Essay 4
Minimum of 3 sources for your MLA Works Cited page.
Choice A
Read Alexandra Sifferlin's "The Weight Loss Trap" and Harriet Brown's "The Weight of the Evidence" and develop an argumentative thesis that addresses their claim that losing weight is a nearly futile quest.
Choice B
Read Barbara Ehrenreich’s “Why I’m Giving Up on Preventative Care” and agree or disagree with her position to quit preventative maintenance.
Choice C
Read Ibram Kendi’s “What’s the Difference Between a Frat and a Gang?” and agree or disagree with the author’s contention that there is a double standard for exacting the law against these groups.
Choice D
Read “What Women Know About the Internet” by Emily Chang and agree or disagree with the author’s contention that regulations are more important than free speech for protecting women.
Choice E
Read the following: “Speaking Ill of Hugh Hefner,” “Why Hugh Hefner’s Haters Won’t Let Him Rest in Peace,” “Negative Obituaries Prove Hugh Hefner Was Right,” and 10-minute video Maher vs. Douthat. Then develop an argumentative thesis that addresses this question: Was Hefner a warrior for equal rights, free speech, and higher culture, or was he a selfish, salacious Peter Pan who denigrated women? Or a bit of both?
Choice F
Read Conor Friedersdorf’s “In Defense of Harvey Weinstein’s Harvard Lawyer” and agree or disagree with the contention that representing someone as monstrous and diabolical as Harvey Weinstein performs a civic good.
Choice G
Read Jelani Cobb’s “Black Like Her” and "I Refuse to Rubberneck Rachel Dolezal’s Train Wreck" by Kitanya Harrison and write an argumentative thesis that address the contention that it is morally objectionable for white woman Rachel Dolezal to fabricate an identity to pass as being black for several reasons, not the least of which she is appropriating blackness in the manner of a “culture vulture.” How do you address the counterargument that she is simply choosing her racial identity the way one has the right to choose one’s sexual identity? Is the comparison fair? Explain. You can also consult the parody of Rachel Dolezal in the Donald Glover’s Atlanta episode “B.A.N.” in which Paper Boi discusses “trans-racial” issues with Montague. You can also consult Netflix documentary The Rachel Divide.
Option H
Watch The Game Changers on Netflix and develop an argument that either supports the claim that the documentary makes a persuasive case for a plant-based vegan diet or the assertion that the documentary is a work of cheap propaganda.
The Game Changers Criticisms:
One. The producer is an investor in a pea protein factory.
Two. Some of the information is not as scientific as presented.
Three. Some of the vegans haven't adopted veganism long enough to make a credible appraisal of their results.
Four. There is no attention paid to long-term adherence since most people find a vegan diet to be punitive.
Five. They don't acknowledge that on a vegan diet you need to eat more protein than an animal diet because vegan protein doesn't assimilate inside the body as much as animal protein.
November 12. We will see some of the Netflix documentary The Game Changers. We will read Alexandra Sifferlin's "The Weight Loss Trap" and explain why it is so difficult to lose weight and keep it off. We will also read Harriet Brown's "The Weight of the Evidence." We will see Netflix Explained on this subject of weight loss. Homework #15: Read Barbara Ehrenreich’s “Why I’m Giving Up on Preventative Care” and agree or disagree with her position to quit preventative maintenance.
November 14 Go over Barbara Ehrenreich’s “Why I’m Giving Up on Preventative Care” and agree or disagree with her position to quit preventative maintenance. Homework #16 for next class: Read Ibram Kendi’s “What’s the Difference Between a Frat and a Gang?” and agree or disagree with the author’s contention that there is a double standard for exacting the law against these groups.
November 19 Go over Ibram Kendi’s “What’s the Difference Between a Frat and a Gang?” and agree or disagree with the author’s contention that there is a double standard for exacting the law against these groups.
Read “What Women Know About the Internet” by Emily Chang and agree or disagree with the author’s contention that regulations are more important than free speech for protecting women.
Homework #17: Read “Speaking Ill of Hugh Hefner,” “Why Hugh Hefner’s Haters Won’t Let Him Rest in Peace,” “Negative Obituaries Prove Hugh Hefner Was Right” and then explain in 200 words why Hugh Hefner is such a controversial figure.
November 21 We will examine the Hugh Hefner debate: Was Hefner a warrior for equal rights, free speech, and culture, or was he a selfish, salacious Peter Pan who denigrated women? Or a bit of both? We will study the following: “Speaking Ill of Hugh Hefner,” “Why Hugh Hefner’s Haters Won’t Let Him Rest in Peace,” “Negative Obituaries Prove Hugh Hefner Was Right,” and 10-minute video Maher vs. Douthat.
We will read Jelani Cobb’s “Black Like Her” and "I Refuse to Rubberneck Rachel Dolezal’s Train Wreck" by Kitanya Harrison and address the contention that it is morally objectionable for white woman Rachel Dolezal to fabricate an identity to pass as being black for several reasons, not the least of which she is appropriating blackness in the manner of a “culture vulture.” How do you address the counterargument that she is simply choosing her racial identity the way one has the right to choose one’s sexual identity? Is the comparison fair? Explain. You can also consult Netflix documentary The Rachel Divide.
Your homework #18 for next class: Read Conor Friedersdorf’s “In Defense of Harvey Weinstein’s Harvard Lawyer” and agree or disagree with the contention that representing someone as monstrous and diabolical as Harvey Weinstein performs a civic good.
November 26 Go over Conor Friedersdorf’s “In Defense of Harvey Weinstein’s Harvard Lawyer” and agree or disagree with the contention that representing someone as monstrous and diabolical as Harvey Weinstein performs a civic good.
November 28 Holiday
December 3 Chromebook In-Class Writing Objective: Write introduction, thesis, and first supporting paragraph.
December 5 Chromebook In-Class Writing Objective: Write supporting paragraphs and counterargument-rebuttal paragraph.
December 10 Chromebook In-Class Writing Objective: Write conclusion and MLA Works Cited and proofread entire essay.
December 12 Essay 4 due on turnitin. We will grade Portfolio #2, responses 10-18.
Choice A
Read Alexandra Sifferlin's "The Weight Loss Trap" and Harriet Brown's "The Weight of the Evidence" and develop an argumentative thesis that addresses their claim that losing weight is a nearly futile quest.
"Why Diets Fail" on Netflix
See Netflix Explained: Why Diets Fail and linked to Vox.
Review of "Why Diets Fail":
One. Our body has a skinny rebel, the hormone leptin.
Two. Snack industry brainwashed us into snacking so that we constantly have elevated insulin, resulting in obesity, metabolic syndrome, diabetes, etc.
Three. Food industry has us addicted to processed foods, which are higher profit than whole foods.
Four. After World War II, calories became "low-hanging fruit," easy pickings.
Five. "Normal" is eating in excess of 3,000 calories a day when, from an evolutionary level, we're more suited to under 2,000.
Six. Diets may or may not work. It doesn't matter because most of us don't stick to them in the long-term.
Seven. Related to Six, most people don't stick to diets because weight-loss management is a full-time job not suited to people who have to work, go to school, parent, etc. If you're rich and have the whole day to focus on your navel and hire a personal trainer and have an Instagram account showing off your Hot Bod, then perhaps you will be a string bean. But that's not most of us.
Eight. The only people who tend to manage their weight find a way to enjoy eating whole foods for their lifetime.
Choice A
Read Alexandra Sifferlin's "The Weight Loss Trap" and Harriet Brown's "The Weight of the Evidence" and develop an argumentative thesis that addresses their claim that losing weight is a nearly futile quest.
Harriet Brown, "The Weight of the Evidence"
Headings are mine.
(Diets are futile)
If you’re one of the 45 million Americans who plan to go on a diet this year, I’ve got one word of advice for you: Don’t.
