Posted by Pattie on 12/25/2004 08:33:00 AM

Merry Christmas and Happy Eating!

I read this today:

From Medscape General Medicine™
Webcast Video Editorials

How to Prevent the Obese From Becoming "Obeser" -- Stop Eating

Posted 12/17/2004

Ho! Ho! Ho! Here we are in the holiday season right between those 2 great American days of gluttony. What is Scrooge's holiday greeting this year? It is about overeating, of course. How can we stop the obese from becoming more obese? Pretty simple. Stop feeding them. Think about the other common self-destructive human behaviors. On a commercial airplane, in a saloon, or at a professional sports event, if the customer is deemed to be drunk, the keepers of the booze key will lock the cabinet. If a person drives a car at a dangerous speed, the driver is subject to substantial penalties. For young persons known to be at high risk for early chemical addictions, society tries to prevent exposure to the addicting drugs. Overeating with underexercising is now killing more Americans than anything else except tobacco addiction. Yet, an obese person enters an eating joint, or a supermarket, and buys and eats any and everything he or she wants, and nobody seems to care. Does that make any sense to you? Meanwhile, Big Science strives to understand why people get fat; Big Genetics searches for the obesity gene so that stem cells could correct the flaw; Big Surgery lines up the morbidly obese to shunt their stomachs; Big Pharma seeks the next weight-loss pill that will help more people than it kills; Big Nutrition hawks the newest sure-thing, weight-loss diet; Big Fast Food pushes "healthy food" lines right next to their billion dollar unhealthy food lines; Big Soda and Big School Boards share the profit from drowning kids with calories from vending machines; and Big Exercise pushes group rates for aerobics class. Money made by so many special interests. All this while the simple answer is to stop eating; stop feeding the obese until they are no longer obese. Of course, that may be hard to do, and who makes any money that way? Fat chance for this crazy idea to go anywhere. That's my opinion. I'm Dr. George Lundberg, Editor of MedGenMed. Happy Holidays!

Readers are encouraged to respond for the editor's eye only or for consideration for publication via email:

George D. Lundberg, MD, Editor-in-Chief, Medscape General Medicine
Disclosure: George D. Lundberg, MD, is an employee of WebMD

It pissed me off so much that I wrote this:

As a person who has struggled with weight loss most of my life and whose health has suffered from the number of starvation diets and dieting schemes I have attempted, I cannot begin to tell you how offended I am that WebMD would publish an editorial advocating what amounts to apartheid. What’s next? A so-called scientific justification for genocide?

Has medicine fallen prey to Big Fitness and Big Diet so much that they cannot see the harm such thinking can cause. Thousands of young people each year develop eating disorders because they believe their bodies and their food intake are to be highly regulated. Advocating a stricter food cop system than we already have will only increase these disorders and lead to poorer health for those who spend their lives weight cycling.

You cannot know my history or my health from looking at my body. I eat and exercise more sensibly than I ever have before and I am fat (remaining pretty close to my highest weight). When I eat at restaurant (which I do a lot because I travel a lot), I make food choices based upon what my body needs. I frequently eat less and leave more on my plate than everyone else at the table. How dare you decide without knowing me (or advocate that a restaurant worker decide without knowing me) what and where I should eat. Do you do all your diagnoses without talking to a patient? Do you really phone-in your medical practice so blatantly that you would not consider a patient’s history before making an order?

I spent the better part of my life listening to food cops and fighting my own natural tendencies towards a large body. The weight-cycling, over-exercising, drug abuse and starvation I hoisted upon my body left me with an autoimmune disorder, arthritis and fatter than ever. Dieting is harmful. Not eating is simply not good for human beings.

The underlying assumptions in this so-called opinion are prejudice and stigmatization, not science or medicine. Fat people do not eat substantially more than their counterparts. In fact, I spent most of my life eating substantially less. Fat people are usually afraid to eat a lot in restaurants because of the stigma they experience eating in public. Fat people are not lazy, good-for-nothing gluttons who can’t help themselves when food is placed in front of us. Most fat people I know are constantly restricting their eating. If eating less and exercising more created weight loss, do you really believe that fat people wouldn’t try it? We are constantly bombarded with messages that say our bodies are bad. We are marked by our bodies as “less than human.” Most of us spend almost every waking hour dealing with this fact. It is a waste of energy, time and effort. Diets don’t work. Eating well and exercising regularly and safely lead to better health, but not necessarily weight loss. I am quite please with the fact that my weight has been stable for the past 3 years that I have stopped dieting. How could someone know this about me with just one look?

If you want to take on Big Food, why not put legislation in place that prevents price gouging in poorer neighborhoods and guarantees good food choices (fresh produce and leaner meats) in all groceries, instead of just the ones in rich suburbs or high-rent downtown corridors. If you want to take on Big Pharma, then why not advocate a stricter scrutiny of medicines designed for weight loss, instead of adding to the panic that has led the FDA to believe “better dead than fat” when approving experimental drugs. I find it particularly ironic that you would evoke the “say no to drugs” mentality regarding young people while reinforcing the “fat is always bad” mentality that leads to so many drug abuses in the name of weight loss. If most weight loss drugs had to prove long-term efficacy alone, they would not make it to market. But on top of ignoring how effective they are, the FDA doesn’t even pay attention to the potential harms they cause.

By the way, didn’t you take an oath at some point that said something about “First, do no harm”? Restricting calorie intake is harmful. It is called starvation and it leads to a breakdown of the body’s systems. I am not advocating gluttony. I am suggesting the human beings have a basic right to eat and fat people are human beings.

I am not an MD, but I am a PhD (imagine that, a fat smart person) and, as a medical sociologist, I’ve studied the history and culture of medicine enough to know that a physician advocating prejudice and discrimination based upon phenotype is not a new thing. Advocating the refusal of service to people based upon how they look smacks of the days when no African American was allowed at the counter and had to use the back door in order to purchase food in a strange town. Do you not believe that fat people travel? Do you think that food is a luxury? Do you really advocate the starvation of some “for their own good”? The current “obesity epidemic” is going to be regarded by our descendents in the same light as medical assertions that “Negroid phenotypes” are indicative of low intelligence, that being female meant menstrual blood letting and therefore not enough blood to the brain, that poor people are oversexed, and that having certain bumps on the head was indicative of poor character. Let’s bring back eugenics and genocide as forms of medicine while we are at it. All of these injustices had “good medicine” justifying them at one point or another in history.

So bring on the apartheid and I guarantee you that this fat lady will be sitting in at the lunch counter and singing “We Shall Overcome” with my fat brothers and sisters as well as our thin friends who understand that health is not a matter of body type and that taking food away from human beings is a matter of injustice.

Pattie Thomas, Ph.D.
Medical Sociologist
Author of Taking Up Space (Pearlsong Press, Inc., 2005)

PS, I have copied this letter to the newsroom and the Public Relations department for WebMD. I thought they should know that they have a segregationist working for them and that they should consider what kind of reputation such an advocate for apartheid creates for their product. Whatever respect I had for WebMD has been severely reduced knowing that George D. Lundberg, MD, is the Editor-in-Chief, Medscape General Medicine.

It remains to be seen, I guess, if they dare to print my letter.

In the meantime, enjoy the feast (it is a festival!) and eat guilt-free.

See you at the lunch counter.