by Marion Nestle
Jan 26 2008

Eating Liberally Asks Marion: is the “obesity epidemic: a myth?

In this week’s “Let’s Ask Marion,” Eating Liberally’s kat wants to know what I thought about the recent piece in the New York Times about the fat acceptance movement. Her questions are always exceptionally thoughtful. My answers try to be. Enjoy!

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  • Daniel Ithaca,NY

    Loving people and accepting them as people (including yourself) is not the same as accepting poor health to be your norm and avoiding support to make positive changes.

    Accepting people who happen to be obese and the individual accepting obesity for themselves are drastically different things.
    Whereas the person’s eating habits and/or lack of physical activity may not be associated with violence or motor vehicle accidents (maybe distracted driving?) obesity is a health risk like, for example, alcoholism. Saying (as one fan commented on Ms. Harding’s site.) “I will always be fat. I accept that now.” Is similar to saying “I will always have problems in using alcohol, I might as well not seek treatment.”

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  • Lifestyle only goes so far in determining body size. I’m quite slim (and have been all my life), and my boyfriend is very tall and a bit chubby, but we eat almost the exact same food every day (very healthful, tons of fruits and vegetables, all home-prepared) – I actually eat a bit more than he does. We also get about the same amount of exercise (lots of walking, though probably not enough), and neither of us drink or smoke.

    Nothing about his lifestyle can explain why he’s not thin, and why I am (especially since he weights more than 1.5x what I weigh, but nevertheless consumes the same calories on a daily basis) – or why there are lots of people out there who are heavier than I am but who get lots of exercise in addition to eating healthfully.

    It’s not simply exercise and diet that determines body size. While obesity is a serious problem, and most Americans have terrible diets, there are plenty of big, healthy people out there. BMI is not an accurate measure of health, and it’s unfortunate that otherwise rational people think it is and discriminate accordingly.

  • I think producestories’s comment is another indication of why a one-size-fits-all approach doesn’t work. Maybe her boyfriend would be slimmer on a different diet than hers.

    I sympathize with the fat acceptance movement, even if I don’t agree with it. I have never been clinically obese, though I have been just shy of it at 167 lbs and 5’3″. (I’m now down to 143 and still losing.) The moral stigma attached to obesity is pervasive; every signal society sends says, “You are fat because you are a lazy glutton,” even if some people couch that stigma in politer language like “eat less and move more.” It still implies that obesity is largely one’s own fault.

    Personally I think that the standards by which we measure obesity are wrong – the standard should be measurement of body mass composition (% lean body mass and % fat) rather than some ridiculous height-to-weight ratio like BMI, which doesn’t tell us the most important thing of all: are we carrying around excess adipose tissue? But I also think obesity is neither a risk factor for disease nor a disease in itself. It is a symptom of an underlying metabolic problem, just as a sore throat is a symptom of an underlying strep infection. Treat the metabolic problem, and obesity will go away on its own, just as taking an antibiotic will cure the strep, and the sore throat goes away on its own. If, on the other hand, you treat only the symptom (cough drops for strep), the underlying condition will not only fail to clear up, it will likely worsen.

  • Fentry

    I’m not sure I agree with Dan from Ithaca’s thoughtful comment. Perhaps I do, depending on where the stress is put.

    I believe we should fight obesity in ourselves and ignore it in others.

    This is not to say that we can’t give people help and information. But we should remember that everyone has his own cross to bear.

  • I think Fentry’s right on all counts.

    Both my fella and I feel very healthy and energetic, though we look different. And you know, I used to have a pretty severe drinking problem, eat terribly, and smoke, and I never weighed much more than I do now – I’ve always been thin, but I haven’t always been healthy.

    My boyfriend was thin when he had just dropped out of college and couldn’t afford to eat enough calories – but he certainly wasn’t healthy then. I’m sure folks see him and assume he overeats (and judge accordingly), and it’s those type of assumptions that the fat acceptance movement strives to overturn. I’m happy to have him with 20 extra pounds rather than sick all the time from malnutrition.

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