The Other American Expansionism

Julia Belluz flags new research showing that American waistlines continue to grow:

Overweight peopleResearchers looked at waist circumference measurements taken from over 32,000 adults in 1999 and 2012. During that period, participants’ waists grew nearly a whole pants size, from 37.6 inches to 38.8 inches. Some groups gained an even more significant amount of abdominal girth. White women, aged 40 to 49, experienced a 2.6-inch expansion; the waists of black men, aged 30 to 39, got padded with 3.2 extra inches; Mexican-American men, aged 20 to 29, added 3.4 inches to their frames; Mexican-American women over the age of 70 packed on 4.4 inches; and black women between the ages of 30 to 39 increased their waists by 4.6 inches. (Abdominal obesity was defined as a waist circumference greater than 40 inches in men and 35 inches in women.) That racial minorities are experiencing greater gains maps on to the fact that they’re also disproportionately struggling with obesity compared to white people in the US.

Interestingly, Americans’ average body mass index has held relatively steady over the past decade. Or as Alison Bruzek puts it, “People haven’t been getting fatter, but their waistlines are still increasing”:

“We’re a little bit puzzled for explanations,” Dr. Earl Ford, a medical epidemiologist at the Centers for Disease Control and Prevention and lead author of the study, tells Shots. The two measures are closely related: While body mass index or BMI measures fat overall, waist circumference helps measure fat distribution. Stress, hormonal imbalances, environmental pollutants, poor sleep or medications that help pack on abdominal weight are possible causes, health and nutrition researchers speculate. And older adults typically lose muscle as they age, while fat continues to increase.

(Photo by myLoupe/Universal Images Group via Getty Images)

The Gay Women’s Health Crisis

by Dish Staff

Well Being Gallup

Shannon Keating flags a recent Gallup survey on well-being that shows “queer women lag behind straight women where queer men do not lag behind straight men as much – or even at all”:

Differences in physical well-being between straight and queer men, for example, are too small to be statistically significant; the overall deficit in physical well-being for the LGBTQ community at large is driven entirely by the low scores of queer women (24 percent to straight women’s 36 percent). Gallup indicates that reportedly high levels of smoking and drinking among lesbians and bi women could be a potential contributor to the discrepancy. I’ve seen from accompanying girlfriends on many a smoke break outside of bars how cigarettes and alcohol remain an obstinate fixture of queer girl culture.

Further, where queer men assess their communities with close to as much contentedness as straight men, queer women feel less connected to where they live than their straight female counterparts. Just 31 percent of queer women feel they are thriving in terms of community involvement, safety, and security, a full 9 percent less than straight women.

A recent national survey from Stop Street Harassment helps explain why queer women feel unsafe. The major finding – that two-thirds of American women have experienced street harassment at some point in their lives – is bolstered by two smaller key findings: Seven in 10 LGBT people have experienced street harassment by age 17, compared to 49 percent of straight people, and 41 percent of people of color say they experience street harassment regularly, compared to just a quarter of white people.

Relatedly, a reader flags this item:

A federal study to determine why 75 percent of lesbian women are obese and gay men are not has totaled nearly $3 million. … Researchers at Brigham and Women’s Hospital have come to several conclusions since studying “the striking interplay of gender and sexual orientation in obesity disparities,” which is slated to last until 2016. They have determined that gay and bisexual males had a “greater desire for toned muscles” than straight men, lesbians have lower “athletic self-esteem” that may lead to higher rates of obesity, and that lesbians are more likely to see themselves at a healthy weight even though they are not, the Free Beacon reported.

Update from a reader:

It astonishes me that anyone can look at those numbers and only see a crisis for gay women. True, they are the worst off by a big margin – I am not trying to minimize the main point of the article at all. But almost as shocking is the 6- to 8-point gap between men and straight women. Why is it not even mentioned that men generally are much worse off than women in this regard? (At ~5% of the female population, the lesbian numbers would bring women’s overall score down by about half a percent.)

