Weight of the Nation: Does Anybody Care?

Weight of the Nation: Does Anybody Care?
Courtesy of HBO - theweightofthenation.HBO.com

One week after HBO premiered its documentary, Weight of the Nation, there is a dearth of commentary on this 4-part series.  Has anyone out there taken the time to watch this?

I wrote about this last week.  It was my hope to engage readers in a discussion about our country's obesity epidemic and HBO's handling of this very complex topic.

My post received only two comments.  One came from the group, Association for Size Diversity and Health (ASDAH).  The group's website - since taken down - commented on the film before even viewing it.

Even on The Huffington Post - a forum known for progressive politics, eco-friendliness, and healthy lifestyle advocacy - there were but a few posts with a small number of comments for each.

Not surprisingly, the blog with the most comments was written by the author of Health at Every Size, proponent of the Health at Every Size Movement, and blogger at ASDAH, the ironically-named researcher, Linda Bacon.  Still, her controversial counter-argument garnered less than 100 comments.  Compare that with this morning's headline on the Facebook IPO that is currently at 3800 comments and climbing...

Do people just not care about the "obesity epidemic" in America?

Are we in denial that this is a public health crisis?

Or is commenting on obesity not as interesting as voicing an opinion on whether or not Facebook was worth 100 billion dollars or Mitt Romney's work as a venture capitalist qualifies as relevant experience for the office of president?

As someone who suffered a heart attack, I have become extremely interested in health and fitness issues over the past three years since that life-changing event.  If a person who exercised regularly, wasn't overweight, didn't smoke, rarely drank, and tried to eat healthy could come close to dying at 43, how high could the risk factors be for 2/3 of the Americans who are classified as overweight?

I couldn't understand why commentary on this engaging HBO film wasn't trending higher on the Internet.  The first few articles I found were written as opinion pieces.  There was a great post by Alexandra Le Tellier at the LA Times  that received only one comment.  Two other well-written pieces by authors that struggled with weight issues - Mary McNamara in the Kansas City Star and Daniel J. Schultz in the Huffington Post , received one and five comments, respectively.  Each voiced their concerns about what was said and what was left unsaid in the film.  None were controversial.

Beyond posts like those highlighted, there was just outrage by a group that feels too much attention is being focused on the weight metric.  Their outrage was nothing close to that of the NATO protesters on display last week in Chicago...

So where is the concern that the obesity rate is rising, metabolic syndrome (heart disease, stroke, diabetes, cancer, obesity) is affecting more Americans, more children are developing Type 2 diabetes, and rising healthcare costs for this epidemic are unsustainable for our nation?

I found this series to be interesting, engaging, fair, balanced, positive, and short on controversy.  The statistics presented were not delivered in a manner to instill fear, but to encourage awareness.  The real-life stories didn't evoke pity or place blame.  It laid the problem bare and shined a light on it.  It confronted the obesity epidemic.

Now it's time for us to discuss a solution.

Read my followup post from May 24, 2012 here.



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  • fb_avatar

    How is this kind of repulsive fat hate "fair and balanced"? Except in the Fox News sense of the term.

    No one needs to watch this to get their daily "fat-hate' not when GMA, The Doctors, The Revolution etc...etc...live and thrive.

    Yes, people hate fatties like me, but maybe not enough to sustain a show in cables, "all violence and nudity all the time" demographic, thank goodness for that...but don't worry turn to another channel and there will be all the "fair and balanced" fat hate you need to gloat about your fitness level.

  • In reply to Fulton Fry:

    Fulton, thanks for taking the time to read and reply.

    I plan on watching the entire series a second time, but my first impression was that it was fairly empathetic toward the individuals profiled. I was actually impressed that it didn't paint them as victims or portray them as lacking in self-esteem. I felt it was very fair in this regard.

    Personally, I wish the documentarians would have taken the food industry to task. The correlation between obesity and metabolic syndrome runs parallel with the introduction of high fructose corn syrup starting in late 1984. It tastes sweeter than table sugar, it's cheap to add, and it suppresses the hormone that tells your brain you're full. As a result, the average American consumes 600 calories more per day than he/she did in 1980.

    I am not a fat hater. I firmly believe my issue with high triglycerides was caused by the HFCS in my diet. I had a heart attack despite being fit. I wouldn't wish that on anyone. In fact, I do everything I can to create awareness of metabolic syndrome.

    I didn't have any visible warning sign that I was at risk. I view added weight as a marker for risk factors. It's like the error code your car's computer stores when something causes the "check engine" light to come on. Even though your car seems to run fine, something happened that may increase the odds for a major breakdown later on. You can have it checked out and head off the breakdown or you can ignore it - it's your choice.

