Saturday, May 12, 2012

Saturday Stories: Disease Screening and an HBO Related Double Shot

Alan Cassels on how screening tests (for prostate cancer, breast cancer, etc.) over promise, under deliver and may cause more harm than good.

Jezebel's Lindy West and her Weight of the Nation inspired plea to stop shaming fat people.

John Hoffman, Executive Producer of HBO's Weight of the Nation discusses the basics of his documentary series.

[While a great many have been quick to condemn the documentary sight unseen, I'm looking forward to watching it. Certainly John's post suggests it'll be a far cry from individualized blame and instead  may well be a first mainstream and literally prime time foray into teaching the world that obesity's an environmental issue, that it's not as simple as just pushing away from the table and saying "no".  To me at least, that sounds like a monumental step forward and slamming folks for taking it may not be the best way to further, encourage or inspire an important shift in thinking.  Perhaps instead we should be looking to further their and the world's thinking through polite, thoughtful, and common ground acknowledging discussions.]

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  1. I would call "sight unseen" only technically correct. Many of us are judging it based on the trailer, press release, etc. although we haven't seen the full series. When the trailer engages in panicked, fear-mongering hyperbole such as "Obesity will crush the United States in oblivion," I have a problem with that. Being told my entire existence as a person with an "unhealthy" BMI threatens my country... yeah, that's a bit offensive.

    My personal opinion is that the epidemic in this country is an epidemic of bad food an inactivity, not necessarily weight. Simply addressing those issues will improve health significantly, but will not necessarily make us all thin. When we hold up thin, rather than health, as the gold standard, we lose focus on the things that will help most.

  2. I think both ASDAH's and Michele Simon's concerns re Weight of the Nation are both polite and thoughtful.

    I will certainly be watching, but I'm more skeptical than you that this will be a monumental step forward.

  3. Look at the "take action" portion of their website where they suggest "Ask your employer to initiate workplace health assessments. Overweight workers have higher medical costs and miss more days of work than normal- weight coworkers."

    Health and weight are not the same thing. There are healthy fat people and unhealthy thin people. Those numbers are based on embarrassingly bad study conducted by Duke University of Singapore and funded by Allergan, makers of the lap band, to prove to insurance companies that they should fund the lap band surgery because it's cheaper than having overweight workers. Yet HBO is encouraging bosses and other employees to see fat workers as costing money and missing work based on a completely bogus study, when there is not a single study that shows that we have any idea how to make fat people thin in the long term. It's irresponsible and dangerous for people of size.

    Their website is also still touting energy balance theory - which suggests that everyone who tries hard enough can permanently lose weight - even though we've been trying that for at least half a century with no success.

    Any time we take a group of people who we can identify by sight, attempt to calculate their "cost" on society, and create a National program to eradicate them, we are making a grave mistake.

    Especially considering the results of studies like Wei et. al., Matheson et. al, the work of the Cooper Institute etc. that suggest that simple healthy habits make healthy bodies of all sizes (in stark contrast to the research on intentional weight loss which even the National Institutes for Health admit shows that it fails for almost everyone within 5 years, and has the opposite effect much of the time) it is time to stop conflating weight and health and have a National conversation about access to healthy food options, safe movement options that people enjoy, and affordable evidence-based health care for people of all sizes.

    Peter Muennig's work shows that the stress of constant stigma is correlated to the same diseases to which obesity is correlated and that women who are concerned with their weight have more mental and physical illness than women who were fine with their size, regardless of their size. We don't know how an end to shame would affect the so-called obesity epidemic but it's easy to find out since we could stop shaming fat people right now.

    Creating a documentary that hyperbolizes a problem and tells the country to see obese people as "crushing the United States into oblivion" based on extremely sketchy math is not a step in the right direction.

    The United States could be a model for health if we would give up trying to be a model of thinness.

    Ragen Chastain

    1. Anonymous10:38 am

      Well said!! Thanks for the great response. I'll check out your blog now.

  4. Peter Jennings did a very fine documentary about the environmental problem back in 2006 ...

    Ken Leebow

  5. Anonymous1:47 am

    I find it very interesting that a “documentary” takes such a slanted view of an issue and does not offer any information or interviews with experts that hold opinions that counter those offered.
    The Association for Size Diversity and Health (ASDAH) has prepared a response to the upcoming HBO documentary series, "The Weight of the Nation." (WOTN) The response is called "Debate the Weight" and we invite you to check it out here:

    Here are some components of the response:
    • An overview of the Debate the Weight response, with more useful links
    • An episode by episode, evidence-based breakdown of what to expect from the WOTN series
    • A detailed response to the WOTN trailer
    • ADSAH's "Debate the Weight" video