Gayle Madwin (queerbychoice) wrote,
Gayle Madwin

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Why It's Healthier to Weigh More Than the U.S. Government Says You Should

Last night on AIM, rhekarid pointed out to me a fantastic collection of articles on nutrition by Sandy Szwarc, a registered nurse who is, among other things, a member of the Association for Size Diversity and Health, and an advisory board member for the National Association to Advance Fat Acceptance. (There's a "Next" button at the end of the page that's easy to miss, and that leads to even more of her articles.) I'd like to point out some of the highlights of her work.

First, why it's healthier to weigh more than the U.S. government says you should. From her article "Bon Appetit!":
Being overweight is actually associated with reduced mortality rates. Being well nourished is healthful. In fact, looking at the data on nonsmokers, ages 29-59, those who are "overweight" or "obese" (BMI 30-35) have 66 to 77% of the mortality risk of government-approved "normal" bodies (BMI 18.5-25). For an average 5'4" woman, that means weighing 145 to 205 pounds is the least risky; for someone 5'11", the lowest risks are at 172 to 247 pounds.

But being underweight, even after accounting for smoking or illness, is 25% more dangerous than being "normal" weight. And it's considerably more dangerous when compared to either "overweight" or "obese" (BMI 30-35): 89% to 62%, respectively. After the age of 60, being underweight becomes especially hazardous and is the riskiest of all: almost 200% greater risks than those associated with "normal" weights, 266% greater than "overweight," 145% more than "obese" (BMI 30-35), and even 29% more than the most extreme obesity (BMI >35). In contrast, obesity only reaches the same risks as underweight among younger ages (25 to 59 years) at the uppermost extremes of BMIs over 35, which represents a mere 8.3% of the population. That's a far cry from the government's claim that 66% of us are "too fat." . . .

[But] even while extremely high BMIs may be associated with health problems or increased mortalities, that still doesn't mean that fatness is the cause. According to a 2003 report by the Surgeon General, "obesity" is significantly higher among minorities, poor women and those with lower levels of education. Lower educational and employment opportunities, poverty, negative social environment and discrimination, increased levels of stress and feelings of hopelessness and isolation, and less access to preventative health services all add to their health risks.
Building upon that last paragraph, her article "Dying to Be Thin" mentions:
A 1992 National Health Interview Survey found increased BMI was associated with decreased preventative health care services. On Jan. 1, 2002, the National Task Force on the Prevention and Treatment of Obesity reported obese patients are less likely to receive certain preventative care services, exacerbated by patient concerns of being disparaged by doctors or medical staff because of their weight.
Furthermore, the risk of losing weight is much greater than the risk of simply remaining at any existing weight or gaining weight. From her article The War on Fat's Casualties:
In 1992, the NIH held a conference on Methods for Voluntary Weight Loss and Control in which the country's top experts reviewed the body of scientific evidence on weight and dieting. Their consensus statement was stark and startling: Most studies, and the strongest science, shows weight loss, although seemingly to reduce risk factors, is actually strongly associated with increased  risks of death -- by as much as several hundred percent.

These risks weren't a result of excessive weight loss or extreme diets, but as little as 10 pounds and even moderate calorie restrictions. Moreover, the NIH determined that studies that appeared to show opposite results, such as a famous Metropolitan Life Insurance study, were seriously flawed.

[Frances] Berg [M.S., editor-in-chief of Healthy Weight Journal] summarized the research in Health Risks of Weight Loss (Healthy Weight Journal, 1995) and showed in study after study -- Framingham Heart Study, CARDIA study, the CDC NHANES I, MRFIT, Harvard Alumni Study, Dutch Elderly, Alameda County, Baltimore Aging, Honolulu Heart, Lipid Research, British Heart -- that weight gain with age, or stable weights, for both men and women offered the lowest death rates, while dieting, weight loss or fluctuating weights, significantly increased the risk of death, cardiovascular diseases, diabetes and cancers. Follow-up studies since the 1992 conference have found similarly strong results, Berg reported.

