The medical basis for obesity treatment

The Medical Basis for Obesity 'Treatment'

You've seen the headlines: 'Millions of Americans are Obese', 'Americans Don't Exercise Enough', 'You May Be Obese According to New Study.' Americans have a higher percentage of obesity than any other country in the world, while we are the country most obsessed with being thin. Obesity is unhealthy, we are told, and we are paralyzed by the thought that we might be fat and, therefore, unhealthy.

Admittedly, the 'obese' Americans these studies worry about tend to be the 'couch potato' types, the ones who do not perform even the basic exercise of a daily walk. But a daily walk is not normally the treatment suggested to people classified as medically obese.

"In fact, research purporting to show a relationship between weight and various health risks is currently the subject of considerable controversy. For example, studies often fail to control for income and may suffer from a number of confounding variables, since in Western nations fat people are poorer than thin people. These studies compare the rich and poor on health risks, and poor people do not have the same access to health insurance and preventative care. Fat people diet more than thin people, and dieting itself can result in a number of health risks� including the very health risks associated with obesity, such as hypertension, high cholesterol, and diabetes." (1)

Americans believe in science. Science is seen as the great unbiased method, the perfectly objective way to determine the state of things, and it can be� if it is applied properly. Without careful control of variables, a study is worthless because the specific datum being studied may not be the one having an effect. (This would be like testing civic pride in two cities by seeing whether people water their lawns and ignoring the fact that one town is in a desert.) Obesity may be related to health, but though a correlation has been shown, the studies may not have been done in such a matter as to pinpoint obesity as the cause of the problems.

"Up-and-down dieting changes the body's metabolism, making it easier to gain weight and harder to lose it, and possibly also increasing the risk of becoming hypertensive. When rats are put on a regimen of yo-yo dieting, their blood pressures rise significantly and dangerously after the third 'crash diet.' The link between hypertension and being overweight that doctors warn about may be a result of the person's having been on several crash diets, not a result of the weight per se." (2)

Americans believe in science to the point that its flaws are overlooked. Decades of research have told us that obesity is a problem, and that to be healthy, we should be thin. Over the years, 'thin' has changed to 'thinner' with no set limit. Everyone is at risk for obesity, so everyone should watch their diet and exercise. Everyone should head for their ideal weight (or Body Mass Index, as the most recent studies say is the proper term) which is the same for males and females. BMI is a ratio of height to weight, and new studies show that even more people are overweight than previously thought.

"In the First Federal Obesity Clinical Guidelines (released June 1998), overweight was defined as a body mass index value between 25 and 29.9; and obesity was defined as a body mass index value greater than or equal to 30. According to this report, an estimated 97 million adults in the United States are overweight or obese." (3)

BMI measurements are supposed to hold true no matter your bone structure, genetic inheritance or gender. To be healthy, one should fall in a predetermined range for one's height. A big-boned, full-figured woman should fall within the same range as a wiry man of the same height. Medically, if she does not, she is overweight.

"The words �do no harm' are fundamental to medical care, but for fat people this promise is broken again and again. Millions of healthy fat people are denied health insurance solely because of their weight; those who seek care may encounter insults, humiliation, or verbal abuse from physicians." (4)

Many people who are overweight do not like going to the doctor. Certain insensitive physicians will precede every examination with "You need to lose some weight." Others may blame the 'obesity' for health problems without a thorough examination that could turn up other factors. Cases where enormous tumors, weighing more than 60 or 100 pounds, are not found because the physicians did not thoroughly examine their 'fat' patients only highlight this problem. (5)

"Ninety percent of those people who lose 25 or more pounds on a weight loss diet regain the weight lost within 2 years, and 98% regain the lost weight within 5 years." (6)
"If diets really worked, then why are there so many of them?" (7)

Likewise, these doctors are the ones most likely to find new diets for their patients and then chide them if they don't lose weight. My grandmother had an experience where she went to the doctor repeatedly for health problems and was scolded for not sticking to a diet that she had, in fact, kept. (It was later discovered that she was retaining water and proper medication was prescribed.) She developed a distaste for visiting doctors because they always told her the same thing.

Obesity creates a blind spot in the minds of some health professionals. It may encourage physicians to not look beyond the fat on a person's body. By continual nagging, the doctor may drive the patient away� or the patient may learn to ignore the doctor's advice. Either way, the patient does not get the health care that is needed, and the studies show another instance of how obesity is unhealthy.

back *** forward
which way are you going?

(1)Rothblum, Esther D. "'I'll Die for the Revolution but Don't Ask Me Not to Diet': Feminism and the Continuing Stigmatization of Obesity." Feminist Perspectives on Eating Disorders. Fallon, Patricia, et al., eds. (New York: The Guilford Press, 1994) p. 55.

(2)Tavris, Carol. The Mismeasure of Women. (USA: Simon & Schuster, 1992) p. 34-35.

(3)Mealformation and your Body Mass Index.

