Weight Maven

Nearly a year ago, I wrote a post titled Obesity: cause or symptom? It was a riff on the idea that much of what we attribute to obesity is misplaced; that in reality, obesity is as much of a symptom as metabolic syndrome or heart disease or cancer. And that the real cause was the excesses in the standard American diet (chiefly sugar, refined grains, and veggie oils with their high levels of omega 6 PUFAs).

Anyways, it’s time to revisit this, as I’m finding that I’m often commenting on Twitter when the media uses “obesity” — whether intentionally or sloppily — when discussing research involving causation and correlation.

Obesity’s not benign

Now I realize that fat tissue is not inert — and that there are reasons that abdominal (or visceral) fat is more problematic than the fat in your butt and that being fat adds an inflammatory burden that most thinner folks don’t have to be concerned with. And trust me when I say that I am very, very aware of the impact of excess weight on the joints.

So no, I’m not going to argue that fat is “good” or even benign. However, what I will argue is that the focus should be on what really is the cause of our lifestyle diseases, including obesity.

Michael Pollan gets it:

When you hear the phrase “health care crisis” or “health care cost crisis,” that is a euphemism for the catastrophe that is the American diet. 75% of our health care spending is on chronic diseases linked to diet. That’s really what’s bankrupting us, and that has to do with the way we’re eating — way too many calories, too much processed foods, tons of refined carbohydrates.

Elsewhere though, the common refrain is “lose weight to get healthy” or “lose weight to avoid heart disease” (or dementia or cancer or whatever); as if you’re a picture of health eating your Big Macs and fries … as long as you’re thin.

My argument is that it shouldn’t just be (or perhaps even mainly) about losing weight. It should be about avoiding the foods in our diet that both make us fat AND make us sick!

Industrial food == cigarettes?

One of the challenges with pointing the finger at our American diet is that there are so many people walking around, seemingly fine, eating these foods all day long. From their perspective, it’s not the food (in moderation anyways), it’s all the fat folks’ fault for eating too much and moving too little.

Well, Gary Taubes made an interesting point about this in Why We Get Fat:

Whether you’re born predisposed to get fat is beyond your control. … A comparison with cigarettes is apt. Not every longtime smoker gets lung cancer. Only one in six men will, and one in nine women. But for those who do get lung cancer, cigarette smoke is far and away the most common cause. In a world without cigarettes, lung cancer would be a rare disease, as it once once.

Now, I don’t agree with Taubes on every point in WWGF, but this comparison is certainly spot on: not every person who eats the standard American diet — with its excesses of sugar, refined grains, veggie oils — becomes overweight or obese. But for those who become obese, diet is far and away the most common cause.

Aye, but here’s the rub. Cigarettes can’t be sold to minors, they have warnings on each pack, there are restrictions about how they can be advertised.

But industrial food? Well, it’s really all money, all the time:

“The bottom line is we’re in the business of making money, and we make money off of what we sell,” said Beth Mansfield, spokeswoman for CKE Restaurants Inc., which owns the Carl’s Jr. and Hardee’s chains. “If we wanted to listen to the food police and sell nuts and berries and tofu burgers, we wouldn’t make any money and we’d be out of business.”

To me, this is a really interesting area for the future (maybe I should study policy rather than nutrition). Our health care system cannot sustain this current trajectory, but before we all finally make the connection between the modern food industry and our health, there is gonna be a dark period in the US where “personal responsibility failure” is going to mean a lot of stigmatizing of fat people.

Then again, with 2/3rds of Americans either overweight or obese (not to mention the “normal weight” obese), it could wind up being a culture clash of considerable proportions (picture the fight for DADT repeal or marriage equality with 2/3rds of America gay).

Health, not weight

I don’t know necessarily that the health at any size folks have it all exactly right, but I think it’s a better start than “eat less, move more” — largely because weight is not the whole picture.

There’s an expression that goes: If you’re not part of the solution, you’re part of the problem. I’m convinced that generic “lose weight” recommendations — those that don’t consider the role and/or context of industrial food — are in the neighborhood of being part of the problem!