Bicknell Lecturer Paul Campos: War on Weight is Hazardous to Health

Posted on: October 18, 2013 Topics: bicknell lecture

This summer, there was much rejoicing in the public health community, as the Centers for Disease Control and Prevention (CDC) released data showing obesity rates among preschoolers falling in many states for the first time in decades.

“Although obesity remains epidemic, the tide has begun to turn for some kids in some states,” CDC Director Thomas Frieden said in heralding the news. “While the changes are small, for the first time in a generation, they are going in the right direction.”

For Paul Campos, concerns about obesity have been headed in the wrong direction for generations.

The University of Colorado at Boulder law professor, who authored the controversial 2004 book The Obesity Myth: Why America’s Obsession with Weight is Hazardous to Your Health, has been a vocal critic of what he considers a self-defeating war on fat that has no basis in science and can have devastating consequences for women.

On Oct. 24, he brings his critique of America’s obsession with weight to the BU School of Public Health, where he will deliver the 2013 William J. Bicknell Lecture. The lecture, which is free and open to the public, will be followed by a panel discussion on obesity that includes Frank Hu, professor of nutrition and epidemiology at the Harvard School of Public Health, and Abigail Saguy, associate professor of sociology and gender studies at UCLA and author of What’s Wrong with Fat?

Campos_Paul2_3Paul CamposCampos argues that the health risks of obesity have been exaggerated by medical and public health professionals and the $50 billion a year weight-loss industry. Against a cacophony of voices calling attention to weight – from the CDC to First Lady Michelle Obama – he concludes that the health risks associated with body fat have been overblown, save for a small minority of people who are at the extremes of body weight. He also argues that the potential harm of short-term weight loss — usually followed by weight re-gain — is significant.

Q: What reaction did you have to the CDC’s childhood obesity findings?

“Like most of these reports that come out about weight, I think it’s important to contextualize. Obesity among preschoolers, as an indicator, was just invented a few years ago by the CDC – not based in science, but just an arbitrary definition. Basically, they took the 95th percentile of the height-weight chart from the 1960s and 1970s and treated that as a definition of childhood obesity. So it’s kind of a made-up definition. And I have trouble seeing a decline in a made-up definition as a big deal.

“In terms of context, rates of obesity and overweight have flattened out or declined all over the world. Much of the alarmism about obesity is based on projections that people were just going to get fatter and fatter, and it appears from the data over the last 10 to 12 years that this has just stopped. The alarmism in many ways has never been based on a sound scientific analysis, but on classic moral panic, in the sociological sense.”

Q: Where is that ‘moral panic’ coming from?

“There are several factors. One is a very straightforward economic one – there’s an enormous weight-loss industry in the U.S. I don’t think most of this is really conscious at all — people’s economic interests just dovetail with beliefs. We have a very strong aesthetic preference for thinness in this society, and this gets medicalized. It becomes a sign of moral quality, essentially.

“Another factor is that we have, in many ways, an eating-disordered culture in this country. Anorexia nervosa is rampant. If you look at the normal representation of a female body, it’s in the 2 percentile. That just feeds into this tremendous anxiety about weight.

“There’s also a generalized anxiety about overconsumption, especially among the upper classes. Look at the popularity of the TV shows about hoarding – there’s a fascination with people consuming too much.”

Q: So there’s a social class element to this?

“Absolutely. Obesity in our culture has become a marker for lower class status. This is something that makes people in higher economic status nervous. We think, ‘Who are these overweight people? Well, they’re people of color who are shopping at Walmart.’ And since we have a culture with a lot of downward mobility at present, that anxiety gets fueled by weight. It’s tied up with a lot of discriminatory beliefs and actions.

“With women particularly, you have to get to extreme emaciation before you evoke a similar kind of revulsion from mainstream culture. Fatness is considered a respectable reason for scorn. We have this very stigmatizing culture surrounding weight.”

Q: If it’s so ingrained in our thinking, how do we fix it?

“Well, first we have to give up on this phony notion that we somehow know how to make fat people thin. We don’t. Every discussion of this subject should start with an acknowledgment that we don’t know how to turn fat people into thin people.

“I’m all for encouraging people of all sizes to be active and avoid eating-disordered behavior. Physical activity and nutrition are good things. What I’m not for is stigmatizing people and haranguing them about their weight. It doesn’t make them thinner, and it doesn’t make them healthier.

“It’s like that old aphorism that defines insanity: Doing the same thing over and over again and expecting different results. That’s where we are with weight in this culture.”

The 2013 William J. Bicknell Lecture is 10 a.m.-noon Thursday Oct. 24 in Bakst Auditorium, 72 East Concord St. It is free and open to the public. The annual lecture honors the late Dr. William J. Bicknell, founder and chair emeritus of the BU School of Public Health Department of International Health.

Submitted by: Lisa Chedekel