I’m listening to an interesting interview of Dr. Paul Ernsberger, Associate Professor of Case Western Reserve University, and Dr. Eileen Seeholzer, Director of Obesity and Weight Management Program for Metrohealth (a nonprofit, county operated healthcare system located in Cleveland, Ohio) on a show called The Sound of Ideas. The show is titled “Eat Less, Exercise More? Maybe not.”
My first problem is that Dr. Ernsberger, who has a PhD, was not referred to as “doctor”; only Dr. Seeholzer (an internist) was referred to by that title. It may or may not be a small thing, but I think it showed a lack of appreciation for Dr. Ernsberger’s qualifications.
Dr. Ernsberger pointed out that a focus on health and healthy behavior rather than weight is more effective in improving the health of fat folks; and that many people can achieve significant health benefits by a change in behavior without any weight loss.
I was pleasantly surprised to find Dr. Seeholzer agreed with almost everything that Dr. Ernsberger had to say, but her ultimate focus remains on weight. Even so, her focus on weight loss is based on improving health numbers such as blood pressure, glucose levels, cholesterol) than achieving thinness.
The doctors did butt heads over the use of BMI, with Dr. Seeholzer believing that BMI along with waist circumference can be used as a starting place for predicting health goals.
Then the host opened the show up to callers.
Begin the parade of “I lost” by “doing this” and “all you have to do is” and “ain’t I wonderful”.
I found the smugness and the reek of moral superiority almost unbearable. And of course these callers were all congratulated, as the show quickly devolved into diet talk.
Dr. Ernsberger did his best to point out that (a) these people are in the minority; (b) that often the lifestyle described by the callers to maintain their weight loss may border on obsessive-compulsive; (c) that focusing so much on what you eat may lead to an unhealthy relationship with food; (d) that you cannot tell a person’s health or their lifestyle behaviors just by looking at them; and (e) such behavior is probably not sustainable in the long run (5 years) Dr. Seeholzer also took a shot at explaining why dieting doesn’t work for most people and why weight loss and weight loss maintenance are much more difficult for different people. But it was clear that Dr. Seeholzer was solidly behind the dieters and while Dr. Ernsberger brought up the issue of the difficulty of long term weight-loss maintenance (especially in regards to a lady who is on Weight Watchers), Dr. Seeholzer completely ignored this issue.
Of course, no one wants to say “Well, pin a rose on you,” to the dieters. Well, I do (sarcastically of course), but I wasn’t invited to the party.
I did find enlightening Dr. Ernsberger’s comments about how people who have lost weight often experience a post-weight loss glow (due to all of the compliments, and feelings of control and achievement) and that feel-good glow should not be confused with good health. Numbers such as blood pressure are more important.
One caller was going on how she lost so much weight from taking up swimming and a vegan diet, and you just have to find “something that works for you.” Dr. Seeholzer chimed in with you need to develop a self-identity as a healthy eater and fit person. Dr. Ernsberger brought up synchronized swimming group, the Water Lilies, who (he believes) are also mostly vegan, and are all fat. The point is that regular swimming can be fun and may have health benefits irrespective of weight.
I was hoping that this show would be about focusing on health for fat people rather than focusing on weight loss; but the callers brought the conversation down to “I’ve lost weight and am therefore better than anyone who hasn’t.”
So, some people lost some weight. Pin a fucking rose on you.
And I’m fat. Pin a fucking rose on me too!
“Look in the mirror, and don’t be tempted to equate transient domination with either intrinsic superiority or prospects for extended survival.” – Stephen Jay Gould