I talked to a woman the other day who was seriously concerned about her two-year-old's big belly and that maybe her daughter was overeating. She was really relieved when I told her that it's normal- even desirable- for toddlers to be pudgy.

With babies, it's even weirder the way people are. I've made comments about my 6-mo-old's "fat" legs (which they are, because he's a baby, and babies are fat) and had people defend him to me, as though I had been criticizing...

I have never heard "lots to love" used as a slogan of the fat acceptance movement and I feel at least reasonably involved, and anyway, I'm not sure what the point of noting that in the context of this toy is?

Fat is just such a negative word to most people, I guess. I know when I describe myself as "fat" most people are horrified, some try to console me but most are just at a loss because they know I'm fat and won't deny it and, I guess, most people seem to think fatties are in denial or oblivious to our state or we'd do something about it so to have one say it outright is just shocking to them. Wow, long sentence that.

The fat issue is culturally ingrained in so many weird ways in the USA (and other countries). In many central American countries, it's acceptable to use "fat" as a descriptor (e.g. you can call a chubby little boy "gordito"). In France, calling a woman a "gourmandise" is kind of a backhanded thing to say-- it literally means someone who enjoys food, but it also means fat.

Then there's the whole "I'm don't care if you're huge! I'm just worried about your health" scenario... Not that it's not legitimate, but it's interesting how we try to phrase things to make it sound like a legitimate concern.

(I'm not saying obesity isn't a major health issue. It is. Just pointing out the strange ways we deal with things that are uncomfortable to talk about directly.)

IT SAYS "IT'S JUST BABY FAT" ON THE BOX. OH MY GOD BURN THESE DOLLS.

The obesity scare is an insidious, terrifyingly powerful force in America/Canada right now, and it's honestly starting to scare the sh*t out of me. It's no longer driven by "health concerns" (IF it ever was, because you can even argue that). It's aesthetic fear-mongering under the guise of "we know better than you." The "you" is people with any body fat. The "we" is everyone of every size who buys into the obesity scare--especially the media and dieting industries. The "know" is fake and/or twisted science perpetuated by a lot of people who think fat is shameful and just want an excuse to justify that. The "better" is the MORAL bent the obesity scare has pushed, which says both directly and indirectly that a fat person is worse than a thin person because of the fat and what it symbolizes.

I'm glad kateharding.net exists, because seriously. I have goosebumps I'm so disturbed by this doll.

The public health community has made a huge mistake linking health and looks. There is already overwhelming evidence that discrimination causes disease. And fat is one of the few socially sanctioned discriminations left. Furthermore, health correlates much better with exercise and a healthy diet, regardless of weight. The consequences are that fat people who have dieted and given up (and that is most fat people) don't bother anymore because it won't change their looks. And thin people who don't eat right or exercise (and there are quite a bit) are under the false assumption they are healthy. And you don't need to be an athlete. A moderate amount of exercise is sufficient. The obesity epidemic is based more on a morality judgment than sound science, and it is going to do a lot of damage.

Thin people who do not exercise have twice the morbidity and mortality than fat people who do.

Studies from the US, Canada, and Japan have shown that people with "overweight" and "obese" BMIs live longer than people with "normal" BMIs. Health concern my behind.

I'm familiar with "More to love" but not "Lots to love" re the fat acceptance movement.

@Katie and Nataly: My bad. I mentally conflated "more to love" with "lots to love." All apologies. I'm reasonably acquainted with the FA movement as well, so shame on me for that.

These Lots to Love dolls aren't new. I used to work at Walmart and I remember stocking them seven or eight years ago.

Cite a large recent study which finds no link between obesity, and host of preventable dieses. Furthermore, find the peer reviewed comments following such a study. The fact is obesity, is about to replace smoking as the lead preventable cause of death. There is a difference between obsession with the popular notion of appropriate and genuine health concerns, and its pretty damn obvious. As some one who used to smoke, and catch hell for it, I have no pity for people who are chided for living a unhealthy lifestyle. I might also add, that working a hospital has given me personal experience with the burden of dealing with an obese population.

A correlation between obesity and various health conditions does NOT meant there is CAUSATION. Perhaps someone became fat through never exercising and eating an unbalanced diet. (NB - not casting any judgments here on whether people SHOULD exercise and eat "healthy".) Now, Drs Stephen Blair and Glen Gaesser conducted a huge, peer-reviewed, published, legitimate study a few years ago which showed that fat men who were physically active were healthier than sedentary normal-BMI men - thus showing that physical activity is a far more important indicator of health than weight. Dr Jeffrey Friedman, one of the world's most prominent researchers into the genetics of obesity says that it is in fact impossible for most fat people to keep lost weight off. He's spent 25 years researching it and I dare say he knows more about it than pretty much everyone else on the planet. He's also concurred with Drs Blair and Gaesser that physical activity is a key health issue, not weight itself.

Being fat may be a symptom of poor health but not necessarily a cause. Stress raises cortisol levels which causes you to put on weight. Various medical conditions can increase weight gain, such as PCOS, underfunctioning thyroid (up to 1 in EIGHT women have this), depression, musculoskeletal conditions, autoimmune conditions, adrenal conditions, and many more. The medications used to treat these and other conditions can also increase your weight. Antidepressants are notorious for causing weight gain. Insulin causes weight gain. Steroids cause weight gain. Hormonal contraceptives cause weight gain.

And there are plenty of studies, if you care to look, which demonstrate that deliberate weight loss attempts rarely work long-term, and in fact the cycle of weight loss and regain is far more detrimental to health than remaining at a high but stable weight. Dieting, even if you call it a lifestyle change, is a huge predictor of future weight gain.

How many studies "proving" that obesity causes X Disease adequately control for dieting history, socioeconomic status, mental health, self-esteem, etc?

Go to pubmed an do your own damn research, E. Here's some starter tips: Search for "obesity stigma". Whenever a study claiming being fat causes something-or-other, go read the actual study instead of the recycled press release. The results are usually quite flimsy.

Also, E, anecdotes aren't data. Just because YOU see fat people in hospital doesn't mean you can imply anything about the fat population in general. I went to hospital once and I saw an awful lot of redheads there. Therefore having red hair is a big health risk, right?

But all data is anecdotal.

I've come to realize recently that so many of the hang-ups people have about babies (particularly THEIR babies) are just projections of their own insecurities. I know, I'm late to the game on that one.

For instance, Julia's story about people who "defend" her baby, in my opinion, shows a) their own weight insecurities, and b) how ingrained the response "no you're not" to the phrase "I'm fat" is. (That sentence was constructed strangely, so I'm just going to leave it there.)

Look also at the hyper-feminine and hyper-masculine clothes that babies wear. I'm sure that an 18-month-old couldn't care less whether he/she is wearing pink or blue. It's the parent's (or parents') fears about gender ambiguity projected onto his/her/their child.

Just a comment on the seat: I'm pretty sure from the look that it's meant to be one of these (http://www.bumbobabyseat.com/), not a potty training seat.

Kelle, would you agree with the statement that the BMI is a flawed measure and should not be used in studies except when those studies validate your point of view?

Overfat, as distinct from BMI-derived overweight, is linked to many negative health consequences, as we've gone over in the comment thread on this post.

Meanwhile, that "fit and fat" people are healthier than "unfit and thin" does not disprove the link between overfat and ill health, unless you can show that there is no correlation between fitness and fatness. (Or, in other words, that fat people are just as likely to be fit as thin people.)

Mothers who smoke have a very small chance of having obese babies. It is true.

I have a bumbo seat and a potty seat, and I think this one is a potty seat.

Also sociologically interesting that the baby has a bottle. Because babies are assumed to feed themselves from bottles, rather than being nursed by their mothers. This image is so prevalent that my daughter who was mostly breastfed, and who has mostly seen other babies breastfeeding, still talks all the time about how babies drink milk from bottles.

Of course since studies have correlated bottle-feeding with obesity, maybe incuding the bottle is totally appropriate in this (weird) instance.

Thanks Kelle, I really didn't have the time to compile all of that! :) Great response. And P, there are many reasons fat may correlate with worse health outcomes. First and foremost, stigma. Stress due to stigma has already been shown to be a predictor of heart disease. Of course we only take that seriously for every other stigmatized population, but not fat people. The other culprit might be dieting itself. Many are dangerous. Most of the drugs approved by the FDA for weight loss turn out to very dangerous, and eventually get pulled. And the constant gaining and losing is really bad for your heart. There are actually studies that show that fat women who don't diet do not have the same risk for heart disease of fat women who do. Although I can't imagine how hard it must have been to find participants. Don't most American women constantly diet. The diet industry is killing us way more than any fabricated epidemic.