You’ll likely lose weight in the short term, but your chance of keeping if off for five years or more is about the same as your chance of surviving metastatic lung cancer: 5 percent. And when you do gain back the weight, everyone will blame you. Including you.
This isn’t breaking news; doctors know the holy trinity of obesity treatments—diet, exercise, and medication—don’t work. They know yo-yo dieting is linked to heart disease, insulin resistance, higher blood pressure, inflammation, and, ironically, long-term weight gain. Still, they push the same ineffective treatments, insisting they’ll make you not just thinner but healthier.
In reality, 97 percent of dieters regain everything they lost and then some within three years. Obesity research fails to reflect this truth because it rarely follows people for more than 18 months. This makes most weight-loss studies disingenuous at best and downright deceptive at worst.
(Author questions if obesity is linked to bad health)
One of the principles driving the $61 billion weight-loss industries is the notion that fat is inherently unhealthy and that it’s better, health-wise, to be thin, no matter what you have to do to get there. But a growing body of research is beginning to question this paradigm. Does obesity cause ill health, result from it, both, or neither? Does weight loss lead to a longer, healthier life for most people?
(BMI is a different issue than true obesity; don't use a bait and switch.)
Studies from the Centers for Disease Control and Prevention repeatedly find the lowest mortality rates among people whose body mass index puts them in the “overweight” and “mildly obese” categories. And recent research suggests that losing weight doesn’t actually improve health biomarkers such as blood pressure, fasting glucose, or triglyceride levels for most people.
(What are the causes of our weight obsession? Glamour, privilege, wealth, success, self-esteem, etc.)
So why, then, are we so deeply invested in treatments that not only fail to do what they’re supposed to—make people thinner and healthier—but often actively makes people fatter, sicker, and more miserable?
Weight inched its way into the American consciousness around the turn of the 20th century. “I would sooner die than be fat,” declared Amelia Summerville, author of the 1916 volume Why Be Fat? Rules for Weight-Reduction and the Preservation of Youth and Health. (She also wrote, with a giddy glee that likely derived from malnutrition, “I possibly eat more lettuce and pineapple than any other woman on earth!”) As scales became more accurate and affordable, doctors began routinely recording patients’ height and weight at every visit. Weight-loss drugs hit the mainstream in the 1920s, when doctors started prescribing thyroid medications to healthy people to make them slimmer. In the 1930s, 2,4-dinitrophenol came along, sold as DNP, followed by amphetamines, diuretics, laxatives, and diet pills like fen-phen, all of which caused side effects ranging from the annoying to the fatal.
The national obsession with weight got a boost in 1942, when the Metropolitan Life Insurance Company crunched age, weight, and mortality numbers from policy holders to create “desirable” height and weight charts. For the first time, people (and their doctors) could compare themselves to a standardized notion of what they “should” weigh. And compare they did, in language that shifted from words like chubby and plump to the more clinical-sounding adipose, overweight, and obese. The word overweight, for example, suggests you’re over the “right” weight. The word obese, from the Latin obesus, or “having eaten until fat,” conveys both a clinical and a moral judgment.
In 1949, a small group of doctors created the National Obesity Society, the first of many professional associations meant to take obesity treatment from the margins to the mainstream. They believed that “any level of thinness was healthier than being fat, and the thinner a person was, the healthier she or he was,” writes Nita Mary McKinley, a psychologist at the University of Washington-Tacoma. This attitude inspired a number of new and terrible treatments for obesity, including jaw wiring and stereotactic brain surgery that burned lesions into the hypothalamus.
(Desperation results in bariatric surgery)
Bariatric surgery is the latest of these. In 2000, about 37,000 bariatric surgeries were performed in the United States; by 2013, the number had risen to 220,000. The best estimates suggest that about half of those who have surgery regain some or all of the weight they lose. While such surgeries are safer now than they were 10 years ago, they still lead to complications for many, including long-term malnutrition, intestinal blockages, disordered eating, and death. “Bariatric surgery is barbaric, but it’s the best we have,” says David B. Allison, a biostatistician at the University of Alabama-Birmingham.
