AS MORE AMERICANS ARE FAT AND GETTING FATTER, SOME SAY IT’S POSSIBLE TO BE “OVERWEIGHT” AND STILL HEALTHY –AND THEY’RE WAGING A CONTROVERSIAL WAR FOR ACCEPTANCE
Living large: Some heavy people are waging a controversial fight for acceptance
‘‘You’re fat,” the doctor told Bridget Kelly, and it stung. It wasn’t that she hadn’t heard it before, at 5 foot 7 and about 195 pounds. But now Kelly, a 27-year-old roller derby skater, was in a doctor’s office. She’d spent hours working out with the Queen City Roller Girls, and complained of knee pain.
The doctor, in apparent disbelief, recommended more frequent exercise for Kelly, and Advil for the pain. “Once she realized how fat I was,” said the Town of Tonawanda woman, “she basically stopped paying attention to me.”
Kelly’s damaged knee tendons were eventually diagnosed by another clinician, but her respect for dieting never recovered. She’s going to keep eating carefully and exercising, she said, but never diet again.
Now she’s part of the “fat acceptance” movement, which preaches that people can look chubby, or even fat, and still be healthy. “Fat people make easy targets,” Kelly said. “Thin people get heart disease, too.”
The first fat activists, in the early 1970s, declared that “A diet is a cure that doesn’t work for a disease that doesn’t exist.” Decades later, the first part of their slogan remains true for about 95 percent of Americans who try to lose weight.
The second part is hard to swallow, considering news from the fat front. Americans are bigger than ever, exercising less, and public health authorities have declared child obesity an epidemic.
Despite everything, more and more people are talking about open rebellion against the American War on Weight. Whether they call it “fat acceptance,” “size acceptance,” or striving to be “healthy at every size,” they’re reconsidering what they thought they knew about what fat means.
Some believe the $60 billion-a-year diet industry, with help from the medical establishment, has scammed people into torturing themselves. To fight a pitched battle with their own bodies to conform to the society’s opinion of what they should look like, even if the DNA wired into their bodies makes it next to impossible.
“Weight itself is not a health problem, except in the most extreme cases,” writes Kate Harding, a fat acceptance blogger. Not exercising and eating junk food, Harding notes, causes health problems in people of all sizes. Other studies show a strong genetic predisposition for weight and report little connection between weight gain and poor health in moderately overweight people.
No wonder the War on Weight is on the evening news. Last week, Los Angeles officials said they were fighting youth obesity by temporarily banning new fast-food restaurants in inner-city neighborhoods.
Meanwhile, a study released last week by a University of Michigan obesity researcher suggested that about half of the overweight people in the country have normal blood pressure and cholesterol levels, while a startling number of trim people suffer from some of the ills associated with obesity.
The issue sparked debate about the ways we measure obesity in our society, and the conclusions often made about weight and health.
Behind the headlines and swelling statistics are millions of quiet struggles. Most Americans over 30 have decided to do something about their weight, one way or another. Many will only glimpse success, while a hard-core few will resculpt their bodies.
The big picture
What’s the least I can do to stay healthy? The eternal dieting question has answers, but one size does not fit all.
Scientists have turned out blizzards of dieting studies with surprising and sometimes contradictory findings. Diseases have long been associated with obesity, but proof that a bit of chubbiness makes people sick remains scarce.
What if stressing over your weight hurts you more than the weight itself? That may be the case for some dieters, according to a Columbia University study released in March.
Last year, “Rethinking Thin,” a book written by New York Times health reporter Gina Kolata, reviewed what researchers have been able to learn about dieting. Many dieters, Kolata reports, may be essentially limited to the weight range imprinted in their DNA.
On the Body Mass Index, a chart used to help decide if a patient is dangerously fat, Kelly is “obese.” Her rail-thin boyfriend David Kleinschmidt, at 6 foot 3, 135 pounds, is “underweight.”
“He and I eat basically the same amount,” she said, noting that the Body Mass Index does a poor job of adjusting for muscle mass. While she skates hard 10 hours a week during the Queen City Roller Girls season, he’s a lump, tapping away at his laptop.
But if you saw them together, who would you expect to be healthier? Kelly asks.
“He’s applauded for being so thin,” she laughs. “He makes no effort to do that, and he is probably less healthy than I am.”
Today, there’s no doubt that fat is adding a heavy load to health care systems too, said Ann Morse Abdella, executive director of the Chautauqua County Health Network. When Abdella sees overweight elementary school students who “basically can opt out of their gym classes and eat fast food every other meal,” she worries.
