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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.

Tattoo Regrets In Los Angeles

True story: As a fourth-year medical student I spent a summer working with a dermatologist in Los Angeles. In addition to all the skin cancer removal, sun damage, and Mohs surgery patients, my preceptor had a thriving laser tattoo removal business.

One day a rock band electric guitarist came into the office requesting help for an incident he’d had the night before. Apparently he’d gotten terribly drunk (+/- stoned) and made an impulsive tattoo decision that he regretted deeply in the light of morning.

The gaunt, long-haired gentleman entered the dermatology suite with his head hung low. He sat down in the exam chair and explained that he was there for a tattoo removal consultation. “Man, I can’t believe I did this to myself,” he muttered as he unbuttoned his shirt.

I wondered what on earth could be so terrible…

And then I saw it.

It was an 8 inch by 4 inch, bright yellow and black tattoo…

On the left side of his neck…

An exact replica of…

The periodic table of the elements.

The Friday Funny: Liposuction

I’m introducing a new feature to the blog: a weekly cartoon posted every Friday. If you’d like to subscribe to the cartoon feed (perhaps you’d like to feature the weekly cartoon on your website?) please contact

Enjoy your weekly dose of humor from Dr. Val! By the way, what time on Friday should I publish these do you think? I’d appreciate your feedback.

Guest Post At Dr. Bates’ Blog: Think Twice About Lip Plumping

While I was “homeless” my blogging friends kindly invited me to guest post at their websites. Ramona Bates at Suture For A Living posted this for me:

I have a great plastic surgeon friend who offered to fill a facial scar for me. I was bitten in the face by a dog when I was very young, and the small (1/2 inch) divot of flesh from my cheek still bothers me slightly. I’ve generally ignored it but thought it might be fun to see if it could be corrected in any way – so I happily agreed to try a Restylane (hyaluronic acid) injection.

My surgeon and I decided not to use any numbing medication because it distorts the contours of the face, making correction more challenging. So I tried my best not to squirm as he inserted a fairly long needle parallel to my nose…

To read the rest of the post, please click here.

"Doctor Fish" Give Great Pedicures?

Thanks to my friend Jen for highlighting this unusual “health story.” Apparently a type of fish (called “doctor fish” – not sure how I feel about that) found in Turkish hot springs thrive on dead human skin. They’ve been used in the past to treat psoriasis, a condition that produces skin cell overgrowth. And now, an enterprising salon has imported these fish to nibble off dead skin found on pedicure seekers’ feet.

Images of the movie “Piranha” came to mind for me until I read the fine print – these fish have no teeth, but use a kind of suction action to feed. Also, the silvery creatures are the size of minnows.

Some clients say that the process tickles, and it feels as if their feet are being “kissed” by hundreds of fishies. The salon owners claim that the fish have doubled in size since they were first unleashed on American spa-goers.

I suppose this is an “organic” way to live in a symbiotic relationship with nature’s creatures – but as a physician, I can only imagine all the potential fungus and wart viruses thriving in the warm fishy waters. [Shudder]

I’m going to stick with my pumice stone.


You may also like: “Flip Flop Foot” and “Conversations at the SpaThis post originally appeared on Dr. Val’s blog at

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