Possibly because the suffering of men tends to get erased in favor of focusing on the suffering of women? Just saying, the fact that the male population as a whole is significantly less healthy than the female is also a big. fucking. deal, and one that affects far more people in absolute numbers. I guess us dudes are just so privileged to get to live sicker and die sooner.

Who Wants To Tell A Kid He’s Fat? Ctd

A reader writes:

I am an emergency room pediatrician, and your post about reluctance to tell a patient he or she is fat struck home. Overweight and obese children, aside from the well-publicized risks of diabetes, hypertension, and heart disease later in life, are at increased risk for things like injury (because when they fall their weight makes them more likely to be seriously hurt) and delayed diagnosis of appendicitis (because it is much harder to rely on an exam of an obese child, and radiology exams like ultrasound are much less reliable in overweight children.) The same mind-set that says “every kid deserves a trophy” is at work here. Doctors, and perhaps more so parents, are so afraid of harming a child’s self confidence that we refrain from telling the truth.

In addition, remember, most of us work in practices where we are judged on “patient satisfaction,” meaning we have to avoid saying or doing things that might upset parents. I have been cursed at by parents for even suggesting that weight loss might improve there child’s health.

Along the same lines, I’ve had parents walk out of the emergency room when I told them that the biggest risk to their asthmatic child’s health was the parent’s smoking. In some states, mentioning gun safety and risk (gunshot wound being the most likely cause of death after a car accident for most of the pediatric population) can land you in jail. Under Obamacare, hospitals and physicians can be docked pay if their patients aren’t satisfied enough.

Society has come to a place where hard truths are the last thing many want to hear. Most physicians, most of the time, would rather not buck that trend.

Another reader:

Your post struck such a chord for me. I’m the father of two young-adult daughters who are morbidly obese. They were above-average on the height/weight charts pretty much from birth, and compulsive overeating runs through both sides of our family. Our pediatrician was a wonderful person, yet it was clear that she had no training in or comfort level with addictive eating disorders as they relate to children. This is somewhat understandable since research on the psycho/bio-chemical triggers for overeating is still pretty new. But even when we quizzed our pediatrician about the issue and urged her to look into it more, she found that there just isn’t much info out there that will give doctors the comfort level they want before broaching such a volatile subject.

I feel like my wife and I failed our daughters. We couldn’t figure out how to balance being too restrictive with being supportive. We talked with both our daughters about it a lot and made them aware of the issues. But both daughters are morbidly overweight.

Yes; personal choices by the parents and the child matter in childhood obesity, but there are built-in societal causes (high-fructose corn syrup anyone?) and hereditary factors (addiction) that drive these negative outcomes for those with the predisposition. I only hope that pediatric practice will continue to improve its knowledge of this subject so that effective and compassionate interventions can someday become the norm.

Who Wants To Tell A Kid He’s Fat?

Not pediatricians, according to Russell Saunders, who admits, “I absolutely hate talking to patients about being overweight”:

Reading the results of a new study from the Centers for Disease Control (PDF), I couldn’t help but wonder if other medical providers are even more reluctant to talk about weight with their patients than I am. Using survey data collected from children ages 8-15 from 2005-2012, the study finds that roughly a third of children and adolescents misperceive their body status. Only 23 percent of overweight children knew they were heavier than was healthy, and 41 percent of obese respondents thought their weight was about right. …

When overweight children are roughly similar in appearance to many of their peers, it takes someone telling them their weight is unhealthy for them to realize it. Though the study does not report on the reasons for the rate of body status misperception among overweight children, I strongly suspect it’s that those conversations simply aren’t happening. Further, I suspect they’re not happening because they are so challenging. Trying to tell little girls and boys that their weight is too high without making them feel bad about themselves or their appearance is a daunting task. It’s relatively easy to give across-the-board recommendations about what comprises a healthy diet and getting enough physical activity. Discussing what changes a specific child might need to make to get back into a healthy weight range is trickier, and clearly isn’t happening nearly as often as it needs to be.

As important as fostering self-esteem in children is, medical providers cannot be so afraid of damaging it that they sidestep sensitive but clear conversations with patients and their parents when the child’s weight is unhealthily high.

One medical provider who doesn’t have such qualms: