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I was fighting my own prejudices when I accompanied my son on a presurgery visit with the doctor. What should have alarmed me was the cursory way the doctor responded to our questions, and maybe the Sweet fat teasing he whined about health-care reform. But now, after two failed operations on my son's hand, I think I should have also paid attention to my deep misgivings when the doctor Sweet fat teasing walked through the examining room door—because he was fat. And I hate fat people. Yes, I know we're not supposed to say that. Hating fat people is like hating any other social group; it's good neither for the object of hatred nor for the people doing the hating.
Being fat is not a reliable indicator of incompetence, even among doctors who see the health consequences of obesity every day in their examining rooms. And given that two-thirds of Americans are now overweight or obese, you're liable to be in the position of hating your wife, your mother, your best friend, or your child, along with Santa Claus and Oprah Winfrey. And yet an awful lot of us hate fat people, and the fatter we become, paradoxically, the more we hate them us. In scientific studies, men say they would rather date a recovering drug addict than a fat woman.
Schoolchildren say they would rather have a friend who's in a wheelchair or who has a facial disfigurement than a friend who's fat. Obesity researchers actually have a Fat Phobia Scale, a questionnaire for determining weight bias. Even some nurses, who can spend much of their time caring for fat people, admit that they're repulsed by them. All those hurtful words about fat people leap to mind—lazy, unattractive, self-indulgent, shapeless—plus a few others the nurses might suggest, like "hard to roll over in bed.
Fat advocates, an increasingly vocal group, protest that hating fat people is the last socially acceptable prejudice. It infuriates them that obesity is a standard topic of comedy both low and high, from "Yo mama so fat" jokes to Shakespeare's "huge hill of flesh," Falstaff.
They argue that being fat is fine—even "flabulous. And they act, as I complained to a friend one day over lunch at a New York restaurant, as if it's the airlines' fault when seat 4E can't quite contain their bulk. Then we started to count the reasons for our hatred. Mostly it was because of the excuses. They blame their girth on bad genes or big bones. They blame fast-food companies or high-fructose corn syrup. They blame "social contagion. Blame Friends" a headline in the New York Times declared. Isn't it their own fault? Why not just say, "It's because of what I choose to put in my mouth.
It's because I fail to work it off"? Obesity researchers argue that our sugared-up, Whopper-hawking, Thickburger world "hijacks" and "subverts" the systems that ought to regulate eating and weight. But if our "obesogenic" environment really makes being fat almost inevitable, then how had my friend and I managed to stay thin? We had ordered Thai noodle sal, which when they arrived at our table turned out to be as big as haystacks. So were we skinny because we proceeded to pick at this astonishing mass of food instead of wolfing it down?
Was it because we had the sense to drink water with the meal, skip dessert, and fit plenty of exercise into our schedules? Was it, in short, our moral superiority, as we plainly liked to think? Or was it just dumb luck, a by-product of genes, upbringing, or living in neighborhoods where we could go for a walk without risk of a drive-by shooting?
It made me want to take a closer look at the attitudes and assumptions underlying our biggest health threat. Almost the first thing I learned, a little awkwardly, is that I am apparently one of the fat people. The body mass index BMIa quick ratio of weight to height squared, is the standard tool for measuring how fat we've become. You can easily calculate yours at nhlbisupport. But be prepared for an ugly surprise. Console yourself with the knowledge that the BMI is better at analyzing population Sweet fat teasing than assessing individual Sweet fat teasing.
It's also not very good at distinguishing fat from lean muscle. I row 7 to 10 miles three or four times a week. So I had assumed that I could let my weight take care of itself. But at 5'11'' and pounds, I had a BMI of That's well into overweight territory which is a BMI of 25 to 30 and not all that far from obese plus. Somewhere along the way, my shadow regimen of snacking and boozing had caught up with me. In the off-season, I count time on exercise machines according to how many India pale ales I burn off.
My waistline had spread to 39 inches, and I had not seen the maximum normal weight for my height, pounds, since my college days. Like most people when they hear they may be fat, my first response was denial. I don't look fat—or at least I don't think I do. But this may just be the insidious way fat works: As everybody else gets fatter, studies suggest, our perception of what's fat also creeps upward, and fat starts to look okay.
