Wednesday, October 14, 2009

Fat Phobia Sweeps the Nation! Story at 11!

Yeah, so it's no secret I'm obese. My BMI is above the "obese" mark. America would put a big red "O" on my dress if it weren't for the fact that conveniently, everyone already knows already. My doctor sure knows. He can barely keep it together enough to tell me anything else other than the importance of diet and exercise. I don't disagree, but what I do disagree with is the assumption that all fat people are walking time bombs and all thin people are naturally healthier. It was this assumption that led an endocrinologist I saw to suggest weight loss surgery within a few seconds of meeting me. Can you say "kickbacks"?

It is also this assumption that is leading a new trend (reported on this week) for companies to charge a higher insurance premium to its obese and overweight employees. (To be fair, they added smokers to it too...and the irony of the State of North Carolina being at the forefront of this is too good to pass up. But that is easier to hide, isn't it.) This is ridiculous for so many reasons. Why not charge people with more problems? Despite what "scientific" studies tell us (as reported by the media who we all know love nothing more than talking about how bad fat people are), not all fat people are unhealthy. Do you charge former smokers? Former fat people? People who eat fast food regularly but are not fat? Do you charge African Americans differently because they have a higher propensity for certain diseases? Or those from Mediterranean backgrounds? Or Asian? See what I mean? So MANY factors play into a complete health risk picture.

But YOU can help it, you say. To a degree, yes. If people are honest with you, though, they'd tell you they don't fully understand why certain people are fat and certain people aren't. There's no doubt that if I were absolutely "perfect" with my diet--ate 1,500 calories a day and worked out every day, I'd be smaller. I would probably NEVER be able to maintain what the CDC considers "healthy" though. I find sticking to a 1,500 calorie diet difficult even when I try really hard. Why? Because the world (and by the world, I mean the U.S.) makes it so easy to NOT do that. Foods are calorie dense and everywhere. You have to really plan to get low cal foods prepared, and if you work late or the kids are sick or whatever other reason you can't, you have some difficult choices to make. Anyone faced with food choices at, say, a hotel snack bar in the middle of a rural area can attest to that (may I recommend the peanuts?).

The short argument is this, everyone is dealt a set of cards--genetic, social, mental, emotional, and othewise. And you make the best play you can with what you've got. Some people, like in populations living in poverty-stricken areas, can't go to Whole Foods to get their organic skim milk for $4 a half gallon. They walk to the Checkers to get the 2 for 1. I am fortunate to not be in this category. But, for the "system" to pick on a category of people, in this case "the fat," without treating the underlying causes, that is just discrimination.

What is particularly awful to me is that things to cause obesity (like subsidized corn--got high fructose corn syrup anyone?--and other food industry atrocities, suburbanized development patterns that prevent walking, etc) have been institutionalized, and now the same institutions are trying to do an about face and pushing the cost to those affected by the policies.

I really didn't mean for this to be a tirade, but I guess it turned out that way. What I REALLY intended to share was this GREAT blog I found devoted to exposing some of the hype in the media about medical issues, and one of those is obesity. (  In general, I don't trust much of the "establishment" to tell me anything about anything. More often than not, there is a profit motive. Follow the money. If that makes me a radical, well, braid my hair and call me Moon Flower!


  1. You have so nailed it on the potent combination of institutionalization of unhealthy habits plus blaming.
    While I regard HFCS with suspicion (though not with complete avoidance), I think a lot of the issue is suburbanization. In a dense city like San Francisco, the middle class and up are thin, and I think it's more from habitual walking than from outrageous grocery prices (or from being unable to afford anything but ramen noodles after paying the mortgage). But in suburbanized settings (like where I live now), extensive walking is neither practical nor safe -- and this is true of more "cities" than people realize.

  2. Wende, YES! This is what originally drew me to get a degree in City Planning. Of course, now, I'm doing less of what I orignally intended! Even in DC, which is certainly an urban format, I find there are things I need or places I need to go that I can't get to by walking or even taking transit.
    I have no idea if HFCS is bad...but one thing it certainly HAS done is made many high calorie/sugary foods more affordable. I don't know if I agree with taxing these types of foods more, but certainly, making healthy food more affordable and unhealthy food more expensive would do more to change the health of Americans than charging more for health insurance on certain groups of people. These same health plans won't pay for certain preventative programs but will pay for the eventual disease treatment. Argh, I could go on and on. It fires me up! Oh and my favorite thing in all of this is that the CEO of Safeway is one of the biggest proponents. Does he support higher prices on bad food? Uh, no.

  3. Amazing that they target people like this. I am drinking a healthier coffee with out all the "big" coffee fat.

  4. Solid observations Christine. The idea of targeting certain groups for higher insurance premiums because of habits superficially appeals to those of us who, of course, would end up paying the least (spoken as a slim non-smoker), but were do we draw the lines of exclusion? Targeting specific demographics will always evoke discrimination, and understandably so.
    I agree with DrWende to a certain extent about suburbanization promoting obesity, but I made the same claim several years ago (as have many public health journals), and someone else quickly rebutted that some of the highest rates of obesity are often visible in extremely low-income inner city neighborhoods that by most standards are quite walkable. That person was right. These regions are also the "food deserts" that a recent Planning magazine elaborated upon. But I remain unconvinced that grocery stores simply refuse to locate in poor neighborhoods, or that they fail to stock healthy food against the local residents' will. Unfortunately some of this is simply catering to their market: when I lived in Philadelphia I shopped at times at a very "inner city" grocery store and saw absolutely no one around me buying anything but unhealthy, processed food (often in bulk), even though the store sold produce and fresh dairy. Far too many inner city populations simply demonstrate little demand for healthy food, so the vendors have no incentive for selling it. The mentality will not necessarily change just by bring Whole Foods-type merchandise into these neighborhoods. It require convincing these populations that healthy food is worth eating even if it doesn't offer the same immediate taste gratification and despite the fact that it usually costs more--this is a huge challenge.

  5. Thanks, Eric, er, Dirt. :) Good point. There are many forces at work there. As someone who is often assessing retail demand, stores will try to go to an area that is on the edge of both the poorer areas and richer areas, to take advantage of both markets. I think the idea that poorer people don't buy nutritious food is largely because of cost. One of the most poignant parts of Food, Inc for me was the family looking at buying apples versus some kind of processed food...the processed food won out because it was ostensibly cheaper. Even despite my education on these matters, I find myself making similar choices on a higher price point when I'm at the supermarket. The other big part of food that people overlook is that food is wrapped up in culture and memory and attitudes that you form early on. People eat to bond with the community in which they live...and while people in my "community" now might eat sushi, if I still lived, say, in Western PA where I'm from, my community would eat sandwiches that have french fries on them! :) You get my point. The "obesity epidemic" sits at the confluence of all these forces...but the one people focus on most is "personal responsibility" and the idea that it's a personal failure of a weak person. It's irritating.


Since you have great taste in blogs, I don't think I have to tell you to be nice to each other...and don't spam me. Thanks!