believe, were it not for the fact that there were attendants present at each meal who dutifully recorded everything the men ate.
Once the men were fat, their metabolisms increased by 50 percent. They needed more than 2,700 calories per square meter of their body surface to stay fat but needed just 1,800 calories per square meter to maintain their normal weight.
When the study ended, the prisoners had no trouble losing weight. Within months, they were back to normal and effortlessly stayed there.
In other words, it’s pretty hard to change what nature gave ya. It’s also worth noting that while obesity is genetic, obesity-related problems like diabetes and heart disease also have genetic factors. So perhaps drawing cause-and-effect lines between obesity and other medical complications isn’t so simple.
Now, there are obviously a variety of factors that lead to weight gain and loss. According to research cited in many of these articles, there’s about a 30-pound range that most people naturally fall into. That is, a person’s weight will naturally fall between, say, 110-140 pounds, and they can move between those two extremes without drastic measures. But if you’re already in the upper range of your natural weight and you’re unable to access the kinds of things that will allow you to eat better and maintain physical activity, it’ll be harder to move back down, and easier to continue inching up.
While it’s cruel and simply inaccurate to blame weight gain solely on food and lack of physical activity, it’s foolish to ignore the structural issues that contribute to obesity and general unhealth. Obesity rates fall along socio-economic lines, with the poor shouldering much of the burden. If you’re living on a tight budget, you’re going to buy cheap and filling foods — pasta, ramen and frozen vegetables as opposed to fresh greens and fish. If you’re on a tight budget and you’re busy (working full time, raising kids, etc), McDonald’s is going to make a lot more sense than coming home and cooking. And if you’re poor, you probably aren’t going to purchase a gym membership. You may not live in a place where it’s safe to go for a long walk. You may have so much else to do that taking a leisurely stroll or taking a jog isn’t an option. And there are a million other factors that make it very, very difficult for low-income people to afford the healthiest food and engage in the kind of physical activity necessary to lose a significant amount of weight.
In fact, socio-economic status is highly correlated with health in general. Surprise, surprise. Poor people get the short end of the stick on just about everything — and our cultural myth of “if you work hard you’ll do well” only worsens the situation by demonizing both poor people and fat people. Instead of helping people get healthy, we shame them for the factors that are making them sick. And being poor is often what makes you sick:
Over time, research linking health and wealth became more nuanced. It turns out that “what matters in determining mortality and health in a society is less the overall wealth of that society and more how evenly wealth is distributed. The more equally wealth is distributed, the better the health of that society,” according to the editors of the April 20, 1996 issue of the British Medical Journal. In that issue, American epidemiologist George Kaplan and his colleagues showed that the disparity of income in each of the individual U.S. states, rather than the average income per state, predicted the death rate.
“The People’s Epidemiologists,” an article in the March/April 2006 issue of Harvard Magazine, takes the analysis a step further. Fundamental social forces such as “poverty, discrimination, stressful jobs, marketing-driven global food companies, substandard housing, dangerous neighborhoods and so on” actually cause individuals to become ill, according to the studies cited in the article. Nancy Krieger, the epidemiologist featured in the article, has shown that poverty and other social determinants are as formidable as hostile microbes or personal habits when it comes to making us sick. This may seem obvious, but it is a revolutionary idea: the public generally believes that poor lifestyle choices, faulty genes, infectious agents, and poisons are the major factors that give rise to illness.
Fat-shaming is an easy way to avoid actually doing anything about our broken health care system. It enables all of us to shift the blame to people who we can blame for being lazy or gluttonous, instead of taking a hard look at the inequitable system that allocates more health-related resources to some than others. It also allows a lot of people to feel morally superior for no good reason.
Which brings me back to Cavett. Dick Cavett does not like fat people. The vitriol he levels at them is unbelievable. And so I have to wonder if it’s because fatness is threatening. Unlike, say, smokers — a group it’s also generally acceptable to dislike — fat people represent something you could be if you aren’t careful (or so says the diet industry). The truth, of course, is that if you are a thin person and your parents are thin people, you are probably not going to be obese. But our social construction of fatness revolves around an idea of personal failing, and of self-control — watch what you eat, or you’ll end up looking like that. Smoking isn’t something you slip into, it’s something you choose. According to the dominant cultural myth, fatness is something that happens to you if you don’t check yourself. Fat people just didn’t check themselves. They weren’t as careful as you are. If you fear fat, that’s a more tolerable way of approaching life than recognizing that fatness is a complex social issue, dictated largely by things beyond your immediate control.
Emphasizing that fatness is unattractive or inherently unhealthy does absolutely nothing to improve nation-wide health conditions. It does nothing to help the many people who are declining higher education because their self-esteem and ability to socially function is so thoroughly damaged by a lifetime of shaming and mocking. It does nothing to help people access health care, or even healthy foods. But it can certainly make Dick Cavett feel morally superior. And I suppose that counts for something.