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Let's Ask Marion: Are We Getting Bigger, Or Is The Obesity Epidemic A Big Myth?
Submitted by KAT on Fri, 01/25/2008 - 11:25pm.
Kat: Tuesday's New York Times had a piece about the fat acceptance movement and some of its more voluble proponents, who are blogging away in the "fatosphere" about America's obsession with obesity. They challenge many commonly held assumptions about fat and encourage those who are overweight to stop castigating themselves and come to terms with the fact that people come in all shapes and sizes, and dieting and exercise may just be an exercise in futility for some folks.
It seems reasonable to me that someone who's overweight but active could well be healthier than a person who's skinny but sedentary. And there's no disputing the fact that our culture's veneration of thinness is tiresome and tyrannical. But, as the Times noted, many of the bloggers dismiss the obesity epidemic as just "hysteria," and an excuse to vilify fat people.
Meanwhile, manufacturers are recalibrating everything from infant car seats to amusement park rides to accommodate Americans' ever widening girth. It seems pretty clear that there's more to more of us than there used to be. What do you say to people who insist that that the obesity epidemic is a myth?
Dr. Nestle: I tread very carefully in these waters. Obesity is one topic for which the difference between populations and individuals really matters. It is one thing to talk about an obesity epidemic in a population, and quite another to talk about an individual who happens to be overweight. This difference is especially acute if that individual is someone who has been battling excess pounds for decades, knows everything there is to know about diets and dieting, and is fed up to here with having to confront overt discrimination and rude personal comments on a daily basis.
So let's start with populations. Across the entire population of the United States and most other countries in the world, body weights are going up and are higher on average than they were 25 years ago. They have increased or are increasing among populations of all ages, social groups, and classes. That's why we have larger clothing sizes, hospital beds, movie theater seats, and coffins. Populations that are overweight are at higher risk for several chronic diseases, and populations that are most overweight have even higher risks.
Now let's talk about individuals. A person who is overweight has a higher risk for, say, type 2 diabetes, but not everyone who is overweight will develop this condition. An overweight person who is physically active and eats a healthier diet is less likely to develop symptoms of type 2 diabetes than a person of the same level of overweight who is sedentary and eats a lot of junk food. But these are individuals and we are talking about risk. Both overweight people may develop type 2 diabetes or neither may develop it. Both are at higher risk than a person who is not overweight, especially if that person is physically active and eats healthfully.
The chance of getting type 2 diabetes is small, but it increases with increasing bodyweight, sedentary behavior, and poor diets. So I say the obesity epidemic is real for populations, but for individuals it depends on who they are and what they do. Eating healthfully and being active are good things to do at any weight. I think we should treat individuals as individuals, respect personal differences and personal choices, and do everything we can to change the food environment. Right now, the food environment encourages everyone to overeat. Let's do what we can to change the food environment so it is easier for everyone to be active and make more healthful food choices. How's that for a concept?
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