The Blog of Michael R. Eades, M.D.

As a group the elderly are keenly health conscious. Probably as a percentage of their population more elderly try to eat right and take care of themselves than any other group. And with good reason since the Grim Reaper is lurking right around the corner waiting to harvest them at the earliest opportunity. Senior citizens have seen their friends and relatives succumb to disease and realize more than most how precarious life really is.

But the elderly have a problem. Most of them get their health information from the mainstream press. And as regular readers of this blog know, the mainstream press is more often wrong than right. (See Gina Kolata’s review of Gary Taubes’ book in last Sunday’s New York Times and you’ll see what I mean.)

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A commenter today made me remember yet another reason that observational studies such as this one are never to be used to determine causality that I didn’t mention in the original post. It’s important enough that I want to post it here so that those who don’t read the comments and/or my responses to them will read it as well. Here is my response to the comment:
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American tourist at Dauchau

A type of activism called fat acceptance activism - or in the words of all the isms we’re now afflicted with: Sizeism - is currently on the move. Overweight people who are the movers and shakers of the various fat acceptance groups are trying to make the point that it’s okay to be overweight and that one should revel in one’s fatness and not try to deal with it. I don’t really have a problem with this way of thinking as long as people are willing to accept the risks that ride along on obesity’s coattails.

I think it’s fine that overweight people are trying to gain acceptance. I don’t believe that they should be discriminated against anymore than I believe people with leukemia or high blood pressure should be discriminated against. But, obese people need to realize that in the vast majority of cases their obesity is self inflicted.

I can’t tell you how many patients I’ve seen in practice who say these very words: Doctor, I just can’t understand it. I almost don’t eat anything at all and I can’t lose weight. My husband (it’s usually a female patient that says this) eats everything and he never gains weight. As we’ve seen self deception is an easy task.
I’ve made it a hobby to watch people at all-you-can-eat buffets, and what I see is obese people piling the food on their plates- mainly high-carb food - and going back for more. Thin people go back to their tables with small plates of food. I often wonder how many of these people with the huge plates of food are telling their doctors that they don’t eat much of anything at all yet still can’t lose.

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