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Managing the condition

May 26, 2009

Slate columnist William Saletan reports on the relative success of surgical weight loss as opposed to diet and exercise and very thoughtfully suggests this might be a good avenue for government agencies to pursue to cure the population of obesity:

So look out, fat folks. As we learn more about the intractability of your condition, the good news is that people may stop expecting you to diet or exercise your way to a thinner body. The bad news is, they may start expecting you to go under the knife.

Ever thought that maybe–just maybe–we shouldn’t expect people to be thin? That we shouldn’t expect people to undergo a dramatic surgical restructuring of their internal organs to avoid the dreaded “fat” label?

I am not the die-hard anti-surgery type. For some people, these opportunities dramatically increase the quality of their lives. But if we can expect only about 2% of Americans to have BMIs over 40, the point of “morbid obesity” (about 290 pounds for a 5’11” man, about 235 pounds for a 5’4″ woman), we’re looking at a fairly small population of individuals potentially at the point of morbidity, and I’d like us to be a bit cautious about the wholesale prescription of a painful and invasive procedure based on some pretty faulty notions of what constitutes health.

Fat should not be viewed as a condition in need of management. We need to extricate “health” from weight so that when Congress pushes to give business managers more leeway in rewarding their employees for better “health”, we recognize health at every size. Weight loss is not an uncontested good, and we should be wary of punishing an individual that is otherwise free of health problems (or even those who aren’t) for choosing not to lose weight.

So, look out. It might turn out that it is totally unreasonable to expect that you lose weight without dramatic surgery. Unfortunately, that doesn’t mean it will be totally unreasonable to demand that you be thin.

2 Comments leave one →
  1. Becky permalink
    May 27, 2009 12:56 AM

    It’s also probably the easiest way to get your head back.

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