Science: review

Tom Naughton is a comedian and writer who has a bone to pick with Morgan Spurlock, the creator behind the documentary Super Size Me. Spurlock’s documentary depicted him consuming 5,000 calories a day and gaining 11.1 kilograms (24.5 pounds) from a one month diet consisting of only McDonald’s foods.

Naughton argues that it doesn’t take more than common sense to recognize that McDonald’s foods are high in fat and calories, but to blame fast food for an obesity epidemic is just not credible. Naughton responds in his documentary entitled Fat Head that showcases his analysis of obesity research, nutrition, and the concept of fat-causing heart disease ­— all while loosing weight on an all McDonald’s diet.

Fat Head
The documentary starts off in a doctor’s office where Naughton is receiving a physical and is told the news that he, standing at 180 centimeters and weighting 93.4 kilograms (206 pounds), is obese. While his blood work comes back good and he is told he is healthy, his doctor still tells him to try harder to eat right and exercise. This scene sets up a baseline for the entire movie; there is a social stigma associated with fatness, and weight loss campaigning is rarely only about health and instead primarily about aesthetics.

Naughton launches into an investigation of diets and nutrition, interviewing doctors, nutritionists and civilians. He immediately writes off crash dieting and the concept of creating a calorie deficit by counting calories and exercising.

Political scientist Eric Oliver (author of Fat Politics) argues that there isn’t any real evidence that links weight to heart disease and that BMI (the ratio of weight to height) is not an accurate way to measure obesity in an individual or in society. He observes flaws in conventional statistical analyses of obesity, and states, “How we look at statistics and figures are fuelled a lot more by our cultural prejudices and by framing that’s done by the diet industry and the pharmaceutical industry than in fact the scientific facts behind body weight, mortality and morbidity.”

The film investigates the relationship between paternalism towards fat people and minorities; it suggests that fat people are seen as ignorant, lazy and dirty, and the people fighting the obesity epidemic are often thin and white.

Oliver states that blaming weight is blaming a symptom and not the root cause of being “overweight” and unhealthy. He notes that, often, heavy people don’t like going to doctors because doctors may treat them differently, even poorly, because of their weight. Oliver surmises that it is likely that obese patients have other health problems that are overlooked or remain undiagnosed due to their physical appearance. The result may be that they end up having more chronic health problems or death from a variety of diseases because they aren’t treated properly in the first place. Oliver contends that perhaps if the “overweight” didn’t face discrimination from their doctors they might get earlier check ups for the conditions that later get misattributed to their weight.

Oliver claims there are discrepancies in the statistics demonstrating a causal relationship between obesity and mortality.

“If you were obese and you died of a snakebite, they [The Centers for Disease Control and Prevention] would say it was your obesity that caused your death, not the snakebite,” Oliver says in Fat Head__ .

The Lipid Hypothesis
Naughton goes on to entertain what is known as the “Lipid Hypothesis,” (LH) and a connection between plasma cholesterol level and the development of coronary heart disease (translation: obesity causes heart disease). The LH purports to explain how heart disease is caused by high cholesterol and/or a high fat diet.

But as Dr. Al Sears notes in Fat Head, cholesterol doesn’t cause heart disease; cholesterol is what heart disease acts upon.

Heart disease begins when your arteries become damaged or inflamed and Low-Density Lipoprotein (LDL) then transports cholesterol to heal the inflammation.

LDL damaged from oxidation can penetrate arterial walls, and if inflammation and oxidation continue a plaque can form and cause heart disease.
Oliver charges the research community with routinely ignoring evidence suggesting that the LH may be inaccurate, and claims that some researchers may even be manipulating their data for the sole purpose of conforming to the LH.

The politics of fatness or the obesity-industrial complex
The documentary concludes that the government manipulated scientific research to convince the public that a low fat, low cholesterol diet was necessary to achieve good health. The USDA guidelines may focus more on promoting commodity agriculture than on defining and promoting “health” in its many individualized forms.

Naughton’s (and Oliver’s) unconventional perspectives on obesity — its stigmatized portrayal in the public sphere, as well as how heavier patients are perceived and treated by medical professionals — struck a responsive chord in me.

While I am not qualified to predict whether the views expressed in the film will ever hold-up to the scrutiny of the medical research community, this film provides valuable counter-perspectives to two harmful norms: that of obesity as a choice (one that kills), as well as that of body weight as indicative of health.