Everything They Know About Obesity is Wrong—But I Knew Better
Huffington Post published an incredible article about the effect weight bias has on the lives of everyday people, titled “Everything You Know About Obesity is Wrong,” and you need to read it.
I posted part of this on Facebook, but there was so much about the article that I wanted to point out, that I needed to bring it here and just go in for a while. I don’t get to do my “I told you so” song and dance often, so clear the floor while I break it down right quick.
Everyone is talking about this article, and rightfully so. People are gravitating towards large chunks of it, specifically talking about fat-shaming in medicine and inadequate health care because of the obsession with bringing patients to task about weight. If I’m there to talk about cysts, I don’t want to spend ten of the fifteen minutes I’m with you talking about my weight. I’m not paying you all this money for that.
But I’d like to draw attention to a few really specific and, I guess, more nuanced points that get lost in the sauce of the tears, the anger and, really, the feeling of “being seen” by this article:
1) I said, years ago, that personal trainers are not weight loss experts, and I got ALL KINDS of shade. Like, passive aggressive shade, at that. Well, guess what? I was right. They’re *not*. I have my certifications, and have had them for years. They’re not taught anything about *weight loss* beyond calories in vs calories out.
So let me make you even madder: Neither are doctors. I know the average doctor is a tinge too narcissistic to believe there are limitations to what their MD can advise on, but they are ill equipped to discuss what’s happening in the current food climate. This article reflects that pretty clearly.
2) The article mentions that *no* nation’s obesity rating has decreased. Like, ever. In the back of your mind, consider the fact that American food manufacturers are exporting our processed food industry to other countries in an attempt to cultivate a larger fan base. The NYT has a series, inappropriately titled “Planet Fat,” that discusses what happens in countries like Ghana, Brazil, India, and Chile when processed food from multinational corporations makes it way there. That article on Brazil is a *real* doozy.
3) People keep trying to make obesity an argument about genetics, trying to couch it under “nature vs nurture.” This is and always has been weird to me. Nurture IS nature, and vice versa. Those little 3-to-6 year olds who “worry about being fat” didn’t learn that from just anywhere—they learned that degree of body anxiety from their parents, often (unfortunately) the mother. And, that anxiety has the potential to change their relationship with food in ways that can undoubtedly create the problem that results in them sitting in the doctors office, ashamedly admitting that their mother had a weight problem too; at which point, the doctor goes “oh so it’s genetic.”
If you’re eating in response to anxiety, anxiety you developed in response to a parent constantly harping on your weight, what do you think happens in adulthood? A completely mentally healthy with no anxiety issues, disorders, or weight problems? It’s possible, but it’s not where I’d bet my money.
Portions of obesity might have to do with genetics—I’m not debating that. But I’m saying that’s overblown. There are behaviors that we learn from family which, as a family, contributes to us all experiencing the same consequence. I’m not focusing on the size—I’m focusing on the learned behavior, here. Because it’s worth pointing out that, over the years, I’ve had *countless* women come to me talking about how they developed eating disorders because of trying to manage their weight in the face of learned compulsive behavior.
4) The article refers to metabolism with a very traditional understanding that I’ve been writing about since I began this blog. It’s something that people frequently screw up.
Here’s the quote:
Since 1959, research has shown that 95 to 98 percent of attempts to lose weight fail and that two-thirds of dieters gain back more than they lost. The reasons are biological and irreversible. As early as 1969, research showed that losing just 3 percent of your body weight resulted in a 17 percent slowdown in your metabolism—a body-wide starvation response that blasts you with hunger hormones and drops your internal temperature until you rise back to your highest weight. Keeping weight off means fighting your body’s energy-regulation system and battling hunger all day, every day, for the rest of your life. [source]
So, describing the mechanics of metabolism as “biological and irreversible” strikes me as excessively dramatic. It’s not that it’s ‘irreversible’—more on that in a minute—but it is undeniable.
Metabolism is little more than “the amount of energy required to maintain the processes that keep a living being alive.” (Much more on that here.) Every cell in your body utilizes energy in some way either in its generation, it’s maintenance, or its breakdown. If there are fewer cells, or smaller cells (in the case of fat cells), then fewer units of energy are necessary to maintain that being’s existence, hence the decrease in measured metabolism.
Some kinds of cells require more energy for their maintenance than others, as is the difference between muscle fibers and fat cells. (More on that here from PopSugar; I wrote about it here.) Muscle fibers are more active—and, thus, require more energy—because there are more processes involved with them.
Most people lose weight through measures that force the loss of muscle as well as fat, usually through excessive cardio with no real effort for replacing muscle that was lost, which dramatically lowers metabolism. Caloric deficits that are too steep wind up losing lots and lots of muscle and, therefore, lots of your metabolism. This happened to me at one point, and I blogged about it. When the research surrounding the inability of some Biggest Loser contestants to maintain their losses blew up on the Internet, I blogged about it then, too. This isn’t some penalty for losing weight—this is literally just how metabolism works.
You’re not being “blasted with hunger hormones”—your body has a specific call-response cycle that involves very specific foods in very specific quantities, giving you very specific feelings, and without that cycle and strategic efforts to separate yourself from that habit, you will dive nose-first back into it. It’s also not about it happening “until you’re back at your highest weight”—it’s about your habitual and compulsive behavior resulting in you being back at that weight, specifically and precisely because a person indulging in that behavior and consuming that amount of calories would weigh that amount.
5) Also? The language of “starvation” is extremely problematic to me—every effort to reduce calories cannot be written as “starvation,” and this is something I frequently see in anti-weight loss content. A feeling of starvation can happen in the midst of a binge eating session containing thousands of calories, and a feeling of satiety can happen even when someone is in a nutritional deficit. And I don’t say that as some rebuttal to what is clearly a community’s desire to protect itself from the normalized comfort with ‘starvation’ often found in pro-anorexia content on the web and in the world. I get it. But I think that normalizing every understanding of a deficit or decrease as “starvation” also serves to normalize some of the most harmful ideas in our current food climate, one of which being that all calories are equal. Not all calories feel the same when we eat them, not all calories have the same ability to be equally filling, and not all calories contribute to the same processes in the body. It’s subtle, but I see it and it squicks me out.
6) This is why diets don’t work.
Pay special attention to the fact that the only successful measures referenced in the article were the ones that included therapy. Not because ‘fat people are crazy,’ nor should you view it that way, but because overeating is a compulsive behavior, just as gratifying as gambling or shopping or—yes, as past research has noted—cocaine. That’s because compulsive behavior is an escape from anxiety, and anxiety is soothed and ameliorated by the temporary satisfaction of compulsive behavior.
And that’s why fat-shaming doesn’t work—it creates an anxiety that can send a person right back into compulsive eating behavior. That’s also why the only thing that DOES work is self-compassion and empathy—because nothing pulls a person from the brink like being reminded that they are, in fact, human.
But y’all already knew that. Or did you?
Rea the article, then let me know your thoughts.