"...clinical-sounding terms like adipose, overweight, and obese."
March 24, 2015 10:02 AM   Subscribe

How Obesity Became a Disease [The Atlantic] And, as a consequence, how weight loss became an industry.
posted by Fizz (66 comments total) 28 users marked this as a favorite
 
Aren't overweight and obese actual clinical terms? I.e., not just 'clinical-sounding'.
posted by biffa at 10:07 AM on March 24, 2015 [2 favorites]


Yes but how the use of terms become "clinical" in use is socially derived. It's not a state of fact that infuses reality into the terms we use, we are the ones who design terms to represent reality as we understand it, with our own bias and fault often fully intact.
posted by xarnop at 10:14 AM on March 24, 2015 [6 favorites]


From the article: The word obese, from the Latin obesus, or “having eaten until fat,” handily conveys both a clinical atmosphere and that oh-so-familiar sense of moral judgment.

No online latin dictionary bears this out. It just means large, thick, etc. without any eating or moral angle.
I wonder how many other "facts" in this article are similarly...let's say questionable.
posted by rocket88 at 10:15 AM on March 24, 2015 [11 favorites]


It's taking the medical term out of the clinical setting and using it imprecisely that makes it "clinical sounding" as compared to clinical.
posted by Dip Flash at 10:16 AM on March 24, 2015 [4 favorites]


There is something hinky about this article. Adipose is the name for the tissue that contains fat cells within our bodies; obesity and overweight are names for categories that define the amount of overweight of a person. Perhaps we need more specific names for obesity/overweight and the associated physiology, because we need to communicate effectively about it? Blaming the production of clinical names for the obesity epidemic is like saying that until we named the anterior cruciate ligament, no one ever experienced knee problems.
posted by holyrood at 10:17 AM on March 24, 2015 [30 favorites]


No online latin dictionary bears this out. It just means large, thick, etc. without any eating or moral angle.

It's not 100% correct but it's not far off. From Online Etymology Dictionary:
obese (adj.) 1650s, back-formation from obesity and in part from Latin obesus "fat, stout, plump," past participle of obedere "that has eaten itself fat"

obesity (n.) 1610s, from French obésité and directly from Latin obesitas "fatness, corpulence," from obesus "that has eaten itself fat," past participle of obdere "to eat all over, devour," from ob "over" (see ob-) + edere "eat" (see edible).
obesity and overweight are names for categories that define the amount of overweight of a person

That's a circular definition. Over what weight? Who defines that and what are the motivations for doing so?
posted by muddgirl at 10:19 AM on March 24, 2015 [4 favorites]


until we named the anterior cruciate ligament, no one ever experienced knee problems.

OWWWW MY KNEEEEEEE
posted by grumpybear69 at 10:19 AM on March 24, 2015 [3 favorites]


This article reads like propaganda for the fat acceptance movement. It handily avoids talking about whether obesity is healthy, whether obesity in the US has risen dramatically in the last 50 or 100 years, etc. The Atlantic sure has become crappy.

One thing that bugs me about the fat acceptance movement is that it seems to give a free pass to the US agribusiness industry to destroy the health and quality of life of many Americans by getting them addicted to junk foods. It seems pretty clear that obesity IS a health problem and that it is largely caused by big business (as well as other unhealthy aspects of American life).
posted by jayder at 10:25 AM on March 24, 2015 [37 favorites]


It's an interesting question: should gross overweight (whatever you call it) be classified as a disease or not? We certainly need to do something, but I confess I don't know if the disease classification would help or not.

Related anecdote: A friend of mine is really into 1970s gameshows. She showed me a bunch of clips on YouTube and we had lots of fun lampooning the hideous clothing of that era. But then it struck me: after watching old gameshow clips for a solid hour, I hadn't seen a single obese person. Not a single one. Switching back to contemporary gameshows was jarring.
posted by Triplanetary at 10:32 AM on March 24, 2015 [14 favorites]


I used to be an adventurer like you until my anterior cruciate ligament was nearly severed by a ballistic projectile.
posted by Foosnark at 10:32 AM on March 24, 2015 [27 favorites]


One thing that bugs me about the fat acceptance movement is that it seems to give a free pass to the US agribusiness industry to destroy the health and quality of life of many Americans by getting them addicted to junk foods. It seems pretty clear that obesity IS a health problem and that it is largely caused by big business (as well as other unhealthy aspects of American life).

Do skinny folks not eat junk food? I went to a nerd school rife with junk food, so I think I can authoritatively state that skinny people can indeed enjoy junk food in excessive quantities. Can't people argue against a dangerous agribusiness model that promotes junk food without dehumanizing anyone or turning anyone into an unwilling poster child?

But then it struck me: after watching old gameshow clips for a solid hour, I hadn't seen a single obese person.

Weren't both men and women still commonly wearing girdles in the 1970s? I wonder how much our public perceptions of obesity rates are related to the declining rates of both well-made clothing and restrictive shapewear.
posted by muddgirl at 10:43 AM on March 24, 2015 [28 favorites]


No online latin dictionary bears this out. It just means large, thick, etc. without any eating or moral angle.

"Latin obesus was past participle of obdere 'that has eaten itself fat' and was translated into English as oferfæt 'overfat.' " -- The Inside Story on English Spelling, Paquita Boston (2014).

On the other hand:

"[Richard] Klein points out that obese, from the Latin obesus, 'having eaten well,' 'had a sinister rebirth in popularity ... in the hands of nineteenth-century doctors and health workers seeking to wield power over bodies by policing the language with which one might once have referred, for example, to someone's embonpointment.'" -- Revolting Bodies?: The Struggle to Redefine Fat Identity, Kathleen LeBesco (2004)
posted by blucevalo at 10:44 AM on March 24, 2015 [3 favorites]


The Atlantic sure has become crappy.