    I highly recommend watching the documentary and focusing on the statistics related to developing metabolic syndrome. I'm sure you have a lot of people in your life that would be very upset if something bad happened to you that could have been prevented...

  • Since when has ASDAH's website been taken down? Their page "Debate the Weight" is still right here: https://sizediversityandhealth.org/content.asp?id=167

    Maybe it would be useful for you to listen to and try to understand the concerns of those who are against sizeism, fat-shaming, and junk science, and for a weight-neutral approach to health.

  • In reply to DrSA:

    Thanks for taking the time to read and reply. As of the time I posted this blog this morning, I could not activate any link to the ASDAH site, even though I had them bookmarked prior. I will try again and post it in any updates to this blog.

    I understand the concerns of those against sizeism and I respect their right to have strong feelings about it. I can't accept dis or mis information, however.

    Dr. Bacon's post on the Huffington Post was very defensive and dismissive of the health experts (plural) that appeared in the series DESPITE her only having reviewed the trailer prior to writing her post.

    It is one thing to empathize or even sympathize with individuals who struggle with weight issues, but it is entirely another to discourage them from performing their own analysis of the statistics, science, and expert advice presented in the documentary.

    Added weight is a marker for risk factors. There is strong correlation between added weight and diabetes, heart disease, stroke, and certain forms of cancer plus other health issues such as arthritis and liver disorders.

    The metabolic process is complex and varies by individual, so there is no way to show causation in anything but laboratory animals. If the odds of developing metabolic syndrome are greater for people who store more fat, how is making all individuals aware of these risk factors discriminating in any way?

    Calling the work of a slew of health practitioners - board certified doctors who are bucking the trend of simply pushing pharmaceuticals to treat symptoms in order to educate the public - purveyors of "junk science" borders on negligence for Dr. Bacon. These are medical doctors - not hawkers of unregulated supplements on late night infomercials.

    This documentary is about informing the public. I challenge you to disprove any piece of information presented.

    Please watch the documentary without the "fat-shaming" glasses on...

  • Also, that's an interesting rhetorical trick you've got there - framing the diet industry's stance as one of "concern" and the Size Acceptance/Health At Every Size community's stance as "outrage."

  • In reply to DrSA:

    DrSA, please read Dr. Bacon's blog on Huffington Post (http://www.huffingtonpost.com/linda-bacon-phd-ma-ma/weight-of-the-nation_b_1516251.html). A reasonable person would categorize this response as outrage.

    I didn't find the documentary to be backed by the diet industry. But I do plan on going back to watch it again to see if I missed that slant.

    I am no shill for the diet industry. An informed individual can read a book like Michael Pollan's "In Defense of Food" and formulate his or her own approach to a healthy diet. That's what I did and I shed 35 pounds by eating the right number of calories for my desired weight, eliminating HFCS, substituting whole fruit for prepackaged snacks, eating more vegetables, eliminating saturated fats, and sticking with lean protein.

    Eating healthy is about understanding how your body processes macronutrients and building a plan around it. You shouldn't need to pay a third party to do this for you - just educate yourself.

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    I hear how upset you are that people aren't engaging in enough obesity hysteria for you. Perhaps people are suspicious that the people in the documentary have so many monetary ties to the weight loss industry, or are noticing that waging war on fat people isn't an appropriate health intervention?

    The truth is that while (as I believe the HBO documentary pointed out) we don't have any method of weight loss that has shown long-term success for more than a tiny fraction of participants. Over half a century of research on weight loss all says the same thing - we don't know how to get it done. There's no other medical intervention that has failed 95% of the time in every study for over half a century and is still being widely prescribed.

    Meanwhile over 30% of obese people are metabolically healthy and there is a mountain of evidence (Wei et. al., Matheson et. al, Cooper Institute etc.) that shows that simple healthy habits even out the risk factors between people of different weights and are our best chance for healthy bodies of all sizes.(This is a great place to start: http://youtu.be/aUaInS6HIGo)

    Meanwhile Peter Muennig's research from Columbia University shows that the stress of constant stigma is correlated with all the same diseases with which obesity is correlated, and that women who are concerned about their weight have more physical and mental illness than those are are fine with their size regardless of their weight.

    A truly evidence-based solution would acknowledge that there are healthy and unhealthy people of every size and that weight and health are two separate things, would cease to pathologize body sizes, and would discourage stereotyping people based on how they look.

    Instead the evidence clearly shows that our best bet is to focus on creating access to a wide variety of foods, safe movement options, and affordable evidence-based health care for people of all sizes while simultaneously putting an end to body shaming and weight bullying.

