Is Fit and Fat Really a Myth?

news liesRecently some studies have come out that suggested that the idea that you can be fit and fat is simply not true.  I was going to do a take down of the study, but thanks to the days I took off for the marathon and recovering from the marathon (hey have I mention that I completed a marathon?  :) ) other people including Glenn Gaesser of Dr. Oz Fame, and the brilliant Deb Burgard have already broken it down beautifully (though the picture leaves something to be desired.)

I will say that what immediately stuck out to me as the biggest issue was that they didn’t control for cardiovascular fitness, even though the other studies about fitness and fatness (Wei et. al., Matheson et. al., the Cooper Institute Longitudinal Studies), cardiovascular fitness was shown to make the difference in relative risk of all cause mortality and health hazard ratios. As Dr. Gaesser put it “This study, statistically speaking, assumes that all fat people, all thin people and everyone in between are of equal fitness, equal physical activity levels and have the same diets.  And that’s just an absurd assumption.” Tell it, Dr. Gaesser.

To me there is a much bigger issue media who are happy to report the results of weak research as hard and fast news, adding a extra layer of crap with their inflammatory and misleading headlines.  Though that’s just the tip of the iceberg here.

No study on weight and health can control for the effects of the constant stigma, shame, and oppression that fat people deal with.   This is a big deal.  Diseases that are correlated with obesity are also correlated with being under a high level of stress over long period of time. Like, for example, the stress of having your government declare war on you for how you look. So in order to even start to prove that fat causes diseases, there would need to be a control group of fat people who have not suffered a lifetime of stigma to see if their disease incidence was the same as the first group. Except that no such group of fat people exists in this culture.

Also, they can’t control for the effects of dieting.  Yo-yo dieting has also been correlated with some of the same diseases correlated with obesity, and I to wonder if a lifetime of dieting -  spending a large part of your life feeding your body less food that it needs to survive in the hopes that it will eat itself and become smaller – may have some long term health effects.  In order to start exploring that we would need a control group of fat people who hadn’t dieted, again an extremely difficult group to find in this culture.

Let’s remember that what the research is doing is seeking correlations based on a physical characteristic – in this case a ratio of weight and height.  This research is undertaken on the basis that weight can be changed and that making a fat person into a thin person will give the fat person the same future health outcomes of a thin person.  Even if body weight did cause health problems and earlier death (and I’m certainly not convinced that it does) and even if we had some way to successfully suppress a fat person’s weight long term (which we currently don’t), it still might not make any difference.

Men have shorter lifespans than women but we don’t recommend sexual reassignment to change that.  Tall people have shorter lifespans that shorter people but we don’t suggest that we try to make tall people shorter.  Men with male pattern baldness have a much higher risk of cardiovascular events but giving them hair plugs won’t reduce their risk of a heart attack.  Different people have different health outcomes for various reasons, but trying to make everyone look the same as a way to equalize their health hazard ratios and relative risks of all cause mortality is probably not the best way to go.  Plus this is all based on the idea that our body size is completely within our control, which is not supported by the research.

In order for us to discuss weight loss as a cure, preventative, life-extender etc. we would need first have to have some evidence, some reason to believe, that weight loss is possible.  Not just studies where the average participant loses 5 pounds in two years, but studies that show that people can move from the “overweight” and “obese” categories into the “normal weight” categories and stay there.  We would need a study where more than a tiny fraction of participants were able to achieve and maintain that weight loss long term.  No such studies exist. In fact, the vast majority of people fail at weight loss, including a majority who experience weight gain – so if fatter people die sooner then the worst thing we can do is recommend weight loss attempts.

If I were the underpants overlord the media would discuss study limitations in every article and would do better than a sensationalism of the research under an even more sensational headline.  Until then, it’s up to us to ask questions, remember limitations and critically examine what we read.

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Published in: on December 7, 2013 at 5:59 am  Comments (34)  

34 CommentsLeave a comment

  1. Reblogged this on Sly Fawkes and commented:
    As I pointed out in a comment on one of these articles, slender people are at a higher risk for osteoporosis than people with larger body types, but one doesn’t find slender people being admonished to eat more so as to circumvent the risk of osteoporosis.
    The only thing that I really took out of these types of articles is that they are, as usual, saying that if you’re fat you’d better not accept yourself, because no matter what you do, you will not be acceptable.

