XXL: Obesity and the Limits of Shame Paperback – Mar 12 2011
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'Messrs. Seeman and Luciani's suggestions will annoy both the left and the right. Market forces are anathema to the top-down thinking of many on the left, and handing money to the "undeserving" is anathema to many on the right. But the very fact that their idea defies conventional wisdom suggests that it is a good one.' (Matt Ridley, international bestselling author of The Rational Optimist and Genome The Wall Street Journal)
'This book takes a fresh, bold, and deep look at an important human error stemming from the illusions of control and the overestimation of knowledge of the human body and behavior. It shows the mistakes committed when governments, in a top-down and naïve manner, try to control our biology.' (Nassim Nicholas Taleb, Distinguished Professor, New York University Polytechnic Institute and author of New York Times best-sellers The Black Swan and Fooled by Randomness)
'This book provides the one thing that's sorely lacking amidst the cacophony of claims about what will fix the obesity crisis: A recognition that this is a massively multi-factorial problem utterly resistant to universal, simple solutions, and that individuals require customized strategies for losing and keeping off weight. The idea that public policy can and must support individualized weight-loss plans is as close to a winner as we're likely to see.' (David H. Freedman, best-selling author of Wrong: Why Experts Keep Failing Us – And How to Know When Not to Trust Them, and contributing editor of Inc. Magazine)
'This slim book is fat with data and ideas, and stands on the imaginative frontier of a very fast-moving public policy debate ... It's bound to cause controversy and thought as we face the public health challenge of trying to engineer weight control.' (Michael Bliss, University Professor Emeritus, University of Toronto, and author of The Making of Modern Medicine and The Discovery of Insulin)
'Promising, thought-provoking and smart.' (David Frum, best-selling author and adviser to former President George W. Bush)
'XXL critically examines the money and policies we're throwing at the obesity epidemic and proposes a new, thoughtful and sensitive approach—healthy living vouchers—that offers meaningful incentives to those who ever have, or ever will, struggle with the emotional and physical battle of weight gain.' (Bertha K Madras, Professor of Psychobiology, Harvard Medical School)
'XXL offers both an authoritative yet readily accessible review of the relevant science and, even more important, an imaginative proposal for government action.' (Frederick Lowy, OC, MD, CM, LLD, President and Vice-Chancellor Emeritus, Concordia University, former Dean, Faculty of Medicine, University of Toronto)
(This title received Outstanding rating by members of the 2012 University Press Books committee…. They are essential additions to most library collections)
(Christina Beaird University Press Books for Public & Secondary School Libraries, 2012)
‘Entertaining and insightful are not two words you would normally associate with a book about obesity, but this book certainly has both traits…. I would recommend this book for all large public libraries
‘The authors have provided us with a clear summary of our current obesity challenges alongside the range of possible avenues to take on this “wicked problem,” all smartly compiled in this readable book.’ (Terrence Sullivan CMAJ February 2013)
About the Author
Neil Seeman is director of the Health Strategy Innovation Cell and a senior resident in health system innovation at Massey College, University of Toronto.
Patrick Luciani is a senior resident at Massey College, University of Toronto.
Most Helpful Customer Reviews on Amazon.com (beta)
Page 7. There is a passage concerning the self-esteem of "chubby" children which seems fundamental to the frame of obesity and self-esteem, yet none of the statements which the authors make and generalize to overweight children are cited at all. This is one example of a fairly common trend throughout the book.
This book also suffers from linguistic concerns as well. On page 9, the authors refer to severely obese people as "XXLs because of the size of the clothes they need to wear," which seems 1.) unprofessional, 2.) a really inaccurate way of categorizing people, and 3.) totally unnecessary if the term "severely obese" already exists to classify these people. Later, on page 28, the authors describe mean weight increase in men and women over time. While men experienced a 20 pound mean increase between 1981 and 2008, women experienced an 11 pound mean increase in the time time period. Yet the authors choose to write that men simply increased mean weight, while women "ballooned" to their new mean weight, which is odd since the male mean increase was almost double that of the female increase. Linguistically troubling habits plague the rest of this book as well.
Even the authors' policy recommendations seem poorly thought out. To use one of many, many points as an example, on page 109 they recommend giving food vouchers to poor people so that they can buy "organic" meats and dairy. Considering the authors' supposed expertise in the field of public health, it is confusing that they would make such a recommendation given that most studies looking at organic foods do not claim that organic food is better at controlling weight that non-organic foods. There is nothing about a food being free from pesticides that decreases its caloric content. People who eat organic foods may have lower BMIs, on average, than those who eat non-organic foods, but this is likely due to those people who eat organic foods being of higher SES and having many other healthy eating/living habits that are co-linear with buying organic foods.
Ultimately, this book is distracting in how many errors and truly bizarre moments it contains, which takes away from some of its better points. It may be useful to own simply because it has a decent bibliography, but I would be extremely hesitant to reference this book itself in any type of academic writing.
(Disclosure: I am a PhD student working in the field of sociology of medicine, focusing on obesity in the United States.)
The real problem with this is that obesity--when not caused by some endocrine dyscrasia or severe genetic disorder, and both are fairly rare--is easily addressed and easily solved. It really is. If you eat more calories than you need and will burn during the day, you will gain weight. Conversely, if you burn more calories than you consume, you will lose weight. Millions of people have done it and continue to do it. The first step is decide that your obesity is YOUR problem and not try and blame it on someone else, or something else.
I'm of the opinion that the age of "there's no such thing as personal responsibility" has fostered a number of problems in our society. These would include the era of entitlement we see among many people and a softening of our spirit, our bodies and our resolve (in many ways).
The arrival of bariatric surgery has not helped this. Al Roker went on an eating binge two days before his surgery, just to show how weak and unserious he was about taking responsibility for being fat. I see a lot of patients who think there must be a pill or a surgery or a magic wand which will cure them of their problem, whereas a little resolve and a backbone would go a long way. Losing the weight would make the joint pain or the plantar fascial pain or the muscle pain or the poorly controlled diabetes mellitus or the hypertension or just about anything else you're dealing with more manageable. Usually, when suggested, the retort is: "doctor, I can't lose weight. I've tried everything".
Just as I hear a large number of people claim that they "can't stop smoking", I hear a very large number of individuals claim that they "can't lose weight" and, in reality, what they really mean is "I won't quit smoking" or "I won't lose weight". That would take some hard work and some effort and--more importantly--would take some self-control.
In the 1970's, there was a book entitled: "I'm o.k., you're o.k." and this book is the obese person's version of that tome. Unfortunately, you may not be o.k. and telling you that you are fosters both a type of co-dependency and a concerted effort to gaze elsewhere but the mirror for the culprit and does no one any good. Diet and exercise will allow almost everyone to lose the extra weight they don't need. That's a fact. If you're embarrassed when someone stares at you because you have a 120" waist, well, you should be, as it isn't normal. Whether you're Walter Hudson or Manuel Uribe--or a lot less--you were not meant to look that way, eat that much or blame it on someone or something else.
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