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July 27, 2009


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I have to disagree. While I've met plenty of people who have "given up" the hope of ever being anything but fat, I've never known anyone who is happy being fat. (I have cared for patients as light as 47 lbs (at 5'4" - anorexic)and as heavy as >850 lbs, the highest our scale can measure.) Even proponents of the "fat acceptance" movement, if secretly given the choice, I'd be willing to bet a dollar, would choose to be thin.

I think that scientists are asking the wrong questions. Obesity/morbid obesity seems to me every bit as much an illness as depression. Why do so many people try (and fail) to lose weight? Or lose weight only to gain it back and add a little more? I think that there is something, somewhere going wrong in the brain of obese people. Perhaps there is an interplay of environmental/endocrine causes that permanently or substantially alter brain chemistry. Does that sound far-fetched? Everybody knows that if you drink too much alcohol, you can do permanent damage to your liver. Isn't it possible that we can do similar damage to the parts of the brain that regulate/control appetite?

I am neither a physician nor a scientist. (Nurse.) However, I have personal experience having lived until my early adulthood at a normal weight, then gaining 90 lbs while taking a medication prescribed for bipolar disorder. Being fat is nothing short of a constant, unrelenting, unforgiving, humiliating misery. I am now on different medications and it is as if that uncontrollable appetite switch has been turned off. I've lost 36 lbs and counting, with no special effort.

There has to be an explanation of why my husband, who is 6'1" and weighs 125 lbs can eat anything he wants any time -- and why, if I even smell what he is eating, I gain 5 lbs.


Well, anecdote is relevant, but I have known plenty of people who are happy being fat. We are socialized to be deeply ashamed and unhappy to be fat, but bucking the socialization is precisely the point of fat acceptance movements.

It's no good to link obesity and morbid obesity, as you do via "obesity/morbid obesity," because we are in entirely different epistemic positions WRT to both. We have very strong evidence that morbid obesity is linked quite robustly to morbidity and mortality. The evidence is much more equivocal WRT obesity, which is a moving target given how often BMI has shifted over the last fifty years.

And terming obesity an illness is not tenable to me, since there are plenty of obese people who are metabolically and otherwise healthy. Branding them all "sick" is stigma, as far as I am concerned.

I am sorry you found fatness to be a constant, unrelenting, unforgiving, humiliating misery. There are a growing number of people who feel otherwise.

As for the explanation of why your husband can eat whatever he wishes and gain no weight, that is precisely the point -- what we do not understand about why people gain or lose weight dwarfs what we do know. Hence chalking fatness up to personal choices is vastly oversimplified.

Thanks for reading and commenting.

The whole Fat-o-sphere would be one place where being happy in your own size, any size, is a relatively common position:


The Fat-o-sphere was exactly what I had in mind . . .

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