Tuesday, August 18, 2009

To be Fat in America ...

This is one of those posts where I am not sure where to begin and really not sure where to end.

I read a couple of different things yesterday that got me thinking. First of all, the Chief something or other at the Cleveland Clinic said that if it were up to him, he wouldn’t hire fat staff (he may have used a more precise term, such as obese or overweight). I sort of assume there might be a lead by example sort of thing there.

I also read something from a researcher who denies that obesity is actually a problem. Collectively our BMI has tipped from something like 29 to something like 30. This researcher (can’t remember his name, I am sure you could find it) says that statistically the slightly overweight do better in life expectancy than people with a “normal” BMI, so how could this small change be so negative. Now, he left himself an out, distinguishing between being physically fit or not, but if you are physically fit and yet have a high weight to height ratio, you pretty much have to be Arnold Schwartzenger (sp?).

I read comments on one blog (Shakesville?) about the Cleveland Clinic guy. One women in particular complained that she had a joint disease, exacerbated or caused by being over weight, she was in considerable pain, and yet doctors only told her to los weight (after waiting for hours for an appointment). What’s worse, they made no suggestions for an exercise or dietary program.

Now, I don’t know the circumstances of the woman’s doctor’s visit(s), how she was as a patient. But I believe it is true that many doctors don’t have a clue about how to recommend healthy diets (and by diet I mean regular eating plan, maybe geared to a certain calorie number), and/or may not recommend specific exercise plans either. Plus, we know (*know*) that agribusiness, grocery stores and the restaurant/fast food industries stack the deck against us. Healthy foods in grocery stores are relegated to the edges of the store, and have experienced considerable price inflation while the less healthy processed foods have gone down in price. And restaurant portions have gone down in price.

I do want to take a brief tangential sidetrack right here to say that I realize there can be much more involved here than just health, in fact, health may not be part of the equation when people talk about weight. Women have struggled and continue to struggle with body image issues and diseases that have a strong social component like anorexia and bulimia. I, for one, believe it is perfectly reasonable to bring those issues up in this discussion. I still believe in weight management for purposes of assisting in having good health. But I think that no one, female or male, should be hounded about their weight for purposes of conforming to a social ideal.

Even as I write this, I am sitting at my computer, as I will sit all day at a computer. I did a bit of exercise earlier this morning, and I will walk a mile-ish from where I park to my office. At lunch I will walk a bit, maybe a mile, after I eat. But all that is not enough. Despite what this researcher says about BMI, I am overweight. As a consequence, my blood pressure and blood sugar is up, and I need to get both down.

And that’s really what this is about. You can decide for yourself if you are overweight or not. And if you are reading this, you are smart enough to take some control. I realize that single moms, for example, are somewhat trapped in having no one to watch the kids while they exercise (well, maybe a boyfriend, but not necessarily), and have to eat (to some extent) what the kid(s) want to eat. But in general it should be possible to take some control of your diet, and to go on Craiglist and snap up that twenty five dollar exercycle. This is one of those public policy questions where we could each decide individually to make the change and end the issue. That would be big win for health care reform.

No comments: