The mass media propagate a view of obesity that is mostly fiction. This unscientific view is broadcast with good intentions. Journalists want to help people lose weight. Yet the information is so unreliable that it is unlikely to help anyone and even has the potential for doing harm.
What is the problem?
Although being obese is associated with all manner of health problems from heart disease and joint problems to kidney disease, cancers, and sleep problems, carrying extra pounds is not necessarily dangerous.
This point is illustrated by the fact that many professional football players are technically overweight (or obese) despite being highly conditioned athletes. I have been above the obesity threshold myself without ever experiencing any health problems as a result.
The problem is not overweight in itself but the health problems to which overweight may lead given a sedentary lifestyle and other risk factors, including poor diet. This is very hard for journalists to illustrate. It is all too easy to show visuals of fat people waddling across a beach. The all important internal factors of metabolic disease, such as insulin, cholesterol, and blood pressure defy easy illustration because they are hidden killers.
What causes the problem?
If communicating the specifics of the metabolic syndrome is poorly done, journalists are even worse at explaining the cause of the problem. Once again, visual storytelling gets in the way. When large portions of food find their way into a person's stomach, it is all too easy to think of their girth expanding.
The story is easy to tell, and intuitively appealing. Yet, it is substantially wrong. The fact is that Americans likely ate much more a century ago, when obesity was not common, than they do today. Moreover, anthropologists find that foraging people, such as the Ache of Paraguay eat far more than we do and have little or no obesity.
What is the solution?
If body weight is not the real problem, then it is no surprise to learn that bringing down body weight offers no guarantee of good health. Indeed, rapid weight loss is quite dangerous.
Although this fact is well known to medical researchers, it is poorly communicated to the public. It is very disappointing to hear journalists equate "getting thin" with "getting healthy" without ever noting that the process of rapidly losing weight can be more dangerous than remaining obese.
The real solution is not rapid weight loss but changing to a more active lifestyle with a more sensible diet so that any weight loss is gradual. This phenomenon may be illustrated by comparing the lifestyles of the elite, where there is little sign of metabolic disease or obesity, with those of Joe six pack. Wealthy people generally lead active lives filled with expensive activities such as sailing and skiing.
The guilt trip
Journalists do a very bad job at communicating the biggest health story of our time. It may be unfair to expect them to master all of the scientific subtleties of the problem and its solution. Yet, I cringe the most when I see what they do in terms of motivating people to change their lifestyle.
To begin with, far too much attention is paid to fashion and the fact that overweight people are considered physically unattractive. That makes the topic sexy but the desire to fit into a smaller dress is really not the best reason for adopting a healthier lifestyle.
The story of obesity gets transformed into a mean-minded morality play where unsightly fat is a sign of moral failure. The obese are blamed for being too fond of fatty foods and sweets. As punishment for their overindulgence in these sinful pleasures, they need to suffer.
They must go to the gym to work off those "holiday calories." Or perhaps they need to torture themselves on the wrack of an exercise machine in their basement.
The key to an active life is having many pursuits that we enjoy. If one enjoys golf, or bricks-and-mortar shopping, that is just as good as going to the gym. Gardening is as good as jogging. Painting the attic is as good as doing sit-ups. Virtually any active pursuit is better than resting on the couch.
Of course, doctors have done a poor job here as well. On the premise that exercise is going to be painful, they recommend an absurdly low level of half an hour per day five days a week. If a person was doing some activity they enjoyed, why would they restrict themselves to two-and-a-half hours per week?