You can hardly ignore the growing numbers of Americans who are horizontally challenged: at least a third of us are obese by the governments standards, and probably more than two-thirds are unhealthily overweight, according to a 1995 report by the National Academy of Sciences. Foreigners are aghast when they gaze upon Behemothus americanus, and one British friend of mine likens our well-larded countrymen to the giant balloons that float above the Macys Thanksgiving Day parade in New York.
This being the Decade of the Victim, though, its hardly surprising that there are groups who proclaim not only that "fat is beautiful," but that it is virtually harmless as well. Dedicated to the proposition that all men (and women) are not created equal — some are just meant to be fat — the pro-tubbies have their own lapel ribbons (light blue). Now they have their own book, too: Glenn A. Gaessers Big Fat Lies.
Thats just what people with large and ever-growing bodies want to hear, people like Charles Van Dyke, chairman of the board of the National Organization for the Advancement of Fat Acceptance (NAAFA), the nations most prominent obesity-rights group. Van Dyke is quoted on the dust jacket gushing about Gaessers work: "Finally, truth and justice for the fat person. People will vary, and cannot all fit some insurance chart." Indeed, it would take three insurance charts laid end to end to fit Charles Van Dyke: he weighs 600 pounds.
Gaesser picks and chooses among various obesity studies to make his argument. He cites evidence, for example, that shows a link between obesity and lower rates of lung cancer and pre-menopausal breast cancer, but doesnt mention that pre-menopausal breast cancer is fairly rare, nor does he talk about any other types of cancer.
Why? Because study after study has shown that obesity is a major risk factor for post-menopausal breast cancer and a variety of other cancers. The American Cancer Society has found that, for people whose weight was 40 percent above average or more, death from cancer overall was a third higher for men, and over 50 percent higher for women. A 1995 study in the Journal of the National Cancer Institute documented that the heaviest men it looked at had three times the risk of contracting cancer of the esophagus as the lightest ones. A 1994 study found that weight gain of only 20 or even 10 pounds, in women age 30 and over, may substantially increase the risk of breast cancer later in life. One Harvard researcher has found that women just 44 pounds over ideal weight fully doubled their risk of breast cancer.
If thats not bad enough, yet another study has found that overweight women who detected breast tumors as a result of self-examination generally caught the lumps at a later — and more dangerous stage — than leaner women. As one health reporter put it, "The trouble with trying to feel for a pea under 20 mattresses is that most of us wont find it — unless its the size of a basketball."
Gaesser concedes that there does seem to be a connection between obesity and certain health problems; but, in his view, the connection isnt necessarily causal. "If you just eliminate the excess hypertension and coronary disease and cancer among this group," he argues, "you find that their death rate is no higher than that of the thinner people."
This is correct in the same way that a heavy, sharp blade was not the actual cause of death of Louis XVI. Rather, it was the severing of his vertebrae, the cutting of all the blood vessels in his neck, and the slicing of his windpipe that did the killing — with, of course, the trauma caused by his head dropping several feet into a wicker basket to be factored in as well. As Gaesser puts it, "No study yet has convincingly shown that weight is an independent cause of health problems."
The real problem is with Gaessers disingenuousness. He points, for example, to a Duke University study of 600 obese men and women who completed a low-calorie, low-fat diet and exercise program lasting at least four weeks. They all lost weight, yet all were still obese. He then notes that their cholesterol levels, their blood pressure, and the amount of fat in their bloodstream all fell. The lesson to be learned, he emphasizes, is that "It is possible to greatly improve or even cure diabetes and other serious health problems while still remaining markedly overweight."
This is the same Gaesser who earlier warns the reader about the "myths" that "weight loss is good [and] that thinner is necessarily healthier." He calls one chapter of his book Diet and Die, yet cites a program of diet and exercise in which weight loss correlates to improved health. Of course its true that you can improve your health by losing some weight, even if its not as much as you should. If you believe yourself utterly incapable of ever reaching your height-weight table norm, at least try to lose something and keep the pounds off. But it doesnt mean you cant improve your health further by losing even more weight. If you can reduce your chance of premature death by, say, 10 percent, thats good. If you can reduce it by 50 percent, though, thats a lot better.
Gaesser explores at length the difference between what he calls "good" and "bad" body fat; the "good" stuff is on the hips and thighs, the bad in the muscle under the belly. "Its not how much body fat you have," he declares, "but where you have it that is important." The long-accepted belief has been that its safer to be pear- (fat on the hips) rather than apple-shaped. Fat under the belly, Gaesser says, appears to be responsible for "such killers as heart disease, cancer, and diabetes, for example."
Unfortunately, it so happens that about half of the human race — those of us known as "males" — almost always lay down their extra fat in just that region. When was the last time you saw a man with one of those ripply stomachs but who has fat hips and thighs?
In fact, lower-body fat is not "good"; its not even neutral. As a 1995 report in the Journal of the American Medical Association put it not so elegantly, "Noncentral obesity [being pear-shaped] is not metabolically benign." Researchers looked at over 2,300 Canadians and grouped them both by their shape and their overall heaviness, regardless of where the fat is located. They found that overall heaviness "tends to be the stronger predictor" of things that can cause illness and death such as high blood pressure and high cholesterol. And they specifically warned against the belief that people who are overweight but carry the fat below the waist are at no risk.
Gaesser tells us of the case of an acquaintance he calls Lucy, a 30-year-old woman who, despite being 206 pounds and only five feet, five inches tall, "has excellent levels of cholesterol, blood sugar, and blood pressure." How can this be? "Lucy, like a lot of women, carries the body fat on her hips and thighs," he points out. But heres the rub. At the age of 30, Lucy would be in no real danger of heart disease no matter what these various indicators showed. Only about 1,100 American women between the ages of 25 and 34 die of heart disease each year.
Its only after menopause, which usually takes place around the mid-40s, that a womans risk of dying of heart disease starts to go up. About 8,100 American women die each year of heart disease between the ages of 35 and 44; between 45 and 54, over 22,000 women do. But what also happens after menopause is that estrogen levels drop dramatically, and a womans body fat to a great extent shifts up above the waist. She becomes an apple. Just when Lucy least wants that shape, shell get it anyway. Its proof once again that life isnt fair.
For the thin or merely pot-bellied, books like Big Fat Lies may be easy enough to dismiss; but to all too many obese people — willing to grasp anything to confirm a defeatist attitude about their condition — such books can become bibles, their deadly advice notwithstanding. During a three-month period in early 1996, emergency crews had to cut two men out of their homes to take them to the hospital.
Both lived in the same New York borough of Brooklyn, and both weighed around 1,000 pounds. One lost weight in the hospital and was discharged. The other died. He could have well bought into the same fat-acceptance theology that Gaesser spews in Big Fat Lies. Now, though, hes just a big fat corpse.