The plague we don't speak of

We direct the fashionable outcry of each generation against those vices of which it is least in danger and fix its approval on the virtue nearest to that vice which we are trying to make endemic. The game is to have them running about with fire extinguishers whenever there is a flood, and all crowding to that side of the boat which is already nearly gunwale under. Thus we make it fashionable to expose the dangers of enthusiasm at the very moment when they are all really becoming worldly and lukewarm; a century later, when we are really making them all Byronic and drunk with emotion, the fashionable outcry is directed against the dangers of the mere "understanding". Cruel ages are put on their guard against Sentimentality, feckless and idle ones against Respectability, lecherous ones against Puritansm; and whenever all men are really hastening to be slaves or tyrants we make Liberalism the prime bogey.

-- a demon character in CS Lewis's The Screwtape Letters

If I believed in demons, I would certainly see signs everywhere that they are using the Screwtape strategy in our society today, to considerable effect. Moralists rail against unconventional sexual behavior and sexual content in the media -- in what remains the most absurdly sexually-puritanical nation in the Western world. Political correctness urges vigilance against any manifestation of "Islamophobia" -- while Islamists openly preach and plot the annihilation of our civilization. And we fret endlessly about anorexia and sneer at people we judge to be "too" thin -- in the midst of the most massive (in more senses than one) obesity epidemic in world history.

The term "epidemic" is not inappropriate. It’s like living in the middle of some terrible plague that no one else seems to notice. Most Americans are overweight, a significant fraction -- casual observation suggests 15% to 20% if not more -- grotesquely so. And there’s no doubt that all this excess fat is doing people a wide range of different kinds of harm. Besides the well-known risks of clogged arteries and heart trouble, excess weight increases the risk of cancer, has worse overall health effects than smoking or heavy drinking (with predicatble effects on health costs), and is even associated with a decline in mental function, probably due to its effects on blood vessels within the brain. It's increasingly clear that even a small amount of excess weight is bad for health and longevity.

While an individual’s degree of vulnerability to obesity is to some extent influenced by his capacity for self-restraint (political correctness notwithstanding), it would be wrong to view excess weight as a sign of some moral failing. The urge to eat, after all, is natural and healthy; indeed, it’s essential for survival. Evolution designed us to like and seek out tastes such as meat or sweetness which were the mark of energy-rich food. For hunter-gatherers, eating too much is rarely an issue. A day when you can get enough to eat is a good day. Today we have abundant food available at all times -- a situation unprecedented in our evolutionary history. Pleasurable tastes can be artificially concentrated and intensified in quasi-foods such as candy. Meat, a rare energy-rich treat for our ancestors or for our chimpanzee cousins today, can now be had in unlimited quantities by almost everyone. And while primitive humans led strenuous lives out of necessity, our technology encourages an almost sedentary existence. It’s not surprising what is now happening to us as a result.

If it is rightly considered improper to personally attack people for being fat, no such taboo seems to apply to the frankly bizarre habit some people have developed of insulting and sneering at anyone they perceive to be too thin. The exact nature of the psychology behind this escapes me, though a number of obvious possibilities suggest themselves. For some reason, though the individuals who spew such insults can be of either gender, the targets are almost always slender women, rarely men.

The fact is, the preponderance of overweight people in our population is distorting our sense of what the human body is supposed to look like. What is biologically healthy or unhealthy remains healthy or unhealthy regardless of how social attitudes change. Let me use myself as an example. I’m half an inch under six feet tall, and for most of the last few years I’ve weighed very close to 200 pounds. This is actually 20 pounds above the point where my weight starts to shorten my statistical life expectancy; yet at my previous job, on two separate occasions, I overheard people referring to me as "skinny". If I hadn’t set out to educate myself on the subject -- and pushed a less-than-eager doctor to give me a frank assessment -- I could easily be totally unaware that I have a weight problem. (Over the last month or so I’ve gotten it down to 195.)

Some people who suffer from being overweight have committed themselves to the changes in diet and exercise necessary to regain their health -- a course all the more admirable for its extreme difficulty. Many more want to lose weight but have no idea how to start, or are misled by the countless fads and gimmicks on offer. Some honestly don’t realize there is anything wrong. What is truly despicable, however, is the "fat acceptance" movement, which actively works to de-motivate people from the hard work needed to overcome a deadly-dangerous syndrome. Try to imagine how much blood a similar "smoking acceptance" movement would have accumulated on its hands over the last couple of decades, and you’ll have some idea of what these people have to answer for.

In the end, I suppose, technology will alleviate this problem as it has so many others; low-calorie foods for a broad range of tastes are already proliferating, and demand will encourage this trend (though I don’t see how technology can substitute for exercise, which remains a necessity for true well-being). In the meantime, we need to be fully aware that our country is in the grip of a vast, lethal epidemic which few of us have entirely escaped -- and we need to support, not denigrate, those among us who are struggling to become or remain healthy.