I just read Kate’s entry on diet and fitness guru Bob Greene’s recent claim (pulled from his ass or at the very least not established fact, as you can see from the information she cites) that yo-yo dieting is actually healthier than maintaining a higher weight. I was thinking about how we are willing to accept the statements of “experts” unquestioningly, and how we are so desperate to believe that permanent weight loss is within reach that we are all too willing to uncritically believe comments like Greene’s, or casual, unsupported claims that lots and lots of people are permanently successful at dieting, which I seem to hear a lot.

As I thought about this, I recalled that I was watching this asinine talk show called The Doctors yesterday, because I was stuck at the car dealership for what turned out to be nearly 4 hours. I had already taken a long walk, so I couldn’t think of anything to do other than sit in the customer lounge and watch questionable midday talk programming. This particular episode behaved much like an infomercial involving that one trainer from The Biggest Loser, and was hosted by a dude in scrubs who appeared to be about 20. (Yes, I know he’s really not. I did do a cursory check of the show’s web site, and the guy is an actual doctor. But he kind of reminds me of either a stereotypical frat boy or Devon from Chuck, except NOT so awesome from what I can tell.)

So anyway, the episode included a segment where they browbeat “Chunky B,” an employee of the show (who admitted to a poor diet, lack of exercise, and not seeing a doctor in 20 years, which, OK, is maybe not such a good idea, but I can understand how it might happen), into agreeing to go on a diet. And because no such dramatic change is complete without public fatty-shaming, they weighed him and checked his body fat percentage, blood pressure, cholesterol, and blood glucose right there on the stage, then made him exercise with the trainer lady to demonstrate how unfit he was.

(Incidentally, I had to laugh when she had him stop exercising and measure his pulse. It was 155, and she said with great alarm “that’s way too high!” First of all, the upper end of my recommended heart rate range during exercise is around 160, so 155 does not seem “call the ambulance” bad to me. Second, I realize I’m kind of unusual and most people have lower resting and active heart rates, but I have been running for a few years now and was a regular gymgoer before that, currently log 20-25 miles a week including running for 90 minutes straight the last couple of Fridays, and I have to consciously work to keep my heart rate down near 155 during my runs! I don’t doubt it would be right up there if someone had me start doing all kinds of crazy strenuous stuff–the point of which on the show was probably “look at the clumsy, out of shape, pathetic fatty!”–without warming up. What if the guy had been thin? Somehow I think she’d have found a way to explain away that “way too high” heart rate.)

Anyway, the results were as follows: body fat percentage, 29; blood pressure, 170/100; cholesterol, 189; LDL, 40; and blood glucose, I can’t remember, but it was quite low in relation to the reference range they showed onscreen. Host dude was unflatteringly deflated and surprised that the cholesterol result was OK (though he seemed happier about the borderline LDL number, no doubt because it better aligned with his worldview) and glucose low (by the way, weren’t these supposed to be fasting tests? Of course, maybe he did fast and they just didn’t mention it). Because we all know that every fat person in the world has clogged arteries and Type II diabetes. Also, I’m not a health professional, but I could envision that being publicly shamed for your weight on national television, in addition to possible miscuffing (this dude had huge tree trunk arms) might account for some of the scary BP number.

Or maybe not; maybe the guy really is at death’s door. The point is, they couldn’t know just by looking at him, and to me the segment just reinforced my and many other fat people’s experience with “experts” and with the medical profession–doctors presume to know that you’re unhealthy before they look at a single test result, and if you raise a legitimate concern–like miscuffing accounting for inflated blood pressure readings or possible hypothyroidism, or a concern that you have tried reasonable measures to lose weight and they don’t seem to be working, or a joint injury that is making exercise painful–their need to keep you from “making excuses” for your weight seems to trump their interest in actually looking into these factors and addressing them.

Of course, it is not a coincidence in my opinion that most doctors, dietitians, and personal trainers are naturally thin (fat people are told they’re unhealthy from Day One, are given no credibility for knowing what constitutes a healthy diet, and are not encouraged to excel at physical challenges and probably couldn’t get hired as a trainer in any case because they don’t look the part), so many seem pretty much unable to see that the relationship between diet, exercise, weight, and health can differ from their own experience. So maybe eating and exercising in a similar way to your doctor or Jillian Michaels will make you thin (especially if you used to be thin and happened to put on weight somewhere along the line). Maybe it will not make you thin, but will improve your health. Maybe that regimen would be actively unhealthy for you.

Perhaps most importantly, maybe the thin guy who is seen at the next appointment has habits that are just as (or more) unhealthy than yours, but your doctor doesn’t ask him about it or suggest changes to his diet or activity because he’s thin, so he must be healthy, right? (Or he simply asks “Are you eating a healthy diet and exercising? Still not smoking? Good for you!” whereas a fat person is grilled in detail about the number of calories she consumes and minutes of aerobic exercise per week that she performs, and more often than not is assumed to be lying about both.) At that point, your doctor’s assumptions have resulted in a disservice both to you AND to the thin guy.

I just think that suspending–even for a few moments–the snap judgment that convinces an “expert” that he or she knows everything about the state of my health just from 1) my appearance, and 2) the weight the nurse entered on the chart, would go a long way toward actually improving fat people’s health, rather than using them to make oneself feel superior or viewing them solely as reflections of statistics and stereotypes. And isn’t that the goal, if “The Doctors” in this case truly care about the well-being of their colleague and friend?

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