Obesity: Some Observations, Part One

I've been wanting to write about a complex problem from many different viewpoints. There appeared to be numerous topics in the physical sciences and the humanities, but I've chosen to tackle the obesity "epidemic" (note how our language has largely adopted the "medical model" over the last 30 years) for the emotional freight it carries. Fat jokes are everywhere. (I recently heard a comedienne say she greets her female friends with, "What up, fat-ass?" as a phrase of affection.) It's one of the most-cliched tropes in mainstream media: cite a new study that shows how we're getting fatter, then show anonymous shots of 300 pounders meandering in the streets. For me, there's something not only garish about this aspect of the spectacle, but maybe a bit of the sadomasochism of everyday life.

Hey! There's a commonality between many thin left-liberals and right-conservatives: they love to cluck tongues over the fatties. Then there are different levels of acceptance towards the obese. I once acted as a chauffeur for an old man who was one of the kindest people I'd ever known. He was 80 or so, and never had a bad thing to say about anyone. He was quite thin, and as I remember he volunteered to me, socially liberal but conservative about economics and his own personal finances. The worst thing I ever heard him say about anyone else was when we were in a parking lot and a very obese woman was in the midst. He leaned over and quasi-whispered to me, "Can you imagine letting yourself go like that? It must be...so...difficult!" That really was the most "negative" thing I ever heard him utter about anyone else. After studying obesity and our attitudes towards it, I now see him as in the avant-garde.

Last night I had dinner with a dear friend who was agonizing that she'd gained 20 pounds in two years, and she's over 50, has stepped up her exercising, went into too-minute detail about self-imposed dietary restrictions that hadn't worked, and of course, the emotional turmoil. The thing is: she's still relatively thin. She looks good. But she worries, puzzles over loss of control. It seems common to think we can stay the same weight throughout life. As a fact, most of us cannot. And we can't control that as we think we ought.

                              Hippocrates, who over 2400 years ago knew we all had different 

                              metabolisms and body types, and that different foods were more 

                              more liable to make us fat than others, knew we should eat less

                              and exercise more. But he also thought we should vomit to control

                              our weight: "Fat individuals should vomit in the middle of the day,

                              after a running or marching exercise and before taking any food."

I think that's maybe the most insidious thing, aside from the very real human misery and health costs related to true obesity: loss of control. Wanting to be in control in this ever-accelerating world. And you can't even keep your own weight down! 

How many times I've had to listen to my female friends wax vexingly about their perceived issues around weight! I have male friends who are overweight, but they seem relatively more accepting. Maybe they just don't want to talk about it? But I think the pressure to be thin and beautiful in this heavily mediated world is quite the recipe for depression and self-loathing. And let's face it, it's not all that interesting a kvetch, as kvetches go...

I am not fully conscious about why I have zero weight issues. (To those with perceived too much adipose tissue, take heart: I'm a too-nerdy neurotic asthmatic, who, despite thinness, is genetically predisposed to high LDL cholesterol. Also: I have not been scanned, and there's a chance I'm a "tofi"and wouldn't THAT put me in my place! The "thin outside, fat inside" finding is just one of many weird, counterintuitive things I found when reading on obesity.)

I've always been able to eat as much as I wanted and I have always been thin. In my late teens I took up weightlifting and protein shakes in order to gain as much weight as I could, with limited success: lots of muscle on bone. Even though I've reached 50, I still can't get over 170 pounds on my 6-foot frame. Why? I don't know, but there's plenty of reasons to chalk most of it up to genes. Because I don't feel "proud" of my genes (which reminds me of the avowed racists I read who say they're "proud to be white": how about taking pride in something you accomplished?), I can't summon much opprobrium for the obese. 

                                   Nietzsche had read - of course! - the famous The Art of Living Long,

                                   by the Renaissance Venetian Luigi Cornaro, who said he'd eaten 

                                   like a pig in his younger days, but now ate very little, and what he

                                   did eat was bland and virtually tasteless.  Cornaro seems to 

                                   prefigure some of the annoying tofu-addicted food-scolds
                                    I see around Berkeley. Fred N has this to say about Cornaro: 
                                  "A scholar in our time, with his rapid consumption of nervous energy, 
                                   would simply destroy himself on Cornaro's diet. Crede experto -  

                                                  believe me - I've tried."

Of course, there are those who seem the very picture of gluttony, but the news out of various corners of neuroscience and genetics and other lines of thought mucks this picture up too much for me. I will give plenty of credence to the "fat and sugar act as drug-like rewards in the brain" line; or the "food as drug-addiction" rhetoric, which I find very persuasive. And addiction is not, in my eyes, a conservative Republican's simple moral issue of self-discipline. I think we'd see even more of this cant from conservatives, but too many of them are obese themselves. (Which doesn't stop them from railing about addicts of other drugs.)

And there's plenty of reasons why those the government would classify as "overweight" (Body Mass Index over 25), obese (BMI of 30+), or "severely obese" (BMI over 40, or 100 lbs overweight) feel bad about themselves. Well, not all, but probably most: the non-obese culture tends to look down on the  corpulent for reasons that seem not to do with concerns about human health and happiness, but, as Louise Foxcroft writes in her history of obesity, Calories and Corsets, from "aesthetic distaste." 

In reading a couple hundred articles on obesity, and about it in many books recently, I'm not at all sure we have as much agency as the popular culture would assign to us and our fatness. More of it seems out of our hands than meets the eye.

                                      Lord Byron, archetypal progenitor of gorgeous movie 

                                      and rock stars, binged and purged. Is there

                                        nothing new under the sun?

My study of obesity met my needs for something personal (friends and fellow citizens) and urgent (the spiraling costs of health care). It was also filled with enough complexities that I felt sufficiently "whelmed": not over- or under- . The study impinges on biochemistry, economics, public policy, environmental interactions, all-too real politick, evolutionary psychology, social perception, sex, genetics and epigenetics, neuroscience, aesthetics, rhetoric, history of diets, creative solutions and counterintuitive studies, futurology, delusions and depravity, and lies, damned lies, and statistics.

I hope to not bore The Reader and instead impart a sense of optimism that we can, if not solve, greatly ameliorate the suffering of obesity. I also hope to encourage a more nuanced understanding than is usually found in the mainstream press. As I alluded to earlier, I think the notion of personal agency is much more difficult than is generally appreciated. 

Fatness is a touchy subject, and fraught with emotion, and I know that if I write, "If this bothers you, why don't you put down that box of lard, get off the couch, and wheeze around the block, you tub of goo!," I might be misunderstood, as the Internet is filled with Missing Information; you cannot know that I would be saying this ironically, and that I care deeply about us and this weighty problem. Our problem. I also abhor Political Correctness. When a subject becomes almost taboo to talk about, I am one of those who will talk or write about it with reckless abandon. So: a sense of humor, please? Or do you think that, because I'm personally not obese - or have at least presented myself as such - I have no "right" to joke? (Rail in the comments, please!)