This article is an excerpt from a book, so blame the book for crappiness if you disagree with it, but "The Atlantic sure has become crappy" is about as sweeping a generalization as the rest of your comment. You can say that agribusiness and the processed food industry make money from obesity. You can also say (as this article does) that the fitness and diet industry and its various savory and unsavory hangers-on make money from whipping the fear of obesity.
posted by blucevalo at 10:53 AM on March 24, 2015 [5 favorites]


It’s rare to find an obesity researcher who hasn’t taken money from industry

Ooh ooh me! I'm one! All my obesity research money came from the government.

Or wait lemme make some changes here...

It’s rare to find an obesity researcher who hasn’t taken money from industry

...because industry is still interested in funding science, but it's getting damn hard to convince the government to do so. What, you think all us scientists are just going to quit and go work at WalMart? If you want good science, you have to provide unbiased funding.
posted by caution live frogs at 10:58 AM on March 24, 2015 [36 favorites]


It's an interesting question: should gross overweight (whatever you call it) be classified as a disease or not?

Unless there is some argument I am missing, obesity is clearly not a disease. It may be caused by disease in some cases. It may make disease more likely. But to label obesity itself a disease is to stretch the world so far as to make it nearly meaningless. I was reasonably thin three years ago, and then packed on pounds (which I am now unpacking) as high workloads ate into my exercise time and made me more reliant on quick fast food breaks during my brief downtimes. It would be really weird to think that I have been afflicted with a disease for the last few years which I am now curing with vegetables and jogging.
posted by Pater Aletheias at 10:58 AM on March 24, 2015 [26 favorites]


obesity and overweight are names for categories that define the amount of overweight of a person

That's a circular definition. Over what weight? Who defines that and what are the motivations for doing so?


Scales measure things and we put arbitrary limits on scales, yes indeed. I argue that clinical language is created to produce names for things and thereby make it easier for health professionals to communicate accurately and simply with each other.

Clinical medical language is not designed with people's feelings in mind. It's designed to accurately communicate something. For example, in clinical language you rarely say "patient does not" unless you have test results to prove it. It's "patient denies." Your chart is full of phrases like "Patient denies taking any street drugs" or "patient denies having unprotected sex with strangers." This isn't because your doctor suspects you are doing drugs or being promiscuous and wants to underscore how you're lying by denying it; it's just how professionals have decided to replace the sentence "I asked this person this question and they answered no, but I didn't test it using an objective standard or it can't be tested, so I can't be 100% sure they are not lying" with two words.

Yes, language changes how we view and interact with the world. But naming a category doesn't cause it to come into being. These clinical categories were created because clinicians needed to talk about weight more often and more specifically, and the words "fat" and "thin" were not useful enough as descriptors, or required so many additional words/phrases to be used in combination that communication was obscured.
posted by holyrood at 11:04 AM on March 24, 2015 [15 favorites]


Do skinny folks not eat junk food? I went to a nerd school rife with junk food, so I think I can authoritatively state that skinny people can indeed enjoy junk food in excessive quantities. Can't people argue against a dangerous agribusiness model that promotes junk food without dehumanizing anyone or turning anyone into an unwilling poster child?

Um, you're saying skinny people and fat people consume the same number of calories, some people are just unlucky that it makes them fat? So agribusiness has nothing to do with the rise of US obesity?

Weren't both men and women still commonly wearing girdles in the 1970s? I wonder how much our public perceptions of obesity rates are related to the declining rates of both well-made clothing and restrictive shapewear.

I think the answer is "related very little if at all." Every legitimate study shows a huge increase in US people's weights.

And who said anything about dehumanizing? I mean, it should be relatively unproblematic to say that big business has turned a huge swath of the populace fat.
posted by jayder at 11:08 AM on March 24, 2015 [18 favorites]


Um, you're saying skinny people and fat people consume the same number of calories, some people are just unlucky that it makes them fat? So agribusiness has nothing to do with the rise of US obesity?

That's not even remotely what that comment is saying. The comment says that literally everyone in our food economy is affected by the dangerous agribusiness model currently in play, so there is no reason to single out overweight people for this concern.

Signed,
Skinny girl who mostly lives on pizza and muffins and really effing should not do that, but nobody ever says peep to me about it because so far I'm not fat.
posted by We put our faith in Blast Hardcheese at 11:16 AM on March 24, 2015 [49 favorites]


it's always funny when someone else steps in to authoritatively explain what another mefite means.

this really weird contortion you're engaging in, trying both to not stigmatize obesity while still condemn agribusiness, is pretty silly. sorry, some conditions (like morbid obesity) are just not optimal for people. to say "well skinny people eat a lot of junk food too!" is not addressing the basic issue which is that obesity is a dangerous health condition. and I believe linkbaity, propagandistic pieces like this Atlantic piece are dangerous misinformation that, while intended to assuage the self doubt of people suffering from obesity, are making the fat cats at Frito Lay and their ilk smile all the way to the bank.
posted by jayder at 11:30 AM on March 24, 2015 [8 favorites]


Nope, that's what I meant. Thanks, We put our faith in Blast Hardcheese.
posted by muddgirl at 11:40 AM on March 24, 2015 [9 favorites]


I mean, it should be relatively unproblematic to say that big business has turned a huge swath of the populace fat.

It's true that a huge swath of the populace is far, but you can't just assert that it's because of "big business" full stop. That is problematic because the causes of the current obesity epidemic are complicated.
posted by Justinian at 11:45 AM on March 24, 2015 [4 favorites]


obese, from the Latin obesus, 'having eaten well,' 'had a sinister rebirth in popularity ... in the hands of nineteenth-century doctors and health workers seeking to wield power over bodies by policing the language with which one might once have referred, for example, to someone's embonpointment.