    Finally, I imagine someday you may look back and be embarrassed that, while trying to be taken seriously, you went for the cheap joke about the last name of a Ph.D with three post graduate degrees who is actively involved in finding evidence based solutions to help people. I would expect more from a reporter for a Junior High School newspaper, but that's just me.

    ~Ragen Chastain

  • In reply to Ragen Chastain:

    Ragen, thanks for reading and the very considered reply.

    I believe you mischaracterized the intent of my post. I'm genuinely surprised that this documentary didn't create more controversy or discussion online. As a blogger - an individual with an opinion and a place to post it - I write dozens of posts that don't solicit a single comment and it's mainly due to a lack of controversy. This topic should have generated dozens of posts and thousands of comments.

    I am not anti-overweight, anti-obese, a fat-hater, or one who puts others down to raise myself up. I am someone who firmly believes that the average American, like myself, has never been taught enough information about food to make decisions that were in his or her best interest. I was hoping that this documentary would address our food supply and the insidious nature of the food companies Americans are asked to trust with their health. IMHO, the documentary fell far short on this.

    I do believe that the documentary's portrayal of individuals who store more fat - let's not label them as overweight or obese for purposes of our discussion - was fair. It didn't stand in judgment of individual choices nor did it seek to place blame. It stated the increased likelihood of developing metabolic syndrome for individuals who stored more fat. It showed the consequences of storing more fat. It showed choices for reducing stored fat. It talked about the serious disadvantage it places children at. If any of the information presented as fact is in dispute, please feel free to point it out.

    I fully empathize with your cause. Discrimination against individuals because of their size is unacceptable. I do disagree with you about stereotyping. The HBO film took great pains NOT to stereotype any of its profiled individuals. If anything, I thought it made an effort to help knock down stereotypes.

    I also take issue with your touting a statistic that 30% of obese individuals are metabolically healthy. This implies that 70% are not. With 3:1 odds against, it is pure negligence to try to "sugar coat" the risk factors in order to avoid hurting someone's feelings. Excess stored body fat puts an individual at a higher risk for developing metabolic syndrome. Discouraging anyone from discovering these facts - and they have been proven in studies like the Bogalusa Study - is disingenuous and dangerous. Everyone needs to know what their individual risk factors are for life-altering and life-threatening health issues.

    As I stated in my post, I was not overweight and didn't possess any of the risk factors for heart disease, other than a family history. I truly believed that I had beaten the family history since I did not visibly demonstrate any warning signs that I was at risk. Yet I still had a heart attack. Had I been on top of my own health with something as simple as a routine lipid profile, I would have discovered an elevated risk due to high triglycerides and low HDL cholesterol. A followup C Reactive protein screening could have shown inflammation and an angiogram could have shown plaque buildup with the potential to rupture. My heart attack could have been avoided by heeding warning signs based on elevated risk factors.

    Pretending that individuals who are storing more fat are not at an elevated health risk while instead focusing on all the peripheral issues surrounding obesity is like using the 12-step program to treat sclerosis of the liver. If the damage has been done, no amount of coming to Jesus and apologizing to those you hurt is going to repair it. It requires medical attention. Fortunately, metabolic health can be improved right up to the point before a heart attack, stroke, or diabetes diagnosis.

    I agree with your statement about access to a wide variety of foods, movement options, and affordable evidence-based health care. It all starts with knowledge. Once I discovered that my X-factor was high fructose corn syrup, I eliminated it from my diet cold turkey. I learned about eating real food by reading Michael Pollan's "In Defense of Food" and I formulated an eating plan that led to a weight loss of 35 pounds that I have sustained. I never wanted to suffer a heart attack - nor would I want anyone else to go through what I went through - so I had all the motivation in the world to eat right, continue exercising, and manage stress. No psychological factors could have derailed my decision to change - I wanted to live.

    As far as me pointing out the irony of Dr. Bacon's name, that's just my sense of humor. Comments people make remind me of song lyrics and movie quotes and I chuckle at puns. I am stuck in that junior high mode, so I'll take it as a compliment that you picked up on that.

    I will say that the defensive nature of Dr. Bacon's blog on Huffington Post put me off to taking her seriously as a researcher. There is room for her to concede that people who store more fat are at a higher risk for metabolic syndrome and still advocate for their fair treatment in society. She can be empathetic, sympathetic, and supportive without being an enabler. The BMI may not be the best tool for measuring stored fat, but that doesn't make all the correlations regarding BMI comparisons irrelevant. I would rather see a campaign to encourage lipid profiles with C-Reactive screenings for everyone regardless of size than the discounting of the importance of testing for anyone because of size.

