Question:
obese vs. thin

I though our members would like to read this..I have always known this, but it also helps to uncover the injustice for all to see. <p> The lean are not "better" or superior persons because their weight appears "under control." Their thinness is a biological gift. They are the lucky ones who have won the "Weight Sweepstakes." Somehow, by a Monte Carlo roll of the dice, they received a biology which has kept their bodies within a range of weight our society regards as "normal." The human body controls the weight of the lean with the same basic mechanisms as it does that of the obese. They, therefore, do not deserve any more praise or blame than the obese for being driven by their own biology. <p> What is deserved, however, is our society coming to finally accept that the obese (as well as the lean) are powerlessness in voluntarily controlling their own weight. We all are truly powerless because we do not know the exact details, the "secrets," of how our biology controls our weight. Someday, we will fully understand those "secrets" so that we may help develop medical treatments to keep or make everyone thin, at least if they want to be. Someday, we'll know--not for a good while I expect, despite the hype about "cures" in animals and new treatments we frequently see, hear and read in the media. <p> But, for now, without possessing those "secrets" about how the body's biology keeps a person thin or fat, and having little else practical to offer most morbidly obese persons for their greatly excess weight and associated co-morbidities, surgery is the appropriate weight control option to consider for those who meet the bariatric surgical standards. <p> If surgery is not acceptable or available for some reason, we should at least treat the obese with respect. We should regard them as victims of their disease which they are, because, once we see them as victims, not culprits, they have our sympathy, our hearts go out to them, we understand that their condition is something fundamentally beyond their control. We can at least help them to cope better with their disease and its co-morbidities instead of allowing them to be mocked, derided and scorned on a daily basis. <p> The fat cells of the obese progressively overgrow their bodies, gathering more and more fat like a huge enveloping overcoat, a gigantic tumor which, at the same time, is invading every body organ. These obese victims have greatly increased chances of a shorter life, heart disease, hypertension, diabetes, sleep apnea, cancer and many other conditions known to be associated with obesity, particularly morbid obesity. <p> Morbid obesity thus has a malignant nature which is often unremitting, punishing and lethal. To "politely" ignore it is as ludicrous as the courtiers in the children's story saying the naked Emperor was well-clothed. In an analogous case, saying that the morbidly obese Emperor "has a little weight problem which he needs to control" totally denies the truth and enormity of the subject. Our society, likewise, remains largely in denial about the truly serious, basically involuntary, malignant nature of obesity. <p> This malignancy makes the obese victims of their own biology, the helpless products of chance associations between their genetics and their environment. How can they, in all honesty, be more "guilty" than the lung cancer victim who smokes heavily, the heart attack victim who chronically consumes a high fat diet or others who acquire sexually transmitted diseases? How can our society dare to deny the obese a share in this victimhood? All of these other victims may likewise possess genes which promote a specifically compulsive lifestyle which our exceptionally bountiful, permissive environment promotes. Yet, medical insurors and their ilk almost always support treatment for these other diseases but deny it to obesity. They draw the line, an unfair, stereotypical, highly visible one. And, obesity is nothing if not highly visible. Superficially at least, you can hide your addiction if you are an alcoholic or drug addict or have somewhat different approaches to sex. But, unlike certain movie plots, the obese cannot magically shrink. Obesity is obvious; it is there for all to see, even at a glance. Their outsize skin and all of its contents make the obese walking billboards, highly visible targets. If you have a hang-up or need to "take it out" on someone, or even to help improve your medical insurance company's bottom line, they are there, targets for abuse without penalty. <p> And, they are there almost all alone, most obese persons passively accepting the scorn and their "guilt" as well-founded. Their gross mistreatment is further supported by "political correctness" which freely punishes the obese since they have become the "last bastions of prejudice." They are truly the undeserved victims of a cultural, as well as medical, disease, the modern medical-moral equivalent of lepers. <p> Our Society must come to understand that the obese deserve the same compassion and understanding as do other disease victims, regardless of how they came to be victims. A disease is a disease is a disease is obesity. <p> As a first step towards making amends for past damage, let us resolve to not add to the already tragic malignancy of their condition by heaping more abuse upon the obese victims. Rather, let's resolve to treat others, and ourselves where indicated, better, to love and care for people regardless of their weight. And, as part of this respect for all people, we must deny weight harassment and fat-ism any place within the boundaries of our society. It should be made as illegal as sexual harassment and with at least as many penalties. <p> Bibliography <p> Cowan GSM Jr, MD Smalley, N Defibaugh, KB Cowan, ML Hiler, W Sehnert, S James. Obesity Stereotypes Among Physicians, Medical and College Students, Bariatric Surgery Patients and Families. Obesity Surgery 1(2):171-176, 1991. <p> Cowan GSM Jr. Bariatric Surgeons, Stereotypes and Paradigms. Obesity Surgery. 2(1):7-12, 1991. [Delivered as Presidential Address to American Society for Bariatric Surgery, June, 1991]    — Victoria B. (posted on May 11, 2000)

