So, I was going to write about Claire Suddath’s article in Time about why Southerners are so fat over at Pith, but Hargrove beat me to it, so I’m posting it here, where we can talk frankly, if we have to, about cooters.
I have a few objections to the whole “The South is fat because it’s hot and there’s no public transportation” line of thinking. The first being that it’s not even clear how the folks who declare us fat are determining fat. Notice how, at both Time and Pith, the picture used to illustrate the story is of someone who is quite fat. But the definition of “obese” when determined by BMI is so problematic that people who are muscular fall into the “obese” range.
Think of it like this. Say, for the sake of ease, that everyone in the state is the same height, and say that a person at that height is considered “obese” if they weigh 151 or greater. We could have a whole state full of people who weight 155 and our state would be among the “fattest,” because we had 100% obesity, but Kentucky (also the same height as us), could have 15% of the population who weighs 600 and be less fat than us, because they only have 15% obesity.
But using the bodies they do to illustrate the story makes it seem like we’re talking about states full of very fat people.
And we all know that’s a problem because…
Um…
Why again?
Oh, yes, because being fat is associated with all kinds of health risks.
Which brings me to my next point (which, okay, frankly, I probably would not have talked about at Pith). I’m fat, as you all know. And my whole life I have been told that I would lose weight if only I ate less and were more active and still I gained and gained and gained and what do you know? Finally, I find a doctor who’s like “Wow, that’s really weird. Let’s run some tests. Holy shit. There’s something wrong with you. Here’s some medication. Take it and let’s at least see if we can’t make your body work right.”
So, my fat was a symptom of something being wrong with me, which was instead read as a personal failing on my part. And, until I found the right doctor, neither me nor my doctors saw it as anything other than a personal failing.
We live in a very poor state where a lot of people don’t have access to proper healthcare. How many of them have something medically wrong with them that is being dismissed by themselves and their doctors as just poor impulse control? If they even have doctors, of course.
We are also, frankly, constantly being poisoned. Tomorrow people are being encouraged not to drive in Nashville because the air quality is so bad. We talked about Cato Road, and that is not an unusual occurance in this state, toxic dumps that leak into the ground water. And look at the little present the TVA left us.
Even if we were to accept a model of fat being unusual, unhealthy, and abnormal (which I reject, but let’s just go with it a second), to act as if we live in a completely neutral environment that has no adverse effects on us and it’s all just a matter of eating right and exercising is stunningly stupid.
I don’t know. I think the other reason I don’t like stories like this is that, in overlooking the health and environmental issues, it just feeds into this whole notion of the South as this ignorant place that the rest of the nation needs to alternately fear and feel great pity for.
And I’m kind of tired of that narrative, because much like “they’re fat because it’s hot,” it just seems too easy.
Filed under: America how can I write a holy litany in your silly moo
The “no public transport” issue does correlate with fatter and (far more importantly) less fit populations. Strangely enough, it *also* correlates neatly with poorer populations. But that’s just too hard for anyone to do anything about, so let’s just blame individuals and/or locales for their terrible, terrible fat/poor/sick people.
Have you been to http://fathealth.wordpress.com to check out horrible stories of medical abuse because all disease is blamed on being fat and lazy, especially for women? I’m the person who posted about not having thyroid cancer diagnosed for 18 months, because I was obviously just fat and lazy. And that was with excellent and free medical care available, to a white, young and articulate person.
Just as a for-instance: BPA (found in some plastics, and pretty much everywhere in our environment these days) has been linked to insulin resistance.
Which, as I know from personal experience, can make you fat.
And that’s just one chemical. In isolation.
as a 5th generation Southerner from the DEEP South, I’ll answer your question: we natives cook our veggies with BACON GREASE – whether it’s pure grease from the pan or fat back from the grocery- yeah, it’s horrible for a person and at one time it was ok, b/c we were in the fields sweating it out of our bodies after eating it, but now we still eat it, sit in air conditioning at computers and it’s clogging our arteries.
