In the Scientific American article, the authors do not claim the BMI is racist. Its a well reasoned essay on the history of white medical practitioners' racist attitudes toward Black women's bodies in which they claimed larger bodies were proof of a Black inferiority. The authors claim that those racist attitudes toward larger Black women continue to the present and mask how interrelated social factors impact black women's health. In this piece, Maratos-Flier et al are incorrect when they claim the Huffington Post article does not include commentary from medical scientists. Jennifer Gaudiani provides convincing commentary. She is an MD, Board Certified in Internal Medicine who completed an undergraduate degree at Harvard and medical school at Boston University School of Medicine, and her internal medicine residency and chief residency at Yale. She runs a clinic that treats eating disorders and explains that BMI can be used as a tool to diagnose health, but that some doctors use it in racist ways when they don't go beyond obesity to investigate the health of Black women. The title of the Huff Post piece was a poor choice. The BMI is not inherently racists - its a measurement number that is one indicator of health. Maratos-Flier et al miss the point that it is not the BMI scale that is being claimed as racist, but the way doctors do not go beyond the BMI in diagnosing the health of Black women that is racist.
Higher BMI is correlated to worse health outcomes, sure, but that's not the interesting question. The real issue is whether all the "nudging", which is pretty much the only intervention we have, has made anyone skinnier or healthier. I think at some point we're going to realize that public health research has tended to focus on certain problems because they are easy (although not that easy, Brian Wansink couldn't even reach seemingly obvious conclusions about those fat Americans and their huge portions without committing research misconduct) and neglected harder ones -- like, say, infectious disease.
I agree with some of those points. Above and beyond the fact that losing a substantial amount of weight is just really hard (I learned from personal experience), the understandable resentment at feeling judged accounts for a large part of the problem. Attacks on BMI as a metric seem more like misdirected frustration than honest evaluation of the utility of a particular metric.
Where I might disagree with you is the distinction between hard and easy problems. Researching the cure for an infectious disease strikes me as a much easier problem than making the large scale behavioral changes which would be needed to bring down rates of obesity. That being said the obesity rate seems to be leveling off in the US, so I guess we are either getting better at this or bumping up against some genetic ceiling effect.
While efficacious treatments beyond nudging are limited they exist. Bariatric surgery, appropriate for thos with Class II and Class III obesity is effective 80% of patients, leads to durable weight loss and remission of type 2 diabetes.
A few medications, notably the injectable Saxenda, can produce upto 10-15 % weight loss at a year. Responses are variable, and patients need ongoing treatment and monitoring.
Sadly, while surgery is very effective it is not widely available. In fact in order to get it some resort to "medical tourism" to South America. Successful medical therapy requires tough combination of insurance coverage, being in responsive group and ongoing commitment by both patient and provider.
I have 2 wonderful friends, a couple, who underwent the Bariatric surgery, and it changed their world. The health impacts of their extreme obesity were beginning to disrupt their daily lives, and every attempt to lose weight through diet alone had failed. Their high blood pressure issues resolved and not having to deal with the side effects of that medication let them become active as they had always wanted to be. It was good in the short term and good for their long term health. I admit I had my doubts and I was worried for them when they decided to have the surgery, but it’s been 8 years and they’re just healthy. I’m sorry that it isn’t available to all who would benefit from it.
Yes, there’s discrimination against fat people (even by doctors), there are no laws against fat discrimination, some health studies are funded by the diet industry, and dieting is less than 5% effective against obesity.
But it’s nuts to categorize the BMI as racist. When journals such as Scientific American, sacrifice scientific principles by publishing unsubstantiated theory, it should be obvious that grievance studies-type thinking and critical-race politics get too much legitimacy.
Advocacy against fat discrimination (based on actual data) is one thing. But this is not that.
Any comparison of Black compared to white is racist if it does not control for the vast differences in income and poverty. Poor whites have a very high BMI but they are a much smaller portion of the white population so these numbers do not show up until a variable controlling for poverty is used to make the comparison. Please be careful.
Attacking BMI as racist is itself racist. Why would any researcher (even sociologists) want to disarm minority communities from recognizing and eradicating a key factor in morbidity and early death. Obesity is a major factor in Covid deaths, and a disproportionate number of those dying are blacks and latinos. Obesity may not be a complicating factor in all cases, but it is in enough here (and with other diseases) that you have to question the motivation of those seeking to recast a major medical problem as a cultural bias.
Has absolutely everything in life become about race? That Huffington Post article is ludicrous, and it scares me that this is seen as science and not agitprop. The Left is losing its Center.
It’s a sad day when a one time respectable publication comes out with balderdash like that. “Scientific” American is now an oxymoron.