    I believe we're on the same side - better health for all.

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    "As someone who suffered a heart attack, I have become extremely interested in health and fitness issues over the past three years since that life-changing event. If a person who exercised regularly, wasn't overweight, didn't smoke, rarely drank, and tried to eat healthy could come close to dying at 43, how high could the risk factors be for 2/3 of the Americans who are classified as overweight?"

    As someone who is "overweight" doesn't smoke, rarely drinks, tries to eat healthy and exercises fairly regularly I am insulted by the insinuation that b/c I am overweight that I am unhealthy. I would like to think that the lack of interest is b/c people are starting to understand that fat does not always equal unhealthy just like thin doesn't always equal healthy but I am not naive enough to believe that, most likely its b/c so many people are out of work they can't afford HBO.

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    In reply to Jen Lott:

    You can watch it for free on HBO's website.

  • In reply to Jen Lott:

    Jen, thanks for reading and replying.

    I didn't mean to imply that overweight people are unhealthy. I was making a statement about risk factors. I didn't possess a single one of the risk factors, yet I had a heart attack. I didn't have any reason to believe that what I was suffering was actually a heart attack and not acting quickly enough should have cost me my life. Had I gone for a lipid profile, I might have developed concern over my high triglycerides and my low HDL might have tipped me off to risk for plaque buildup and inflammation. I could have done more tests if only I had a reason to be concerned.

    Overweight is a marker for risk factors. As the series points out, likelihood of developing risk factors increases with stored fat. Not all people with a greater percentage of stored fat will have elevated triglycerides, lower HDL, higher LDL, high blood pressure, or high (or low) blood sugar. They may be blessed with better genetics or the cumulative effects have yet to manifest themselves. Statistically, the odds are greater and this shouldn't be dismissed or ignored.

    The documentary is about educating the public on risk factors. It's well worth watching. You can follow the link provided in my post and watch it for free online.

  • In reply to Brent Cohrs:

    Now you're confusing me, Brent - are you saying that you would actually have been healthier if you had one risk factor (like, being fat maybe) because then you would have paid more attention to your health and got blood tests before the heart attack?

  • In reply to lilitu:

    Lilitu, I wish I had paid more attention to my family history and not presumed that not having a visible risk factor meant not being at risk.

    I really enjoy bicycling - as one might gather from reading my blog. A side benefit of bicycling is fitness. Strong heart, strong lungs, and the ability to burn a crapload of calories in a single outing. I wrongly assumed that my ability to burn calories at will erased the negative effect of those calories as they were being consumed.

    I allowed popular conceptions to dictate my perceptions about my own health. I suffered for this. I didn't take the time to educate myself because I had a preconceived notion that was obviously false. Without any visible, outward indicator, I chose not to have a lipid profile - something I strongly advocate for everyone now.

    Would I have been healthier had I been overweight? I believe that the damage was done regardless, but the added weight may have served as a reminder to be more proactive in testing. Testing is the only thing that could have shown me my elevated risk factors with any certainty. I have no one to blame but myself for not testing.

    As my replies go, my biggest discovery was just how dangerous my diet was. Despite turkey sandwiches on whole wheat bread, cutting out mayo, and sparingly eating burgers - the soda I drank and the Little Debbies I scarfed for a feel good pick me up erased the benefit of my other healthy choices. No amount of biking could compensate for these poor food choices, as I found out.

    As I said, I would have preferred the documentary to focus more on food by explaining the complex metabolic process that makes fructose so harmful.

  • In reply to Brent Cohrs:

    I should apologise for being a little flippant in my last comment, but I think you took it in good humour, so thank you!

    I don't believe we fully understand how food affects us, a calorie may be a unit of energy but they are not all the same or delivered in the same way. I agree we could do with more information, in the meantime though I hope the fat-shaming epidemic dies down. It is also possible to fixate on diet to the point of being unhealthily obsessed - if you get to make dietary choices that you like you are already doing better than about 70% of the world's population. (that's a guess - don't condemn me for that one! :-D)

    As someone who had an invisible health problem I would think that you would appreciate that health is not something we can see, but we can test actual levels of various things to check on people. So focussing on fat (a lot of which is about how unacceptable it is in modern Western society to *look* fat - how many skinny people do you know who eat nothing but rubbish and are still considered healthy by the general public?) is not the most helpful thing we can do to promote better health.

  • In reply to lilitu:

    Great comments - I really appreciate your contribution to the discussion.

    It's tough to consistently make good food choices. I had to teach myself to cook! It's also a PITA when I travel for work.

    I just have one motivator each time I get hungry - never to put my family through that heart attack drama again.