Reading the research on obesity treatments sometimes feels like getting stuck in an M.C. Escher illustration, where walls turn into ceilings and water flows upward. You can find studies that “prove” the merit of high-fat/low-carb diets and low-fat/high-carb diets, and either 30 minutes of daily aerobic exercise or 90 minutes. You’ll read that fen-phen is safe (even though the drug damaged heart valves in a third of those who took it). Studies say that orlistat (which causes liver damage and “uncontrollable” bowel movements) and sibutramine (which ups the risk of heart attacks and strokes) are effective. After reading literally more than a thousand studies, each of them claiming some nucleus of truth, the only thing I know for sure is that we really don’t know weight and health at all.
“We make all these recommendations, with all this apparent scientific precision, but when it comes down to it we don’t know, say, how much fat someone should have in their diet,” says Asheley Skinner, a pediatrician at the University of North Carolina–Chapel Hill School of Medicine. “We argue like we know what we’re talking about, but we don’t.”
(Maintaining a skinny body is more stressful than healthy)
For instance, much of the research assumes that when fat people lose weight, they become “healthy” in the same ways as a thinner person is healthy. The evidence says otherwise. “Even if someone loses weight, they will always need fewer calories and need to exercise more,” says Skinner. “So we’re putting people through something we know will probably not be successful anyway. Who knows what we’re doing to their metabolisms.”
Debra Sapp-Yarwood, a fiftysomething from Kansas City, Missouri, who’s studying to be a hospital chaplain, is one of the three percenters, the select few who have lost a chunk of weight and kept it off. She dropped 55 pounds 11 years ago, and maintains her new weight with a diet and exercise routine most people would find unsustainable: She eats 1,800 calories a day—no more than 200 in carbs—and has learned to put up with what she describes as “intrusive thoughts and food preoccupations.” She used to run for an hour a day, but after foot surgery she switched to her current routine: a 50-minute exercise video performed at twice the speed of the instructor, while wearing ankle weights and a weighted vest that add between 25 or 30 pounds to her small frame.
“Maintaining weight loss is not a lifestyle,” she says. “It’s a job.” It’s a job that requires not just time, self-discipline, and energy—it also takes up a lot of mental real estate. People who maintain weight loss over the long term typically make it their top priority in life. Which is not always possible. Or desirable.
While concerns over appearance motivate a lot of would-be dieters, concerns about health fuel the national conversation about the “obesity epidemic.” So how bad is it, health-wise, to be overweight or obese? The answer depends in part on what you mean by “health.” Right now, we know obesity is linked with certain diseases, most strongly type 2 diabetes, but as scientists are fond of saying, correlation does not equal causation. Maybe weight gain is an early symptom of type 2 diabetes. Maybe some underlying mechanism causes both weight gain and diabetes. Maybe weight gain causes diabetes in some people but not others. People who lose weight often see their blood sugar improve, but that’s likely an effect of calorie reduction rather than weight loss. Type 2 diabetics who have bariatric surgery go into complete remission after only seven days, long before they lose much weight, because they’re eating only a few hundred calories a day.
Disease is also attributed to what we eat (or don’t), and here, too, the connections are often assumed to relate to weight. For instance, eating fast food once a week has been linked to high blood pressure, especially for teens. And eating fruits and vegetables every day is associated with lower risk of heart disease. But it’s a mistake to simply assume weight is the mechanism linking food and disease. We have yet to fully untangle the relationship.
(But no one said weight loss is a panacea or cure all; is the author using a Straw Man argument?)
Higher BMIs have been linked to a higher risk of developing type 2 diabetes, heart disease, and certain cancers, especially esophageal, pancreatic, and breast cancers. But weight loss is not necessarily linked to lower levels of disease. The only study to follow subjects for more than five years, the 2013 Look AHEAD study, found that people with type 2 diabetes who lost weight had just as many heart attacks, strokes, and deaths as those who didn’t.
