NYT: Comparing Fatness and Shortness

Daniel Engber asks in  the New York Times Sunday Magazine why the “reduce obesity” drumbeat doesn’t also spawn a “reduce shortness” drumbeat.

We’ve long known that stature can serve as a crude measure of public health. If everyone came from a perfect home, the average height across the population would be a function of our genes alone. (There would still be tall people and short people, but we would all have grown as much as we possibly could.) Anything less than an ideal standard of living, though, tends to stunt a child’s growth.

Daniel Engber also asserts that (in what seemed to me to be more radical a notion) notes that neither are about individuals but about populations. (Emphasis mine:)

Controlling our country’s height may be just as plausible — or implausible — as controlling its weight. It’s true that someone who is fat can lose weight on purpose, while a short adult can’t do anything to gain height. Yet instances of radical, lasting weight loss are exceedingly rare. Diet and exercise schemes tend to yield only minor effects over the long term. While lesser changes to your weight may be associated with modest health benefits, they won’t help all those obese adults to become slender. […]

Given how hard it can be to lose weight, a realistic war on obesity starts to look a lot like a war on shortness. In both cases, we’re dealing with a complex function of genetics, social class and poor health in childhood.

Early-life experiences play an important role in the development and consequences of body size. Exposure to malnutrition, infectious disease, chronic stress and poverty stunt a child’s development and seem to explain many of the long-term problems associated with short stature. Environmental factors may promote obesity, too: lack of breast-feeding, bad nutrition, chronic stress and poverty have all been associated with early weight gain and a higher risk of health problems down the road.

A danger here is to assume that anyone who’s fat or short had a bad childhood.  As noted above, genetics will mean there’s still height and weight variance.  With fatness, repeated dieting / weight cycling often leads to weight gain in the long term; I don’t think height has an analog to yo-yo’ing your weight up.

I do think it’s interesting that those who are shorter tend to graduate college less often, earn less, and are more likely to have heart disease, stroke, or diabetes — same as those who are fatter.  Yet the US is all about individuals losing weight and ignores shortness.  Perhaps a reason why is the US is so individualistic; anything individuals can do through self-improvement programs is lauded; height is mostly seen as something you’re stuck with.

The idea of the overall society working on improving children’s lives and health overall gets stuck in the details of “socialized” health care and parents’ rights in the US, but this could play well in some parts of Europe or Canada; I don’t have enough of a sense of other cultures (Australia?) to know about them.

What do you think?

10 thoughts on “NYT: Comparing Fatness and Shortness

  1. My childhood resonates with the “chronic stress” meme. I had a very good childhood, overall, with loving parents and a tolerable big sister :-) But, my father had a series of heart attacks starting when I was about five years old and culminating with a triple bypass when I was 10 years old (one of the first ever done). I had the stress of not knowing if he was going to be OK which translated into “will I be OK?” in my child’s mind. I also had a couple of severe illnesses before I was 5. So stress does not necessarily mean a bad childhood but could be a factor in even a “good” childhood.

    I hope this makes sense, I’m writing with the flu. Or rather, on the computer while I have the flu.

  2. I’m pleased to see anything in a mainstream publication about misunderstandings in the obesity scare. It gives me hope that the fat hatred I’ve seen so much of in the health care debate might eventually go away.

  3. Stress and small children: I had undiagnosed PPD after my girls were born and I still feel guilty that I didn’t get any help :( Especially with all this research about how stress affects the developing brain.

    As for shortness – I am short for a NZ woman (5 foot 6) and fat and yet my Mother was the poster child for feeding her children ‘correctly’. We ate strictly by the food pyramid, had our own veggie garden, rarely had junk… pretty much the ‘perfect’ diet. But, I ended up short (like Dad’s side of the family) and fat (like Mum’s). While I do think my continued good health as an adult owes a fair bit to my early diet I think my height and weight are pretty much the ‘prizes’ of biological lotto.

