DETROIT – Traveling across America again after a year of pandemic isolation, it is impossible to avoid noticing the widebodies flooding airports.
And we’re not talking airplanes here.
Walking through the concourses in Seattle and this Midwestern city, it is all too easy to believe the March report from the American Psychological Association concluding two in five people have gained “an average of 29 pounds (with a typical gain of 15 pounds, which is the median)” for the population overall.
Fifteen pounds is a lot of weight for a healthy American to pile on in a year. Twenty-nine pounds is a staggering and dangerous amount in a country where most people were already too heavy.
More than a decade before the SARS-CoV-2 pandemic savaged the country, doctors were already talking about an “obesity epidemic.”
“Among adults, obesity prevalence increased from 13 percent to 32 percent between the 1960s and 2004,” researchers from John Hopkins University reported in a peer-reviewed study in Epidemiologic Reviews 14 years ago. “Currently, 66 percent of adults are overweight or obese; 16 percent of children and adolescents are overweight and 34 percent are at risk of overweight.
“Minority and low-socioeconomic-status groups are disproportionately affected at all ages. Annual increases in prevalence ranged from 0.3 to 0.9 percentage points across groups. By 2015, 75 percent of adults will be overweight or obese, and 41 percent will be obese.”
Americans might be deeply divided between two political camps. They might be split into all sorts of minority groups. But a supermajority share one thing in common:
They were fat before the pandemic, and they are now fatter.
Fat is the new normal.
Those of us who are so-to-speak “chubby” now look the healthy members of the species loose among the morbidly obese plodding through the country’s airports.
Some seem to think this is fine, too.
“When it’s safe to re-enter the world, my (oversize) sweatpants are coming with me. Because I’m not planning to get my ‘pre-pandemic body’ back,” Virginia Sole-Smith wrote last week in Good Housekeeping.
“And you don’t have to either.”
Her essay was part of the magazine’s “ANTI-DIET Special Report.”
A near millennial (her LinkedIn profile says she graduated from New York University in 2003), Sole-Smith has a long list of why the pandemic weight gain is not her or your fault:
“Surviving a global pandemic is also a major life event, not a weirdly extended staycation….Maybe some people ended up with a lot of free time they could spend hiking or working out in the safety of their own home gyms. But most of us, especially working parents left scrambling for childcare, have had far less free time than we did before, and certainly, fewer options for exercise.”
The pandemic forced you to eat more calories than you burn? A home gym is now a requirement for exercise? You can’t load the children in a baby jogger and take them for a walk, possibly in the process of demonstrating to them what a healthy lifestyle entails?
Granted, these might be issues if Sole-Smith was a poor woman living in a third-story walkup in New York City, but she’s living in a small town in the Hudson River valley and working, in her words, “as a journalist who covers weight stigma (negative beliefs about large bodies that lead to discrimination against fat people).”
Her description of what she does could also be characterized as trafficking in the idea that it’s OK to be fat even as being fat is killing people.
In March of this year in a commentary in Scientific American, Sole-Smith chastised the mainstream media, which one could argue writes too little about the epidemic of obesity, for latching onto a study of a half-million Spaniards that undermined the idea that people can be fat and fit.
Take the word as one of those who would qualify as fat and fit from time to time that you can gain fitness while overweight but your overweight self is never going to be as fit or as your healthy weight self.
Sweat is good
There is no doubt that obese people who regularly engage in cardiovascular exercise and raise their level of metabolic fitness are healthier than obese people of similar size and weight who spend their time sitting on the couch or at a desk.
There is also no doubt exercisers with 15 to 25 percent body fat are going to be healthier than those with 50 percent body fat, or that obesity had become the leading risk factor for preventable disease and death in this country even before the SARS-CoV-2 virus developed into the deadly disease COVID-19.
The COVID-19 death count in the U.S. is now approaching 570,000, according to the John Hopkins University tracker. The vast majority of the dead were suffering from chronic illnesses before they were hit by the contagious disease, according to the CDC. And nearly half of all chronic disease has been linked to obesity.
There is something of a debate about how much of a COVID-19 risk factor obesity itself constitutes. Most studies point to it as an inherent risk of COVID-19 severity and death. But even if the studies that dismiss it as a direct risk are right, there is still the little matter of those chronic diseases that raise COVID-19 death rates.
“Obesity as a risk factor is by far the greatest contributor to the burden of chronic diseases in the U.S., accounting for 47.1 percent of the total cost of chronic diseases nationwide,” the Milken Institute, a think tank, reported last fall.
Obesity isn’t just costing people their lives, either. It’s costing the country a small fortune.
“In 2016, chronic diseases driven by the risk factor of obesity and overweight accounted for $480.7 billion in direct health care costs in the U.S., with an additional $1.24 trillion in indirect costs due to lost economic productivity,” the Milken report added.
Costs have only gone up since the pandemic began, given all the obese filling U.S. hospitals. A metanalysis of the data for the first six months of the pandemic published in the peer-reviewed journal Nature reported that the obese were:
- About three times more likely to develop severe COVID-19.
- About three times more likely to have it progress to acute respiratory distress syndrome.
- About 1.35 times more likely to end up in an intensive care unit.
- And about 1.76 times more likely to end up on a ventilator.
The only good news in the Nature study was that the doctors and nurses treating all these oversize patients were able to hold their death rate even with that of the non-obese early in the pandemic.
But the study cautioned that large, new studies have since “identified an increased risk in mortality in obese patients infected with SARS-CoV-2, and these studies and likely other relevant studies were not included in our meta-analyses because of the cut-off date for our search.”
The medical literature makes it clear that there was never a good time to be fat, but this is an especially bad time to be fat. And yet there are those who continue to push the “body positivity” narrative that it’s fine to be fat.
It’s not fine to be fat.
Obesity is now recognized as a disease like drug addiction or alcoholism. Nobody should be held responsible for their disease, let alone shamed for it.
Nobody wants to get a disease, and as a practical matter, shaming people with addictions – be they drugs, booze or food – has not proven very effective at helping them get free of those addictions.
As Dr. Fatima Cody Stanford, an instructor of medicine at Harvard Medical School and researcher and practicing physician at the Massachusetts General Hospital Weight Center told the Harvard Health blog, stigma, blame and shame add to the problem and become obstacles to treatment.
What the obese need is professional help.
Telling them that they’re fat and that they need to fix it doesn’t work any better than telling them that it’s OK, and they should embrace their fatness.
But the latter idea needs to end.
As a society, we don’t send the message that it’s OK to be an alcoholic or a drug addict or a cat burglar or person with any number of other obsessions that are bad for them or bad for society.
And there is a reason. It rests in the fact the first step to solving a problem – any problem – is accepting there is a problem. It’s time we accept – all of us – that
obesity in this country is one big, fat problem and get behind a national effort is needed to deal with it.