Not only that, since 2002, study after study has turned up what researchers call the “obesity paradox”: Obese patients with heart disease, heart failure, diabetes, kidney disease, pneumonia, and many other chronic diseases fare better and live longer than those of normal weight.
Likewise, we don’t fully understand the relationship between weight and overall mortality. Many of us assume it’s a linear relationship, meaning the higher your BMI, the higher your risk of early death. But Katherine Flegal, an epidemiologist with the CDC, has consistently found a J-shaped curve, with the highest death rates among those at either end of the BMI spectrum and the lowest rates in the “overweight” and “mildly obese” categories.
(Treating obesity is a big money industry)
There’s a lot of money at stake in treating obesity. The American Medical Association—against the recommendations of its own Committee on Science and Public Health—recently classified obesity as a disease, and doctors hope insurers will start covering more treatments for obesity. If Medicare goes along with the AMA and designates obesity as a disease, doctors who discuss weight with their patients will be able to add that diagnosis code to their bill, and charge more for the visit.
Obesity researchers and doctors also defend what appear to be financial conflicts of interest. In 2013, the New England Journal of Medicine published “Myths, Presumptions, and Facts About Obesity.” The authors dismissed the often-observed link between weight cycling and mortality, saying it was “probably due to confounding by health status” (code for “We just can’t believe this could be true”) and went on to plug meal replacements like Jenny Craig, medications, and bariatric surgery.
Five of the 20 authors disclosed financial support from sponsors in related industries, including UAB’s David Allison. I asked him how he would respond to allegations of financial self-interest. “It would be no different than anybody saying about any other person who puts forth an idea, ‘I want to comment that you have this background or personality, this sexual orientation, weight, gender, or race,’ ” he argued. “These conflicts were disclosed, we didn’t hide them, we weren’t ashamed of them. And what’s your point?”
(Fat stigma affects doctors' judgments)
Another layer to the onion may lie in our deeply held cultural assumptions around weight. “People, journalists, and researchers live in a world where it’s taken for granted that fat is bad and thin is good,” says Saguy.
Doctors buy into those assumptions and biases even more heavily than the rest of us, which may explain in part why they continue to blame patients who can’t keep weight off. Joseph Majdan, a cardiologist who teaches at Jefferson Medical College in Philadelphia, has lost and regained the same 100 or so pounds more times than he can count. Some of the meanest comments Majdan has heard about his weight have come from other doctors, like the med-school classmate who asked if she could project slides onto a pair of his white intern’s pants for a skit. Or the colleague who asked him, “Aren’t you disgusted with yourself?”
“When a person has recurrent cancer, the physician is so empathetic,” says Majdan. “But when a person regains weight, there’s disgust. And that is morally and professionally abhorrent.”
(Obesity is seen as a moral choice, evidence of poor character.)
The idea that obesity is a choice, that people who are obese lack self-discipline or are gluttonous or lazy, is deeply ingrained in our public psyche. And there are other costs to this kind of judgmentalism. Research done by Lenny Vartanian, a psychologist at the University of New South Wales, suggests that people who believe they’re worthless because they’re not thin, who have tried and failed to maintain weight loss, are less likely to exercise than fat people who haven’t strongly internalized weight stigma.
(In conclusion, author asks us to "let go")
Not that abiding by competent eating, which fits the Health at Every Size paradigm, is easy; Robin Flamm would tell you that. When her clothes started to feel a little tighter, she panicked. Her first impulse was to head back to Weight Watchers. Instead, she says, she asked herself if she was eating mindfully, if she was exercising in a way that gave her pleasure, if she, maybe, needed to buy new clothes. “It’s really hard to let go of results,” she says. “It’s like free falling. And even though there’s no safety net ever, really, this time it’s knowing there’s no safety net.”
One day she was craving a hamburger, a food she wouldn’t typically have eaten. But that day, she ate a hamburger and fries for lunch. “And I was done. End of story,” she says, with a hint of wonder in her voice. No cravings, no obsessing over calories, no weeklong binge-and-restrict, no “feeling fat” and staying away from exercise. She ate a hamburger and fries, and nothing terrible happened. “I just wish more people would get it,” she says.
Reasons for Making Claim That Diets Don't Work
One. 80-97% of dieters gain all their weight back and more.
Two. We have an unrealistic notion of a good skinny body.
Three. Skinny=healthy=good person
Four. Maintaining weight loss is a full-time job; it's just too hard.
Five. Curing obesity is a money-driven industry, so a lot of claims about who's obese are inflated.
Six. Obesity=lazy=bad person.
Seven. Biggest Loser Failure Argument
Eight. No one diet works for everyone
Nine. Eating Western Diet (sugar and processed foods) is cheaper than eating healthy diet.
Ten. We have a Set Point.
Eleven. There is no Magic Bullet. We don't want to know the boring truth: Cut down on sugar and exercise more.
Success Factors for Weight Loss
One. You have a health need. You might die if you don't find religion and find a way to lose weight. There is a gun to your head. Now you're moving in the right direction.
Two. You did research or due diligence.
Three. You desire change.
Four. You like your new diet enough.
Five. You have healthy outlets so you don't rely on junk food as your exclusive drug.
Risk Factors that Make Weight Loss Unlikely
One. You have stress.
Two. You live in poverty.
Three. You suffer from depression.
Four. You suffer from learned depression.
Five. Your diet was triggered by an act of caprice, whim, or compulsion and therefore lacked due diligence.
Six. You lack basic food education so that you don't know difference between whole food and processed food.
Seven. Peer pressure doesn't give you support you need to eat well.
Sample Essay That Responds to Option A
The High Failure Rate of Dieting Is No Excuse
Stuck at 220 pounds for nearly four weeks, my Inner Fat Man was whispering in my ear, “Give up, dude. Game over. Your metabolism is adapting to your sugar- and gluten-deprived diet. Your metabolism is essentially shutting down. It’s a protest, dude. Don’t you see? Your body is telling you and your diet to go to hell. But no need to feel ashamed. Over ninety-five percent of dieters regain all their weight and get even fatter. Just surrender and admit you’re in the Fat Man Club.”
My Inner Fat Man had a point. The odds were against me. All the research showed that my body would eventually rebel and make my Fat Man triumph over my attempt at gaining control of my tendency toward fatness with all of its related health catastrophes.
Writing for Time, Alexandra Sifferlin in her article “The Weight Loss Trap: Why Your Diet Isn’t Working” describes the findings of scientist Kevin Hall, who doing research for the National Institute of Health, studied the reality-show The Biggest Loser to see if the contestants’ successful weight loss could be studied to help the population at large. Their weight loss was dramatic. Hall observed that on average they lost 127 pounds each, about 64% of their bodyweight. But Hall soon discovered that transferring the rigid training and dieting to the real world was not a realistic proposition. Sifferlin writes:
What he didn’t expect to learn was that even when the conditions for weight loss are TV-perfect–with a tough but motivating trainer, telegenic doctors, strict meal plans and killer workouts–the body will, in the long run, fight like hell to get that fat back. Over time, 13 of the 14 contestants Hall studied gained, on average, 66% of the weight they’d lost on the show, and four were heavier than they were before the competition.
Like other studies I’ve read, people who go on weight-loss programs do indeed lose the weight, but they always gain it back and even get heavier. But worse, after they soar to an even fatter version of themselves before they went on a diet, their metabolism is set at a lower speed, so they’re worse off than before. As Sifferlin explains Kevin Hall’s research,
As demoralizing as his initial findings were, they weren’t altogether surprising: more than 80% of people with obesity who lose weight gain it back. That’s because when you lose weight, your resting metabolism (how much energy your body uses when at rest) slows down–possibly an evolutionary holdover from the days when food scarcity was common.
