A new miniseries has come out on HBO, and I do not get HBO so I am not watching this thing, but it has to do with obesity in America. The work was controversial before it even aired, with various fat-acceptance promoters and fat apologists jumping to the conclusion that the series would be just another "fat people are gross and lazy" lowest-common-denominator denunciation of the people, rather than the problem.
The real issue is, of course, that America DOES have an obesity problem; and that problem has to be addressed by the people who share it. Which is everybody, because we all share the costs of a population that's overweight and unhealthy.
I'm not going to call it an "epidemic" because IMO that particular term ought to be reserved for communicable diseases, and obesity is neither communicable nor a disease: it is the physical consequence of a behavioral disorder.
So there is no vaccine for it, and all the government propaganda and subsidies in the world will not solve the ultimate dilemma: which is that the American way of life makes it much too easy to get fat.
I would be the first to say I get it. I work full time, I have to fit meal planning, shopping, cooking, and exercise in around the edges just like everybody else.
Unlike many, however, I've deliberately shaped my life so that my entire working day does not consume my entire waking day. I pay high rent so that I can live close to my employment. That high rent buys me 2-4 hours a day that many of my co-workers spend in their cars.
I also get that losing weight is a damn sight harder than maintaining weight.
I have never gone over 150 pounds and am currently around 135. According to the Body Mass Index graph, that puts me squarely into the "normal" range. http://en.wikipedia.org/wiki/Body_mass_index Also according to the graph, if I did edge over 150 pounds I would officially be into the "overweight" range.
The trouble with BMI is that body mass does not equate to body fat. I could be the same 135 pounds, or less, and still have too much body fat. Or I could be 150 pounds or more, with 10% body fat - if I were a champion bodybuilder.
And because of this, the fat-acceptance people and the fat apologists like to claim that BMI is a useless measurement and that BMI has nothing to do with health and that Will Smith would be obese according to the BMI graph (he wouldn't, by the way) and a bunch of other bullshit.
The designers and users of the BMI method said right from the start, BMI is a useful measure for populations and is not an ideal tool for making diagnosis of individuals.
Going back to the example. Let's say I am still 5 foot 6 and 135 pounds, but I do no exercise whatever. My body mass would therefore be much less evenly distributed between bone, muscle, organ meat, and fat: my body fat would likely be 35-40%, versus the 20-25% it probably is now. (I don't actually know, because the most accurate way to get this measurement is an expensive test.)
At 5 foot 6, by the BMI graph, at 115 pounds I would be considered "underweight." At that weight, my body mass would be distributed between bone, organ meat, and a little bit of muscle - just enough to get me out of bed, basically. The only way for me to sustain that weight and be nominally healthy would be for me to do hours of cardio a day and eat, more or less constantly, a very low-calorie, high-protein diet. If I got to 115 pounds just by dieting and did no exercise, I would be a very sick puppy.
On the other end of the scale, I tip over into "overweight" at 150 pounds. In my opinion this is an understatement.
The reality is, most 5 foot 6 inch women who weigh 150 pounds are carrying 15-25 pounds of pure fat on top of whatever muscle they have. This isn't a value judgement. It's simply a fact.
So the apologists and the acceptance people can bark all they want about how BMI is a poor measure. If that's all you look at, it IS a poor measure. It is only one of the numbers everyone should be looking at. The failure of BMI to serve as an individualized diagnosis - something it was never intended to do - is irrelevant in its application to our obese population.