Annoyed, do you mean to tell me that stigma and dieting history are what causes overfat individuals to, for example, have compromised postural stability and increased fall risk? I appreciate the fact that fat is viewed negatively in Western society, and that this may cause physical as well as mental anguish to the overfat. I also appreciate the fact that yo-yo dieting and unproven dieting supplements, pursued by uninformed individuals as a means to get-thin-quick, are anything but healthy. But that does not mean that you need to either A.) fabricate conspiracies about a predatory "diet industry", or B.) cover up or ignore any and all evidence showing overfat to contribute to ill health and poor fitness.

P,

A.) There were about 40 billion peices of proof that the diet industry has something to gain by making people believe that fat is bad for them last year alone. It is naive to think that a corporation who is interested in selling a product is not going to do everything they can to make sure the public believes that it needs that product. Companies do not exist to help people, they exist to make money, there is nothing wrong with that, but that means that we, as consumers, have to protect ourselves. If you want to trust that weight watchers is really your BFF who is just "concerned for your health" and wants to sell you this nice product to help, well, good luck with that.

B.) As other people have mentioned correlation is not the same as causation. For instance the more firemen fighting a fire, the bigger the fire is going to be. Therefore firemen cause fire? You're arguing that fat makes people unfit, and that they are in poor health, but what if people who are in poor health are unfit are just more likely to get fat. Ultimately what we are trying to get to is that itsn't the FAT that's the problem, it's all of the underlying health issues, and solving those issues may or may not make you less fat.

Here is an interesting article from the NYTimes that cites mutliple studies you may find interesting. http://www.nytimes.com/2007/05/08/health/08iht-snfat.5614611.html?pagewanted=1&_r=2

P, compromised postural stability is only going to be found in the morbidly obese. And it is hardly what is causing the moral outrage/public health crises. Are you trying to say the surgeon general is freeaking out over posture?

These are not conspiracies. there is a large and growing number of scientists questioning the validity of the "epidemic." Including the head of my department at the top public health school where I got my MPH.

It's a great teaching example in an epi class because you can see how relative risk can be used to inflate perceived risk. Nobody is arguing that there isn't a correlation, and that part of that is because some heavier people don't exercise. What we are arguing is that it is a complicated issue that has been simplified into fat=evil. The roots of which stem from the protestant ethic rather than science.

If we encouraged people to exercise rather than change their looks, we would get a healthier population. If we encouraged people to eat healthy instead of buying into fad diets or crappy diet foods, we would get a healthier population. For many, changing their looks is impossible, but being healthy is not. Concentrating on looks also deceives thin people into believing they are healthy regardless of whether or not they exercise or whether or not they eat healthily.

Here is a good example of how things get blown out of proportion when industry and the media get hold of science. Smoking has a 12% mortality and morbidity rate. Don't get me wrong, that is huge! It is the highest for any behavioral related chronic disease. Yet if you ask someone on the street what they think that percentage is, especially smokers, they will tell you 95%.

Except with obesity we are going after the way people look. I find that problematic.

"Awwww" and "cute"
were part of what 'my' wife said when I showed her the photo.

If we encouraged people to exercise rather than change their looks, we would get a healthier population. If we encouraged people to eat healthy instead of buying into fad diets or crappy diet foods, we would get a healthier population.

I agree completely. However, one problem is that overfatness often locks people into a low level of fitness, in addition to contributing directly to some maladies. For the former, the issue of postural stability is actually quite relevant. In general, an overfat individual may find it much more challenging to begin and sustain an exercise program than an individual of the same fitness level who is not carrying around excess fat. So in that sense, overfat=bad, to riff on your equation.

Now, another problem is that our standards for fitness and healthy eating are quite low and often very muddled. What is physical fitness? Is it the ability to sit on the couch and watch Oprah without keeling over and dying? The ability to run X miles a week? The ability to do X pushups? The ability to do a pull-up - and how many Americans can legitimately claim even one quality pull-up? Is it the ability to lift a couch, push a car, do a handstand? In the face of all these complications, we are left with "fitness" standards that are either much too vague, or much too low.

The same is true with "healthy" eating. "Intuitive eating," often championed by FA activists, makes no sense in an environment where eating and food are anything but intuitive. Put bluntly, we as a population have lost nearly all innate understanding of what is food, how much food we need, etc. Meanwhile, the various popular prescriptions for "eating healthy" (e.g. Pollan's dictum) are platitudes covered in half-truths. Unhelpfully, what eating "healthy" means depends on one's fitness and activity levels, which again are hard to define.