May 11, 2000
Great article. I think that most of us that have gotten this far understand this but it is the "lean" that have a hard time realizing all of these facts. Thanks for reminding us why we are here.
   — S S.

February 5, 2002
Great article!
   — Toni C.

February 5, 2002
I don't buy it. I've been thin and I've been obese. I know that I got fat because I ate too much. When I cut down on my food, I lost weight. It's that simple. If everything that I just read is true, why don't we stay fat even after WLS?
   — [Anonymous]

February 5, 2002
I think Mr. or Mrs. anonymous missed the whole everloving point! Scientific fact would support the theory that if you stapled an obese person's mouth shut, the pounds would just melt away, until death from starvation. But remember this, before we start the concentration camps back up, people don't expect a sunbather to cut their own skin cancer off. Stop pointing fingers, the "its as simple as that" attitude, and lets look at this as it really is. An illness. Nobody I've ever known likes to live life in that condition. Obesity is hard enough without disrimination.
   — kyle S.

February 5, 2002
"This malignancy makes the obese victims of their own biology, the helpless products of chance associations between their genetics and their environment." Well, I have to agree with the other "Anonymous". The only helplessness here is being unable to keep our mouths shut. It's a simple equation: eat less = weight less.
   — [Anonymous]

February 5, 2002
These anonymous posters aren't paying attention to the argument they are commenting on. The statement "This malignancy makes the obese victims of their own biology, the helpless of chance associations between their genetics and their environment.", is followed by "How can they, in all honesty, be more "guilty" than the lung cancer victim who smokes heavily, the heart attack victim who chronically consumes a high fat diet or others who acquire sexually transmitted diseases?" Look at the whole statement in its context. I wonder why these people are posting anonymously. As far as a "simple equation" I totally disagree. Eating less is not simple for most obese people. Metabolism, satiety, physical ability, and genetic predisposition play a big part of that "simple equation". Not so simple, huh. The whole point to the post is not to judge how people got to their state of illness. If Joe Camel gets cancer and isn't discriminated against, than neither should the obese for an eating disorder. Please try to comprehend what your commenting on.
   — kyle S.

February 5, 2002
I personally think it goes deeper than just the fat cells. When I ate less, it always made me GAIN weight because my metabolism crashed. I think we lose weight after WLS not only because we eat less and absorb less but because we feel SATISFIED eating less and are (hopefully) making better choices with the food we do eat. I know that before WLS I could eat a LOT and not be satisfied. I was eating more than my body needed but that is NOT what my body was telling me. Some chemical or physical trigger that thin people have was not being pushed to say "That's enough!" and my body was always on acquisition mode!
   — ctyst

February 5, 2002
Most diets focus on cutting back on fat and calories, thus decreasing insulin. The body interprets this as a sign of starvation and thereby switches to survival mode. The result is that the Basal Metabolic Rate (BMR), the amount of energy needed to maintain life, slows down and fewer calories are burned. The lack of insulin actually causes a breakdown of the muscle tissues and diminishes the amount of lean body mass. Furthermore, as soon as weight loss takes place, an enzyme in the fat tissue sends messages to the brain to increase caloric intake. This is why most dieters develop cravings and an urge to binge. With all these factors working against us, no wonder it is so hard to keep off the fat! The pouch or altered anatomy offers some protection to this happening again.. And No!!! It's not as simple as eating less or just pushing away from the table.. (sigh) anonymous posters never cease to amaze me.
   — Victoria B.