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Helpful oppressors

[ 395 ] March 16, 2011 |

Michelle

I have some thoughts at the Daily Beast about what Casey Heynes’ response to being informed that he’s fat might tell us about Michelle Obama’s Let’s Move campaign. Casey’s shift from dissent to resistance, as they used to say in the 1960s, is of course extremely upsetting to people like Michelle, who want to “help” him overcome his “problem.”

This brings to mind parallels with various other civil rights movements. There have always been plenty of white people eager to help black people overcome their “problems” in the same way Michelle wants to help fat kids. They point out that a brother just needs to look and talk like Sidney Poitier and most people will stop hassling you about the black thing (hey it sort of worked for her husband).

Similarly, lots of men have over the years pointed out that women wouldn’t have so many problems fitting in to [male-dominated] society if they just stopped being so emotional and shit. And of course there’s a cottage industry dedicated to getting rid of oppression against gay people by turning them into straight people.

Inexplicably, at some point people start getting mad about receiving this sort of help. And then the helpful people get mad and resentful and scared in return. After all they were only trying to help!

Update: Several people have mentioned in comments that they can’t see how a campaign whose explicit purpose is to “solve” the “childhood obesity epidemic” within a generation (i.e., a campaign whose goal is to make sure that a generation from now there’s no or as little as humanly possible “childhood obesity”) involves fat shaming. This is precisely equivalent to a first lady making an assault on the “childhood homosexuality epidemic” her main public policy issue, with the goal of eliminating childhood homosexuality in a generation, and then having a bunch of right-thinking conservatives argue that this has nothing to do with gay bashing. Since doubleplusgoodthinking liberals seem to have a whole lot of trouble grasping this analogy, I’ll spell it out a little further: “Homosexuality = “Obesity.” “Gay” = “Fat.”

If you pathologize a human characteristic and then argue for eliminating this “disease” or “syndrome” you’ve invented via pseudo-scientific framing, it’s rather bizarre to claim that your pathological and eliminationist frame isn’t pathological and eliminationist. Saying you have nothing against “homosexuals” but that it would be a good thing to get them to stop being gay makes exactly as much sense as arguing that you have nothing against “obese” people but it would be a good thing to get them to stop being fat.

Update II: [gmack writes in comments]

De-lurking for a moment: one of the main moments in the gay liberation movement was to challenge the binary of homosexual vs. heterosexual and to replace it with the binary of gay vs. straight. They did so because the homo-hetero binary medicalized the issue (they argued that the labels turned the issue into the normal vs. the deviant), and instead they preferred the gay/straight designation because it was more egalitarian and highlighted the political dimensions of the conflict (being gay is not a medical designation but a politicized identity). In any case, Campos’ main goal is to do the same thing with “fat”–to transform the discussions about obesity from a medical/health discourse into a political one. This is not to endorse Campos’ position here or his rhetoric/argumentation style (in my view, he tends to obscure the crucial issues). Rather, I’m just trying to situate what is at issue here.

Let me also add, if somewhat hopelessly, that the question of whether being “fat” can be considered a political identity is not solvable by appeals to facts alone. When a new political identity is declared or appears on the scene, it always looks absurd (or even insulting, as that appearance often is done by way of comparison to earlier emergences–such that fat activism becomes a piece of earlier liberation movements, which some find to be a wrong and insulting demeaning of those movements; but it’s worth noting that the same attitudes emerged when, for instance, when feminists or gays raised their claims). Thus, the determination of whether one should accept or deny Campos’ claims should not be made by trying to figure out whether “fat activism” is “really” like gay activism or not; in the existing order of things, the claim is false, but the whole purpose of the claim is not to describe the truth of things but to bring into being a new organization of the world in which fat people are treated differently. So in my opinion, the question of whether to support Campos’ activism turns on the question of whether the world that this activism is trying to create is something we would want to endorse or not.

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  1. wengler says:

    I actually agree with Campos on BMI. A measure that records the best athletes in the world as grotesquely overweight and therefore unhealthy is a silly thing for doctors to use as a diagnostic criteria. The question is and always should be health.

    • Thlayli says:

      Pardon my rudeness, but “BMI is useless because look at NFL linebackers!” is a really silly argument.

      OK, IF you’re an NFL linebacker, and you weigh 250 pounds with 3% body fat, then obesity probably isn’t your biggest health issue and you can ignore all of this.

      But the rest of us who aren’t NFL linebackers don’t get to hide behind them.

      • wengler says:

        I don’t care if you’re rude, but what validity does BMI have when it incorrectly gauges those at peak fitness?

        We need a test that tells us when people are unhealthy at any size. Rather than one that tells you if you are fat…or REALLY FAT. This question can usually be answered very quickly(assuming you aren’t hiding behind a NFL linebacker).

  2. gocart mozart says:

    We have replaced your regular LGM poster with new Althouse Special Blend. Lets see if anyone notices.

  3. Matt says:

    The homosexuality equals gay analogy (WHICH NO ONE MAKES MS. PALIN) is inappropriate. No one suggests anymore that being gay shortens your life, or that if someone becomes less gay they might feel better, have lower medical bills, and maybe even be happier.

    How about comparing being overweight to something a little more similar, such as nearsightedness. If a bunch of kids can’t see and the government gives them eye tests, are you gonna say nearsighted = gay? And if the government then gives glasses so they can see, are you then going to say it. And if the government then says, wear your damn glasses, then do you say it. And if the government then tells companies to stop selling crap products that diminish eyesight, what you going to say then?

    • Bijan Parsia says:

      Actually, people surely have and still do!

      • Bijan Parsia says:

        Er…about being gay shortening your life. Read about the history of AIDS and of homosexuality conceptualized as mental illness. Heck, just look at any “curing homosexuality” web site.

        Of course, just because there is an analogy doesn’t mean the analogical inference follows (Hitler was a vegetarian! Abortion is like the holocaust!). But it’s worth considering seriously and carefully.

  4. Marilyn Wann says:

    The review article I mentioned earlier:

    Nutrition Journal
    24 January 2011
    “Weight Science: Evaluating the Evidence for a Paradigm Shift”
    Linda Bacon and Lucy Aphramor,
    http://www.nutritionj.com/content/10/1/9

    A fun quote from the section on clinical ethics:

    “There are serious ethical concerns regarding the continued use of a weight-centered paradigm in current practice in relation to beneficence and nonmaleficence. Beneficence concerns the requirement to effect treatment benefit. There is a paucity of literature to substantiate that the pursuit of weight control is beneficial, and a similar lack of evidence to support that weight loss is maintained over the long term or that programs aimed at prevention of weight gain are successful. Nonmaleficence refers to the requirement to do no harm. Much research suggests damage results from a weight-centered focus, such as weight cycling and stigmatization. Consideration of several dimensions of ethical practice – veracity, fidelity, justice and a compassionate response – suggests that the HAES paradigm shift may be required for professional ethical accountability [168].”

    Also, Pattie Thomas has an excellent Psychology Today blog post questioning the poison pill of weight-loss goals in promotion of health-enhancing eating/exercise behaviors, called “Jump for Joy or Solicit for Stigma: If you believe exercise and diet work, why be afraid of Health At Every Size?”…
    http://www.psychologytoday.com/blog/i-take-space/201103/jump-joy-or-solicit-stigma

    I would repeat her Hate-Free Health Challenge here.

    If you believe that sensible eating and exercise habits lead inevitably to good health (and weight loss), then why is it necessary to talk about weight at all?

    I fail to see the point in comments about some tradition re BMI commentary. Campos is certainly not the only person who questions the weight=health, fat=doom belief system. The Health At Every Size approach involves an international community of people from medicine, science, psychology, fitness, and nutrition and a professional organization called ASDAH, the Association for Size Diversity and Health. In the humanities and social sciences, people who question the current lockstep thinking on weight are publishing in a new, interdisciplinary field called fat studies. (The Fat Studies Reader is available from NYU Press.) And of course, fat pride community has a 40-year history of resistence. These communities do not operate without data or basic levels of caution where health is concerned.

    I find it intriguing that commenters here, who I imagine are willing to question all sorts of received wisdom on other topics, balk at questioning a suspiciously monolithic belief system regarding weight and health.

    • Anonymous says:

      I think a lot of the commenters here question or reject the conventional thinking on obesity and weight loss but reject as hopelessly silly the notion that encouraging kids to eat better and get some exercise is somehow an eugenics campaign.

      • Marilyn Wann says:

        Wishing fat children did not exist whiffs of eugenics to me. I’m all for good nutrition/fitness — I do that stuff myself and want such health-enhancing, enjoyable habits for all children (the thin ones, too!).