  2. I’ve seen the bad effects of lifelong yo-yo dieting. I’m convinced that’s what killed my mother when she was only 54. She’d been dieting for most of her life, starting at age 8, and it damaged her.

  3. I had access to the study and editorial. Interestingly, in the editorial they state that cardiorespiratory fitness is a strong indicator of mortality independent of BMI. What they were comparing (or trying to) was only based on metabolic markers. Alas, the news outlets trumpeted it as “fit and fat is a myth!”

    That said… unfortunately, most of the studies they chose to use for the meta-analysis used the presence or absence of full-blown metabolic syndrome as an indicator for “healthy.” You can have one or two significant risk factors without passing that bar. So they weren’t actually comparing perfectly healthy people to perfectly healthy people.

  4. It is very important to remember that the real study in any of these cases almost never really says what the sensationalized headlines say, as Sandy Szwarc always warned us about & it is also important to do research & find out who conducted the study &, more importantly, who PAID for the study. Those in the pharmaceutical industry hawking diet drugs & others in the weight loss/bariatric surgery industry are most often behind this kind of nonsense. When people are in a business raking in over 60 billion dollars every year by selling fear & self-hatred, they don’t want anyone upsetting their apple cart with the truth.

    The closest thing to a study done on fat people who are not stigmatized was done in Samoa long ago by anthropologist. As I expect most of us know, being fat & growing fatter with age is quite natural, quite a part of the genetic makeup of Pacific Islander peoples. While I expect that ‘progress’ has somewhat negatively affected their laid back, accepting outlook by now, back then fat people had NO increased risk of heart disease, stroke, diabetes, or ANY of the health problems modern culture loves to blame on ‘obesity’, that lovely made up ‘disease’. And judging from the large number of us fat people who are already old or well on the way to getting there & the large number of fat people who are or have been very old, I seriously doubt that being fat has any negative effect on health, in & of itself, & it is shown to be protective of health in many ways, especially as we age. I also do not think that the rise of the obesity panic has coincided with the aging of my generation, the baby boomers, the largest single generation in the history of this country.

  5. Sorry..I meant that I did not think it is a coincidence that the rise of this panic has coincided with the aging of my generation. People almost always gain some weight with middle age & menopause, until they grow old enough to start losing a little bit with age-related ‘wasting’, so we are a huge market for the vultures.

  6. It seems to me that in addition to the Samoan study Patsy mentioned, there was also a study of an American group sometime in the middle of the 20th century. For some reason, this one small group was kind of cut off from a lot of things, they were almost universally fat, and they kept living really long lives. As I recall, the big difference between them and other fat Americans was that they faced little if any social pressure to become thin.

    Does anyone out there remember any details on this group and the study done on them?

    • Here, the Rosetans: http://junkfoodscience.blogspot.ca/2008/02/i-think-therefore-i-am-part-one.html

      • Ooh, people who feel happy and socially accepted live healthy lives? What a silly idea! *rolls eyes*

        What on Earth would happen if we could stop marginalizing everyone who didn’t fit a certain profile. Possibly the sun would explode.

        I personally have a fondness for cheesy holiday movies, but so far, they are ALL about white middle-class youngish, thin, heterosexuals.

        It actually gets kind of depressing after awhile. I know this is true for movies and tv shows in general, but it especially bothers me when a holiday supposedly promoting joy and love is depicted as only for being for certain people.

    • Thanks for mentioning that, Twistie. I believe they were a community of Italian Americans who lived in their own small community & remained remarkably healthy, happy, & long-lived by living their own way & largely ignoring the culture around them. Maybe we would all be wise to follow their example.

  7. You know, we can cure all age-related diseases by killing people off while they are still young, like they did in Logan’s Run.

    • That is another good point. As someone who is definitely aging (well, everyone is from birth, but it becomes more noticeable at my age), I am so sick of this culture which promotes & profits from the idea that aging is a disease, instead of a normal, natural process.

  8. The biggest problem I see with research like this (aside from the assumption that correlation equals causation, of course) is that they all appear to start from a perspective that fat people cannot be healthy and it must be disproven that it’s even a possibility. I’d love to see someone set out to see if they can find fat healthy people and what the correlations are in that situation — although I doubt that there would be a lot of money in that sort of research, so I’m not holding my breath.

    Also, I’m sure there are a ton of health “experts” that would call me simple for saying so, but until you can prove to me that no thin person (especially no thin person with metabolic issues) has the problems associated with the “disease” of obesity, why would I even bother? Not only is there no guarantee I can change my body that way, but there’s no guarantee of better health if I did get there.

    The only true health advantage I can see of becoming thin is that my real issues would be taken more seriously by medical professionals — but that really shouldn’t be my problem to fix in the first place.

    • Natural blondes have a higher risk of macular degeneration than brunettes or redheads. I don’t see anyone suggesting they solve this problem by dying their hair, and I definitely don’t see anyone desperately and angrily insisting they have a moral obligation to dye their hair regardless of its efficacy so they don’t “glorify blondness” and “make other blondes too comfortable with their unhealthy hair color.

      • I had no idea about blondes.

        • Well… considering how well studies like the one quoted in this article hold up to scrutiny, perhaps I should have said “a few reports have shown a correlation between naturally fair hair and macular degeneration, bearing in mind I have not personally read those reports, and for all I know, they were just as or even more deceptive and reaching than the one we’re talking about. It’s another like the examples Ragen gave; we don’t hear about guys with male pattern baldness being pelted with garbage when they leave the house, or tall people getting regular catcalls of, “If those pants are too short for you, just lose height!”, or blondes being told to cover that disgusting hair because nobody wants to see that… and we don’t hear those things because fat hate isn’t really about health, and it wouldn’t have mattered if this study were as conclusive as they want it to be or even less than it already is. Health is not what fat hate is about. It’s just a convenient excuse for it.

          • Now I feel like I should add a disclaimer, just in case I didn’t word this so well, that I do not mean blonde hair is disgusting, but am referencing the “Cover your disgusting fat body! Nobody wants to see that!” line we’ve probably all gotten for wearing anything other than jeans or sweatpants. I myself am fair-haired.

      • This reminds of a thing I saw on Yahoo News the other day, a very minor thing, but amusing to me personally, which claimed that redheads go grey younger than blondes & brunettes. Now, I doubt that anything is universal for everyone & I suspect that this all has more to do with genes than anything else, but I am a natural redhead, I am 64 years old, & from my own observations as well as from what I have been told by those who cut my hair, I don’t have a grey hair in my head, & the other redheads in my family have not shown grey until they were well into their 70′s. If they are publishing such things as this as ‘facts’, it does make you realize that there have to be much larger & more glaring errors & misstatements when they are talking about such things as weight, health, life expectancy, etc. It reminds me of the old age…”believe nothing you hear & only half of what you see.” It certainly seems to relate to what you hear on the news or read on the internet.

        • That’s how it’s been with my grandpa too. He had a full head of red hair until he turned 89 or 90. Now he’s 92 and has a mixture of white and pale gold hair.

        • That was ‘old adage’, btw.

  9. Brilliant as usual, and so was Dr. Gaesser.

  10. MY BFF said a news doctor reported this almost gleefully. “See! I’ve been saying this all along! No fit fatties! No fit fatties!” I think the media was so quick to jump on this is because they want to believe it so damn bad.

  11. I can honestly say that my health today as a “normal” weight individual really isn’t different than it was in the days when I qualified as OMG!FAT! I have the bloodwork to prove it as well. People have a very hard time believing this however.

  12. People assume I MUST have been terribly unhealthy when my BMI was mid 30′s. Just as the assume I MUST be uber healthy now that its barely over 20. But that’s just not so. I was healthy then, healthy now, and the bloodwork shows it.

  13. Something I’ve been meaning to ask but haven’t got around to in terms of the war on obesity and the discourse surrounding it: we all know so-called “experts” are forever claiming that our Western society is fatter than ever before (particularly America), and that these experts are often pointing to crap dietary lifestyles as the cause. And we do obviously have a lot of preservatives, artificial flavours, excess salt, excess sugar, hydrogenated fats and God knows what other catastrophic chemistry experiments in our food. So I guess what I’m wondering is, first of all, are we really fatter as a society than ever before, or is that mostly hype? And if we are actually fatter, then what might the real causes be? I’d be interested to know your thoughts on this, Ragen, or anyone else who knows more about this than I do.

    • I hope you don’t mind me replying, but I have family photos back to the 1800s, and most of those folks have the squarish frames and what looks to me like largish sizes. My generation may be bigger, but we also have more access to food and a more sedentary lifestyle.