“Is that child going to more than likely end up with diabetes? Now we’re seeing diabetes in people in their 20s, 30s and 40s, when it used to be a disease that hit people in their 60s,” she said. “We’re accelerating the aging of our bodies with poor choices.”
That said, there’s also a better understanding that the number on the scale is just one part of the larger story of your health, Abdella said.
Given the example of a 205-pound roller derby athlete, Abdella said, “Here’s the question: Does she feel good? Does she just feel good when she wakes up in the morning?”
“Cosmopolitan wants you to be 5-10, 110 pounds,” Abdella said, “but it’s healthier if you can stop that noise in your head and focus on: Are you happy? Do you feel balanced? Are you eating the way you’re supposed to?”
“Health at every size” is a slogan aimed at getting people to focus less on the scale’s numbers and more on the big picture, said Abdella. Eat right, find physical activity that you can make part of your life, and avoid the extremes of bingeing and starving.
“You want to be searching for that balance,” she said. “It’s finding what works for you, finding what makes you feel healthy and fit.”
Diet AND exercise
For all the second thoughts about dieting, getting fat still depends on two variables: what you eat and how much you move, said Tina Colaizzo- Anas, a registered dietitian and professor at Buffalo State College.
“To effect significant weight loss, one must limit calories,” said Colaizzo-Anas. “Exercise alone won’t do it –you have to reduce calories, too. You need both sides of the equation to effect weight loss.”
It’s easier to skip a 140-calorie Coke than jog a mile and a half, though both rate the same on paper. “I don’t think people realize that,” said Colaizzo-Anas. “It takes a lot of exercise to expend a lot of calories.”
A former clinician, Colaizzo-Anas has seen attitudes toward fat and dieting change a lot, including the rise of the “health at every size” philosophy.
Once freed from counting calories and daily weigh-ins, some people respond well, she said. “There have been a number of studies that suggested dieting actually has a negative influence on weight-loss success, emotional health, etc.”
But the bottom line remains: Too much fat? Still bad.
“You can lower your risk with good diet and exercise,” said Colaizzo-Anas, “but you cannot neutralize the effect of your excess body fat.”
A blog boom
Whether its members call the cause “fat acceptance” or “size acceptance,” there are organized chapters in New York City, Chicago and Florida, but none here in the birthplace of the Buffalo-style chicken wing.
They meet online, though. Much of the movement’s growth has been centered around blogs like Kate Harding’s Shapely Prose (kateharding.net), Marianne Kirby’s the Rotund (therotund.com), and Paul McAleer’s Big Fat Blog (bigfatblog.com).
“Just because you’ve heard over and over and over that fat kills doesn’t mean it’s true,” Kate Harding writes. “It just means that people in this culture really love saying it.”
Such views are on the more radical end of the weight discussion, but milder versions of those ideas are taking root in unexpected places. Even diet industry titan Jenny Craig has noticed, launching an “Ideal Size” marketing campaign, focusing in part on women not normally shown as “AFTER” shots in diet ads.
Doing what you can
In the end, despite all the time, money and energy invested in dieting, we still don’t know how to convince people to avoid unhealthy choices, Abdella says.
We can’t even set health insurance rates to reward the do-gooders, she says. “I don’t get incentives because I exercise five days a week and eat a vegetarian diet,” she says. “We only pay for things that go wrong.”
A 20-year-old guy who registers his red 2008 Mustang has to pay more for auto insurance, because of the known correlation between young men, fast cars and wrecks.
“But when I’m 400 pounds and smoke three packs of cigarettes a day and have raging blood sugar, I’m going to pay the same amount in health insurance as you,” she said. “There’s no incentive to get that person to own some more responsibility for the life that’s being insured.”
On the other hand, she’s seen too many people whose quality of life was weighed out by the pound. “They do the yo-yo thing – lose the weight, then go off the wagon, feel terribly guilty and depressed –then they get it back.”
Abdella, 48, said she’s worked at controlling her weight for her entire life. Lately she’s been trying to drop a few pounds, an effort compounded by the effects of early menopause and sports injuries.
But she’s going to keep doing the best she can, Abdella said.
“It’s like people say, I wasn’t born with a Maserati body,” said Abdella. “I have a Jeep body, or a pickup truck. But I’m going to be one fine lookin’ pickup.”