  5. Dirk Gently says:

    It’s so frustrating how Camps and others like him complain about “fat shaming” and the conflation of body image with medical attempts to rectify the downsides of obesity, while this is precisely what’s being done here. The social stigma of “fat” is, I would agree, something we need to be sensitive to. But the overwhelming correlation between obesity and extremely serious health side effects (certain types of cancer, diabetes, heart disease, etc.) is undeniable. BMI is not a “pure” metric, anyway: only a guideline to see if further intervention/testing is required.

    • minervaK says:

      Actually, the correlations between obesity and all the health conditions most people assume are related are quite tenuous. Everyone assumes that they know what conditions are “caused” by obesity, but what they “know” is what’s been marketed to them by an interpretive middleman with an agenda of one kind or another — weight-loss program owners, pharmaceutical companies, think tanks looking for more grant money. If fat is so deadly, why is average life expectancy rising along with average weight?

      • C.S. says:

        Actually, the correlations between obesity and all the health conditions most people assume are related are quite tenuous.

        Interesting. Cite, please?

        • Golda says:

          See, e.g., Dr. Linda Bacon’s “Health At Every Size: The Surprising Truth About Your Weight.”

          • Dirk Gently says:

            SOME correlations are tenuous, others are overwhelming. It’s perfectly okay for some people to be overweight and be healthy. However in the VAST MAJORITY of cases, being overweight is the result of a lifestyle that shortens life (insufficient exercise, imbalanced diet, etc.).

            Because there is money to be made from getting people to lose weight, and because this is badly conflated with body image issues having to do with the so-called beauty industry, it’s easy to be cynical (and in many cases, rightly so). But that doesn’t change the FACT that being overweight (particularly “obese”) can be a major health problem.

            tl;dr: you can only take Foucauldian critiques of scientific discourse so far; sometimes science tells us something that’s true.

          • John says:

            Oh, that book sounds like it’s written by someone with no agenda.

            • Hogan says:

              Yes, I too prefer books that don’t come to any kind of conclusion at all.

              • chris says:

                Well, they at least shouldn’t write the conclusion *first*.

              • Hogan says:

                And how do you know she did that? Just based on the title?

              • schmemily says:

                Bacon’s work is heavily researched and peer reviewed. Health at Every Size is widely accepted as the best approach in the field of eating disorders. Ellyn Satter, probably the most well respected authority on childhood nutrition, advocates for a HAES-style approach with your children (I don’t think she uses the term, though). How about you do the minimum amount of research before jumping to conclusions?

            • sannanina says:

              John, do you seriously think that mainstream obesity researchers have no agenda? First of all, these people are just as vulnerable to bias as the rest of us – and there is clear evidence that “obesity” is highly stigmatized in contemporary Western societies. Secondly, their studies are often financed by parties that have an inherent interest to show again and again that being fat is unhealthy. Third, even if this is not the case, it is much easier for a researcher to be taken seriously if their research is in line with the common notion that being fat is bad for you.
              And yet, even in this climate, the actual results of the mainstream studies do not justify the conclusion that obesity has as much a negative effect on people’s health as Michelle Obama’s campaign as well as pretty much every newspaper article on the topic would make you believe. Yes, these studies show that being fat is a risk factor, but not to the degree that most people seem to think these days – certainly not if you control for factors such as physical activity, experiences of stigmatization, socioeconomic status, and body image.

      • Bijan Parsia says:

        If fat is so deadly, why is average life expectancy rising along with average weight?

        This is a really bad rhetorical question.

        It could be rising because of improved infant and childhood mortality rates (the most common cause!)

        It could be because although “fat is deadly” we made such great strides in some other killer that fat has not yet made up the difference. (Or, more simply, survival rates increase with GNP.)

        It could be because although it is harmful, we fight it with heroic (or expensive) treatments.

        It could increase morbidity but decrease mortality.

        Etc. etc.

        IOW, you really should argue the epidemiology directly.

  6. Marilyn Wann says:

    As minervaK rightly argues, correlation cannot prove causation. For comparison, people who smoke tobacco are 300 times more likely to die from lung cancer alone. The fattest people see only a doubling of mortality risk. As minervaK says, a rather weak correlation. (A doubling of risk is barely significant in epidemiology, given the likely influence of confounding variables; for fat some populations, mortality risk doesn’t even double.)

    Confounding variables that likely influence morbidity and mortality risk for fat people:

    - fitness level (Active fat people are healthier and live longer than sedentary thin people, according to Blair.)
    http://jama.ama-assn.org/content/298/21/2507.short

    - weight cycling (losing weight, regain, repeat)
    http://www.ncbi.nlm.nih.gov/sites/entrez/17133237?dopt=Abstract&holding=f1000,f1000m,isrctn
    http://www.ncbi.nlm.nih.gov/sites/entrez/11079659?dopt=Abstract&holding=f1000,f1000m,isrctn
    http://www.clinsci.org/cs/096/cs0960677.htm
    http://www.ncbi.nlm.nih.gov/sites/entrez/17676383?dopt=Abstract&holding=f1000,f1000m,isrctn

    - stress from weight discrimination
    http://www.medicalnewstoday.com/articles/218080.php

    - barriers to healthcare for fat people
    http://www.nature.com/ijo/journal/v30/n1/full/0803105a.html

    - lower quality healthcare for fat people
    http://www.nature.com/oby/journal/v9/n12/full/oby2001108a.html
    http://www.nature.com/oby/journal/v17/n5/full/oby2008636a.html

    Any one of these confounding variables (which are more likely to be present for fat people) could contribute significantly to the rather weak correlation between weight and morbidity/mortality.

  7. Chris says:

    Paul, I understand your purpose, even if I think your analogies are awful. Still, it’s not fat shaming to suggest that we reduce obesity in children. It’s not much different, to run with one of your awful analogies, to trying to reduce unsafe sex among gay men in the 80s and 90s. That is, it doesn’t say “Big people are bad,” it says, “Obesity, which is unhealthy, is bad… that’s what unhealthy means.” You can be big and eat well or exercise. You don’t have to be thin, you just need to be healthy. Nothing, and I mean absolutely nothing, in Obama’s campaign suggests otherwise.

    I assume you see a subtext, or at least the absence of a countering of an inherent subtext when the issue of obesity is broached, related to fat-shaming, and that’s fine. But go there, don’t go to “liberals are talking to fat people like white southerners to black people in 1920,” because the former makes sense, and is an important point to raise, while the latter is just stupid. And I mean stupid. I don’t usually use that adjective, but if ever there were an argument that called for it… All you had to do was say that in addition to trying to increase the overall health of children by combating a dangerous medical condition, the First Lady should also talk about body image issues, the prejudices and discrimination that large people face in our society, etc. Instead, you attacked the goal of making children healthy as the equivalent of telling black people to be more white to get ahead in the world.

    • Michelle says:

      That is, it doesn’t say “Big people are bad,” it says, “Obesity, which is unhealthy, is bad… that’s what unhealthy means.” You can be big and eat well or exercise. You don’t have to be thin, you just need to be healthy.

      Then why not focus on eating habits rather than obesity (which, is, of course, being big)?

      Eating twinkies? Bad. Drinking soda? Bad. Not exercising? Bad

      Being fat? Neutral. Like being short.

      • John says:

        But that’s not entirely true. Obviously, there are genetic predispositions, but that only accounts for part of weight gain. I find it hard to believe the fact that I’m 30 pounds or so heavier than I was when I graduated from college nine years ago cannot be attributable to the fact that I eat badly, drink a fair bit, and don’t exercise very much. If I ate better, drank less, and exercised more, I suspect I would lose some weight (and, indeed, when I do that, I do lose weight, although I find it hard to sustain). Paul’s argument that it’s basically impossible for just about anyone to lose weight by better diet and exercise just seems so divorced from actual everyday experience that it’s difficult to take seriously.

        • sannanina says:

          I do not know how long ago you graduated from college. But you are aware that some weight gain over the years seems to be healthy and protective when you come to middle age, yes?

          Also, while exercise and eating a more balanced diet (without restricting) might make a person a little thinner it totally fails at turning a fat person into a thin person.

    • Anonymous says:

      combating a dangerous medical condition

      The human body is not a medical condition.

  8. Golda says:

    I’m just writing this comment to say that I agree with this post and I’m glad that Mr. Campos continues to point out the fact that policies that focus on weight loss for fat people rather than promoting good health for all are discriminatory and unhelpful.

  9. Meowser says:

    Anyone who still thinks M. Obama has backed off on the “we must get rid of fat kids” – speak needs to read this. Apparently, fat kids aren’t just unhealthy, it’s their fault that their parents don’t have jobs!

    I was a chubby kid, and all the criticism and rejection that came with that contributed to my becoming suicidal by the age of 11. I started dieting around then, too. Guess how fat I am now?