    I agree with you about the skinny people who eat crap. It's all on the inside and everyone needs to know his/her lipid profile and risk factors, regardless of what's on the outside.

    Check out today's post and add your comments there - I really appreciate your input!

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    In reply to Jen Lott:

    Why are you insulted? It's either true or not, fat may cause increases in insulin resistance and be endrogenic, or it may not. There's no insult, it's just science.

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    My impression is that the great majority of people just don't want to discuss obesity in a sensible manner. Most conversations I see are either hateful or defensive, with little basis on medical facts.

  • In reply to Liliana:

    Liliana, thanks for reading and replying.

    You hit the nail on the head. That was pretty much the reason I posted. I was surprised that this very well done documentary didn't receive more discussion and I presume its because half the people are insulted and the other half are in denial that it's a serious problem.

    The documentary is full of medical facts, statistics from studies like the one done continually in Bogalusa Louisiana since 1972, and anecdotal observations from experienced medical practitioners.

    As I said, it's short on hype, long on information, and it's pretty fair and balanced in its portrayal of individuals who store more fat. Americans of every size can benefit by watching it.

  • Firstly, the ASDAH website is still very much there. https://sizediversityandhealth.org/Index.asp

    Secondly. It is perfectly possible to be fat and healthy. People can follow all the behaviours you claim as good and still be fat. Are you going to look at them and assess them as unhealthy simply because their bodies are larger than yours is? It isn't possible to tell someone's health by looking at them, so please consider promoting healthy behaviours instead of those supposed to make bodies smaller. After all, the way you describe yourself you sound like the stereotypical 'picture of health' but apparently you had some hidden risk factor of which you weren't aware. Relying on appearance as an indicator of health is dangerous, wouldn't you say?

    Please stop and consider why there would be outrage that weight is so focussed on, you sound as if you are dismissing that concern completely. Instead of blaming fat for health complications (unless you have the studies to prove that it is the one thing to blame) why not ask if the rise in average weight and cases of ill health are symptoms of the same problem? What sort of debate about this were you looking for? Were you hoping for a public outcry and an epidemic of fat shaming because those are already here and no one was ever shamed healthy yet. Let's focus on health, not weight.

  • In reply to lilitu:

    Lilitu, thanks for reading and your reply. I really appreciate adding your voice to the discussion.

    Yes, I was very surprised that I had a "hidden risk factor". So surprised that I dismissed the symptoms and exacerbated my prognosis by waiting too long to seek treatment. I could have died from my ignorance / denial. I wrongly believed that an appearance of good health equated to good health.

    As I searched out the "why" during my recovery, I kept coming back to the high fructose corn syrup that was also "hidden" in many of the food items I consumed. Soda is the most obvious, but it exists in so-called "healthy" foods that are classified as low fat and low sodium. When I made a conscious effort to eliminate HFCS from my diet and eat more whole foods, I lost weight (35 lbs) and improved my lipid profile.

    I was expecting more of the documentary to focus on this insidious food ingredient that tastes sweeter than sugar, suppresses the hormone that tells us we're full, elevates triglycerides, spikes blood sugar, and likely causes inflammation. Sadly, the documentary makers weren't brave enough to take on Big Ag and Big Food.

    I'm not one to blame individuals for health complications. Rather, I look at excess stored fat as an indicator of an increased risk of metabolic syndrome. Body fat is a result of excessive triglyceride production in the liver. Elevated triglycerides - fat in the blood - are a marker for heart disease, stroke, and diabetes. They weren't caused by fat - they were caused by the food we chose to eat.

    The "obesity epidemic" as the film refers to it should be called "the stored fat" epidemic. Don't you find it curious that the rise in average weight AND the rise in metabolic syndrome parallel the rise in HFCS in our diets?

    This is where I feel the discussion should be.

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    Brent does your family have a history of heart problems? You stated "I didn't possess a single one of the risk factors, yet I had a heart attack." Family history of heart disease is the biggest risk factor more than anything else. My dad's best friend dropped dead at 29 playing football with his sons out in the yard. He had a massive heart attack and this was in the early 70s so no one tried cpr or even knew about it or he might be alive. He was a very thin active guy, but the men in his family have been dropping like flies for a 100 years all from heart failure.
    I get it that people are hysterical about risk factors. People want to feel like they have some control, but they don't have control. You can't health your way to immortality. Sure you can eat healthy and ride a bike etc, but if you have crappy genetics you're probably going to have problems. Being fat is just as risky as anything else. Shows like this and other "Obesity Epidemic" scare fests are backed more by prejudice and disgust with fat people than concern over health.
    If people really want to help fat people they should shut up about it. People act like there isn't enough chatter about the fatties. You can't turn on the TV without hearing it. It's on every channel all the time. Perhaps you aren't aware of this because the finger isn't pointing at you. Fat people know they're fat and they know the world hates them for it. NEws at 11!