(4)Burgard, Debora and Pat Lyons. "Alternatives in Obesity Treatment: Focusing on Health for Fat Women." Feminist Perspectives on Eating Disorders. Fallon, Patricia, et al., eds. (New York: The Guilford Press, 1994) p. 214.

(5)Burgard and Lyons, 215.

(6)Kilbourne, Jean. "Still Killing Us Softly: Advertising and the obsession With Thinness." Feminist Perspectives on Eating Disorders. Fallon, Patricia, et al., eds. (New York: The Guilford Press, 1994) p. 399.

(7)Society and Eating Disorders.

Hosted by www.Geocities.ws

	You've seen the headlines: 'Millions of Americans are Obese', 'Americans Don't Exercise Enough', 'You May Be Obese According to New Study.' Americans have a higher percentage of obesity than any other country in the world, while we are the country most obsessed with being thin. Obesity is unhealthy, we are told, and we are paralyzed by the thought that we might be fat and, therefore, unhealthy. Admittedly, the 'obese' Americans these studies worry about tend to be the 'couch potato' types, the ones who do not perform even the basic exercise of a daily walk. But a daily walk is not normally the treatment suggested to people classified as medically obese.
"In fact, research purporting to show a relationship between weight and various health risks is currently the subject of considerable controversy. For example, studies often fail to control for income and may suffer from a number of confounding variables, since in Western nations fat people are poorer than thin people. These studies compare the rich and poor on health risks, and poor people do not have the same access to health insurance and preventative care. Fat people diet more than thin people, and dieting itself can result in a number of health risks� including the very health risks associated with obesity, such as hypertension, high cholesterol, and diabetes." (1)	Americans believe in science. Science is seen as the great unbiased method, the perfectly objective way to determine the state of things, and it can be� if it is applied properly. Without careful control of variables, a study is worthless because the specific datum being studied may not be the one having an effect. (This would be like testing civic pride in two cities by seeing whether people water their lawns and ignoring the fact that one town is in a desert.) Obesity may be related to health, but though a correlation has been shown, the studies may not have been done in such a matter as to pinpoint obesity as the cause of the problems.
"Up-and-down dieting changes the body's metabolism, making it easier to gain weight and harder to lose it, and possibly also increasing the risk of becoming hypertensive. When rats are put on a regimen of yo-yo dieting, their blood pressures rise significantly and dangerously after the third 'crash diet.' The link between hypertension and being overweight that doctors warn about may be a result of the person's having been on several crash diets, not a result of the weight per se." (2)	Americans believe in science to the point that its flaws are overlooked. Decades of research have told us that obesity is a problem, and that to be healthy, we should be thin. Over the years, 'thin' has changed to 'thinner' with no set limit. Everyone is at risk for obesity, so everyone should watch their diet and exercise. Everyone should head for their ideal weight (or Body Mass Index, as the most recent studies say is the proper term) which is the same for males and females. BMI is a ratio of height to weight, and new studies show that even more people are overweight than previously thought.
"In the First Federal Obesity Clinical Guidelines (released June 1998), overweight was defined as a body mass index value between 25 and 29.9; and obesity was defined as a body mass index value greater than or equal to 30. According to this report, an estimated 97 million adults in the United States are overweight or obese." (3)	BMI measurements are supposed to hold true no matter your bone structure, genetic inheritance or gender. To be healthy, one should fall in a predetermined range for one's height. A big-boned, full-figured woman should fall within the same range as a wiry man of the same height. Medically, if she does not, she is overweight.
"The words �do no harm' are fundamental to medical care, but for fat people this promise is broken again and again. Millions of healthy fat people are denied health insurance solely because of their weight; those who seek care may encounter insults, humiliation, or verbal abuse from physicians." (4)	Many people who are overweight do not like going to the doctor. Certain insensitive physicians will precede every examination with "You need to lose some weight." Others may blame the 'obesity' for health problems without a thorough examination that could turn up other factors. Cases where enormous tumors, weighing more than 60 or 100 pounds, are not found because the physicians did not thoroughly examine their 'fat' patients only highlight this problem. (5)
"Ninety percent of those people who lose 25 or more pounds on a weight loss diet regain the weight lost within 2 years, and 98% regain the lost weight within 5 years." (6) "If diets really worked, then why are there so many of them?" (7)	Likewise, these doctors are the ones most likely to find new diets for their patients and then chide them if they don't lose weight. My grandmother had an experience where she went to the doctor repeatedly for health problems and was scolded for not sticking to a diet that she had, in fact, kept. (It was later discovered that she was retaining water and proper medication was prescribed.) She developed a distaste for visiting doctors because they always told her the same thing. Obesity creates a blind spot in the minds of some health professionals. It may encourage physicians to not look beyond the fat on a person's body. By continual nagging, the doctor may drive the patient away� or the patient may learn to ignore the doctor's advice. Either way, the patient does not get the health care that is needed, and the studies show another instance of how obesity is unhealthy.