The Cheese Grates It: Correlation is Still Not Causation

Photo copyright Molly Adams

This is a response to an article by Dr. Heather Metcalf.

There are certain medical conditions which may be correlated with having a larger body type, often endocrine conditions.

Correlation is not causation.

Having a larger body type does not "cause" diabetes, hypertension, or any of the supposed "diseases of obesity." which are actually diseases of aging. Hypertension is not in and of itself a "disease" in any case, it is an effect caused by a systemic imbalance. Idiopathic hypertension has no traceable cause and is the most common kind of hypertension. The "diseases of obesity" affect people of all sizes.

Let us postulate that three people go to the doctor. They all stand 5'6" tall. One weighs 60 pounds, one weighs 160 pounds, and one weighs 600 pounds.

Medically speaking, it is likely that something is amiss with both the 60 pound person and the 600 pound person. However, assuming that nothing could be wrong with the 160 pound person because they fall within "normal" weight perimeters is erroneous. All three people need to be examined for potential health problems, regardless of how "healthy" they look.

The 60 pound person is likely to be treated with compassion even if zir dangerously low weight is due to self-starvation.

The 600 pound person will be treated with contempt and admonished to eat less, even if they are not overeating and their weight issues are caused by a physical dysfunction, likely an endocrine malfunction. 

Even if the 600 pound person's weight is the result of massive overeating (and I mean really massive, not being "naughty" and having a big piece of pie every day after dinner), this is the rare case and is likely caused by a condition such as Prader-Willi syndrome, or certain types of tumors affecting the satiation centers of the brain, in which the sufferer is constantly hungry.
As was pointed out by an online friend, most people are not super-obese due to conditions such as I mention here. They become super-obese due to deprivation dieting, wherein a person may temporarily lose weight but ends up regaining the weight and then some. I myself had to stop dieting so I wouldn't end up gaining more weight. Diets don't work and benefit only the diet industry.

All people deserve to be treated with compassion, regardless of their size. They should be able to express their needs and concerns to their doctor without fear of being shamed.

Many larger people forego medical treatment because they fear being shamed by medical personnel.

Many "normal" weight and slender people forego medical treatment because they have been led to believe that being a "proper size" means that they are healthy.

I worked with a woman who was very slender. She ate "right," didn't smoke, didn't drink, and had a "positive" outlook on life. She was 65 years old and should have had a long life ahead of her. She died from sudden cardiac arrest due to an undiagnosed heart condition, and everyone expressed surprise because she was thin and apparently "healthy."

Every patient deserves access to compassionate, affordable health care. No patient should be treated dismissively or with contempt because of their size.

The Cheese Hath Grated It