Memo to Pregnant Women and People with HIV: Lose Weight, Tubbies

I'm not sure which one of these recent stories infuriates me more:

1.A new study says obese women shouldn't necessarily gain weight while pregnant -- and it's even okay if they lose.

2.We're now supposed to be upset about obesity among people living with HIV -- because it's "overtaken 'wasting syndrome' as the top concern."

Seriously, you guys. We are now supposed to be worried about teh fat in pregnant women and people with HIV.

Sandy at Junkfood Science has covered both of these subjects in the last day, and Rachel at The F Word wrote an excellent post on the HIV story. I don't really have much to add to their critiques of this bullshit, but that's not gonna shut me up.

So, the study on pregnant women broke down the category "obese" into 3 subcategories: BMI 30-34.9, BMI 35-39.9, and BMI 40+. You'll note, however, that the headlines do not take into account that breakdown -- which actually shows that only those with a BMI over 40 gained any benefits (according to their criteria) from losing weight, and women in the lower BMI categories had the best outcomes when they gained weight.

About 3 percent of the population has a BMI over 40. That includes men. So even if we take this study at face value, the advice to lose or not gain weight applies only to a tiny, tiny fraction of the population at any given time. The headlines don't tell us that. I have to get 11 paragraphs into the AP article to learn that for obese women in the same BMI range as me (i.e., most obese women), "the best outcomes came with a weight gain of 10 to 25 pounds." Which, as far as I know, is consistent with the existing recommendations for obese women anyway -- although interestingly, the American Pregnancy Association's guidelines only address "underweight," "normal," and "overweight" women. We all know really fat chicks can't get laid, so I guess it makes sense that they wouldn't be included.

Anyway. What are these complications we're supposed to avoid by eating for less than one instead of two? High blood pressure, Caesarean deliveries, and having something other than a "normal weight" baby. On that last point, they don't tell us if that means the babies are too big or too small -- but check this out:
The Missouri study found that the least-heavy obese women [again, that's BMI 30-34.9] who lost weight were at somewhat higher risk to have a low birth-weight baby. However, they still benefited by having fewer other complications.

So most obese women (presuming the incidence of obesity among pregnant women reflects the general population) who lose weight during pregnancy are at a higher risk of low birth-weight babies, yet the thrust of this article is about how it's okay for fatties to lose weight while pregnant? The risk of, say, delivering by C-section is still considered a noteworthy benefit in the face of a low birth-weight baby? Are you fucking kidding me?

And that refusal to acknowledge that being underweight is in fact far more dangerous, in both babies and adults, than being fat brings us to the HIV story.

People with HIV are now living much longer than ever before. Far fewer of them than ever before are suffering from wasting syndrome, an unexplained loss of 10 percent or more of one's body weight -- alongside super fun symptoms like diarrhea, fever, weakness, and increased susceptibility to illness. Which, you know, is kinda the last thing you want when you've got HIV.

And yet, somehow this is not perfectly awesome fucking news? Because why?

Because they've gone and turned into fatty boombahs.

Turns out, people with HIV now have rates of overweight and obesity similar to the general population. The general healthy population. This is a problem, evidently. Heaven forbid people with HIV start to look just like everyone else, instead of being unable to maintain a body weight high enough to keep their energy and resistance to illness up.

And what does this mean in terms of pounds gained, by the way?
When patients gained weight, they tended to put on an average of 13 pounds over a decade.

13 pounds over a decade. Among a group of people who used to be at risk of quite literally wasting away. I'm sorry, but WHY ARE WE NOT DANCING IN THE STREETS ABOUT THIS?
"It would be very sad to survive HIV and die of something else that was preventable," said [Dr. John T.] Brooks of the CDC.

Oh, I see. Yes, I can imagine how surviving HIV and finding out you're still mortal anyway would be a major bummer.

Also, don't even get me fucking started on how the researchers blithely assume all these people gaining an average of 13 lbs. over a decade must be eating crap and never exercising. Because that's the only possible explanation for gaining weight, ever. And don't you love how the fact that people with HIV are now surviving long enough for their weight to be tracked over decades is just casually pushed aside, because ZOMG THEY'RE GETTING FAT?

And of course there's absolutely no chance that the weight gain has anything to do with the increased survival rates. Here, for once, obesity researchers actually seem to remember that correlation doesn't equal causation. So clearly, that's not even worth looking into.

I don't even know how to wrap this one up. All I can think to do is cry, "Where does it end?" or some shit like that. We are at the point where pregnant women and people with HIV are being told to lose weight. If you had any doubt that the obesity panic is indeed a panic, and that it's way the fuck out of control, there you go.

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