Obesity, that is, an understanding of fatness as a medical problem, is the dominant way of understanding fatness in the contemporary United States and Europe. And yet this has not always been the case and is not true everywhere. In other times and places, fatness is widely regarded as beautiful and healthy. And it was not until quite recently in the United States, at the middle of the twentieth century, that fatness came to be viewed as a medical problem and even later—at the end of the twentieth century—as a public health crisis.
Calling fatness by the medical term obesity was crucial in convincing public opinion that fatness represented a medical problem. According to sociologist Jeffery Sobal, mostly male physicians began to portray fatness as both a disease in itself and, beginning in the 1970s, as a risk factor for other diseases, including cardiovascular disease.
Once physicians were able to convince society that fatness was a medical problem, they could use medical procedures and interventions to treat it. Technological interventions included jaw wiring, intestinal bypass surgery, gastric bypass surgery, liposuction, weight-loss pills, laxatives, and diuretics. While the medical profession was dominated by men, it was middle-class, white women, desperate to lose weight for social reasons, who created a high demand for these interventions, despite (or because of) the fact that their results were typically not permanent.
People, and especially middle-class women, increasingly engaged in weight-loss dieting under a physician’s care, and many weight-loss organizations applied a medical model to weight loss, often in cooperation with physicians. This served to legitimize weight-loss organizations, while providing a source of revenue to physicians.
According to political scientists Rogan Kersh and James Morone, invoking medical scientific evidence is necessary for garnering public support for U.S. government intervention in citizens’ private habits. The science does not have to be accurate to have an impact, they argue. They point to cases, such as that of tobacco, in which there was strong scientific evidence of harm and others, such as that of liquor, in which the science was only partially true: “Liquor contributes to health problems, but it is not poison, as prohibitionists insisted.”13 In still other cases, they show that “the science can be entirely fictitious, as when Victorian physicians warned men that self-abuse or too much sex could maim, blind, or kill them.”14 Moreover, medical knowledge is rarely in itself sufficient to stimulate a political response, they argue. Rather, it needs to be spread by policy entrepreneurs.
According to a biology frame, obesity is highly heritable, determined by genetic and other biological factors. For instance, molecular geneticist and MD Jeffrey Friedman likens body weight to height, arguing that the former is as tightly regulated by genetic factors as the latter. He concedes that people can often lose 10 pounds or so but insists that it is exceedingly difficult to lose large amounts of weight and keep it off. In other words, each person has a “set point,” or a certain weight range, to which his or her body naturally returns.
While people can diet and lose weight temporarily, their weight inevitably drifts back up to where it started. This theory is consistent with studies of weight-loss programs, which show that people often lose a lot of weight at first but typically regain it within a year or two and, at best, are able to sustain a 5 to 10 percent loss. “In trying to lose weight,” Friedman says, “the obese are fighting a difficult battle. It is a battle against biology, a battle that only the intrepid take on and one in which only a few prevail.”55 Discussing Friedman’s work, New York Times journalist Gina Kolata concludes, “Free will, when it comes to eating, is an illusion.”
Properly adjusting for age and other factors, using the NHANES data and the full “normal weight” category as the reference group, the Fat-OK study found that being overweight-but-not-obese (BMI greater than 25 but less than 30) was associated with 86,094 fewer deaths. It further found that having a BMI over 30 was associated with 111,909 excess deaths in 2000 and that these deaths were concentrated in the category of BMI greater than 35, a category into which about 15 percent of the U.S. adult population fell in 1999–2000.
“being very thin increased the risk of death, even if the thinness was longstanding and not due to illness,”
Drawing on the NHANES 1999–2004, an epidemiological study estimated that the proportion and number of people in the “normal weight,” “overweight,” and “obese” BMI categories that were metabolically healthy or metabolically abnormal, based on six measures of cardiometric abnormalities: elevated blood pressure, elevated triglyceride level, decreased HDL-C level, elevated glucose level, insulin resistance, and systemic inflammation.35 They found that 23.5 percent of people in the “normal weight” category, or 16.3 million people, have an abnormal cardiometabolic profile, whereas 51.3 percent of people categorized as overweight (35.9 million people) and 31.7 percent of those categorized as obese (19.5 million people) have normal cardiometabolic profiles. This suggests that using BMI as a proxy for cardiometabolic health, in which “normal weight” people are considered healthy and the “overweight” and “obese” are assumed to be unhealthy, may lead doctors to overlook as many as 16.3 million (“normal weight”) people who have abnormal cardiometabolic profiles while over-treating 55.4 million (“overweight” and “obese”) people who actually have normal cardiometabolic profiles.
From Abigail Saguy's - What's Wrong With Fat (isbn: 978-0199857081)
Reading her book and her articles/op-eds where she's regularly published shows that this anti-fat crusade is a relatively new thing, and that most of the greatest proponents in the science/medical field are actually the ones making the most money off of it by having weight loss clinics. It's been in the last few years that studies have shown that the medical frame, and the obesity epidemic is faulty bad science and propaganda, and in many ways, an attack on women.
What most studies and research has found was that bmi has no correlation to actual health.
The bad news is that people have a NEED to shame, attack, and bully others. Where they once used sex, since the 90s it's become weight, and it's just one more product of how piss poor society and humanity can be.