So what has this got to do with fat? It is a fact that a great many more Americans are fat now than were in the past, and that today's fat Americans are generally fatter than yesteryear's. Obviously, fad diets and a cornucopia of weight-loss "aids" have not made these people leaner or healthier. Fat acceptance gets this much right. However, swinging to the other end of the scale - imaginary weight set-points, the insistence that any degree of overfat has no negative effects on health, repeated allusions to an elusive legion of the "fat and fit" - doesn't make much sense either.

Realistically, people can and do effect dramatic improvements in their health and equally dramatic declines in their bodyfat percentage. However, this takes way, way more than "eat less and exercise," or any other shorthand prescription for better health. Realistically, the American population will continue to get fatter and suffer the ill consequences of overfat unless the stewards of the public health steer it onto a healthier track. The reasonable aspects of fat acceptance - anti-discrimination, anti-snake oil, health over looks - would gain much more traction if the movement stopped denying these truths.

P,
"So in that sense, overfat=bad, to riff on your equation." Uhm, you're not RIFFING here, you're actually changing what the other poster said, or in fact, disagreeing.

I disagree with so many things you've said here it is hard to know where to begin.

Lets start with being fat or overfat if you prefer is not the only thing that keeps people from fitness, long work hours, children, lack of money to join a gym, and just the fact that starting an exercise program is hard for anyone can "lock" people into being unfit. I think a key thing to note here is that it is only the 'overfat" people who are publicly shamed for not working out. Thin people who don't go to the gym are much more socially accepted.

Our standards for fitness as they are currently defined in the medical community (BMI) are nonsensicle and extremely rigid. However, I would argue that it is not the place of society as a whole to place standards on the physical capability of individuals. What about those who are disabled or experiencing chronic pain, or arthritis? Are they also obligated to be able to run X miles and do X pullups? What about people who can swim but lack stability to land exercises. What I am saying here is that we need to trust that people WANT to be fit, and that they will find a level of fitness that it is reasonable for them to maintain.

(I define reasonable as not placing too large a financial, lifesytle or physical burden on the individual as is defined by them. Because, we are all individuals with a right to behave as we choose.)

Also your arguments about inuitive eating are ridiculous. We cannot eat intutively because the environment we live in is not intuitive? Or something?

I highly recommend that you read a book called Health At Every Size by Linda bacon. If you are interested in understanding how people of all sizes can seek health and be fit it is an excellent place to start.

No, I agree that being fat (i.e., not being thin) does not prevent people from being or becoming fit. However, being overfat does add another layer of challenges to being fit on top of the ones you describe. Overfat can stress the joints and cardiovascular system, complicate balance, and just plain get in the way of the correct execution of some exercises. It is not a sentence to be unfit, but an obstacle to fitness.

We can argue from here to eternity what the "right" fitness standards should be, and how they do or do not discriminate against certain groups. I think, at minimum, that fitness standards should encourage people of most ages, weights, and abilities (excluding the very fit) to challenge themselves and surpass their past achievements. I don't see that sentiment in the quasi-standard of fitness you propose.

Now, on intuitive eating - just as the diet industry contributes to an environment in which people feel the need to diet "unnaturally," so, too does the food industry (as well as folk customs and good ol' human psychology) contribute to an environment in which "eating when you're hungry, stopping when you're full" is a fading mirage.

There are a lot of assumptions in your post that are not actually backed by scientific evidence. In fact, much of the foundation for the obesity epidemic is consensus rather than evidence. Blood letting was backed by a strong consensus as well. And researchers ignored the evidence that it did not work. And what is this new term "overfat?" Try reading the article that Shinobi posted above. Gina Kolata, a science writer for the NYT, and a marathon runner, completely believed all the hype when she first started reporting on the obesity epidemic. After reading the research, she realized the data was not saying the same things the researchers were saying. It's been proven over and over again that dieting does not work. Only people who become anorexic can keep the weight off.

It's funny, your definition of enough exercise is that they have to challenge themselves. That actually has roots in the protestant ethic more than it does in science or health. Walking a few hours a week will not make you thin. But it will keep away heart disease.

