November 6, 2007

the scientific method v. cultural myths

The CDC just reported that being overweight makes you less likely to die, over-all. When you consider all sources of mortality, people who are 'overweight' are much less likely to die from a number of diseases, which cancels out a higher death rate from a few well-known ones. They also found that being underweight is associated with higher mortality, and I think it's worth pointing out that the article didn't mention any possible alternative explanations for obesity being associated with higher mortality, but listed several possible alternatives to the heresy that being skinny is itself unhealthy (e.g. people get thin because they're sick or smoke).

Like many other ideas about body size, the idea that being over a particular size will kill you was one with scant or no evidence; now we have actual evidence against it.

In response, a preventive medicine specialist told the New York Times that "excess weight makes it more difficult to move and impairs the quality of life." Let's stipulate that there are people for whom this is true. But there is no evidence that people can lose weight and keep it off except becoming obsessive about it in the way that anorexics are obsessive about it; and I would bet money I don't have that for most people, "excess weight" mostly "impairs the quality of life" because people are assholes about it, because there's practically no positive media about anyone over a size 4, and because of the constant pressure to get thin. Those issues, incidentally, affect almost all women of all sizes, and use up a good chunk of the brain power of a couple generations. Have I mentioned that fat is a feminist issue?

One of the researchers very sensibly said, "If we use the criteria of mortality, then the term 'overweight' is a misnomer."

Another, after stressing that it was his personal opinion, said, "If you are in the pink and feeling well and getting a good amount of exercise and if your doctor is very happy with your lab values and other test results, then I am not sure there is any urgency to change your weight."

Which is such sensible advice, and so well supported by his research. And yet fat is such a crazy issue in American medicine that he had to qualify the hell out of it. Being sensible is a dangerous position in the diet wars.

1. Quotation marks because saying people for whom arbitrary combination of their height and weight is over 25 weigh 'too much' is ridiculous, as the article linked to points out. 'Too much' for whom? For what reason? Over what weight?

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