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140: Mythbusting about fat and BMI with Dr. Lindo Bacon
4th July 2021 • Your Parenting Mojo - Respectful, research-based parenting ideas to help kids thrive • Jen Lumanlan
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This episode kicks off a series on the intersection of parenting and food.   We begin today with a conversation with Dr. Lindo Bacon, where we bust a LOT of myths about the obesity epidemic that is said to be plaguing people in the United States and other countries that follow a similar diet.   The messaging we get from government entities seems pretty simple: being fat is bad for you. It causes increased risk for a host of diseases as well as early death. If you're fat, you should lose weight because then your risk of getting these diseases and dying early will be reduced.   But what if this wasn't true?   What if this messaging had been established by people who own companies that manufacture weight loss products who sit on panels that advise international governmental entities like the World Health Organization?   What if body fat was actually protective for your health?   We dig into all these questions and more in this provocative interview.   We'll continue this series with episodes looking specifically at sugar, as well as supporting parents who have or continue to struggle with disordered eating, and how to support children in developing eating habits that will serve them for a lifetime, not just get the vegetables into them today.   Jump to highlights:
  • (01:00) Introducing Dr. Lindo Bacon and starting our series of episodes on the intersection of parenting and food
  • (02:22) Stripping the word ‘fat’ of it’s pejorative meaning and reclaiming the term while acknowledging that it may be jarring for some people
  • (03:09) Kicking off the conversation with how we measure health using BMI and how it might not be accurate
  • (05:03) The resistance to Katherine Flegal’s seminal research in weight and longevity
  • (05:49) The development of the Body Mass Index was with scientific bias to fit the bell curve
  • (07:30) Higher body weight does not necessarily mean a person has greater risk of poor health
  • (10:59) We actually know that the research is highly exaggerated in terms on the role that it plays on health
  • (13:16) Dr. Bacon’s turning point: When they found out that BMI recommendations were created by an organization funded by pharmaceutical companies who produce weight loss drugs and products
  • (17:35) Taking the issue one step further with the American Medical Association’s recommendation whether to categorize obesity as a disease or not
  • (19:19) The Obesity Paradox is an observation in the research that people who are obese who get the same diseases as those with ‘normal’ weight are living longer
  • (21:15) The concept of dieting just doesn’t work according to the data
  • (30:33) A story of Dr. Bacon’s and their father’s knee problems
  • (34:40) Individual factors only accounts to 25% to somebody’s total health outcomes and social determinants account to about 60%
  • (42:05) It is cool right now to be your authentic self but not everyone can so easily be their authentic self when their authentic selves are not valued by society at large
  • (45:48) Improving the health of individuals is more communal than individual
  Resource Links:   [accordion] [accordion-item title="Click here to read the full transcript"] Jen Lumanlan  00:02 Hi, I'm Jen and I host the Your Parenting Mojo Podcast. We all want her children to lead fulfilling lives, but it can be so hard to keep up with the latest scientific research on child development and figure out whether and how to incorporate it into our own approach to parenting. Here at Your Parenting Mojo, I do the work for you by critically examining strategies and tools related to parenting and child development that are grounded in scientific research and principles of respectful parenting.   Jen Lumanlan  00:29 If you'd like to be notified when new episodes are released, and get a free guide called 13 Reasons Why Your Child Won't Listen To You and What to Do About Each One, just head over to YourParentingMojo.com/SUBSCRIBE. You can also continue the conversation about the show with other listeners in the Your Parenting Mojo Facebook group. I do hope you'll join us.   Jen Lumanlan  01:00 Hello, and welcome to the Your Parenting Mojo Podcast. I'm very excited about our episode today because we're at the very beginning of what I hope is going to be quite an extended series of episodes at the intersection of parenting and food. And I'm hoping to look at ideas like eating disorders and intuitive eating and how sugar impacts our children and what we should do about that, if anything, how we should approach eating issues with our children more broadly and how we can all be a little bit happier in our bodies. And today we're kicking off this series with Dr. Lindo Bacon whose seminal book Health at Every Size was written over a decade ago now and which exposes how the ideas that most of us believe about body fat and weight are actually not grounded in scientific research. She followed that by co-authoring a book called Body Respect, and her most recent book is called Radical Belonging: How to Survive and Thrive in an Unjust World (While Transforming it for the Better). Dr. Bacon earned their PhD in physiology from the University of California Davis, where they currently serve as an Associate Nutritionist. They also hold graduate degrees in Psychology and Exercise Metabolism. Dr. Bacon is industry independent, which means they have pledged not to accept money from the weight loss, pharmaceutical or food industries, which makes them almost unique among non governmental researchers on issues related to weight and food. Welcome, Dr. Bacon. I'm so glad you're here.   