A Modest Conversation: In Which A Psychologist Proposes a Swift Solution to Reports of Death and Disease Due to Weight

After reading yet another article in which death and disease were attributed to "excess weight" or "obesity" by researchers, reporters, and/or health professionals who must have missed the lectures on correlation and causality in their statistics classes (if such classes were actually a part of their education at all)....I have composed, and herewith submit for your perusal, an imaginary conversation with the purveyors of such "information."

If "excess weight" CAUSES deaths from stroke, diabetes, osteoarthritis and breast, bowel, and endometrial cancer, why don't they "cure" those diseases (once diagnosed) by immediately instituting starvation diets, fasting, etc. so that the patients lose as much weight as quickly as possible? No problem if they're too weak to exercise -- in fact, losing muscle mass might be a good thing (if "excess weight" CAUSES deaths) because muscle weighs more than fat, right? Hey! Why not cut to the chase and amputate a limb? There's an immediate weight loss for you!

Oh, you say, but it's FAT, not "excess weight," that's really the problem? Excellent! Then we already have a quick cure -- liposuction! As soon as someone is diagnosed with any of those diseases, let's suck the fat right out of them! That'll cure cancer, stroke, diabetes, etc., right? Oh, wait a minute...someone's already researched that and found that removing fat from the body through liposuction has NO effect on blood sugar, blood pressure, etc.? How can that be possible if FAT causes these diseases?

Oh, you say, it's the BEHAVIORS that lead to FATness that are the real problem -- that's where we need to intervene! What kind of behaviors are we talking about? "Underexercising" and "overeating?" No problem! We'll get -- heck, in a matter of life and death, we'll FORCE -- people to exercise and eat less! That'll make them lose weight -- I mean, FAT -- so they'll be thin and healthy, right?

Oh, wait...Most people who lose weight -- err, FAT -- gain it back, and sometimes more. No problem -- we just get them to lose it again! After all, it's a matter of life and death, right? Oh, wait...there's research showing that losing and regaining weight causes health problems! Bummer. Oh, yeah, and apparently not everyone who exercises more and eats less actually loses weight -- I mean, FAT. Some even get FATTER! And whoa, here's a shocker -- not everyone who's FAT "overeats" and "underexercises!" And some people who "overeat" and "underexercise" aren't FAT!

So what can we do? It's not like we can just focus on BEHAVIORS instead of getting rid of FAT...it's not like people with diabetes or high blood pressure can improve their health simply by making changes in eating and activity even without losing weight (err, FAT)! Oh, wait -- they can. Wow! If that's the case, then why muddy the message by focusing on weight -- err, FAT -- in the first place? Why not simply encourage healthy behaviors without focusing on weight (FAT)?

That's it! That's the answer! We make everyone eat right and exercise! That'll cure all those diseases, right? Amazing...the cure for cancer has been right in front of us all this time. If we make everyone eat right (by "right," of course, I mean "what we think is best") and exercise (by which I mean, of course, following our recommended activity plans whether they enjoy them or not), then no one would die from stroke, diabetes, or breast, bowel or endometrial cancer! No one would develop osteoarthritis! Sure, you say it's a free country and we can't "make" people do anything they don't want to do...but we can work on that.

What do you mean, "no?" "Slippery slope," my ass...we're talking about life and death here! If we can get people to eat right and exercise more, the human race might even become immortal!

What do you mean there are other factors involved? Genetics? Personal history? Stress? Sociocultural factors? You make it sound so complicated when you get right down to it. Like there's a whole lot more to health and longevity, and improving both, than just weight (err, FAT).

So why didn't you say so in the first place?

Peggy Elam, Ph.D.
(with a nod and a wink to Jonathan Swift)

Comments

[Jason D. Ranieri, MFTI]

Excellent rebuttal to health professionals who are hypnotized by all the hype surrounding "body fat" and it's reduction to produce health and keeping a low BMI is the ticket to health.

I've found that as a 36 year old man who weighs more than people think, I'm supposed to be morbidly obese according to the BMI. Yet, I have a 40inch waist and a great amount of muscle. I have a barrel chest and my bones really are thick. I'm not giving excuses.

My doctor did my vitals, finding that my blood pressure was good to low and that my cholesterol was normal. He told me that he thought I could stand to lose maybe ten to twenty pounds. I'm 5'10". Then he put me on the scale. And boy did his tune change. Suddenly, since I weighed 250 lbs. or so I was "morbidly obese." That means that I could die because my BMI said so when his assessment before gave me a clean bill of health.

I say phooey to those governmental statistics and the body obsessed culture we have.

Has anyone thought that the stress of being told that you are "morbidly obese" and looked at by others as large and therefore somehow defective might be the actual cause of high morbidity of people who the BMI and society judge as obese?

Until this society of ours accepts that we have completely changed our lifestyles in comparison to our ancestors and thus we have gained weight, and that this is not necessarily a bad thing, it just is, we will continue to see the rise in depression, suicide, stress related strokes and heart attacks, and anxiety.

Being in the mental health profession has taught me that by accepting oneself, one may acheive happiness. And if one his happy the body follows and becomes even more healthy. We are more than our bodies, and we are more than our minds, or spirits. We are whole beings and all parts of us are integrated. When these studies and these doctors tell us large people that we are going to die unless we lose weight "fat" they create a great amount of stress that is much more harmful than having some extra fat in our bodies.

[Peggy Elam, Ph.D.]

What is it that makes otherwise sensible (I would hope) physicians lose their common sense where weight is concerned? (Yeah, yeah, I know...programming from the diet-pharmaceutical industrial complex, for one thing.)

I agree completely about the use of the phrase "morbidly obese." Last night, in a celebration of International No Diet Day (May 6), some friends and I discussed the same point you make. Labeling people with that horrible phrase is like placing a death curse on them.

It's great to know there's another mental health professional out there who "gets" it! Thanks for commenting.