How Many Epidemiologists does it take…
… to declare an Obesity Epidemic?
According to this article in the International Journal of Epidemiology, none.
ZOMG! IT'S AN EPIDEMIC!!!
Apparently, according to this article, in a peer-reviewed epidemiology journal, the obesity panic is not an epidemic. The authors surveyed research in the field of “ZOMG! ALL YOU FAT FAT FATTIES ARE GOING TO DIE FROM DETHFATZ!!” and have found that the data does not bear out the label of “epidemic.”
The article then goes on to further discuss the four main selling points of the obesity epidemic, and why current research in the field doesn’t bear out those selling points. What are these selling points? I’ll lay them out.
Point 1: All countries are experiencing an obesity epidemic or substantial trend upward in weight. Which is crap. The US has had a slight upward trend, but nowhere near enough of a gain to be considered an “epidemic” by any sane measure. Also, the increase appears to have tapered off in the last ten years or so. No data was presented for other countries in this article.
Point 2: Being overweight is an accurate predictor of mortality. It isn’t. Yes, people at both extremes of weight (very underweight and morbidly obese) are at higher risk for mortality. However, the research does not bear out that being overweight or even obese puts one at any greater risk for death, and some studies have found that being overweight may help the elderly recover from certain types of medical events. Also, there have been very few studies done on why there may be a correlation between extreme (morbid) obesity, and death, just as there have been few studies of why extremely thin persons are more likely to die. The few studies there are have not taken into account factors other than weight, such as diet drugs, yo-yo dieting, laxative abuse, bariatric surgeries, and other “interventions” the overweight and obese frequently put themselves through in order to “get healthy.”
Point 3: But we KNOW that fat and death are totally linked. Actually, we don’t. There is some correlation, but that is not the same as causation, and like I said above, most studies don’t take other factors like histories of yo-yo dieting, diet drug use and the like into consideration. They just go, “Oh, look, dead and fat. Yup, it was the fat.” (Yes, I’m exaggerating somewhat, but sometimes that’s what it seems like.) There is also the fact that many of these studies don’t ever consider that sometimes the fat is a symptom of the real cause of death. More and more evidence is pointing towards fat being a symptom of someone being pre-diabetic and diabetic, rather than the cause.
I realize this is anecdata, however, it is indicative of the persistent bias against the fat in the medical profession, which bleeds over into the research. I went to the doctor, because in spite of having cut high fructose corn syrup out of my diet, and not changing either my calorie in-take or exercise levels, I had started gaining weight, and was evidencing some other weird symptoms like hair loss on my head, and excessive hair growth elsewhere. My blood test numbers (blood sugar and cholesterol) had remained the same (excellent), and my blood pressure remained, as always, low normal. When I asked my doctor about this her response was, “Well, quit drinking soda and exercise more.” When I responded that I didn’t drink soda, and that I didn’t think my hair loss was caused by being fat, she got exasperated with me and announced that I obviously had PCOS* and she’d put me on metformin if I really wanted. Well, no, I really didn’t want that. I wanted an answer to what the hell was wrong with me, and didn’t get it. When I brought up my mother’s history of thyroid issues, she blew me off, told me it wasn’t my thyroid (no test)**, and said that I was in danger of being labelled non-compliant for my “refusal” to lose the weight.
I left in tears.
However, this brings me to Point 4: The pervasive belief that long-term weight loss is an achievable goal for the majority of the population. Most studies on long-term weight loss have found that about 5% of the population can achieve and maintain a substantial weight loss for five years. Not forever. Five years. There isn’t much, if any, data past that. The other 95% of us are shit out of luck for even that small an amount of time. The truth of the matter is that we don’t know how to make fat people skinny. A change in diet and exercise will usually result in a moderate or small change in weight. And just as we don’t know how to make fat people skinny, we don’t know how to make skinny people who are just naturally skinny, fat. You can make them eat more than they normally would, and they might gain weight for a little while, but it won’t stay.
Does this mean you should, as a lot of the straw man arguers that come here accuse me of saying, just give up and mainline a sugar and lard mixture and never leave your couch?
Well, no. Because getting exercise and eating food that is actually food and good for you will make you feel better. It will increase your health and energy levels and bolster your immune system, which should be enough of a reason to do it for anyone. And if we lived in the sort of world where people actually gave a shit about your health, as opposed to your looks, I’d be riding to work on a lavender unicorn named Lancelot every morning.
Because this society is concerned with “form over function” no matter how fit or healthy you are, if you aren’t thin, people are going to be assholes to you. I hate to say it, but it’s true. And no matter how healthy you are, even your doctors, people who should fucking well know better, are going to tell you that you engage in dangerous practices (diet drugs, severe calorie restriction, bariatric surgery, self-imposed ketosis) to lose weight for “your health.”
*I’m reasonably convinced that the labeling of syndromes is actually the medical profession saying, “We really don’t care what’s wrong with you crazy bitches, and can’t be assed to look for the actual cause, so we’ll call it a syndrome and throw some pills at the symptoms to shut you up.”
**I did finally harass her into ordering a test, and my levels were normal. So, in this one instance she was right. However, when she sent me to an endocrinologist, not only did he not think I had PCOS, he said there was no sign of pre-diabetes (like she’s been telling me I have for several years) and when I laid out the changes my husband and I had made in our diet since he was diagnosed with diabetes, asked me if I would come lecture his Intro to Diabetes patients about how to do it.
Polimicks 
Wow – what a great article! I think I just read half of it to my husband without really meaning to. (You know how you read one sentence aloud to the person you’re with… and then the next one is so interesting you have to read it aloud too… and then the next one… Yeah. Like that.) Thank you very much for the pointer.
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This was really great, thank you. Lexica and another friend directed me here because of the solid debunking you did in this post. 🙂
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