Monday, August 13, 2007

Obesity in the News (or, Why Language Matters)

Obesity research is all over the news today:

From the BBC, obesity is linked to birth defects and health risks: a large scale study in the journal Archives of Pediatrics and Adolescent Medicine says that women who are obese when they conceive are more likely to have chronic diseases, fertility problems, miscarriages and complications during pregnancy, as well as birth defects including missing limbs and malformed hearts.

Then there's a study reported in Cell, which suggests that the skeleton is part of the endocrine system, specifically helping with the regulation of osteocalcin, which in addition to regulating mineralization appears to regulate glucose and deposits of body fat. This likely explains, at least in part, the connection between obesity and type two diabetes; researchers will move forward to look more closely at this link, next.

Following that, a study out of UPenn says that obese kids are more absent from school than others, and in fact suggests that obesity is more an indication for how much school a child will miss than any other factor, including race, gender, or socioeconomic status. The lead researcher is pretty succinct about why this is, too: the kids don't want to be teased or bullied over their weight.

According to a report at an American Physiological Society meeting, estrogen loss leads to weight gain, as well as hypertension, suggesting that estrogen treatment is beneficial for both the heart and the body.

And finally, it looks like people overeat due to another hormone-gone-wonky. People who don't manufacture leptin tend to overeat, becoming chronically obese. People who are deficient in leptin have the same areas of their brain react, at the sight of food, that react to rewarding emotions/desires.

So what's the point to all the fat talk? For some people, fatness, being overweight, obesity, is simply a medical issue. You are overweight for a reason, be it medical or psychological, it is bad for you, you should work on not being overweight, which is good for you. There are clear concepts of good and bad tied to this model of viewing weight, and it tends to be a part of the general medicalization of weight we see - to be thin (but not too thin) is healthy, to be fat is to be unhealthy. And within healthy/unhealthy there are specific moral and value-laden beliefs that tie into good and bad; to be healthy is to be good, to be fat is to be bad.

But there are people out there, often people who are overweight, that reject this sometimes value-laden, binary attitude towards weight. They are comfortable with their weight, and don't appreciate being "bullied" by society to adhere to an ideal they don't believe is accurate. These folks often espouse the motto "healthy regardless of weight", placing an emphasis on health outside of weight. After all, the reasoning goes, if someone is 65 lbs overweight, but perfectly healthy otherwise, what business is it of anyone just what that weight is? People come in all sizes, and as long as the individual is healthy, what that size is shouldn't matter to anyone. While this group, often known as fat activists, embrace the notion of being healthy, they reject the idea that healthy is thin is good, and unhealthy is fat is bad.

How news reports discussing obesity are received tends to depend on how they are written. If they are written, as most are, in the medicalized and moralized language of the first model, a group of people - perhaps the group of people most affected by the research being reported on - are alienated from the outset by the language, and judgment, being used. People are sensitive to the language being used to describe them, and very few people respond positively to being preached at.

A healthy body is a goal that is hard to argue with, and if we communicated consistently in such a manner, we might very well discover that many of the medicalized concerns about the overweight/obese would be addressed to everyone's satisfaction.


Anonymous said...


Only addition I have is to note that Gard and Wright point out that despite the significant uncertainty that attends the vast majority of food science and obesity research, such uncertainty is not communicated at all.

This naturally leads to the question of why some questions which remain deeply uncertain, including 'why do people gain/lose weight,' and 'are sedentary lifestyles responsible for weight gain,' are answered with an almost axiomatic, self-evident assessment.

Gard and Wright posit, along the lines of the fat activists you've noted, that stigma of fatness has much to do with the answer.

Anyway, great post. I'm linking over at ours . . .

Rebecca Scritchfield said...

Interesting post... I agree with you. There is so much health and nutrition information out there, it is so difficult to make sense of.

I have training in nutrition and physical activity and speaking from that perspective I have met many people from these fields and in my personal life who are not the "societal ideal" weight. Many would be considered overweight by BMI charts. One friend completed a marathon last year, plays kickball, yoga and exercises at the gym (in her spare time). She doesn't have a perfect body but she is happy -- and healthy.

Most of the women in my family are overweight and obese (grandma, mother, sister). They definitely experience health issues related to their weight, but largely it is physical (like joint issues). They don't have diabetes, high cholesterol, not even metabolic syndrome. That doesn't mean that they won't ever develop health issues related to their weight, but medically, they are healthy. Through conversations with them, I have learned that they have suffered a decreased quality of life, partly due to mobility and physical limitations but more so psychologically. They tell me that they've had to "come to terms with their weight and embrace it" while at the same time making changes that will improve their health (like watching sodium and cholesterol intake, overall calories and portion sizes, decreasing restaurant dining, giving up sodas etc.) regardless of their weight.

Eli said...

Also in the news, from The Onion:

Should we be shaming obese children more?