I received an e-mail from reader Melissa who asked some good questions really respectfully, so I thought that I would answer them publicly. To be clear, when I talk about trolls and such, I’m not talking about Melissa, it just happens that her questions frame a larger debate that I and lots of other fat people deal with:
If study after study shows us a correlation between obesity and the so-called diseases of civilization, aren’t you curious about the potential causal link there? Some of the study authors may be doing bad science, oh yes indeedy, and I’m not implying that the way the media goes about reporting on these things or pushing the “beauty ideal” is the way to go. And I’m certainly not arguing with you that you can’t be fit—all evidence suggests to me that you are. Do you believe that obesity’s correlation with disease is unrelated to the obesity itself and may be a result of other choices that some obese folks make (such as not remaining as fit as you)?
First, there is a reason that “Correlation does not imply causation” is such an important fact. It is the most basic tenet of research. The problem with correlational research is that it only proves that things happen at the same time, it does nothing to prove that one thing causes the other, and if you can’t prove the cause then you don’t know the cure.
- The body size and the health issue could both be caused by a third factor
- They could be unrelated and so losing weight would just mean that they would just have the same problem in a smaller body.
- The health problem could be causing the body size and so weight loss would either do nothing or could even exacerbate the problem.
- They could caused by two different things and then neither issue is treated properly.
- They could both be side affects of a behavior, but the behavior change my help the health problem but not change the size of a person’s body – unfortunately that person may be labeled a “failure” because, even though they reversed their health problem, they “failed’ to reverse their weight.
These are just a few possible scenarios. I’m not saying a causal link is impossible, I’m saying that it’s not proven and that nobody seems to be too worried about finding out because they are too busy yelling “IT’S YOUR FAULT FATTY EAT LESS AND EXERCISE MORE!!’ Look at the comments these two posts on health and you’ll see story after story of people who received poor medical care because their doctor thought that weight loss was a cure-all. Hell yes I’m going speak out against this practice and point out every chance I get that there is NOT a proven causal link because lots of people, including medical doctors, think that there is and that lack of simple knowledge can kill people.
The media does an abhorrent job of researching stories about weight and health before they spread them far and wide and so a study wherein 3% of children lost weight on a diet gets the headline “Say Goodbye to Obesity”. The CDC retracted their statement that 400,000 deaths per year were caused by “obesity related disease”. The retraction stated that only 110,000 deaths could be connected and admitted that “the link was probably weak” but I’ve seen three stories this week that said that according to the CDC 400,000 deaths a year are caused by obesity – which not only ignores the retraction, but also the fact that nobody ever claimed causality except the media.
I’ve never said that I know the answers to these things, I’ve just pointed out that there is evidence that runs counter to the mainstream, and that people are running around acting like they know the answers when they don’t. And if the media’s numbers are to be believed, it’s putting the health of over a third of Americans (who are “obese”) at risk due to improper medical care.
There are thin people who have diseases correlated with “obesity” and “obese” people who don’t. I think that we need to stop looking at weight and start looking at health. We have the ability to evaluate health with everything from blood pressure cuffs to blood panels to VO2 Max scores, so there’s just no reason to look at someone and make guesses about their health based on their size. It’s just cheap, lazy medicine. Also, when we continually repeat that weight is the “reason” for health issues, it gives thin people a false sense of security that they are healthy as long as their bodies remain small.
I believe that health is a combination of genetics, access, environment, stress, and behaviors. I also think that people’s prioritization of their health and the path, if any, that they choose to get there is nobody else’s business. Telling people to lose weight to be healthy is telling them to do something that nobody can prove is possible for a reason that nobody can prove is valid and I have a problem with that. I don’t think that health is a moral, societal, or personal obligation but I do think that if someone is interested in greater health, the best chance that they have is to practice healthy habits. (Actually, statistically the best chance is to be born to wealthy parents with good genes in a city where they have access to robust healthcare but I assume if they’re reading the blog then that opportunity has either come to fruition or passed them by.)
I do not see how blaming everything on a ratio of weight and height and telling people that the solution to their problems is to give their body less food than it needs to survive so that it eats itself thereby becoming smaller and changing their height/weight ratio (despite a marked lack of evidence that that is even possible over the long-term, or that it will solve their problem if it does) is a better idea than telling people that if they want to be healthy they should practice healthy habits and then actually evaluating their health to check their progress.
Lastly I wanted to note that it might be helpful for ammunition against your detractors if you kept a food log for a couple of weeks and posted it. This, it seems to me, would be as great a testimonial for who you are and how you live as the lovely exercise photos. They may not all believe you’re telling the truth, but some might, and it’s possible that some will then question the old “calories in, calories out” canard. I think that’s a worthy goal.
No. I don’t try to prove things to people any more. I understand that you are well intentioned and where you’re coming from with this, but I’m not going to do it. I’ll post my food log and then I’ll have to deal with 1,000 comments and e-mails where people call me a liar, or tell me what I SHOULD be eating to lose weight, or offer to let me try their weight loss plan for free etc. I don’t feel like dealing with it and I don’t owe anyone an explanation.
This blog is not meant to be an exercise in persuasive writing and it’s not my job to prove anything to anyone, least of all my detractors. (To be honest, it wasn’t that long ago that 6 people, including my mom, formed the entire readership of this blog, so the fact that it’s popular enough to have detractors makes me kind of happy. Although, of course, not as happy as the fact that I have fans – I can’t even type that without smiling). I try my best to provide my well-researched, thoughtful, and level-headed (most of the time!) point of view that is outside of what the diet industry spends billions of dollars a year promoting. I doubt I have a single reader who agrees with everything I’ve ever said. Some people like my blogs about self-esteem and body size but disagree with what I say about science and statistics. Some people love my science and stats blogs but say that the self-esteem and body size ones are “fluff”. Some people get upset that I write blogs responding to criticism. All of that’s fine.
In blogging as in life, I think that the absolute worst thing that I could do is try to become what I think other people want me to be. Not only does it not typically work, but it would leave me in a place of being inauthentic which is way worse than being disliked or called a liar. So my detractors can detract away while my fans – like Melissa – can read this blog and others like it, ask questions, and have intelligent and interesting discourse. Yay us!
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