Is it right to push the overweight to shed their excess fat? In spite of the many strong and simplistic opinions that continue to be loudly expressed on this question, it is actually a charged and complex one that deserves some careful and nuanced consideration.
First of all, ought we as a society or as individuals have any say in what sort of weight it's OK for others to carry? The arguments from one side: As Sarah Palin puts it, it is among our "God-given rights" to be obese; it may not even be as bad from a health perspective as everyone makes it out to be; and besides, the overweight are typically powerless to do anything about it, so why make them feel bad about it? From the other side: Obesity is, according to a wealth of evidence, a major health crisis that affects all of us, in that the burden that obesity-related disease places on the health-care system raises everyone's health-care costs; obesity is associated with lower productivity that hurts the economy; and the prevalence of obesity makes it more likely that children and others will become obese, because as social creatures we closely influence one another.
Does pushing the overweight to lose weight even accomplish anything? On one side: The overweight already want to lose weight, and many have tried desperately to do so, so giving them grief about it only makes them feel worse, and in fact it tends to be counterproductive. On the other side: Many of the obese aren't working at diet and exercise, and may not even see their or their children's excess weight as much of a problem, suggesting there's room to usefully raise consciousness; and doctors, public-health officials, early education providers, loved ones and close friends, at least, can't be expected to stay mum as people they care about or are to some extent responsible for remain on a collision course with obesity-related disease.
Is losing weight simply a matter of taking responsibility for one's behavior? On one side: Anyone can lose weight--just eat less and exercise (or do whatever magic one-size-fits-all solution you believe in, be it cutting carbs, or cutting fat, or drinking water, etc.). On the other: It's in the genes, and diet and exercise won't fix it.
My own take on these questions:
· I think it's absolutely fair for any of us to get involved in encouraging the overweight to lose weight, because of the hard and soft costs to society. It's real money, it's our money, and it affects our children.
· I think attempts to push the overweight into losing weight are frequently ineffective, harsh and stigmatizing, and that's just unfair, unreasonable and even cruel. We ought to only push in certain, careful, helpful ways, and only so far. Instead of being confrontational and critical, especially on a personal level, it's much more reasonable and helpful to make changes in society that will make sure everyone gets the right messages about health, and is prompted to eat healthier food and become more active. We can make these changes in schools, in the workplace, in foodstores, and in the media. And we can make more and better behavior-change resources available for individuals and families. At the same time, we need to stop muddying up the picture with the sort of distorted messages that encourage people to either downplay the problem of obesity or to think that fad diets, excessive exercise, surgery or pills can fix it.
· I believe most people who are significantly overweight, with some exceptions, can lose weight and become far healthier by changing diet and becoming more active--they are absolutely not doomed by genes, in spite of all the anecdotal evidence and highly flawed studies that are held by some to suggest otherwise. But that's not the same as saying the overweight need to get on the ball and fix themselves. It's clearly extremely challenging for most people, overweight or not, to simply cut way back on their calories or take up intense exercise regimens and then maintain the weight lost that way--our bodies and brains fight that sort of traumatic intervention with everything they've got. But if we can fix the environment and otherwise help the overweight into making a series of relatively small, gradual, easy-to-live-with changes that become lifelong habits, most overweight people will benefit from it, and without having to submit to futile self-torture. If our involvement takes the form of assistance and encouragement and support, then we can help make a difference instead of merely being nasty gadflies. That attitude puts the blame for obesity where it belongs: on all of our shoulders.
I know many and probably most overweight people simply want to be left alone about it. But I don't think we're obligated to respect that wish--not if it's a condition that affects all of us. Let's just make sure we're being reasonable, respectful, caring, wise, and helpful about the sorts of tactics we bring to bear.