And the statistics that supposedly prove that many more Americans are fat than they used to be is hotly debated in the field. Some data shows that we may have only gained an average of 8-20 pounds in the past twenty years. That's hardly an epidemic. The data showing more are fraught with missing data and changing definitions which distort the results.

What is overfat anyway? Is it morbidly obese? Because that is actually much rarer than the general public thinks. Most people in this country are moderately overweight which by newer terminology is called obese and spurring the moral panic.

Thank you for calling my attention to the article. I did read it, but did not find it entirely relevant for this debate. It will not surprise you that I found the designs of most of these studies flawed, especially the studies which entailed fat people losing a lot of weight or thin people gaining it. That is because dieting alone does not work - either way. This is one factor that confounds obesity research - to be scientifically valid, a data set should control for everything and vary only the independent variable, yet holding activity level constant and just changing the subjects' diet has quite the predictable effect: the weight change will stick only at incredible cost, and even then only some of the time. Therefore, such studies are only partially related to the real-world feasibility of long-term weight loss.

As for the twins studies, I noticed that the article did not say anything about whether twins raised apart experienced significant differences in activity level, diet, etc. Absent this variation, such studies do not conclusively prove the role of genetics in predicting obesity.

To address your other points:

- Overfat is hardly a new term. Gaesser describes it here. In using the term, I have in mind something akin to Krista's discussion of fat: overfat is a level of bodyfat above a certain range.

- Averages are misleading when it comes to weight in a population. There is some evidence that weight, unlike many naturally-occurring phenomena, is not distributed on a bell curve, meaning that a small change in the statistical mean hides no or little change in part of the population and a large change in a different part.

- I never gave a definition of "enough exercise." I was talking about standards for fitness. The current standard for fitness, as Shinobi notes, is based on the BMI - which is totally nonsensical. I don't know what a better standard would say, but I think it should give most people concrete, achievable, and worthwhile goals.

I love it when people find the studies they disagree with flawed but fail to critically analyze the studies that resonate with them. Without trying to teach statistics to everybody, I am really not sure what to do about it.

I study the soc of knowledge. I am interested in how science is translated and disseminated often with black/white, good/bad simplifications that are just plain wrong. I am also interested in areas where research is affected by the protestant ethic more than data. What we even decide to research has more to do with religion that being the most pertinent social problem. For example, diabetes and heart disease (obesity related diseases) don't even come close to the amount of people who die due to violence and injury.

As it turns out, race, obesity, addiction and gender are the places where science is used most to stigmatize and discriminate, and justify social inequality.

I do have to say I am surprised you mentioned Gaesser since he argues the same thing I have been in these posts, and criticizes the same research while showing as examples the research you see as "flawed."

I was going to recommend Gaesser's book to you, on why Americans are afraid of All the wrong things.

All research is flawed by the way. There isn't enough money, and it would be unethical to do perfect unrefutable research. However, the research on disputing the "dangers" of obesity is overwhelming.

I imagine you come from a place where eating healthy and exercise are really important. And they are to me too. I just don't judge others who don't look like me. I don't assume they are lazy and unhealthy. I don't assume I know things that nutritionists haven't figured out even if I think it makes common sense to me.

For the record, I agree with the studies in the sense that their outcomes seem plausible. What I disagree with is the assertion that these studies prove that people cannot lose fat and keep it off, and that one's level of bodyfat is genetically predetermined regardless of environmental conditions, respectively.

I am not asking for flawless research. I am asking for you to mull over how the research you approvingly cite fails to substantiate the conclusions that you draw.

Reading a lot of the research on obesity has led me to the conclusions I have come to. Not one study. Those were just a handful. And about the twin studies: They are large enough sample sizes, so they should get representative amounts of different lifestyles. And you can't control for everything without losing statistical power.

Ironically, the obesity epidemic proponents continue to cite the same 4 flawed studies over and over again. At least in these studies the data matches the conclusions. If you analyze the data from the studies proving fat is harmful separately from their conclusions, you find a u shaped distribution with the lowest and highest BMI's being risky while those who are normal and slightly overweight have the best health outcomes.

I think part of the problem is that you might be thinking that morbidly obese is what these researchers are talking about when they say obesity is deadly. First morbid obesity has remained relatively rare and has not drastically grown in numbers. It is slightly overweight to obese (a lowering of the BMI category helped here as well as some conveniently located missing data) that has grown in pop size and which has not been proven to be unhealthy. And it is stigmatizing fat people, misleading thin people who do not exercise, and encouraging people to diet which is what is really bad for you. Think about it, if you were an overweight person who has dieted and exercised unsuccessfully for most of your life (and it starts young) and it hasn't significantly or permanently changed your looks, wouldn't you give up. But if it weren't about looks it might be different. If you knew that to be healthy, you needed to eat right, not be hungry, and exercise moderately, you might do that.