This is putting the cart before the horse, it seems. First, there's question-begging inherent in the unsupported claim that the transition from a term with a good connotation (embonpointment) to another occurred due to "language policing" by people seeking to "wield power over bodies" (i.e., a malicious act, a pre-planned activity by The Powers That Be, for a nebulously sinister goal) rather than due to a broader shift in attitudes or even one of those language shifts that occurred without any clear reason that we can determine, of which etymology is full of.

It also assumes that because the doctors specifically shifted to the use of "obese", it must also be a shift based in maliciousness because today the word is an extremely negative one. But because we now define that word as a bad thing doesn't mean that they necessarily did to anywhere near the same degree then. "Having eaten well" is not a phrase saddled with any innate negative connotation: that connotation was created, much as people only recently have begun to demonize the word "normal" because it implies not-normal which in turn implies or is used to imply "bad".

To be fair, this is one quote, and perhaps the book makes a solid case elsewhere to support all that it implies. But in isolation it doesn't amount to much.

A definite attempt at language policing would be an attempt to get rid of the term "obese". However, since changing the terminology doesn't actually address underlying issues (not to mention the stigmas that go with it), you'll just tar the next term picked with the same brush, just as "retarded" shifted to "handicapped" and then handicapped was saddled with all of the same problems and so even newer terms are being frequently used to replace the replacement. And none of this gets us around the fact that we're a lot fatter than we used to be and that there's serious health effects that result from this (absurdities from the HAES movement aside) and that's an issue regardless of what word we use.
posted by Palindromedary at 11:46 AM on March 24, 2015 [3 favorites]


I think I can authoritatively state that skinny people can indeed enjoy junk food in excessive quantities.

Well, people who lack a genetic or environmental predisposition to becoming drug addicts enjoy Oxycotin in excessive quantities, but that doesn't mean that we shouldn't restrict the ability of Big Pharma to encourage doctors--through financial incentives and the like--to write unwarranted scripts for opiates. Opiates are bad news for all recreational users, addicts and otherwise.

Can't people argue against a dangerous agribusiness model that promotes junk food without dehumanizing anyone or turning anyone into an unwilling poster child?

On this point I agree. Whether we're talking about recreational opiates or junk food, the focus should be on the substance, rather than the user or consumer. Many fat people gained their excess, er, adiposity from eating healthy foods. And skinny people can become malnourished by eating junk-food based diets.
posted by Gordion Knott at 11:47 AM on March 24, 2015 [6 favorites]


Blaming the production of clinical names for the obesity epidemic is like saying that until we named the anterior cruciate ligament, no one ever experienced knee problems.

I see it more like how we continue to need to evolve new clinical terms for mental disability because the old ones rapidly developed really nasty baggage.

sorry, some conditions (like morbid obesity) are just not optimal for people. to say "well skinny people eat a lot of junk food too!" is not addressing the basic issue which is that obesity is a dangerous health condition.

Nobody is saying that morbid obesity isn't a major health problem. But the issue isn't that - it's that people associate thinness with health, when there is a growing body of evidence that questions that. It turns out that someone who is classed as "overweight" (and don't get me started on how badly misused the BMI is) that works out regularly is going to be in much better health than someone who is the "proper" weight but does nothing to improve their health. And yet it's the overweight person who is the one getting shamed over being unhealthy. Not to mention that weight loss is a major industry, so there's some heavy profit motive that helps uphold that attitude.

So please spare me the pontificating on the dangers of obesity, because it's becoming clear that the issue is a lot more complex than that.
posted by NoxAeternum at 11:49 AM on March 24, 2015 [12 favorites]


It is not obesity itself that is a dangerous health condition, it is other factors, which for most (but not all) people will cause weight gain and/or obesity: unhealthy eating, not exercising, genetics, etc.

Obese persons who eat right and exercise are as healthy (no elevated risk of cardiovascular disease) as skinny people who exercise and eat right.
posted by LizBoBiz at 11:50 AM on March 24, 2015 [10 favorites]


That's just one study. There are other studies which indicate the opposite.
posted by Justinian at 11:54 AM on March 24, 2015 [1 favorite]


(and note that "waist circumference" was one of the factors used to determine metabolic health. It should be intuitively obvious how that will skew things.)
posted by Justinian at 11:55 AM on March 24, 2015 [2 favorites]


Justinian—non-rhetorically, are you a researcher in this field? My strong impression from recent meta-analyses on metabolic health and fitness in addition to expert reviews was that there was some good evidence that people who are "fit yet fat" have relatively attenuated negative outcomes from being heavier, and might oftentimes have better outcomes from slimmer but less fit folks. In other words, that while it's better to be, well, physically "perfect," if you had to pick you'd rather be metabolically fit but fat rather than skinny and metabolically awry or out of shape.
posted by Keter at 12:02 PM on March 24, 2015 [10 favorites]


In other words, follow the money. Doctors want to be paid for delivering weight-loss treatments to patients. Coding office visits for Medicare, for instance, is a complex process that involves counting the number of bodily systems reviewed and the number of diseases counseled for. If Medicare goes along with the AMA and designates obesity as a disease, doctors who even mention weight to their patients could charge more for the same visit than doctors who don’t.

But that’s trivial compared with the sorts of financial conflicts of interest defended by some in the field.


UGh ugh ugh ugh ugh

Being paid for providing a service is not a "conflict of interest" is implied by these statements. There are a number of issues associated with obesity (hypertension, apnea, diabetes etc) that can be treated in concert if you help a patient reduce their weight, rather than trying to treat each condition piecemeal. We should be encouraging doctors to treat patients holistically rather than as a collection of symptoms, and reimbursement is part of that.

The implication that doctors want people to be over-treated in order to fatten their own pockets is the reductio ad absurdum of these types of terrible articles.
posted by Existential Dread at 12:03 PM on March 24, 2015 [10 favorites]


Whether morbid obesity can officially be called a capital-D Disease or not seems like semantic quibbling over what shade of red paint was used on the house, while watching it burn down. Obesity can rightly be described as epidemic in scale, given the increase in the number of afflicted over the past three to four decades. Obesity is causal and associative in type II diabetes, pulmonary, cardiovascular and inflammatory diseases, and other afflictions with high comorbidity rates. Basically, obesity tends to lower our overall quality of life, and particularly at end-of-life. Some of this can be mitigated with specific lifestyle changes: being less sedentary and making dietary adjustments. We live in a capitalist society, for better or worse, and whatever part of it can help us live healthier, higher-quality lives overall would seem like a decent thing to discuss, explore, and encourage.
posted by a lungful of dragon at 12:04 PM on March 24, 2015 [5 favorites]


Being paid for providing a service is not a "conflict of interest" is implied by these statements.

It's the same logic used to discredit climate change researchers: they're just fishing for those sweet research grants, not doing real science. Insinuation becomes proof.

Money ties are a reason to more closely examine someone's research. They're not the invalidator of research.
posted by Palindromedary at 12:08 PM on March 24, 2015 [5 favorites]


Keter: you're absolutely right, there is good evidence that fit-yet-fat people have relatively attenuated negative outcomes and can sometimes have better outcomes than slimmer but less fit people. But that's not what LizBoBiz said. The assertion was that obese people who eat right and exercise are as healthy as thinner people who eat right and exercise. Which isn't true, and isn't even what the study she links said.
posted by Justinian at 12:08 PM on March 24, 2015 [6 favorites]


I should say "which doesn't appear to be true" rather than "which isn't true" since, obviously, you always have to leave room for new data.
posted by Justinian at 12:09 PM on March 24, 2015 [1 favorite]


An obese person may be healthy by observable/measurable metrics, or by the simple absence of observable illness, but given enough time the health issues that will plague an obese person have no good interventions that help things like joint damage, immobility, more difficult issues with diagnostic radiology for detecting cancers, etc. Heavier people are just simply harder to keep healthy. At some point all of us need medical care, and being 50 or 100 pounds overweight poses challenges to good care that are hard to summarize in a research paper or metafilter thread response.
posted by docpops at 12:09 PM on March 24, 2015 [19 favorites]


Here's another study from 2014

From the abstract: "Compared to normal weight-fit individuals, unfit individuals had twice the risk of mortality regardless of BMI. Overweight and obese-fit individuals had similar mortality risks as normal weight-fit individuals."

We can keep going back and forth though because we can find a study to prove pretty much anything.

The point I am trying to make is that the focus on weight itself as the cause of health problems is misguided. The focus should be on making sure everyone eats right and exercises. Even if every single person ate a well balanced and healthy diet and actually exercised the recommended amount, some people would still be overweight and obese. Because everyone is different and everyone's body is different.
posted by LizBoBiz at 12:19 PM on March 24, 2015 [6 favorites]


What exactly is "obese-fit"? If you're under 6 feet and weigh over 300 pounds then is it possible for you to be "obese-fit"?
posted by I-baLL at 12:24 PM on March 24, 2015


disclaimer: I am a fat person and my doctor insists I am a healthy fat person. Meaning I have no stakes in the fat-shaming business and also I regularly discuss (and test) evidence for my health with professionals. In my family, I have seen how a slightly higher BMI can be an advantage at the outset of cancer or very old age.

However - on a statistical level, there is no doubt that obesity is a rising health care concern in many countries. More people have obesity related illnesses. We need to help these people, both for their sake, and for national economies' sake. Reframing the issue will not change its consequences.
posted by mumimor at 12:28 PM on March 24, 2015 [2 favorites]


This article addresses a lot of questions that I have been pondering for some time now but didn't want to ask on the green for fear of sounding like a dumb. We do a disservice to overweight people, underweight people, and everyone in between when we blindly say thin = healthy, fat = unhealthy.

Weight is one number that relates to a person's health but I think people fixate on it because it's something you can see and measure easily, so we use it as a proxy for all of these other numbers. My sister is obese and when she was pregnant, her insurance company just decided that she had gestational diabetes. She had to test her blood sugar four times a day during her pregnancy because some genius somewhere looked at her weight and height and diagnosed her without ever meeting her. Her blood sugar *never* indicated gestational diabetes but the insurance company repeatedly sent her tips on what food to eat while pregnant with gestational diabetes.
posted by kat518 at 12:35 PM on March 24, 2015 [6 favorites]


One thing that bugs me about the fat acceptance movement is that it seems to give a free pass to the US agribusiness industry to destroy the health and quality of life of many Americans by getting them addicted to junk foods.

How weird, that's completely the opposite of my experience actually being a member of the fat acceptance movement.
posted by palomar at 12:48 PM on March 24, 2015 [26 favorites]


People are really invested in fat being unhealthy and universally bad. It's such a moralistic stance that gets all fancied up as being "concern" over other people's health. It's hard to unpack because it's so ingrained in society and what's 'obvious' about health. There's a massive assumption that thin = healthier and there is no amount of evidence that will suffice to change someone's mind even a little bit. It's an article of faith.
posted by stoneweaver at 12:54 PM on March 24, 2015 [16 favorites]


What exactly is "obese-fit"? If you're under 6 feet and weigh over 300 pounds then is it possible for you to be "obese-fit"?

Considering that being 6ft and 300lbs doesnt say anything about health and only maps to a weight category, then yes.

