“The Weight of the Nation” Pros and Cons (so far…)

Posted By elissa on May 17, 2012 | 1 comment

I watched Part I of the HBO documentary, “The Weight of the Nation” online, last night. I hope to catch Part 2 later tonight.

For the most part, I liked what I saw. The producers did a good job of conveying the complexity of obesity, and the roles that poverty, genetics, food culture and the built environment play (in addition to the usual “personal responsibility” issues of diet and exercise). The people struggling with obesity and/or diabetes were treated with dignity; and the medical experts that were interviewed did a good job of explaining themselves. The show was blunt, and even graphic at times (the comparison of post-mortem normal vs. diseased hearts made me wince), but not gratuitously so.

In other words, “The Weight of the Nation” is as serious as a stroke.

Nonetheless, I don’t think Part I did a very good job of…

1. …drawing a line between overweight and obese. While “obesity” was stressed, the impression I was left with is that all excess body fat is… well, “death fat.” It was almost as if the writers felt that “overweight” was just a brief, transitional stage between “healthy” and “obese.”
2. …conveying the nature of risk. Obesity is a risk factor for cardiovascular disease and type 2 diabetes. But increased risk does not imply inevitability – a distinction that was constantly blurred. In truth, some 25% – 30% of clinically obese folks are metabolically healthy. Conversely, having a “healthy” BMI is no guarantee of metabolic health – thin “fat” people are very much at risk for CVD and diabetes, too.
3. …making a distinction between the effects of eating too many calories… and eating too many calories from high fat/sugar, low nutrient-density foods. Yes, the two often overlap, but I think it’s still possible to tease them – and their effects – apart. For example, one part of the show focused on a woman enrolled in a study, where the goal was to have the (already overweight) subjects gain an additional 5% of their starting weights. She was instructed to add 1000 calories/day to her diet – all from fast food. Not surprisingly, various markers of risk increased along with her weight. This was attributed (at least on screen) to her weight gain… but was it solely due to that? IMHO, pounding down excess, unbalanced, fatty, high-sodium poor-quality food could have had something to do with it, too.

Of course, these points may be covered in the following episodes, so it may be that the above criticisms are premature. We’ll see.

At any rate, Part I was certainly thought-provoking. Definitely worth watching.