The girth of a nation

Okay, so how much do you weigh?

I weigh 165 and I am 5-foot-8. I am probably overweight by government definitions right now because I had lunch, but I was not overweight this morning. I have the same BMI -- slightly less -- than George W. Bush. We are both extremely healthy, extremely active people who are not typed as fat or even overweight, culturally speaking. But we're overweight according to standard definitions because we have a BMI over 22.

But then, a 127-pound woman of average height will be overweight if the people who want to lower the BMI for the definition of average weight to less than 22 get their way. [Harvard professor of epidemiology and nutrition] Walter Willett says most people would be healthier if they had a BMI below 22. It's as if he said most people would be healthier if they were more than 6 feet tall. It makes exactly as much sense. I think he's typical of this culture of anorexic people telling Americans how to think about their health.

What do you mean when you refer to people like Willet as anorexic?

I think these people have an anorexic ideation, to use a technical term. That means that their mind frame is similar to that of a person who is diagnosed as anorexic. One of the things that's true in this country is that the same kind of ideation -- the same perceptual tendencies, same ideological orientation toward issues of weight -- are found among many, many more people than the number of people who are technically diagnosed as having an eating disorder.

The line between having an eating disorder and eating-disordered thinking is very fuzzy. If you're obsessed with being thin, if you have major control issues, if you're obsessed with the idea that fat is bad and thin is good, if you place foods in good and bad categories, if you have an unrealistic body image and you think of yourself as fat -- all that stuff is classic eating-disordered ideation. It's so normalized now that people don't even notice it.

What's happening is the institutionalization of this kind of ideation in the form of these government standards. I am not trying to be provocative here -- this is what I actually think. Policies on this issue are strongly influenced by anorexic ideation. The NIH, the surgeon general, the official government public health agencies -- in terms of definitions, in terms of advice about what people should be striving to achieve, in terms of the demonization, and the pathologizing of most of the range of normal body mass variation -- they have turned most human bodies into diseased bodies by coming up with this very bizarre notion of what constitutes a normal body.

How much of the obsession with weight loss has to do with people wanting to be healthier and how much has to do with people wanting to look like Jennifer Aniston?

There is overwhelming evidence that the latter consideration is vastly more important to people. As for Jennifer Aniston, she has a BMI of 18.3. Her husband -- the hunky Brad Pitt -- has a BMI of 27.5. For Jennifer Aniston to have the same BMI index as her husband she'd have to weight about 55 pounds more than she does now. That highlights the extent to which we put a premium on extreme slenderness as the sexually desirable ideal for women. Brad Pitt could be fairly described as a large individual. He appears to be in excellent shape. Largeness in men is considered quite desirable while extreme slenderness is what's supposed to be sexually attractive in women.

Next Page: "America is just too big. Our anxiety about fat is our anxiety about our own bigness"

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