This week we got two links which connect us to the U.S. national elections.
Greater than >100 lb. weight loss with diet/exercise is rare, and even rarer is keeping it off. The reason that Huckabee’s story garnered so much media attention was that it was “man bites dog.” Partly as it is so rare, there are no incidence numbers, but a reasonable estimate of the number of people in the U.S. each year who through diet/exercise lose >100 lbs. is fewer than 1000.
On the other hand, the number of people in the U.S. in 2003 who had gastric bypass surgery was estimated at 102,000. So, if all we know is that someone rapidly lost 110 lbs., the chances that it was through gastric bypass surgery are about 100 to 1. So, before we even start considering the particulars of Huckabee’s story, in comparison to relatively commonplace bariatric weight loss, the diet/exercise diagnosis an many times less common, and thus less likely.
If this turns out to be true, then Huckabee is straight-up lying about how he lost weight. (“I was able to go through a program that was largely behavior modification through our med school. You know, I changed my lifestyle but I’ve had friends for whom that didn’t quite work and they went the route of the surgery.”) And, as anyone who remembers the Clinton/Lewinsky clusterfuck remembers, the mantra, “It’s not what he did, it’s that he lied about it,” is the death knell for an American politician.
Personally, I don’t give one damn whether Huckabee had WLS or not. But if he did, and he’s yet another scamster trying to convince the American public that their willpower is at fault if they diet and don’t lose weight, well, that’s about what I expect from the rest of his positions.
More interesting, or at least more complicated, is Barack Obama’s recent comment on obesity, and the responses it’s gotten in the blogosphere. Obama said, “”If we could go back to the obesity rates of 1980 we could save the Medicare system a trillion dollars.” Meowser at Shakesville picked this up as an anti-fat people statement, and Lindsay at Majikthise attempted to reframe the conversation.
While Meowser is talking about prejudice against fat people, a subject dear to Body Impolitic, Lindsay is talking about obesity as a social problem, and making the point that Obama was doing the same. True enough; it’s easy to imagine much worse comments about fat coming from the presidential race. But I see some real problems with Lindsay’s response.
First of all, while I have some sympathy with Lindsay’s response to Meowser’s emotional reaction, I also resonate to Meowser’s position.
Meowser: When I found out Barack Obama (much like Hillary Clinton, who has made similar remarks in the past) wanted to disappear me solely because of my weight in order to save the government money, I had to ask: Just how far are they willing to go to make that a reality?
Lindsay: I find this rhetoric offensive. The United States government really is disappearing untold numbers of people, and not because they’re fat.
Disappearing fat people is indeed different from disappearing “criminals” to Guantanamo or elsewhere. That’s true. At the same time, Meowser is responding from an awareness of what it’s like to be fat in this country, in this world today, and just how many people would be delighted to make Meowser, or me, or thousands of us, one third the size that we are, if they could only figure out a way. It doesn’t have to be detention with waterboarding to be present, plausible, and the stuff of nightmares. I think it’s important to acknowledge the real experience behind Meowser’s response to Obama.
Lindsay is one of the best bloggers around–very frequently insightful and superbly well-informed on politics and feminism–but she isn’t up to date with the scientific evidence on obesity. She backs up her defense of Obama with a bunch of inaccurate claims. (Obama didn’t back his claim up at all; his position is so popular that it doesn’t call for much in the way of defense, which is why we care so much about continuing to point out the myths.)
Experts disagree about the extent to which excess body fat itself causes health problems. However, there’s no doubt that high calorie, low nutrient diets will eventually cause weight gain in a large percentage of the population. We know that poor nutrition and inactivity are harmful, even to those who don’t gain weight. What isn’t showing up on your abs may very well be collecting in your arteries.
So, the increasing prevalence of obesity is genuinely worrisome, if only because it appears to be linked to deteriorating diets and declining activity levels on a societal level. Weight isn’t a good indicator of individual health. However, it is troubling to see entire populations getting heavier, at younger ages.
Sounds good, but…
In 1998, the National Institutes of Health lowered the overweight threshold for BMI from 27.8 to 25 to match international guidelines. The move added 30 million Americans who were previously in the “healthy weight” category to the “overweight” category.
There’s your epidemic. Just about all of it. Other than that, the average American weighs 3-4 pounds more today than she did twenty years ago.
As for the claim that “However, there’s no doubt that high calorie, low nutrient diets will eventually cause weight gain in a large percentage of the population. We know that poor nutrition and inactivity are harmful, even to those who don’t gain weight. What isn’t showing up on your abs may very well be collecting in your arteries,” while it sounds like common sense, it is also wrong.
Your weight is determined, above all, by your genetic heritage. If you have a genetic heritage for becoming fat, high-calorie diets will probably make you fat. If you don’t, you’ll gain ten or fifteen pounds, and then stop. Lindsay is conflating high-calorie and low-nutrition as if they were one thing (which they often are, but by no means always–consider, for example, a diet high in beef, avocados, and bananas). She then makes the much more disturbing error of treating poor nutrition and inactivity as if they were one thing.
Just to be perfectly clear, inattention to nutrition combined with an active lifestyle is almost certainly better for you than excellent nutrition (which no one can come close to defining) paired with inactivity. Additionally, excellent nutrition by contemporary standards does not correlate to body weight, and neither does activity. Many fat people are vegan or vegetarian (and no, they are not “cheating”), many are athletes, and some are both . Read Gina Kolata’s Rethinking Thin for a careful explanation by one of the country’s best science writers about the relationship between what you eat and what you weigh.
Finally, the “What isn’t showing up on your abs may very well be collecting in your arteries” is a reprise of this piece of junk science, which Laurie and I blogged in May. There is no supporting evidence for this whatsoever; it’s simply a theory designed for the popular press.
I know how hard it is to keep from believing the incessant drumbeat of “obesity epidemic,” “fat kills,” etc., etc. and so forth. I know how easy it is to buy into the popular myth. Fortunately, the evidence that it is a pack of lies just keeps mounting and mounting, and the claims are easier to refute every month than they were the month before.
Alan Bostick pointed us to Majikthise (and both of them were fast, since Laurie and I read both of those blogs ourselves).