Fat Politics

I just finished "Fat Politics" by J. Eric Oliver. It's a fascinating look at America's so-called obesity epidemic from a political-social point of view. Oliver is a political science professor at the University of Chicago, and he starts by saging, "This is not the book I intended to write." He thought he would be writing a book about how America was going to overcome the political challenges posed by the obesity epidemic.

Instead, the book Oliver has written is a thoughtful, well-constructed indictment of the influences and motivations behind the panicky claims of epidemic that we swallow without questioning, and how a focus on fatness/weight obsures the real issues facing us.

Oliver shows how a handful of doctors, government bureaucrats and health researchers, with huge financial backing from the pharmaceutical and weight-loss industries, have campaigned to misclassify more than 60 million Americans as "overweight," to grossly inflate the health risks of being fat, and to promote the idea that obesity is a killer disease. It is, in fact, not a disease. There is little proof that obesity causes so many deaths (the CDC claimed in 2004 that 400,000 deaths each year are "caused" by obesity, but in 2005, after a scathing analysis by Harvard of the research the CDC based this number on, they were compelled to revise the number to 24,000, and even admitted that people classified as "overweight" statistically live longer than people who are normal weight). And for a vast majority of people who are 20, 30 or 40 pounds overweight, there is scant evidence that losing those pounds makes them healthier.

It's all a smokescreen. Our concern - our anxiety, fear and panic - about fatness is fueled more by social prejudice, beaucratic politics, and industry profit than by scientific fact. Oliver makes it clear that by pushing forward the concept of fat=unhealthy and thin=healthy, what he calls the medical-industrial complex has billions of dollars to gain.

Telling Americans that they need to be thin (instead of saying they need to be more active and more selective about what they eat, regardless of their weight), proponents of the "epidemic" push millions of people towards dangerous surgeries, crash diets, harmful drugs, and - most distressing of all - a focus on the wrong thing - unrealistic expectations for losing weight and keeping it off. For most people who are 20, 30 or 40 pounds "overweight," the biological predisposition for them is to be at that weight, to store a certain amount of fat and to be that size. Their efforts to fight against their body's weight set-point are mostly in vain.

Oliver talks about why we hate fatness so much, in others and in ourselves. A Protestant distaste for the sensuous pleasures of the flesh and anxiety about class and position (fatness=poor, thinness=rich) is a large part of it. He also talks about how the dramatic changes in the place of women in society created greater pressure to be thin for millions of women entering the expanded sexual marketplace. He talks about the self-perceptions of (primarily) white women on thinness and how this developed.

Oliver says that our freedom to eat what we want, when we want it, is very "American" - life, liberty and the pursuit of happiness - but that maybe our freedom has consequences. He also says that our free market economy predisposes the vast array of fatty, salty, sweet snacks readily available for us, along with government-subsidised high fructose corn syrup and dietary guidelines promulgated by food manufacturing giants.

His discussion on how food and consumption used to be constrained is very interesting. Not so long ago, we used to eat our meals with our families, at certain points of the day, because the meals had to be prepared (usually by Mom). And Mom made our food choices for us. Between-meal snacking, except for apples and bananas, were unheard of, and the opportunity to snack wasn't available. He says our freedom to snack in the car, in the living room, to eat our meals wherever and whenever we want, to basically have no constraints on consumption, is a major change that our society hasn't learned to handle well yet.

Oliver makes it clear that our food choices and our lack of activity are at the heart of our modern-day health problems, but that there's not the huge profits to make by recommending a return to unprocessed foods and encouraging people to exercise, as there is in telling everyone to lose weight. Enormous profits are made in the food industry by processing food. Telling people to eat a celery stick instead of a nutter butter cookie makes nobody rich. And since exercise can be done without special equipment or a pharmaceutical, telling people to move more is not nearly as profitable as performing a $50,000 gastric bypass operation.

I haven't explained this book very well. There's an enormous amount of information here. It's an overview of a complex issue, along with an analysis of the complex ways in which it's been "sold" to us, and it gave me much to think about.