And They Will Lean That Way Forever

You can ask ten people what the hell something means and you’ll get ten versions of I Don’t Have A Fucking Clue:

The Fat and Short of It

I’m feeling more Poirot than Clousseau. Tape on your detective mustache. We’re going in.

At nearly 6 feet 2 inches and about 175 pounds, Barack Obama may be the slimmest president since the Civil War. His body-mass index hovers near 23, well within the healthy range and somewhat to the left on the bell curve of American bodies. Perhaps he has some credibility, then, when he encourages the rest of us to shed a few pounds. During the presidential campaign, Obama suggested that rolling back obesity rates would save a trillion dollars for Medicare.

This is just the first of fourteen paragraphs of amateurish logicating and thinkerizing. I bet he wrote this drunk.

He’s right that there is a connection between excess fat and public health. Obesity is associated with a higher risk of cancer, diabetes, cardiovascular disease and other problems. If we could somehow slenderize the fattest people in America all at once, we would prevent an estimated 112,000 deaths a year, according to the Centers for Disease Control and Prevention. But girth shouldn’t be the only dimension in the health care debate. There’s at least one more bodily attribute that’s eating away at the Medicare budget: shortness.

Once again: 100% of people drop dead eventually. If you live 130 years, you will still go tits up and your life insurance company, far from being sorry, will still laugh all the way to the bank. Sucker! You lived 130 years! Your premiums sent executives’ kids to Yale!

We’ve long known that stature can serve as a crude measure of public health. If everyone came from a perfect home, the average height across the population would be a function of our genes alone. (There would still be tall people and short people, but we would all have grown as much as we possibly could.) Anything less than an ideal standard of living, though, tends to stunt a child’s growth.

Aha. Author Daniel Engber took a connecting flight to a dumb destination: tall people = healthy, short people = expensive loads. Sort of:

Many problems associated with being overweight correspond to being “underheight.” The shorter you are in America, the more likely your chances to develop coronary heart disease, diabetes or stroke. Fat people and short people lead briefer lives, and they put an increased burden on the health care system. Economists estimate that excess weight alone accounts for 9 percent of the country’s medical spending. There’s no such figure for insufficient height, but we do know that obesity and shortness play out in similar ways across the socioeconomic landscape.

Underheight? I’m fucking exhausted from these logical leaps. Not a shred of evidence, but a metric assload of innuendo.

In the labor market, the effects of height and weight tend to run in parallel. A 2004 study by John Cawley of Cornell University found that severely obese white women who weigh more than two standard deviations above average — women who weigh, for example, more than 212 pounds if they’re 5 feet 4 inches tall — are paid up to 9 percent less for their work. Likewise, a decrease in a man’s height to the 25th percentile from the 75th — roughly to 5 feet 8 inches from 6 feet— is associated with, on average, a dip in earnings of 6 to 10 percent.

One study? One? I could find one study suggesting we’re actually characters in a failed Vonnegut novel.

And like obese people, short people are less likely to finish college than those of average weight. A paper from the July issue of the journal Economics and Human Biology used survey data from more than 450,000 adults to conclude that male college graduates are, on average, more than an inch taller than men who never finished high school.

I bet they’re whiter and upper middle-classier, too. Call it a hunch.

Moreover, just as a buildup of abdominal fat increases the risk of chronic illness, so can short stature have a direct impact on physiology. Smaller people, for example, have smaller lungs — and reduced lung capacity is a risk factor for death from cardiovascular disease. Shorter people also have narrower coronary arteries, which may be more susceptible to atherosclerosis.

I guarantee you no one looks at me and thinks about reduced lung capacity.

Whatever the cause, higher weight and lower height are associated with chronic disease, low wages and poor educational attainment. And while we are getting fatter, we may be getting shorter too. The economist John Komlos has shown that the United States is losing height relative to other developed nations, and some American demographic groups are even shrinking in absolute terms. Yet we tend to discount shortness as a mere byproduct of genetics and early-life experience, while treating the obesity epidemic as if it were a grave danger to public health. Why can’t our campaign to reshape the American body have two fronts? If we really want to make our country healthier, let’s have a war on shortness too.

What the hell is this guy on about? Does he even know? And why do I want to mail him a toy gun and a card telling him his Declare A War On Whatever problem is absolutely not at all about a tiny penis?

You’re excused for scoffing. You probably think of weight as a problem we can fix, while height seems beyond our control. We could try to make people thin by taxing junk food or by raising their insurance premiums unless they go on a diet. But what kind of policy could make someone taller?

