I often get pushback because I promote a war against obesity. Often this results in claims of “fat shaming”. I have also caused friction by suggesting “personal responsibility” for one’s health. I am sympathetic to my critics, but I nevertheless continue to suggest that a significant reduction in the overall body composition of the American population would save billions of dollars in health care cost (not to mention the benefits to overall productivity).
A friend shared an article titled “Whole Foods CEO John Mackey: The ‘best solution’ is to not need health care and for Americans to change how they eat and live” by Catherine Clifford1. It spoke of an op-ed written by Mackey in 2009 in the Wall Street Journal, “The Whole Foods Alternative to ObamaCare.” I confess, I haven’t read it, and, while I might agree with his call for Americans to take more personal responsibility for their health, I would not go as far as to say we would have no use for health care or that we should do away with it. Frankly, if Mackey is that concerned about the American diet, he should make a concerted effort to bring Whole Foods to the poorest of our communities at affordable prices. He does make valid points about the severity of the obesity crisis (more than two-thirds of Americans are overweight and more than 40% are obese; cardiovascular disease costs $351 billion annually and diabetes costs $327 billion annually in health care costs and lost productivity1). Something needs to be done.
That Americans need to lose body fat, however, does not mean we should favor the unrealistic body images that we see in advertisements, magazines, and entertainment. Indeed, few might ever achieve—let alone maintain—the “perfect physique”. For one, these images are often altered. Also, actors and bodybuilders go to extremes to prepare for movies, photo-shoots, and competitions. They are never leanest for more than a brief time. Genetically, the majority of us will never (nor should we ever) reach these idealistic physiques. So, is it an excuse or motivation?
It is easy to allow our genetics to excuse our physical performance (or lack thereof). Individually, however, we each have our optimal body composition. Of course, some will be leaner (naturally) than others. Vive la difference. Embrace your best self. Mesomorph? Ectomorph? Endomorph? Doesn’t matter.
BMI (body mass index—weight in kilograms divided by height in millimeters-squared)? Frankly, not a good measure—especially for more athletic individuals. A BMI over 25 kg/m2 is considered overweight (above 30 kg/m2 is obese). Anyone with appreciable muscle mass is likely to be “overweight” according to BMI. This is a good thing. In fact, researchers have shown that overweight can benefit life expectancy—somewhat of a “J” with underweight and obese having a significant negative effect on life expectancy. Personally/Professionally, I believe this is due to the contribution of lean muscle mass. More muscle mass (i.e., strength) permits a higher level of physical activity as one ages. That there might be some body fat covering this muscle is of less importance. It is okay to have a six-pack in a soft cooler. There is a point, however, in which body fat crosses the line from healthy to unhealthy. It is that threshold we want to be below.
I would contest that a BMI range of 25-27 kg/m2 is possibly most ideal for general health—provided that muscle contributes more to body composition than does fat. BMI is a guess, at best. Better to have body composition measured (via skinfolds, hydrostatic weighing, BodPod, etc.) and know how much fat and lean tissue you have. Changes in body composition can be monitored simply using the old Special K “pinch an inch” and the mirror. Bigger folds of fat mean more fat. More weight with no change in fat means more muscle (and, possibly, a higher BMI). An ideal body composition is less than about 18% body fat for males and 25% body fat for females. Essential fat is considered to be 2-5% for males and 10-13% for females. Below these levels is unhealthy. Where one falls in the range of “healthy” is a matter of personal choice and opportunity. Maintaining a low-healthy body composition takes considerable commitment, consistency, and sacrifice. Maintaining a moderate-to-high-healthy body composition takes less effort, but nonetheless some effort—small changes.
So, when health professional suggest we combat obesity, it is not to judge people who struggle with body fat (frankly, given the statistics, the majority of us do struggle with body fat). Instead, consider it a call for systemic change and an offer to help. It is not to suggest that one should compare himself or herself to another. It is to suggest that we pursue our best self.
It will never be enough (or proper) to guilt people into change or to appeal to the conscience. It will require policy and the support of the likes of John Mackey and others who are in a position to help. Communities need to be more activity friendly. Gyms need to be accessible. Education needs to educate. Affordable, healthy foods need to be readily available to all. And, of course, we need to incentivize healthy lifestyles. Note, though, the emphasis is on health, not appearance.
Be your best today; be better tomorrow.
Carpe momento!!
1https://www.cnbc.com/2021/01/04/whole-foods-ceo-john-mackey-best-solution-is-not-to-need-health-care.html?fbclid=IwAR11fMPUebehFBLoS2c-mUTp_bQ6LdnP3FWHCYFtLrJE3XDnfTJ6E_7H2BA