Dieting is incredibly dangerous. Dieters have the health problems. We only have about a 30-50 pound range that we can control and that isn't an amount that is going to cause morbid obesity or health problems. It is an amount that is going to get you closer or farther from the societal ideal. But it won't affect your posture or give you diabetes or heart disease. And when people go off the severe calorie restriction, and try to maintain, they usually gain to a point higher than they were to begin with, and have heart problems.

It's like the obesity epidemic is causing the obesity epidemic.

There is a lot of research showing that weight, to a large extent is genetic. We are born with a certain amount of fat cells that can grow and shrink (causing weight fluctuation), but short of liposuction we really can't control the amount of fat cells we have which is very variable from person to person.

Perhaps "fat" is not a the best bench mark for measuring exercise or proper diet, and many thin people neglect both exercise and proper diet. But honestly how many obese people do you see exercising habitually for a number of years. Proper diet and exercise might not make someone "thin" and they might still appear somewhat "fat", but it sure would make it rather difficult to be obese. The BMI is obviously flawed, but even an RN could tell you with a fair amount of certainty that someone is obese or not. The fact is Americans do not exercise enough nor eat a proper diet. Obesity is just the most visually obvious outcome of such. Still, the link between obesity and an increase of many health risks is pretty clear. You can argue all you want that obesity might not cause these problems, but it is marker that these problems are more likely.

I agree with nearly everything in these two posts. Very low and very high BMIs are linked to poor health - not .2 points over the arbitrary cutoff of 25. Ditto for very low and very high bodyfat percentages. Dieting as we know it - "lying on the couch and starving" - is never a good idea. The exercising that most people have tried - steady state cardio - is just about the worst thing one could try for fat loss. For most people, eating right (and enough) and exercising moderately will go a long way towards better health.

Still, I cannot get behind two of your points. To say that weight is genetically determined is, I believe, misleading. Genetics is a blueprint, not a destiny. Genes do not encode for "on October 4th, 2010, Joe Smith will weigh 184 lb with a 32.41% bodyfat." It would be more accurate to say - "based on his genetics, given Joe's current diet and activity level, this is about how much he will weigh, and this is more or less where his body will store fat." Related to this, your assertion that "we only have about a 30-50 pound range that we can control" seems entirely arbitrary. Tell this man that he could not have possibly lost all that weight (or gained it in the first place). In fact, tell everyone associated with the Jules Hirsch experiments that their results are bunkum, since the participants could not have lost 100 lb on average. People can control their body - and body weight - to a remarkable degree, but they find it hard to maintain losses (or gains) outside of the range you describe because of the extreme (but not necessarily unhealthy) modifications they must make to their behavior.

I do want to thank you for not treating me as the next Michael Karolchyk for arguing these questions. The same goes for Shinobi, as well as other commenters who have responded to my posts in these threads.

Also I mentioned working in a hospital for one reason. Obese patients are more a risk in surgery, ask any anesthesiologist. Also simply moving and accommodating obese patients requires more work and time. I will admit, accommodating obese patients might sound trivial, but it really makes the OR less efficient and slower. The risk of operating on obese patients is however well documented, leading to increased fatalities and legal actions.

The thing is, right now, is it's a value judgment. We assume when we see fat people that they don't exercise. Most people assume that is a fact not an assumption. But we don't actually have that data. And I think many fat people give up, because to change their looks, they have to be an athlete. They can't just moderately exercise. And you don't have to be an athlete to be healthy.

I know this is anecdotal and doesn't prove anything, but my best friend is obese. She eats organic and local. And when we run together, she runs faster and longer. About the only thing I can think of that she does differently is drink more wine. And so what? Giving that up isn't going to change her weight much or her health. She is judged every day as lazy and unhealthy. And I know she is an exception because hardly anyone eats organic and local fat or skinny. And hardly anyone runs 5 miles a few times a week fat or skinny. But I think when we assume that fat people are fat and lazy and eat unhealthy, we drastically underestimate the amount of lazy, McDonald's eating thin people. It might actually be equal.