      It is my personal belief that any bigger sizes are due to better food access and less activity.

      Whether this is good or bad still remains to be seen. If our culture would stop freaking out about it, maybe we could find the truth. Since we are all living longer lives on average, I can’t think it is all the terrible.

      • Also, if all these ‘terrible, unhealthy’ foods so many of us are eating these days are so bad for us, why is the average life expectancy increasing, why are Americans overall healthier & living longer than at any time in history? And I second that about seeing pictures of people, relatives, etc., taken 150-200 years ago which showed a lot of fat people, people who were often doing backbreaking physical labor all day long & obviously not eating processed foods.

        My mother-in-law is 91 years old & has been short & chunky all her life, much as she tried to change that, but she also hates to cook & is a terrible cook. All her life, for as long as they have been available, she has lived (& raised her two children) on frozen pot pies, tv dinners, canned soups & pastas, whatever foods were easiest to fix or cheapest, & her favorite restaurant is McDonald’s. She used to drink alcohol regularly when she was younger & she smoked unfiltered Camels for over 35 years before she quit. Yet, here she is at 91, still alive & kicking, still living alone in her apartment, & still putting Banquet frozen chicken dinners into her oven.

        My own grandmother was born in 1888 & was fat all her life & lived to be 90. Fat is not some new invention, as I would think might be indicated by some of the fat statues found which are 30,000 years old or more. IF we are fatter now than 40-50 years ago, I would guess that it is largely because of dieting, with some help from the aging of my generation. And I certainly know that in many cases, including my own, being sedentary has not been a factor.

        • Archaeologists says that the Egyptian female Pharaoh, Hatshepsut, was obese. Plus we have medieval kings as well (eg. Louis the Fat, Sancho the Fat, Henry VIII). Also literary greats were obese (eg. Ben Jonson, Samuel Johnson).

  14. Thank you, Ragen. Ever since the “news story” broke earlier in the week, I’ve been struggling to stay fat positive. I was wondering what the reasonable counter arguments were, hoping that there some, and you’ve confirmed that for me. Thanks again.

  15. I know it’s possible to be fit and fat because I used to be fit and fat. I did cardio three days a week and weight training three days a week, and I walked everywhere during the week and hiked for fun on the weekends. My life changed; I no longer have time or space for dedicated exercise and I couldn’t hike with little children. The remaining activities I am able to do can’t keep me fit. I can definitely tell the difference between fit and fat and not-fit and fat.

    • Well, the public library that used to be at the bottom of our hill and halfway up a nearby low hill is now across downtown and at the crest of a very high, steep hill. They just had their grand reopening. Wow, getting there is a workout now–especially when your little ‘un doesn’t want to ride in the stroller you brought along in case he got cold or tired, but wants to keep up with your older two who are out of sight ahead of you, and he doesn’t understand about crossing streets yet, so you have to push the stroller full of books at top speed. That felt good! It felt like going to Curves, back when we had a Curves and I could afford to go. I think we need to schedule weekly visits to the library, weather permitting.

      • That’s the wrong nick. Above is me.

  16. How the heck is it so hard to be fit and fat? Fitness is fitness, if you take care of your body, no matter your size you’re a person who’s dedicated to fitness. I don’t understand this? So if a fat person has the paper work to prove it, they will still be labeled unhealthy because their body size falls into the fat category? That doesn’t make any damn sense.

    I’m becoming so depressed because it seems like every time the fat acceptance movement begins to gain mainstream attention, there’s always something like this to try and make sure fat people stay and remain unseen, and confined. Why are they so afraid of fat healthy people? Why? Gosh I feel like screaming!!!

  17. They are afraid of us because they are TERRIFIED of losing their social status at superior beings & all the thin privilege, but mostly they are afraid of us because they are crapping their pants at the idea of all fat people (& maybe also the not fat ones who insist on dieting a lot anyway) accepting our bodies & dumping the whole weight loss industry on its greedy little butt. There are probably at least 66 billion reasons every year for them to hate healthy (& especially fat positive) fat people. Always look for the money…& the power is a nice perk too.

  18. This has been driving me nuts. Thank you for doing all the work of putting the reasons together for me! Once again, you are my hero. A sane woman in a crazy culture.


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