In the study though, fitness was measured through cardiorespiratory fitness.
posted by LizBoBiz at 12:59 PM on March 24, 2015 [3 favorites]


I-baLL : Obese fit? At 6'1" I would be obese at 228 lbs. I've been as high as 235 a few times (most recently 2 years ago), and I was definitely overweight (read: it wasn't all muscle). At that weight, when I started exercising, I had my residual strength and cardio from being a swimmer in highschool (and years before), despite not having exercised beyond dog-walking and normal house-work for about 15 years since highschool. By residual cardio, I meant that I could run on an eliptical for 40 minutes, and it actually looked like running. I'm sure that without a change to my diet, I wouldn't have lost any weight by exercising (which really prompts my appetite). I'd have very quickly been fit, but technically obese.

I admitedly carry my weight well (I.E. it's fairly evenly distributed). Even when I've been as high as 235, people at work referred to me as not fat (I.E. no one tried to force me to eat, but I was mentioned as a reference target when other guys were talking about dieting) despite being obese.

If you have problems thinking about fit-obese, it might be because you don't necessarily realize what obese can look like.

Additionally I've seen some people at some 10k runs who looked to be obese (based upon a frame similar to mine at peak weight), but turned in times under an hour which I'm willing to call "fit."
posted by nobeagle at 1:01 PM on March 24, 2015 [6 favorites]


Skinny people can be fat too. It's called being skinnyfat. As in: underweight, yet with low muscle mass, and high bodyfat. Nerds who eat junk food but are "skinny" are in fact also fat. This described me for most of my life too. We're all fat!!

We know people are fatter than they were three or four decades ago. And also... lower testosterone levels among men, too. Higher levels of neurological/cognitive deficits, disorders, atypicalities, whatever you call them. More allergies. Cancer too (some of them). Fatness might be the fault of the fat, but ADHD? Peanut allergies? I'm no Food Babe "chemical"-phobe but I can't help but wonder... the environment has changed a lot since the 70's.

In my family, I have seen how a slightly higher BMI can be an advantage at the outset of cancer or very old age.

This is why I'm shooting for jacked and tan until about 55, then I plan to let myself go a little bit. A few extra pounds going into your old age is good for you.

If you're under 6 feet and weigh over 300 pounds then is it possible for you to be "obese-fit"?

Fit for what? Sumo wrestlers, powerlifters, strongmen all can get up into 300's and 400's. They are fit for their chosen professions. So, fit? Sure! Healthy? Nah. Even lean - and there are 350+ lb strongmen who are very lean - it is hard on the body. And... even they slim down when their careers are over (if they're smart). For all the reasons docpops listed... joint problems, diabetes, etc.
posted by mrbigmuscles at 1:04 PM on March 24, 2015 [2 favorites]


"Fit for what?"

That's what i was wondering. The obese part in the study a few comments up is measured by BMI but I don't know anything about CRF so I'm reading up on it now.
posted by I-baLL at 1:11 PM on March 24, 2015


This article is an excerpt from a book, so blame the book for crappiness if you disagree with it, but "The Atlantic sure has become crappy" is about as sweeping a generalization as the rest of your comment. You can say that agribusiness and the processed food industry make money from obesity. You can also say (as this article does) that the fitness and diet industry and its various savory and unsavory hangers-on make money from whipping the fear of obesity.

I have had a subscription to the Atlantic for years, and I think that in the last year or two they have started publishing way more book excerpts, or maybe they are just crappier book excerpts that I am noticing more. Either way, it is a trend that I have noticed and I don't find it to be a positive trend for them. (The New Yorker does this all the time with fiction, but much less often with non-fiction, and the quality of their fiction excerpts doesn't seem to have changed in recent years.)
posted by Dip Flash at 1:21 PM on March 24, 2015


The obese part in the study a few comments up is measured by BMI but I don't know anything about CRF so I'm reading up on it now.

This is exactly the problem, illustrated: BMI has replaced actual cardiorespiratory fitness as The Fitness Metric for most laypeople, to the point where we now tend to use weight as a lazy shorthand for actual fitness despite ample evidence that the two are frequently decoupled.
posted by dialetheia at 2:37 PM on March 24, 2015 [10 favorites]


I think I can authoritatively state that skinny people can indeed enjoy junk food in excessive quantities.

Anyone can enjoy junk food in excessive quantities. But it will increase your risk of cancer and cardiovascular disease, regardless of how much you weigh.
posted by straight at 3:56 PM on March 24, 2015 [3 favorites]


muddgirl: It's not 100% correct but it's not far off. From Online Etymology Dictionary:

Eww. Let's use the OED instead, just to be safe.
classical Latin obēsus fat, stout, plump < ob- OB- prefix + ēsus , past participle of edere to eat (see edible adj.). The classical Latin verb obedere is otherwise unattested. Compare Italian obeso (1588), Spanish obeso (1606), French obèse (1825).
Rare before the 19th cent.
And why not, one of the earliest usages:
1654 E. Gayton Pleasant Notes Don Quixot i. iii. 8 One said of an Over-Obese Priest that he was a great Arminian; grant, quoth a second, that he be an Arminian, I'll swear he is the greatest that ever I saw.
posted by barnacles at 5:23 PM on March 24, 2015


For me, it went hypertension, serious sinus infections, fatigue and shortness of breath, then weight gain. My doctors did all sorts of tests up until I hit 160 lbs. Then I was sent on my way with a diet. After two years of steadily gaining another thirty pounds, I finally convinced my doctor to get a few tests. It came back indicating COPD. He gave me an inhaler and didn't offer any referrals to help me regain my cardiorespiratory fitness.

Once I lose the weight, then I'll be allowed to get fit.

I switched doctors because I'm going on three years of being unable to walk the thirty stairs to my house without taking a pause to catch my breath.

The new doctor put in a referral to the nutritionist, but not a pulmonologist. I had to send her a reminder that I would like to breathe.

I'm two years away from the age when my mom was diagnosed with kidney cancer. And if I don't escape those genes, it's definitely going to kill me. Because my doctors will be too busy pointing their fingers at the scale to worry about any other underlying conditions.