  • In reply to Diann Johns:

    Diann, thanks for reading and taking the time to comment.

    Yes, there is a family history of heart disease on one side of my family. But having low blood pressure and low LDL (tested 8 years prior) led me to believe that I didn't inherit those genes. I was mistaken.

    You bring up a very good point about risk factors. Mine was hidden in bad genetics, but I remained convinced that there had to be something that I had done to contribute to my heart attack. I found it when I read up on inflammation and elevated triglycerides. There is a strong correlation between elevated triglycerides, inflammation, and high fructose corn syrup. That was my X factor.

    I was disappointed that the documentary didn't focus more on this strong correlation in the Standard American's Diet. If we're consuming an average of 600 calories more per day (and storing more fat) than in 1980 and the one major thing that has changed is the addition of HFCS to all types of processed foods from sweetened beverages to snack foods to "healthy" low fat and low sodium offerings, we should all focus on this dangerous substance.

    I still feel that the documentary treated the individuals profiled very fairly. It's unfortunate that some will be offended by the emphasis on the weight and not the cause of the weight gain from the poor food choices we make. It's really a "stored fat" epidemic caused by bad food. Body fat is just a marker of the damage done and an indicator of elevated health risks.

    I wish I had had a more visible marker, but I have no one to blame but myself for not taking the family history more seriously and getting periodic lipid profiles. I could have saved myself and my loved ones a lot of anxiety had I been more proactive with my health - not just my fitness.

  • In reply to Diann Johns:

    Yes, this is the problem I have with the whole concept of the programme - it wasn't about the *health* of the nation, or if it was why did it focus on weight? That sort of thing is going to get a sigh and an eyeroll from most fat people, because yes we already know, no we don't need random strangers criticising us or our (assumed) choices simply because we happen to be fat. And it is rare for reasoned debate to break out about any public health issue because everyone has an axe to grind and the whole topic seems to attract haters like flies round honey.

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    I am surprised that your reaction to your own heart attack was one of support of body-shape based science. If I had been in your position I would be outraged at the focus on weight and bodysize - if my doctor knew I had family history and decided that because I was thin I was safe from heart disease due to his/her own weight bigotry and then for me to suffer what you went through I would be taking all weight-focused weight practises to task! It was because of their assumptions that your cholesterol wasn't checked - you had to nearly die before they clued on that you were at risk!

    I hope this doesn't sound condescending - I think the way you are looking at the statistics is a bit off. You had a heart attack (and I am very glad you are better and recovered) and were healthy weight and following all the guidelines for good health. That doesn't mean that because someone has a higher risk than you and you had a heart attack that this means they are super-double going to have a heart attack or poor health too - it just means that you were unlucky with your statistics (family history aside). Other people's health are independent from yours - your risk does not influence other people's risk, unless you are related and have very similar lifestyles.

    I don't really have much to add to the commenters above me as they have expressed my thoughts on the damage telling the public obesity [read obese people] is a massive threat to the US far more eloquently than I ever could. As someone who is still recovering from the terrible effects weight stigma has on my mental health I would like to tell you that this stuff can be far more emotionally damaging than most healthy weight people would think possible.

  • In reply to Sarah Hillier:

    Sarah, you make some excellent points - thanks for reading and commenting.

    I never looked at it that way before, but you're right - the emphasis on "fat" being unhealthy and "thin" being healthy had affected my perception and caused me to dismiss my heart attack symptoms (to my own peril). Thanks for pointing that out.

    As I've mentioned in numerous replies, it wasn't just a family history that caused my heart attack - it was my diet. My poor arteries were apparently more susceptible to inflammation and plaque build-up and a diet that elevated my triglycerides with simultaneous low levels of HDL was a recipe for disaster.

    Had I been proactive and had periodic lipid profiles and C Reactive Protein screenings, I could have identified my risk factors and possibly averted a heart attack.

    Excess stored body fat is a result of elevated triglycerides. People with excessive stored body fat measured by the controversial BMI and labeled as overweight or obese have a more visible marker than I did for indicating an elevated risk factor. All the correlations highlighted in the documentary show this.

    Excess stored body fat doesn't CAUSE metabolic syndrome - it is a marker of the possible effects of it. In a way it's no different than my own family history being an elevated risk factor for my own heart disease.

    And that's pretty much my point. If people choose to see this documentary as just another prejudice against the overweight and obese, there is a likelihood to dismiss the science, statistics, and anecdotal information presented by the health experts featured.

