October 6, 2008

In The News: Is Fat Acceptance Acceptable?

Yesterday's New York Times Magazine ran a short piece on the "growing" fat-acceptance movement (although it's been around for approximately three decades and has yet to catch on, but I digress.)

"Fat-acceptance activists insist you can’t assume someone is unhealthy just because he’s fat, any more than you can assume someone is healthy just because he’s slim. "

In fact, this movement firmly believes that "it is possible to be healthy no matter how fat you are."

No matter how fat? Really?

So how do they explain, then, the countless research studies that have observed reductions in LDL ("bad") cholesterol, type 2 diabetes risk, and blood pressure in overweight and obese individuals who lose weight, even just five pounds?

Well, they point to a report published in The Archives of Internal Medicine this past August, which "reported that fully half of overweight adults and one-third of the obese had normal blood pressure, cholesterol, triglycerides and blood sugar — indicating a normal risk for heart disease and diabetes, conditions supposedly caused by being fat."

Too bad that study didn't examine levels of C-reactive protein, a marker of inflammation.

Remember, most diseases -- especially cardiovascular ones -- have cellular inflammation as a precursor.

And guess one of the factors that increases C-reactive protein levels? Overweight and obesity!

Additionally, one of those study's co-authors was quoted as saying that "among people of healthy weight in the study, elevated blood pressure, cholesterol and other factors were more common for people with larger waists or potbellies" and that "among overweight and obese adults, those in the “healthy” category tended to have smaller waists than those with at least two risk factors.

Need I say more?

The problem with this entire "movement" is that it attempts to kill two very different birds (social acceptance of overweight/obese physiques and the health consequences of being overweight/obese) with one stone.

It is one thing to denounce the media's obsession on borderline unhealthy bodies, but how anyone can believe weight has nothing to do with health status is beyond me.

All you have to do is speak to formerly obese people.

Ask them how they feel walking up a flight of stairs now as opposed to when they were carrying an additional 60 or 70 pounds on them.

Ask them how their lipid profiles have changed.

Ask them, very simply, if they miss carrying that excess weight.

Similarly, people who are extremely underweight (purposefully or not) are also at increased risk of mortality.

I point that out to show that nutrition and weight management are not inherently "anti fat," it's just that with the obesity rate doubling in the past 30 years in this country, it is not surprising that most public health nutrition efforts are concentrated on that particular problem.

Back to the Times article, I can't help but roll my eyes at the mention of "a new book out this fall, Health at Every Size, by Linda Bacon, a nutritionist and physiologist at the University of California at Davis, which is less about dieting than a lifestyle change that emphasizes “intuitive eating”: listening to hunger signals, eating when you’re hungry, choosing nutritious food over junk."

What exactly is so revolutionary? The guidelines mentioned above are precisely the same ones advocated for permanent weight loss and increased health awareness by many Registered Dietitians.

In fact, if any of you have ever been to a Registered Dietitian, you know the focus is on establishing healthy dietary patterns. It's not about six packs, fitting into size 0 clothes, or looking like the cast of the new Beverly Hills 90210.

To place the nutrition field on the same level as a celebrity diets segment on The Insider is preposterous and extremely reductive.

I don't see the damage in advocating for a healthy medium, where the end goal is to not be underweight or overweight.

1 comment:

Anonymous said...

Thanks for helping expose the fat acceptance movement and its' favorite mouthpiece the New York Times.

Fat Acceptance is not a growing movement. Its' most recent incarnation in the fat o sphere is bogged down with election year politics, and loses members and blogs everyday.

Intuitive eating is a dangerous idea. Anyone who advocates it, especially to the obese should be viewed with skepticism.

IMO, Intuitive eating does not acknowledge that are dietary desires are based on being substance level creatures, with starvation potentially around the corner. Thus we have a disproportionate desire to eat the "rare" high octane foods that contain fats and sugars.