Fat Chances

The Fat of the Land: The Obesity Epidemic and How Overweight Americans Can Help Themselves, by Michael Fumento, New York: Viking, 330 pages, $25.95

Eat Fat, by Richard Klein, New York: Vintage, 272 pages, $13.00 paper

A few years ago the National Center for Health Statistics reported that one-third of Americans were obese in 1991, compared to one-fourth in 1980. You might have seen the front-page article in The New York Times. Perhaps you shook your head and thought, "Those poor fat bastards."

Not so fast. Michael Fumento wants you to know that obesity, "defined as being at least 20 percent fatter than [you] should be," is only part of the story. "According to the Institute of Medicine of the National Academy of Sciences," he writes on the first page of The Fat of the Land, "about two thirds of us are too heavy for optimum health." Two-thirds.

I hope I have your attention now. Do you remember the last time you looked at that weight table in your doctor's office? You probably thought, "Come on. Nobody stays in that range once they get out of college." In fact, according to survey data from 1996, 74 percent of Americans exceed their maximum recommended weight. "So instead of talking about a third of Americans being at risk because of be-ing overweight," Fumento writes, "we really should be talking about somewhere around three fourths."

Worse, it turns out that the current weight table, based on 1983 figures from the Metropolitan Life Insurance Company, is relatively lenient. The 1959 table allowed even fewer pounds. The targets were changed as Americans got fatter--for no good reason that Fumento can see. Like the Center for Science in the Public Interest, he seems to prefer the older, stricter table, which better reflects the weight ranges associated with the lowest mortality rates. So we really should be talking about ...nearly everyone, I guess.

Fumento, a medical journalist, resident fellow at the American Enterprise Institute, and former REASON science correspondent, has tackled many overhyped or imaginary hazards in his books and articles, including heterosexual AIDS, radon, electromagnetic fields, pesticide residues, and secondhand smoke. He has argued tenaciously and persuasively that highly publicized "illnesses"--Gulf War Syndrome and multiple chemical sensitivity--do not exist. Now, having lost 25 pounds of extra weight after years of trying, he turns to obesity, and his message is: It's worse than you think.

This might seem like a bold thesis, given our national obsession with thinness. To most Americans, though, weight is primarily a matter of physical attractiveness, and Fumento emphasizes its impact on health, including an increased risk of heart disease, high blood pressure, diabetes, and certain cancers. Furthermore, he argues convincingly that false beliefs about the causes and consequences of obesity help explain why Americans keep getting fatter despite their preoccupation with weight. Having digested a mountain of research, he takes on the cranks, hucksters, activists, and government officials who help perpetuate these misconceptions. Unfortunately, in his single-minded pursuit of the facts, he neglects the role that values, tastes, and preferences play in decisions about diet and
exercise.

Maybe you've put on a few pounds--moved up a pants size, started to round down when asked your weight--but you figured it was purely an aesthetic issue. Wrong. The latest research shows that being even just a little overweight can shorten your life. "Unless you are affecting your immediate health (such as some anorexics do) one cannot be too thin," Fumento writes. "Making yourself little but skin and bones is not healthy; being below average weight in a country where most people are overweight is healthy." Judging from the results of one study, "the average woman weighs 30 pounds too many to have a full life expectancy."

Are you depressed yet? Maybe you're just annoyed. Maybe you're wondering, "What's `a full life expectancy'? How many years will I lose because of an extra 10 pounds?" You will not find the answers to such questions in The Fat of the Land. Fumento gives us an annual death toll (300,000) and the increase in mortality associated with certain weight ranges in a couple of studies. But he never gives us an idea of the lifetime risk facing someone who does not quite fit into the appropriate range on the 1959 Metropolitan Life Table.

It's a telling omission, because this is the sort of information you'd want if you were trying to decide whether losing those extra pounds and keeping them off would be worth the effort and forgone pleasure. For Fumento, the answer is obvious: Of course losing weight is worth it. After all, this is a matter of health. He never concedes that people could rationally accept the risks of being overweight in order to eat as much as they want and skip all that dreary exercise. He is dismayed by "an obese friend" whom he encouraged to lose weight with the help of prescription diet drugs: "But nothing doing. He's a gourmet; food is an integral part of his life and he wasn't going to give up any part of it." Imagine!

Fumento seems to start from the assumption that physical health trumps all other values, that it's irrational--and, indeed, immoral--to trade longevity for pleasure. It's not clear how far he would push this premise. There is some evidence, for instance, that severe, long-term calorie restriction can extend your life span. It works in mice, anyway. A UCLA researcher recently told The New York Times Magazine that an 18-year-old man who sticks to a spartan diet of 1,800 calories a day (vs. the recommended 2,000 to 2,500) "would have a chance of living to 160." Suppose this is true. Should all of us adopt such a diet? If we are not willing to be hungry most of the time for a chance at a few extra decades, are we crazy?

Fumento not only condemns heftiness, he pathologizes it, leaping from the observation that being overweight increases the risk of certain diseases to the conclusion that being overweight is itself a disease. It is "the underlying disorder," "a chronic illness," "one disease that can just keep getting worse and worse," "a national epidemic." A disease is something inherently undesirable; no one in his right mind wants to be sick. The disease metaphor therefore reinforces the idea that no sane person could prefer to be fat, given the alternative of eating less and exercising more.

Since a disease is also something that happens to you against your will, it's puzzling that Fumento adopts this terminology, because his message is mainly one of individual responsibility. Over and over again, he stresses that people are overweight because they eat too much and don't exercise enough. The fact that Fumento has to argue this commonsensical point is a measure of the flimflammery and magical thinking fostered by the desire to lose weight.

"Telling people to eat less and exercise more might send them fleeing for the hills," he writes, "so the diet book authors and women's magazines search valiantly for some aspect of eating to blame, some way of telling people they can stuff their faces--and still lose weight." Intelligent, well-educated people will plunk down $25 for a book that claims you can lose weight by eating chocolate, or cutting out fat, or cutting out carbohydrates, or eating foods in certain combinations, or eating as much as you want of whatever you want. If you know some of these people, you may want to give them copies of Fumento's eminently sensible book instead, before they fall for the latest fad.

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