Trend towards fat acceptance bodes ill for future well-being
LOOK around and chances are you’ll see that more than one adult in three is overweight or obese. Perhaps you are among them and you’re thinking, “That’s okey, I’m no different from anyone else, so what’s the point in waging yet another losing battle against the bulge?”
You are not alone. A subtle form of peer pressure has convinced many, consciously or otherwise, that it’s acceptable to be significantly heavier than the “normal” weight ranges listed on a body mass index or doctor’s height-weight chart.
As Americans have gained extra kilos in recent decades, Mary A Burke, an economist with the Federal Reserve Board in Boston who studies social norms, says they seem to have adjusted to a new normal regarding weight.
A study she and co-authors published in 2010 revealed that a growing proportion of overweight adults – 21 of women and 46% of men (up from 14% and 41%, respectively, in the 1990s) – consider their weight “about right”.
And a study published in JAMA medical journal last year found that fewer adults who were overweight or obese were trying to shed excess pounds.
Public health experts fear that this trend toward “fat acceptance” bodes ill for future well-being and the soaring costs of chronic weight-related ailments like heart disease, hypertension, Type 2 diabetes and more than a dozen kinds of cancer.
As Burke wrote in a recent issue of JAMA devoted to obesity, public health and medical professionals worry that “individuals who do not believe they are overweight, or who view obesity in a positive light, are less likely to seek treatment for weight loss”.
In an editorial in the JAMA issue, Dr Edward H Livingston, bariatric surgeon at the University of Texas Southwestern School of Medicine, suggested that perhaps a different message – one that encourages physical fitness – would do more to improve the health of individual patients and the overall population “than continuing to advise weight loss when that message is increasingly ignored”.
Indeed, as one team of specialists put it in JAMA, “Low cardio-respiratory fitness may pose a greater risk to health than obesity”. The team, headed by Ann Blair Kennedy of the University of South Carolina School of Medicine, cited a 2014 analysis showing that, compared with normal-weight people who were physically fit, unfit individuals had an increased risk of death regardless of what they weighed, and those who were fit and overweight or obese did not face a significantly greater mortality risk when compared with normal-weight individuals.
But before you give up trying to lose weight, a better understanding of the likely sources of those extra kilograms and the most successful approaches to losing them may help you achieve a double goal: more fitness and less fatness.
Several decades of commercial weightloss diets, ranging from the Drinking Man’s diet to the low-carb Atkins diet, each claiming to be the best way to get rid of unwanted fat with minimal or no sacrifice to taste and satiety, tempted those struggling with rising poundage.
Most, however, involved a radical change in people’s eating habits that was rarely sustainable. After a while, dieters returned to their old habits and regained the lost weight, often more than they had lost in the first place.
As Livingston said, “Providing patients with the false hope that if they only reduce one class of foods or another (for example, carbohydrates or fats) they will lose weight can become frustrating, and may in part explain the failure of most diets.”
Even reducing consumption of sugar-sweetened beverages (which provide no nutrients beyond sweet calories), he wrote, “is not likely to influence obesity at the population level”, which has continued to increase even as cooldrink consumption has declined.
Rather than a cooldrink tax, Livingston endorsed taxes based on the calorie content of foods, and using the revenue generated “to subsidise healthy foods to make them more affordable”. Noting that “the common denominator for all successful diet plans is calorie reduction, irrespective of how that is achieved”, he said. – The New York Times