    If I felt that way then, I can’t imagine what it’s like for a fat kid today, having to not just suffer the slings and arrows from other kids, but to have everyone on earth, including the First Lady telling them they’re bad and defective and a burden to society, even though they eat LESS than their thinner counterparts.

    When fat kids hear rhetoric like this, how do you think they respond? By saying, “Gee, I guess I should try out some new veggies and maybe go for a bike ride”? No. They want to get rid of this thing that brands them a loser AS FAST AS POSSIBLE. That means a DIET, often a very radical one. Know what diets do to kids? If you guessed “stunt their growth and trash their metabolisms for the rest of their life,” you get a gold star. Every woman I know who weighs 300 pounds or more was on a diet well in advance of middle school.

    Any so-called “public health initiative” that doesn’t seriously involve the input of the people it claims to be trying to help is bound to be a spectacular failure. Where are the voices of fat kids — and fat adults who used to be fat kids — on this? People sure do a lot of talking about us, but talking to us? That they can’t actually bother with. They evidently think every word out of our mouths is going to be “donut donut donut donut,” and thus we’re too stupid and deluded to be worth listening to.

    • djw says:

      Jeebus. I haven’t been paying enough attention to Michelle Obama’s activism and language on this issue to have a worthwhile opinion on whether Paul’s characterization is a fair one or not, but that’s not good. The message to kids there is an ugly and cruel one–essentially, it’s your fault for being so fat that your parents miss work and don’t make money when you get sick. Granted, she’s not sending *this* message to the kids directly, but still.

    • sannanina says:

      When fat kids hear rhetoric like this, how do you think they respond? By saying, “Gee, I guess I should try out some new veggies and maybe go for a bike ride”? No. They want to get rid of this thing that brands them a loser AS FAST AS POSSIBLE. That means a DIET, often a very radical one. Know what diets do to kids? If you guessed “stunt their growth and trash their metabolisms for the rest of their life,” you get a gold star. Every woman I know who weighs 300 pounds or more was on a diet well in advance of middle school.

      Yep. Been there, done that. And not only this but considering that even supposedly sensible weight-loss diets (oh, sorry, “life-style changes”) do not result in significant weight loss that is maintained in the long term in most people, being stuck in the cycle of weight loss and weight gain in turn might actually cause feelings of helpless. My hunch is that telling people that they have to lose weight to be healthy and not giving them other options will result in quite a few people getting the message that since they apparently do not/ cannot/ “lack the will power”/ “are too stupid” to keep their weight down they should give up on doing anything for their health in general since it is useless anyway to try. Great message.

      Any so-called “public health initiative” that doesn’t seriously involve the input of the people it claims to be trying to help is bound to be a spectacular failure. Where are the voices of fat kids — and fat adults who used to be fat kids — on this? People sure do a lot of talking about us, but talking to us? That they can’t actually bother with. They evidently think every word out of our mouths is going to be “donut donut donut donut,” and thus we’re too stupid and deluded to be worth listening to.

      This.

      • nothingforducks says:

        Apparently, fat kids aren’t just unhealthy, it’s their fault that their parents don’t have jobs!

        Where does Obama say that?

        Any so-called “public health initiative” that doesn’t seriously involve the input of the people it claims to be trying to help is bound to be a spectacular failure. Where are the voices of fat kids — and fat adults who used to be fat kids — on this? People sure do a lot of talking about us, but talking to us? That they can’t actually bother with. They evidently think every word out of our mouths is going to be “donut donut donut donut,” and thus we’re too stupid and deluded to be worth listening to.

        I’m a not-fat adult who used to be a fat kid, so maybe my voice is a priori worthless, but where on Earth are you getting the idea that “fat” people are not taking part in this initiative or have not been consulted? Plus, the overall tenor of many messages in this thread is that the obese are basically subject to some sort of false consciousness and have been duped into believing that lifestyle changes (which now apparently must be equivalent to “fad diet”) are possible at all or even desirable.

        • sannanina says:

          Plus, the overall tenor of many messages in this thread is that the obese are basically subject to some sort of false consciousness and have been duped into believing that lifestyle changes (which now apparently must be equivalent to “fad diet”) are possible at all or even desirable.

          Sorry, but this is incredibly condescending. I cannot speak for any other person criticising Michelle Obama’s campaign, but I have read numerous (peer-reviewed) articles on this topic and considering that I a) have a BSc in biochemistry and cell biology and b) a MSc in psychology and work towards a PhD in psychology I think I am better qualified than most people to actually understand those papers. Should that make people take what I say at face value? Hell, no. But I think I deserve to be taken seriously on this topic – both for being a fat person, and for being pretty well informed when it comes to actual “obesity” research. Nobody duped me into anything – in fact, I would argue that I have been duped into weight-loss dieting many years ago. And believe me, I do believe in life style changes. I just don’t believe that true life style changes result in long-term weight loss for a significant number of people.

          • nothingforducks says:

            I did not mean to be condescending, I apologize if I came across overly brusque. But again, the question:

            Any so-called “public health initiative” that doesn’t seriously involve the input of the people it claims to be trying to help is bound to be a spectacular failure. Where are the voices of fat kids — and fat adults who used to be fat kids — on this? People sure do a lot of talking about us, but talking to us? That they can’t actually bother with. They evidently think every word out of our mouths is going to be “donut donut donut donut,” and thus we’re too stupid and deluded to be worth listening to.

            This.

            How do you know that fat children and fat people have not been consulted and taken no part in this initiative’s creation or implementation? Why is Obama objectifying you and putting the words “donut donut donut” with this program? We have an overall positive program with a figurehead who at times has used inadvisable rhetoric on the issue. “No Child Left Behind” was a shitty program because it was a shitty program, not because Bush or his Secretary of Education may have used the wrong rhetoric in promoting it.

            • sannanina says:

              You are right, nothingforducks – I cannot know that for sure. Given that fat people and especially fat women tend to be underrepresented among people usually consulted as “experts” on the topic I think is very likely. Is very likely good enough? Probably not. Also, a lot of fat people do absolutely support weight loss focused programs for kids and adults alike. And while I think this is mostly because of societal pressure to try and try again to lose weight these people have a right to their opinion just as I have a right to mine.

              So the question is what should be done. Personally, I think the best thing would be to do a pilot study first, one promoting increased levels of exercise and better nutrition with the explicit goal of lowered childhood obesity levels, the other one taking a health at every size approach and promoting fun exercise, positive body image, harassment free environments for kids of all sizes, and good nutrition. (Actually, since those programs differ on more than one dimension there probably would need to be more than just two programs.) Use those programs for a few years in schools that are comparable in terms of socioeconomic background of students etc and then measure a number of mental and physical health indicators among fat and thin students, as well as their attitudes towards fatness and fat people, their own body image, the rate of clinical and subclinical eating disordered behavior among them, and their exercise and eating habits. Once you have the results you can start a campaign like “Let’s move” – but not before.

        • chris says:

          I’m a not-fat adult who used to be a fat kid, so maybe my voice is a priori worthless

          It’s worse than that, I’m afraid: according to the majority of the fat activists posting here, you cannot exist, since long-term weight loss is impossible.

          • sannanina says:

            I posted links to several peer-reviewed articles concerning the long-term failure rate of intentional weight loss (usually through calorie restriction) further down. Unfortunately, my post is stuck in moderation at this point – probably due to the links. That said: I cannot speak for anyone else, but I do in fact believe that weight change is possible under certain circumstances, most notably circumstances that change your energy metabolism. Chronically increased levels of cortisol, for example, often result in weight gain. Thyroid problems can result in weight gain or weight loss. Concerning non-pathological weight changes, kids usually gain weight before growth spurts and then end up with a lower BMI after the growth spurt due to, well, growing and middle aged adults generally tend to gain a limited amount of weight when approaching old age. Quite a few people gain a few pounds in winter and lose them in summer. All those weight changes do not occur voluntary, and when they occur in adulthood they tend to be limited in magnitude (big, involutary changes in weight in either direction generally tend to indicate that something is wrong). None of this proves that it is possible for a significant number of people to lose large amounts of weight voluntarily and keep it down.

          • Meowser says:

            No more “impossible” than getting a Ph.D. in astrophysics, or graduating from a 4-year college by age 18. But since when do we hold up outliers as universal role models?

            A lot of fat kids “outgrow” their fat by adulthood. It doesn’t make them any more inherently virtuous than those who did not.

          • B. Adu says:

            Long term weight loss is not impossible, we just don’t know how to produce it.

            Long term weight loss diet success is as possible as ‘cure’ by homeopathy, probably less so. But I don’t expect you to understand what I’m talking about.

  10. Marilyn Wann says:

    Chris, I get the impression that you think health status can be diagnosed by weight. Thus your defense of the term “obesity.” Making health assumptions based on weight will lead to false-positives for fat people and false-negatives for thin people, with the result that you’ll be wrong 1/3 of the time.

