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"Who Says Size Counts!" proclaims the cover of the Sept. 29 People magazine. "So what if they aren’t size six?" says the subtitle. "Healthy, wealthy, and unabashed, they’re proudly proving big is beautiful too." This is the way the U.S. is dealing with its obesity epidemic.
Americans are the fattest people on earth. A third of us are certifiably obese (more than 20% overweight), and about three-fourths are heavier than our optimal weight. We’ve gained an average of 12 pounds in just the last decade. Three hundred thousand of us die prematurely each year because we’re too fat, making obesity the leading cause of preventable death after cigarettes.
Yet instead of a public health crusade against fat, we see a celebration of it, exemplified by the People cover story, along with a slew of recent "fat acceptance" books with titles like Big Fat Lies, Losing It, How Thin Do I Have to Be? and the only somewhat tongue-in-cheek Eat Fat. The Body Shop, a politically correct toiletry chain, has posters depicting a doll that looks like a cross between a nude Barbie and a dirigible. The chain knows that a huge number of its customers are huge.
All of this propaganda, along with that of the inevitable victim groups like the National Association for the Advancement of Fat Acceptance, pretend that the nation’s "obsession with thinness" is based primarily on simple prejudice.
In fact, studies repeatedly show that aversion to corpulence, especially gross corpulence, is built into our genes. And for good evolutionary reasons: Fat women are less fertile and twice as likely to give birth to babies with severe defects such as spina bifida.
As to fat men, it’s hardly surprising that our female ancestors wouldn’t want a mate who couldn’t possibly run down a rabbit or keep up with a mastodon herd. Even today, the leaner your mate is, the better chance you have to grow old together. The nation’s two largest ongoing obesity studies have both found a steady, strong inverse correlation between overweight and longevity.
Obesity causes death primarily through heart disease, but also through stroke, diabetes and cancer. An American Cancer Society study found cancer deaths overall were 33% higher for men and 53% higher for women whose weight was 40% or more above average. Overweight men had a much higher chance of dying of colon, rectal and prostate cancer. Overweight women had much higher rates of endometrial, gallbladder, cervical, ovarian and breast cancer.
Can big be beautiful?
In the case of breast cancer, obesity is a double whammy: It tremendously increases a woman’s risk of getting the disease, and it increases the likelihood of fatality, because fat makes it harder to detect tumors early. A recently published finding from the Nurses’ Health Study found that women who are just 44 pounds overweight doubled their risk of breast cancer. A just-released Yale study found that severely obese women were more than three times as likely to be diagnosed late.
Obesity also leads to numerous diseases that don’t necessarily kill but can make life miserable, including arthritis, gallbladder illness, gout and even cataracts.
Still, the fat advocates tell us, the obese harm nobody but themselves. Let them assume the risk of their activities. But few fat people really know how much harm they’re inflicting upon themselves. No smoker can deny the danger of tobacco. But the recent onslaught of books, magazine articles and corporate campaigns celebrating fat perpetuates a myth that all too many of us eagerly embrace.
As the culture becomes more accepting of obesity, Americans become fatter — and this cycle feeds on itself. Fat parents often have fat children: The Sept. 25 New England Journal of Medicine reports that parental obesity more than doubles the risk of children becoming obese when they grow up. Genetics may play a role in this, but the study’s lead author fingered environment as the greater cause. Noting that Americans on the whole are getting fatter by the year, he observed, "Our genes aren’t changing that fast." Instead, children are imitating their parents’ eating and exercise habits.
So it is in society as a whole; we imitate each other and react to social cues. We must stop glossing over the activities that lead to obesity, such as the trend toward ever-growing food and drink servings and watching more and more television. It’s time to go back to old-fashioned terms like "gluttony" and "sloth," and drop the cutesy euphemisms like "big eaters" and "couch potatoes."
And while we shouldn’t make fat people the pariahs that smokers have become, neither should we pretend that their diet and exercise habits are just neutral choices, like choosing a blue car over a red one. Nobody chooses to be obese, but people do choose the activities that make them obese.
Society needs to clarify that choices causing obesity are wrong, in the same way we readily say that smoking is wrong (or at least stupid). We need to recognize that our stunning growth of girth is part of a culture of self-indulgence: We want everything; we want it now; and we aren’t willing to pay for the adverse consequences. We want a free lunch — and we want it to have no calories. By no coincidence is our nation fattening up even while it’s dumbing down.
Even when Americans do try to slim down, they usually do so in the wrong way. The biggest fad for the last several years, pushed by countless best-selling diet books, has been to demonize fat consumption while saying it’s OK to pig out on carbohydrates. The second biggest has been to demonize carbohydrates while saying it’s OK to pig out on fat! In fact, "the studies are clear," says Walter Willett, chairman of the department of nutrition at Harvard’s School of Public Health. "It doesn’t make any difference where your calories come from."
What about pharmacological treatments like Redux and fen-phen, recently withdrawn from the market? Far from being magic pills, they quickly lost appeal for most users even though they did effectively reduce obesity. Why? Because the pills work by reducing appetite, and most Americans want to indulge their appetites. They want a pill allowing them to eat anything in sight, watch 4.4 hours of TV a day and still be thin and beautiful.
Sorry, but there’s no such thing in sight. And maybe that’s not such a bad thing. Self-restraint is a virtue, after all. Neither low-fat desserts, nor fad diets, nor fad exercise devices, nor pills can substitute for it. This is not a call for asceticism or puritanism, but rather for simple moderation. It’s no exaggeration to call moderation a lost virtue. A mail-order firm selling clothes to immense women actually calls itself Nothing in Moderation.
I know the anger that calling for even slight denial can provoke. I also know what it’s like to lose a wonderful but grossly obese friend to a heart attack at age 29. With 300,000 Americans a year joining him, and the numbers rapidly growing worse, it’s worth a few hurt feelings and cries of outrage.
Calculate your BMI to see if you are obese. What the scores mean: