"Big" is Different from "Fat"

This week I've been treated to two radio experiences dealing with "fat". Both had to do with social clubs that cater to "plus size" people and other people who like to be with them. Since 25% of the U.S. population is now officially obese, I guess it's time that some folks realized they represent more of a business opportunity than just extra large clothing. And being "fat" doesn't mean being poor; large people also can make good money and spend it, too. But some of the propaganda being put out by these folks is downright dangerous, because there is a very important difference between being "big" and being "fat" (obese).

One can be big and heavy without being "fat". Lots of pro football players are living proof of this; their percentages of body fat are lower than many people who look "skinny". Genetics have everything to do with body shape, and some people have big bones and bulky body shapes. Good for them! If they stay in reasonable shape they will have nice low blood pressures and pulses, avoid diabetes, and expect a normal life span. They can even go to these clubs that cater to big people, if they choose.

But it really dismayed me to hear a woman say, straight out, that it's OK to be obese...that it's wrong to criticize people for being obese. She was one of these fat people who so oppose the stigma that fat people often endure that she's gone off the deep end of acceptance. Fortunately, the interviewer on NPR had the guts to challenge her position. She came back with the argument that people can be big and heavy, without being fat - which is true. But she would not admit that obesity is a serious health problem or that she was trying to rationalize it away.

Why do I care? I'm not fat, none of my relatives are fat, and few of my friends and acquaintances are obese. That is primarily because I came from an upper middle class home and live in an upper middle class area where most people are health-conscious. But I care because I've seen, close up as an EMT, the terrible toll that obesity takes on a human being. And, I care because obesity is an extremely expensive problem for our country as a whole.

Obesity is a major cause of disability in younger people. How many very heavy younger people do you see limping? Their knees and hips are being destroyed by weight their body was not meant to carry, and by middle age they will be tooling around in power chairs. Their weight also puts a huge strain on their cardiovascular system; they sweat even in average temperatures, and they get short of breath with minimal exertion. They are likely to get type 2 diabetes, which attacks multiple organs and may well result in severe circulatory problems and even amputation. These issues make them far less able to live normally and often shorten their lives. Lastly, their disability payments and obesity-related medical costs are, in total, a truly giant sum that society pays.

It's true that most of us lead lives that are unhealthy in one respect or another. I smoked cigarettes for many years, for example. Others of us are too sedentary or perhaps even skinny to the point of emaciation. But, to be honest, there is no common voluntary behavior that has anywhere near the total negative health affects as does obesity. As a culture, we need to "reduce it". Alot. Making obesity seem OK is just plain wrong and dangerous.

Don't get me wrong. I feel badly for people who put on pounds fast and have a hard time getting them off. Their situation may well be genetic or socially-determined, and it's not fair to laugh at the mental and phyical struggles obese persons may face every day. We've just got to do everything we can to help these folks take off the weight and get in shape, just like we try to help people quit smoking and get in shape. And, we all can be nice about it.