1 00:00:05,080 --> 00:00:09,280 Speaker 1: In two thousand five, Katherine Flegal and her colleagues did 2 00:00:09,480 --> 00:00:14,280 Speaker 1: a research study. Catherine didn't think it was going to 3 00:00:14,360 --> 00:00:19,160 Speaker 1: be controversial. Unfortunately, that was a miscalculation on my part. 4 00:00:19,440 --> 00:00:23,000 Speaker 1: It was a huge deal. Catherine was a researcher at 5 00:00:23,000 --> 00:00:26,400 Speaker 1: the Centers for Disease Control and Prevention at the time, 6 00:00:27,120 --> 00:00:30,000 Speaker 1: and the study she was working on looked at weight 7 00:00:30,080 --> 00:00:36,880 Speaker 1: associated deaths. It actually found something surprising, something that ran 8 00:00:37,080 --> 00:00:43,840 Speaker 1: contrary to a pretty core idea about weight. Their analysis 9 00:00:43,840 --> 00:00:48,360 Speaker 1: suggested that extra pounds might not be so bad for you. 10 00:00:49,320 --> 00:00:52,519 Speaker 1: When they published what they found, their study kind of 11 00:00:52,560 --> 00:00:57,080 Speaker 1: went viral. I had to get a separate phone line 12 00:00:57,120 --> 00:01:00,360 Speaker 1: just to feel the calls from reporters and criticism them 13 00:01:00,480 --> 00:01:07,200 Speaker 1: came really quickly. This one professor had begun preemptively contacting reporters. 14 00:01:07,480 --> 00:01:09,679 Speaker 1: The study had been featured in the Journal of the 15 00:01:09,720 --> 00:01:14,640 Speaker 1: American Medical Association, a highly respected journal that vetted the 16 00:01:14,680 --> 00:01:19,440 Speaker 1: work before publishing it. But an academic was going around 17 00:01:19,680 --> 00:01:23,840 Speaker 1: telling the press that Catherine's study was bad. So by 18 00:01:23,840 --> 00:01:26,040 Speaker 1: the time they talked to me, they had already talked 19 00:01:26,120 --> 00:01:29,080 Speaker 1: to another person who had said that my stuff was 20 00:01:29,319 --> 00:01:33,720 Speaker 1: rubbish and completely wrong and fatally flawed. And things like that, 21 00:01:34,040 --> 00:01:37,479 Speaker 1: And something similar happened at a scientific meeting not long 22 00:01:37,520 --> 00:01:40,720 Speaker 1: after the paper came out, and this other professor took 23 00:01:40,760 --> 00:01:43,959 Speaker 1: the stage when he wasn't supposed to be speaking and 24 00:01:44,800 --> 00:01:48,120 Speaker 1: just issue the condemnation of our article, just out of 25 00:01:48,120 --> 00:01:52,640 Speaker 1: the blue. So what was everyone so angry about. Anyway, 26 00:01:52,800 --> 00:01:55,520 Speaker 1: We were trying to estimate the proportion of this in 27 00:01:55,560 --> 00:01:59,240 Speaker 1: the United States that were associated with different bm I levels. 28 00:01:59,520 --> 00:02:03,480 Speaker 1: Cavin specifically for a CDC division known as the National 29 00:02:03,560 --> 00:02:08,040 Speaker 1: Center for Health Statistics. That's the agency responsible for coming 30 00:02:08,120 --> 00:02:12,480 Speaker 1: up with data to help make Americans healthier, And like 31 00:02:12,680 --> 00:02:17,160 Speaker 1: Catherine said, she was focused on figuring out how many 32 00:02:17,240 --> 00:02:21,560 Speaker 1: deaths in America were associated with different b m I s, 33 00:02:22,320 --> 00:02:26,959 Speaker 1: or body mass index, which is basically a mathematical formula 34 00:02:27,120 --> 00:02:32,880 Speaker 1: for estimating a person's body fat. In other words, Catherine 35 00:02:32,919 --> 00:02:39,119 Speaker 1: was investigating the link between weight and death. But these 36 00:02:39,120 --> 00:02:43,280 Speaker 1: weren't just numbers something to stick on a website or 37 00:02:43,480 --> 00:02:47,840 Speaker 1: pamphlet somewhere and forget about a lot of things done 38 00:02:47,960 --> 00:02:51,480 Speaker 1: at the National Center for Health Statistics are supposed to 39 00:02:51,480 --> 00:02:57,720 Speaker 1: influence policy. At the time, body weight was already emerging 40 00:02:57,919 --> 00:03:02,679 Speaker 1: as public health enemy number one. The deadly impact of obesity. 41 00:03:02,800 --> 00:03:06,639 Speaker 1: The toll on Americans far greater than previously thought. Why 42 00:03:06,680 --> 00:03:09,960 Speaker 1: are Americans so fat? The United States is the world's 43 00:03:10,000 --> 00:03:13,960 Speaker 1: baddest developed nation, with an obesity right double of that 44 00:03:13,960 --> 00:03:18,600 Speaker 1: in many European countries. The CDC had declared obesity a 45 00:03:18,800 --> 00:03:25,960 Speaker 1: growing epidemic years earlier, and Catherine and her colleagues weren't 46 00:03:26,040 --> 00:03:29,080 Speaker 1: the first to look at the subject. The paper that 47 00:03:29,240 --> 00:03:32,600 Speaker 1: came out before ours estimated that obesity was about to 48 00:03:32,639 --> 00:03:34,800 Speaker 1: overtake smoking is the major cause of death in the 49 00:03:34,880 --> 00:03:39,080 Speaker 1: United States. Remember, at this point, there was also tons 50 00:03:39,160 --> 00:03:43,280 Speaker 1: of awareness that smoking is bad for you, So the 51 00:03:43,400 --> 00:03:47,760 Speaker 1: idea that being heavy could be more dangerous than smoking 52 00:03:49,040 --> 00:03:53,720 Speaker 1: that really sent people into a tail spin. It looked 53 00:03:53,760 --> 00:03:58,560 Speaker 1: like America had this big weight problem. But when Catherine 54 00:03:58,560 --> 00:04:01,880 Speaker 1: and her colleagues sat down to do their own analysis, 55 00:04:02,640 --> 00:04:06,720 Speaker 1: they came to a very different conclusion. Our paper didn't 56 00:04:06,720 --> 00:04:10,320 Speaker 1: suggest that the city associated deaths were anywhere. They're likely 57 00:04:10,360 --> 00:04:13,240 Speaker 1: to overtake smoking as a major cause of death. Using 58 00:04:13,320 --> 00:04:19,480 Speaker 1: data from what's called the National Health and Nutrition Examination Survey, 59 00:04:19,560 --> 00:04:23,360 Speaker 1: they examined the health of tens of thousands of Americans. 60 00:04:24,480 --> 00:04:28,760 Speaker 1: They also tracked how many of those participating over the 61 00:04:28,880 --> 00:04:31,719 Speaker 1: years had died. If you look at the number of 62 00:04:31,760 --> 00:04:34,279 Speaker 1: deaths and you adjust for all these things like age 63 00:04:34,320 --> 00:04:38,479 Speaker 1: and gender and socio economic data and so on, we 64 00:04:38,560 --> 00:04:41,440 Speaker 1: get this many more desks than would be expected, and 65 00:04:41,680 --> 00:04:44,720 Speaker 1: this many fewer deaths would be expected, making that comparison 66 00:04:44,760 --> 00:04:48,120 Speaker 1: to normal weight. They basically wanted to figure out how 67 00:04:48,160 --> 00:04:53,839 Speaker 1: many more people considered overweight or obese we're dying then 68 00:04:53,960 --> 00:04:56,640 Speaker 1: would have been expected if they had been at a 69 00:04:56,920 --> 00:05:01,159 Speaker 1: so called normal weight A. When they crunched the numbers, 70 00:05:01,800 --> 00:05:06,000 Speaker 1: Katherine and co. Found that obesity wasn't about to pass 71 00:05:06,080 --> 00:05:09,120 Speaker 1: smoking as a top cause of death in the US, 72 00:05:09,960 --> 00:05:14,400 Speaker 1: not even close. They also found that the number of 73 00:05:14,440 --> 00:05:17,840 Speaker 1: deaths connected to higher b m I s is actually 74 00:05:17,960 --> 00:05:21,200 Speaker 1: pretty low, so it was a very different result. They 75 00:05:21,240 --> 00:05:25,320 Speaker 1: find that fewer people with a b m I classified 76 00:05:25,360 --> 00:05:30,360 Speaker 1: as overweight We're dying than would have been expected at 77 00:05:30,400 --> 00:05:33,400 Speaker 1: a normal weight b m I. We didn't say that 78 00:05:33,480 --> 00:05:37,120 Speaker 1: these things are caused or were protected, or that or 79 00:05:37,160 --> 00:05:39,479 Speaker 1: we is protected. We just reported the numbers. Now, people 80 00:05:39,480 --> 00:05:41,520 Speaker 1: have a lot of takeaways from that, but I don't 81 00:05:41,520 --> 00:05:44,599 Speaker 1: feel responsible for all their takeaways. But to say the 82 00:05:44,680 --> 00:05:50,159 Speaker 1: least they're finding was really unexpected. After all, carrying around 83 00:05:50,279 --> 00:05:54,000 Speaker 1: extra pounds is supposed to be bad for you. That's 84 00:05:54,040 --> 00:05:58,360 Speaker 1: the whole basis for medical categories like overweight or obese. 85 00:05:59,400 --> 00:06:03,440 Speaker 1: This is the scientific foundation on which weight lost empires 86 00:06:03,520 --> 00:06:08,640 Speaker 1: have been built. Where did that idea come from? Anyway? 