Let's run with the anecdote about your friend - if you would pardon the pun. It doesn't have to be a value judgment to say that as an able-bodied person (a runner, no less), she could change her body through different eating and exercise patterns, probably to the point where she would no longer be classified as obese. (I am not saying that that's what she should do - only that it is entirely within the realm of what is physiologically possible.) People shouldn't assume, when they see her, that she is lazy or eats out of the nearest McDonald's dumpster. It is unfortunate that they do, but that does not disprove her capability to become leaner.

She's battled with it her whole life. If she is healthy, and calorie restriction is hard on one's heart. Then controlling her looks may affect her health negatively.

Plus, for a heavier person to maintain a lower weight, they have to seriously calorie restrict permanently. To me, that does not sound like a fun way to live. I have read stories of people who have had to exercise intensely everyday while eating only 1000 or less calories a day just to maintain a normal BMI, not even be thin.

It reminds me of people that say poor people just need to work harder, while totally taking for granted their own advantages.

And why do we expect people to do this for looks rather than accepting diversity?

It shouldn't be considered healthy to go through that for looks.

But that's my whole point - extreme lifetime calorie restriction (and 1000 or less is quite extreme) and extreme exercise (hours daily) are not necessary. As I said, the only way most people know to lose weight is through calorie restriction and steady-state cardiovascular exercise. When they inevitably stop losing weight, they understandably reach for more calorie restriction and more steady-state aerobics. When that inevitably fails, they understandably give up on weight loss.

It doesn't have to be like that. People can and do lose weight (and fat) and maintain their losses and health by eating differently - not just less; and exercising differently - not just more. That's neither good nor bad. It's just true - even if rare.

From a soc of knowledge standpoint, it's rare because the most widespread ideas about health - the aerobics craze, the "heart-healthy" high-carb diet, unfounded health claims for local and organic foods, our totally skewed perceptions of what activity levels look like - do not facilitate and often hinder fat loss. It's also rare because, for better or worse, most people do not care to put in the thought and effort required to do this. That's not a function of being fat. It's a function of being human.

First, it is a value judgment that most people do not care to put in the thought and effort required. If they can be had by the diet industry than they obviously have put in a lot of thought and effort. And there are still plenty of doctors advocating severe calorie restriction. And those are the ideas I am trying to fight.

But you are also proving my point. My friend doesn't have much control over her weight if she is already doing what you promote and is still heavy.

But more than that, who cares? She's in great shape. She has low cholesterol and her blood pressure is fine. Why does what she looks like matter? Why can't we accept diversity?

I am not arguing that people won't lose weight by changing to healthier eating habits and exercise. What I am saying, is that it won't make everyone thin. And while it will make a morbidly obese person healthy, it might just lower their BMI into the obese range. They still won't have the unhealthy but desired underweight BMI that portrays health and industriousness. It certainly won't make many people look like the unrealistic societal ideal. This is why health should be the goal rather than looks. Because unlike being thin, being healthy is a goal anyone can accomplish.

I think we have a lot of similar ideas about health. I imagine that I probably have a more relaxed standard for moderate exercise, but on the whole, I think are ideas are similar. Where I differ is that I divorce those ideas from looks. I think the obesity epidemic is overblown, because it relies on faulty research, overestimates the health of thin people, confuses a risk factor with a disease, stigmatizes a population which discourages them from getting healthy, and promotes unhealthy dieting.

If the cdc put as much energy into changing the food industry and the environment that discourages activity rather than demonizing fat people, we would have a much healthier population.

Yes, we do see eye to eye on much of this issue. Yet there is a real difference between arguing for FA on the grounds that it is one's right to be treated with respect regardless of how one looks; and on the grounds that, golly gee, one has tried everything and just can't lose any of that-there weight. The former argument appeals to our senses of decency and justice. The latter argument chains all the positive aspects of FA to claims that are demonstrably untrue - e.g., that it would somehow be impossible to gain or lose over 50lb of weight.

In advocating for a better societal approach to health and fitness, I think we would all do best if we could examine our beliefs and lay aside those which are less of a compelling reason to change the system and more of a rallying cry for our respective cliques.

Because unlike being thin, being healthy is a goal anyone can accomplish.

Well, not really...

It's actually NOT normal for babies to be "fat". This is a common misconception created by the prevalence of formula feeding. Breastfed babies (note: the way nature intended babies to be fed) are leaner.