I still get invitations from Kaiser to attend their bariatric surgery seminars. Every time I go to the doctor, I briefly consider it. Not to be thin. But to stop being invisible because of my weight.
posted by politikitty at 5:31 PM on March 24, 2015 [14 favorites]


"One thing that bugs me about the fat acceptance movement is that it seems to give a free pass to the US agribusiness industry to destroy the health and quality of life of many Americans by getting them addicted to junk foods."

I have been overweight since I was a kid, and weight has been a constant struggle which I am genetically not well-adapted to deal with. I am very supportive of fat acceptance on one level, as people who are fat need to know that they deserve to be treated well, and that their obesity isn't just a negative, but also a potential positive, that oftentimes comes hand-in-hand with greater empathy, thoughtfulness, and creativity, just as many things which make one an outsider tend to push people in that direction.

The thing is, once you begin to accept yourself and have greater self-knowledge, not only about your situation, but also how things like agribusiness, the food industry, and government have played their part in making you heavier and generally more prone to numerous health problems.... then what?!

I can't tell you just how little in the way of processed carbs I need to eat in order to effectively lose weight, due, in part, to the way that obesity progresses. That's why most of my diet is low carb, low caloric density, and low fat, and I go about 30 miles worth of walks a week. But if I do choose to eat something less healthy as a special treat once in a blue moon, I sure as hell don't deserve to be criticized for it, especially when I'm surrounded by people in life who have the genes that allow them to deal with a high processed carb / low exercise lifestyle effortlessly... at least so far.

Yes, I will eat this donut, eff you very much... but I'm not, knowing what I know, going to eat a box of donuts every morning, because there's a difference between accepting yourself and accepting being an addict, catered to by abusive, amoral corporate dealers, who don't want us to distinguish between a special, delightful treat, and, say, real food. True acceptance means not only accepting and appreciating yourself, but also being empowered to make the right choices.
posted by markkraft at 5:36 PM on March 24, 2015 [8 favorites]


Social isolation, chronic social stress, are known to cause weight gain regardless of diet given in mice. High fat diets have also been shown to provide benefits against the negative physical problems of social stress in mice. I've seen a large number of studies on this and it would be interesting to see a lot more of that kind of research in people. Everyone assumes high fat diets are the "wrong" foods during times of stress but I wonder if it's the opposite. And the effects of social isolation and social stress of feeling rejected/isolated are as bad as the health effects associated with obesity.

I think people are being fed really bad stuff, and I want that to stop! I also want the assumption that people who are coping with their own life issues are always doing the wrong thing to stop. The assumption that over-eating is unhealthy predates the research and is an underlying assumption in the way the research has been designed. It SHOULD be challenged and a lot of research does challenge the idea thatbad choices drive some people having heavier weights, or the idea that having a heavier weight is a sign they are making unhealthy choices- or even that their WEIGHT is the greatest risk to their health their community should be worried about.

If social isolation and feelings of rejection are as bad for your health as obesity, it begs the question whether fat shaming is actually a greater injury to a person's health than the fat on their body.
posted by xarnop at 6:21 PM on March 24, 2015 [10 favorites]


Two points.

First, trying to treat the public health issue of high obesity rates by individual counseling and diet plans has been tried for at least two decades to little obvious effect. It is a failure as a public policy.

Second, the guy making a crack about me being "barrel chested" was not actually concerned about my joint health.
posted by Zalzidrax at 6:22 PM on March 24, 2015 [1 favorite]


"over-eating"- that concept itself assumes a high fat/salt diet is always the wrong one, so bad word choice to convey my point.
posted by xarnop at 6:22 PM on March 24, 2015


Regardless of some later lawyering to try and support it, i can't escape the idea that this was sort of written with a conclusion they wanted in mind and then solved back for after teh fact... all over the place. The kind of grey area specious roots of the words, grouping of different kinds of words together, etc.

I'm kind of amazed it's a pullout from a book, because it sounds like the kind of thing me or some of my friends would have really self righteously written in some big ass blog post when we were like 17.

"Don't be an asshole and blame people for stuff that may or may not be their own fault for reasons that are probably bullshit" isn't something you need mountains of evidence to back up. It's just "dont be a dick". "Language itself is inherently shitty" is something you can conclusively solve for, and something that can be fairly easily debunked if you're going to claim it without doing some research. If you're going to up the stakes to that level, you have to bring your A game.

Pretty much, just because the "bad guys" are being linguistic prescriptivists in usually easily demolished ways for the sake of being asses doesn't mean that doing the same thing in reverse to fight the good fight is at all worthwhile.

It kinda surprises me that the same site which publishes freaking brilliant, well thought out, meticulously written and researched stuff like well... Fucking everything Ta Nehisi Coates has ever written would publish this. It's tumblr reblog grade at best, not some battering ram of speaking truth to power.

There's some good stuff in there, and a decent premise, but i found my self pretty turned off and disgusted with how they were getting from A to B.


I also think physically fit not-traditionally-overweight person versus physically fit heavy person is a lazy "checkmate" comparison, because the average person doesn't do shit. Is the average sedentary or mostly sedentary heavy person less healthy than the average non-heavy person?

Most people go from their couch to their car seat to their chair/standing around at work and don't do shit regardless of what they weigh. Why not compare that?

And bear in mind, i'm already sold on the entire "but their health!" thing usually being bullshit. I'm not trying to sell that, it's just that we've already gone to the "you can be just as healthy if you exercise!" health at any size place here. Are you less healthy if you're overweight AND don't exercise than someone who is just "skinny-fat"?
posted by emptythought at 7:00 PM on March 24, 2015 [1 favorite]


I think the argument is that we should encourage people to eat right and exercise rather than simply to "lose weight". Which I sort of agree with except that we've been doing that for decades and it hasn't worked. Of course telling people they're bad people for being fat and they should feel bad doesn't work either and is assholish to boot.

News flash, people like to sit around all day and eat lots of tasty high calorie food. People don't like to eat a bunch of broccoli and spinach and exercise three hours a day. All the education in the world won't change that.

I'm hoping for (and expecting though not necessarily in the next few years a pharmacological solution.
posted by Justinian at 7:58 PM on March 24, 2015


re you less healthy if you're overweight AND don't exercise than someone who is just "skinny-fat"?

The thing is, that comparison only makes sense coming from a perspective of judging people for being fat, rather than a perspective about caring about health or self improvement.

Say a person wakes up one morning and decides that they're too fat and lazy and sit in front of a computer all day and eat too many cheetos and too much pizza.

Now, sure, they can become skinny and active and healthier eating all at the same time - If they're the sort of Nietzschean Ubermensch who can will to power their way through. But most of us aren't so lucky. So you've gotta start somewhere, and there's three things to do:

Excercise more
Eat a healthier mix of food
Eat less

For most people, the best chance of success is starting with just one.

Now I'm not actually sure which of these is the right thing to focus on. And it probably depends on the person, too. A person who hates exercise but likes organizing might find dietary changes relatively easier. And someone who's has a massive proportion of body fat may just be best served by losing weight no matter what.

But regardless of what is actually right for an individual's health, we've got all this societal investment in the message "lose weight at any cost." And I'm sure that isn't healthy.

Our hypothetical person could fastidiously limit themselves to *half* a medium meat lover's pizza and a mountain dew per day (1300 calories) per day, still lounge in front of the computer all day, and they're almost certainly going to be losing weight. They're going to get praised for it. It may be the only choice anyone is going to give them praise for, especially if said person happens to be a woman.

And there's no way that can be healthy.
posted by Zalzidrax at 8:58 PM on March 24, 2015


I think the argument is that we should encourage people to eat right and exercise rather than simply to "lose weight". Which I sort of agree with except that we've been doing that for decades and it hasn't worked.

Could very well be the population's health would be even worse without those decades of encouragement. Anyone know any populations in similar environments who received no eat right / exercise messages to compare to?
posted by save alive nothing that breatheth at 10:43 PM on March 24, 2015


> muddgirl: It's not 100% correct but it's not far off. From Online Etymology Dictionary:

Eww. Let's use the OED instead, just to be safe.


Why the "Eww"? The Online Etymology Dictionary is an excellent resource. No, it's not the OED (except initially, which is admittedly annoying), but what is? Get back to me with a list of laughably incorrect entries and I'll reconsider my position, but I'm happy to recommend it to people who don't have an OED subscription and want reliable etymologies (not to mention that many of the etymologies in older, unrevised OED entries are outdated).

It would also be nice if rocket88 would revisit his snide, and entirely unjustified, dismissal of the article on the basis of an etymology that turns out to be perfectly sound.
posted by languagehat at 6:26 AM on March 25, 2015 [1 favorite]


If you look around, in the U.S., you see what a HUGE business unhealthy eating is. Watch TV around dinnertime and look at all the ads for those awful restaurants serving huge portions of horribly unhealthy food. Look at all the junk food that crowds the shelves of grocery stores. Someone is eating all of that stuff! I truly think that agribusiness is committing a crime against humanity. I made the comment earlier about how the "fat acceptance" movement is giving agribusiness a free pass, and palomar took issue with that. But palomar provided no evidence of any statement or intervention by a fat acceptance organization against the food industry for its role in causing obesity. I have NEVER seen a statement by any fat acceptance organization, criticizing the U.S. food industry for its efforts to get people addicted to junk food. And the food business absolutely is like a drug peddler. It wants people addicted. One time I stumbled across the resume of someone who is a "flavor specialist" for a major food company, and the amoral tone of his descriptions of his work was absolutely chilling and at the same time comical, almost like something out of a David Foster Wallace story.

I feel like the honest discussion of these issues surrounding obesity is obstructed by the fact that obesity is a visible condition that is quite uncomfortable for people in a society where so much importance is placed on personal appearance. Because it is a condition that so deeply affects a person’s physical appearance, whenever there’s a discussion of health effects of obesity, people come out of the woodwork to (rather dishonestly) argue against the demonstrated dangers of obesity, arguing basically that obesity is not unhealthy. It seems like they are not arguing based on what doctors and scientists say, they are arguing based on a desire to not make overweight people feel bad. It’s fine, obviously, to argue against treating people poorly because of their weight (once again, as I said in my very first comment, I believe they are addicted to food through nefarious US agribusiness interests and other unhealthy aspects of U.S. life), but it is not okay to intentionally misinform the public about health matters based on the desire not to make people feel bad. And telling people that being obese is not unhealthy is deliberate misinformation.

I do understand why obese people WANT to find evidence that being obese is not unhealthy. In addition to the aesthetic issue (problems they face in a society where there is a lot of emphasis on personal appearance), it doubtless does not feel good to be very visibly affected by a condition that is unhealthy. But that does not justify misinforming people ... it is immoral to misinform people about health.

These are the ways these discussions get sidetracked by deliberate obfuscation (of which the Atlantic article/book excerpt is an example):
  • Any suggestion that obesity is not an optimal condition is met by accusations that such suggestions are “shaming” and “stigmatizing.” No, it’s not shaming to say that obesity is unhealthy, any more than talking about the need to eradicate heart disease is stigmatizing heart disease sufferers.
  • People try to muddy the waters with statements like this:
    • “skinny people eat a lot of junk too” -- Skinny people do not eat nearly as much junk food as overweight people.
    • “skinny people can be unhealthy” -- that is not the issue -- the issue is whether obesity is a dangerous health condition, and the answer is obviously yes.
    • “skinny people can be fat too” -- skinny people, by definition, are not fat, except to the extent that every living person has some bodyfat. Skinnyfat is a marketing term coined to sell weight loss products and gym memberships to skinny people.
  • Claims are made that obese people can be “fit.” The concept of “obese fit”/”fat but fit” has been thoroughly debunked: According to media summaries of this study, there is no “healthy obesity.” Apparently other studies have debunked the concept of “fat but fit” as well.

This article gives a run-down of the fat acceptance movement and points out that the movement exists in a climate of "social hypocrisy, hatred for fatness coupled with a free ride toward the industries that exploit the susceptible." That's kind of what I was saying in my first comment in this thread, that I feel like nobody is holding the food industry accountable for fostering obesity.

This seems like a pretty sensible argument, from a feminist perspective, arguing that the overemphasis on fat acceptance has come at the expense of the more important health and social justice issues signified by the exploding levels of obesity in the U.S.

My dad is a board-certified ob-gyn who has been practicing for thirty years, which means he is a primary care physician who is in the highest ranks of his profession and knows a lot about health. And he has always spoken of obesity as a grave health threat; he sees the effects first-hand in his patients.

So all this talk about how obesity really is not a health threat has always struck me as a really pernicious kind of lying, telling untruths in order to make some people not feel bad, when the reality is that they SHOULDN'T feel bad anyway, because they are victims.
posted by jayder at 8:07 AM on March 25, 2015 [4 favorites]


Jayder, so what?

I am unhealthy and I am fat. I was unhealthy before I got fat. As soon as I got fat, I turned invisible in the medical community. They give me a treatment that is about as effective as pulling out. And they ignore other underlying problems, because most symptoms can be attributed to being fat.

All my diagnosis have come from me reading the lab tech reports. My doctor orders blood tests, and tells me to lose weight. When I get the blood tests, it says that I have a severe D3 deficiency. She didn't add that to my chart, I had to prod her. Same with the mild COPD result. And mild sleep apnea. The folks in the lab who don't have my weight in front of them clearly make these notes on my file. The doctor reads these notes and doesn't act on them or relay them to me. He says I'm fine and just lose weight.

Wouldn't it be easier for me to lose weight if I was fully rested by treating my sleep apnea? If I had a bronchodilator or steroids so I could climb stairs? If I was getting the essential nutrients I need to function?

I understand not giving a smoker a lung transplant. But would you deny them chemo if they developed cancer? Would you refuse treatment until they gave up tobacco?

We have successfully stigmatized tobacco. But smokers are still treated as human. They're still treated, period. They aren't left out in the cold to be tempted by the very industry that helped them get there. They aren't left to barely trained nutritionists and trainers. Most of whom don't have expertise in rehabilitation, simply the luck of enjoying healthy food and working out. How many trainers cause the overweight to blow out their knees or suffer other injuries because they don't actually understand the limitations overweight folks have on our joints?

The medical community treats me as the problem. And by doing so, they make it virtually impossible to get better.
posted by politikitty at 10:46 AM on March 25, 2015 [13 favorites]


"But would you deny them chemo if they developed cancer? Would you refuse treatment until they gave up tobacco?"

Giving up tobacco isn't going to effectively treat cancer, once you have it. Chemo etc is necessary regardless of whether the person quits or not. Maybe a better comparison is to treating smokers with chronic bronchitis.
posted by alexei at 1:55 PM on March 26, 2015


No, that is not a better comparison. Losing weight will not fix health problems that aren't related to being day. Just like quitting tobacco would do nothing to treat cancer.
posted by stoneweaver at 2:24 PM on March 26, 2015


Are you saying that we should treat cancer but not a smoker's emphysema or chronic bronchitis?
posted by politikitty at 4:48 PM on March 26, 2015 [1 favorite]


It would also be nice if rocket88 would revisit his snide, and entirely unjustified, dismissal of the article on the basis of an etymology that turns out to be perfectly sound.

Yes, it turns out I was wrong about the etymology of the word, and I apologize for that.

I checked several sources of obesus and found no definitions that mentioned eating, and several referring to size only without reference to cause. I also saw several uses of obesus in binomial nomenclature for species that were rotund by nature and not by overeating.

But it's a fact that obesus is formed from obdere which definitely does mean "fat from overeating", and some definitions of obesus (not the ones I originally checked) also use that definition.

So while the claim in the article is technically correct in a prescriptivist sense, it seems the clinical use of obese refers to size only in most uses. The article's claim that the medical and scientific community chose that term specifically to shame and blame overeaters is still specious, I think.
posted by rocket88 at 10:29 AM on March 30, 2015 [1 favorite]


Specifically? No. But the scientific and medical community is not above buying into the moralistic views of weight which society perpetuates.

When you consider a treatment plan, you need to factor in patient compliance. That's why we don't support Abstinence only education. It's 100% effective, if we discount patient compliance. After all, it's those dumb sluts who are really fucking up a perfectly cheap and effective medical approach to birth control.

Yet we do the exact same thing for fatties. We blame the person, not the fact that we put them on a medical plan that requires so much discipline, 1 in 20 people can't even do it for two years.

If we didn't have such moralistic views, we would expect the default view to be "that a pill and watching tv is just as effective as exercise". But we wouldn't want to encourage folks to have sex, I mean, be lazy.
posted by politikitty at 11:08 AM on March 30, 2015


But palomar provided no evidence of any statement or intervention by a fat acceptance organization against the food industry for its role in causing obesity. I have NEVER seen a statement by any fat acceptance organization, criticizing the U.S. food industry for its efforts to get people addicted to junk food.

First, I didn't realize I was under obligation to provide a link to any such statement. Second... so what? What does that have to do with anything? Seriously.
posted by palomar at 10:25 PM on April 12, 2015


« Older Huggability seems to be a plus   |   Life as a Modern Shepherd Newer »


This thread has been archived and is closed to new comments