87 00:06:09,080 --> 00:06:13,320 Speaker 1: And is it even true? What Catherine and her team 88 00:06:13,560 --> 00:06:18,440 Speaker 1: found called at least some of this into question, so 89 00:06:18,760 --> 00:06:23,599 Speaker 1: other scientists freaked out. It seems like they decided the 90 00:06:23,680 --> 00:06:28,000 Speaker 1: only explanation was that Catherine and her team had messed 91 00:06:28,080 --> 00:06:33,040 Speaker 1: up somehow. That was easier for them to swallow than 92 00:06:33,160 --> 00:06:37,520 Speaker 1: considering the opposite, that Catherine and her team could actually 93 00:06:37,560 --> 00:06:42,559 Speaker 1: be right, that the relationship between weight and health could 94 00:06:42,600 --> 00:06:48,200 Speaker 1: be different. The funny thing is this Catherine and her 95 00:06:48,240 --> 00:06:53,279 Speaker 1: colleagues hadn't meant to call into question the very foundations 96 00:06:53,320 --> 00:06:56,800 Speaker 1: of weight science. We just blundered into this. I mean, 97 00:06:56,839 --> 00:07:00,200 Speaker 1: we weren't trying to cause a fire. Back to what 98 00:07:00,360 --> 00:07:04,080 Speaker 1: Catherine and her colleagues found, It wasn't that there was 99 00:07:04,360 --> 00:07:08,800 Speaker 1: no link between b m I and death exactly, but 100 00:07:09,080 --> 00:07:13,000 Speaker 1: that link existed among people with higher b m I 101 00:07:14,000 --> 00:07:18,400 Speaker 1: of thirty or higher, which is the cutoff for obesity, 102 00:07:18,640 --> 00:07:23,640 Speaker 1: and especially thirty five or higher, and when the researchers 103 00:07:23,760 --> 00:07:27,800 Speaker 1: added it all up, the total number of deaths tied 104 00:07:27,840 --> 00:07:33,000 Speaker 1: to these categories of overweight and obees turned out to 105 00:07:33,080 --> 00:07:38,440 Speaker 1: be pretty small. More people were dying in those years 106 00:07:38,480 --> 00:07:43,320 Speaker 1: from car crashes and gun violence, and more people were 107 00:07:43,680 --> 00:07:47,800 Speaker 1: definitely dying from smoking, so there was a very large difference. 108 00:07:48,400 --> 00:07:52,680 Speaker 1: Before Catherine published the research, she also looked at a 109 00:07:52,760 --> 00:07:56,680 Speaker 1: bunch of other studies. She wanted to know whether her 110 00:07:56,720 --> 00:08:03,160 Speaker 1: team's findings were unusual. After all, their paper contradicted what 111 00:08:03,360 --> 00:08:07,400 Speaker 1: most people think about weight and health, at least when 112 00:08:07,440 --> 00:08:11,560 Speaker 1: it comes to the category of overweight. But it turned 113 00:08:11,600 --> 00:08:15,720 Speaker 1: out that there's wasn't even the first study with findings 114 00:08:15,760 --> 00:08:17,720 Speaker 1: like these. There's a lot of other studies that have 115 00:08:17,720 --> 00:08:21,000 Speaker 1: shown this already, so it's not a big deal. Those 116 00:08:21,040 --> 00:08:24,640 Speaker 1: other studies had also found little risk of death associated 117 00:08:24,680 --> 00:08:28,800 Speaker 1: with having a b m I classified as overweight, But 118 00:08:28,840 --> 00:08:31,920 Speaker 1: it was Catherine's study that for some reason really struck 119 00:08:31,920 --> 00:08:35,360 Speaker 1: a nerve, and a lot of those tacks were coming 120 00:08:35,559 --> 00:08:42,840 Speaker 1: from academics at one particular institution, Harvard, especially this one 121 00:08:42,880 --> 00:08:48,240 Speaker 1: guy Walter Willet. At the time, Walter was the chair 122 00:08:48,280 --> 00:08:53,520 Speaker 1: of the nutrition department. After another paper, Catherine wrote, he 123 00:08:53,559 --> 00:08:57,640 Speaker 1: went around calling her work a pile of rubbish and 124 00:08:57,640 --> 00:09:03,040 Speaker 1: said people should ignore it. The prestigious journal Nature actually 125 00:09:03,160 --> 00:09:08,880 Speaker 1: ended up writing an editorial basically criticizing Walter's comments and 126 00:09:09,000 --> 00:09:13,680 Speaker 1: saying he was oversimplifying the science. But there was more 127 00:09:13,720 --> 00:09:17,319 Speaker 1: than just that. And then the Harvard School of Public 128 00:09:17,320 --> 00:09:22,560 Speaker 1: Health group that was mainly, although not exclusively, the antagonists here, 129 00:09:23,280 --> 00:09:27,560 Speaker 1: they decided to schedule a symposium at Harvard to basically 130 00:09:27,559 --> 00:09:30,520 Speaker 1: to show what was wrong with my article. That's right. 131 00:09:31,120 --> 00:09:36,080 Speaker 1: Researchers opposed Catherine's findings so fiercely that they put together 132 00:09:36,200 --> 00:09:39,439 Speaker 1: a whole event just to talk about how much they 133 00:09:39,480 --> 00:09:44,240 Speaker 1: hated it. And Catherine says that the conference organizers didn't 134 00:09:44,280 --> 00:09:47,480 Speaker 1: even make it possible for her and her co authors 135 00:09:47,520 --> 00:09:52,160 Speaker 1: to attend. As you can imagine, all of this was 136 00:09:52,640 --> 00:09:56,080 Speaker 1: a lot for Catherine. This is getting really stressful. I 137 00:09:56,080 --> 00:09:58,360 Speaker 1: had a very high adrenaline level, I would say, because 138 00:09:58,400 --> 00:10:01,720 Speaker 1: I was always finding the weird attacks in places that 139 00:10:01,800 --> 00:10:04,920 Speaker 1: I just would not have expected, like Wikipedia. The gist 140 00:10:04,920 --> 00:10:07,640 Speaker 1: of all this criticism was that there were things Katherine 141 00:10:07,679 --> 00:10:11,360 Speaker 1: and her colleagues had simply missed. They had found. The 142 00:10:11,360 --> 00:10:14,680 Speaker 1: people living in bigger bodies were dying at similar rates 143 00:10:14,720 --> 00:10:19,239 Speaker 1: to those in smaller bodies. But like I said earlier, 144 00:10:19,760 --> 00:10:23,200 Speaker 1: it was easier for prominent scientists to imagine that Katherine 145 00:10:23,280 --> 00:10:27,040 Speaker 1: and co. Were wrong, then that they're finding could be true. 146 00:10:28,480 --> 00:10:32,679 Speaker 1: The explanation critics landed on, according to news coverage at 147 00:10:32,679 --> 00:10:36,880 Speaker 1: the time, was that their numbers must have been off. 148 00:10:38,040 --> 00:10:41,719 Speaker 1: After all, people can be thin because they're sick with 149 00:10:41,840 --> 00:10:47,880 Speaker 1: diseases like cancer, or because they're elderly. The critics said 150 00:10:48,080 --> 00:10:51,720 Speaker 1: that these sorts of things must have thrown off the study. 151 00:10:52,840 --> 00:10:57,080 Speaker 1: They also said that Katherine's team didn't use enough long 152 00:10:57,200 --> 00:11:03,000 Speaker 1: term data, but Katherine says, no, that wasn't it at all. 153 00:11:03,720 --> 00:11:06,160 Speaker 1: The issue was that people had already meet up their 154 00:11:06,160 --> 00:11:10,480 Speaker 1: minds about weight and health, and Catherine was undermining those 155 00:11:10,480 --> 00:11:16,280 Speaker 1: preconceived notions. Catherine was basically an atheist, renouncing the gospel 156 00:11:16,360 --> 00:11:19,960 Speaker 1: about weight and health. There's this real drive to say 157 00:11:20,080 --> 00:11:22,440 Speaker 1: anything finding like that is unusual. It needs to be 158 00:11:22,440 --> 00:11:25,839 Speaker 1: explained away. We need to get rid of this. How 159 00:11:25,840 --> 00:11:27,440 Speaker 1: do we get rid of it? We've got to say, well, 160 00:11:27,440 --> 00:11:29,520 Speaker 1: maybe it's because of ages, or maybe it's because of this. 161 00:11:30,040 --> 00:11:32,320 Speaker 1: It's because of that, you know. So there's all you 162 00:11:32,320 --> 00:11:36,160 Speaker 1: have to explain away in convenient findings. Catherine says this 163 00:11:36,320 --> 00:11:40,600 Speaker 1: stuff wasn't really an issue, and in fact, she and 164 00:11:40,640 --> 00:11:44,560 Speaker 1: her team said right in their paper that factors like 165 00:11:44,679 --> 00:11:48,960 Speaker 1: illness and duration of follow up didn't have a big impact. 166 00:11:49,679 --> 00:11:52,160 Speaker 1: So this was all based on pretty much nothing, But 167 00:11:52,200 --> 00:11:55,439 Speaker 1: it was very influential, and this kind of stuff went 168 00:11:55,440 --> 00:12:00,160 Speaker 1: on literally for years. Disagreements like these are actually a 169 00:12:00,280 --> 00:12:04,560 Speaker 1: really key part of the scientific process. The whole point 170 00:12:04,760 --> 00:12:08,440 Speaker 1: is to go back and forth about findings so people 171 00:12:08,480 --> 00:12:12,480 Speaker 1: can trust that they're accurate. But the way Catherine describes it, 172 00:12:13,080 --> 00:12:16,920 Speaker 1: the criticism crossed the line. What could have been a 173 00:12:17,000 --> 00:12:24,120 Speaker 1: legitimate scientific debate evolved. Misinformation started flying, Like when one 174 00:12:24,160 --> 00:12:28,360 Speaker 1: group claimed that Catherine's findings were renounced by the CDC, 175 00:12:29,679 --> 00:12:33,559 Speaker 1: she says they weren't. When I asked the CDC about it, 176 00:12:33,679 --> 00:12:36,120 Speaker 1: they didn't get back to me. So there's just all this, 177 00:12:36,280 --> 00:12:39,360 Speaker 1: at least falsehoods lying around, and I didn't know what 178 00:12:39,400 --> 00:12:42,040 Speaker 1: to do about them. Some of it was just kind 179 00:12:42,040 --> 00:12:46,719 Speaker 1: of disrespectful about Catherine's skills as a scientist. The one 180 00:12:46,760 --> 00:12:49,960 Speaker 1: who was kind of insults saying that my paper was 181 00:12:50,080 --> 00:12:53,680 Speaker 1: my faintly flawed. That was nonsense. It was rubbish, that 182 00:12:54,120 --> 00:12:58,000 Speaker 1: we made very simple errors that were completely wrong. Harvard 183 00:12:58,040 --> 00:13:01,680 Speaker 1: didn't return a request for comment by our deadline. In 184 00:13:01,760 --> 00:13:05,640 Speaker 1: an email to me, Walter Willett said that Katherine's paper 185 00:13:05,960 --> 00:13:10,920 Speaker 1: quote was causing serious confusion among physicians and patients, with 186 00:13:11,000 --> 00:13:16,720 Speaker 1: potentially dangerous clinical and public health consequences. He also says 187 00:13:16,800 --> 00:13:21,480 Speaker 1: that many large analyzes have refuted the findings showing that 188 00:13:21,600 --> 00:13:26,240 Speaker 1: overweight and obesity have poor health effects. It's clear from 189 00:13:26,240 --> 00:13:31,200 Speaker 1: talking to Catherine that these criticisms rankled her because she 190 00:13:31,320 --> 00:13:34,800 Speaker 1: cares a lot about the science. She retired from the 191 00:13:34,840 --> 00:13:40,439 Speaker 1: CDC in and is currently a consulting professor at Stanford. 