Food has often been a topic of conversation among theologians (I’ve recently read Shannon Jung’s book Food For Life, and David Grumett and Rachel Muer’s book Theology on the Menu), but aside from a few important conversations about eating disorders, I haven’t seen much on the global weight loss crisis. Catholic commenters have, on occasion, commented on diets like “Weigh Down” and recently, popular writer Mary DeTurris Poust has written Cravings: A Catholic Wrestles with Food, Self-Image, and God. Some Catholics commented on Mayor Bloomberg’s soda ban in New York, largely speaking about it in terms of individual freedom (just as the broader society did).
So, it would seem that Catholic conversation – pace society – tends to focus on individuals and their weight loss and how they can garner enough self-control or willpower or manipulate their environment in order to lose weight. As a moral topic, it might seem that our main conversation is therefore: “How do we help people develop more self-control?” How do we help people focus on the old “calories in, calories out” mantra and live it so that it works?
Yet if long-standing as well as recent research is right, that mantra does not in fact work, in part because it is too simplistic. We are coming to understand that the human body digests food in different ways and that “calories in” is not wholly representative of what needs to be “burned off” so to speak. But also, a calories-in, calories-out mantra neglects to take into account all the ways in which food is part of a whole culture of eating, and that culture socially assists people in the ways they eat. In other words, human health is complex, as most bioethicists would readily state.
I’m wondering if our current collective efforts at weight loss count as a health care crisis in part in response to a BBC series I’ve been watching on YouTube, called “The Men Who Make Us Thin” (the title is catchy, but should also include women!) and in part from looking at recent research and listening to some researchers in the field of bariatric medicine who have been recommending this series (See episode 1, episode 2, episode 3. A fourth episode aired last week.)
The series explores the complexities of weight loss, starting with raising significant questions on how overweight and obesity are commonly diagnosed. One common chart was devised in the 1940s by an insurance company to match weight against morbidity (and of course, against insurance premiums); this chart changed the view of overweight. Instead of merely a few people being listed as overweight, the number labeled as “overweight” doubled almost overnight. The film suggests that thus, the diet industry was formed. Another form of diagnosis, the BMI chart (body mass index chart) was developed in the 1830s. In 1998 the NIH recategorized BMI and created a category known as “overweight”. Once again, instantaneously, millions of people were now labeled as Overweight and therefore in need of intervention.
But the series notes at least two problems with the ways overweight and obesity were diagnosed. One is that research has long suggested that diets don’t work. People can’t sustain low caloric intake over time, and once the restrictions are removed, we regain all the weight plus some. Though the series does not quite make this connection, shall we someday come to the point of seeing that our collective dieting done over a period of 60 years has actually been responsible for the “obesity crisis” or for some of its attendant health concerns like metabolic disorder and so on?
In addition, as at least two researchers interviewed for the show point out, BMI doesn’t adequately reflect morbidity and health. People with BMIs between 25 and 27 (the Overweight category) actually have very slightly lower death rates. And, when it comes to obesity, the level of a person’s fitness and health doesn’t necessarily match up with their weight. People who fall into the “obese” category can be far more fit than those who don’t, and those people who are fit do not experience the same kinds of high risks associated with obesity, including heart disease and stroke.
Indeed, in its interviews with pharmaceutical representatives, bariatric surgeons and researchers, the series shows some of the ways weight loss links to capitalist economy, and to political policy making. A former weight loss program CFO proclaims that it’s obviously beneficial that weight loss programs don’t work, since people are back always wanting more. A bariatric surgeon baldly states that he will do surgeries on post-partum models with a BMI of 27, to get them down to BMIs of 18 or 19, so that they can work. But that’s because they can pay the money. Other people – people with higher BMIs but who might have Medicare – won’t get the same treatment. And then there’s the FDA and the UK’s national health care system – approving diet drugs even despite indications of fatal side effects.
Part of what seems to be driving these several industries is the social good that weight loss represents. The reasons why weight loss is seen as good include health costs and care for our bodies. We should lose weight – because look at the rise in obesity and the simultaneous rise in obesity-related disorders like heart disease and diabetes. We should lose weight – because we should love ourselves enough to want to be thinner. Yet skinniness isn’t necessarily good. Cigarettes, throwing up, eating white foods only, and so on have all been actions people have done on the quest toward “thin.”
Theologians should reflect further and deeper on what it means to suggest that thinness – in all the ways we are told this – equals virtue. Where virginity might have been the prized physical attribute of the past that represented virtue (especially a virtue of self control), these days it’s what our bodies weigh on the scale. And because skinniness equals virtue, we spend a lot of time trying to protect and preserve, or achieve, that level of virtue. (It would be interesting to do an historical study on this as well.)
But what does this focus – which is at least partly due to the political/economic maneuverings of the BMI charts – do for how people understand themselves as being in the image of God? How unable are we to recognize the dignity of others when we’re focused on their weight as a symptom of their virtue? (A question that Richard Simmons, pictured in the accompanying photo for this post, also wonders….) More than that, how does such an intense focus on dieting make us “curvatus in se” – curved in on ourselves – and less able to both encounter and preach good news to others?
“The Men Who Make Us Thin” offers a documentary overview. It is not in depth, but is good for showing to classes, as well as for getting a broad sense of some questions about weight loss at a time when I think many of us are not thinking about it much. It raises some important questions that deserve to be probed and studied in more depth.