    Decades of efforts to turn fat people into thin people have shown that the available array of interventions do not produce this result. Given that fat people exist and that efforts to turn us into thin people are ineffective, it becomes hateful to define public health goals in terms of eliminating fatness in the population.

    I will make one effort at unsnarling the gay/fat analogy…

    The AIDS virus causes disease; one method of transmission is unprotected sex. Some populations may correlate more highly with risk of having HIV/AIDS, but these correlations do not prove that, say, being gay or being from Africa causes people to get HIV/AIDS. Risky sex behaviors have a causal relationship with this disease.

    If public health messages addressing HIV/AIDS told people, “Don’t be gay.” or, “Don’t be African.” these efforts would be misdirected, ineffective, and prejudicial. The useful public health message would not any one population, it would target behavior. It would say to everyone, in a respectful manner, “Use safer sex.”

    A public health message addressing diseases like heart disease and diabetes that tells people, “Don’t be fat.” will be misdirected, ineffective, and prejudicial. The useful public health message would not target a specific population, it would target behavior. It would say to everyone, in a respectful manner, “Enjoy good nutrition and physical activity.” We know that people can change eating/exercise behavior and that these behaviors help reduce risk of heart disease and diabetes. Whether or not people lose weight in the process.

    The magic pills for health are enjoyable nutrition and fitness habits.
    The poison pill for health and social justice is weight-loss goals.

    I appreciate the good intention of making an analogy between weight-based prejudice and other, more familiar forms of prejudice — a way to inspire understanding and perhaps even compassion. I am struck by how insistently people here have twisted such comparisons, in many cases displaying the sort of anti-fat venom the original post seeks to point out.

    As a fat activist, I stand in solidarity with people who face racism, sexism, ablism, homophobia, transphobia, and other forms of oppression — which I oppose. (I don’t want to play oppression Olympics!) Someone who makes a racist slur is likely to link those words with fat-hating concepts and homophobic comments. There are significant overlaps of oppressions — people will experience multiple otherings, with intensifying effects. And, as my friend Jonny Newsome (of And Castro for All, a group that address racism in queer community) says, “The freedom bus doesn’t leave until we all get on.”

    It’s perfectly possible to work for health for all of us without reinforcing hateful, prejudicial, stigmatizing, pathologizing attitudes toward people who happen to be fat. I’m curious what valuable thing people here feel they would lose with a weight-neutral approach to public health…

    • MPAVictoria says:

      Is it possible to turn thin people into fat people?

      • Julie says:

        It’s difficult to do through behavior change alone, unless of course they used to be fat. For someone who is naturally thin, eating enough to become obese is a chore.

      • kmd says:

        Is it possible to turn thin people into fat people?

        Sure. By dieting.

        Pretty typical example: Genetics gives a young girl a thicker waist and wider hips than her peers in high school. She (and their parents, and teachers, and peers) see this as a moral failing on her part because oh my god she is fat. So she goes on a diet. She loses 25 pounds and everyone says omg you look so good! A year later, she’s gained back all 25 pounds and put on 15 more.

        Lather, rinse, repeat. With enough shaming and yo-yo dieting, she could get up to 250 pounds and beyond.

      • justaguy says:

        When I was 18 I weighed 110 lbs at 6ft2, and the most I’ve weighed in the past couple of years is 230lbs or so in my early 30s. That’s not going from thin to fat as much as it is going from freakishly underweight to having a little bit of a gut. I had a hyperactive thyroid that gave me a really high metabolism, and part of getting to a healthier weight – which is to say gaining 100 punds – included eating healthier and exercising a lot more. Go figure.

      • B. Adu says:

        I’d say yes, just not through calorie restriction (i.e weiht loss dieting).

        At best-in rare cases- you can hoover in reduced obese status for a while. That’s the people who are ‘keeping it off’.

        If WLD worked there would be no need for that.So even when dieting is claimed as a ‘success’ it is still a failure.

        It’s just if compare mere failure, to abject unmitigated failure, you can fashion the former into ‘success’ amongst the willing.

  11. Yusifu says:

    This entire post is written from such a position of white privilege and heterosexual privilege it’s almost impossible to parse. They’re not analogous.

  12. Ed Marshall says:

    God, this shit sucks. Why did I read 200+ comments about Paul’s fat fetish?

  13. justaguy says:

    Can someone point me to a review article on evidence for the relationship between obesity and health outcomes in a peer reviewed medical journal? While I haven’t clicked through every link here, I see a lot of dodgy claims like the fact that BMI is going up while lifespan is going up proves that higher BMI is not unhealthy. It proves nothing of the sort – it could easily be that whatever unhealthy effects of higher BMI are negated by other advances in health care (I’m not saying that this is the case, but rather that the argument is faulty). And some specific health claims are interesting – people judged overweight by whatever arbitrary standards tend to recover from surgery faster – but might not have any influence on overall mortality.

    My sense is that discussing obesity – even assuming that its a meaningful medical category – as if its a coherent disorder, rather than the outcome of any number of things, is hopelessly confused. I’ve known plenty of people who are larger, physically active and eat very healthy. I know other people who are larger, physically inactive and eat horribly. To suggest that they’ve got the same thing, called teh fat, is silly.

    • sannanina says:

      I agree: we do not have data that provides evidence that a high BMI has no negative health consequences in and of itself at all. But I think it is also important to note where this claim of some fat acceptance activists comes from. I would guess that it is a reaction to the often repeated claim that because of obesity today’s children will be the first generation to have a shorter life expectancy than their parents, or, even more dramatically, that they will die before their parents. And there is zero data to back that up. None.

      Also, while I cannot provide you exactly with the kind of article you asked for, this article might be helpful: http://jama.ama-assn.org/content/293/15/1861.long

      My sense is that discussing obesity – even assuming that its a meaningful medical category – as if its a coherent disorder, rather than the outcome of any number of things, is hopelessly confused. I’ve known plenty of people who are larger, physically active and eat very healthy. I know other people who are larger, physically inactive and eat horribly. To suggest that they’ve got the same thing, called teh fat, is silly.

      I agree with this. But I think there are additional factors to keep in mind that tend to be ignored. Stigma is a significant predictor of health, and not just mental health. So is socioeconomic status (and fat people tend to be poorer on average). This is not just a problem with discussing obesity. In general, we tend to focus on factors that influence health that are supposedly under individual control and ignore the factors that would require societal change, even if those factors can account for just as much or even more of the variance of inter-individual differences in health. We also tend to overestimate purely physical factors (such as nutrition and amount of exercise) and tend to underestimate psychological factors (such as enjoyment of food/ exercise, but maybe more importantly factors such as a functioning social network) even though psychological and psychosocial factors have shown to have significant effects on not just quality of life, but also life expectancy and risk for disease.

  14. Brad P. says:

    Meowser’s link definitively settles this for me:

    “Childhood obesity is affecting your workforces too – obese children are less healthy and miss more school on average,” leading to more parental tardiness and absenteeism at businesses in their communities, she said. “When we talk about childhood obesity we are talking about the workforce you are trying to build, businesses you are trying to attract, budgets you are trying to balance everyday,” Obama said warning that businesses may be reluctant to invest and build in communities with an unhealthy future workforce.

    When I said in an earlier thread that liberals have a tendency to treat people like objects rather than subjects, this is precisely what I mean. Comments like this place people in the same role as wildlife, as if there is a standard definition for the preferred condition and characteristics of a population people, and the government needs to step in and manage it without much consideration for the subjects they are trying to help.

    And I find it very distressing that the vast majority of people commenting on this are so quickly and vigorously rejecting the complaints of people who are very clearly personally offended and threatened.

    • djw says:

      I guess we all find the villains we’re looking for, but when I read that I despaired at the unbiquity of neoliberal assumptions of the proper organization of economic activity. In my realistic utopia, we recognize we’re rich enough as a society that parents missing work due to ill children is the sort of productivity hit we can and should all absorb as a decent and humane society, regardless of that child’s BMI.

      • Brad P. says:

        In my unrealistic utopia, wealth is not a social goal at all. GDP would be a measure of the economic preferences of the people, not some vague benchmark that the government tries to constantly increase.

        The problem is that progressives typically rely on the same economic models that are based on pointless aggregates as neoliberals to justify their preferred programs. I admit that you can study statistics and find individuals, groups, and organizations that are advantaged and disadvantaged, but managing aggregates really has no objective basis except what academics and economists want.

        And when I see progressives arguing for single-payer health care systems and high-speed rail running from Tampa to Orlando, I get the feeling that they are less concerned with the practical effects of their programs, and more concerned with feeling embarrassed when they travel abroad.

  15. Rarely Posts says:

    I’m glad that Paul (and Shakesville) are drawing attention to the social injustice of fat shaming.

    Nonetheless, these comment threads always contain people suggesting that no effective method of long-term weight loss has been developed. I’m not an expert, but this statement runs directly contrary to my personal experience. I have been overweight/obese twice in my adult life, and I successfully lost 30 pounds and kept the weight off both times under the South Beach diet (I know, stupid fad diet, but it appears to work for me).

    First, it’s true that I went through one period of weight gain (one year during a ten year period) after starting the diet in response to massive period of stress etc. If the test is that a method has to work despite all other events/impacts in a person’s life, then I think we’re using the wrong metric. A method that results in sustained and long-term loss over the vast majority of 10 years except in periods of extreme stress should qualify as having some success.

    Second, it also did correlate with a far HEALTHIER diet, as it taught me to eat a lot more vegetables, more greens, more fiber, and more nuts, and it taught me to cut “empty” calories (chips, candy, pasta, bread, etc.). Once again, those things are good regardless of the weight loss, so there’s no need to focus on the weight loss. At the same time, my desire to lose weight did provide me with the incentive to change my diet in that way.

    Am I just a total anomaly? I have several friends who have had similar experiences. It just doesn’t seem true that no methods for permanent weight loss exist. I know this isn’t peer review, but given these experiences, the statement that it is impossible seems incredible.

    None of that suggests that fat shaming is acceptable or just. But it does seem contrary to the assertion that long-term, permanent weight loss is impossible. Or am I not understanding the claim being made?

    • Paul Campos says:

      Significant long-term weight loss is not achievable for the vast majority (estimates run from 90%-98%) of people who attempt to achieve it. This isn’t a “claim” unless things like “cigarette smoking causes cancer” are also “claims” — i.e., there’s overwhelming empirical confirmation of the assertion.

      You could be certain this was the case even if you had never looked at the scientific literature for a pretty obvious reason: Have you ever seen Weight Watchers or Jenny Craig or South Beach etc etc tout anything resembling credible evidence for the efficacy of their methods? Of course not, because there is no such evidence. If there were they’d be running ads about it 24/7, and putting it on 200-foot high billboards.

      • John says:

        Paul: Why should anyone trust that you are giving a good faith summary of the scientific literature on this subject?

      • nothingforducks says:

        Maybe these weight loss ads don’t appeal to the scientific evidence just like you didn’t in your blog post: the calculating desire to reach one’s audience through as emotional and tawdry a channel as possible.

        Everyone is conflating diets, which are typically short term, require fast and easy results, and are seldom possible to follow healthily for a long time, with actually changing and regularly following a different exercise and eating regiment that is sustainable (which is of course what Obama and many others in this thread are talking about). Whether they have an identical result (according to many in this thread, yes, i.e. no measurable weight change), it must be at least conceded that their approach is substantially different. Is the “failure” rate for long-term weight loss considering only those who successfully maintain such regimens at a healthy level for the long-term, or is it also considering those who only have done one-off diets that had no chance of working from the start or those who lapse from healthier consumption and exercise habits? There’s a big difference between “It is not really possible medically and anatomically to maintain long-term weight loss” and “Not many people have been good so far at choosing, adopting, and sticking to appropriate food and exercise habits, instead opting for 10-day 10-pound nonsense or falling off the wagon”. How about some actual links to actual journal articles surveying the actual medical literature?

        And further more, this ignores the whole damn point of the Get Active iniative, which is not weight loss, but weight gain prevention. Which would require a completely separate set of scientific literature, as this is an issue distinct from that of weight loss. Again, you could show us the overwhelming empirical evidence you allegedly have (not in individual studies, but surveys of the field).

        And again: why the variance in obesity rates among countries and other categories if bodyweight is naturally determined to such a strong degree? Scientific literature, etc.

        • Marilyn Wann says:

          1/3 to 2/3 of weight lost is regained within one year and all is regained within 5 years.

          SOURCE: National Institutes of Health (NIH): Methods for voluntary weight loss and control (Technology Assessment Conference Panel). Ann Intern Med 1992, 116:942-949.

          * * *

          Dieters regain more weight than they lose.

          Researchers write, ““In sum,” the authors report, “there is little support for the notion that diets lead to lasting weight loss or health benefits.”

          SOURCE: Mann T, Tomiyama AJ, Westling E, Lew AM, Samuels B, Chatman J: Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer. Am Psychol 2007, 62:220-233.

          • Guest says:

            Everyone is conflating diets, which are typically short term, require fast and easy results, and are seldom possible to follow healthily for a long time, with actually changing and regularly following a different exercise and eating regiment that is sustainable (which is of course what Obama and many others in this thread are talking about).

            Both of our cites are about the former. Your second cite is specifically about “calorie-restricting diets”.

            The first doesn’t say what you claim, but rather “information on long-term effectiveness and safety up to 5 years is limited”. It’s also from 1992 and has a disclaimer on the published online version: “some of the material is likely to be out of date, and at worst simply wrong”.

    • kmd says:

      You describe two isolated incidents of being “obese” in your adult life. Was there something that happened right before you gained weight, both times?

    • B. Adu says:

      But it does seem contrary to the assertion that long-term, permanent weight loss is impossible.

      With respect, you contradicted this statement yourself by saying you had to diet twice.

      I think the point is, nothing can be a 100% fail, which is never the test of medical/scientific efficacy anyway.

      If it was, nothing could be said not to work, because there’s always placebo effects in the mix.

      It’s about overall effectiveness. As weight across the board has either increased or not decreased besides a bourgeoning slimming industry. It’s hard to rationally conclude anything else.

  16. McWyrm says:

    Marilyn Wann:

    [T]he weight focus in Let’s Move is counterproductive – behavior change linked to weight loss expectations Means people don’t maintain behavior change. It’s an unnecessary poison pill. Behavior change and health improvements last with weight-neutral approach.

    The useful public health message would not target a specific population, it would target behavior. It would say to everyone, in a respectful manner, “Enjoy good nutrition and physical activity.”

    Marilyn, can you point to any instance of the Let’s Move campaign advocating behavior changes linked specifically to weight loss expectations? I realize that the intent of the program is to reduce or eliminate childhood obesity, but I have never seen any message emanate from this program along the lines of “Eat well and exercise to loose weight” – I’ve only heard “Eat well and exercise to be healthy.” Can you point at any part of their program that encourages exercise or better nutrition specifically as a means of weight loss?

    Let’s Move “Eat Healthy” page:

    Parents and caregivers play a key role in not only making healthy choices for children and teaching children to make healthy choices for themselves. But in today’s busy world, this isn’t always easy. So Let’s Move! offers parents and caregivers the tools, support and information they need to make healthier choices while instilling healthy eating habits in children that will last a lifetime.

    Let’s Move “Get Active” page:

    Physical activity is an essential component of a healthy lifestyle. In combination with healthy eating, it can help prevent a range of chronic diseases, including heart disease, cancer, and stroke, which are the three leading causes of death.

    I really fail to see how this program fails to meet your requirements.

    • Paul Campos says:

      I’m not speaking for Marilyn, but bundling these messages within an over-arching frame of obesity prevention/elimination guarantees that these messages will be understood (as indeed they are understood by the media — check out the coverage of the program) as weight-loss/weight-gain prevention methods.

      There was a huge battle within HHS to NOT present these messages in the context of “obesity prevention/elimination.” The higher-ups decided to ignore all the people who were telling them that doing so was a bad idea, because they wanted to make as big a media splash as possible, and “eat your vegetables and go outside and play” isn’t as sexy a message as “omigod all our kids are fat and are going to die younger than their parents.”

      • kmd says:

        they wanted to make as big a media splash as possible, and “eat your vegetables and go outside and play” isn’t as sexy a message as “omigod all our kids are fat and are going to die younger than their parents.”

        Exactly. Fat hatred sells.

        • Anonymous says:

          … so if I’m hearing you correctly, Let’s Move is a fat-shaming eugenics campaign to gently encourage all children towards exercise and proper nutrition as a means to better health.

          If you can point me towards any instance where Let’s Move singles out fat children or encourages them to use diet or exercise regimes solely as a means to reducing their weight please do so.

          • Brad P. says:

            No, the Let’s Move campaign is a program that is going to do very little but receive a lot of press.

            That means the practical effects of it will be the way it effects attitudes.

            In that sense, those pushing it must be absolutely certain that they do not shift attitudes unfavorably, and Paul is correct that Michelle Obama is using a very poor choice of rhetoric in targeting fat people.

            And she is likely choosing that because of all of the pop references to “Fat Americans”. Call me a cynic, but I think this is purposeful public fear-mongering.

    • Marilyn Wann says:

      Shall I also define the word “is”?

      Fat people are not necessarily lazy or stupid; people who gullibly believe in stereotypes, however, are.