192 00:13:41,480 --> 00:13:47,400 Speaker 1: But the attacks became personal too. Lisa and Darovitch, who 193 00:13:47,480 --> 00:13:50,760 Speaker 1: was a PhD student at Harvard about a decade ago, 194 00:13:51,640 --> 00:13:58,000 Speaker 1: said a professor there even criticized Katherine's weight, saying that 195 00:13:58,120 --> 00:14:01,000 Speaker 1: was why her work couldn't be trust stid. I got 196 00:14:01,080 --> 00:14:04,199 Speaker 1: very stressed trying to deal with this stuff and trying 197 00:14:04,200 --> 00:14:07,920 Speaker 1: to respond to things that people were saying. This was 198 00:14:08,120 --> 00:14:12,679 Speaker 1: Catherine's scientific reputation on the line, This is her career, 199 00:14:13,600 --> 00:14:18,000 Speaker 1: and this loud chorus of scientific feedback is saying legal 200 00:14:18,120 --> 00:14:20,880 Speaker 1: must be wrong. Legal is wrong. Legal is wrong. She 201 00:14:20,960 --> 00:14:23,440 Speaker 1: must be wrong, or this must be wrong, or therefore 202 00:14:23,480 --> 00:14:28,000 Speaker 1: she's wrong. But what if Catherine wasn't wrong? What if 203 00:14:28,040 --> 00:14:33,080 Speaker 1: the dangers of being heavy have been overstated or misrepresented? 204 00:14:34,400 --> 00:14:38,200 Speaker 1: A small but vocal contingent of experts and advocates say 205 00:14:38,320 --> 00:14:43,360 Speaker 1: just that. They argue that weighing more isn't inherently bad 206 00:14:43,400 --> 00:14:47,280 Speaker 1: for you. In fact, when people say that, they are 207 00:14:47,360 --> 00:14:53,880 Speaker 1: mixing up correlation and causation, a classic scientific error. This 208 00:14:53,960 --> 00:14:58,080 Speaker 1: is obviously counter to the predominant thinking. But the idea 209 00:14:58,200 --> 00:15:00,600 Speaker 1: here is that we have been folk using on the 210 00:15:00,640 --> 00:15:05,920 Speaker 1: scale too much and not enough on healthy behaviors. Our 211 00:15:06,000 --> 00:15:10,240 Speaker 1: weight bias has become a major blind spot, something that 212 00:15:10,320 --> 00:15:14,480 Speaker 1: keeps us reciting the same old lines about weight and health, 213 00:15:15,280 --> 00:15:19,280 Speaker 1: even as a body of scientific evidence suggests that this 214 00:15:19,320 --> 00:15:23,440 Speaker 1: way of thinking is wrong. We're going to get into 215 00:15:23,480 --> 00:15:26,720 Speaker 1: that in this episode, and we're going to take a 216 00:15:26,880 --> 00:15:31,600 Speaker 1: close look at evidence behind it. I'm Bloomberg News health 217 00:15:31,680 --> 00:15:37,560 Speaker 1: reporter Emma Court and from the Prognosis podcast This is 218 00:15:37,640 --> 00:15:51,520 Speaker 1: Losing It. There's some things pretty much everyone will agree 219 00:15:51,800 --> 00:15:56,120 Speaker 1: is true. The earth is round, the sky is blue, 220 00:15:57,040 --> 00:16:01,920 Speaker 1: and weighing more is bad for you. That's the message 221 00:16:02,000 --> 00:16:05,720 Speaker 1: we get in a million overt and subtle ways every 222 00:16:05,760 --> 00:16:09,920 Speaker 1: single day. Just look at who gets featured on the 223 00:16:09,960 --> 00:16:15,400 Speaker 1: cover of fitness magazines. And then there's the actual messages 224 00:16:15,840 --> 00:16:20,480 Speaker 1: people with bigger bodies get from their doctors, from friends 225 00:16:20,520 --> 00:16:25,280 Speaker 1: and family, and even sometimes from random people on the street. 226 00:16:26,520 --> 00:16:31,800 Speaker 1: Lose weight and you'll be healthier. Tracy Man, a psychologist 227 00:16:31,880 --> 00:16:34,760 Speaker 1: who runs a health and eating lab at the University 228 00:16:34,800 --> 00:16:39,240 Speaker 1: of Minnesota, puts it really well. The air we breathe 229 00:16:39,400 --> 00:16:43,320 Speaker 1: is weight stigma. Treating people in bigger bodies poorly is 230 00:16:43,360 --> 00:16:46,760 Speaker 1: so common that lots of people don't even notice it 231 00:16:47,280 --> 00:16:50,360 Speaker 1: or think of it as discrimination. We've been brought up 232 00:16:50,400 --> 00:16:54,600 Speaker 1: with views that it's not okay to be obese and 233 00:16:54,640 --> 00:16:57,680 Speaker 1: that you need to be thin, and you, at least 234 00:16:57,840 --> 00:17:01,920 Speaker 1: a minimum need to be trying to be thin. Tracy 235 00:17:02,000 --> 00:17:05,520 Speaker 1: thinks that's why diets keep getting pushed over and over 236 00:17:05,560 --> 00:17:08,919 Speaker 1: and over again, even though they don't really work for 237 00:17:09,000 --> 00:17:13,639 Speaker 1: long term weight loss, not for most people anyway. Like 238 00:17:13,920 --> 00:17:16,680 Speaker 1: she says, even if the deck is stacked against you, 239 00:17:17,359 --> 00:17:20,479 Speaker 1: the expectation is that you should at least try to 240 00:17:20,560 --> 00:17:25,479 Speaker 1: be thin. The message is persistent. Getting thin should be 241 00:17:25,520 --> 00:17:30,720 Speaker 1: your goal, otherwise you're doing it wrong. The way Tracy 242 00:17:30,840 --> 00:17:35,720 Speaker 1: put it really struck me. Wait, stigma is the air 243 00:17:35,760 --> 00:17:39,879 Speaker 1: we breathe, and so is the idea that living in 244 00:17:39,920 --> 00:17:45,320 Speaker 1: a bigger body means you're unhealthy. Think about it. When 245 00:17:45,359 --> 00:17:48,719 Speaker 1: did you first hear that weighing more is bad for you? 246 00:17:50,280 --> 00:17:54,040 Speaker 1: And how often have you heard it since then? Every month, 247 00:17:54,760 --> 00:17:59,240 Speaker 1: every hour? Did you ever question why that's the case 248 00:18:00,400 --> 00:18:03,840 Speaker 1: or have you always just accepted it at face value? 249 00:18:05,040 --> 00:18:08,160 Speaker 1: I'm guessing that for most of us it's the latter. 250 00:18:09,080 --> 00:18:11,639 Speaker 1: I've just heard it said that that you can be 251 00:18:11,640 --> 00:18:14,840 Speaker 1: fat and healthy. Actually you can't think. I'm sure that 252 00:18:14,880 --> 00:18:18,359 Speaker 1: you're excess if that is unhealthy, I don't think anyone 253 00:18:18,520 --> 00:18:21,000 Speaker 1: is agons off with it. But how do we know 254 00:18:21,400 --> 00:18:26,520 Speaker 1: that being heavy is bad for you? Tracy and others say, 255 00:18:26,560 --> 00:18:32,360 Speaker 1: we actually don't. We don't know that. We know that 256 00:18:32,400 --> 00:18:37,360 Speaker 1: people at heavier weights can have health problems, but they 257 00:18:37,440 --> 00:18:42,479 Speaker 1: don't always, and it's not clear that weight itself is 258 00:18:42,560 --> 00:18:47,560 Speaker 1: the issue. Here's the deal. Higher B M E s 259 00:18:47,680 --> 00:18:51,360 Speaker 1: are at greater risk for a lot of different diseases, 260 00:18:51,680 --> 00:18:56,560 Speaker 1: medical conditions, and depth. It's a really long list, so 261 00:18:56,720 --> 00:19:00,400 Speaker 1: I'll just read it off the cdc S website. High 262 00:19:00,400 --> 00:19:06,719 Speaker 1: blood pressure, high cholesterol, type two diabetes, coronary heart disease, stroke, 263 00:19:07,400 --> 00:19:13,320 Speaker 1: gall bladder disease, ost arthritis, sleep apnian, breathing problems, many 264 00:19:13,359 --> 00:19:18,760 Speaker 1: types of cancer, mental illness like depression and anxiety. You 265 00:19:18,800 --> 00:19:21,880 Speaker 1: get the idea. You hear this kind of thing all 266 00:19:21,880 --> 00:19:25,040 Speaker 1: the time, like from doctors who say, all of the 267 00:19:25,119 --> 00:19:30,120 Speaker 1: chronic diseases that we deal with, high blood pressure, cardiovascular disease, diabetes, 268 00:19:30,440 --> 00:19:33,720 Speaker 1: they're all related to weight problems. The CDC also lists 269 00:19:33,720 --> 00:19:37,200 Speaker 1: some more vague sounding things as risks if you're heavier, 270 00:19:38,040 --> 00:19:42,399 Speaker 1: like low quality of life and body pain and difficulty 271 00:19:42,520 --> 00:19:47,440 Speaker 1: with physical functioning. You might be wondering what the connection 272 00:19:47,680 --> 00:19:52,879 Speaker 1: is between weight and all these problems, the why of 273 00:19:52,960 --> 00:19:59,000 Speaker 1: it all. Doctors and scientists are specifically concerned with extra fat, 274 00:20:00,000 --> 00:20:03,080 Speaker 1: which they say can put lots of stress on the body, 275 00:20:04,200 --> 00:20:09,120 Speaker 1: including pressure on bones and joints, and fat cells can 276 00:20:09,240 --> 00:20:15,080 Speaker 1: lead to inflammation, affecting things like regulation of blood sugar levels, 277 00:20:15,280 --> 00:20:19,960 Speaker 1: which can lead to diabetes. But again, the conditions I 278 00:20:20,080 --> 00:20:25,679 Speaker 1: listed earlier are risks associated with higher weights, Like the 279 00:20:25,760 --> 00:20:30,679 Speaker 1: doctor we just heard talking said, heart disease and diabetes 280 00:20:30,840 --> 00:20:36,200 Speaker 1: and all the rest are linked with weight or associated 281 00:20:36,280 --> 00:20:42,159 Speaker 1: with weight the reason for all that careful language. Here's 282 00:20:42,200 --> 00:20:47,719 Speaker 1: tracy again. Weight is correlated with many problems, but correlation 283 00:20:47,960 --> 00:20:53,320 Speaker 1: does not mean it's causing those problems. Correlation is not causation. 