It's like having beer goggles on. It's only when we wake up in some leaner country, like France or Japan, or when we look at snapshots of random Americans from side by side with snapshots of random Americans fromthat it dawns on us: "Oh my god, how did we ever let this happen? Or maybe it's not. The second stage in my denial took statistical form. In the course of an interview at a high-calorie, low-budget restaurant, a prominent food researcher leaned across the table and confided that a lot of people who are now deemed overweight would have been classed as normal a few years ago.
When I repeated the overnight-change idea to William Dietz, M. Under either BMI standard, old or new, I'd still be fat, and chances are, so would you. The U. The CDC says that's an apples-to-apples comparison, not a result of mixing old and new BMI standards, as fat-acceptance advocates sometimes allege. Moreover, the rest of the world is tagging close behind.
Our Sweet fat teasing could plausibly, if illogically, admonish us to clean our plates because of the starving children in China. But today, likely for the first time in history, the overfed out the underfed by a large margin: There are 1. After denial, the usual next step in coming to terms with an unpleasant idea is anger, and there are plenty of reasons to be angry about fat.
It's not just an epidemic—a pandemic, really—but a monster whispering sweet things in our ears while sticking us right in the gut. Dietz estimates.
That's 10 percent of the nation's total health-care bill, due mainly to the chronic disorders linked with obesity, including diabetes, coronary artery disease, congestive heart failure, hypertension, stroke, osteoarthritis, sleep apnea, depression, and certain cancers among them larger and more aggressive prostate tumors, according to a new study. Taxpayers pick up half that cost through Medicare and Medicaid programs.
Childhood obesity used to be rare, Dr. Dietz points out. But today, obese year-olds are diagnosed with type 2 diabetes often enough that doctors have stopped calling it "adult onset" diabetes. Extremely obese teenagers can be candidates for coronary artery bypass surgery. Sweet fat teasing means they'll run up higher-than-normal medical bills in the usually low-cost young adult years. Being obese also means they'll face diminished prospects for a normal life in almost every regard. Studies have repeatedly shown that an obese job applicant is less likely to be hired than a normal-weight applicant with identical qualifications.
Even if the obese candidate is hired, he or she is less likely to be promoted and receive a raise. That's partly fat bias in action. That puts families, companies, and the nation at an economic disadvantage. In the past, a stocky kid who couldn't find a job could still the military.
But even the military now turns away 27 percent of young adults because they are "too fat to fight," in the words of a report recently issued by a group of retired brass. Obesity, the report asserts, is "an epidemic Sweet fat teasing threatens national security. The final stage in coming to terms with an unpleasant idea is acceptance, and a lot of voices now say that's how we should deal with obesity. Just like there's nothing wrong with being short or tall, or black or brown," writes Marilyn Wann, whose book Fat!
They are birthright. They're beyond cures or aesthetics. They provide the diversity we need to survive. People need to forget about Sweet fat teasing, she argues, and focus on their health and fitness. And she's right, up to a point. But she also apologizes for being out of breath from making her way to the phone. Wann won't even use the word "obesity" because "it medicalizes normal diversity. It's how everybody else reacts to it: "So if a fat person receives poorer quality health care than a thin person does, that might have an effect.
If fat people live in a society that's stigmatizing and discriminatory, we know that discrimination has a profound effect on people's health. These are accurate descriptions of the status quo. But they glaringly omit any hint that individuals themselves should take responsibility for staying within even a given range of weights. In the worldview of fat acceptance, fat people can jeopardize their health by trying, and failing, to lose weight.
Efforts by government to reduce obesity rates are "a eugenics project," a way to "eradicate fat people from society. According to fat-acceptance advocates, the abundant medical evidence that obesity itself is killing fat people is just part of the Big Lie. Robison, that rare creature, a normal-weight American, argues that prejudice against fatness has "biased the science into saying things about the relationship between health and weight that are not supported by the research. He acknowledges that people who have a higher BMI are more likely to develop type 2 diabetes.
In fact, about 55 percent of newly diagnosed cases are obese people. But that doesn't mean that 55 percent of obese people are diabetic; only about 15 percent are. So obesity doesn't necessarily cause diabetes, he argues. It's just a correlation, and having the condition doesn't warrant the recommendation of weight loss as a remedy. That doesn't mean if you give a bald man a toupee you lower his risk. By way of suggesting that some fat people can be healthier than thin people, Robison cites a study published in the Archives of Internal Medicine.
One of the study's conclusions was that a quarter of normal-weight adults were "metabolically abnormal," meaning they had multiple cardiovascular disease risk factors.Sweet fat teasing
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The Fat Trap