Dr. Lindo Bacon  02:20 Thanks, Jen. I'm looking forward to talking to you.   Jen Lumanlan  02:22 And before we get started, I just want to acknowledge that I'm going to follow your lead in your books by using the word fat in this interview and using that in a way that's really been stripped of its pejorative connotations. And many people it seems who are fat, who are now reclaiming the term in this way. But I do acknowledge that it may be jarring to some listeners to hear if they aren't accustomed to hearing it like that.   Dr. Lindo Bacon  02:45 Yeah, I think it's important to name all of that. So thank you, Jen. And I also just want to note for the listeners that if you do feel uncomfortable when you hear the word, then that's something helpful to look at, because that really shows that you've absorbed the cultural ideas about that. And hopefully, we can start to normalize it so that you could feel better about it.   Jen Lumanlan  03:09 Yeah, and hopefully this conversation is going to be a big part of that as well. So I wonder if we can start at the beginning with what I know is a big topic as it were, which is how we measure health. And so this body mass index, or BMI for short, has become the standard measure of how much weight a person is carrying compared to their height. And it's best considered an indicator of how healthy they are in some way. And it's used by everybody from the Centers for Disease Control in the US to the World Health Organization. Is the BMI actually a good measure - I guess I should start by saying of anything at all and then we can go from there and to health.   Dr. Lindo Bacon  03:47 You right. I think that your question already answered itself, but it really does not play much of a role in health at all. And I think that its use has been quite damaging to people. So I wish that the medical industry would throw it out.   Jen Lumanlan  04:03 Yeah. So where did it come from? How did we end up here?   Dr. Lindo Bacon  04:07 Well, it actually was written by or devised by someone who was a statistician looking at insurance, and that it wasn't meant or designed for health. And it was meant to look at what's going on in a population, not what's going on in an individual. And it's amazing when you start to look at the research of how it corresponds to health and you find some really surprising things. For example, it's pretty clear from the research that that the people that are in that category we call overweight are the people that are living longest. Most research studies are showing that and the people that are in the obese category, most of them are living as long as people in the normal weight category, or the I'm sorry that we call normal wait.   Jen Lumanlan  05:03 Yeah   Dr. Lindo Bacon  05:03 Right. And it's only really at the very extremes that you start to see things that are different. Mm hmm. And but yet, the end, there was an expose a that was actually published just a few days ago by a former CDC researcher, who was her name was Katherine Flegal, and she actually did some of the seminal research in weight and longevity. And the history she said, of how she was shut down, and how all of people in industry were trying to discredit her, it was just amazing to see how much resistance she ran up against, and how people fought her.   Jen Lumanlan  05:49 Yeah, it's, I think that that seems to be quite pervasive. And I think we're gonna talk some more about how political issues impact the way that we think about these things. But I just want to really be crystal clear about this, we were talking about somebody who was a statistician who developed the original idea of the BMI and was looking to understand and define the characteristics of normal man. And we can insert the word white in the middle of there I assume. And fitting that distribution around the norm. He wasn't, you know, he's not looking to understand an individual person's health. He's trying to find this statistically interesting relationship that fits the bell curve. And somehow we've latched on to this idea, and we're using it to try to say whether an individual person is healthy or not?   Dr. Lindo Bacon  06:38 Right? I know, it's really interesting. I think about, like, if you did a height curve, you would come up with the same bell curve. And I would be all the way the extreme end in the 5%, because I'm rather short. But obviously, that doesn't indicate disease. You know, it's just, there will be some people who are on the extremes of the bell curve. That's the nature of bell curves.   Jen Lumanlan  07:04 Right. Yeah, somebody has to be there. Okay. And so I'm wondering if we can look at this sort of commonly accepted wisdom that people with higher body weight have a greater risk of poor health, and you've already sort of indicated implied and mentioned that that's not necessarily the truth.   Dr. Lindo Bacon  07:23 Right.   Jen Lumanlan  07:24 What's going on here? Why is the commonly accepted idea different from what the research is actually showing us?   Dr. Lindo Bacon  07:30 Right. Well, as I mentioned, with the suppression of the researcher, who came up with this, one of the things that was fascinating to me in that was, nobody debated her with actual data that challenged it. It was more just, you know, like, they didn't want it out. Right. And that that was what was fascinating. And still to this day, you'll see almost regular reports in the media about how damaging that is. And one of the things that I want to suggest is that every time we see a new research study, we've got a look at whether our belief system is so strongly entrenched, that we see through that lens, and we can't really see our data anymore. And that's what's happening. So for example, if you have a research study that shows that the majority of people that have diabetes are fat, then they'll make the conclusion that if you're fat, you're going to get diabetes. Right. And we do, in fact, have that research that shows that, but that research doesn't demonstrate that it's the fat that's causing the disease. There could be other mitigating factors that play a role. For example, there's one obvious factor that's going to play a role. And that's that the people that are fatter meet up with a lot of weight stigma, people don't treat them as well. And we know from the research that when people are stigmatized and disrespected, it wreaks havoc in their body and increases health problems. So it's very clear that that's an example of something that's a contributor, and we can come up with a lot of other contributors. But when we start to kind of tease everything out, we just don't have solid research that shows that it's causative of most of the diseases for which it's blamed.   