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Thursday, June 29, 2006

It's not that simple...

One of the blogs I regularly visit brought attention to this article - Scientists List "Top 10" Reasons for Obesity. From the article, this is the list:

  1. Inadequate sleep. (Average sleep amounts have fallen, and many studies tie sleep deprivation to weight gain.)
  2. Endocrine disruptors, which are substances in some foods that may alter fats in the body.
  3. Nice temperatures. (Air conditioning and heating limit calories burned from sweating and shivering.)
  4. Fewer people smoking. (Less appetite suppression.)
  5. Medicines that cause weight gain.
  6. Population changes. (More middle-agers and Hispanics, who have higher obesity rates.)
  7. Older birth moms. (That correlates with heavier children).
  8. Genetic influences during pregnancy.
  9. Darwinian natural selection. (Fat people outsurvive skinny ones).
  10. Assortative mating, or "like mating with like,'' as Allison puts it.
Of course, there are immediate detractors. You'll note that diet and exercise are nowhere on the list, and since everyone knows that the only reasons people are obese is because they're too busy stuffing their faces to get any exercise, this list is likely to be brushed off by many - especially those in the diet industry.

While diet and exercise are certainly issues, I'm glad to see this list. It acknowledges that being overweight is not as simple as calories in/calories out. We all know skinny people who never exercise, eat any junk they want, yet never gain weight. Likewise, there are a lot of overweight people who exercise diligently and eat healthy, balanced meals, yet not only don't loose weight, but may even gain more. In our culture that worships thinness, it's far easier to stigmatize the overweight for being lazy gluttons, and a billion dollar industry depends on our continued disgust with fat - all in the name of "health," of course.

Personally, my own list of top causes of obesity would be slightly different. Here is my totally unscientific, based on my own research and experience, list of top contributors to the
"obesity epidemic."

1. The BMI: this thoroughly flawed index has somehow become the sacred definition of health. As long as you fit in the "normal" segment of the index, you are assumed to be healthy. If you are outside that very narrow field, you are considered unhealthy or, at the very least, at risk. The problem is three fold. First of all, it's based on an index developed by a life insurance company as a way to charge people higher premiums, which in turn was based on a hodge-podge of research that was used to back it up. Second, not too long ago, the upper margin of what a person's "correct" weight is was dropped some years ago. Overnight, thousands of people who had been considerred their correct weight were now considered overweight. And finally, the BMI is useless. I know people who, according to the BMI, are considered obese, yet to look at them, you wouldn't even think of them as being overweight in the first place. When I was my thinnest and strongest, the BMI put me at overweight. Today, based on the chart, I would be considerred "morbidly obese." Now, I know I'm fat, but there's no way anyone - including doctors before they actually weigh me and look at their charts - would consider me morbidly obese. I actually had one doctor completely change the way she treated me the instant after looking at the chart that rated me "class 3 obese." I was too busy laughing at the fact the chart was put out by a diet pill manufacturer to take it seriously.

The thing is, the BMI is nothing more than a mathematical formula. It gives no information about a person's actual health. Worse, it is a distraction, turning excess weight into it's own problem to be solved, rather than viewing as a possible symptom of larger health issues. The same doctor that suddenly treated me differently after seeing my chart immediately jumped to my weight being the problem, even though I came there for a completely different issue. In fact, she assumed that my reason for being there (extreme pain in my legs) was caused by my weight, rather than the other way around. It wasn't until she got the results of my blood tests, which came back "perfect," (her word, not mine) that she had me go for xrays and my OA was finally discovered.

2. Dieting. Research and statistics show that the more people try to lose weight by dieting, the more weight they gain in the long run. While they may loose weight in the short term, approx. 95% of dieters regain all or more of the weight they lost within 5 years. This yo-yo effect is shown to be extremely harmful to a person's overall health. Studies comparing groups of people who diet to loose weight with those who have never dieted show that the dieters often end up heavier than when they start dieting, and will all the obesity related illnesses we keep reading about. People who have never dieted to loose weight tend to stay the same weight in the long term, and don't show signs of these "obesity related" illnesses.

3. Thyroid problems. Of all the "morbidly obese" people I know, all but one of them has thyroid issues. Even among the simply overweight people that I know, for most, it's their thyroid that caused them to gain weight. One young man I know is a martial arts expert who used to travel on the competition circuit. He's got black belts in multiple arts and various belts in even more. As for his diet, he probably eats far less than he should. He's also on the highest dosage of thyroid medication his doctor feels he can safely prescribe, yet my friend is still overweight and struggling not to gain more.

and finally...

4. Illness/injury. I suppose thyroid problems could've been included in the "illness" category, but I've seen it so much, I gave it it's own. Illness and injury, however, is the category that hits closest to home, and not only because of my own injuries. My husband's initial struggles with weight began with a severe back injury that sometimes left him bedridden. As his overall health collapsed over the years, he found himself somewhere around 450 lbs. We don't know the actual amount, since we didn't have a scale he could weigh himself on. Even the dr's scale only went to 350 lbs. This, dispite the fact that he trained and taught martial arts, ate modestly, and maintained as active a lifestyle as he could without re-injuring himself. Since then, especially after his sleep apnea has been treated, he's lost about 100 lbs. He's still ill and we still don't know why. Another example is a co-worker of mine who is quite large. She's also got damaged ankles and at least one knees is badly injured. Despite the pain she lives with every day, she's one of the most active, hardest working people at my job, with more strength and stamina then then any of our thinner co-workers.

My whole point being, of course, that there's more to gaining and loosing weight than diet and exercise, and that prejudging a large person based on their size is down right stupid.

3 comments:

  1. That makes sense... I know I don't get enough sleep, and I don't eat properly, my weight doesn't seem to be going anywhere unusual.

    (Which is good.)

    The BMI was made by a diet pill manufacturer? (sp?)

    ReplyDelete
  2. Fat kids are sick and they need help. Growing up obese is like a death sentence. Obesity needs to be treated like a serious illness.

    ReplyDelete
  3. Thank you, spider63, for proving my point.

    Wrayth, the BMI is based on a chart originally developed by a life insurance company. The chart the doctor was using was a version of the BMI on a wheel chart, and *that* was made by a diet pill company, logo prominently displayed in the center of the wheel. It had a rediculoursly tiny area for "normal," a slightly larger area for "overwieght," slightly larger for "class 1" and "class 2" obese, and a huge area for "class 3" obese. It would've been almost impossible for any normal person to not be either overweight or class 1 obese based on that chart. In fact, the amount of weight a normal woman fluctuated during her cycles could easily make the difference between "normal" and "obese."

    ReplyDelete

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