Thursday, August 16, 2007


Hallelujah! As if Farthingsworth the Pardoner had generated the appropriate Papal indulgence, I have been absolved of any responsibility for my extra thirty or so pounds. You see, I am not to blame - it’s my Friends.

Supported by a grant from the National Institutes of Health two professors recently published the findings of their study, The Spread of Obesity in a Large Social Network over 32 Years, in the New England Journal of Medicine, concluding that, “Having fat friends to include those hundreds of miles away can affect a person's weight.”

James H. Fowler, Ph.D., an associate professor of political science at the University of California in San Diego and Nicholas A. Christakis, M.D., Ph.D., M.P.H., a physician and professor of medical sociology (?) at that bastion of higher learning aka the Harvard Medical School and the principal investigator engaged this 32 year study (1971 to 2003) that involved 12,067 people. Their findings which used information from medical check-ups, suggest that obesity, only recently touted as a disease process (more later), is seemingly spreading through social networks ("is socially contagious") and that, generally speaking, your chances of becoming obese appeared to increase by 57% if your friend was obese.

Christakis continues: having an obese Friend of the same sex increases the risk of you becoming obese by up to 71 per cent. Overweight siblings increase your chances of becoming fat by 44 percent for brother on brother and 67 percent for sister on sister. Christakis noted that obesity in a sibling of the opposite sex did not affect the chance that the other sibling would become obese (must be gender bias). However, that dreaded overweight significant other increases your odds by 37 percent. In short, Fowler and Christakis state that your Friends and Family (same sex) are making you fat.

Dr. Christakis in an extraordinarily obvious “eureka moment” explains that, “Friends affect each others’ perception of fatness. When a close friend becomes obese, obesity may not look so bad.” Yea, yea, I remember when I went and bought my 1978 Chevy customized van and many of my Friends went out and bought one too. Monkey see, monkey do…. though those vans served us and our Families well.

Many with an agenda that just happens to include obesity are reveling in this news that insinuates that obesity is akin to a socially transmitted disease process. Those with agendas seeking economic opportunity under the obesity banner include, among others, academics, Fat is Beautiful lobbyists, medical researchers, anti-discrimination lawyers and skinny teary-eyed liberals wont to embrace their fat opposite numbers.

As an example, the New York Times has reported that Fat Studies are gaining credibility in academia and, indeed, The Harvard Crimson cited a 2006 New York Times report indicating that University of Wisconsin, Milwaukee, Professor Margaret Carlisle Duncan offers a class on “The Social Construction of Obesity”. The Times has also reported that the University of Pennsylvania’s Anthropology Department offers a class, "Fat and Society," that examines psychological and sociological issues concerning body image. It would appear that the number of people interested in these fat courses is expanding in direct correlation to the waistline of Americans. Maybe that’s not all bad since this issue needs a lot of attention.

We need, however, to put this whole issue in proper perspective. We don’t need to engage what was no doubt an expensive 32 year study to conclude that we tend to emulate the values and life style of those we embrace as Friends. We don’t need to catalogue obesity as a disease process either. By accepting this premise we are failing to hold ourselves accountable for our own behaviors. Through our own government we have become the ultimate enablers.

In 2002 the IRS ruled that for tax purposes obesity is now a disease. This allowed Americans for the first time to claim deductions for health expenses related to obesity, just as they could for those related to diabetes, cancer, heart disease, and other illnesses. However well intended, the IRS with a wink and a nod cast the dice.

Medicare recognized obesity as a disease entity in 2004 reversing a long-standing policy. Center for Medicare and Medicaid Services (CMS) Administrator Mark McClellan, MD stated then that, "From the standpoint of Medicare coverage and the health of our beneficiaries, the question isn't whether obesity is a disease or a risk factor. What matters is whether there's scientific evidence that an obesity-related medical treatment improves health.” We certainly agree though there’s that old wink and nod again.

I’m buying into the simplistic and majority theory that obesity is a symptom of our society and can be attributed to among other factors, poor dietary habits, the development of the TV remote, an overall lazy sedentary lifestyle, a forest for the trees culture that places the almighty dollar over Family and, in some cases, genetics. The Fowler and Christakis study is an almost amusing (if it wasn’t true) reaffirmation of a patently obvious truth.

Seems that some (OK, most) folks just can’t differentiate between the chicken and the egg. Obesity is a symptom and not by itself a disease process. It’s obesity that causes the disease processes that we know as diabetes. Yes, obesity is an omnipresent, insidious condition in our United States. It’s farcical to engage the rationalization that we have to modify our behaviors and start to hold ourselves accountable for the consequences of those behaviors. That truth is as obvious as sweet tea in summer. If we can’t or won’t do so as individuals then the life and health insurance industry, the federal government and many employers will. I am not entreating those overweight folks with causative genetic or health-related problems, rather those of us that had options and chose to be lazy.

I did take a cursory survey of my close Friends and Family, near and far and find that most of my Friends and Family are well within accepted norms though over the last several years two close Friends (both morbidly obese) died of complications from diabetes and a stroke. I noted that two of my brothers are indeed overweight though probably not obese. Their influence on my person is apparently negative and I have engaged the services of a good Fat attorney.


Ned Buxton

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