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Is Obesity the Worst “Choice” a Person Can Make?



I am guessing that by now, everyone on this planet has probably watched the video of US TV anchor Jennifer Livingston, who delivered a sincere and well thought trough ‘comeback’ to an e-mail taunter, who declared that she was a bad model for viewers because,

Obesity is one of the worst choices a person can make and one of the most dangerous habits to maintain“.

While the public discourse and the world-wide media coverage of this issue has gone off on some interesting tangents (like for e.g. whether or not this e-mail actually constituted ‘bullying’ or was merely stating the facts), the immense outpouring of support that Livingston received may be a first indication that the tide on what is acceptable behaviour towards larger people may indeed be turning.

Interestingly enough, the statement that obesity is a ‘choice’, implying that the opposite is also true and that anyone can ‘choose’ not to be fat, remains a widely held notion. Irrespective of the fact, that the vast majority of people who ‘choose’ to lose some weight, actually end up putting it back on (and more), the belief that anyone can lose weight and keep it off if only they ‘choose’ to do so is prevalent even among people who have been battling their weight all their lives.

Thus, many of my patients blame themselves for their excess weight and blame themselves for not trying hard enough or failing again. It is one thing for the non-obese public to think of obesity as a self-inflicted matter of choice, It is something else entirely, for someone, who has already spent enormous time and effort on losing weight (over and over again?) to blame themselves for failing to make the right ‘choice’.

As health professionals, the one thing we can certainly acknowledge to our patients is that managing weight is anything but easy. Any health professional, who still tells their clients that managing weight is as simple as eating less and moving more (ELMM), has not yet grasped the very fundamentals of human biology.

Take someone with a genetic predisposition (i.e. the majority of us) and throw them into an environment of stress, sleep deprivation, sedentary jobs, hour-long commutes, abundant and omnipresent energy dense foods, unhealthy body-image promoting media, and obesogenic medications and I’d be surprised if they did NOT gain weight!

And remember, weight has never been a good measure of health or of a healthy lifestyle anyway.

So, kudos to Livingston for her comeback and kudos to everyone who jumped to her defence.

If you are one of the few remaining people on this planet, who has not yet seen this video – here it is (e-mail subscribers will have to head to my site to see it):

Appreciate your comments.

AMS
Edmonton, Alberta

10 Comments

  1. At the time I left it, I was number 183 among the messengers to this woman, providing words of support. I don’t know whether she’ll see it in the fray, but I advised her to Google you Dr. S. Wouldn’t it be fantastic if she were to use her position as a reporter to debunk the Biggest Loser mythology that weight loss is the hard part and weight maintenance can be assumed for anyone who merely chooses a zippy and only mildly challenging lifestyle? Some variation on that theme must be reported weekly in my hometown. It’s so horribly discouraging for the handful of people who know the reality, but for the reporter pulling together a story it’s easy journalism. The profiteers of weight loss (sadly, some are MDs, Dr. S.) will supply everything a reporter needs, including a 20-second sound bite. No need to do original research, much less bother to change the language in a press release. It makes me sad. Maybe this woman will go the extra mile. We can pray. On the off chance she calls you, I trust you’ll return her call.

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  2. I can so relate to this issue and the public bias towards healthy lifestyle and size. Becuase of a job change, my day is filled with more sitting than previous, to address this increase sedentary time, I hike a mountain (25 mins. ) and jog the base 3.5 K four days a week and once a week I run 10K and a 6K. I cut back on calories by about 200/Day and have not lost a pound. I feel great, but people look at me “you really do that much exercise and are that size”. …..I used to ask myself the same question, yes I have hypothyroidism but my labs are in the normal range with replacement hormone. My doctor told me to add strength training so I do a boot camp 3 days/week and am the same size and weight. this is my healthiest size and I am happy about it.

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  3. Of the entire email she received that was the line that definitely resounded with me the most. I was somewhat shocked people still believe that obesity is a “choice”. I’m glad someone finally addressed this in a post.

