Tag Archives: BMI

An Open Letter to Liz Dwyer at TakePart

Debbie says:

Dear Liz Dwyer:

You don’t know me.

I subscribe to TakePart.com’s newsletter, which I find very useful in keeping me informed about a variety of social justice issues. I’ve taken to looking for your byline, or finding that when I read an article I like about body image issues, your byline is there. I love your interest in the same kind of wide range of body issues Laurie and I write about here. I love how you call out body shaming, over and over and over.  But interspersed with these fabulous articles, many of which are so clear about how wrong it is to body shame anyone, including fat people, you still write articles like “The Five Shocking Facts About Obesity in America.”

Hint: There really isn’t an obesity epidemic in America (or at the very least, not one that reflects people eating badly and not taking care of ourselves). Being fat (especially if we lived in a world without fat shaming) is not a major health risk.

It’s time you cop to those facts, and write about them. I’ll give you some resources.

Let’s look at your five shocking facts:

1. More Americans are obese than overweight.

This paragraph is based on BMI, which I hope you know was invented by a statistician with no medical training. The distinction between “obese” and “overweight” which you are giving credence to is arbitrary, and makes no distinction between a weight-lifter with a huge amount of muscle and a person with a large amount of fatty tissue. And study after study shows that “overweight” BMI is the category with the longest life expectancy.

Overall, people who were overweight but not obese were 6% less likely to die during the average study period than normal-weight people. That advantage held among both men and women, and did not appear to vary by age, smoking status, or region of the world. The study looked only at how long people lived, however, and not how healthy they were whey the died, or how they rated their quality of life.

The study abstracts don’t say how “underweight” and “normal” fared, but they do say that what they call “Category 1 obesity” (BMI of 30 to less than 35) is effectively indistinguishable from overweight life expectancy, thus making the categories even more ridiculous.

2. Overall, more men than women are too heavy.

Well, statistically, men have larger bones and more muscle mass. So if you use BMI as your criterion, that’s an automatic likelihood. It probably means nothing.

3. If they’re heavy, women are more likely to be obese than overweight.

I take exception to “Of the ladies that need to drop some pounds,” especially given the life expectancy numbers above. Also, BMI remains meaningless.

4. Black Americans are the most obese racial or ethnic group.

5. Latino Americans are struggling with the scale too.

You invoke Black Lives Matter here (we could not agree more) and you also invoke poverty. You say nothing about genetics, and nothing about food deserts. Closer to my heart, you say nothing about how being shamed is bad for your health, how internalized oppression expresses itself through the body. Black and Latino people are oppressed in so many ways; fat people are oppressed in other ways. Black and Latino fat people face double oppression. Black and Latino/a fat women, trans people, gay people,  disabled people, or Blacks and Latinos in more than one of the above categories) face additional oppression. And the illnesses that stem from oppression are the illnesses we attribute to fatness: high blood pressure, cardiac issues, stroke, and so on. You are so very capable of connecting the dots; why don’t you connect these?

You close this article talking about soaring health care costs and make the oh-so-common, oh-so-unproven claim that diet and exercise are the solution. Do you really still believe in dieting? Have you read Gina Kolata’s Rethinking Thin? Do you know David Berreby’s amazing article about leptin and ghrelin?

Consider, for example, this troublesome fact, reported in 2010 by the biostatistician David B Allison and his co-authors at the University of Alabama in Birmingham: over the past 20 years or more, as the American people were getting fatter, so were America’s marmosets. As were laboratory macaques, chimpanzees, vervet monkeys and mice, as well as domestic dogs, domestic cats, and domestic and feral rats from both rural and urban areas. In fact, the researchers examined records on those eight species and found that average weight for every one had increased. … Allison, who had been hearing about an unexplained rise in the average weight of lab animals, was nonetheless surprised by the consistency across so many species. ‘Virtually in every population of animals we looked at, that met our criteria, there was the same upward trend,’ he told me.

That article links junk food not just to calories but to calorie retention. This, of course, would put the burden of weight gain onto the corporate food industry. It’s so much easier to blame individuals, but you are better than that.

One more reading suggestion, one I haven’t gotten to yet myself: The Big Fat Surprise, by Nina Teicholz. The Wall Street Journal, hardly a radical publication, had this to say:

It is a commonplace in public-health discussions of obesity to warn that the search for “perfect” or “better” evidence is the enemy of good policy and that we can’t afford to wait for all the information we might desire when there is a need to do something now. Yet Ms. Teicholz’s book is a lacerating indictment of Big Public Health for repeatedly putting action and policy ahead of good evidence. It would all be comical if the result was not possibly the worst dietary advice in history. And once the advice had been reified by government recommendations and research grants, it became almost impossible to change course. As Ms. Teicholz herself notes, she is not the first to point out that saturated fats have been sinned against by bogus science; and yet, the supermarket aisles are still full of low- and no-fat foods offering empty moral victories.

Teicholz’s book is near the top of my to-read list.

So please, keep up your remarkable work talking about race and gender, body shaming, and other political issues. And please think about how to address the “obesity epidemic,” BMI, and the American (and increasingly global) diet. I promise; I’ll keep reading your work even if you don’t change your mind.

Want to Reduce Risk of Dementia? Don’t Diet!

Debbie says:

I know I’m not alone in being more frightened of old-age dementia than any other thing that could happen to me. Everyone is different about these things, but for me, my mind is me, and without it I do not want to survive.

That fear, a lifetime of body image activism, and my hatred of junk science combine to make this the best science news possible.

The analysis of nearly two million British people, in the Lancet Diabetes & Endocrinology, showed underweight people had the highest risk. …

Dementia is one of the most pressing modern health issues. The number of patients globally is expected to treble to 135 million by 2050.

At least by basic criteria, the science is impeccable. There were 1,958,000 subjects.

Compared with people of a “healthy weight,” underweight people (BMI <20 kg/m2) had a 34% higher (95% CI 29–38) risk of dementia. Furthermore, the incidence of dementia continued to fall for every increasing BMI category, with very obese people (BMI >40 kg/m2) having a 29% lower (95% CI 22–36) dementia risk than people of a “healthy weight.” These patterns persisted throughout two decades of follow-up … [quotation marks added]

In other words, it’s not just that low BMI correlates with greater dementia, but higher BMI, well into the categories that modern medicine continues to describe as “morbidly obese,” correlates with even less dementia. The difference between having an “underweight” BMI and an “obese” BMI is a 54% (!) reduced risk of dementia. That’s a gigantic number.

Of course, BMI is and always has been a bullshit benchmark. Also of course, the scientists are thrown for a loop by their own findings, because they went in assuming that fat would fry your brain, just as their counterparts continue to insist (against evidence) that fat destroys your body. They really have to grasp for their “faith sentence” here, and what they came up with is:

… the findings were not an excuse to pile on the pounds or binge on Easter eggs.

“You can’t walk away and think it’s OK to be overweight or obese. Even if there is a protective effect, you may not live long enough to get the benefits,” he added.

We know from other large-population studies and analyses that this isn’t true.

Of course,  no one is suggesting that these results suggest that low-BMI people should try to gain weight. Just to be clear, I’m not suggesting that either; people find their own weight and everything, including dementia risk, has multiple complex factors. But you do know what they would be saying if the study had gone the way they expected!

For me, I will continue to live the way I live, to follow my doctor’s advice (“Whatever you’re doing, keep doing it”), to appreciate my fat body, and I will breathe just a little easier when fear of dementia sneaks up and ambushes me.