Psychologist and HAES co-founder Deb Burgard has written an article — Examining the So-Called “Evidence” — on the recent study re weight and health.
One point that I think deserves a lot more discussion:
There is no study that I know that tests the fundamental assumption that a fat person losing weight will have the risk profile going forward of an always-thin person, because there is no large enough group of formerly fat people who maintain their weight loss, even in the Weight Management Registry. There are studies that show intentional weight loss is linked to earlier death, and studies that show weight cycling is linked to poorer health outcomes. And so using the study’s reasoning is going to push more people down the road that actually raises the risk of developing the very metabolic factors that are associated with the events they are saying are caused by obesity itself.
Many (most?) fat people are people who have scary diet histories … I know I do! Can you think of another health condition where the “cure” is potentially a big contributor to the actual problem?
Burgard closes her piece with a “correlation is not causation” plea:
I would like to see a time come when a finding that higher weight people have more illness or die earlier (if arrived at properly) was framed as evidence of a clear health disparity for higher-weight people, implicating not the higher weight person’s body, but rather the obvious and empirically demonstrated problems in accessing the resources for a good life: racism, economic discrimination, lack of access to health care, weight bias and weight stigma within every sphere of life including medical care, etc. Do we really think that these factors will not have an impact on people’s health?
I must admit that I cringe every time I see someone make the shortcut that obesity causes the things it is linked to. As I’ve written before, I do not think adipose tissue is benign. But I would bet a good chunk of money that the study does not exist that addresses all the potential confounds (some of which Burgard lists above and some which Ragen Chastain addresses in her Dances With Fat post today Are Fat People at Higher Risk?).
What keeps me from being a full-blown card-carrying HAES evangelist is that I don’t think that having a third of the population overweight and a third obese in a little more than a generation is just normal weight distribution. Well, actually it may well be “normal” in this environment … it’s certainly clear that it’s common as cultures adopt a more Western lifestyle.
But more importantly, if the reality is more along the lines of my thinking (what makes us fat makes us sick), then it is essential to focus on identifying what are the right interventions to address that. IMO, “losing weight” is a side effect, not the cure.