Tuesday, October 13, 2009

Torquemadas and the Totalitarianism Over Tonnage: The Skinny on Obesity

Originally written August 12, 2009.


This is Maple Street on a late Saturday afternoon. Maple Street, in the last calm and reflective moments...before the monsters came.

Every epidemic causes panic. In the Twilight Zone episode The Monsters are Due on Maple Street, aliens tamper with the electrical system of a small town. The ensuing paranoia and intolerance causes the townspeople to turn on themselves, allowing the aliens to conquer the planet with ease. The current contagion appears to be weight-gain in industrialized countries. Our species has run for millennia trying to find enough calories to survive—and boy are we out of breath!

A few weeks ago another Facebooker brought to my attention that Obama’s pick for Surgeon General, the leading spokesperson on public health, was Regina Benjamin, a 52-year-old obese African-American woman who has overseen the reconstruction of her clinic after two natural disasters, Hurricanes Georges and Katrina. This person went on to say this was a bad choice for Obama, the argument against her being that weight statistically contributes to poor health and that as a symbol of good health she ought not to serve in this position. To avoid setting up a straw man, let me reiterate the argument.

* Major premise: The Office of Surgeon General is a symbol of public health, and ought to be occupied by a person whose body is indicative of a healthy lifestyle.

* Minor premise: Regina Benjamin is overweight.

* Conclusion: Therefore, Regina Benjamin ought not to be Surgeon General.

Going on, the question was posed rhetorically if a person would have their car repaired by a mechanic with a broken down car; or, who would go to an overweight doctor? Here I question both the major premise and analogies. The confusion, I would argue, comes from a fallacy called equivocation. Equivocation means you are arguing from two different definitions. The problem with the word ‘health’ is it connotes two different things: the status of the biological condition and the science that examines it. From here on, I will differentiate between health as the biological condition of humans and medicine as the study of that condition.

Now the question becomes more articulated: Is the position of the Surgeon General the nation’s chief promoter of human health, an expert in the science of human medical care (to say nothing of the political savvy and economic expertise the job requires), or both? I would argue the job of health promotion, as I’ve defined it, belongs more to Denise Austin than C. Everett Koop. Put another way, the Surgeon General is not the mechanic of the medical profession: it’s the CEO of a major car company—and he or she doesn’t need to know how to change the oil in their car to do their job well.

Of course, in a perfect world, the person with the best resume would also be a world-class tri-athlete with three well-adjusted children and a Doberman. Barring that, however, if and when America is hit by plague or medical services have to be rendered to a tragedy-hit emergency disaster area, perhaps we could do worse than a corpulent medical doctor with an MBA who at times didn’t take a salary or moonlighted to keep her clinic open. We might want to be thankful this angel’s wings can’t get her off the ground because she’s desperately needed here.

Meme Roth Pointing at Out the Elephant in the Room

A similar case arose from National Action Against Obesity (NAAO) front-woman Meme Roth. Pariah of the “fat, fab and happy” club, she has repeatedly gotten scorn for her excoriations against the horizontally challenged. Back in 2007 she said Jordin Sparks was too fat to win American Idol, because her weight makes her a poor role model to young children. The argument the same: We ought not to give people prestigious jobs and awards because they are portly. Notice we are not talking credentials: Benjamin is a competent doctor and Sparks a proficient vocalist.

Yet, this would under no circumstances be tolerated for any other group. If someone was calling for Sparks’ crown or Benjamin’s withdrawal because they are black, or women, America would call for their heads—rightfully so. What an awful precedent we could send if we start if we deny people careers when they are living less than idyllic lives already. Shall we next make them enter through separate entrances, double-wide doors saying “fatties only”?

