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Tuesday
Dec042012

Women and Men of Substance 

Joel Rivlin: Flickr.com

What does this term actually mean and why do I use it?

People of substance have character and integrity.

These people are trustworthy, honorable, charitable, compassionate and kind. They are people who value and respect their family and their friends. They are people who cherish peacefulness, conscientiousness and commitment. 

These people are educated in things that matter to others and they are people who will act to right wrongs wherever they might come across them.

They are not necessarily famous or rich. In fact fame likely makes it much harder to be a person of substance. If they do happen to be endowed with fame and wealth, then they are never ostentatious and they are treat these gifts as things to be shared for them to have any meaning.

And, most importantly, a person of substance is not experiencing a state of being, s/he is rather practicing these traits purposefully and consciously. No man or woman of substance is perfectly applying these traits, but they strive to do so.

Meet Lauren

One of our intrepid members (jamiedory) tweeted me on November 24 to ask me to sign Lauren's petition at change.org. I did and retweeted the request to my followers as well. Seventeen Magazine had come out with a truly unscientific and shockingly thin-skewed ‘healthy’ BMI range and Lauren petitioned to have them remove it.  

She succeeded and on December 1, 2012 Seventeen had taken down their online BMI calculator.

How excited am I? Truly thrilled!

Why Is This Important? 

There is no such thing as a de facto healthy or unhealthy BMI range.

Normal body weight is distributed in a bell curve like height. Most media promote an unhealthy thinness or impossibly lean muscularity. The narrow range suggested by insurance company tables or other charts for individual weights are often used inaccurately. These weights are averages, not norms.”

[PH Mehler et. al. 2010]

Bell curves identify a range, and when considering human attributes such as height or weight, perhaps only the furthest points of a bell curve may involve any negative health impacts at all. If you are exceedingly tall (beyond about 8 feet in height), then your life expectancy is negatively impacted. And in fact mortality rates for height are more severe for the tallest at the right hand end of the curve when compared to the shortest at the left hand end. However, the opposite is true when it comes to weight you see on the bell curve below (expressed as body mass index, or weight over height squared): mortality is more severe for the thin than the fat [KM Flegal et. al., 2005; A Jerant, P Franks; 2012].

If BMI 26 were truly unhealthy then our life expectancies would be dropping right now, and instead life expectancy has increased by four years in the past 25 years alone [Centers for Disease Control, 2012].

So if more than half of our population is naturally “overweight” then who decided to call it “overweight” and not “average weight” given that BMI identifies averages and not an optimum or a norm? I go into a lot of detail on this in the Fat Series, but suffice to say the 1998 NIH Panel on Obesity chaired by F. Xavier Pi-Sunyer had two questionable studies upon which they based their decision to shift the markers of “over weighted-ness” to within one standard deviation from the mean (the peak of the bell curve) and that is already a marked departure from the accepted application of statistics.

Furthermore, the committee members’ involvement with the weight loss indsustry as well as the pharmaceutical and medical device industry focused on obesity interventions (all but one of the committee members had some conflict of interest along these lines) suggest that calling ourselves overweight rather than average may have more financial rather than health value driving the skew in our understanding.

We know that obesity onset and the presence of obesity are not tied to food intake or activity levels [W. Kulesza, 1982; JA Baecke et al., 1983; RJ Myers et al., 1988; ML Johnson et al., 1956; L Lissner et al., 1989; AM Prentice et al., 1986; R Jeffrey et. al. 2006; P Togo et. al., 2001; J Holsten, 2009; J Couzin, 2005;  MA Grediagin et. al., 1995; BS Metcalf et. al., 2011; JS Speakman et. al., 2006 and H Pontzer et. al., 2012 ].

For the population over BMI 30 who additionally suffer metabolic chronic conditions such as diabetes, heart disease, generalized inflammation (just over 50% of that group in total) they are not suffering from moral laxness. They are not gluttonous, slothful, wanton, uncouth individuals. Something other than food and/or exercise has triggered an inflammatory response within their adipose (fat) organ.

