Interview with Sarah McCain of NPR Rehabilitation phase Hosted by Michael Hobbes and Oberoi Gordon where most do not do health and fitness podcasts, they evaluate popular dietary advice and fitness trends.
Sarah McCayman, Host:
Every year, millions of Americans go on a diet. Americans also spend billions of dollars on weight loss products. So why, despite all this, is the obesity rate in the United States steadily rising?
Oberoi Gordon: It’s an incredibly complex problem that we don’t have the answers to, but we continue to use the increasing rates of obesity in our culture to help people lose weight.
MCCAMMON: This author is Oberoi Gordon. She co-hosts the podcast “Maintenance Phase” with journalist Michael Hobbs. And she says when she first started, she wanted to focus on the big questions. That other health and fitness podcasts weren’t necessarily asking.
Gordon: I felt able to talk about it, like, well, well, what’s really the science behind it? What are the motives of those who are offering all these junk foods, all these welfare trends? Like, what’s the story behind it?
MCCAMMON: I talked to Aubrey Gordon and Michael Hobbs the other day, and we started talking about the medical consensus that obesity can lead to health problems.
Gordon: Yes, there is a clear link between weight and poor health outcomes, but weight is not the only thing that has to do with health. We know that poverty has devastating effects on people’s health. Life expectancy varies by 20 years in different US counties. In America’s poorest, most backward counties, people live for about 65 years. And, like, I think it’s Boulder, Kolo, or whatever, they live until they’re 85 years old. We accept as communication.
And yet, strangely enough, when it comes to obesity, it’s like, oh, no, no, we know obesity is causing it, right? Like, people have jumped on the bandwagon to explain why. And there is a very strong association, but there are very strong associations of all kinds with health outcomes. So the question is why are we putting weight at the center of our understanding of health when in fact there are so many sophisticated ways to help people stay healthy and we really aren’t doing that?
MCCAMMON: You spend an episode looking at how obesity has been described not only as a risk factor for certain diseases, but ultimately as a disease itself. Can you just give us a brief version of how this happened?
Gordon: I mean, I think to talk about “obesity as a disease”, you have to talk about BMI, which I think we now have a hard and fast. Think of speed as a step and a goal. Measure size and health. The first BMI type definition of overweight public policy in the United States was that the fattest 15% of us should be considered overweight. It was not linked to their specific health outcomes at the time. That’s all, we’re going to call the fattest 15% of us overweight.
Basically, what happened here was that there was a public health person at CDC who really felt that our conversation about weight and weight loss was too simple. And he thought that redefining obesity as a disease would help people understand that it is more complex than the story of personal responsibility, such as hard driving.
The challenge is, as he did, a group of pharmaceutical companies began to support his efforts because if more people were declared obese, they would have more clients for weight loss drugs and surgery. shall be. This is not to say that these products did not work for some people and did not cause weight loss for some, but to say that it was not a neutral medical decision that was not affected by capital is fine. Is? Like any other industry – right? – In the food industry and the healthcare industry, profit motives are still in play.
MCCAMMON: I mean, isn’t something often called a disease to be more sympathetic? I mean, we see it with the drug war – right? – Seeing drugs as a disease, which means it doesn’t have to be anyone’s fault. This is something that needs to be treated, not punished, not ridiculed.
Gordon: Yes. I think that was the intention of this person at CDC. Conversely, and unfortunately, what we have seen in the years since this new definition is reaching the sky of prejudice against obese people. This has happened among healthcare providers. This has happened among social workers. It’s happening among ordinary people in the United States that we’re seeing, you know, a dramatically rising level of anti-fat prejudice. So despite the best intentions behind this new definition, it has unfortunately created the opposite.
MCCAMMON: I want to ask you both something. You know, you talk a lot about how weight loss shouldn’t be – maybe your lifestyle change shouldn’t be the goal. You know, full disclosure, I’ll tell you my experience. About four years ago, I lost 60 pounds. I gained weight during a stressful time in my life. It’s complicated, right? A lot of things went wrong. And so I usually weighed more than that.
I have very slowly and without caution, you know, any kind of extreme change has started to make small lifestyle changes to improve the quality of my food, just go for a long walk. Is. When I was heavier, I was still quite healthy, but all the objective health measures, you know, like my blood pressure looks better than four years ago. And I’m just sharing this to say – and you won’t offend me because I want to hear your honest opinion – is there a healthy way to think about weight loss? Is it ever okay to be a goal?
Gordon: I don’t want to snatch anything from anyone, right? I don’t want to tell people you know trying to lose weight that it’s a bad or unworthy goal for them. I want to tell people that this is a much more complex project than we have been persuaded to believe. The story you just told was that I changed the food I was eating. I changed the quality of the food I was eating. The way I was moving and how much I was changing. And then I lost weight. And then the signs of my health changed.
So you can still do all the other things. You can still change your behavior to produce health benefits, and whether or not you lose weight as a result. And it’s still a win-win for your health, right? I think we will all do an important service by focusing only on the health signs and not the proxy for the health markers, which is weight.
Michael Hobbes: What we’re interested in is systems. So public health, we should not aim for weight, we should aim for health. If we are talking about medical care, it is really important for doctors to listen to patients. And if they want to talk about weight loss, if a patient brings it up, I think that’s fine.
All we get is the constant stories of obese people going to the doctor with migraine headaches and their doctor telling them to lose weight. He goes in with a car accident, his doctor tells him to lose weight. They go in with a tumor, their doctor tells them to lose weight. It’s something that’s really, really destructive to the health of obese people that people basically don’t listen to.
MCCAMMON: What, if any, did you get from the medical community for your podcast?
Hobbes: Oh, that’s right, incredibly – these are some of the most frustrating emails I’ve ever seen. Like, it’s like a sentence by sentence. This bias does not seem to exist. And, oh, here’s my bias. It’s interesting to me that like a very basic thing – ask them about their diet and exercise habits before you burn them out in calories, such as root, boring advice. Like, it has a lot of resistance.
Gordon: So Mike tends to get line-by-line, very biased emails. I tend to get emails from healthcare providers who talk about things, oh, my god, I never thought why I need to put BMI on every patient chart Oh, my God, now we’re talking about that before we give any patient dietary recommendations, training for anti-fat bias and screening for eating disorders. Like, every time Mike checks his email, the message he gets is that the doctors hate us. And every time I get my own – I check myself, I’m like that, everything is changing, and things are visible.
Hobby: I know. We only need to trade one of these days for motivational purposes.
Gordon: (laughs) We really do. I don’t know if I can handle it.
MCCAMMON: Michael Hobbs and Aubrey Gordon are hosting the podcast “Maintenance Phase”.
Thank you both very much for talking to us.
Hobby: Thanks for having us.
Gordon: Thank you.
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