  17. larryb33 says:

    As far as I’m concerned anti-obesity crusades are a perfect example of how we give short shrift to mental health in our society. The link from the commenter to Michelle’s thoughts on the economic impact of “obese” children is pretty horrifying.
    In asshole governor news, my governor has cut all sorts of health funding, but has proposed a small increase in anti-obesity program funding. Where is the science behind this?

    • fasteddie9318 says:

      What do you have against those with alternative mental states? Why do you want the government to weed out an entire category of people simply because their brains don’t work the way you think they should? Even your framing is offensive (“mental health,” implying that anyone who doesn’t meet your standards is mentally UNhealthy and therefore defective and probably also a bad person). Eugenics, much?

      For many of the conditions so callously categorized as “mental health” issues, there’s little empirical evidence to suggest that they are the direct cause of negative outcomes. This shaming of those with alternative mental states is counter-productive and oppressive.

      • larryb33 says:

        Yes, well if I take your claim that there is overwhelming empirical evidence to suggest that “obesity” (and not just morbid obesity) is the cause of negative health outcomes can you also show me the overwhelming empirical evidence that we know how to make and keep people thin.

        • fasteddie9318 says:

          Since I made no claims about overwhelming empirical evidence for anything, I’m not sure what you’re on about. But you do make a good general point, so I’d like to see your overwhelming empirical evidence that we know how to make and keep people in a “normal,” in whatever probably-offensive way you wish to define “normal,” mental state.

        • nothingforducks says:

          This is not a formal scientific survey, just some time messing around on google. But the evidence exists! The evidence against the possibility of long-term weight loss may indeed be stronger, but it is not overwhelming. And you have cited nothing to support your contention that every dietary and exercise change is of equal merit to a fad diet.

  18. Testudo says:

    There are two factors that make being gay different than being obese, and these differences are what make it immoral to legislate against homosexuality and moral to legislate against obesity. The first is that being gay is not a choice, whereas being obese is. Nothing is 100% genetic or social, but in general, homosexuality is something you are born with. Obesity does have a genetic factor, but it is more strongly determined by diet than genetics. Legislating against an aspect of someone that is inborn is persecution, legislating against something someone chooses to do is not.

    The other difference between homosexuality and obesity is that obesity causes harm to others, where as homosexuality does not. The medical complications that accompany obesity put severe strain on our healthcare system’s limited resources, taking those resources away from others who need them and causing them harm. In contrast, homosexuality does not directly cause harm to others.

    Because of these two differences, it is moral to legislate against obesity and immoral to legislate against homosexuality.

    • Ed says:

      Geez, Testudo, even Michelle in Meowser’s (very revealing) link says that “sweeping new ordinances” aren’t necessary to deal with all the fat kids. She does seem to be worried that we’re not providing our struggling military with quality cannon fodder, though:

      In addition to her remarks, the first lady has been traveling the country to explain the long-term consequences of childhood obesity for the economy and national security. In a January visit to Fort Jackson in South Carolina, Obama said the epidemic has an adverse effect on the military’s ability to recruit with over 25% of 17-24 year olds deemed too overweight to serve.

    • Marilyn Wann says:

      I’m opposed to oppression, even if the group concerned choose to be in that group. See: religious freedom/choice/protections.

      • Marilyn Wann says:

        Also, some people have always been fat. Some people are fat now. In the future, some people will be fat. It would be much better for society in general, for the economy, and for public health to celebrate weight diversity and to encourage people of all sizes to love our bodies and as an expression of that delight, to enjoy good nutrition and physical activity. Pleasure principle, not punishment principle.

        Deeming me as a fat person immoral, and arguing that the government designate me as such? Kinda proves my point that weight-based stereotype, prejudice, and discrimination exist and are lamentable.

    • Marilyn Wann says:

      I love it when people just directly say: Throw the fatties out of the life raft! It’s such a refreshingly direct form of hate. During my entire adult life, I have not been allowed to purchase health insurance as an individual based on my weight alone. This overt weight discrimination has been a cost burden to no one but me.

      I have never once heard an “obesity” expert disagree with the routine denial of such basic access to healthcare for fat people. That’s just one reason why I find it impossible to believe they care about the actual wellbeing of people like me I think they care about something else. Could be career. Could be money. Could be fame. Not fatties.

      • Testudo says:

        The reason obese people are often denied health insurance is because it is the result of a self-chosen activity (overeating) that leads to health problems. This is the same reason people who smoke can’t get health insurance. Its wrong to deny people health insurance based on a human characteristic that causes them to need more medical care. For example women need more medical care so they have to pay more for insurance. The new health care law does away with this form of discrimination. However, obesity is not something you are born with, it is something you choose to be by overeating. If you don’t want to face the negative consequences over overeating, eat less.

        • Marilyn Wann says:

          Testudo, there is no data about a person’s eating habits on a health insurance application form. If people who eat a lot of food were refused medical care, I predict those we doom would be a mix of weights. I wouldn’t support a policy that allows insurers to deny coverage at all, much less issues denials based on behavior. I certainly don’t support allowing insurers to deny coverage to a large percentage of people. I don’t think that’s good for public health. Do you?

          Calories-in/calories-out does not account for human weight diversity. Genetic predisposition plays is the predominant influence in individual weight.

          In a study of 500 adoptees in Denmark, researchers found a correlation between weight between children and biological parents but no correlation between weights of children and their adopted parents.

          SOURCE: Stunkard AJ, Sorensen TI, Hanis C, Teasdale TW, Chakraborty R, Schull WJ, Schulsinger F: An adoption study of human obesity. N Engl J Med314 : 193–198,1986

          Another study looked at the effect of overfeeding on identical twins. All pairs of twins consumed the same amount of calories for 3 months. The amount of weight gain was nearly identical for each pair of twins, but varied between pairs from 8.8 pounds to 29.3 pounds.

          SOURCE: Bouchard C, Tremblay A, Despres JP, Nadeau A, Lupien PJ, Theriault G, Dussault J, Moorjani S, Pinault S, Fournier G: The response to long-term overfeeding in identical twins. N Engl J Med 322:1477 –1482, 1990

          The reverse also holds. Identical twins on caloric restriction lose similar amounts of weight, but the amount of weight lost in different twin pairs varies greatly.

          SOURCE: Hainer V, Stunkard A, Kunesova M, Parizkova J, Stich V, Allison DB: A twin study of weight loss and metabolic efficiency. Int J Obes Relat Metab Disord 25:533 –537, 2001

          • larryb33 says:

            Well done. My reply would have been more along the lines of “you’re kidding, right?”

          • Testudo says:

            This is very strong evidence that obesity is genetically determined. I am very impressed with this reply, and it has made me stop and reconsider my position on this issue. However, if obesity is primarily determined by genetics, why then as the childhood obesity rate increased so dramatically over the last 20 years? Genetic factors should remain constant over time.

            Also, you did not address the second point I made, which is that the overt weight discrimination does have a cost to other people. The obese are more likely to have heart trouble and diabetes, which means that allowing the obese to be covered under a medical plan will raise the rates for everyone. This means some of the people who can barely afford health insurance will no longer be able to afford it if obese people are added to the plan. You are essentially asking the poor to give up their medical insurance so you may be covered. Now, if universal health care were passed (as it should be) then the burden of covering the medical expenses of the obese falls to the taxpayers. If that’s the case, then the government, who is subsidizing your medical coverage, has the right to attempt to reduce its costs by reducing obesity. That right is being demonstrated in programs like the Let’s Move campaign.

    • Meowser says:

      I actually do know people who self-identify as queer who say they cultivated an attraction towards people of the same sex, that it didn’t come to them instinctively. Do those people deserve more abuse and fewer rights than those who “can’t help it”?

      And maybe it takes one of us alter cockers (old farts) to remind you that as recently as 25 years ago, we WERE being told over and over again that gay people were sick and perverted and were going to die from their sickness and perversion, and kill innocent straights with their sickness and perversion because of AIDS. (That lesbians were less likely than any straight people to contract the disease was an inconvenient afterthought.)

      And trust me, as a liberal straight, I knew plenty of liberal straights in the 70s and 80s who thought gay people could be “turned around” with therapy and/or meeting the right partner, and that they and everyone else would be better off if they were. I, in fact, got fired from a job in 1980 for saying gay people should have the right to marry each other and adopt kids. The standard line I always got from people was, “But then EVERYONE will turn gay and our species will die out!” It sounds completely preposterous now, but people really did think that.

      As Earnie Larson liked to say, “Nothing changes if nothing changes.”

      • Testudo says:

        The reason the liberal straits who said homosexuals could be “treated” were terrible was because homosexuals can’t be treated. Some part of being homosexual may be socially determined, but it is mostly determined by genetics. The other reason arguing homosexuality should be “treated” was terrible was because homosexuality doesn’t hurt anyone. People wanted to eliminate it simply because they found it gross. People may say that homosexuality hurts other people, but they are lying to justify their own prejudices.

        Obesity, on the other hand, can be turned around and does hurt other people. This makes it acceptable to enact policies to treat it.

        • Meowser says:

          How exactly am I harming you by being fat, other than offending your personal sense of aesthetics?

          And before you whip out the “health care costs” argument I must warn you of several confounding factors: 1) Many fat people who are ill or disabled are so because of their illnesses and disabilities, not the other way around, 2) Many of us gain serious weight as a result of medical/psychiatric treatment, 3) Fat people are often tested for lots of shit they turn out not to have, simply because they are presumed to be ill simply because of their size, and 4) People who live the longest (presumably the virtuously healthy thinner folks) rack up the highest lifetime healthcare costs.

          The latter is something I know about firsthand. I’ve worked on medical records for the better part of two decades; I’ve seen THOUSANDS AND THOUSANDS of medical records, from all over the U.S. If you think every hospital bed is filled up by a fatty, you could not possibly be more mistaken. OLD people (over 70), of all different weights (and yes, there are fat people well over 80), use up most of the healthcare, by a huge margin.

          The older someone is when s/he presents to the emergency room, the more likely s/he is to be admitted, regardless of the presenting complaint.
          IOW, if you’re 50 and you to the ER hacking your lungs out and running a fever and you get diagnosed with pneumonia, you’re likely to be discharged with antibiotics and outpatient followup; if you’re 75 and present with the same symptoms, you are strongly recommended hospital admission (although of course, you can refuse if you are not unconscious or on conservatorship). That’s true regardless of the patient’s weight. Old people also tend to be on many more medications and are much more likely to have survived multiple bouts of cancer, need hearing aids, home health nursing, prostheses, and so on.

          And yet, all these people who think their awesome health habits are going to make them live to be 100, while my scandalously hedonistic fat ass will cack by age 70, somehow also think that amounts to them being low-maintenance for their fellow taxpayers. I don’t get it.

          • Meowser says:

            Errata:

            1) Many fat people who are ill or disabled are so fat because of their illnesses and disabilities, not the other way around, etc.

          • Testudo says:

            The “health care costs” argument is pretty much the argument I am making. My understanding is there is a moderate but significant correlation between overeating and obesity (controlling for all the factors you mentioned) and a strong correlation between obesity, heart disease, and diabetes. Your post has made reconsider these beliefs, so I guess I’ll have to do some more research to see if you are right or not.

          • Joe says:

            “many” means “many” are not

            This is why generalizations along with comparisons with gay people et. al. are so troubling. There are various things at issue here and that is how it should be looked at.

            The movement against “obesity,” for instance, is not the same thing as being against “fat” people. The latter is a very arbitrary term. The former, not quite as much.

            Second, ‘many’ people are overweight (however we define it) for health reasons or genetics or whatever. Some very well are overweight because they live unhealthy lives. It is not wrong to address that.

            Finally, living unhealthy can shorten lives. Let’s say you have a heart attack. Your doctor, I’d think not as a result of anti-fat bias, is quite likely to put you are a certain regime, tell you to cut back on certain foods, to be sure to exercise etc.

            This is not the path to nirvana or anything, but healthy living (which “fat” people do all the time, whatever “fat” means — getting out of the house, getting fresh air, walking some etc. is better for people of all sizes) is not a bad thing. We can promote it w/o hurting “fat” people.

            • Joe says:

              “you” here is a general “you,” not addressing any person writing here.

            • Meowser says:

              I use the term “fat” rather than “obese,” because the root of the latter word wrongly implies that fatness is caused exclusively by gluttony.

              It might help to recognize that much of medicine is guesswork. They might think, for example, that tight control of cholesterol levels prevents heart attacks, but the evidence for it is surprisingly equivocal. Sure, if someone has really severe dyslipidemia (like LDL and triglycerides over 300), that probably does require some sort of intervention.

              But it’s also true that dietary interventions only help a small percentage of people (like maybe 10%) reduce cholesterol or blood pressure (or for that matter, body weight in any significant way), and if you press doctors about this, most of them will admit it’s true. That’s the danger of looking at people as collections of numbers, rather than as individuals.

              Likewise, a diet and exercise regime that makes one person thrive could well make another person wilt. I’ve had gut problems my whole life, and doctors have said, “Well, eat more fiber.” So I ate more whole wheat bread and more broccoli and brown rice and apples and all that good stuff, and felt worse. I was told that effect would go away when I got used to it; it didn’t. Finally I realized I had absorbency issues that prevented me from being able to properly digest those things, and that not only did very few doctors had sufficient training in nutritional medicine to really understand those issues, but there isn’t even a single unifying theory of nutritional medicine! It doesn’t exist!

              Just like they “guess” veggies and exercise will make all the children slim ‘n’ healthy, without doing a damn thing to correct the socioeconomic inequities that take such a terrible toll on people’s health. Yeahright.

  19. sannanina says:

    For those who want data supporting that dieting or “life-style changes” with the goal of weight loss generally fail in the long term:

    1.) http://tinyurl.com/6jjkylm

    2.) http://tinyurl.com/5uuvq4e
    (Unfortunately, I cannot legally provide you with the full-text article, but there is also an article talking about this research on the UCLA website: http://tinyurl.com/5wkrg35)

    3.) http://tinyurl.com/6zmr3lb
    (Once more, I unfortunately cannot legally provide the full text)

    I should add that studies supposedly reporting successful weight loss interventions either have a) a very high attrition rate (so high that I have in the past wondered how the authors ever got the respective research published in a peer-reviewed journal) and/ or b) follow their participants for less than two years. Even if participants are followed for one year, you often find that while they might on average be thinner than before the intervention they have started to gain weight. Without more data there is no good reason to assume that this weight gain will stop before they reach their initial weight. Furthermore, depending on the study a weight loss of 10% is generally counted as success. A 10% weight loss does not make any obese person reach a normal weight.

    (Also, there is quite a lot of research on how food restriction/ dieting actually predicts later weight gain in children and adolescents. You can probably imagine that while I have the respective articles on my hard disk finding them there and then locating them on the Internet takes some time – therefore, I have not yet included them here. If anyone is interested, however, I can still do that.)

  20. CJColucci says:

    When I try to lose weight per se, the results don’t last. But when I eat healthy food and get plenty of exercise, my weight drops noticeably, and it stays down as long as I maintain a healthy lifestyle. When I stop exercising, and start eating a lot of crap, it goes up again. Does the science say anything different?

    • larryb33 says:

      So, why do you stop exercising and eat a lot of crap? Why not just be “good” all the time.
      My experience is that if I eat a lot of crap and exercise less I don’t gain much. What does the science say about that?

  21. Nosmo King says:

    There is the National Weight Control Registry, which tracks those approximately 10 percent of people who lose weight and keep it off for long periods of time, in an effort to find out what the common threads are on a scientific basis.

    On an unscientific basis, my anecdotal observation is that “healthy at any size” is possible, but “healthy at any size and age” is a lot harder to do. If you’re very large, 20 to 45 is a sweet spot. Before then and after then, problems arise.

  22. Joe says:

    I’ll spell it out a little further: “Homosexuality = “Obesity.” “Gay” = “Fat.”

    The problem is they aren’t equal. There is some overlap but they aren’t equal. For instance, there are quite a few “fat” children who are “fat” because they live unhealthy lives. Like there were many children in the past (and some now) who have vitamin deficiencies. It is not a bad idea to try to help them live healthier lives.

    I don’t see the equivalency in gay children. The same with fat adults. It is one thing to talk about fat shaming and to talk about hacks trying to sell dangerous fad diets and talk about how our image of body type in this country is overly skewered etc. Fine. But, again, many fat adults are unhealthy and if possible, it would be good to in a healthy way address it.

    OTOH, where are the examples of gay adults where it is a good idea to address their gayness since it’s unhealthy that they are gay in a comparable way? Put aside that fat people can marry and so forth while same sex couples can not, you start to see why many of us find “=” asinine even if we don’t find various aspects of your campaign wrong.

    If Scott wants to calmly let this sort of thing go on (contra him finally needing to respond to your comments about Bush v. Gore and the SSM case in Iowa), fine. But, yet again, lots of comments suggest not as much useful conversation as one would like.

  23. Testudo says:

    This is similar to what I was trying to say. I was just a lot angrier about it because I think the original post insulting to gay people.

  24. McWyrm says:

    Scott Lemieux:

    “Encouraging” fat people not to be fat: counterproductive

    kmd:

    But the stated goal, to “eliminate childhood obesity” is based in un-scientific ignorance, fat hatred and bigotry. Every scientific study, ever, has shown that exercise and good nutrition improve health but that there is NO such thing as permanent weight loss.

    vesta44:

    Michelle Obama wants fat kids to become thin kids through healthy eating and exercise.

