There are movements right now that, under the banner of respecting diversity or whatever, find being obese or overweight not only OK but also fashionable. They criticize fitness regimes, sometimes even claiming that such regimes commit violence (mental or otherwise) against people who do not fit the expected norm. How do you evaluate such movements?
Well, this is very interesting because there have been different times over human history when it has indeed been more desirable to be overweight. In ancient times or even currently, in societies where food is not plentiful, it would only be the wealthier or more advantaged parts of the population that would have sufficient calories and leisure time to be able to become obese. So, similar to having more financial resources nowadays, this was considered desirable. People might look up to that, even if, as we know with financial resources, just because you’re wealthy doesn’t mean you’re a better person — they often mean the opposite.
So, it is not out of historical context to have people consider obesity OK and fashionable. It is a matter of societal choice what is attractive and beautiful, which even varies today from culture to culture. It’s arbitrary.
What is more important, I think, is to understand that there are indeed health consequences to bearing extra body fat and being obese. That, at least in my view, should override societal considerations or personal preferences. We know that being obese increases one’s risk of developing a host of health problems including, perhaps most importantly, cardiovascular disease, diabetes, metabolic syndrome, and even such things as joint problems and worsened arthritic conditions that are not quite as obviously linked.
How robust is the science that associates weight with health? Is being overweight undeniably unhealthy?
It is undeniable that being overweight is unhealthy, but it varies quite a bit from individual to individual and from condition to condition. Sometimes, we only have hints as to whether it will affect you. I’ll give you a related health example.
We probably all know people who smoke cigarettes and live to age 99. They could easily say, “Cigarettes didn’t hurt my health. I don’t know. I’m not so sure cigarettes are bad for my health. I never got lung cancer or chronic obstructive pulmonary disease. What is this about smoking, Nonsense?” Cigarette companies might like that view, but we know from epidemiologic studies that it is quite clear that you are playing Russian roulette and taking your chance. Yes, you may be the 99-year-old, whose body is not as susceptible for whatever reason. We don’t understand all of those risk factors, but you might be the unlucky one who at age 40 gets lung cancer and dies a year later. Do you really want to take that chance?
You can say something similar, perhaps not as dramatic, for most cases of obesity, but we know that you increase your chance of diabetes by several folds by being obese. The more obese you are, the higher your risk of getting type two diabetes, to the point where if you are — what they used to call — “morbidly obese”, “severely obese”, or “class III obese” — where you approximately weigh twice what is considered a healthy weight — you’re almost destined to get diabetes.
Are you destined to get arthritis? Well, that is much more variable. The odds are less heavily stacked against you. The other consideration is: are you in a family whose members live till 99 and never get heart attacks or strokes? Well, then obesity might be less likely to harm you than if you were born to a family where even when they’re not obese, its members tend to have their first Myocardial infarction (MI) in their 50s. So, there are probably largely genetic differences in susceptibility to different diseases and the effects of excess adipose tissue. But the science is, by and large, fairly robust.
Is there racial bias or gender bias in obesity?
Yes, and I hesitate to call it actual bias, but there are some differences in average weight and, perhaps more importantly, the distribution of fat. We sometimes call, and the science is strong on this, abdominal obesity or visceral obesity — which is a tendency to gain weight around our bellies — the “male pattern obesity” because it does tend to be more frequent among men and among women. And we know that it is a more dangerous kind of weight gain. It is thought to be a more temporary storage location for fat in humans. So, if you quickly gained 10 pounds, you’re probably going to put most of it around your belly, whereas if you gain it more slowly, it will be more evenly distributed.
The classic female pattern of weight gain is not so much around the belly but around the hips and thighs and rear. Depending on the society, that might be considered attractive or not attractive, but it is a safer storage place for fat. Unfortunately, we don’t have the ability to tell the body where to put the extra fat when we gain weight. One of the good things is that often when we have extra belly fat and lose weight, it tends to come off the belly first; you won’t get skinny hips, but you’ll get a skinnier belly as you start to lose weight, which may frustrate people who wanted the extra fat around the hips to come off.
Anyway, that is one of the differences between men and women, although typically, when you become severely obese, the fat is all over. There are some racial and ethnic differences as well in where fat is distributed. So, you can call that a bias, or you can call it a probably largely genetically determined difference in different populations.
In the section ‘Overcoming Mindset Barriers’, you make an interesting point: “The second most common mindset barrier to success that we see is almost the opposite problem. Instead of rebelling against other people’s expectations of their weight loss, some people are choosing to lose weight because they are expecting the world to treat them better if they do. Interestingly, when people who hold this belief do lose weight, they are often surprised to find that the world does not necessarily treat them differently — which can in turn be demotivating.” Could you please elaborate on that?
Yes. I find this not to be an infrequent occurrence. Perhaps I can go back to the example I used earlier of wealth.
We have lotteries in the United States — I don’t know if you have such things in Iran. You buy a $1 ticket and you might wake up the next morning and be a millionaire or 100 millionaire. These prizes go very high. Let’s say you, my dear interviewer, are one of the wealthy ones and you buy a single lottery ticket and the next day, you’re worth $100 million. My expectation is that everyone would love you much better now that you are a 100 millionaire. Your employers at the newspaper may even say, “Please, please, don’t quit, we want you to continue working here” because they think you don’t care anymore. You can do what you want. You have freedom. And yes indeed, people might treat you differently.
If you lose weight as well, it might not be quite as good as winning $100 million in a United States lottery but it’s worth something in our culture. Again, it varies from culture to culture, but at least in the US culture, you would be considered somewhat more attractive. There are even studies in the United States that senior-level managers are very unlikely to be obese. So, there is some judgment of people based on their appearance, which is not that surprising. Someone who is considered attractive may also be considered more worthy of promotion.
In any case, the real world doesn’t always treat us that way. You lose weight and you think, “I am someone who no one has ever looked twice at. I was not considered attractive. And now that I’ve lost weight, am I more attractive?” Well, to some extent, it is one’s attitude towards others that influences how they view us. So, if you carry through life a view that you are not desirable or worthy of positive attention, then it doesn’t matter what you weigh or what you look like. You will be treated the way you think of yourself.
So, this is a trap, and the trap cuts both ways. Just because you’re obese does not mean you cannot be someone that people would look up to or find interesting or desirable. It is more how you present yourself and approach others. That is influential.
On the flip side, if you lose weight and you’re still someone with a low self-image, then you will not get the wonderful response that you might otherwise anticipate. So, the trick is to feel good about yourself for those things that are positive. They are usually completely independent of weight. Being smart, good, giving, loving, or kind has nothing to do with what your body mass index is. Give yourself credit for that.
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