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.


  1. Well Elizabeth, one problem is terminology. A diet is nothing more than ones customary food. Without a diet we would all die. But it has taken a secondary meaning to be reduced caloric intake. It is kind of similar to the word Bi-monthly, which means twice a month and every two months at the same time (I kid you not, look it up)

    So diets definitely do work, just not dieting.
    One thing you do overlook though is people do get heavier as they age, due to decreased metabolism and being more sedentary. And women, of course, also bear the burden of weight gain due to childbearing. If you lose a lot of weight and put it back on over a ten year period, you are likely to be very better off then if you hadn't lost the weight since you would have been likely to have gained even more weight had you done nothing, and would have also spared your body the strains of the weight when you were thinner. Granted, yo yo dieting is more adverse.

    Another is obesity and overweight. The clinical definition of obesity is a body mass index (BMI) of 30 or higher. It is bad for your health no matter how you cut it, being overweight is not necessarily so.

    I suppose I am more cynical than you. I don't think it will matter if we do encourage exercise and a whole food diet. It will take a far more profound re-ordering of the American mind, which is based on consuming our way to happiness (whether via food, clothes, housing, electronics, etc.) You mention focusing on health, but it goes deeper than that. Lifestyle changes and instant gratification don't easily go hand in hand.


  2. What doesn't work is changing you diet temporarily for the purpose of losing weight, then going back to the diet that put the pounds on in the first place. That's why people don't keep weight off, they go right back to the same foods that made them fat to start. What's the definition of insanity? Doing the same thing and expecting a different outcome. It is insane to expect to go back to a diet that made you fat and not become fat again.

    And while I don't have a cite in mind, ISTR that being a little zaftig is better than being slightly thin -- in later life.

  3. I can nitpick the early paragraphs of your post, because I disagree with the semantics, as charo seems to. But your plan to increase healthful foods, eliminate health-harming foods, and pay attention to feeding your body what it needs (both in terms of nutrition and movement) rather than restricting based on formula...I agree with all that. So. No point in disagreeing with your approach or your argument, because I like the plan you lay out for an end goal, and I agree with your two final points about why focusing on obesity misfires in two cases.
    I also agree with gadfly in taking your argument a step farther. Why focus on health when we can focus on our flawed decision making? This is bigger than health versus obesity. It's poor information and lame sound bites turning a nation of borderline informed people into lemmings. Let's start thinking about all of our choices...purchasing and debt, food and health, comfort and consequences. We're getting pretty intellectually lazy, looking for pills and legislation and shortcuts to fix everything in our lives, instead of really examining choices and their results.

  4. As one who has lost 14 pounds, (goal 20) I can tell you that eating healthy seems to be working. Although my diet lacks the wonderful fried foods at my favorite fast food place, along with sugar, pasta and the wonderful world of Goldfish crackers.... Vegetables, fruit and small portions of meat, fish and chicken do after a while make one thin. Oh yes, I also visit the gym on a daily basis. And JG,,, I can hardly wait to reach my goal so I can descend upon Micky D's. (Just one time).

  5. UJ, the very occasional splurge isn't what sinks people, rather the progression from occasional to routine to back to the Old Habits.

    As far as choosing McD for a splurge, and believe me, I've eaten there, too, it just illustrates how little rational thought drives our choices in the basic areas of life. Food, sex, possessions, you name it, and invariably our choices are not rational but emotional. Education levels make very little difference, we want what we want without needing the approval of our prefrontal cortex. With luck, we override most of the bad choices, but the struggle remains. Such is the human condition.