I’d thank him for his permission, but I’d scoff without it. By the way, we will come back to this paragraph soon, because:

Controlling our country’s height may be just as plausible — or implausible — as controlling its weight. It’s true that someone who is fat can lose weight on purpose, while a short adult can’t do anything to gain height. Yet instances of radical, lasting weight loss are exceedingly rare. Diet and exercise schemes tend to yield only minor effects over the long term. While lesser changes to your weight may be associated with modest health benefits, they won’t help all those obese adults to become slender. For most of us, changes in body size follow a long, slow pattern across our adult lives. Every year, we lose a tiny bit of height and gain a pound or two of weight until, in our older years, we shrink in both measurements.

So…we can’t really fix our obesity problem, or this height “problem” and we’re shrinking and gaining and WHAT IS THIS GUY TALKING ABOUT?

Given how hard it can be to lose weight, a realistic war on obesity starts to look a lot like a war on shortness. In both cases, we’re dealing with a complex function of genetics, social class and poor health in childhood.

Can’t we try height and weight diplomacy?

Early-life experiences play an important role in the development and consequences of body size. Exposure to malnutrition, infectious disease, chronic stress and poverty stunt a child’s development and seem to explain many of the long-term problems associated with short stature. Environmental factors may promote obesity, too: lack of breast-feeding, bad nutrition, chronic stress and poverty have all been associated with early weight gain and a higher risk of health problems down the road.

We veer so close to a real point – but no. This paragraph goes nowhere.

A range of sensible interventions could address both problems at once. To win a war on shortness, we might promote the consumption of fruits, vegetables and other foods that are low in calories and high in micronutrients. Or we could invest in education as a means of alleviating poverty and environmental stress. Better access to doctors for children and their parents would improve prenatal and postnatal care and stave off the stunting effects of childhood disease.

Education. [W]e might promote the consumption of fruits, vegetables and other foods. All right, let’s talk about that. The feds fund a program called WIC that is run by each state. This is the rather straight-forward website for New Jersey. Pennsylvania’s is ornate and condescending, and the charming Nutrition facts in the foods list is an especially stinky touch. You should have a look at your state’s WIC website and ask yourself this question: do people who can’t afford food have computers and net connections?

From the outside, these programs look like a reason for optimism. If so, you’ve never spent a day shuffled from desk to desk and line to line with endless demands for documentation, suspicion about your identity and disdain for your need for help. I applied to this program when I was starving. Apparently, I wasn’t starving enough, which was news to me. Anyway, WIC is perpetually underfunded. The checks are very small. The rules are very strict. I recently waited in a checkout line behind a customer using WIC checks for groceries and watched the lengthy checkout process with horror. It seemed designed to publicly shame and humiliate the customer. But hell, why not? That woman’s children are probably short. She’s got it coming!

None of these policies treat body size as an end in itself. We would never just prescribe growth hormones and bariatric surgery to every child who doesn’t fit a tall, slender mold. Obesity and shortness are society-wide measurements, not reflections of individual virtue or good health. To that end, our goal should be to improve the quality of life for children. If we can manage that, they just might end up a little taller — and thinner too.

One doesn’t have to be a fictional detective to notice that at no point did our author prove anything at all about health advantages of height. Nowhere. Nothing. He said smaller people are unhealthy and did not document it. His reference about shortness distinguishes between ordinary variations in size and a medical condition that needs treatment, but that distinction is lost on Engber, who seems more interested in economics than health anyway. Look, I have no credentials, but I can read. I asked a woman with some public health experience in Africa to read this article and offer an opinion. Her opinion was that Daniel Engber had no idea what he was talking about.

This is bothersome:

…we would all have grown as much as we possibly could.

If Engber were intellectually honest, he would come out and say that Americans have to suck it up, get over our terribly terrifying terror that someone, somewhere is getting more than he or she deserves – we’ll talk about that word deserves very soon – and get down to the business of properly feeding and caring for the people within our shores. No hissyfits about socialism. No hiding behind bullshit libertarian economics justifying selfishness and inequality. Children grow taller and stronger if they are properly fed and cared from even before birth, which requires money and resources; they will lead longer, healthier and more productive lives. Mostly. What Engber doesn’t have the balls to say is that if better public health is our priority we should collectively pay for it, enjoy it and shut up, and if taxing fast food and increasing insurance premiums is what we do instead, then we don’t actually give a shit about public health. No. We’re just scapegoating the short, the fat, the poor, the uninsured, the malnourished, the sick, the defenseless.

There’s more to talk about and I’ll get to it, but I’m going to have a glass of wine and calm down before this dumb fucker’s nonsense gives me an expensive aneurysm.

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