In a CNN piece about as groundbreaking as the remake of Starsky & Hutch, Tammy Worth asks whether the fat acceptance movement — which she defines rather broadly as including the Dove Campaign for Real Beauty — will "undermine the progress being made toward heart health?" Worth notes that "studies have indeed shown that fit overweight or obese people have cardiovascular mortality rates that are lower than thin, unfit people." "But," she asks, "are such studies just an excuse for overweight people — most of whom aren't fit — to remain complacent about excess weight?" Adding to the panic over complacent fatties is Dr. Barry Franklin of the Cardiac Rehab Program and Exercise Laboratories at a Michigan hospital. He tells Worth,
I don't want to take on any specific organization...but a social movement that would suggest healthy at any size in many respects can be misleading. We can't say that every overweight person is healthy.
Of course, his comment suggests a misunderstanding of Health at Every Size — no one would say that every overweight person is healthy. Like all humans, overweight people suffer from a variety of ailments. Some ailments may be related to their weight, but as it turns out, this is also true for thin people. Especially in women, fat plays a role in building bones, so women with less fat may be at higher risk of breakage and osteoporosis.
From stories on the risks of both obesity and weight loss, it's easy to get the message that you need to be thin but not too thin, that you need to watch your diet but also watch how you're watching your diet, lest you slide over the magic threshold into unhealthiness. Franklin tells Worth "that people who are overweight or obese already have one strike against them in terms of heart health, and need to compensate by monitoring other factors like exercise, blood pressure, and blood sugar," and given all the things that supposedly need "monitoring," it's hard to imagine how anyone could be complacent. Indeed, many of us, regardless of weight, live in a constant state of feeling like we're failing health class, because paying attention to the myriad and often conflicting recommendations we get every day would leave us with no time for anything else.
Maybe the solution is not to keep trying and failing, but to accept that perfect health is something of an illusion. That's the message of Live a Little! Breaking the Rules Won't Break Your Health, by Dr. Susan Love. Love tells Tara Parker-Pope of the Times Well blog that "the goal is to be as healthy and have as good of a quality of life as you can have. It's not to be thin." More broadly, she says, "the goal is not to get to heaven and say, 'I'm perfect.' It's to use your body, have some fun and to live a little." In an age when health often seems more like a Sisyphean struggle than a comfortable state, Love's words are pretty refreshing.