Posts Tagged ‘Eugene Robinson’

Eugene Robinson’s Legacy

October 31st, 2011

Drum roll please. Here’s the first, certainly not the last, nominee for The Eugene Robinson  Award for Weight Discrimination. The School Board fight in Fairfax County, Virginia has had one candidate lay down the Robinson formula that an overweight person is not qualified to hold public office based on his weight.

Snapshot of contested Fairfax School Board seats – The Washington Post  Great job, Gene! (See Robinson’s column on Chris Christie at Chris Christie’s big problem – The Washington Post

What’s Wrong with a Little Fat-Bashing?

October 3rd, 2011

So what actually is wrong with fat-bashing? Everyone does it. Isn’t it a good thing to embarrass and ridicule people into healthy behavior? Well, yes. I guess. If it worked. The round of vitriol directed at Chris Christie for his weight is nothing which millions of persons with obesity haven’t experienced in their own families or workplaces or just walking down the street. The problem with telling a person with obesity to eat a salad and take a walk ,like the Washington Post’s Eugene Robinson did, is like telling a person with Parkinson’s disease to just stop shaking or a drug addict to just say no. It ignores the complexity of disease focusing only on the visible end point of a long and complex biological and social process.  

Given the context of the fat-bashing regarding New Jersey Governor Chris Christie, it is useful to revisit Dr. Jeffrey Friedman’s 2003 commentary, “Make War on Obesity, not the Obese.”  

Jeffrey Friedman and Douglas Coleman’s names came up this weekend as possible contenders for the Nobel Prize in Medicine. (They would have my vote if I had a vote) for their work in the discovery of leptin in 1994. Their work  revolutionized obesity research, showing how a hormone produced by fat tissue plays a key role in body weight regulation. 

Friedman’s commentary is still timely and deserves revisiting while obesity, especially extreme or severe obesity, is in the news. I think it remains one of the best scientific explanations of obesity and should give pause to anyone who wants to throw a stone or two.

 His major points are:

 

  1. “There can be no meaningful discussion of obesity until we resist the impulse to assign blame.  Nor can we hold to the simple belief that with willpower alone, one can consciously resist the allure of food and precisely control one’s weight.“

  2. The facts are these “(i) the increasing incidence of obesity in the population is not reflected by a proportionate increase in weight; (ii) the drive to eat is to a large extent hardwired, and differences in weight are genetically determined;  and (iii) obesity can be a good thing depending on the environment in which one (or one’s ancestors) finds oneself.”

  3. The change in weight attributable to any recent changes in diet or a more sedentary life-style is much smaller than the enormous differences in weight, often numbering in the hundreds of pounds, that can be observed among individuals living in today’s world.”

  4. “Twin studies, adoption studies, and studies of familial aggregation confirm a major contribution of genes to the development of obesity. Indeed, the heritability of obesity is equivalent to that of height and exceeds that of many disorders for which a genetic basis is generally accepted. It is worth noting that height has also increased significantly in Western countries in the 20th Century.”

  5. “In general, obesity genes encode the molecular components of the physiologic system that regulates energy balance. This system precisely matches energy intake (food) to energy expenditure to maintain constant energy stores, principally fat. That there must be a system balancing food intake and energy expenditure is suggested by the following analysis. Over the course of a decade, a typical persons consumes approximately 10 million calories, generally with only a modest change in weight. To accomplish this, food intake must precisely match energy output within 0.17% over that decade. This extraordinary level of precision exceeds by several orders of magnitude the ability of nutritionists to count calories and suggests that conscious factors alone are incapable of precisely regulating caloric intake.”

  6.  “Feeding is a complex motivational behavior, meaning that many factors influence the likelihood that the behavior will be initiated. These factors include the unconscious urge to eat that is regulated by leptin and other hormones, the conscious desire to eat less (or more), sensory factors such as smell or taste, emotional state, and others. The greater the weight loss, the greater the hunger and, sooner or later for most dieters, a primal hunger trumps the conscious desire to be thin.”

  7.  The increase in weight is not evenly distributed in the population. “In modern times, some individuals have manifested a much greater increase of BMI than others, strongly suggesting the possibility that in our population (species) there is a subgroup that is genetically susceptible to obesity and a different subgroup that is relatively resistant.”

  8.  “Obesity is not a personal failing. In trying to lose weight, the obese are fighting a difficult battle. It is a battle against biology, a battle that only the intrepid take on and one in which only a few prevail.” A war on obesity, not the obese. [Science. 2003] – PubMed – NCBI.

Wash Post’s Robinson Joins Christie Fat-Bashing Crowd

September 30th, 2011

Eugene Robinson has a column in today’s Washington Post titled, “Christie’s Hefty Burden.” Chris Christie’s big problem – The Washington Post I cannot recall the last time I disagreed with one of Robinson’s columns but this one is really bad. The middle of the column is a recitation of facts about obesity, seemingly taken of f the NIH website. Robinson’s mistakes are two, one at the beginning and one at the end of his piece and they stigmatize persons with obesity.

 In the first paragraph, Robinson says that whether or not Christie runs for President he needs to lose weight. (I’m sure Christie is grateful for that insight.) But he goes on to state, “Like everyone else, elected officials perform best when they are in optimal health. Christie obviously is not.”

Whoa! Let’s look at this. First, being obese, even having extreme obesity, does not mean that a person cannot perform a given job. They may have a health problem, like diabetes, or joint problems or their weight may aggravate another problem but their weight, per se, does not mean they cannot perform a job. Does one have to be in “optimal” health to perform their best? Tell that to FDR with his polio  or JFK with his back pain. Tell that to tens of thousands of persons with handicapping conditions and diseases who go to work everyday and perform and, often, outperform, their colleagues. Even if Christie has some of the comorbid conditions of obesity, such as hypertension, type 2 diabetes and high cholesterol, many of these are manageable by medicine.

 In the last paragraph, Robinson offers Christie some “sincere advice: Eat a salad and take a walk.” I’d like to suggest Robinson go to anyone of thousands of Weight Watchers meetings this weekend or to the group sessions of bariatric surgery patients and see what reaction such ill-informed and gratuitous advice provokes. If it were so easy, we would not have an obesity problem. If a columnist did some homework, he might learn that even the best, most motivated behavioral interventions produce between 5% – 10% weight loss.

Of course, as most dieters will see, Robinson presumes that Christie is at his highest weight. Maybe?  Or maybe he has lost significant amounts of weight already. Maybe he has sustained that weight loss for a long time. To presume, as Robinson has, that Christie is (a) currently in bad health, (b) cannot perform a position such as governor or President if he is obese, and (c) hasn’t heard the message on eat less exercise more is ludicrous. (Actually, a lot of normal weight persons, in my experience, feel they are just a great person if they tell a fat person to eat better and exercise more.) It is an example (as if we needed another one) that obesity remains the last socially acceptable excuse for discrimination.

 The team on MSNBC’s Morning Joe this morning discussed Robinson’s column and, frankly, had a much more intelligent discussion than Robinson displayed. Hopefully, this will be a moment to educate Americans about the realities of obesity and avoid stigmatizing persons with obesity.