284 00:20:54,160 --> 00:20:58,240 Speaker 1: That's kind of a big rule in statistics. Admittedly, I 285 00:20:58,280 --> 00:21:00,959 Speaker 1: haven't been in a math class in a long time, 286 00:21:01,880 --> 00:21:05,840 Speaker 1: but I remember pretty clearly that in high school one 287 00:21:05,880 --> 00:21:09,160 Speaker 1: of our teachers actually had us banging on our desks 288 00:21:09,280 --> 00:21:16,920 Speaker 1: and enchanted. Correlation is not causation. Correlation is not causation. Now, 289 00:21:17,119 --> 00:21:20,879 Speaker 1: there are a lot of places where conflating correlation and 290 00:21:20,920 --> 00:21:26,000 Speaker 1: causation becomes a problem. One of the classic examples has 291 00:21:26,040 --> 00:21:30,840 Speaker 1: to do with ice cream and murder. Ice Cream sales 292 00:21:31,000 --> 00:21:37,160 Speaker 1: increase in the summer, and so do the number of murders. Therefore, 293 00:21:37,920 --> 00:21:44,080 Speaker 1: ice cream causes murders. Seems straightforward enough, but of course 294 00:21:44,480 --> 00:21:48,600 Speaker 1: that's wrong. Murders and ice cream consumption both go up 295 00:21:48,640 --> 00:21:53,520 Speaker 1: at the same time because of a third factor, rising temperatures. 296 00:21:54,440 --> 00:21:58,840 Speaker 1: When it's warm, people eat ice cream, and just generally 297 00:21:59,040 --> 00:22:02,439 Speaker 1: people are out and about more. They're doing more of 298 00:22:02,520 --> 00:22:08,440 Speaker 1: lots of kinds of activities, including apparently committing felonies. Ice 299 00:22:08,480 --> 00:22:13,600 Speaker 1: Cream may be delicious, but it is not to blame again, 300 00:22:13,840 --> 00:22:18,560 Speaker 1: Correlation is not causation, and with weight, just like with 301 00:22:18,640 --> 00:22:22,480 Speaker 1: ice cream and murders, there are other factors that could 302 00:22:22,520 --> 00:22:28,280 Speaker 1: help explain what's going on, things like lifestyle. More on 303 00:22:28,359 --> 00:22:33,160 Speaker 1: that in a minute. We want to understand why so 304 00:22:33,240 --> 00:22:38,359 Speaker 1: many diseases occur so we can prevent them, and many 305 00:22:38,400 --> 00:22:43,880 Speaker 1: diseases are associated with weight. Studies have also shown that 306 00:22:44,000 --> 00:22:49,160 Speaker 1: when people lose weight, they lower their odds of developing conditions, 307 00:22:49,200 --> 00:22:56,200 Speaker 1: including diabetes, and improve things like cholesterol levels. Evidence seems 308 00:22:56,320 --> 00:23:01,520 Speaker 1: clear right losing weight is the way to improve your health. 309 00:23:02,880 --> 00:23:06,160 Speaker 1: But the experts and advocates I spoke with for this 310 00:23:06,200 --> 00:23:11,439 Speaker 1: episode tell a very different story. They say that we 311 00:23:11,720 --> 00:23:17,960 Speaker 1: unfairly blame weight for really complex scientific questions and treat 312 00:23:18,080 --> 00:23:23,480 Speaker 1: dieting as a quick fix. Except it's actually not a 313 00:23:23,560 --> 00:23:28,679 Speaker 1: quick fix because, as we've learned in this podcast, losing 314 00:23:28,720 --> 00:23:34,919 Speaker 1: weight long term is a really challenging and almost impossible enterprise. 315 00:23:36,560 --> 00:23:41,120 Speaker 1: So what could be actually causing these diseases and other 316 00:23:41,200 --> 00:23:46,399 Speaker 1: issues if not weight? Now, this is a subject that's 317 00:23:46,680 --> 00:23:52,520 Speaker 1: really charged, so I ask you to reserve judgment. Here 318 00:23:52,520 --> 00:23:56,560 Speaker 1: are experts out. It turns out that there are a 319 00:23:56,600 --> 00:24:00,920 Speaker 1: lot of things that are correlated with weight, aren't so 320 00:24:01,000 --> 00:24:05,720 Speaker 1: good for you, including being sedentary. Sedentary a k a. 321 00:24:05,960 --> 00:24:09,719 Speaker 1: Not moving around a lot. This is actually a pretty 322 00:24:09,720 --> 00:24:12,879 Speaker 1: big issue, and not just for people at heavier weights. 323 00:24:14,119 --> 00:24:18,800 Speaker 1: Many many people live sedentary lives. We drive to work, 324 00:24:19,480 --> 00:24:23,200 Speaker 1: we sit at a computer, that kind of thing. In fact, 325 00:24:23,359 --> 00:24:25,720 Speaker 1: people in the Western world have been living like this 326 00:24:25,920 --> 00:24:30,320 Speaker 1: for hundreds of years. We talked about that in episode two, 327 00:24:30,760 --> 00:24:34,720 Speaker 1: how the Industrial Revolution shaped the conditions of modern life 328 00:24:34,800 --> 00:24:38,280 Speaker 1: and modern dieting and made us all a lot more 329 00:24:38,359 --> 00:24:42,359 Speaker 1: likely to just sit around on our butts all day. 330 00:24:43,440 --> 00:24:45,720 Speaker 1: At a certain point, it starts to get tough to 331 00:24:45,800 --> 00:24:49,640 Speaker 1: separate out how we live from how much we weigh. 332 00:24:49,920 --> 00:24:51,879 Speaker 1: You get into a little bit of a chicken or 333 00:24:51,880 --> 00:24:56,800 Speaker 1: egg thing. Here's Glenn Geyser, a professor of exercise physiology 334 00:24:56,920 --> 00:25:01,320 Speaker 1: at Arizona State University. People who are overweight or beasts 335 00:25:01,640 --> 00:25:04,600 Speaker 1: tend to be less physically active. They tend to eat 336 00:25:04,680 --> 00:25:09,159 Speaker 1: unhealthier diets. That is on average what we see. But 337 00:25:09,240 --> 00:25:12,800 Speaker 1: that doesn't mean that the weight is the problem. Means 338 00:25:12,840 --> 00:25:17,880 Speaker 1: that it's probably the lifestyle. The problem is lifestyle, not weight. 339 00:25:18,560 --> 00:25:21,440 Speaker 1: This is the problem that we have in America. We've 340 00:25:21,440 --> 00:25:23,960 Speaker 1: got this disconnect. We think weight is the big issue 341 00:25:23,960 --> 00:25:28,359 Speaker 1: when it's really not. It's the lifestyle that oftentimes goes without. 342 00:25:28,800 --> 00:25:33,000 Speaker 1: Of course, weight is way more complicated than just lifestyle. 343 00:25:33,760 --> 00:25:37,320 Speaker 1: Not all of it is in our hands. Your genetics, 344 00:25:37,400 --> 00:25:42,040 Speaker 1: for example, are a really important factor too, but you 345 00:25:42,080 --> 00:25:47,919 Speaker 1: can actually change your lifestyle. Higher weights are also connected 346 00:25:47,960 --> 00:25:52,720 Speaker 1: to other things too. Here's tracy again. It's also correlated 347 00:25:52,760 --> 00:25:58,600 Speaker 1: with poverty, and there's a ton of research showing links 348 00:25:58,600 --> 00:26:04,679 Speaker 1: between poverty and health problems. Heavier people also experienced stigma. 349 00:26:04,960 --> 00:26:09,000 Speaker 1: Often they're treated worse because of how they look. That 350 00:26:09,240 --> 00:26:13,359 Speaker 1: has been shown to be correlated to health problems, even 351 00:26:13,440 --> 00:26:17,199 Speaker 1: controlling for whatever the person weighs, and there's lots of 352 00:26:17,240 --> 00:26:20,720 Speaker 1: reasons for that. People in bigger bodies often go to 353 00:26:20,760 --> 00:26:24,560 Speaker 1: the doctor and just get told to lose weight, almost 354 00:26:24,600 --> 00:26:28,200 Speaker 1: as a reflex. Doctors just assumed that weight is the 355 00:26:28,320 --> 00:26:32,560 Speaker 1: issue and don't investigate what might actually be causing someone's 356 00:26:32,560 --> 00:26:37,000 Speaker 1: health issues. And when things like that happen, people get 357 00:26:37,119 --> 00:26:43,480 Speaker 1: sicker and they also avoid doctors. That's wait stigma in action. 358 00:26:44,760 --> 00:26:49,600 Speaker 1: Wait stigma is incredibly prevalent, not just for medical providers. 359 00:26:50,200 --> 00:26:53,000 Speaker 1: Doctors are the number two source of fat phobia and 360 00:26:53,000 --> 00:26:57,760 Speaker 1: wait stigma outside of family. This is Veronica Garnett. Veronica 361 00:26:57,800 --> 00:27:00,119 Speaker 1: is a dietitian and one of the leaders of a 362 00:27:00,160 --> 00:27:04,680 Speaker 1: group called the Association for Size Diversity and Health or ASDA. 363 00:27:04,800 --> 00:27:07,159 Speaker 1: And then if you're in a fat phobic we live 364 00:27:07,160 --> 00:27:10,960 Speaker 1: in a fat phobic society and world. It is stressful 365 00:27:11,200 --> 00:27:14,040 Speaker 1: to be treated poorly because of the way you look. 366 00:27:15,000 --> 00:27:18,639 Speaker 1: Lots of evidence has suggested that stress is not good 367 00:27:18,680 --> 00:27:22,520 Speaker 1: for people and can have all sorts of terrible effects 368 00:27:22,560 --> 00:27:26,000 Speaker 1: on their health. It starts to feel like some kind 369 00:27:26,040 --> 00:27:31,840 Speaker 1: of vicious cycle. We assume people's weight makes them unhealthy, 370 00:27:31,960 --> 00:27:37,240 Speaker 1: and those assumptions then harm their health. It's also stressful 371 00:27:37,280 --> 00:27:40,879 Speaker 1: to navigate a world that, just in general, was not 372 00:27:41,080 --> 00:27:46,000 Speaker 1: designed to accommodate your body. Here's Annie Jansen, another one 373 00:27:46,119 --> 00:27:50,640 Speaker 1: of asda's leaders. Annie is also a dietitian and has 374 00:27:50,640 --> 00:27:54,720 Speaker 1: a master's in public health. Fat people's health is impacted 375 00:27:54,760 --> 00:27:59,120 Speaker 1: by fat phobian weight stigma. Even outside of the medical realm. 