And I know of what I say b/c I keep a jar of bacon grease in the fridge for those “greens” and “pole bean” emergencies.
Greens & pole beans don’t taste proper without the grease!
But bacon grease doesn’t answer the question for everyone, Beth.
As a Memphian transplanted to Philadelphia (which, interestingly, is also listed as one of the fattest cities in the U.S., along with the ugliest and rudest, for whatever that’s worth), I notice a weird similarity between “the South is the fattest part of the country!” and “the South is more racist than the North.” The former claim seems to crop up frequently in “the US as a nation is getting fatter” arguments. The latter claim is not one I’ve heard recently (after all, one of our pools just publicly embarrassed themselves in a spectacularly racist manner), but it’s a claim I’ve heard often, mostly from students, and it’s back on my mind because of the pool incident. Both claims seem to be based on spurious if any data, mostly anecdata. And I’m pretty convinced – have been, for some time – that making statements like these do some kind of comforting yoga for the brains of my fellow northerners. Like, “Well, the whole US is getting fatter, but the South is the fattest – my insane dieting/workout plan/etc. must be having some impact!” and “Okay, maybe we have a little racial tension in Philadelphia. But it’s not like we’re the South or something.” And not only are these statements not measurably true, but they are also phenomenally unhelpful for having any real conversations about health or race.
But if we’re dealing in anecdata, here’s mine: up North, I walk/bus everywhere. I support community agriculture and receive a box of vegetables every week, which I cook with very little oil and no bacon grease because I like to keep light, so I don’t feel weighed down when I walk. I do yoga several times a week because it feels good, and I drink no sugary sodas because I don’t like them. And I feel great, and have the luxury of good health.
I also weigh more right now than I have ever weighed in my entire life. Slid right from “normal” into “overweight” on the BMI scale this year. Go figure.
B, what is it about your posts that make me write mini treatises in the comments?
I don’t know, but I love it! Good lord, if there’s one thing writing at Pith has shown me it’s that, in a just world, I would have a list of all your names and addresses and I would come over and clean your bathrooms to show my gratitude for how thoughtful, thought-provoking, and interesting you are.
I still think there’s something to the paucity of smoking, too. We really can’t tell if we’re any fatter than our smoking grandparents would have been (once American food started being fairly easy to come by) if they hadn’t been sucking down an appetite suppressant (not that all smokers are thin or that all thin people are smokers, of course).
But I also keep thinking about something Paul Campos said in his book–about how, when your body craves something, it’s really hard to deny it. So, say that you really want a chocolate chip cookie. Mmm. Melt in your mouth chips with chewy, sweet cookie surrounding.
Well, in my grandma’s day, that chocolate chip cookie would have been made of lard.
If you were having that craving because your body wanted fat, you could have eaten one cookie and your craving for fat would have been satiated.
But, now, if you’re craving a cookie, how many of us pull out our little 100 calorie lo-fat snacks and we eat it and we still feel like “ugh” and so a little later we have another one, after all, it’s just 100 calories. And a little later another?
Campos’s argument is that, if we recognized that our body was craving fat (not just something that tasted sweet), we’d be better off having one full lard (or full butter) cookie than four 100 calorie snack packs.
And I can’t help but wonder if there’s something to that, too, that in denying ourselves some food we end up doing more harm than good.
First of all, tanglethis is my new favorite person. I don’t know where the word “anecdata” has been all my life, but I’m in love with it. It’s been added to my vernacular in high rotation.
Second, I don’t disagree with anything in the article. It’s all true. But as a commenter at Pith pointed out, the difference in the obesity rate between Colorado and Mississippi isn’t exactly something to crow about. It’s still high. Southerners are only slightly more obese than the rest of the country. That’s the statement that’s missing. But it’s obvious to anyone who’s been outside the south (or has a television and watches reality shows) and has a pair of working eyes.
