Epidemics And Myths

Ezra posts about the rise of obesity in America, and the fact that there has been a decided uptick in obesity rates across the country over the last 15 years, in pretty much every county of every state. He uses this information as an argument against the set point theory, which is the idea that everyone has an ideal weight set point, and it's very hard to change that point.

Now, I'm fairly agnostic about the set point idea. I am also fairly uneducated about it, because, for reasons I'll get to in a bit, I don't think it's very important whether it's true or not. But I am assuming that it's a simplified caricature to say that it states that people have a specific weight which basically never changes. Because, both anecdotally and statistically, that is pretty clearly wrong. Most people get heavier throughout life. So I am assuming that the set point functions as a baseline which is very hard to get and maintain below, but that you can raise it if your weight gets and stays high for a period of time.

I know that, anecdotally for me, I have been pretty much stuck between 200 and 205 for quite a while now, 5 years or so. It seems almost independent of how I eat, how much I exercise, etc. I am certainly more muscular now than I was at the beginning of that 5-year period, and I *definitely* eat more healthily, but the weight seems to magically remain nearly constant.

Now, I've posted previously about my secrety identity as a fat lesbian in a fairly thin man's body, so I might be a bit biased on this subject. But I find very convincing the field of thought that says that obesity is actually not a significant risk factor for health. My authority in this field, although I haven't done enough reading to really know if he is considered an authority, is Paul Campos, who is a law prof at CU who has a weekly column in The Rocky Mountain News out of Denver. His book on the topic is titled The Obesity Myth, and is a very interesting read.

The main points of the book, and the anti-anti-obesity movement more generally, are that obesity itself is not a particular health risk and, in fact, being mildly obese is much healthier than being mildly underweight. His contention, which the statistics appear to bear out under serious regression analysis, is that the main risk is the modern American sedentary lifestyle. Now, under most circumstances, there is a good (negative) correlation between activity level and weight. But it's far from 100%; everyone knows that guy who never does a situp or goes for a run, but naturally has 6% body fat, and likewise there are plenty of people who exercise constantly, but still are defined as overweight or obese by modern medical standards.

The statistics appear to say that being slightly overweight (BMI around 25-28), but leading an active lifestyle, is in fact the best thing you can do for your life expectancy. I don't remember the details, but I remember the stats as being fairly convincing. The simplest fact is that, even as we have gotten fatter over the last 25 years, our life expectancy has continued to climb.

The problem, of course, is severalfold. For one, you cannot easily measure someone's activity level, whereas to measure their height and weight and calculate a BMI is trivially easy. So extracting this info from the statistics requires a much more intricate study. For another, it doesn't sell a lot of diet books or weight-loss drugs to say 'hey, ride your bike to work and walk a little more.' For a third, we have the cultural belief that 'thin is beautiful' and 'overweight is ugly', which complicates any story on the issue.

It remains to be seen what the long-term solution might be, but I strongly believe that, even if scientists discover a wonder pill that helps people shed pounds, it's going to be discovered that those who don't eat like shit and don't live a car-centered lifestyle are healthier, regardless of their weight.