Intriguing candidates that are likely combinatorial in the onset of inflammatory obesity are genetic predispositions, gut microbiota [JK DiBaise et. al., 2008; PD Cani, NM Delzenne, 2009], broad spectrum antibiotic use (both systemically in our food and for individual treatment) [ML Phillips, 2009; JA Hawrelak, SP Myers, 2004; OC Thompson-Chagoyán et. al., 2007; DL Smith et. al., 2002; CM Lathers, 2001], the use of endocrine disruptors and mimickers in every day personal hygiene and household products [RR Newbold et. al., 2007; JJ Heindel, 2003; EE Hatch et. al, 2001; MV Maffini et. al., 2006; MA Elobeid et. al., 2010; E Karoutsou, A Polymeris; 2012], chronic stress (often present for those in low socioeconomic strata) [MF Dallman et. al., 2003 and 2010; J Laitinen et. al., 2002; JA Martinez, 2006; M Bose et. al., 2009; AJ Stunkard et. al., 2003; JS Yudkin et. al., 2000],  and possibly attenuated weight cycling or yo-yo dieting over many years [J Gast, SR Hawks, 1998; I Amigo, C Fernández; 2007; GA Gaesser; 2004].

Inflammatory obesity impacts approximately 5-11% of our entire population [NHANES 2005-2006 data above]. The remaining metabolically healthy obese are merely at their optimal weight set points in the natural range of weights that humans can be due to genetic predisposition. They too are not these natural weights because they are lazy overeaters.

The eagle-eyed ED-driven among you might notice that the above BMI bell curve would actually suggest that 70% are optimally between BMI 23-31 whereas I always quote that 70% are to be found between BMI 21-27. That shift to the right has occurred in the past 30 years and it coincides with the aging out of the Boomers in that time frame.

I specifically use the 1978 BMI bell curve because this community is actually youthfully skewed and not representative of the population at large. Of course we do have those born between 1945 and 1964 (those born during the post-war baby boom) as members here as well, but they are in the minority whereas they are most certainly the majority in our population at large. The shift to the right on that BMI bell curve may be entirely attributable to the natural increase in weight that will occur between the ages of 25-65. However beyond age 65, weight naturally decreases into old age and that may be why so-called obesity rates are essentially flat now and have been for the past few years. In fact they have been declining for women since 2006 and slowing in rate of increase for men since 2004 [Centers for Disease Control, 2010].

Real Reason Lauren's Win Is So Imporant

All of that BMI burble is me going through the compulsories of addressing those who are so steeped in dogma that they struggle to understand how truly irrelevant the BMI ranges are when it comes to identifying anything to do with your health and wellbeing.

The real reason that Lauren’s win is so important is that a BMI calculator that suggests any health status is absolute within the entire range of human variation in weight and height is spreading misinformation and falsehood. And a BMI calculator that targets some almost 5 million young girls and women ages 12-19 to mislead them as to whether they are healthy or not, that is subsequently removed due to the actions of one young woman of substance, is the real reason why this news is so important.

The beginning of the end of ‘healthy’ BMI range is just that tiny bit closer, no? 

I have just discovered that Lauren had a wonderful co-conspirator: Shirley. Yet another young woman of substance. My congratulations to both Lauren and Shirley (picture below of Shirley)!

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Reader Comments (3)

I like this post. Especially how you have added so many references!

December 11, 2012 | Registered Commenterhouseelf

Houseelf! How nice of you to drop by -- yes it is indeed reference-heavy! I am glad you like the post. G.

December 12, 2012 | Registered CommenterGwyneth

This is mostly about how most people's BMI's are naturally on the higher end or above what is called healthy weight. Is it possible that someone's natural weight set point is below? My older sister is NOT restrictive AT ALL, but her BMI is 17.3. She's 18 now. My mother always talks about how she was under 100 lbs when she graduated high school, and my older brother is really skinny too. And they don't look bony or anything, they're just petite. My pre-ed weight was 110 lbs and i went down to 89. If my top weight was 110, my bmi would still only be 18.2. Is it possible that this is natural for me, or should i aim for higher? I'm 16, and as of now i'm 100 lbs :)

September 15, 2013 | Registered Commenterbelieve-me
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