This Ugly Diet and Weight-Related Complication is Crippling Care and Progress

I've no doubt you've seen it. It complicates the provision of compassionate medical care, sours public discourse, poisons media and editorial discussion, and fuels the food industry's ability to suggest they're partners in health. And it doesn't just affect adults. Cartoons give it to our children, and teachers and homework assignments often reinforce it -- as we go about our business thinking there's nothing wrong.

And I promise I'm going to get to it, but first I want to walk you through a recent news story. It's an incredibly good news story out of Sweden where researchers found that a full 80 percent of heart attacks in men were wholly preventable by means of living a healthful lifestyle. This wasn't a small study, either. Researchers studied the lifestyle habits of 20,721 healthy Swedish men between the ages of 45 to 79 for 11 years. They followed the men's diets, alcohol consumptions, smoking statuses, degrees of physical activity and waist circumferences, and then looked to see if a combination of those behaviors prevented heart attacks. The results were beyond impressive. Men who consumed a low-risk diet, had a moderate alcohol consumption, didn't smoke, walked or cycled more than 40 minutes a day, undertook one hour of purposeful exercise per week, and had a waist circumference below 37.4 inches were 86 percent less likely to have a heart attack. Take away the waist circumference requirement, and the risk reduction was still an incredible 76 percent.

The results, tremendous as they are, fit right in line with what my colleague Dr. David Katz has been preaching for years -- that 80 percent of all known chronic diseases and their resultant premature deaths are preventable by means of healthful living.

So if 80 percent of all chronic diseases are preventable, why is it that the world only seems comfortable in ascribing shame, blame and guilt to those with obesity? It would seem not a day goes by without a new article, editorial or television show reinforcing the narrative that because obesity is undeniably on-paper-preventable or treatable by means of lifestyle changes, that those with obesity are fairly blamed as simply being too lazy to do something about it. Yet I've never once seen an article lambasting heart attack victims for being too lazy to have prevented their lots. Nor have I ever seen a kid's movie, book or cartoon joking about the lifestyle habits of those with coronary artery disease, osteoarthritis, diabetes, heartburn or gout. And there are no prime-time television shows where idiotic personal trainers scream at people who aren't spending their every waking moment trying to prevent cancer (it's thought that 40 percent of all cancers are wholly preventable by means of healthful living). But of course if a person has weight to lose, and if they aren't making the adoption of those very same healthy lifestyle patterns that would prevent nearly every other chronic disease the focus of their lives, well they're fair game, and the reason why is the ugly, incredibly prevalent, diet and weight related complication of morbid self-righteousness.

Some are self-righteous about diet and think that because everyone can choose to eat healthfully, those who do not, and more specifically those who do not and who also have weight to lose, are fair game for blame. Never mind the skinny guy eating crap all day long, or the fact that the majority of us, if not all of us, aren't anywhere near perfectly healthful eaters.

Some are self-righteous about exercise, and yet I'm fairly certain that if those who lambast folks with obesity for not exercising more were to strap on an additional 100 pounds or so, they wouldn't be moving much either, nor are they chastising themselves for their own lack of exercise given it's only a small minority of folks who truly do enough on a daily basis.

Some are self-righteous about "self control" or "willpower," and warmly embrace the gluttonous sloth narrative of weight -- and yet I'm betting they're not likely to blame stroke victims for their lives' choices, and instead, rightly, show them blameless compassion and positively encourage their recoveries, recoveries tempered with the realism that there will be limits to the bests they can do.

And why is there only self-righteousness when it comes to matters of obesity? Because hateful weight bias is embraced by society as acceptable, and the longer this plague of self-righteousness goes unchallenged, the longer it'll be before we start finding ways to effectively manage and prevent this condition, as if blame and shame were sufficient to lead to sustainable weight loss, the world would be a very skinny place indeed.

Yoni Freedhoff, MD, is an assistant professor of family medicine at the University of Ottawa, where he's the founder and medical director of the Bariatric Medical Institute -- dedicated to non-surgical weight management since 2004. Dr. Freedhoff sounds off daily on his award-winning blog, Weighty Matters, and you can follow him on Twitter @YoniFreedhoff. Dr. Freedhoff's latest book, "The Diet Fix: Why Diets Fail and How to Make Yours Work," is a national bestseller in Canada and is widely available across North America and online.