Monday, November 23, 2009

Omg panic: only 92% of "obese" people think they need to lose weight!

This is not an Onion article, but it's so depressingly hilarious that you'd think it might be.

The article starts with a statistic: in the Dallas Heart study, of the 2056 "obese" people surveyed, 8% "said they were satisfied with their body size or felt they could gain weight."

Well, it's really a shame that only 8% of "obese" people are satisfied with their body size, but I guess that figure is not surprising. Maybe the article will go on to suggest ways we can help fat people to overcome their feelings of inadequacy in a culture that places such intense pressure on people to conform to an arbitrary and very small body norm? Oh... wait... I'm being told that wasn't the point of the article. No, it turns out that the "story" here, according to Tiffany Powell MD, is that those 8% are suffering from a "misperception" and "don't understand they are overweight," and so doctors need to hassle them about it more to get it through their fat skulls that they need to lose weight. Yes, Tiffany, I'm sure that's it: "obese" people are so stupid that they just "don't understand" that they're fat.

Of course, every article about "obesity" has to contain at least one gigantic and utterly unfounded leap of logic, and here it is: "Those with a misperception of body size believed they were healthy. But 35 percent of them had high blood pressure, 15 percent had high cholesterol, 14 percent had diabetes and 27 percent were current smokers. These risk factors are similar to obese individuals who acknowledged they had a weight problem and needed to lose weight, Powell said."

So did they also ask people if they "believed they were healthy," and it turned out that the exact same fat people who were satisfied with their bodies were the ones who said they believed they were healthy? Gee, that would be an interesting finding... but I have a sneaking suspicion that the author of this article is simply asserting that if a person said they were satisfied with their body size then that means they think they are healthy. Earth to mind-bogglingly stupid author of article: those two things are not the same at all. Maybe you should go back to reporting school. Or, like, preschool.

Another teeny problem is the inclusion of smoking as a risk factor that is supposed to have something to do with being "obese". Here's the logic as far as I can see: this person doesn't think she needs to lose weight, and therefore I will assume she thinks she is healthy even though she didn't say that. But really, this person is not healthy, which we know from the fact that she is a smoker. Therefore she needs to lose weight. And therefore she is an idiot for not knowing that she needs to lose weight, because all she needed to do was think about the fact that she is a smoker and therefore obviously unhealthy, and that there could only be one solution to this problem: lose weight!

So, OK, let's just set aside the smoking category (we'll assume the author was smoking something him/herself when he/she decided to include smoking) and look at those other "risk factors". Even if we simply add up all the percentages, we come to 77% of the "obese" people who thought they didn't need to lose weight as having some kind of health problem. Which means that at the very minimum, 23% of the "obese" people who supposedly thought they were "healthy" were absolutely right according to the health measures mentioned in the article! And let us remember that there is likely to be significant overlap between the people who had high blood pressure and high cholesterol, and possibly diabetes too. So possibly up to 65% of the stupid fatties in this study who think they're healthy are totally right.

But hey, let's not get bogged down with the facts -- or even the version of "facts" reported in the article. Let's just continue to assume that all fat people are unhealthy and that our goal should be to make sure that 100% of fat people (not a measly 92%) are fully aware that they are fat and therefore unhealthy and that they have to lose weight. Even if we grant all that, there are some other really questionable conclusions here. For example, "Those who misperceived their body size were less likely to go to a physician. In fact, 44 percent didn't visit a physician during the past year, compared to 26 percent of obese participants who correctly perceived they needed to lose weight." The idea is apparently that it's bad if you don't think you need to lose weight because then you won't go to the doctor. But I have some other ideas that would explain these correlations. How about this: if you are unhealthy you are more likely than a healthy person to go to the doctor. And if you are fat and unhealthy, given all the messages you hear about fat being unhealthy, you are probably somewhat likely to blame your poor health on being fat, and therefore to think that you need to lose weight. Even if not, if you are fat and unhealthy you are likely to be told by your doctor that you need to lose weight. So there, I've just explained the correlation, and notice how my explanation doesn't rely on the idea that a fat person who is stupid enough to be satisfied with his/her body is also too stupid to go to a doctor. Or here's another, more depressing possibility: people who are fat but don't think they need to lose weight avoid going to the doctor even when they get sick because the doctor is likely to tell them that they need to lose weight rather than actually bothering to diagnose their real health problem.

My friend who sent me the link pointed out a similarity between this and our cultural attitude towards "depression": if you're a sensitive, introspective person who feels saddened by the state of the world, rather than being able to glibly go through life thinking everything is hunky dory the way that most people apparently do without getting bummed out by things like war and global warming, then clearly you are the pathological one and you must have a medical problem that needs to be treated in order to bring your worldview into alignment with everyone else's.

Thursday, November 12, 2009

Strikes and gutters

I was so excited to see this article in the Chronicle of Higher Education this week. It's a really nice introduction to fat studies -- naturally, since the authors are editors of a Fat Studies Reader that came out last week (look for a review here -- my copy is due to arrive today!). It's so nice for once to read a sympathetic piece on fat studies that isn't "balanced" by a quote from some doctor saying "Yeah, but just because studies have repeatedly failed to show that being fat is a big health hazard, and 95% of people can't permanenly lose large amounts of weight anyway, it would be dangerous for fat people to think that they are OK." In fact, the article is totally free of such crap, with the teeny exception of the caption on the (awesome) photo of the Padded Lillies, which includes the term "overweight." It's not an unsympathetic caption, but it was clearly not written by the authors of the article, who I am pretty sure would not use the term "overweight". It's not quite as irritating a term as "obese", but for me it always brings to mind the question "over WHAT weight?" (aside: just now in googling the phrase "over what weight?" to see if I could figure out its origin, or at least remember the first place I saw it, I came across a very interesting feminist blog called Professor, What If...?. I've only read a few posts so far, but it seems worth checking out, especially this post.) I think many people consider the term to be more polite than "fat", but "overweight" clearly carries with it some normative weight that everyone should be, which I find icky. But that's a minor nitpick; you should really go read the article because it's great and I love that it appeared in the Chronicle of Higher Ed. It seems to me that we'll need more of that in order for fat studies to really come into its own.

On the negative side, today's features this lousy excuse for an article. Read it for yourselves (or don't); I just wanted to highlight a few of the most idiotic things about it here.

First there's this funny line: "[American Heart Association spokesman Russell] Pate and other childhood obesity experts say more American youths are becoming obese because so many are addicted to television, video games, testing and fast food." I find the thought of kids being addicted to testing pretty hilarious. I personally will confess that I like taking tests, especially the bubble kind, and I liked them when I was a kid too. But I'm pretty sure I was kind of a weird kid that way. Anyway, let's give the editors the benefit of the doubt and assume the author meant "texting"; I'm still going to call bullshit on it. This strikes me as just a list of stereotypes about what fat kids do with their time. Where's the evidence that fat kids engage in more of those activities listed than other kids do?

On a more serious note, there's the whole "ticking time bomb" concept that appears in the headline and is repeated in the article. What a terrible metaphor, especially when you're talking about kids. Hey parents, if you don't make your fat child lose weight right away, he/she will EXPLODE!!! This is exactly the kind of substance-free, sensationalized rhetoric that characterizes the entire "war on obesity" and should lead any thinking person to be skeptical about the whole enterprise.

And then there is the very telling description of Russell Pate's research methodology: "Pate, who has testified about childhood obesity before Congress, says he can tell how American kids have changed by looking at old yearbooks. 'You see fewer overweight kids,' Pate says. 'There were some kids that were overweight in the older yearbooks, but the typical kid was leaner.'" Wow, I can't wait to see the results of that super-objective study where a thin guy flips through yearbooks and concludes that there are more fat kids than there used to be, based on 1" square photos of the kids' faces (which are, by the way, kids' faces -- i.e., commonly kind of chubby regardless of the child's overall physique). Maybe I'll do my own study where I flip through some modern yearbooks and conclude "Hey, everybody looks OK to me!"

There are plenty of other things to pick on in the article, but I'll just point out one last little ironic thing, which is that the photo that goes with the article is of a chubby person (I guess it's supposed to be a kid, but it's hard to tell) in a swimming pool. So if the whole point of the article is that kids don't exercise anymore, isn't that kind of a stupid photo to run with it? Well, maybe the person who selected the photo was being subversive. If so, kudos to them for getting one thing right: it's entirely possible for a fat kid (or adult) to exercise and still be fat. When I was a kid I did a sport every season: swim team, soccer team, basketball team, softball team, plus horseback riding lessons, and later marching band. And I was still fat. Gym class in middle school and high school were almost humiliating enough to take all the joy out of exercising for me (like the time sophomore year when the gym teacher's daughter, who was in my class, got put in charge of weighing everyone and she told her friends how much I weighed... incidentally, although my body composition is a lot different, I weigh the same now as I did then; how many self-righteous fat-bashers can say that for themselves?). Somehow on my own I discovered the fun of running when I was in college, and I have continued with running and/or other kinds of exercise pretty consistently since then. But it was absolutely not due to gym class -- so the idea suggested in this article that phys ed classes are the solution to the "childhood obesity problem" is, in my opinion, way off base. I'm pretty sure the people quoted in the article who promote this idea were not fat kids, or they'd know that phys ed as it is traditionally taught in American schools is no way to get fat kids excited about fun and healthy ways of moving their bodies; quite the contrary.

Oh well. I guess I gotta remember that at least there are people out there like Sondra Solovay and Esther Rothblum and Marilyn Wann.