376 00:27:59,200 --> 00:28:02,520 Speaker 1: Chairs are are not accessible to all people. In restaurants, 377 00:28:02,880 --> 00:28:07,520 Speaker 1: um and theaters, and other public spaces. UM people face 378 00:28:07,880 --> 00:28:12,960 Speaker 1: direct hate and comments about their bodies when they're out 379 00:28:13,000 --> 00:28:16,879 Speaker 1: in public, limiting their ability to participate in public life. 380 00:28:17,600 --> 00:28:21,439 Speaker 1: Doctors are people affected by bias like any other person, 381 00:28:22,280 --> 00:28:25,920 Speaker 1: and bias can also affect the scientists doing the studies. 382 00:28:26,600 --> 00:28:31,119 Speaker 1: It's easy for people to find diseases correlated to higher 383 00:28:31,160 --> 00:28:34,600 Speaker 1: weights when the research itself is biased um, and it's 384 00:28:34,600 --> 00:28:37,639 Speaker 1: easy for people to accept that and not really be 385 00:28:37,760 --> 00:28:42,000 Speaker 1: critical about how well done those studies are. There's one 386 00:28:42,040 --> 00:28:47,840 Speaker 1: more thing, a really important thing. As we've established by now, 387 00:28:48,400 --> 00:28:51,640 Speaker 1: people who live in bigger bodies are facing all this 388 00:28:51,960 --> 00:28:57,480 Speaker 1: pressure to diet and lose weight. Losing weight isn't usually sustainable, 389 00:28:57,680 --> 00:29:02,800 Speaker 1: though so many people gave weight back. This is known 390 00:29:03,000 --> 00:29:08,360 Speaker 1: as yo yo dieting, or, in more scientific terms, weight cycling. 391 00:29:09,560 --> 00:29:13,600 Speaker 1: There's actually a lot of evidence connecting it with health problems. 392 00:29:14,200 --> 00:29:17,840 Speaker 1: Weight cycling is an independent risk factor for diabetes, hypertension, 393 00:29:17,960 --> 00:29:22,480 Speaker 1: insulin resistance, and a slipidemia, which is essentially high bad 394 00:29:22,520 --> 00:29:27,600 Speaker 1: cholesterol and or good are low good cholesterol. You'll notice 395 00:29:27,640 --> 00:29:31,440 Speaker 1: that all of those disease listed are typically diseases associated 396 00:29:31,440 --> 00:29:35,960 Speaker 1: with higher BMI. This is again something that studies have found. 397 00:29:36,840 --> 00:29:39,720 Speaker 1: I know you're sick of me saying it, but correlation 398 00:29:39,880 --> 00:29:44,840 Speaker 1: is not causation. So how come with weight we've thrown 399 00:29:44,920 --> 00:29:50,040 Speaker 1: out this incredibly basic scientific principle. A lot of doctors 400 00:29:50,080 --> 00:29:53,400 Speaker 1: and scientists would say that we have it, and that 401 00:29:53,480 --> 00:29:58,600 Speaker 1: there's clear evidence extra weight harms health, evidence like the 402 00:29:58,640 --> 00:30:02,920 Speaker 1: way people's health and prooves when they lose weight. But 403 00:30:03,040 --> 00:30:06,880 Speaker 1: as I spoke with sources for this episode, I began 404 00:30:06,920 --> 00:30:10,800 Speaker 1: to wonder whether we're just more willing to let correlation 405 00:30:11,000 --> 00:30:16,080 Speaker 1: equal causation when it comes to weight, because we've already 406 00:30:16,200 --> 00:30:21,840 Speaker 1: convinced ourselves that being thinner is better. By the way, 407 00:30:22,240 --> 00:30:25,760 Speaker 1: not all of the findings about higher weights are bad. 408 00:30:26,640 --> 00:30:31,480 Speaker 1: When it comes to a variety of diseases like heart disease, cancer, 409 00:30:31,640 --> 00:30:37,080 Speaker 1: and diabetes, research has found a connection between obesity and 410 00:30:37,200 --> 00:30:42,240 Speaker 1: longer survival. In other words, it looks like when heavier 411 00:30:42,320 --> 00:30:47,000 Speaker 1: people get sick with these diseases, they actually might be 412 00:30:47,120 --> 00:30:54,120 Speaker 1: less likely to die. This is again an association correlation. 413 00:30:55,280 --> 00:30:58,400 Speaker 1: We can't go as far as to say that weighing 414 00:30:58,480 --> 00:31:02,800 Speaker 1: more is the reason people with these diseases survived longer, 415 00:31:04,080 --> 00:31:07,400 Speaker 1: though some scientists have said they think that could be 416 00:31:07,480 --> 00:31:12,760 Speaker 1: what's going on, and longer survival is of course a 417 00:31:12,800 --> 00:31:18,479 Speaker 1: good thing. Still, these kinds of findings don't go on 418 00:31:18,520 --> 00:31:23,719 Speaker 1: the CDC website under obesity. Remember that long list of 419 00:31:23,760 --> 00:31:28,920 Speaker 1: medical conditions associated with higher body weights. The government's web 420 00:31:28,960 --> 00:31:33,560 Speaker 1: designers don't like go edit the page and add an asterisk. 421 00:31:34,400 --> 00:31:38,920 Speaker 1: If they did, the website might say overweight an obesity 422 00:31:39,040 --> 00:31:43,760 Speaker 1: put people at higher risk for diseases like diabetes asterisk. 423 00:31:44,360 --> 00:31:48,080 Speaker 1: But people in bigger bodies who get diabetes actually live 424 00:31:48,200 --> 00:31:51,760 Speaker 1: longer than people in smaller bodies with the same disease. 425 00:31:53,360 --> 00:31:57,479 Speaker 1: Weighing more is supposed to be bad for you, and 426 00:31:57,600 --> 00:32:01,400 Speaker 1: yet in certain cases it doesn't look bad for you. 427 00:32:02,680 --> 00:32:07,600 Speaker 1: That's called the obesity paradox, and it does at some 428 00:32:07,760 --> 00:32:13,960 Speaker 1: levels seem pretty paradoxical. But let's become a term that's 429 00:32:14,040 --> 00:32:18,320 Speaker 1: used for just anything that shows obesity is good for 430 00:32:18,360 --> 00:32:20,160 Speaker 1: you or might not be so bad for you as 431 00:32:20,200 --> 00:32:22,240 Speaker 1: a paradox. Why is it a paradox because you don't 432 00:32:22,280 --> 00:32:26,880 Speaker 1: expect it. That was Katherine Flegal again from earlier. Everyone 433 00:32:26,920 --> 00:32:31,280 Speaker 1: already agrees that being heavy is bad for you. Anything 434 00:32:31,320 --> 00:32:35,520 Speaker 1: that counters the narrative, well, it must be a paradox. 435 00:32:36,160 --> 00:32:40,160 Speaker 1: Catherine's research also ran counter to the mainstream narrative, and 436 00:32:40,240 --> 00:32:42,480 Speaker 1: a lot of people went to a good deal of 437 00:32:42,520 --> 00:32:48,080 Speaker 1: trouble to discredit it and discredit her. But remember how 438 00:32:48,120 --> 00:32:52,960 Speaker 1: before she published, Catherine went through other scientific papers. She 439 00:32:53,040 --> 00:32:56,600 Speaker 1: actually found that a lot of articles had similar findings. 440 00:32:57,360 --> 00:33:00,160 Speaker 1: That's why she was so surprised by the reaction to 441 00:33:00,280 --> 00:33:04,680 Speaker 1: her paper. If that's the case, why did Katherine face 442 00:33:04,840 --> 00:33:09,400 Speaker 1: this big wave of criticism and bad feedback about her 443 00:33:09,440 --> 00:33:14,040 Speaker 1: work for years afterward. Now, when I look back, I 444 00:33:14,120 --> 00:33:16,800 Speaker 1: realized that most articles kind of like ours, would not 445 00:33:17,160 --> 00:33:19,400 Speaker 1: would not just publish the numbers they would come. They 446 00:33:19,400 --> 00:33:22,360 Speaker 1: would start with something, well, everybody, it's really bad for 447 00:33:22,400 --> 00:33:24,400 Speaker 1: you because it causes like X, y Z, And they 448 00:33:24,400 --> 00:33:26,200 Speaker 1: would have all and it costs all us money. But 449 00:33:26,320 --> 00:33:28,080 Speaker 1: even though it costs all us money, it is so 450 00:33:28,120 --> 00:33:30,160 Speaker 1: bad for you, and less found this number, but don't 451 00:33:30,160 --> 00:33:33,520 Speaker 1: pay any attention to it. In other words, most researchers 452 00:33:33,520 --> 00:33:37,280 Speaker 1: would open their studies with a long disclaimer saying that 453 00:33:37,400 --> 00:33:42,240 Speaker 1: extra weight really is unhealthy, even if that isn't exactly 454 00:33:42,280 --> 00:33:45,959 Speaker 1: what their research suggested. I took a look at some 455 00:33:46,000 --> 00:33:49,560 Speaker 1: of the scientific papers about the so called obesity paradox, 456 00:33:50,080 --> 00:33:52,120 Speaker 1: and a lot of those articles are kind of like 457 00:33:52,200 --> 00:33:56,960 Speaker 1: that too. They open with some variation of obesity is 458 00:33:57,000 --> 00:34:01,920 Speaker 1: a big, big problem, will be to be bad. Obesity 459 00:34:02,040 --> 00:34:06,840 Speaker 1: kills people. I'm paraphrasing, of course, and then the studies 460 00:34:06,920 --> 00:34:09,719 Speaker 1: go on to