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11 Responses

  1. LC
    LC August 16, 2011 at 10:24 am |

    And really this should shock absolutely no one. Should and will are, of course, different things.

  2. Jadey
    Jadey August 16, 2011 at 10:40 am |

    None of this is new to me – I’ve been reading research building to this for years now – but I’m so glad it’s getting more and more press. Maybe one day soon we will finally have a fat-positive, non-shaming approach. We largely substituted the “fat is bad because it’s ugly” with a faux-gressively PC “fat is bad because it’s unhealthy” argument in the mainstream dialogue, which might almost have been a win in the long run (for all the frustration, angst, and harm it caused), because “unhealthy” is more explicitly disprovable than “ugly”. Maybe some of the “health!” people will turn around and start objecting to fat on aesthetic grounds again (and it’s not like everyone stopped doing that in the first place), but hopefully this will get at least some of the concern trolls off our backs, especially the white-coated ones in medical spaces.

  3. matlun
    matlun August 16, 2011 at 11:44 am |

    I thought it was already established that BMI by itself is a very blunt instrument to predict mortality?

    This study only seems to be saying that the “Edmonton Obesity Staging System” is much better at predicting mortality than BMI. Since EOSS is based on a complex evaluation of medical data as opposed to a quick calculation from just weight and length that should surprise absolutely no one.

  4. Christina
    Christina August 16, 2011 at 11:59 am |

    Of course, the ongoing media superscare over obesity rarely considers that people with obesity are anything other than fat, lazy slobs. I mean, just look at ‘normal’ weighted people– two people who physiologically LOOK the same might be a marathon runner or a sit-on-the-couch slob. I mean I’m 5″11 and 125lb but I’m as unfit as can be.

  5. Mike
    Mike August 16, 2011 at 1:59 pm |

    I really don’t agree with the whole “you should lose weight at all costs!” argument. And I totally agree with the goals of HAES.

    But this study is REALLY problematic.

    The most troubling analysis is accompanying figure 1, where the findings about people with EOSS 0/1 having a lower occurence of cardiovascular disease than those with so-called “normal weight”. Specifically, examine this line:

    “Adjusted for age, sex, smoking status, exam year, low fitness, dieting, and adequate fruit and vegetable consumption. ”

    Normally, when you’re running regression analysis, this is pretty standard when you expect random variation. However, looking at table 2, we see that the group labeled EOSS 0/1 was 5 times more likely to have low fitness levels! (8.2% of the population compared with 46.83%) This is obviously non-random yet it was “controlled for” meaning that its effect ignored in the final analysis.

    If there is a known connection between low cardiovascular fitness and cardiovascular disease, and if there is also a known correlation between being EOSS 0/1 and having a low level of cardiovascular fitness, then there actually IS a link between being categorized as EOSS 0/1 and having an increased risk of cardiovascular disease, but it is a link the researchers are willfully ignoring through their choice of statistical techniques.

    As they do not publish their full regression results, it is impossible to be sure how strong this link is, but this does seem to be a significant problem.

    Note: BMI is still a totally crap indicator, but that’s no excuse to accept junk science.

  6. shah8
    shah8 August 16, 2011 at 6:31 pm |

    I saw that right away, too, Mike. I didn’t pay that much mind to it, since the overall goal is getting people to live healthier lives and health professionals to do a better job of measuring actual health instead of using cheap heuristics.

    It’s just that the politics are so narfy, I don’t particularly want to talk about it, and I suspect many others are the same. People insist that a complex topic should be simple, when it’s just not.

    As far as fat as a personal issue goes? Health is a lifestyle set of choices. You can’t make the decision to exercise unless you will stick to it for a lifetime. Same with dietary choices. You do what you can do (if you have a stable enough life with access to resources), and let other people mind how you look. They care about it because they want to see themselves as better than you. Eff all that. Just get into a rhythm you can sustain, diet and exercise wise (with input from your own body and your doctor/dietitian), and you will get health benefits, even if it’s invisible in the mirror. It’s hard to do the profoundly simple, but that makes it all the more important to remove distracting complexity from what your choices really are.

  7. News: Prisoner Justice Day, Sex+Motherhood, Fat+Health «

    […] recent study out of Edmonton suggests that being fat isn’t actually inherently unhealthy (what!?!?!??), being unhealthy is what is unhealthy. Emily over at Feministe breaks it down. The original article […]

  8. Tori
    Tori August 16, 2011 at 10:29 pm |

    In other news, if there’s utterly zero indication that anything weight related is going to kill me — my weight is probably not going to kill me?

  9. Jackie
    Jackie August 17, 2011 at 1:18 am |

    Glad to see the doctors in Canada are focusing on health, and not the money they receive from insurance companies. Hopefully America will wake up, and realize the days of headless fat people on the news and shaming should be over.

  10. rae
    rae August 21, 2011 at 8:11 pm |

    Mike –

    But controlling for fitness level allows us to separate whether health problems are actually caused by the obesity itself or if weight correlates to poor health outcomes because both of those two variables are related to fitness levels. These results show that doctors should not be measuring weight, which is sometimes an indicator of fitness level but also is often not a problem at all, and instead should be measuring fitness levels. It’s validation that if you are, say, a 200+ lb woman who works out for 45 minutes every day yet never seems to lose a pound, your weight is not independently a problem.

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