"Studies have found that anywhere from one-third to three-quarters of people classified as obese are metabolically healthy. They show no signs of elevated blood pressure, insulin resistance or high cholesterol. Meanwhile, about a quarter of non-overweight people are what epidemiologists call “the lean unhealthy.” A 2016 study that followed participants for an average of 19 years found that unfit skinny people were twice as likely to get diabetes as fit fat people. Habits, no matter your size, are what really matter. Dozens of indicators, from vegetable consumption to regular exercise to grip strength, provide a better snapshot of someone’s health than looking at her from across a room...
Ask almost any fat person about her interactions with the health care system and you will hear a story, sometimes three, the same as Enneking’s: rolled eyes, skeptical questions, treatments denied or delayed or revoked. Doctors are supposed to be trusted authorities, a patient’s primary gateway to healing. But for fat people, they are a source of unique and persistent trauma. No matter what you go in for or how much you’re hurting, the first thing you will be told is that it would all get better if you could just put down the Cheetos...
Lesley Williams, a family medicine doctor in Phoenix, tells me she gets an alert from her electronic health records software every time she’s about to see a patient who is above the “overweight” threshold. The reason for this is that physicians are often required, in writing, to prove to hospital administrators and insurance providers that they have brought up their patient’s weight and formulated a plan to bring it down—regardless of whether that patient came in with arthritis or a broken arm or a bad sunburn. Failing to do that could result in poor performance reviews, low ratings from insurance companies or being denied reimbursement if they refer patients to specialized care...
in a remarkable finding, rich people of color have higher rates of cardiovascular disease than poor people of color—the opposite of what happens with white people. One explanation is that navigating increasingly white spaces, and increasingly higher stakes, exerts stress on racial minorities that, over time, makes them more susceptible to heart problems...
Many “failed” obesity interventions are, in fact, successful eat-healthier-and-exercise-more interventions. A review of 44 international studies found that school-based activity programs didn’t affect kids’ weight, but improved their athletic ability, tripled the amount of time they spent exercising and reduced their daily TV consumption by up to an hour. Another survey showed that two years of getting kids to exercise and eat better didn’t noticeably affect their size but did improve their math scores—an effect that was greater for black kids than white kids."
FB: " “For something as emotional as weight, you have to listen for a long time before you give any advice. Telling someone, 'Lay off the cheeseburgers' is never going to work if you don't know what those cheeseburgers are doing for them.”...the decisive factor in obesity care was not the diet patients went on, but how much attention and support they received while they were on it. Participants who got more than 12 sessions with a dietician saw significant reductions in their rates of prediabetes and cardiovascular risk. Those who got less personalized care showed almost no improvement at all."
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