Jen Lumanlan  09:39 Yeah, and I think that's such a super important point that there is a ton of evidence linking these two things, they are correlated, they vary together. And then there's, there are fun things you can find online to find completely unrelated things that happened to be co-correlated and you know, things that are wildly, wildly unrelated and could never be connected and they're correlated. So they must be, you know, one must cause the other right? When no that's not the case. It's entirely possible that diabetes may be maybe a contributing factor to increase body weight. That one of the other factors may be causing the body weight. We just don't know. I mean, I mean, and that's not the story we're told, right? The story we're told is, if you get fat, you're going to get these chronic diseases.   Jen Lumanlan  10:28 Right.   Dr. Lindo Bacon  10:29 And just to throw in a kind of a funny story there, I actually saw research that was showing that there are more drownings that happen among people that eat ice cream. Right.   Jen Lumanlan  10:44 I'm never eating ice cream again.   Dr. Lindo Bacon  10:44 Which doesn't make sense. You eat ice cream in the summer and you're more likely to be in the water. Right. But it's not the ice cream that's causing the drowning.   Jen Lumanlan  10:53 Yeah, thank you.   Dr. Lindo Bacon  10:55 That's just an example that shows that.   Jen Lumanlan  10:58 Thank you for that.   Dr. Lindo Bacon  10:59 And I should also say that we actually do know a lot about this, that the research that has tried to tease out a lot of these things, find that it is highly exaggerated in terms of the role that it plays in health. And so that's very clear from the research. But, of course, it's not what people are saying. And I think every time we see a disconnect between what's commonly believed, and what this data actually shows us that one of the big reasons that's going to underlie that is you have to ask, well, who benefits from us not understanding. And there is a huge industry of people that are making money off of our body hatred. It's not just the diet industry and certain aspects of the health industry and the bariatric surgeons, but it's also people that sell cars, can sell them off of the ability that you're going to be sexy, and, you know, fine, and everybody's gonna want you if you drive this car. So everybody seems to capitalize on our insecurity in order to make money. The more we hate ourselves, the more they can use it.   Jen Lumanlan  12:22 Yeah, okay, so let's follow that thread for a minute, then, because there are some super concrete pieces to this as well and around following the money, which is a big reason that I wanted to talk to you, because you do not accept money from outside sources that are affiliated with the industry. And it seems pretty clear that when you look at research that's funded by industries, you know, soft drinks and juice and milk, the results are four to eight times more likely to be favorable to the funders product than when that study is not funded by the manufacturer of the product. And the same goes for the drug trials. And a lot of the weight loss drug papers, you know, the scientific papers are written by the very company that is trying to sell us this medicine. They supply the text to the researchers, and then the researchers publish it. It's almost mind boggling the extent to which this infiltrates what we think of as value neutral science.   Dr. Lindo Bacon  13:16 Right? And I tell you, it makes my job hard because I'm a scientist, right. I'm supposed to be looking at data. And I don't trust most of the research that's coming out, because I know what goes on behind the scenes and how much manipulation there is. And I'll give you an example of this, because I think it's really helpful to see and it's about BMI. And the reason I'm going to give this example is because it really marks the turning point in my career and why I'm talking about these issues today. So I'm going to take you back to 1998 when I was getting my PhD in physiology, with a specialty in weight science. And there was one magical day in June I forget the the actual date that millions of Americans, I think it was 21 million Americans went to bed and normal healthy bodies. And they woke up the next day with a medical designation of being fat and a prescription that they're supposed to try to lose weight. And that wasn't because everybody gained weight overnight. That was because the government lowered our standards for what they would be calling overweight and obesity. Now, I was shocked that they did that, because I was in the middle of my literature review. And what I was seeing was that if anything, we should majorly raise those numbers, not lower them. So I wanted to look at why they did what they did. And I found out which group had devised the government on this and a lot of the advice that they took came from the National Institute of Health advisory panel. And fortunately, I knew somebody that was on that. And I called

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