    No one - of any BMI - can afford to miss this documentary. It's not fear-based, it's fact-based. It's balanced and it presents the many facets of the "excess fat storage" epidemic in an unbiased and thoughtful manor.

    Not being one who has ever been "fat", I can't relate to any of the effects of weight stigma, but I can empathize with those in that position. I don't want to see a single person miss a warning sign and suffer a heart attack like I did. Each and every one of us needs to understand how our bodies process food and the inherent dangers of poor food choices.

    Life is short enough as it is - there's no reason to shorten it further by remaining uninformed.

  • "Excess stored body fat is a result of elevated triglycerides."
    Well not necessarily. I am fat (female, 5'4", 175 pounds) and not only are my triglycerides exceptionally low, but my total cholesterol is 115. No, that's not a typo. One-one-five. I'm physically active, training for my 1st century ride this summer (last year stopped at 89 due to flat tire) and love fruits, veggies and whole grains. Not eat them like medicine because they're good for me, but LOVE them. Unlike what was quoted in the WOTN trailer, I crave broccoli. Like all the time.

    Believing that because you were thin and unhealthy means that if I am fatter I must be more unhealthy does not follow logically. I'm afraid you got bad luck on the genetic draw, coupled with not monitoring some important health measures.

    You also mention that if 30% of obese are metabolically healthy, then 70% are not. I believe we would have more metabolically healthy obese if we put half the effort into encouraging more physical activity and better diet that we do into trying to modify body size.

    No, I haven't watched it yet, but there was enough in the trailer to object to. Hearing that my body weight is somehow going to crush the national into oblivion... yes, I have a problem with that. I have a hard time interpreting that as anything but a fear-based statement.

  • In reply to FatChickinLycra:

    Thanks for reading and taking the time to reply.

    Thanks for pointing that out. It should have read "elevated triglycerides result in excess stored body fat." Triglycerides are stored as body fat so that they can be recalled, converted to glycogen, and converted from glycogen into glucose. The problem is that most people never need to recall them for use as energy, so the stored fat just remains there.

    Not knowing you (and not knowing much more than what I've researched relating to my own condition), I don't know how to respond to your lipid profile numbers other than to say "that's great!" It's a testament to your healthy food choices (and good genetics).

    My argument - and I don't think I'm even being disagreeable, is that body fat is an indicator that there may be metabolic issues that warrant further testing. Statistics back this up, particularly the Bogalus Study featured in the film. I clarified my position in today's follow-up post.

    The documentary is not hype or fear-mongering - it's a snapshot of what is going on and a very fair presentation of all the factors. I highly recommend watching it.

    BTW - Good luck on the century ride - which one are you doing?

  • In reply to Brent Cohrs:

    Since I've never had elevated triglycerides, I'm not sure how I got fat, then. ;-) Although my genetics also tend to a bigger body size.

    Health comes in a greater diversity of body sizes than the BMI chart allows for, and that is the big issue I keep seeing. I believe that everyone -- thin, fat, or in-between -- should keep an eye on their lipids, glucose, blood pressure, etc. I believe every doctor should evaluate their patients for healthy/unhealthy habits, even if they are in "healthy" BMI range. From a population standpoint, yes, as you go up the weight scale you see more issues with diabetes and cardiovascular issues. I will not argue with that correlation, although I believe the causation may include other factors. On an individual level, the picture gets more complicated. By putting the focus on obesity, we miss the larger point that we have an epidemic of bad food and inactivity at all weight levels. We also make the mistaken assumption that if we simply get people to exercise and eat better that their body size will change. Dr. Arya Sharma has some interesting things on this point over at his blog. The Obesity Panacea also have some good, balanced discussion on health and weight issues (just so you know I don't get every shred of info from wild-eyed activists.) I don't know if I will have time to watch the entire documentary, but I will try to look up the study you mention, at least.

    I don't doubt that body size "may" be an indicator, but too often it is used as the be-all, end-all of health. Our end goal is to have healthy people, not necessarily skinny people, correct?

  • In reply to FatChickinLycra:

    Excellent points!

    Thanks for the references, too.

    It is sad that we live in a sound byte society where people have to make snap judgments in order to process complicated information. "Fat-bad, thin-good" is an example of this. It's a shorthand, stereotype that is dangerous for all of us to buy into.

    We are experiencing a bad food epidemic, as I posted in today's followup blog. (http://www.chicagonow.com/easy-as-riding-a-bike/2012/05/weight-of-the-nation-controversy-confusion-and-conflation/) For some strange reason, people are unwilling to recognize the correlation, let alone buy into it.