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  4. Thank you for writing this post! I agree I was disturbed by the “choice” wording. I know I shouldn’t be nitpicking, but there are SO many versions of the YouTube video out there (I think the original is just titled, “WKBT News Anchor Responds to Bullying Letter” or something similar) and you somehow chose the one that was titled “Extremely Obese News Anchor’s Live TV Rebuttal” – I think we would both agree that she’s not “extremely obese” and those sorts of labels are not helping the discussion.

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  5. The rating this post has received so far is really telling. Obviously, some of your readers still believe that obesity is a “choice” and accordingly gave this post a low ranking. Interesting. People really want a simple answer to obesity. You don’t give it. And bravo for that!

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  6. I understand that Jennifer Livingstone is also a triathlete. I wish she had talked about the issue of obesity as “choice” more rather than focus on the “bully”. It was good to educate about bullying, but it would have been great for her to talk about why her looks are as immutable as someone else’s baldness.

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  7. Thanks to all of your for your comments, and yes Debra, if Livingston calls me, I’ll return her call.

    Happy (Canadian) Thanksgiving everyone!

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  8. Great blog Arya, I am sharing this with all my staff. I run a bariatric medical clinic that has 10 internal medicine doctors and 25 mutlidisciplinary staff members. I believe that much of the public and health care professionsal still feel that obesity is choice and that genetics, and biological factors (that may have been triggered by improper dieting) play a minor role. Arya, your book with Yoni Freedhoff called Best Weight, clearly points to the fact that a person can be at their best weight (with healthy metabolics, functionality and psychological aspects) and still be considered obese on the BMI scale. All of our patients should aim for their best weight and clearly Jennifer Livingston (triathlete) is at her best weight.
    This discrimination reminds us of the work that needs to be done to battle against weight bias. Arya, you need to be interviewed for this on NBC, or you need to educate Jennifer a bit on the topic, as I would have also liked to hear her talk more about “healthy at my weight”, vs primarily focusing on bullying. Thanks Sean

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  9. Melinda — I think I understand where you are coming from. I get frustrated that I am somehow considered to be automatically unhealthy at a higher weight (high overweight by BMI, not obese) that seems to be quite healthy for me.

    I do think it was critical that she addressed the bully issue first and foremost. Basic decency and human respect are not size- or habit-dependent. Period. The fact that she exercises isn’t what makes it not OK to email a total stranger and tell them how to fix their lives. It’s just plain not OK to do that. I don’t follow “healthy weight” families around in the grocery store and tell them they shouldn’t feed their kids the frozen meals and cheetos they have in their cart, even though I think it’s not the best diet on earth. I shouldn’t get to do the same thing with someone who is heavier. Part of respecting other people is respecting their autonomy and realizing they may have reasons for their decisions.

    The choice issue is important in shifting the science, and that’s where I see value in coming at it from that angle. She chose to address it first from the human rights standpoint, which I think was the thing to do in this case.

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  10. Obesity is NORMAL in America. The idea of “healthy habits” and positive psychology are nothing new. “7 habits of this” and “7 habits of that” books have been best sellers for the last 30 years. Even when given a national stage and expensive trainers, like on the television show, “The Biggest Loser,” Americans continue to battle with food. It’s a sign of the times. It’s quite possibly the first time in modern human history that a civilization has too much food. We PAY people to help us not eat so much. Think about that statement for a second. If you tried to explain that to someone living in third-world squalor, they wouldn’t even understand. “Wait a minute … you pay someone to help you NOT eat?! Huh?”

    Given that fact, we can’t beat ourselves up over this. It’s not our fault that we have so much food. But it has caught up with us. Parents are now obese and passing that down to their children. For most Americans, the refrigerator is a place where food exists … and has ALWAYS existed. Most children in America today have never wondered if they were going to be able to eat. The irony, perhaps, is that most people in America don’t have much money … but that’s just it: you don’t need much money to buy tasty, fast food.

    There’s an old saying: “You can never get enough of what you don’t really want.” Some people will never be able to reconcile themselves with fitness and a constantly full refrigerator. But having a food surplus is not a “habit.” It’s a life, a society, an entire nation. If and when health becomes a priority for parents in America, it’s conceivable that we’ll be able to lessen the obesity wave. Until then, it is an individual choice … and sadly, immediate pleasure usually wins out against long-term pleasure in human animals.

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