It’s time to call off the war on fat.
That’s the takeaway from two new studies, as reported Tuesday: One from scientists at the University of Alberta and the other from scientists at York University, together they show that physicians shouldn’t consider “just at how big someone is” but rather how well someone takes care of him or herself, says the U of A’s Dr. Arya Sharma. A lot of times even morbidly obese people are in pretty good shape, even if they don’t look it, he says. “They eat healthily. They’re physically fit. They feel good about themselves. They don’t have high blood pressure. They don’t have high cholesterol levels. They don’t have diabetes. They have none of those health problems and so the question is: Why would you treat these people? Why don’t you ask them to just stay as healthy as they are?”
So it turns out the Body Mass Index (BMI), the crude ratio of weight to height, isn’t the be-all and end-all of determining someone’s fitness that we’ve been treating it as. We might have guessed: More than 100 years old, the BMI was developed when the average human was a lot scrawnier and shorter than today’s North Americans. The BMI also doesn’t differentiate between muscle weight and fat, ranking the strapping, but fit, as “obese” while blessing those of middling weight, even if they have excessive body fat, as “normal.”
According to the Centers for Disease Control (CDC) BMI-based tally, one in three Americans and one in four Canadians is obese. But when between a quarter and a third of your population looks abnormal, you could have a rampant health problem — or it might be that you’re using a poor measure of normalcy.
In fact, our long-running reliance on the over-simplistic BMI has mangled our understanding of what healthy weight means, setting off a hysterical overreaction by public health officials and nudnik politicians out to stigmatize all our yummiest foods along with everyone who dares to enjoy them. Surely you’ve heard all the frightening tales of America’s out-of-control obesity epidemic. They took off in the early 2000s, when the anti-McDonald’s documentary, Supersize Me, became a new kind of horror film. Back then, the head of the CDC declared that obesity would prove the next Spanish flu, a deadly scourge claiming 400,000 American lives a year.
But a few years later, the CDC decided it had miscalculated: the actual number of people who would die from obesity-related illnesses, it happens, was just a fraction, one-fifteenth, of the original estimate: Just 26,000 in a population of 310 million, or less than a hundredth of one percent. The seasonal flu has a higher death toll than that.
Yet the momentum behind the war against obesity hasn’t stopped. It’s actually intensified to the point where psychologists and nutritionists warn that all the fanatical anti-obesity propaganda is leading to increased discrimination against the overweight, and in particular, more schoolyard bullying for fat kids. Michelle Obama made fighting childhood obesity her official cause as First Lady, going so far as to call for the constant monitoring of children’s BMI. The City of Los Angeles slapped moratoriums on new fast food restaurants. Health groups, including the Canadian Medical Association (CMA), have called for a tax on calorie-laden foods. The American Academy of Pediatrics and the CMA want the government to outlaw burger commercials aimed at children. New York’s mayor Michael Bloomberg has ordered city restaurants to cut their salt use, while demanding that Washington prohibit Americans from using food stamps to buy sugary drinks. And San Francisco’s city board of supervisors voted in November to ban McDonald’s Happy Meals. “From San Francisco to New York City, the epidemic of childhood obesity in this country is making our kids sick, particularly kids from low income neighborhoods, at an alarming rate,” said board member Eric Mar.
Actually, far from being a runaway epidemic, the CDC reported last year that there had been no statistically significant trend towards increased obesity among the vast majority of American children or women between 1999 and 2008. For the last five years of that decade, obesity rates in men had held steady, too. The only exception was a small subset of boys with the highest BMI: the very fattest got fatter; the rest stayed the same. Meantime, a number of studies have found that people considered overweight – the BMI category below obesity — have lower death rates than people in any of the other categories, including “normal” weight and “underweight” people.
Of course, that flies in the face of our cultural biases, which insist that people with love handles must be sick, and they’re surely lazy and gluttonous, too — all prejudices refuted by the U of A study, which found that 15 to 20% of clinically obese people are every bit as healthy as their skinny friends. The York University study, meantime, found that obese people without other health complications had no higher risk of death than people of supposedly normal weight — whatever that means at this point.
That’s not to say we shouldn’t endorse healthy eating, but it certainly suggests that health and girth are two very different things. Unfortunately, it’s unlikely we’ll be calling a truce in the war on fatness anytime soon. For one thing, it’s in our nature to want to find tragic, fatal flaws in our developed, comfortable way of life; economically prosperous and well fed, we can only think that the price of all this sinful splendor is that we must be destroying our planet while eating ourselves to death. And besides, there’s a $50 billion North American weight-loss industry, a $20 billion fitness industry, and countless public health nannies with a popular cause they can peddle with ease. Because everybody knows being heavy must be bad for you — even if the science stubbornly insists otherwise.
National Post
On Twitter: @kevinlibin
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