And here is where my cynicism kicks in. To the rotund, justice will always be relative. Pop singers won’t sing you tributes and sexual opportunities will be fewer. People don’t feel compassion for the corpulent, so don’t bother asking. Make sure you’ve got thick skin for those thick thighs. Life is a series of trade-offs--make yours without apology or whining. Why can't it be that simple? Bill Maher used to have a quasi-libertarian schtick that sums up my feelings on food and life. "Please stop assuming that longevity and perfect health is always the correct option. No. Sometimes fun costs ya. It just does, you know? And that's OK, you're willing to make that purchase. Sammy Davis, Jr. was 64 when he died. Give me 64 Sammy-years, I'll be happy." Finally, look on the bright side: even Michael Jackson wasn’t happy with his looks.

At the heart of this conversation, I believe, is a deeper conviction: the conviction of the justice of life. If you believe the world is fundamentally just, that the bulge battles we fight are all relatively the same, and those that are fit and trim are simply more disciplined, then the world is binary. The self-controlled is fit; the saint heaven-bound. For these people, output is simply the sum of inputs. Some of us, I think, know otherwise. A world where the gears of our cars and minds stick, of broken homes and ill-working nerves, dashed dreams, toyed-with emotions, used, misplaced trust, and belied hope.

It's the Caveman's Fault I Can't Put Down the Twinkie

We are in the midst of an evolutionary shift. Most people think “health food” is what humans are “supposed” to eat. Whole grains are touted as the ideal staple for human consumption. But, do you not know this is a manufactured food, even in its purest form? Where in nature do you find a loaf of bread? When humans went from hunter-gatherer societies to agrarian ones, people got sick. Once our ancestors ate things we wouldn’t even classify as foods today. Currently, we are taking the next step. Those whose bodies best adapt to the new foods will reproduce with better results. The rest will die off. Is it really so inconceivable that the healthy thing to eat in a few thousand years will be McDonald’s? If so, then either your sense of history or imagination is lacking.

Hence, this is all an explanation for the world, and why it’s not fair. Those that can better process processed foods are blessed. Those that burn calories in excess and eat heartily so they may gain weight, they have been smiled upon by the gods. Some call obesity terrible: I call it unfortunate.

I recall a moment during undergrad, where an attractive woman told me I was “trying too hard” with women. She was probably right, but I remember thinking to myself she didn’t really get it, because she didn’t have to try. She could be stupid (she isn’t) and boring (she is) and men will still want to sleep with her. I learned early on if I ever wanted girls, I wasn’t going to get them with my looks and would have to develop a personality. Most women are uninteresting: there is simply no need to become fascinating. Their story is a dull one -- they traded sex for security. Even the Bible tells mostly of heroic women cleverly using their bodies to get what they want: Tamar, Salome, Ruth. It’s the only charming thing about them.

(To the reader: some of this is to be understood as tongue-in-cheek.)

Health gurus and exercise enthusiasts are the new Torquemadas: their will is to control yours. They care not for your health, but to make you in their image, and have you thank them for it. They will torture you without reprieve or respite, for they claim your soul with conscience clear. They make you holy and whole. I leave you parting with the words of Meme Roth being interviewed by Gaby Wood and I ask if this woman has a healthy relationship with food and herself. Is this the life we want and do the ends justify the means?

I try to pin her down to something more specific. Let's just do a sample day, I say. What about breakfast? Roth grimaces. "I hate to say this, because I think it's counter to what most people should do, but I never in my whole life have enjoyed breakfast. For me, it doesn't work as well as other things."

Right, I say. So how about lunch?

She squirms visibly. "You're taking me where I don't want to go ... What works for me doesn't work for a lot of people."

Well, you've said that, I insist, so taking that into account: lunch? Roth hesitates. "I discovered when I was in college that I work best when I get a workout in and eat after that. Sometimes I'll delay when I eat until I get a workout in. But I don't let a whole day go by without running four miles."

OK, I go on, but supposing you couldn't work out until four o'clock in the afternoon - would you not eat until after that?

"I might."

I look at my watch. It's 3.30pm. Alarm bells start to ring in my head. How about today, I ask. Have you eaten at all today?

Roth is a little quiet.

"No," she says.

There is a pause.

"But I feel great!"


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