After what seems like an eternity, we have finally reached Election Day. Some of us are excited; others, disgusted; and most, just relieved. This post is not about politics but about obesity. These two individuals have entered our lives many times through our screens whether we wanted to see them or not. They will continue to haunt us one way or another for the next few weeks, months and years. I wish to use the images residing in your mind to illustrate the growing weight problem in America, the measure we use to assess it and our conflicting attitudes on the topic. Once the election is behind us, we can again focus on how fat we are becoming as a nation.
I use the more insensitive word “fat” because “obesity” is a more sterile and clinical term that is not generally well understood. We have all heard the statistic that roughly 38% of Americans are obese and another 33% are overweight. That leaves less than 30% of the US population that is either underweight (1.5%) or “normal” weight which is an odd term in this day and age. I think “desirable” might be more the appropriate adjective than “normal.” Of particular concern is the growing number of obese individuals who are considered to be extremely obese.
Most of us tend to think of obese folks as extremely fat, but the video clips of fat people accompanying television reports on obesity or in movies like Supersize Me depict the extremely obese not those merely obese. Neither Clinton nor Trump are as fat as those folks in the video clips, but both of them appear to have put on several pounds since their glamour shots taken 10-20 years ago.
The way obesity is measured is by the Body Mass Index or BMI. It is basically a person’s height in centimeters divided by their weight in kilograms. The cutoff points are 18.4 or below, underweight; 18.5-24.9, desirable weight; 25.0-29.9, overweight; above 29.9, obese; and above 39.9, extremely obese. Note that someone who is 29.9 is considered merely to be overweight while their partner might be 30.0 and classified as obese. There is no wiggle room. To calculate your BMI find a calculator on the internet. One way to lower your BMI is to grow taller. Reports for the height of Secretary Clinton range from 5/4 to 5/7 and Mr. Trump as 6/3. These reports may be products of height inflation. BTW, people in their 60s and 70s tend to shrink rather than to grow.
BMI is used as the measure of obesity not because it is accurate but merely because it is easy to determine and easy to interpret. For a better understanding of the limitations of BMI read Chapter 1 of Obesity 1011. It turns out that the BMI is reasonably good at estimating the number of people in each category for a large population such as the adults in the state of Iowa. Unfortunately, it is not nearly as good at classifying individuals like you and me, particularly for those of us close to the borderlines between desirable weight and overweight or between overweight and obese. One other source of error is that most of us are weighed with our clothes on which can add as much as 5 pounds or more than 2 kilograms to our weight. Mrs. Clinton is reported to be between 132 and 144 pounds and Mr. Trump as 236 pounds, although some claim he is as high as 265. We do not know if either of these weights was done in their clothes or in a cute hospital gown.
Most of us have a pretty clear concept of whether we are fat or not, but we are not as likely to judge whether we or someone we know is obese. Until I started to study the whole obesity thing, I wondered why, if America was so obese, so few of my friends and acquaintances were not. What I learned is that I was slightly overweight and that more people whom I knew were actually obese than I thought. It seems to be much easier to be against obesity when it is an abstract concept than when forced to confront it in ourselves, family or friends. It is also easy to place the blame on food, particularly processed food and fast food. Many home-cooked meals are just as obesogenic, however, as meals prepared from convenient, processed food. Sweet and salty snacks can pose a real threat whether they are from packaged foods, restaurants or prepared at home. Lack of willpower is used by thin people to criticize their overweight counterparts, but obesity tends to be more complicated than that. The more obese individuals are shamed, the more stigmatized they become, the more likely they are to seek out comfort foods, and the more difficult it is for them to lose weight.
So let’s get down to the nitty gritty to see if our Presidential candidates are obese or not. Estimates for Hillary Clinton of 5/7, 144 pounds result in a BMI of 22.6, right in the middle of the desirable weight class. While that number seems credible for her days as First Lady, I am skeptical that it is an accurate value today. Assuming that Donald Trump is 6/3, 236 pounds as reported by Dr. Oz, his BMI is 29.5 or at the high end of being overweight. BOTTOM LINE: Both Presidential candidates this year appear to be overweight and possibly obese. If I had a similar BMI, my doctor would tell me to lose more than the few pounds which is what Dr. Oz recommended to Mr. Trump. We must be careful not to attach more importance to the BMI than it deserves, however. Hopefully, this post has provided a little insight into the limitations of using BMI to classify people into categories such as desirable weight, overweight, obese or extremely obese and a better understanding of what we face as a country with respect to obesity.
Next week: Shrill: Pushing back against fat shaming.
FULL DISCLOSURE: Last time I went to visit my doctor I was 5/6, 162 pounds for a BMI of 26.2 or overweight. I was weighed in loose-fitting clothes, with empty pockets and no shoes. My next visit is Monday where I hope to be closer to 24.9. I will disclose the results in the next post.
1 Obesity 101, L.M. Rossen and E.A. Rossen, 2012, New York: Springer