Sunday, November 20, 2011

The Great Fat Fraud by Mike Schatzki

The Great Fat Fraud by Mike Schatzki helps untangle the issues around fitness, weight, diet, surgery and the weight loss industry.  By the end of the book, the reader should walk away with the understanding that fitness does not equal thinness and that achieving weight loss is much simpler than Weight Watchers, Jenny Craig and LA Weight Loss would have you believe.

Within the first six chapters, the author cites the work of three large, long-term studies (some going back to 1953) that show conclusively that the most reliable predictor of mortality isn’t size but fitness and activity level.  (Although many define “fitness” differently, for this purpose it’s a measure of how well the body can use oxygen.)  An active, fit person has a significantly lower risk of mortality than a sedentary person- regardless of body mass index (BMI).  If mortality is the primary concern, activity is the answer.  Numerous studies have shown that walking 10,000 steps per day is the target for the majority of people to achieve optimal fitness levels.

The next chapters discuss losing weight.  For most people, fitness activity will not result in very much weight loss, if any.  In order to achieve lasting weight loss, people have to 1) reduce their food intake (in other words, diet) until they hit a weight plateau and then 2) follow that up with activity- ie, 10,000 steps per day.  This combination will prevent the body from going into starvation mode and hoarding fat, which is what it does when deprived of calories (ie, dieting).  Weight loss is doable- and in fact, most people on diets have done it before they regain some or all of their weight- but the author takes pains to note that for most people weight loss is an aesthetic choice, not a health imperative.  In these chapters he also cites a study that showed that people who focused on body acceptance improved their health (lipid levels, blood pressure, activity, etc.) more than those who focused on dieting and, not coincidentally, felt better about themselves.

Schatzki spends a brief chapter each on stomach reduction surgery (because of the risks, it’s only appropriate for the most unhealthy 1 or 2 percent of the obese), weight loss drugs (which, unlike other drugs, trick a healthy body into malfunctioning) and weight loss programs (most of them can help you take the weight off, but you won’t keep it off... unless you’re active).  However, the most damning section of the book deals with what he calls the “researchaganda” that promotes the idea that obesity is a public health threat when in fact is not.  

By 1998 the World Health Organization (WHO) and the Obesity Task Force of the National Institutes of Health (NIH) had been manipulated by the weight loss industry to the point that the BMIs for overweight and obese had been lowered (to 25 to 30 and over 30, respectively).  In 2004, the Center for Disease Control (CDC) published a report that obesity was responsible for 400,000 deaths every year.  

Although the CDC study was debunked shortly after it was published (by everyone from the Wall Street Journal and Science Magazine to the Government Accountability Office), the damage had been done.  The media now had a story: fat isn’t just something people didn’t find attractive, it's a dangerous public health issue, and there is nothing modern media loves like a story that scares people- even if it's not true.  

At the end, Schatzki asks readers to take up the challenge to spread the real story about weight, fitness and obesity and offers links to the information cited in his book.

Both well-researched and accessible, this is a short, easy read that debunks obesity hysteria.  Recommended for anyone with an interest in health issues.