    Can any of you point to any place where the Let’s Move campaign encourages currently fat children to become thin? I have looked around the Let’s Move website and looked through the task force report(pdf) and have found exactly one mention of weight loss:

    In addition, the Health Resources and Services Administration at HHS has implemented a new data collection measure for all federally-supported community health centers that tracks BMI assessment and counseling for child and adolescent patients.

    As far as I can tell, no part of the program proposed by the task force involved any effort to encourage currently fat children to loose weight.

    The Let’s Move program does *not* focus on weight loss. It doesn’t even recommend weight loss per se.

    • To emphasize this again, I think the program itself is fine; I object only to characterizing the objectives of the program as “ending childhood obesity” or some such, or the many commenters who have advocated a counterproductive, aesthetically driven focus on weight rather than health.

      • Joe says:

        I’ll spell it out a little further: “Homosexuality = “Obesity.” “Gay” = “Fat.”

        Do you agree? I’m confused myself since many people are unhealthily obese and so forth, while I’m not sure how being homosexual is unhealthy inherently.

        It might not be productive to target “obesity” (not “fat” … the terms are simply not the same thing) but unlike “gay,” obese isn’t some totally benign thing. A Star Trek like world with no obese people isn’t some horrible concept. Ditto if we imagine some future w/o deaf people.

        gm’s update, I apologize, sounds like some sort of graduate seminar abstract.

      • McWyrm says:

        I don’t disagree, Scott.

        A number of the points Paul makes in the Daily Beast bit – for instance, that the program can’t possibly succeed because there’s not way to turn fat people into thin people – rest on the assumption that turning fat kids into thin kids is an essential part of the First Lady’s program. I haven’t been able to find any evidence that the Let’s Move program depend upon – or involves in any way – any such effort.

        On a related note, the Let’s Move program quite certainly does not aim to “end” or “eliminate” obesity. From the task force report, “Solving the problem of childhood obesity” means:

        Our goal is to solve the problem of childhood obesity in a generation. Achieving that goal will mean returning to the expected levels in the population, before this epidemic began. That means returning to a childhood obesity rate of just 5% by 2030. Achieving this goal will require “bending the curve” fairly quickly, so that by 2015, there will be a 2.5% reduction in each of the current rates of overweight and obese children, and by 2020, a 5% reduction.

        • Paul Campos says:

          What’s the justification for this goal? Why is the body mass distribution among American children in the 1960s and 1970s supposedly optimal? After all there were far fewer “obese” children in 1940 than in 1960 (in fact in the 1960s the public health authorities were freaking out about how fat American kids had gotten — that’s what the original presidential council on fitness and all that JFK “vigor” propaganda was about.)

          Or is it the case that all “obesity” is per se bad, but it’s unrealistic to try to get rid of it completely, so we’ll just have to settle for the BMI distributions among children a generation ago? Inquiring minds want to know!

          • McWyrm says:

            These are good questions.

            The fact remains the First Lady’s program doesn’t encourage fat children to loose weight. Arguing that failure is guaranteed because there’s no effective method to turn fat people into thin people demonstrates either ignorance of the program or bad faith.

            • Meowser says:

              What’s the material difference between “reducing BMI” and “weight loss”? The former is the program’s explicit goal. I suppose you could make the claim that you are trying to make children’s weights hold steady before their next height spurt, but there is no intervention that is proven to do this. In many kids, it happens without anyone having to do anything, and in others, intervention means reduced height and slower metabolism, hence increased BMI.

              And make no mistake, kids ARE going to hear this stuff and think, “I have to go on a diet. NOW.” For a kid, time moves at a snail’s pace; even a WEEK of being picked on as the fat kid (by the government, even!) feels like a lifetime. Even before this, over half of all fourth-grade girls were already dieting. I can’t even imagine what that number looks like now.

              • McWyrm says:

                The report talks about reducing the BMI profile of the entire population of children between 2 and 19 over a period of 20 years, not reducing the BMI of any given individual. The link that Campos posted here is illuminating on this point – the upward BMI trend that this program is trying to reverse can be explained (and presumably reversed) by small changes to habits of diet and exercise.

  25. Julie says:

    I’m not going to comment on the analogies to gays or racism, but I get the point of this post. I grew up in a small town in the 70s as the fattest girl in my elementary school classes, though I was just a little pudgy by today’s standards. There was no junk food or pop allowed in my house, in fact I wasn’t allowed in the house if the sun was shining. I walked to school, rode my bike all over town and went to the city pool–I was just as active and fit as any other kid, but I was fat. Somehow I avoided teasing and bullying from the other kids, they just accepted me as I was.

    I was also usually the smartest kid in class, so I remember how much it hurt when my PE teacher signed me up to run with the “special” kids in our school track meet, even though I was faster than some of the skinny girls. I was afraid the spectators would think I was retarded, so I decided not to run at all.

    If Rosalynn Carter had started a campaign aimed at childhood obesity, I would probably have lumped her in my mind with adults like my PE teacher. Not necessarily spiteful, just one of those adults (and they were all adults) who couldn’t see past my weight. Such a campaign would have had no effect on me, except to make me feel more self-conscious.

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  27. Brad P. says:

    That’s why you need to shut up. I wanna see what the serious people have to say without us trolls hijacking this.

  28. Malaclypse says:

    I have a bold idea. You could ask a Con Law prof how the federal government can be allowed to take initiatives affecting both health and education policy.

  29. How should even the not-as-sexy “eat your vegetables and go outside and play” be within the purview of the United States federal government.

    Perhaps you could explain your implication that the government setting up a website violates the Constitution instead. Is it viewpoint discrimination?

  30. fasteddie9318 says:

    You could ask a Con Law prof

    A real one, or a hack? Because he doesn’t know any real ones.

  31. fasteddie9318 says:

    They’ve been trumped by these seven, more terrifying, words: “I’m Ann Althouse and I’ve been victimized.”

  32. Guest says:

    If you’d read the posted article, you’d have seen those words quoted by Campos himself.

  33. Malaclypse says:

    From New Media Meade’s helpful link:

    The Healthy, Hunger-Free Kids Act of 2010 authorizes funding for federal school meal and child nutrition programs and increases access to healthy food for low-income children. The bill that reauthorizes these programs is often referred to by shorthand as the child nutrition reauthorization bill. This particular bill reauthorizes child nutrition programs for five years and includes $4.5 billion in new funding for these programs over 10 years.

    So, not a 4.5 billion web site at all. Maybe New Media Meade should become Old Media Meade and learn to actually, well, read.

    It really is a useful skill, New Media Meade.

  34. Brad P. says:

    It was Scott who said that the government was setting up a website. Meade may have been pointing out that this includes far more than a website (or a really expensive website).

  35. Malaclypse says:

    Meade may have been pointing out that this includes far more than a website

    Okay, it never occurred to me that Meade would question whether the USDA had the authority to regulate food. My apologies to Meade for not realizing how very, very silly he was being.

  36. Scott Lemieux says:

    Yeah, I think the ability of the federal government to fund education with federal tax revenue is pretty well-settled. but if Meade wants to explain why it violates the Constitution I’m all ears…

  37. Testudo says:

    I specifically said homosexuality is not a pathology. No “human characteristic,” as campos calls them, is a pathology. Obesity is not a human characteristic. If being obese was an human characteristic, childhood obesity could not have increased so dramatically over the last 20 years. Childhood obesity is a pathology because its kills people. Like any common cause of death, it is reasonable for our society to take steps to minimize its impact. As Ed mentioned in the above comment, these steps don’t even have to be that radical. Misappropriating the language of identity politics to defend our society’s obsession with fat and salt is insulting to groups who have faced oppression just for being who they are.

  38. Paul Campos says:

    I just want to note that I’m in complete awe at the self-satisfied ignorant stupidity of every word in this comment, including the “ands” and “thes.”

    It reminds me why I got into this business in the first place.

  39. Scott Lemieux says:

    When Meade hands you a TKO in the first round, it’s really time to turn in the trolling license.

  40. Testudo says:

    I responded directly to the points made in the article, offering evidence for my assertions. You have responded with personal insults devoid of content. I’m pretty sure you are doing the trolling.

    If I’m being overly blunt or aggressive when making my points, it is because I find it upsetting you would appropriate the language of identity politics on an issue that has nothing to do with identity politics. I have made three assertions in my posting, that obesity is different from homosexuality because it is not an inborn trait, that is acceptable to legislate against obesity because it is not an inborn trait, and obesity harms society as a whole. If you disagree with these beliefs, make the argument and state your evidence. I find personal insults and self serving abuse of minority rights language unconvincing.

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