Thursday, March 3, 2011

This is what obesity looks like

I've been wanting to write about this for a while, and a report on BBC.com today finally provided the impetus. According to the report, "only" a quarter of Canadians are obese, an approximately 5% lower obesity rate than the US. It seems a strange thing to celebrate, along the lines of promoting that your bottled water now has "5% less arsenic!", but that's not my problem. I object to the BMI chart used to categorize obesity; according to those charts over a third of American adults are obese.

And I am one of them.

According to the chart, at 6'5" and 270 pounds my BMI is 32 (30 and above is obese). If I lost 20 pounds, I would still be categorized as overweight (BMI 29.6). In fact, I would have to lose 60 pounds to reach a BMI of 24.9 ("normal weight") at 210 lbs. That's 20 pounds lower than I've ever been in my adult life, even when I went on a successful diet program and lost so much weight I had to replace every piece of clothing I owned because everything was too big.

For reference, I look like this:


No, wait; sorry, wrong picture. I look like this:


Yes, I have some weight around my gut I could afford to lose. Yes, my waist size is 42, which is 4" above my all-time adult low and  recommended Waist-to-Height ratio. I will accept "overweight" as a label, ignoring for the minute the societal commentary inherent in the idea.

But obese? That doesn't seem right.

Now the chart does admit that "athletes" might have skewed results due to higher muscle mass, and I am off the bottom of the standard chart based on my height, so I might just be in the point where things break down. But while I do have a couple "athletic" hobbies, I've never considered myself an "athlete". Especially since most weeks those hobbies only occupy two nights total. And there's a big difference between "slightly skewed results" and "need to lose 25% of your current weight".

It makes me wonder, though, when I hear these big national numbers. I'm hardly the most "athletic" person out there; if the statistics are (wrongly) labeling me obese, how many other people are falsely propping up these numbers? Should they actually read, "30% of all American adults, minus all professional athletes and people over 6"4"? How inaccurate are they at lower levels? For that matter, if these are based solely on height vs. weight but ignoring the source of that weight (ie, muscle vs. fat) so that an Olympic athlete and a couch potato can show up at the same BMI, how is this a valid predictor of health?

If this were purely a matter of scientific labeling it would be no big deal. But obesity has, over the past decade or so, become both a major political and social issue. And being the "fat kid" has been a major social stigma for much longer than that.

There is serious debate about charging obese people more for certain things, such as airplane tickets and health insurance. This is partially practical (obese people generate higher fuel and medical expanses), but mostly stems from the American Puritanical philosophy of "personal responsibility". Meaning we should punish these people for their sloth and gluttony.

Much better writers than I have pointed out that "fat" is one of the last acceptable forms of public discrimination. Magazines can call out people for their weight in ways they would never be allowed to based on race, religion, gender, or sexuality.

Being labeled overweight, let alone obese, can be emotionally and socially damaging for adults and even more so for kids. I agree that obesity is a major social health problem, and parents that allow (or cause) their children to be obese are performing them a disservice that borders on neglect, if not abuse. But we are throwing around this stigma and labeling and punishment based on a measurement that is flat-out broken.

Regardless of whether charts and measurements are the way to approach this issue at all, making such important measurements using a broken tool is beyond irresponsible.

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