How To Look At Obese People

Dr. George Blackburn of Beth Israel Deaconess Medical Center has a beautiful suggestion for how to respond to obese people:

"We must remember 'There but for the grace of g_d or our genes go I.' Rather than blame or create a stigma for a person of size, become a helpmate."

He added: “Obesity is a confluence of socioenvironmental events that make it very easy to gain weight in this culture, and very hard to take off. Our bodies are rigged in foolproof and redundant ways to hold onto fat, so the operative word here is compassion.”

He was responding to our request to help formulate the correct message on obesity in the wake of a raging Web firestorm. (See our earlier post here.) On Monday, a Marie Claire blogger, reacting to a new sit-com about an obese couple, "Mike & Molly," wrote in effect that obese people aesthetically disgusted her, and that it was their choice to be fat. Thousands responded, most flaming her, some agreeing.
I asked yesterday for expert opinions on the correct public message about obesity. One came from Dr. Blackburn, an obesity researcher and author of "Break Through Your Set Point." His response:

Seventy percent of adult Americans are overweight or obese. It is a national epidemic best attributed to our “toxic" environment. Maintaining weight loss is a major public health challenge.
Individuals often indicate that waning motivation prompts cessation of effective weight management behaviors. A novel weight loss maintenance program is one that specifically targets the individual motivational factors.
Step 1: Personalize your plan. e.g. focus on exercise or an eating plan. Choose an activity you like and you can make it fun, so you will stick with it.
Step 2 Find a helpmate and document your plan, including recording your body weight daily.
We must remember, “There but for the grace of g_d or our genes go I.” Rather than blame or create a stigma for a person of size, become a helpmate."

I also heard from Michael Prager, an author and blogger living in Arlington. His first book, "Fat Boy Thin Man," was issued Oct. 21 by Fisherblue Press, and he blogs about obesity and other food politics at
His response is long, but so wise and candid and eloquent that I've included it here in its entirety:

One might expect me, as a former 365-pound person who's been in a normal-sized body for 20 years, to have been as outraged as so many commenters were with Maura Kelly's post. Surprisingly, to me, I have some sympathy for her and her position, even though she's got a lot of flaws in what she's saying. For example, her suggestion that the show is promoting obesity is absurd. Sitcomdom could barely exist without its exaggerations, but how many of these characters — sluts, bigots, bullies, etc. — are being endorsed?

But when Kelly says she's aesthetically displeased by fat people, far more candidly and quite a bit more vociferously than I think she should have, I believe that she's expressing the thoughts and reactions of many Americans. I don't defend it, but it has the virtue of honesty. Here's some more honesty: I should be as reconstructed as they come, and I have the same reaction, albeit minus the vitriol. I don't like it about myself, but I react negatively to seeing very fat people sometimes too. I think the majority of people, if honest, would acknowledge the same.

And here's the kicker: In my opinion, most fat people don't like how they look, and look askance at others in the same condition. Very few people I know are fat as a fashion statement, even those who proclaim their plus-size beauty. I sure didn't like my form when I was 365, and though I have plenty of body defects left and always will, I like what I carry today a lot more.

I'm not sure she meant to, but she scores a direct hit when analogizes to drunks and heroin addicts. Not everyone, or even close, but a significant number of obese Americans, in my opinion, are food addicts. That is, they react to some food "situations" — most likely refined sugar, refined grain (aka flour), and volume, but with broad variety of experience, too — differently, more intensely, than most other people. There really should be no difficulty understanding this. Peanuts, or strawberries, or shellfish is OK for most people, and lethal for others.

But if you compare obesity to drunkenness in one sentence, you shouldn't say in the next that "obesity is something that most people have a ton of control over," even if there's truth to it. For a lot of people, yes, but not for addicts. Now, I'm not saying that food addicts have no responsibility for being overweight —I put every single morsel of binge food into my mouth, and that's how I got to be 365 pounds — but I am saying that addicts are dealing with more than just calories-in-calories-out. People generally used to think that drunks were lazy sots who just ought to get their lives together, and now it's accepted that brain biochemistry is different in addicts than it is in others. That's all addicts, not just the ones whose existence you're cool with.

To me, the flaw in the discussion originated with the editor who cast the issue as an aesthetic one, even while I acknowledge that aesthetics still exist in a politically correct world. It's a lot less sexy, but we're far better off to be talking about obesity in terms of health, because then it matters far less what anyone thinks about it from across the room. Obesity is generally a sign of ill health, and ill health has actual consequences far more significant than what some blogger thinks is wicked gross.

This program aired on October 29, 2010. The audio for this program is not available.

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Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.



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