Wednesday, May 09, 2007

Fat Like Me

I was a skinny kid; one of those kids who could eat chocolate sundaes for each of my three meals followed by pound cake for dessert. Sadly, that all started to change right around the time I was sixteen when one of my friends helpfully pointed out to me -- while at a pool in front of all my other friends -- that, hey, I was getting fat. (I wanted to thank him with a crowbar).

There are many things that suck about being fat (and at 225 pounds, I'm not going to retreat to euphemisms), but the worst, in my opinion, is the general perception that if someone's fat it's because they've let themselves become fat. There's a smug inversion to that sentiment, too. If someone is thin, they can pride themselves on their wonderful willpower which is evidenced by the simple fact that they aren't fat. I suspect that one of the reasons that obesity is still a safe port for public humor (as opposed to, say, ethnicity) is that there is a perceived moral dimension to weight. If your fat, it is seen as a reflection of your character: you are guilty of being a willful glutton.

When fat people object that their weight isn't their fault, their protests are usually met with skepticism if not outright derision. Do we not have control over what passes through our mouths? Could we not simply eat a little bit less? The reality, however, is that weight actually does have less to do with willpower than most people assume. The first evidence of this came from the research of Jules Hirsch, in 1959.

Hirsch took obese volunteers and put them on a controlled diet. Their weight was painstakingly reduced to that of a normal person. What Hirsch discovered was that the volunteers bodies reacted to the weight reduction in two ways. The first was that the volunteers started to exhibit symptoms of starvation psychosis which mirrored the symptoms one might see in prisoners of war deprived or food or refugees on a starvation diet. The volunteers universally felt hungry to the point of starvation all the time. The second effect, which is even more insidious, was that their metabolisms literally slowed down by as much as 24% which meant that not only were they starving, but their bodies conspired to put weight back on them.

A converse study was performed by Dr. Ethan Sims who took thin volunteers and fed them a high-calorie diet to force them to gain weight and who then monitored what happened to them once they were off the diet. As you might expect, the results were a mirror image of the obesity trials. The volunteers lost their appetites and their metabolisms kicked into high gear. As a consequence, they couldn't help but to lose weight.

This has been further bolstered by twin studies. Identical twins separated at birth will almost inevitably have the same body-mass index while fraternal twins have similar BMIs. Likewise, adopted children are much more likely to have weights that resemble those of their biological parents than of their adopted parents.

The simple conclusion of these studies is that weight is primarily genetic. While it is possible for a fat person to starve themselves thin everything in their biology will fight against that thinness just as those who are naturally thin would have to exercise immense will to become and stay fat. Dr. Jeffrey Friedman has offered the analogy of holding one's breath: while it is possible to do so in contradiction to the instinct to breath, eventually the urge to breath becomes overwhelming.

As someone who is fat, I find this news simultaneously uplifting and depressing. It is good -- really good -- to know that I don't simply suffer from a defective will but it's also disheartening to think that I'll always be stuck with this weight.

There is the temptation to treat this information as license to eat whatever I want. After all, if my body has a natural weight that it wants to be, it doesn't really matter if I try to control my weight. I should be able to eat what I like without any pangs to my conscience. As it happens, I take pains to eat a healthy mix of foods and to keep my caloric intake to under 2,000 calories a day. I have three reasons for doing so.

  1. Because I am fat, I recognize that I'm more prone to certain health conditions. I am much more likely to develop adult onset diabetes (I have several siblings who already have) and heart disease. Eating nutritious foods won't guarantee that I won't develop a weight related condition but it will help to minimize the risk. The fact that I've been able to maintain a healthy blood pressure and cholesterol level are indications that this is a good strategy.
  2. Even though the bulk of our weight (no pun intended) is largely out of our hands, there's about 20 to 30 pounds of drift weight that is amenable to diet and exercise. Although I doubt that I'll even be able to get much below 220, I would rather be closer to 220 than to 245, which is where I was before I changed my eating habits. Even a difference of 20 pounds can feel significant. I have more energy than I did before and I feel much healthier than I otherwise would have. For simply quality of life, this is worth the effort.
  3. I know that whenever a thin person sees a fat person eating a cheeseburger, they nod to themselves and receive another bit of enforcement to their smug preconception that they're better than those of us who aren't thin. I don't want to give the bastards that sort of satisfaction.
I doubt that any number of studies will ever remove the moral stigma of obesity and, until someone comes up with a way to change a person's metabolic set point, those of us who are fat are just going to have to accept the fact that people are going to look down upon us for something that we objectively have limited control over. Be that as it may, I can take comfort in the fact that I don't conform to their stereotypes. If that means trading a Whopper in for the equivalent mass of fruit and lean meat, I'm more than happy to make the exchange.

Acknowledgement to the New York Times for reporting on the historical research. See Linked article.

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