Sunday, March 29, 2015

A Technicolor Rainbow of Gray

I've been reading Harriet Brown's new book, Body of Truth.  I don't want this to seem like a review of the book, because it's not. I've come to learn that I read books differently than most people, so I rarely recommend anything, as I have no idea if anyone else will see what I see. The tendency to read things as black or white is not something I understand--my mind is a technicolor rainbow of grays.

But the black-white dichotomy is one worth talking about. It is this dichotomy that keeps me from loving the book. On the one hand, I do like to see a critical look at the state of obesity research. On the other, deficits in our understanding of obesity does not equate to such hopelessness we should pretend obesity does not exist.

One premise that requires quite a bit of analysis is whether obesity is a disease. Is obesity a disease? I've written about this before, but I think I've come to the conclusion that the answer is "sometimes". Obesity has many characteristics of a disease, and when there are health effects, it's easy to conceptualize as a disease. In these cases, weight loss can be one important part of treatment plan to improve health. But sometimes fat is just a size. Sometimes there are no health effects. Even if we argue that there is potential for future risks, most of the time this sort of weight loss is focused exclusively on weight.

The problem is that there is not an either/or here. Obesity doesn't have to be either a disease requiring treatment or a simply a size. Those who argue that obesity is not a disease often want weight to be something that is not medicalized, that we allow bodies to all exist as they are. (Of course, there are those who think obesity is not a disease because it's subsequent to moral failure, but that's a whole different post.) Those who believe obesity is a disease in all cases, argue that treatment should be made accessible and we should work to remove the stigma of the thin ideal, focusing instead on health.

But this is all true. If you pick a value premise of "No One Knows the Truth About Obesity", or the opposite of "Obesity Will Definitely Kill You", then you miss everything in between. All that gray is where the truth really lies, and the truth may very well differ for everyone.

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