Earlier this year, the Bureau of Economic Research published a paper about the obesity epidemic(TM) and the growing threat it poses to the pursuit of happiness, national security, and not looking at gross ugly fat people in public. Just kidding, the story was about changes in the BMI. The multivariable study considered 27 state-level factors in their analysis of BMI numbers across the nation and attempted to explore potential relationships between those variables and BMI. One of their conclusions is that the average BMI appeared to be higher around areas with a high concentration of ‘restaurants and superstores.’
The media took this to mean, basically, that ‘cheap food,’ ‘too much food,’ and, uh, Walmart are making America fat. The economy is making you fat, you see. I have a lot of thoughts about these conclusions, but before I plunge into them, it’s worth noting the following:
The BMI is not designed to be a tool used in individual patient care. It was originally developed for actuarial tables and predictions about overall survival rates in given populations, for the purpose of determining how to price life insurance and who to offer it to. It does not consider factors like race, physical activity (if you’re weightlifter, you will have a high BMI thanks to all your muscle), or actual health. Nor is ‘obesity’ necessarily a predictor of health, especially given the CDC decision to jack the BMI standards down in the late 1990s, making millions of people fat overnight. It also doesn’t reflect the fact that numerous studies as well as literature reviews indicate that the conclusion between fat and health is not cut and dried, and that in fact people in the ‘overweight’/’obese’ categories may actually have better health outcomes. Setting aside the claim that everyone has an obligation to be healthy, your BMI is not actually a predictor of your health.
Okay, disclaimer over.
So, first off, when you actually read the study and pick the details apart, the researchers didn’t actually assert that an oversupply of food, or cheap food, was the ‘problem’ in this case. They cited a particular set of factors as contributors to BMI, and they were hardly the only ones. Moreover, it’s worth noting that the United States has an extremely high hunger rate, with one in five adults and one in four children experiencing food scarcity at one or more points annually in the U.S. Some of those people also happen to be fat, because weight is, shockingly, more complicated than what you eat.
Fatness, or lack thereof, isn’t a calories in, calories out equation. It’s about a lot of things including what you eat, sure, but also genetics, physical activity, medical conditions, and a lot more. The researchers in this case weren’t simplistically reducing the matter down to food, but journalists felt free to do so, illustrating the dangers of inexperienced reporters cherrypicking information from research so that it conforms with what they want to report, or with preconceived notions about cultural and social issues.
It doesn’t escape notice that many people think fat is bad, and that many people obsessed with ‘fitness’ and ‘health’ are in a class demographic — more about that in a moment — that sneers at ‘fast food’ and Walmart/Costco/the like, the two things journalists kept hammering on when it came to their reporting on the article. The fact that things considered low-class were repeatedly blamed for the tide of fatness rippling across our golden waves of grain was pretty painfully obvious and it reflected a great deal about the social and class attitudes of the journalists involved.
But the study itself also had revealing information about class. If we accept the premise that a higher BMI is a problem (which I don’t) that needs to be fixed (which I don’t), it’s very clear that the strong correlation here isn’t necessarily with what you eat or how you exercise, but with your economic class. Low-income people are more likely to live closer to ‘cheap food and supercenters.’ They’re less likely to live near gyms, let alone be able to afford memberships (gyms were cited as a factor in decreased BMI trends). The list goes on — the factors cited in the study all tied very closely with class and the access that class grants, or does not, depending on whether you’re working class, middle class, or among the wealthy.
So if the goal is to “fix” the BMI and get people to not be fat, joining the class war is definitely go the way. If you view human bodies and identities as something wrong that needs to be put to a stop, the real root problem you need to address is class disparities. Thus, I’d like to welcome the anti-fat brigade along the class war train. We’ve got quinoa and kale in the dining car along with a complimentary gym.
Because here’s the thing: If you raise the minimum wage, you increase access to the foods you call ‘healthy.’ If you create more opportunities for education and better wages, you allow people to move out of mixed commercial-residential neighbourhoods, you know, the ones you sneer at because they contain fast food strips and superstores. If you address the growing class disparities in the United States, you ensure ready access to health care, including nutritional education to teach people how to be less grossly fat, along with opportunities for joining exercise programs for free or at low cost. If you reform social services to ensure that people can actually buy fresh fruits and vegetables when they have to rely on food assistance, you promote ‘healthy eating.’
If you’re concerned about the welfare of fat people — which I don’t really think you are — and you believe that BMI is closely correlated with health, and you accept the outcome of this study, then you should, perforce, conclude that the best way to end the obesity epidemic is to end class disparity in the US. Here’s your hammer and sickle. Careful not to cut yourself on the blades — I just sharpened them.
Image: Stocky Bodies