'Diss the fatties, date the hotties'

The title of this blog post is a slogan on a tee shirt held up by a little man whose name I genuinely forget and can't be bothered looking up - but he's one of those who persuade other idiotic men to part with a load of dosh to be told how to alienate and offend any woman with any semblance of intelligence and self respect. 

Apart from being a reminder of the depths of some idiots'  misogyny, the slogan is important because it reminded me to finish this post about obesity. 

When I was a kid I read a 'Phantom' comic in which a prince refused to marry the woman chosen to be his bride because she was too fat.  Judged by today's standards, 'too fat' was rather plump - certainly not severely obese. The Phantom's solution was to kidnap the young woman and hold her prisoner for a few weeks and make her gather her own food -  thereby forcing her to lose the weight she had gained, presumably through being lazy and self-indulgent.  Once the weight had been lost he presented her to the prince as a slim - and therefore attractive and acceptable - bride. 

There's more than a hint of this in some attitudes to extreme weight gain - i.e. the belief is that people become overweight because they are lazy and self-indulgent and they need a Phantom equivalent to force them to eat a normal diet and to exercise. If only it was that simple.

I know people who are very overweight who swear blind that they eat sensibly and get loads of exercise.  They say diets do not work, that any weight they lose comes back and they get even fatter than they were before dieting.  Often they blame their genes or a medical condition but I'd lay odds that most of them are unaware of, forget and/or are inaccurate about how much food and drink they actually ingest, the type of food it is - and how little exercise they actually get.  That's aside from the complicated stuff of how your body processes different types of food and drink at different stages of life and all the other factors associated with weight gain.

It takes a lot of fortitude to be brutally honest about how much our own actions and inactions contribute to the state of our health.  It is not helped by the mass of misinformation that circulates and the intense pressures to consume that run alongside equally strong pressures to look and behave in certain ways. I understand that the pressures stacked against the individual are enormous. 

There is the fact that, once you are very overweight, and the longer you have been overweight, to lose weight and keep it off means you may have to have bariatric surgery and/or find the psychological strength to always control your food intake and - preferably- to restrict it to whole foods. And you have to do this in a society in which high calorie and cheap food and drink is coming at you from every direction. 

The 'fast' food industry - by which I mean manufacturers and marketers of all processed foods - with its cynical marketing ploys, its reliance on addictive, harmful chemical additives, and its vicious PR-orchestrated attacks on its critics - peddles cheap, high calorie / low nutrient, chemically enhanced products that wreak havoc on people's biochemistry.

Medical 'do no harm' science looks for palliative surgical and pharmacological solutions to the problems that food manufacturers have created. I cannot be alone in seeing the irony in the fact that people who've had bariatric surgery are left reliant on nutritional supplements.  They gain weight because of a combination of ingesting high calorie, nutritionally depleted, easily accessible foods and drinks and having a genetic predisposition to easy weight gain.  They cannot lose the weight. They have surgery and are then made completely dependent for the rest of their lives on a cocktail of supplements produced by a branch of the very industry that produced the crap that caused them to get unnaturally fat in the first place.

Governments typically sit on their hands or actively collude with the whole sorry business refusing to act to control the industry and instead pouring money into education campaigns which never work.  

The mainstream media - as with most other issues - relies heavily on food and drink industry PR and press releases. Those journalists with the intelligence and integrity to want to pursue the truth are often hamstrung by their corporate bosses'  demands for the sort of froth and nonsense that attracts readers/viewers.

For every person who has a genetic or medical reason for extreme weight gain, there are many more whose initial weight gain is due to them having ingested too much of the wrong sort of food and drink, and exercised too little but demonising, shaming or attacking them is not only cruel and destructive, it's stupid. 

At the other extreme, arguing that being very fat is unavoidable because it is genetically determined, or even that it is desirable, is not just foolish - it lets a cynical and profit-obsessed food production industry, and complicit, lazy and/or incompetent governments and media off the hook.

I've been reading some activist websites that focus on obesity.  Some try to normalise it. Some question what we define as obese and are critical of the body-mass index as a useful measure. Some cite studies that claim obese people eat less than thin people and that fat kids are more active.  

Some point to the genetic foundation of weight gain - the so-called 'thrifty gene' theory that humans who could lay down body fat easily had a selective advantage in times of food shortages. When such people are exposed to easily accessible, easily digested, high calorie foods, their genetic blueprint dictates that they will gain weight and not be able to lose it.

The way genes are expressed is hugely complex and variable and even with a proven genetic predisposition to lay down fat stores, in order to put on extreme amounts of weight, the individual has to ingest a far larger number of calories than they burn up and / or be ingesting substances which alter their bio-chemistry. The most obvious way that happens is eating large amounts of high calorie/low nutrient foods and drinks that are laced with various chemicals - preservatives, artificial flavourings, colours etc.

Because we are subjected to the tyranny of the thin does not mean we should idealise being fat. I increasingly see women who are well beyond plump being held up as having a normal and desirable weight. I know overweight people who have as distorted an idea of their body size as an anorexic does because all their peer group is overweight. We are getting used to seeing plump as normal and fat as barely outside normal.

We're not talking about moderate increases in weight. Leaving aside the difficulties of measuring and defining obesity, it's obvious that there are many more overweight - and importantly, many more severely overweight - people today than there were in the past.  

The extreme obesity that features on an increasing number of tasteless and exploitative shows on television and feeds into a thriving internet fetish market, is still relatively rare but between this sort of super-obesity and the people with 'normal' levels of body fat, there are increasing numbers of very overweight people. I don't need BMI based statistics to tell me the population is getting fatter - I can see it. 

I grew up in 1950s and 60s New Zealand and although we ate a lot of fresh food and we got a lot of exercise, we also consumed loads of refined sugar, refined flour and saturated animal fats. The artificial fertilisers, herbicides and pesticides used in agriculture and horticulture were different in type and probably amount but it was hardly a pollutant free environment.  I can remember very few adults who were significantly bigger than my slim parents, only one or two adults who I thought of as being quite fat, and only one or two kids at my school were slightly plump.  I cannot remember ever seeing or knowing about anyone who would have qualified as being severely or morbidly obese. 

Something has changed dramatically in the past 30-40 years which is driving a large number of people's bio-chemistry so far out of equilibrium it's no wonder simplistic measures such as telling them to eat less / exercise more fail to work.  

Like most things, the increase in obesity in general and in severe obesity is multi-factoral - ie. it is not just what you eat and how much of it you eat relative to how much energy you expend, chronic stress, food-based and environmental toxins and nutrient-deficiencies also play a large role.  

Medical science has not had very long to develop an in-depth understanding of the complexities of the human neuro-endocrine system, let alone the peptidergic pathways in the central nervous system and the ways that these are affected by the presence of large amounts of body fat (especially visceral fat), and by the mass of chemicals we are exposed to in our food and in our environment more widely, and by the enormous increase in the amount and the type of sugar we ingest.

What can be said with certainty is that carrying too much body fat long term is NOT a good thing - it places great stress on your musculo-skeletal structures and your cardio-pulmonary system; it compromises your endocrine system; it stresses your liver and kidneys and your largest and most misunderstood metabolic organ - your skin.  

Yes, you can be overweight and 'healthy' by modern health parameters (which are pretty wide ranging) but, the bigger you are, the more strain there is on your essential and irreplaceable bio-systems.  

We need some body fat, too little is also not good but too much is demonstrably harmful. How much is too much will differ from individual to individual and we can carry on arguing about BMIs and thrifty genes or we can agree that there is a vast and increasing  health issue which is exacting a dreadful toll and look to how we might fix it.