Just leave out the middle man (you know, the fat one)

Okay, so in the comments on a previous post, I promised a further post on why I disagree with Michelle Obama's focus on fighting obesity -- I would rather she focus on health. I know you've all been waiting with bated breath. Let me state that my opinion is based on the following:

1) Calorie reduction (by which I mean something like Weight Watchers - wherein no matter what your appetite or your desires, you eat a prescribed number of calories) and exercise reduce weight in the short term.

2) Calorie reduction and exercise do not work in the long term. Ten years out, 98% of people who lose weight have gained it back. Most have put more on. Quitting heroin and cigarettes have a much higher success rate.

3) I do not believe those 98% wanted to gain weight back, or were indifferent to whether they regained weight. I do not believe they have significantly greater weakness of will than heroin addicts.

4) I infer from 2) and 3) that we have much less conscious control over what we weigh than is generally believed to be the case.

5) Reduction of calories, in the long term, seems to cause obsessional thinking about food and irritability.

6) High weight correlates with ill health. It has not been definitively established to cause ill health.

7) Eating fruits and vegetables is correlated with good health.

8) Eating less refined flour and sugar is correlated with good health.

9) Exercise is correlated with good health.

10) People who are thin, or merely overweight, are not warranted to infer that because they are able to resist eating certain desired foods, that everyone else could resist just as easily.

Why do we care about obesity at all? Because it is associated with poor health. It's not obesity in itself, it is claimed, is the problem. If fat people did not have poorer health, we would not care if they were fat. So fighting obesity is merely a means to an end. Thinness is not our goal, the goal is, really, health.

But obesity does not seem immediately under our control. One can stamp one's foot and insist that it is, but studies show again and again: diets don't work. The only thing that seems to work for weight reduction is bariatric surgery.

If our end is, ultimately, health, why not focus on health itself? Why focus on a not-always-reliable predictor of health? There are steps we can take (fruits and vegetables, exercise) to make our health better. They may be only correlated with health, too. But those steps are MUCH easier than reducing weight permanently. If our goal is, ultimately health, let's not waste time on obesity, which is only a middle man between our behavior and our goal.

As it happens, I believe (but have no proof) that doing the following:
a) eating a diet with lots of fruits and vegetables
b) with no processed foods (including white flours and refined sugars)
c) eating of such foods to one's heart's content (i.e., not counting calories and forcing undesired portion control)
d) cooking at home
e) exercising
will (over time) reduce weight without the unpleasant psychological side effects and yo-yoing of calorie reduction. Even if it doesn't, however, such measures have been correlated with good health, and are worth trying to see if it is a cause of such good health.

Part of the problem with the focus on obesity rather than health is that it a) makes skinny people think that whatever they eat is fine, and b) encourages consumption of processed diet foods, from low-fat milk to aspartame sodas to special K cereal bars. If we encourage exercise and a whole foods diet, however, everyone could re-examine what they eat and improve their health directly, rather than through the indirect means of weight control.