All posts by Eric Hau-Yun Chang

 

The invisible enemy

200706_identify1.jpgWhen battling obesity means fighting the body you’re born with.

At age 12, Stacey Eddy weighed over 300 pounds. Her fellow sixth graders’ daily ridicule began on her journey to school. “People wouldn’t let me sit down on the bus because they were afraid I might squash them,” she recalls. In eighth grade, the bus driver assigned her a seat at the front of the bus so that she would at least have a place to sit, but that only made the teasing and taunting worse.

For the last seven months, Eddy, now 33, has made the 10th floor of Columbia-Presbyterian Hospital in New York City’s upper Manhattan her home and losing weight her full-time job. She has come from Long Island, New York to participate in a study on why people have to struggle to keep weight off. At 5 feet 4 inches tall, Eddy currently weighs 308 pounds, a monumental improvement from the 420 pounds she weighed two years ago.

Her hospital room is filled with dozens of Poland Spring water bottles, seltzers, diet sodas, and a small refrigerator containing a carefully portioned liquid diet that, according to Stacey, is “as appetizing as baby food.” With her easy smile and chatty disposition, Stacey speaks candidly about her lifelong obesity. Over 20 years after sixth grade, her bus rides aren’t much different, except that her schoolmates have been replaced by strangers who volunteer such unsolicited advice as, “You should look into gastric bypass surgery.” These daily slights are status quo for the obese. Dealing with them requires a strong mind and a will to persevere in spite of other people’s ignorance — qualities that stand out in Eddy. She, and others like her, are engaged in a war on two fronts. The first is a battle against their own bodies; the second is against those who don’t believe the first battle exists.

The stigma against the overweight and obese looms large in our society; fat people are seen as lazier, less intelligent, and weaker-willed than the average person. The obesity stigma is so severe that it can even spread to others who are not overweight. A recent study at Rice University showed that sitting next to or associating with an obese person decreases your own attractiveness and leaves a negative impression in the eyes of others. The study showed that prospective employers gave lower ratings to a male applicant whose photograph showed him seated next to a heavy woman. When the same applicant — with exactly the same resume and qualifications — was seen seated next to an average-weight woman, he received higher ratings.

This hiring prejudice is just one of many inequities that the obese face; they must also deal with a decreased likelihood of promotion, higher insurance premiums, and with earning about 12 percent less than the non-obese. These persistent biases arise from the assumption that obesity reflects personal choice or a lack of self-discipline. They suggest that the world’s latest health epidemic is a man-made predicament, and that those to blame are the fast food industry and the people who lack the moral resolve to refuse a second serving. According to the Centers for Disease Control, the prevalence of obesity among adults in the United States has reached an astounding 33 percent, affecting 65 million Americans. If obesity is really the result of poor choices and moral failing, then the United States has much more than a health problem on its hands. With so much extra fat on America’s waistlines, scientists are reexamining a central question: Is obesity simply a lifestyle choice, or is it preordained in one’s genes?

It’s all in the family

Lamont Daye is a gregarious 44-year-old with dark sunglasses and an infectious smile; he’s about 5 foot 6 inches tall and weighs 270 pounds. His wife Traci is 34 and weighs about 280 pounds. Sipping coffee at a Manhattan cafe, they relate their lifelong struggles with weight. Both of them have been on diets and 12-step programs like Overeaters Anonymous with limited success. Exasperated at the apparent unfairness of nature, Lamont describes his cousin Tony, who just can’t seem to gain weight because of his fast metabolism. “Tony will eat all the stuff in sight and won’t gain an ounce. If I eat one slice, it’s like — boom!” Lamont motions to his stomach. Traci, who has been more reserved, perks up, “I have friends that complain that they can’t gain weight, and I just want to choke them!” She says this without maliciousness, but with a tinge of frustration. Lamont and Traci’s struggles mirror those of Stacey Eddy; all three of them are trying to lose weight, but their bodies are fighting back. And they all recognize that their bodies are fundamentally different from others who can indulge in food without a second thought.

Science has confirmed this perception. Despite the societal conviction that weight is a choice, whether or not someone becomes fat is largely in the genes. The heritability of obesity is comparable to that of stature. While it’s commonly accepted that one can’t do anything to become taller or shorter, the variability in weight poses more of a conundrum. A 1986 study of adopted children and a 1990 study of twins, both performed by Dr. Albert Stunkard of the University of Pennsylvania, indicated that 70 to 80 percent of our weight can be accounted for by our genes. This means that the environment in which adopted children and separated twins are raised counts for much less than most people think.

Quite simply, obesity runs in families. Traci’s parents are both obese, as are Lamont’s. In addition, high blood pressure and diabetes are common in both of their families. That family history doesn’t bode well for their four young children despite Traci’s hopes that they don’t also become heavy. “I wouldn’t wish this on anyone,” she says.

Back in Eddy’s hospital room, she talks about her overweight mother who chose to have gastric bypass surgery 20 years ago — something that Eddy would never consider doing herself because her mother is often sick and frequently vomits. Eddy wants to lose the weight naturally, by using her mind to battle the genes she was born with.