Fat at college

A friend alerted me to this article in the Chronicle today. I am super mad! The gist is that students with BMI > 30 have to take an additional fitness class geared towards weight loss, and if they fail to lose enough weight to reach an acceptable BMI, they must pass another additional fitness class.

“There’s an obesity epidemic,” Mr. DeBoy says. “The data are clear that many young people are on this very, very dangerous collision course with heart disease, diabetes, and stroke—health problems that are particularly bothersome for the African-American community.”

This is not an epidemic, so can we please stop calling it that? Magazine headline writers made that up because they thought the hyperbole sounded sexy, and they didn’t care what the words actually meant. And okay, look. People stopped getting fatter here a decade ago. That shift was actually relatively minor, and correlated with an increase in height. Both height and weight have similar levels of heritability (about 80%); neither can be changed significantly through force of effort for any reasonable length of time (> 2-5 years) except in a very small minority of cases (which are thus exceptions and probably usually have something else going on, like severe malnutrition in youth, illnesses, medications, etc.); and the weak correlation between certain health risk factors and increased BMI is pretty well balanced by similar weak correlations between other health risk factors and decreased BMI, such that all-cause mortality rates of BMI classes are similar (and lowest in the “overweight” group). When it comes to those correlations, the assumption of causation is made without second thought, leading to methodologically poor studies and false conclusions. BMI is a flawed, white-European-centric, shorthand way of assessing whole populations and is next to meaningless when evaluating the health of individuals. And health problems like heart disease, diabetes, and stroke are particularly “bothersome” for the African-American community for reasons that likely have nothing to do with body size, and everything to do with availability of and access to good treatment.

On the question of whether or not obesity is a disability, as with all levels of ability, that’s a question of context. In the context of a plane seat that is 17″ wide, everyone whose seated hip dimension exceeds 17″ has a disability (which has got to be more than 50% of the population). In the context of a building with stairs and no elevators, ramps, or stairlifts, a person without the use of their legs has a disability. In the context of a store where the top shelves are too high for me to reach, like my local Whole Foods, I have a disability and need to get assistance from store employees to complete my routine shopping. So in the context of a discriminatory school policy that requires 1-2 additional pieces of coursework from anyone with a body over a certain size, those bodies present disabilities — and in this case, it’s because people created that context on purpose, which is worse. This isn’t hard.

As for the question, “Will enforced wellness like this work?” the answer depends on what it means for the program to “work.” Some students will probably lose weight temporarily, so it will appear to meet some arbitrary weight loss goals. Simultaneously, the stigma and shame associated with being singled out and made to complete additional course work on account of factors mostly beyond the student’s [long-term] control will likely negatively impact her emotional and mental well-being, and not just in the short term. Rates of depression are not potentially higher among fatter people because they’re inherently more depressed; it’s because we treat them like shit and then tell them it’s their fault.

My grandmother [probably] had breast cancer. If they had made me take on extra coursework about proper breast health in college (which then stigmatized and blamed me for my heredity!), I would have righteously fucking sued the goddamn school. And I’ve said this before, but all of you folks whose insurance covered your wisdom tooth extractions, because your puny genetics meant your teeth came in all wrong? You drove up my insurance costs. Based on my happily intact third molars, I am confident that you should have taken some wellness classes on proper dental care, you unattractive-toothed loser. Because I care about your health.