    As to socialised health care; we have that in NZ but it’s my feeling that the US has a much greater amount of fat panic than we do. Take my NZ Guide To Pregnancy book – it mentions weight only once, where it says that being underweight or overweight can affect fertility. It reccomends gentle exercise and a good diet through pregnancy and specifically says *not* to seek to lose weight or limit weight gain. But from what I gather the ‘official’ US line is somewhat different. Sure, we have some fat panic over here, but it doesn’t seem to be as prevalent or as virulent.

  4. It’s interesting, yet poorly reasoned. A good example of bad thinking comes with:
    “In the labor market, the effects of height and weight tend to run in parallel.”
    where the examples given are a fat woman and a short man.

    In an article presumptively about health, paying some attention to the way this is *gendered* is a profound oversight.

    Beyond that, he has such gems as:
    “If everyone came from a perfect home, the average height across the population would be a function of our genes alone.There would still be tall people and short people, but we would all have grown as much as we possibly could.”

    Yet he can’t imagine an ideal world in which there are still fat people and thin people

    As much as I want to see articles like this as a positive sign, the sheer amount of bad reasoning in an article that makes a pretense at a thought experiment makes me think we’ve got a long way to go.

  5. I was a fat kid who came from a good home. We did have stress as my youngest brother was born with a severe health issue that we all had to deal with for the first few years of his life. I was only 5 and probably internalized a lot of the stress , but our diet was very good. My dad was a farm boy and it was fresh veggies and balanced meals for us. I also was very active, played sports, but i was still fat. I was the only one of the four who was fat. My sisters are fat now, but they did not get fat until they were well into adulthood. In today’s world, i probably would have been taken away from my loving family simply because of my weight.

  6. I liked this article, overall, and I agree with the thesis that there are things that could be done to impact the population as a whole to shift population BMI to the left, such as stricter regulation of the weight loss industry (so that fewer people are yo-yoing their weight upwards).
    I do believe that for many people, the weight they reach in adulthood has to do with factors that are beyond their control, some of which are established in utero, in early childhood, in later childhood, in adolescence and in adulthood. And, for the most part, weight gained is likely to stay.
    But I think most people don’t see weight as being the same as height.

    I’m short — just over five feet tall. Would I have been taller if my parents had focused on me reaching my maximum height? Maybe a quarter-inch taller — not likely to have a major impact on my quality of life as a shorter person. I don’t mind being this height in most respects. My parents did, to a large degree, focus on me being of “ideal weight.” And it was not pretty. I would likely weigh less as an adult had there been less of a focus on my weight — and more of a focus on my overall wellbeing and more of an effort made to help me find physical activity I enjoyed — as a child.

    I think that weight gain is perhaps more analogous to hair loss — once lost, in the majority of cases, hair is not “regained.” Strictly cosmetic, extreme, expensive, ongoing and sometimes risky things can be done to try to reverse hair loss. There are associations between hair loss and health, but hair loss doesn’t cause poor health, although it is widely considered unattractive (and there are many who find baldness in men sexy — although fewer who find this sexy in women. Hair replacement or cosmetic “improvements” do not change the association between hair loss and health. Always being on a diet is sort of the equivalent of a “comb-over.” There are some causes of hair loss that are temporary (such as after pregnancy or due to some nutritional deficiencies) but in most cases, hair loss is genetically determined, influenced only slightly by individual behavior and a “one way street.” If the entire population had optimal nutrition, there would still always be people on the entire “hair spectrum,” and people might reach their maximum “hair retention” but there would still be people who lose all their hair, most of their hair, some of their hair, and none of their hair as they age.
    (spoken as someone who has thinning hair, is short, and fat.)

    It’s not a perfect analogy, but it’s a bit closer.

  7. I’m a life-long shorty. I had the same diet, stress levels, etc as my normal-height sisters, but ended up 7″ or so shorter. Also, my dad’s family are all 6 footers (men) or at least 5’7″ (women), but mom is tiny.

    • Sounds like you take after your mom and your sisters take after your dad.

      A friend’s mom is 4’11” and his dad is 5’11”. He’s about 5’5″, with his dad’s torso and his mom’s arms and legs.

  8. Pingback: It’s OK To Be Fat « Living ~400lbs

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s