Though, in fairness, it could have been more apparent that the lack of good medical care is a problem. Not just access, but actually getting the care. And having a doctor willing to understand the problem. It’s very feasible that all of this focus on bad food and obesity is simply making doctors lazy, that they’re taking the easy way out of dealing with overweight patients.
I’ve opted not to comment on the article as I’ve written one rambling treatise in your comments already and don’t want to spew all over the place. Also, I know you’ve heard all my thoughts on fat and medicine.
But I, like Lesley, owe my eternal gratitude for the word ‘anecdata’ that I’m now in love with and adding to the “favourite words” file in my mind.
Crap. I do have to say one thing about the article, but I’ll keep it brief:
Hearing medical people discuss bariatrics today is like hearing medical people discuss The Four Humours and bloodletting centuries ago. They just don’t get the deeper workings yet and expect us to be amazed with leechery.
I like “anecdata,” but “leechery” is pretty good, too.
I won’t start a nutrition debate here, but nutritionally speaking there are far worse things in the world to eat than, say, collard greens with backfat. pretty nutritious, actually. Mmm.
As for the attitudes in that article, I agree.
The most succinct way I could describe what annoys me about our culture with respect to health is that for a culture that finds a way to be incredibly victimized at every turn, when it comes to other people (classes, segments of the population, areas, whatever), it’s like we had empathy surgically carved out of our brain.
Writing off anyone’s health problems (perceived or otherwise) as a personal failing makes you a giant dick, basically.
It’s interesting — slight, but related tangent here — I subscribe to a mailing list for urticaria, a particular health defect I’m blessed with. On this list, you tend to get two kinds of messages: long, rambling, incredibly nerdy scientific/medicine articles from people who are proactively taking their health into their own hands, and then messages from people who have been recently diagnosed. Often these are kids, and the messages are pretty heartbreaking (usually along the lines of “WHY IS THIS HAPPENING TO ME :(“).
One of these, a 15 year old girl, posted a fairly distraught message a few weeks ago asking for advice in how to deal with people that basically didn’t believe her — didn’t believe that she was sick — that she was just making it up for attention, or as an excuse. Including her father. It was hard for me to read, because I totally sympathize.. I’ll never forget the anger welling in my gut the first time I exploded into hives/anaphylaxis at soccer practice when I was 16 and my coach claimed it was “nerves” and benched me until I could “grow out of it”.
Anyways, so I did my best to sortof craft a guide to dealing with assholes, basically. How to disarm them and shrug off the fact that they’re basically writing off something that is ruining your life as your own personal failure. Not easy to do, and it’s a damn shame anyone should ever have to do that.
Incidentally, didn’t claire suddath used to be a blogger? in nashville?
Suddath used to write for The Scene. I don’t remember if she had a blog other than Pith.
And yes, god, I have immense sympathy for what that poor girl is going through. I’m still kind of flabbergasted when I think about how nobody (and I’m including myself in this) until I was 34 ever said, “You know it’s really weird that you’re gaining weight like you are. Let’s just check and make sure everything’s okay.” Because even I was caught up in the “well, I’m just fat because I won’t do the work it takes to be otherwise” mentality.
I’ve been wondering, too, about how often this happens with other medical conditions–I know people who have a lot of chronic pain are constantly facing this idea that they’re lying and bringing their problems on themselves.
But I’m starting to wonder if that’s not just some feature of how we practice medicine.
I could rant about this all day, but I shouldn’t, because I don’t necessarily have the answers, but a big part of the puzzle is that traditional (allopathic, but I sorta hate that term) medicine is very quick to treat the symptoms with pharmacology and not really make any attempt to take a wider view. Oh, you have hives? Here, take some antihistamines.
Not, you know, “Oh,you have hives? That’s … weird, maybe you have any one of a bajillion diseases, auto-immune or otherwise, that could cause this.” No, instead, let’s just give you some antihistamines and wait for you to bug us about possibilities.
I don’t think this is born of any particular malevolence, but it’s something I find myself bitter about nonetheless. I feel like I have had to learn to take a very active role in being my own health advocate, because doctors and our health system have no vested interest whatsoever in taking an active role.
Bitter? Why no, I’m not bitter. Maybe a little.
ALSO, I should point out that “taking an active role in being my own health advocate” is actually something I’m not bitter about, per se.. I think it’s something that everyone should do more of.. Unfortunately far too many people take an utterly deferential attitude towards their doctor. They never question anything, they never ask anything, and they never, ever consider that doctors can be wrong.
I wonder about that in terms of TennCare. You saw all the pissing and moaning last week because there are so many people on pharmaceuticals in this state. But how many TennCare patients have a complaint and are handed drugs rather than the doctor trying to get to the bottom of what’s going on with them?
And I agree, I don’t think it’s intentional malevolence, but I do think it comes from a kind of jadedness in healthcare professionals we need to start working against.
“I have had to learn to take a very active role in being my own health advocate, because doctors and our health system have no vested interest whatsoever in taking an active role.” – Yes. That’s why it took literally years for me to get my serious thyroid problem diagnosed. If I had been slightly less educated, slightly less persistent, with slightly less energy leftover (because the disease was doing its best to drain that energy), and with slightly less income and health insurance that allowed me to go back and back and back to doctor after doctor and get second opinions from specialists in a town an hour away, it might have killed me instead. Lucky for me I had those particular privileges and abilities.
The idea of good health care as a privilege makes my heart hurt.
But how many TennCare patients have a complaint and are handed drugs rather than the doctor trying to get to the bottom of what’s going on with them?
This is a huge problem for AI patients. Huge.
And since the rest of what you are all talking about is what I’ve been living, I feel like I should refrain from joining in at the risk of taking over the conversation.
I’ve been spending too much time on Twitter and FB because there are tons of things said by all of you that I want to “like” and “Retweet”.
Going back to something Aunt B. posted, about When You Give A Human A Cookie (that is not, actually, a cookie): I increasingly think that “cravings” are just a metabolic lack of something or other that is out of whack in one’s system. And that tricking your body, substituting diet soda for full-sugared, or no-fat whatever’s for the whatever’s with fat, is self defeating because not only have you ingested something that does you no good, you’re still left with your craving.
I’m looking forward to reading the new Kessler book on the ways that food scientists in the employ of Processed Food have perfected the ratio of fat to sugar to salt in order to satisfy any urge. Why are the O’Charley’s rolls so damn *pleasing* to eat? Because they have a perfect ratio of fat to sugar to salt. They are specifically designed to hit your pleasure receptors.
Real, unprocessed food might also combine those 3 magic ingredients: fresh green beans cooked with bacon or pork jowl and salt are all at once salty, slightly fatty, and slightly sweet. Toothsome, as they call it. Your basic bernaise sauce is the same. But those are balances of food, with intrinsic nutritional value and flavor independent of any lab analysis. Food is good, it is nourishment. Hitting a pleasing cocktail of neuroreceptors is nice, but it’s not good, it does nothing for you beyond that hit of pleasure. As a culture, we’ve strangely abandoned much of what is good in favor of what gets us high.
ITA, EmmyLou. Also, I think that eating some fat with our vegetables is indeed a very desirable thing — otherwise you don’t get all the fat-soluble vitamins.
Also I think that bacon fat from naturally raised pork without sodium nitrite tec. is VERY different from your standard Smithfield bacon — factory-farmed pigs pumped full of antibiotics, jacked up with preservatives. Ditto grass-fed beef versus the feedlot stuff, which has a different fatty acid profile along with different chemical contaminants.
I would love to see the study that compares those two groups of meat-eaters instead of lumping all “meat” or “saturated fat” or whatever consumption all in together. Same thing for refined carbs. Sigh.
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