    A perfect example of this for me is when people ask me how I lost so much weight (35 pounds). "First, I gave up soda, then..." I rarely get past the "then" part. "I could never do that," is the usual reply and the conversation ends there. People don't want to sacrifice life's simple pleasures.

    Ironically, bicycling and other rigorous physical activities secrete similar endorphins and create the same dopamine effect as eating comfort food. If you can get to the point where you can substitute the healthy activity for the unhealthy activity, you find that overly sweet food actually tastes bad. Once you're there - declining desserts, drinking water, and enjoying fruit and vegetables - you don't want to or need to go back.

    We can all be healthy if we have the knowledge and the will to make the right choices.

    Thanks again for adding to the discussion and best of luck with all of your bike rides this year!

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    Hi Brent,

    Thank you for referencing my LA Times post about "The Weight of the Nation." I'm not sure where you got the idea that I used to be obese, but it is not true. I've never obese or overweight and I would really appreciate a correction.


  • Alexandra - sorry about that! I read a few posts in a hurry and that was my initial recollection - I'll correct it ASAP!

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    Thanks, I appreciate it!

    As for the question you pose in your piece: Perhaps Jamie Oliver is onto something? http://lat.ms/Kh2Kl7 Or Ruby Roth? http://lat.ms/IgVwxb

  • The obesity problem is not food. Until we look for the cause, or why are some people fat, we will never understand what obesity really is. I know most wont agree with me, but I have studied the "why" of obesity for over 30 years. It is NOT about eating, it is what the body does with the food. Strawberries are not bad, but some cant eat them because their bodies cant handle them (they break out in hives) the way most of us are able to handle them. Why do people like my husband eat a lot and never gain weight? Why do people like me eat right and exercised but still gain weight? It is a fact. I live it everyday of my life. I am not alone either. That is where we need to look, not at "good food bad food" and calories etc. That is why diets will NEVER work. We are looking in the wrong place.

  • In reply to fatology101:

    Thanks for reading and taking the time to reply.

    You're right, there is no single answer that applies to each individual universally. What works for one may not work for another.

    I will disagree with your statement that we don't need to look at "good foods and bad foods". Foods that are energy dense - high in added sugar - affect blood sugar, insulin, triglycerides, body fat, inflammation, and plaque buildup. They mess with your hormones and how your body creates and retains fat. Eliminating beverages and foods with added sugar will improve your health. Do a before and after lipid panel for proof, if you haven't already eliminated them.

    From there, it's a matter of finding the right amount of calories for your activity level and eating the right combination of macro nutrients for your metabolism. Foods that are nutrient dense - vegetables and whole fruits (with the skin on) will satisfy hunger and nourish your body without adding to stored fat. Focusing on whole foods and eliminating prepackaged, convenience, and prepared foods will add nutrients to your diet and allow you to burn stored fat for energy.

    It's not easy putting together good tasting meals that supply the right amount of energy you need, when you need it, but it can be done. Knowing what to avoid is the key. It will likely take a lot of experimentation to find the right combination but staying focused on whole foods and daily exercise will unlock your stored fat for energy and improve your overall health.

    Don't think of it as a diet - think of it as a daily eating plan. You're not sacrificing anything if it's ultimately causing your body harm. You're just substituting better quality food and retraining your body to process it in a way that is most beneficial to your body.

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    Spending time arguing about weight really has done nothing to achieve improved health. Personally we need to decide what matters most, size or health and then focus on that. Personally I have chosen the side of health and believe that when we are accepting of differences in size, shape, age, gender, ability when it comes to health then we are in the best position to evaluate the things that really count. Weight and talk of weight over-shadow everything else, to the detriment of all. This is neither health or healthy. The questions ought to be along the lines of what has happened in my family that might impact me? What behaviours do I need to improve in order to experience improved health now and in the future? And what is I need to know or learn in order to achieve these things? If I don't know about my family health history, then who do I ask? Have I had biochemical tests run to look at my markers and to monitor how my lifestyle is impacting? Do I need to see a professional to get help with nutriton, pain, sleep, stress, gut issues, mental health. Do I even recognise if these things are an issue for me? All these things are inter-dependent and it's about us taking care of and investing in ourselves.
    We need more ideas, suggestions, support to improve our knowledge and behavious regardless of our size. These messages are not exclusive to anyone group. So programs like WOTN might appear to do this but they really don't. They are tied up in agendas and profits and egos that rely on creating strong negative emotions to make their points. Again negative emotions are not healthy. Alarming, scareing, shaming and blaming are not health promoting emotions and seem to create further divide, discrimination and even more finger pointing.

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