say that patients with diabetes who are 461 00:34:09,719 --> 00:34:13,319 Speaker 1: heavier actually die at lower rates, that when they get 462 00:34:13,360 --> 00:34:18,640 Speaker 1: cancer they actually survive longer. To me, this is a 463 00:34:18,680 --> 00:34:22,880 Speaker 1: story about bias, how it can affect even scientists who 464 00:34:22,960 --> 00:34:25,440 Speaker 1: are supposed to be led by just the facts and 465 00:34:25,520 --> 00:34:30,239 Speaker 1: the data. It's also a story about group think. Once 466 00:34:30,280 --> 00:34:34,120 Speaker 1: there's a narrative out there and it's firmly settled, people 467 00:34:34,239 --> 00:34:38,400 Speaker 1: don't want to complicate it. What if they're wrong, They 468 00:34:38,400 --> 00:34:43,440 Speaker 1: would look pretty stupid. Catherine points out another piece of 469 00:34:43,480 --> 00:34:48,840 Speaker 1: this that scientists are people too, people who have specialized 470 00:34:48,840 --> 00:34:52,160 Speaker 1: in an area and get money to study it and 471 00:34:52,200 --> 00:34:57,080 Speaker 1: whose career advancement depends on it, and like anyone else, 472 00:34:57,560 --> 00:35:04,080 Speaker 1: scientists have goals, power, funding status. I think it would 473 00:35:04,080 --> 00:35:08,600 Speaker 1: be career ending. Career ending. She's saying that because of 474 00:35:08,640 --> 00:35:13,879 Speaker 1: how ferociously her work was attacked. That's what happens when 475 00:35:13,880 --> 00:35:18,120 Speaker 1: you complicate the narrative about wait, or even when you 476 00:35:18,320 --> 00:35:22,440 Speaker 1: undermine it. It's worth pointing out that complicating the narrative 477 00:35:22,640 --> 00:35:27,319 Speaker 1: didn't end Catherine's career. Those things did get pretty unpleasant, 478 00:35:27,960 --> 00:35:31,839 Speaker 1: but Catherine's career at least was protected. We were all 479 00:35:31,880 --> 00:35:35,040 Speaker 1: senior government scientists that inn that we couldn't really be fired. 480 00:35:35,040 --> 00:35:38,120 Speaker 1: We didn't depend on grants, and we didn't need to 481 00:35:38,160 --> 00:35:40,160 Speaker 1: get tenure or anything like that. We couldn't be promoted 482 00:35:40,160 --> 00:35:42,920 Speaker 1: any higher. She says, it would have been a whole 483 00:35:43,000 --> 00:35:46,719 Speaker 1: different story if she was an associate professor somewhere. I 484 00:35:46,760 --> 00:35:49,320 Speaker 1: would never want any grants. That would have ruined my career. 485 00:35:49,880 --> 00:35:52,839 Speaker 1: It was only later that Catherine started thinking of this 486 00:35:52,920 --> 00:35:56,080 Speaker 1: whole dust up a little differently. It felt like her 487 00:35:56,080 --> 00:35:59,920 Speaker 1: fellow scientists had taken a side on the issue all, 488 00:36:00,000 --> 00:36:03,560 Speaker 1: almost as if it were a political campaign. I actually 489 00:36:03,560 --> 00:36:05,720 Speaker 1: was surprised the first of my thoughts I heard someone 490 00:36:06,160 --> 00:36:08,680 Speaker 1: mentioned the idea of sides, like I don't have a side. 491 00:36:09,040 --> 00:36:11,840 Speaker 1: This is the data we use, these are the methods 492 00:36:11,840 --> 00:36:14,440 Speaker 1: we use. It's not a side. It's not a statement 493 00:36:14,480 --> 00:36:17,440 Speaker 1: of opinion. It's not like personal opinion. It was like 494 00:36:17,520 --> 00:36:22,680 Speaker 1: Catherine's fellow scientists had decided being bigger was bad for you, period, 495 00:36:23,520 --> 00:36:28,560 Speaker 1: no nuance, no questions about it. It's been fully established. 496 00:36:29,120 --> 00:36:33,080 Speaker 1: Any data that contradicts it, that data can just shove 497 00:36:33,320 --> 00:36:40,359 Speaker 1: right off. So to summarize, the idea that weighing more 498 00:36:40,600 --> 00:36:47,160 Speaker 1: is bad for you is incredibly prevalent, but well, it's complicated. 499 00:36:48,080 --> 00:36:51,719 Speaker 1: In fact, there's a group of researchers and advocates who 500 00:36:51,800 --> 00:36:55,560 Speaker 1: argue that the dangers of being heavy have been exaggerated. 501 00:36:56,400 --> 00:37:00,960 Speaker 1: They say we've scapegoaded weight for diseases when there could 502 00:37:01,040 --> 00:37:04,839 Speaker 1: be other causes, like a lack of activity or not 503 00:37:04,960 --> 00:37:10,160 Speaker 1: eating particularly healthily. And when scientists put out research that 504 00:37:10,280 --> 00:37:14,560 Speaker 1: suggests being a little bigger isn't so bad, they face 505 00:37:14,680 --> 00:37:22,359 Speaker 1: these vigorous attacks from really prominent people for years. All 506 00:37:22,440 --> 00:37:26,680 Speaker 1: this brings us to the billion dollar questions can you 507 00:37:26,760 --> 00:37:33,640 Speaker 1: be healthy at higher weights? The experts we spoke with say, yeah, 508 00:37:33,840 --> 00:37:36,120 Speaker 1: you can be. Something that we actually can solve is 509 00:37:36,120 --> 00:37:39,040 Speaker 1: how to make people healthier. Much easier to make people 510 00:37:39,080 --> 00:37:43,000 Speaker 1: healthier than it is to make people thinner. I'd say 511 00:37:43,040 --> 00:37:46,040 Speaker 1: this all the time, and I don't know why it's 512 00:37:46,239 --> 00:37:50,440 Speaker 1: so radical a thing to say, but behaving in healthy 513 00:37:50,440 --> 00:37:54,759 Speaker 1: ways will make you healthier. It just won't necessarily make 514 00:37:54,800 --> 00:38:01,000 Speaker 1: you thinner. Healthy behaviors like exercising, eating our vegetables, getting 515 00:38:01,040 --> 00:38:04,720 Speaker 1: lots of sleep, and reducing stress, even if those things 516 00:38:04,880 --> 00:38:09,240 Speaker 1: don't make us lose weight, which they may not. Here's 517 00:38:09,280 --> 00:38:13,759 Speaker 1: Glenn Geeser, the Arizona State University professor again, and at 518 00:38:13,840 --> 00:38:15,560 Speaker 1: some point in our life we have to kind of 519 00:38:15,600 --> 00:38:18,920 Speaker 1: just say, look, this is my weight. This is about 520 00:38:18,960 --> 00:38:21,360 Speaker 1: it for me. I'm just gonna have to settle for this. 521 00:38:22,080 --> 00:38:26,120 Speaker 1: But that is not the same as saying, look, I'm unhealthy. 522 00:38:26,280 --> 00:38:29,600 Speaker 1: I'm just going to have to settle for this. Because anyone, 523 00:38:29,680 --> 00:38:34,759 Speaker 1: regardless of their weight, can improve their health with lifestyle change, 524 00:38:35,080 --> 00:38:38,360 Speaker 1: and as obvious as it sounds, people at all different 525 00:38:38,360 --> 00:38:42,759 Speaker 1: weights do all different levels of these healthy things, which 526 00:38:42,800 --> 00:38:46,040 Speaker 1: is part of the reason it's so wild we group 527 00:38:46,160 --> 00:38:51,720 Speaker 1: people together in these broad, undifferentiated categories. It's like telling 528 00:38:51,800 --> 00:38:55,360 Speaker 1: everyone who is at a so called normal weight, you 529 00:38:55,400 --> 00:39:00,239 Speaker 1: get a free pass vegetables. Who needs them stay at 530 00:39:00,280 --> 00:39:03,080 Speaker 1: that weight and it doesn't really matter what you do. 531 00:39:03,960 --> 00:39:08,200 Speaker 1: B m I stigmatizes those who get classified as overweight 532 00:39:08,360 --> 00:39:12,080 Speaker 1: or obese because of it, but so called normal weight 533 00:39:12,200 --> 00:39:15,200 Speaker 1: people are also getting led astray by b m I 534 00:39:15,920 --> 00:39:18,480 Speaker 1: because they might think they're fine and don't have to 535 00:39:18,560 --> 00:39:22,480 Speaker 1: exercise or anything, even though their lifestyle might be putting 536 00:39:22,520 --> 00:39:27,120 Speaker 1: them at risk. Everyone is getting screwed. Someone who is 537 00:39:27,200 --> 00:39:32,640 Speaker 1: classified as overweight or obese by the body mass indexed criteria, 538 00:39:33,200 --> 00:39:37,080 Speaker 1: but exercises a lot and has a modest, at least 539 00:39:37,080 --> 00:39:40,320 Speaker 1: a modest level of fitness. They tend to be better 540 00:39:40,920 --> 00:39:45,719 Speaker 1: in terms of overall health outcomes than thin people who 541 00:39:45,719 --> 00:39:50,640 Speaker 1: are very sedentary. So fitness matters, fatness not so much. 542 00:39:51,480 --> 00:39:55,359 Speaker 1: That's great news for jim rats around the world. But 543 00:39:55,680 --> 00:39:59,880 Speaker 1: here's the thing. All those classic healthy things I just 544 00:40:00,040 --> 00:40:05,759 Speaker 1: listed off earlier, lots of people aren't doing them. This 545 00:40:05,880 --> 00:40:10,320 Speaker 1: isn't me being judgmental. All that stuff is really hard 546 00:40:10,360 --> 00:40:14,520 Speaker 1: to do the way society is set up. It's hard 547 00:40:14,600 --> 00:40:17,719 Speaker 1: to make time to work out. It's hard to eat 548 00:40:17,760 --> 00:40:22,080 Speaker 1: better when healthier food is way more expensive and inconvenient. 