Typically the risks attributed to obesity aren't separated from those independently due to dieting and regaining weight, David Garner, Ph.D., and Susan Wooley, Ph.D., noted in their comprehensive review of research on diets published by Clinical Psychology Review in 1991. When they are, such as the large-scale study from the American Cancer Society and the CDC published in 1995, premature death rates for women who've dieted to lose just 1 to 19 pounds (over a year or longer) increased as much as 70 percent, cancer mortality as much as 62 percent and heart disease and stroke by up to 167 percent compared to those who were equally overweight but weight stable. Equally alarming results have been found in men. A 1993 study of more than 10,500 high risk men led by Steven Blair, M.D., published in the Annals of Internal Medicine, found weight loss of about 10 pounds increased their mortality from heart disease 61 to 242 percent, compared to men who maintained their body weight or gained weight.
Her article "'You Can Relax About Food and Eat What You Want'" describes a randomized clinical trial of fat women ages 30 to 45:
[H]alf of the women participated in a traditional diet and weight loss program, complete with social support; standard nutritional guidance to moderately restrict calories, on how to count calories and fat, read food labels and shop, maintain food diaries, and monitor their weight; and were given information of the benefits of exercise and behavioral strategies for successful dieting. The other women were instructed to let go of restrictive eating habits and not weigh themselves, were counseled to eat according to their natural appetites, given standard nutritional information about healthful foods, and participated in a support group designed to help them become more accepting of their larger bodies, develop a positive self image, and enjoy their bodies. The second approach is the medical paradigm known as "health at every size." After six months of weekly group interventions among both groups, they were followed monthly thereafter.

The just-released findings show that while the dieting group that had initially lost weight, it had regained almost all of it two years later, while the nondieters' weights had remained stable. Both groups had initially lowered their systolic blood pressure but it had rebounded among the dieters, while the nondieters had sustained their improvements. The dieters showed no change in their total cholesterol or LDL cholesterol, while the nondieters had significantly decreased theirs by the end of the study.
Yet the U.S. government and mass media continue urging everyone to eat less and less. In fact, Szwarc's article "MyPyramid Scheme" describes how the U.S. government's latest food pyramid, which claims simply to illustrate and explain the existing Dietary Guidelines issued by the U.S. Departments of Agriculture and Health and Human Services and intended to help people maintain their existing weights, actually disregards those guidelines and "covertly . . . puts the nation on a diet." An extremely restrictive and gender-biased diet, that completely disregards the different needs of people with differing heights and weights:
In simplifying the Dietary Guidelines for us, MyPyramid claims to give us our own 'personalized' calorie recommendations after we enter our age, gender and activity level at the website. [It doesn't ask about height and weight.] . . .

To illustrate MyPyramid's caloric underestimations -- which become increasingly extreme the larger and more active people get -- adults 31 to 60 years of age active more than 60 minutes a day, are allotted 2200 calories if they're women and 2800 calories if they're men. According to the USDA/ARS calculator, however [which, unlike the MyPyramid website, does take height and weight into account], those are the minimum calories recommended for a comparably active 77 pound woman (BMI 13.2) and a 110 pound man (BMI 15.7). MyPyramid underestimates the calorie needs for most of these active adults by as much as 49% for women and 24% for men. . . . According to MyPyramid, girls should eat more daintily than boys beginning at age 4.
And all of this, dear people, is why I must remind you once again that I do not wish to hear you wishing you were any narrower than you are. Enough with the eating disorders! If you're going to insist on dieting yourself down to a government-recommended weight that actually lowers your life expectancy, the least you can do is create a "self-injury" filter for your LiveJournal posts about it and leave me off the filter so I don't have to watch. Better yet, get counseling and grow some self-esteem! Granted, if you ever again expose yourself to any mass media, you'll probably need more counseling again in no time . . . but hey, just because the Unabomber's idea to blow people up was bad, that doesn't mean his idea to live in a cabin in the woods was necessarily also bad. I bet he didn't have any eating disorders! Cabins in the woods have definite advantages that way.
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