In the Scientific American article, the authors do not claim the BMI is racist. Its a well reasoned essay on the history of white medical practitioners' racist attitudes toward Black women's bodies in which they claimed larger bodies were proof of a Black inferiority. The authors claim that those racist attitudes toward larger Black women continue to the present and mask how interrelated social factors impact black women's health. In this piece, Maratos-Flier et al are incorrect when they claim the Huffington Post article does not include commentary from medical scientists. Jennifer Gaudiani provides convincing commentary. She is an MD, Board Certified in Internal Medicine who completed an undergraduate degree at Harvard and medical school at Boston University School of Medicine, and her internal medicine residency and chief residency at Yale. She runs a clinic that treats eating disorders and explains that BMI can be used as a tool to diagnose health, but that some doctors use it in racist ways when they don't go beyond obesity to investigate the health of Black women. The title of the Huff Post piece was a poor choice. The BMI is not inherently racists - its a measurement number that is one indicator of health. Maratos-Flier et al miss the point that it is not the BMI scale that is being claimed as racist, but the way doctors do not go beyond the BMI in diagnosing the health of Black women that is racist.
Higher BMI is correlated to worse health outcomes, sure, but that's not the interesting question. The real issue is whether all the "nudging", which is pretty much the only intervention we have, has made anyone skinnier or healthier. I think at some point we're going to realize that public health research has tended to focus on certain problems because they are easy (although not that easy, Brian Wansink couldn't even reach seemingly obvious conclusions about those fat Americans and their huge portions without committing research misconduct) and neglected harder ones -- like, say, infectious disease.
I agree with some of those points. Above and beyond the fact that losing a substantial amount of weight is just really hard (I learned from personal experience), the understandable resentment at feeling judged accounts for a large part of the problem. Attacks on BMI as a metric seem more like misdirected frustration than honest evaluation of the utility of a particular metric.
Where I might disagree with you is the distinction between hard and easy problems. Researching the cure for an infectious disease strikes me as a much easier problem than making the large scale behavioral changes which would be needed to bring down rates of obesity. That being said the obesity rate seems to be leveling off in the US, so I guess we are either getting better at this or bumping up against some genetic ceiling effect.
While efficacious treatments beyond nudging are limited they exist. Bariatric surgery, appropriate for thos with Class II and Class III obesity is effective 80% of patients, leads to durable weight loss and remission of type 2 diabetes.
A few medications, notably the injectable Saxenda, can produce upto 10-15 % weight loss at a year. Responses are variable, and patients need ongoing treatment and monitoring.
Sadly, while surgery is very effective it is not widely available. In fact in order to get it some resort to "medical tourism" to South America. Successful medical therapy requires tough combination of insurance coverage, being in responsive group and ongoing commitment by both patient and provider.
I have 2 wonderful friends, a couple, who underwent the Bariatric surgery, and it changed their world. The health impacts of their extreme obesity were beginning to disrupt their daily lives, and every attempt to lose weight through diet alone had failed. Their high blood pressure issues resolved and not having to deal with the side effects of that medication let them become active as they had always wanted to be. It was good in the short term and good for their long term health. I admit I had my doubts and I was worried for them when they decided to have the surgery, but it’s been 8 years and they’re just healthy. I’m sorry that it isn’t available to all who would benefit from it.
Oh for christssake.
Yes, there’s discrimination against fat people (even by doctors), there are no laws against fat discrimination, some health studies are funded by the diet industry, and dieting is less than 5% effective against obesity.
But it’s nuts to categorize the BMI as racist. When journals such as Scientific American, sacrifice scientific principles by publishing unsubstantiated theory, it should be obvious that grievance studies-type thinking and critical-race politics get too much legitimacy.
Advocacy against fat discrimination (based on actual data) is one thing. But this is not that.
Any comparison of Black compared to white is racist if it does not control for the vast differences in income and poverty. Poor whites have a very high BMI but they are a much smaller portion of the white population so these numbers do not show up until a variable controlling for poverty is used to make the comparison. Please be careful.
Attacking BMI as racist is itself racist. Why would any researcher (even sociologists) want to disarm minority communities from recognizing and eradicating a key factor in morbidity and early death. Obesity is a major factor in Covid deaths, and a disproportionate number of those dying are blacks and latinos. Obesity may not be a complicating factor in all cases, but it is in enough here (and with other diseases) that you have to question the motivation of those seeking to recast a major medical problem as a cultural bias.
Has absolutely everything in life become about race? That Huffington Post article is ludicrous, and it scares me that this is seen as science and not agitprop. The Left is losing its Center.