Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Article Comments (3)

Does Normalizing Obesity Do More Harm Than Good?

It is estimated that 44% of Americans will be obese by the year 2030. The AMA warns that increasing obesity rates will lead “to millions of additional cases of type 2 diabetes, stroke and coronary heart disease, as well as arthritis and hypertension. Billions of dollars will be wasted through lost economic productivity and skyrocketing medical costs.”

And yet, a funny thing is happening in consumer land – efforts to normalize obesity are gaining momentum via social media platforms. Take the “beauty comes in all sizes” ad for example. This was shared with me by an old grade school friend on Facebook. And while I can appreciate the sentiment that women of various genetic predispositions are beautiful, I stopped short at the idea that obesity itself was attractive. There is a growing movement among obese men and women to promote acceptance of their size, and if they win this argument they could substantially undermine efforts to help Americans become healthy and avoid disease. I know this sounds harsh, but to me, promoting beauty of all sizes – when that includes obesity- is tantamount to promoting a “smoking is cool” campaign.

Smoking rates in the United States have dropped from 42.4% in 1965 to 19% in 2010. Although one-in-five people still smoke, we have successfully reduced the smoking burden by more than half. The reasons for this reduction are complex, but they include public awareness campaigns regarding the harmfulness of cigarette smoking, increasing taxes on cigarettes, and public policy regarding where and when people can smoke in public.

The same exact approach can’t work for obesity because while people can simply quit smoking, we can’t quit eating. And what we eat is less important than how much we eat. I personally do not favor “fat taxes” on specific food items because almost any food could cause weight gain if consumed in large enough quantities. I also don’t favor singling out obese people for portion reduction at restaurants (this has actually been proposed), or other policies that are similar to what we’ve done with smoking in public spaces. Promoting prejudice against the obese is not constructive.

So that leaves us with public perception/education and peer pressure as our primary national strategy for reducing obesity rates.  (Of course smaller initiatives can help: employers can incentivize weight loss and wellness, policy makers can encourage new housing developments that promote active lifestyles, and local groups and non-profits can promote fitness initiatives and healthy eating behaviors.)

My concern is that if too many people decide that normalizing obesity is better than fighting it, America will lose this battle. Obesity-related disease is already costing us about twice as much as smoking-related illnesses. And both smoking and obesity are nearly 100% avoidable.

Obesity is not beautiful, and we must redouble our efforts to win the hearts and minds of the public on this subject without resorting to the other extreme (idolizing anorexia). Good health lies somewhere in the middle – and keeping our middles within a reasonable range is the most important health goal we have.

You may also like these posts

    None Found

Read comments »

3 Responses to “Does Normalizing Obesity Do More Harm Than Good?”

  1. Ben says:

    Nice article, and I totally agree that normalizing obesity might lead some people to give up a weight-loss regimen more easily, but I think the effect is likely to be pretty trivial. I think most of these campaigns are really more about anti-bullying than actually getting anyone to embrace obesity. Regardless, despite their efforts, obesity is (and will continue to be) heavily stigmatized… unlike the anti-smoking campaign, which was taking something “cool” and trying to make it “uncool”, the this obesity campaign is trying to take something “uncool” and make it “cool”… a much harder task in my opinion, and I just can’t imagine it will really do much to make people think that being fat is OK.

    Also, I’d like to correct the commonly repeated notion that obesity is driving a healthcare cost crisis. While annual costs for the obese are substantially greater than for the public at large, the average lifespans of obese individuals are so dramatically shorter that the net cost of a fat person to the healthcare system is, on average, less than for “healthy” individuals. It’s not a pleasant or desirable outcome, but we shouldn’t pretend that curbing obesity will somehow free up healthcare dollars in the long-run.

  2. Weasel says:

    I am horrified and completely offended by this article. ALL people are beautiful whether obese, skinny, tall, short, handicapped, etc. The fact that people think otherwise is one of the main causes of bullying in America. The last thing we need is for “medical professionals” to use a possible link between obesity and health concerns to fortify this line of thinking.

  3. Ben says:

    @ Weasel – You’re just playing a semantic game. Beauty is necessarily exclusionary (“attractive” people are attractive relative to less attractive people). Humans are built to size up others in large part by physical features to decide who they should mate with, who they should hunt with, who to war with, etc etc, and attempting to rebrand “beautiful” as “everybody” or “worthy” just forces us to switch to another word for beautiful that actually means something (“attractive”,”desirable”, “alluring”,”good-looking”… take your pick). Your larger point – that unattractive people have redeeming value, and that we shouldn’t use the heuristic of physical beauty to define someone’s worth – is well taken, but just calling unattractive people “beautiful” won’t help with bullying. Likewise, declaring that fat people are beautiful shouldn’t affect a physician’s obligation to encourage patients to lose weight… because the “possible link between obesity and health concerns” isn’t just “possible”, it’s “almost certain”.

Return to article »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »