Recently some studies have come out that suggested that the idea that you can be fit and fat is simply not true. I was going to do a take down of the study, but thanks to the days I took off for the marathon and recovering from the marathon (hey have I mention that I completed a marathon? 
) other people including Glenn Gaesser of Dr. Oz Fame, and the brilliant Deb Burgard have already broken it down beautifully (though the picture leaves something to be desired.)
I will say that what immediately stuck out to me as the biggest issue was that they didn’t control for cardiovascular fitness, even though the other studies about fitness and fatness (Wei et. al., Matheson et. al., the Cooper Institute Longitudinal Studies), cardiovascular fitness was shown to make the difference in relative risk of all cause mortality and health hazard ratios. As Dr. Gaesser put it “This study, statistically speaking, assumes that all fat people, all thin people and everyone in between are of equal fitness, equal physical activity levels and have the same diets. And that’s just an absurd assumption.” Tell it, Dr. Gaesser.
To me there is a much bigger issue media who are happy to report the results of weak research as hard and fast news, adding a extra layer of crap with their inflammatory and misleading headlines. Though that’s just the tip of the iceberg here.
No study on weight and health can control for the effects of the constant stigma, shame, and oppression that fat people deal with. This is a big deal. Diseases that are correlated with obesity are also correlated with being under a high level of stress over long period of time. Like, for example, the stress of having your government declare war on you for how you look. So in order to even start to prove that fat causes diseases, there would need to be a control group of fat people who have not suffered a lifetime of stigma to see if their disease incidence was the same as the first group. Except that no such group of fat people exists in this culture.
Also, they can’t control for the effects of dieting. Yo-yo dieting has also been correlated with some of the same diseases correlated with obesity, and I to wonder if a lifetime of dieting - spending a large part of your life feeding your body less food that it needs to survive in the hopes that it will eat itself and become smaller – may have some long term health effects. In order to start exploring that we would need a control group of fat people who hadn’t dieted, again an extremely difficult group to find in this culture.
Let’s remember that what the research is doing is seeking correlations based on a physical characteristic – in this case a ratio of weight and height. This research is undertaken on the basis that weight can be changed and that making a fat person into a thin person will give the fat person the same future health outcomes of a thin person. Even if body weight did cause health problems and earlier death (and I’m certainly not convinced that it does) and even if we had some way to successfully suppress a fat person’s weight long term (which we currently don’t), it still might not make any difference.
Men have shorter lifespans than women but we don’t recommend sexual reassignment to change that. Tall people have shorter lifespans that shorter people but we don’t suggest that we try to make tall people shorter. Men with male pattern baldness have a much higher risk of cardiovascular events but giving them hair plugs won’t reduce their risk of a heart attack. Different people have different health outcomes for various reasons, but trying to make everyone look the same as a way to equalize their health hazard ratios and relative risks of all cause mortality is probably not the best way to go. Plus this is all based on the idea that our body size is completely within our control, which is not support by the research.
In order for us to discuss weight loss as a cure, preventative, life-extender etc. we would need first have to have some evidence, some reason to believe, that weight loss is possible. Not just studies where the average participant loses 5 pounds in two years, but studies that show that people can move from the “overweight” and “obese” categories into the “normal weight” categories and stay there. We would need a study where more than a tiny fraction of participants were able to achieve and maintain that weight loss long term. No such studies exist. In fact, the vast majority of people fail at weight loss, including a majority who experience weight gain – so if fatter people die sooner than the worst thing we can do is recommend weight loss attempts.
If I were the underpants overlord the media would discuss study limitations in every article and would do better than a sensationalism of the research under an even more sensational headline. Until then, it’s up to us to ask questions, remember limitations and critically examine what we read.
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