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2) The Demonization of Obesity

The Top 10 Most Overblown Health Stories of the Past Decade

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Updated December 23, 2009

At the beginning of the 2000s decade, we regarded obese people with traditional benign affection. Seeing a fat man walking down the street might conjure up the image from our youth of jolly Uncle Harry, coming to Christmas dinner with his magic tricks and pockets full of candies for all the kids. It would bring a smile to our face.

But no more. As the decade draws to a close the scales have fallen from our eyes, and we have come to see the obese as a menace.

Perhaps the most telling example of just how far we’ve come in this regard occurred in July of 2009, when President Obama named Dr. Regina Benjamin as Surgeon General. The outcry against Dr. Benjamin, on the basis of her being obviously somewhat overweight, was astounding. It is quite clear that being obese now completely trumps being: a) an African American, b) a woman, and c) a hero who dedicated herself to providing medical care to the Hurricane Katrina-ravaged poor.

The anti-obesity movement has indeed come a long way.

Being very obese is in fact a serious health risk, and the campaign against obesity is, at least on its face, one aimed at encouraging people to become healthier by controlling their weight.

But one does not have to scratch deeply to detect a nastier streak to the anti-obesity movement, a tendency to demonize the obese. And as we move closer to a publicly-funded healthcare system, this tendency is increasing.

To state the underlying premise more starkly than those in the anti-obesity movement generally do, the obese are a problem because they use far more than their rightful share of healthcare resources, thus jeopardizing the healthcare of those of us who have not made a lifestyle of, well, gluttony and sloth. The notion that the selfish behavior of the obese is placing everyone else at risk justifies their demonization. (That one's genetic predisposition to obesity usually plays a huge role is conveniently overlooked.)

Aside from the fact that the obese can now be publicly disparaged without consequence, it seems plain that the peer-reviewed medical journals are giving much latitude to any researchers who come up with novel ways to find fault with the fat. For instance, a recent "scholarly" article (which DrRich has skewered in detail elsewhere) purports to prove that the obese are significantly responsible for global warming. Another equally scholarly article (also analyzed by DrRich) suggests that obesity is actually contagious (and so, one can only surmise, perhaps we ought to gather up all the fat people, cull them out, perhaps concentrating them, say, in special camps).

By their own selfish actions, then, the obese are quickly becoming fair game for whatever manipulations we can devise to cause them to either lose weight, or pay for their sins. Such maneuvers may begin with simple taxes on foodstuffs favored by the obese, but the sky’s the limit. A special “carbon tax” based on their BMI would be legitimate, for instance, since it will always cost a lot of energy to move a fat person from point A to point B, whatever the mode of transportation. And it goes without saying that the ultimate censure - already employed in more enlightened cultures like Great Britain - would be simply to withhold certain healthcare services if one is deemed too fat.

This sort of righteous indignation toward the obese prevents us from seeing that, perhaps, we might be exaggerating the health risk they pose to themselves (and to us). For, while morbid obesity is indeed a very big health risk, and even simple obesity can be an important risk factor for cardiac disease, evidence is accumulating that being a little bit overweight or even mildly obese is perhaps not such a very bad thing in all cases.

For instance, overweight or obese patients who have had stents have been found to have a lower 1-year risk of complications and mortality than those who are thin or of normal weight. Also, being "fat and fit" is associated with a lower risk of death than being of "normal" weight and sedentary. And while obesity itself increases the risk of heart disease, obese people who develop that heart disease seem to have have significantly better survival than thin or normal-weight people who develop the same kind of heart disease.

Such evidence, suggesting that being overweight may not be quite as universally bad as is generally appreciated, is being widely and assiduously ignored. DrRich believes this is because demonizing the obese has moved well beyond the point where mere scientific data can put a stop to it.

Successful anathematization of the obese will establish an important precedent that is needed by the authorities whose job it becomes to restrict, control and tax all the other human behaviors that may cause an increase in our healthcare expenditures (which is to say, nearly all other human behaviors). As DrRich sees it, we are setting a precedent here that will become vital to our emerging new healthcare system.

So, while demonizing the obese is something that, DrRich submits, has gone quite over the top during this past decade, he supposes it's something we're just bound to do.

More of the Top 10 Overblown Health Stories of the Decade.

Sources:

Edwards P, Roberts I, Population adiposity and climate change. International Journal of Epidemiology 2009;1–4

Christakis NA and Fowler JH, The Spread of Obesity in a Large Social Network over 32 Years. New England Journal of Medicine, July 26, 2007;357:370-379.

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