Healthy at any size?

Being fat in this culture is frickin' miserable.

But I don't doubt some can be healthy and fat...200, 250 pounds for the average female may not be a big problem as far as health. I see ladies weighing 230 or so who get around great, have none of the diseases of obesity and look and feel fabulous. Weight loss surgery isn't for them and an ethical surgeon wouldn't consider it, nor would insurance pay for it.

Those are the people who should preach and teach healthy at any size. The problem is when fat moves into morbid obesity...when you're hurting from the effects of obesity...then defining yourself as healthy moves into the realm of denial.

You move through life huffing and puffing, sweat pouring out of your pores as you negotiate a flight of stairs. You often have sleep apnea or diabetes or painful joints. If you don't have them yet, as the years go by into middle-age, you're primed to get these problems. Running is an impossibility, swimming mostly an embarrassment and biking simply doesn't work.

No fool, you know your job and romantic opportunities are more limited by your morbid obesity. Your quality of life undeniably suffers no matter how much confidence you manage to muster up.

You desperately try diet after diet. Your body wars with you. You try and try but it is as necessary and natural as drinking enough water to eat enough to maintain your weight. The prattle about healthy at any size is reduced to bullshit for the morbidly obese. Your life is undeniably cut short by your bulk.

Most small-sized people couldn't get up to 300 pounds plus if they tried. Their bodies simply won't allow them to carry that much weight. If we have the genotype where we can get that fat--it's damn near impossible to lose unless there is an actual famine, hunter gatherer style. Nowhere in the first world supports that sort of lifestyle. We are throwbacks, anachronisms that will die sooner because of the complications of our inherent metabolic disorders. Check out the Pima Indians.

Studies after studies along with boatloads of statistics tell us the only solid way to take weight off and keep it off if you're morbidly obese is weight loss surgery. Other methods work about as well as playing the lottery if you want to get rich.

So merely fat (such as Joy Nash and the like) can indeed be fine and healthy, but the line drawn between health and suffering complications of obesity is a gray one of varying widths. It's not for anyone else to tell anybody when and where it should be drawn.