549 00:40:23,040 --> 00:40:26,439 Speaker 1: It's hard to sleep more and reduce our stress when 550 00:40:26,480 --> 00:40:31,160 Speaker 1: we lead busy lives and have stressful jobs. The world 551 00:40:31,200 --> 00:40:34,240 Speaker 1: we live in is not built to encourage or support 552 00:40:34,440 --> 00:40:38,279 Speaker 1: healthy behaviors, but there are things we could do to 553 00:40:38,440 --> 00:40:44,880 Speaker 1: change that. First, let's talk exercise. The US government recommends 554 00:40:45,040 --> 00:40:49,480 Speaker 1: a few hours a week of moderate cardio plus at 555 00:40:49,560 --> 00:40:55,160 Speaker 1: least two days of muscle strengthening. Most adults aren't doing that, 556 00:40:56,800 --> 00:41:01,120 Speaker 1: and the government actually tracks what people eat. How it 557 00:41:01,200 --> 00:41:06,080 Speaker 1: compares with dietary guidelines. That score has gotten a little 558 00:41:06,120 --> 00:41:12,600 Speaker 1: better over time, but it's still not great. In Americans, 559 00:41:12,680 --> 00:41:18,080 Speaker 1: eating habits rated a fifty ninety nine out of hundred 560 00:41:19,080 --> 00:41:23,040 Speaker 1: at some schools, that's a failing grade. What it means 561 00:41:23,440 --> 00:41:27,920 Speaker 1: is that we're definitely not eating enough vegetables, fruit, or 562 00:41:28,040 --> 00:41:32,160 Speaker 1: dairy each day, and getting the right kinds of grains 563 00:41:32,239 --> 00:41:36,239 Speaker 1: and protein like whole grains and nuts can be a 564 00:41:36,320 --> 00:41:41,480 Speaker 1: problem too. So people aren't moving enough and they aren't 565 00:41:41,520 --> 00:41:45,200 Speaker 1: eating so great. But then let's say they go on 566 00:41:45,239 --> 00:41:49,200 Speaker 1: a diet. They start exercising more and eating in more 567 00:41:49,200 --> 00:41:54,600 Speaker 1: healthy ways. They're doing those quintessential healthy behaviors, and the 568 00:41:54,840 --> 00:41:59,040 Speaker 1: most common ways to lose weight are through exercise and diet. 569 00:41:59,560 --> 00:42:03,760 Speaker 1: And remember are that laundry list from earlier, of all 570 00:42:03,800 --> 00:42:08,400 Speaker 1: the health risks tied to heavier weights. Doctors and scientists 571 00:42:08,400 --> 00:42:11,640 Speaker 1: will tell you that the way you reduce those risks 572 00:42:12,400 --> 00:42:16,360 Speaker 1: is to lose weight. But also, the funny thing about 573 00:42:16,360 --> 00:42:20,520 Speaker 1: diets is that sometimes when people go on diets, they 574 00:42:20,560 --> 00:42:24,160 Speaker 1: actually lean into a lot of those healthy things. So 575 00:42:24,239 --> 00:42:26,240 Speaker 1: now you have to ask the question, will wait a minute, 576 00:42:27,080 --> 00:42:29,959 Speaker 1: if people are exercising and dieting, when they lose weight. 577 00:42:30,360 --> 00:42:33,920 Speaker 1: How do we know that it's the weight loss that 578 00:42:34,000 --> 00:42:38,160 Speaker 1: improves the health and not the exercise and the healthier eating. 579 00:42:38,960 --> 00:42:42,279 Speaker 1: Glenn says that there are studies where people with b 580 00:42:42,480 --> 00:42:46,880 Speaker 1: m I is considered overweight and obese change their diet 581 00:42:46,960 --> 00:42:52,319 Speaker 1: and exercise, but don't lose much or any weight. And 582 00:42:52,719 --> 00:42:56,960 Speaker 1: why do you know these folks start looking healthier by 583 00:42:57,160 --> 00:43:03,120 Speaker 1: measures like lower cholesterol. And in study of what's known 584 00:43:03,239 --> 00:43:07,440 Speaker 1: as the Dash diet, which helps people reduce high blood pressure, 585 00:43:08,360 --> 00:43:13,640 Speaker 1: researchers actually prevented participants from losing weight. They did that 586 00:43:13,800 --> 00:43:18,520 Speaker 1: by weighing people and adding in calories when needed, and 587 00:43:19,040 --> 00:43:25,839 Speaker 1: people's blood pressure declined. Anyway, long story short, people can 588 00:43:26,080 --> 00:43:30,400 Speaker 1: improve their health without losing weight. Tracy Man from the 589 00:43:30,520 --> 00:43:37,160 Speaker 1: University of Minnesota says it's actually easier. It's really really 590 00:43:37,239 --> 00:43:41,280 Speaker 1: hard to lose weight and keep it off, but eating 591 00:43:41,280 --> 00:43:47,480 Speaker 1: your vegetables and getting your steps in that's within reach. Still, 592 00:43:48,000 --> 00:43:51,759 Speaker 1: it's kind of a tough sell, right You're telling me 593 00:43:51,840 --> 00:43:55,040 Speaker 1: to get on a treadmill or whatever, and I'm not 594 00:43:55,120 --> 00:43:58,040 Speaker 1: even going to drop a pant size. We need to 595 00:43:58,080 --> 00:44:00,640 Speaker 1: find a way to help people stick to those health behaviors, 596 00:44:00,920 --> 00:44:04,759 Speaker 1: especially physical activity thing. Two, we've got to get rid 597 00:44:04,800 --> 00:44:07,360 Speaker 1: of weight stigma, because as long as there's weight stigma, 598 00:44:07,760 --> 00:44:11,520 Speaker 1: people are going to keep trying to diet, and people 599 00:44:11,560 --> 00:44:14,480 Speaker 1: are going to continue to make obese people uh feel 600 00:44:14,480 --> 00:44:18,360 Speaker 1: bad and suffer in various ways that are unfair and unjust. 601 00:44:19,040 --> 00:44:20,560 Speaker 1: Um And three, we need to find a way to 602 00:44:20,600 --> 00:44:26,160 Speaker 1: help people feel satisfied with whatever body they have once 603 00:44:26,239 --> 00:44:32,000 Speaker 1: they are behaving in healthy ways consistently. That body won't 604 00:44:32,000 --> 00:44:35,239 Speaker 1: necessarily be thinner at then as you want, but that's 605 00:44:35,239 --> 00:44:37,400 Speaker 1: your healthy body, and we've got to find a way 606 00:44:37,440 --> 00:44:40,799 Speaker 1: to be satisfied with that. Freecy's Lab at the University 607 00:44:40,840 --> 00:44:44,520 Speaker 1: of Minnesota is working on those right now. Adding vegetables 608 00:44:44,560 --> 00:44:49,239 Speaker 1: to your diet um and especially doing the recommended amount 609 00:44:49,280 --> 00:44:52,960 Speaker 1: of physical activity each week. Those are lifestyle changes and 610 00:44:53,000 --> 00:44:56,920 Speaker 1: people should do them. Again, doing them doesn't mean you're 611 00:44:56,960 --> 00:44:59,520 Speaker 1: gonna lose weight, Doing them doesn't mean you're going to 612 00:44:59,600 --> 00:45:02,640 Speaker 1: be thin, and but doing them does mean you will 613 00:45:02,680 --> 00:45:05,480 Speaker 1: improve your health. You have to measure health in a 614 00:45:05,560 --> 00:45:13,080 Speaker 1: different way now at the scale, approaching health in a 615 00:45:13,160 --> 00:45:18,040 Speaker 1: way that's way inclusive. There's actually a movement behind it 616 00:45:18,840 --> 00:45:23,279 Speaker 1: called you Guessed It Health at every size. What we're 617 00:45:23,320 --> 00:45:26,480 Speaker 1: trying to do currently, and the current mainstream approach to 618 00:45:26,560 --> 00:45:30,319 Speaker 1: health and weight isn't working. This is Annie again from 619 00:45:30,360 --> 00:45:35,319 Speaker 1: asda as that advocates for health at every size. What 620 00:45:35,360 --> 00:45:38,160 Speaker 1: we see in the research is that efforts to make 621 00:45:38,200 --> 00:45:41,400 Speaker 1: that people thin are failing. They fail over and over 622 00:45:41,440 --> 00:45:46,040 Speaker 1: and over again. We have decades, literal decades of research 623 00:45:46,719 --> 00:45:48,759 Speaker 1: and so those are not things that people can just 624 00:45:48,960 --> 00:45:52,480 Speaker 1: choose to do, like they could choose to eat more vegetables. 625 00:45:53,120 --> 00:45:55,440 Speaker 1: And so what what happens when we shift the focus 626 00:45:55,440 --> 00:45:57,960 Speaker 1: to things that people actually have control over, like what 627 00:45:58,000 --> 00:45:59,960 Speaker 1: they eat, or how they move their bodies or web 628 00:46:00,080 --> 00:46:04,040 Speaker 1: or not they smoke any Veronica and their fellow activists 629 00:46:04,200 --> 00:46:08,480 Speaker 1: are fighting for exactly that, for people to stop treating 630 00:46:08,520 --> 00:46:12,120 Speaker 1: weight as the equivalent of health. They say that we've 631 00:46:12,160 --> 00:46:15,600 Speaker 1: been telling people to lose weight for their health and 632 00:46:15,680 --> 00:46:19,680 Speaker 1: that's not only wrong, but it's actually causing a lot 633 00:46:19,840 --> 00:46:23,359 Speaker 1: of harm. The vast majority of doctors today are still 634 00:46:23,560 --> 00:46:28,200 Speaker 1: very fat phobic. Ultimately, we need healthcare practitioners to understand 635 00:46:29,320 --> 00:46:32,080 Speaker 1: what the science really does say and and right now, 636 00:46:32,120 --> 00:46:34,919 Speaker 1: the science is contrary to what the mainstream beliefs about 637 00:46:34,920 --> 00:46:37,320 Speaker 1: fatness are. And if a fat person is going to 638 00:46:37,360 --> 00:46:40,759 Speaker 1: get good care in the hands of a doctor. We 639 00:46:40,840 --> 00:46:43,680 Speaker 1: need people to also understand what the science and research 640 00:46:43,719 --> 00:46:48,080 Speaker 1: says about weight and weight loss. This is again contrary 641 00:46:48,080 --> 00:46:51,799 Speaker 1: to how society still thinks about things. Any points out 642 00:46:51,840 --> 00:46:54,520 Speaker 1: that just having a certain b m I, a b 643 00:46:54,680 --> 00:46:57,640 Speaker 1: m I that's considered in the obese range, is now 644 00:46:57,680 --> 00:47:02,440 Speaker 1: itself being called a disease. But the activists at ASDA 645 00:47:02,680 --> 00:47:07,200 Speaker 1: are fighting for more than that too. Veronica and Annie 646 00:47:07,360 --> 00:47:11,480 Speaker 1: argue that even the idea of health itself is broken. 647 00:47:12,440 --> 00:47:16,880 Speaker 1: After all, how did scientists come up with standards for health. 648 00:47:17,680 --> 00:47:22,520 Speaker 1: They did it by mostly studying white heterosexual men. We 649 00:47:22,600 --> 00:47:24,720 Speaker 1: are trying to shift the way that we talk about 650 00:47:24,719 --> 00:47:27,600 Speaker 1: health in health at every size so that we don't 651 00:47:27,640 --> 00:47:33,800 Speaker 1: continue to uphold those white centric, erocentric um standards within 652 00:47:33,880 --> 00:47:36,719 Speaker 1: our own movement. One way to think about this is 653 00:47:36,760 --> 00:47:39,160 Speaker 1: in terms of how much we value health as a 654 00:47:39,239 --> 00:47:43,760 Speaker 1: society and what that really means. Health is often defined 655 00:47:43,800 --> 00:47:47,520 Speaker 1: as the absence of disease right off the bat. That 656 00:47:47,600 --> 00:47:50,680 Speaker 1: leaves a lot of people out, and on top of that, 657 00:47:50,920 --> 00:47:54,239 Speaker 1: some of the sickest people in society are also the 658 00:47:54,280 --> 00:48:00,560 Speaker 1: most marginalized people like people of color, LGBTQ people, more people, 659 00:48:01,280 --> 00:48:05,800 Speaker 1: A fat person, uh could live this healthy, long, happy 660 00:48:05,840 --> 00:48:09,200 Speaker 1: life according to these Western Eurocentric standards of health. Right, 661 00:48:09,600 --> 00:48:12,839 Speaker 1: this is Veronica again. But let's say they don't. Let's 662 00:48:12,840 --> 00:48:15,600 Speaker 1: say a fat person does develop diabetes, then what do 663 00:48:15,719 --> 00:48:18,439 Speaker 1: we do? Do we not care for this person? Are 664 00:48:18,440 --> 00:48:22,399 Speaker 1: they just disposable? Um? And like a lot of times 665 00:48:22,400 --> 00:48:27,600 Speaker 1: it plays out in our medical industrial complex, like fat people, uh, 666 00:48:27,760 --> 00:48:30,600 Speaker 1: disabled people, aging and chronically ill people are just seen 667 00:48:30,640 --> 00:48:33,360 Speaker 1: as disposable. And like if we look at the pandemic 668 00:48:33,440 --> 00:48:36,120 Speaker 1: that we're living in, some people were just left to 669 00:48:36,160 --> 00:48:39,000 Speaker 1: die or people like, oh, well, it's only this COVID 670 00:48:39,040 --> 00:48:41,279 Speaker 1: is only affecting certain people, so like I don't have 671 00:48:41,360 --> 00:48:42,960 Speaker 1: to worry about it, and those people could just get 672 00:48:42,960 --> 00:48:46,160 Speaker 1: sick and die. But is that the type of world 673 00:48:46,239 --> 00:48:47,839 Speaker 1: we want to live in? Is that the type of 674 00:48:48,040 --> 00:48:51,600 Speaker 1: health care system like we want to uphold? Veronica says 675 00:48:51,719 --> 00:48:55,879 Speaker 1: that ASDA wants to change these things to people, no 676 00:48:55,920 --> 00:49:00,160 Speaker 1: matter what size they are or what health can soon 677 00:49:00,200 --> 00:49:02,760 Speaker 1: as they have or don't have, or whatever deserved care, 678 00:49:03,440 --> 00:49:07,920 Speaker 1: they deserve equitable, barrier free access to the care and 679 00:49:07,960 --> 00:49:11,960 Speaker 1: resources they need to support their well being. I wonder 680 00:49:12,080 --> 00:49:14,399 Speaker 1: like what our health care system would look like if 681 00:49:15,520 --> 00:49:19,759 Speaker 1: we actually just all acknowledge that being sick, being like, 682 00:49:19,880 --> 00:49:24,520 Speaker 1: becoming disabled, being disabled, getting old and dying is a 683 00:49:24,560 --> 00:49:27,759 Speaker 1: normal part of the human experience. That means getting the 684 00:49:27,760 --> 00:49:34,239 Speaker 1: message across about health and we isn't enough. Historically, the 685 00:49:34,320 --> 00:49:38,719 Speaker 1: movement has really promoted this idea that we just need 686 00:49:38,800 --> 00:49:43,279 Speaker 1: to get healthcare professionals to stop prescribing weight loss and 687 00:49:43,320 --> 00:49:46,719 Speaker 1: to stop using BMI as a measure of health and 688 00:49:46,800 --> 00:49:49,880 Speaker 1: kind of like we'd be good, like we'd be done. 689 00:49:51,280 --> 00:49:55,799 Speaker 1: And honestly, this promotes a very white centric view of it, 690 00:49:56,160 --> 00:49:59,719 Speaker 1: because for a fat white person, if you can eliminate 691 00:49:59,760 --> 00:50:04,160 Speaker 1: that barrier, all of the sudden, you have health care 692 00:50:04,280 --> 00:50:07,400 Speaker 1: that affirms you. But and he says that isn't the 693 00:50:07,480 --> 00:50:12,280 Speaker 1: case for lots of other people, including black people, trans people, 694 00:50:12,560 --> 00:50:17,760 Speaker 1: and disabled people. That's changing what their organization fights for, 695 00:50:18,480 --> 00:50:21,000 Speaker 1: things like who gets a seat at the table when 696 00:50:21,000 --> 00:50:25,040 Speaker 1: people are doing research. The way health insurance is structured 697 00:50:25,760 --> 00:50:28,719 Speaker 1: use of b M I to access health care services 698 00:50:28,760 --> 00:50:31,960 Speaker 1: like surgery. And now I think what we're shifting to 699 00:50:33,040 --> 00:50:36,240 Speaker 1: is really this understanding that the way that we define 700 00:50:36,320 --> 00:50:39,759 Speaker 1: health as a society, the way that we define it 701 00:50:39,840 --> 00:50:43,920 Speaker 1: when we study it in our research studies, and the 702 00:50:44,000 --> 00:50:48,759 Speaker 1: way that the health care systems engaged with people are 703 00:50:48,880 --> 00:50:52,240 Speaker 1: barriers on so many levels that we need to start 704 00:50:52,360 --> 00:50:57,080 Speaker 1: dismantling and reconstructing the whole thing because they were based 705 00:50:57,120 --> 00:51:00,640 Speaker 1: on one kind of person. It's not just our ideas 706 00:51:00,680 --> 00:51:04,560 Speaker 1: about weight and health are wrong, it's that they are damaging. 707 00:51:05,440 --> 00:51:08,000 Speaker 1: We can all be doing a lot more to shift 708 00:51:08,040 --> 00:51:10,880 Speaker 1: how we think about these things and to make the 709 00:51:10,880 --> 00:51:14,960 Speaker 1: world a better place for people in bigger bodies. As 710 00:51:15,000 --> 00:51:19,080 Speaker 1: we do that, though, we've still gotta eat. And the 711 00:51:19,120 --> 00:51:22,120 Speaker 1: thing about eating is that we've gotten pretty messed up 712 00:51:22,160 --> 00:51:25,759 Speaker 1: about it. All. This talk about what's good for you 713 00:51:25,880 --> 00:51:29,240 Speaker 1: and what's bad for you really does a number on people. 714 00:51:30,320 --> 00:51:34,319 Speaker 1: Diets put so so many rules and food, and they 715 00:51:34,360 --> 00:51:38,200 Speaker 1: can be incredibly hard to unlearn. If we put the 716 00:51:38,239 --> 00:51:42,600 Speaker 1: diet to rest, stop making weight loss the goal, then 717 00:51:42,640 --> 00:51:46,200 Speaker 1: what is there a way to be satisfied and healthy 718 00:51:46,360 --> 00:51:50,920 Speaker 1: in whatever body we've got With self care, self compassion, 719 00:51:51,480 --> 00:51:56,000 Speaker 1: tuning into hunger, fullness and enjoyment satisfaction, our bodies are 720 00:51:56,080 --> 00:51:57,920 Speaker 1: going to be what they're going to be, and it's 721 00:51:57,920 --> 00:52:01,440 Speaker 1: about learning how to be liberated from a belief that 722 00:52:01,480 --> 00:52:03,920 Speaker 1: you have to change your body in order to be acceptable. 723 00:52:04,719 --> 00:52:08,400 Speaker 1: Next week, on the final episode of Losing It, we 724 00:52:08,560 --> 00:52:12,120 Speaker 1: dive into the world of intuitive eating. The scale is 725 00:52:12,200 --> 00:52:15,960 Speaker 1: just a false idle and what we lose when we 726 00:52:16,040 --> 00:52:20,000 Speaker 1: try to lose weight? What would you spend those on? 727 00:52:20,719 --> 00:52:23,719 Speaker 1: What passions do you have of? What creativity would you 728 00:52:23,719 --> 00:52:27,200 Speaker 1: spend it on? What hobbies? What you know? Spending time 729 00:52:27,239 --> 00:52:30,200 Speaker 1: of loved ones? Like what would you do if you 730 00:52:30,320 --> 00:52:34,800 Speaker 1: got that time back? Getting rid of diets? Eating without 731 00:52:34,920 --> 00:52:41,880 Speaker 1: thinking about weight? Is that even possible? Losing It is 732 00:52:41,920 --> 00:52:45,440 Speaker 1: written and reported by me I'm a Court and edited 733 00:52:45,440 --> 00:52:49,719 Speaker 1: by Kristin B. Brown. Magnus Hendrickson is our senior producer, 734 00:52:50,120 --> 00:52:53,719 Speaker 1: Stacy Wong our associate producer, and Blake Maples is our 735 00:52:53,760 --> 00:52:58,080 Speaker 1: audio engineer. Our theme was composed and performed by Hannis 736 00:52:58,120 --> 00:53:01,399 Speaker 1: Brown thanks to Francis A. Leavi and Tim and Nette. 737 00:53:02,040 --> 00:53:05,000 Speaker 1: Be sure to subscribe to Prognosis if you haven't already, 738 00:53:05,400 --> 00:53:07,880 Speaker 1: and if you like our show, please leave us a 739 00:53:07,920 --> 00:53:12,360 Speaker 1: review that helps others find out about it. Thanks for listening, 740 00:53:12,840 --> 00:53:13,719 Speaker 1: See you next time.