With research like this, we can see why any reasonable person would conclude that dieting is not only futile but self-destructive. Driving this point home, Syracuse University journalism professor Harriet Brown in her Slate article “The Weight of the Evidence,” beseeches the 45 million Americans who go on a diet every year to not do so. She warns: “You’ll likely lose weight in the short term, but your chance of keeping if off for five years or more is about the same as your chance of surviving metastatic lung cancer: 5 percent. And when you do gain back the weight, everyone will blame you. Including you.”
In agreement with Harriet Brown is Sandra Aamodt, author of Why Diets Make Us Fat: The Unintended Consequences of Our Obsession with Weight Loss. Aamodt cites studies that show the overwhelming majority of dieters get fatter and mess up their metabolism, making them even more vulnerable to obesity. All one can do is let go of society’s unrealistic body images, eat sensibly, exercise, stop weighing oneself, and let the chips fall where they may.
I will concede that these intelligent writers make a strong case for not dieting and for not embarking on a fool’s errand to aspire to society’s unrealistic slender body images.
However, I find their arguments that we are doomed to fail to lose and keep our weight off ultimately unconvincing. High failure rates of anything don’t impress me because I am a disciple of Sturgeon’s Law, the belief that over 90% of everything is crap.
Sturgeon’s Law dictates that over 90% of aspiring novelists write crappy novels. But that doesn’t mean I’m going to discourage one of my brilliant students from becoming a novelist.
Sturgeon’s Law dictates that 90% of books that are published today aren’t even real books. They’re just gussied-up, padded short stories and essays masquerading as books. But that doesn’t mean I don’t search for literary gems.
Sturgeon’s Law dictates that if you’re part of the dating scene, over 90% of the people you’re dating are emotional dumpster fires, unctuous charlatans, and incorrigible sociopaths. But that doesn’t you can’t eventually find through dating a legit human being for whom you find true love.
Sturgeon’s Law dictates that over 90% of marriages are cesspools of misery, toxicity, and dysfunction. But that doesn’t mean that I would discourage two people who are both well-grounded with strong moral convictions, sincere motivations, and a realistic grasp of what is in store for them to not marry each other.
Sturgeon’s Law dictates that most home-improvement contractors are hacks, fugitives, pathological liars, and snake-tongued mountebanks. But that doesn’t mean you don’t bust your butt looking for a solid referral to find a credible contractor who will redo your kitchen.
I could go on. The point is that if you are looking to do something that is exceptional and long-lasting, you are going to have to commit yourself to hard study and hard work. You’re also going to have to endure a lot of trial and error. Since Sturgeon’s Law dictates that over 90% of people don’t do the necessary groundwork for embarking on any project in a worthwhile manner, then you’re not surprisingly going to have a high failure rate in the realm of dieting.
What we must do to be successful is not point to the high failure rate as an excuse for our own failures, as our Inner Fat Person is want to do. What we must do is study the small amount of successful people and analyze their methods of excellence. There are powerful, life-changing books on this subject. One helpful example is Malcolm Gladwell’s The Outliers: The Story of Success, which propounds the 10,000 Hour Rule, the principle that you need a minimum of 10,000 hours of concentrated work to achieve a base level of competence in your craft. Other books that help us study the methods of success come from Georgetown computer science professor Cal Newport. He has written Deep Work: Rules for Focused Success in a Distracted World and So Good They Can’t Ignore You: Why Skills Trump Passion in the Quest for Work You Love. In both both books, Newport advocates a “craftsman mindset,” in which you achieving mastery in a craft through “deep work.” This mastery is rare and therefore highly marketable and valuable. But only people who have the fortitude, commitment, and proper habits of “deep work,” performing long chunks of focused work on their craft, rise to the top. Newport argues that this kind of achievement is exceptional and therefore highly prized.
Of course it is. Sturgeon’s Law dictates that this be so.
When we look at everything through the prism of Sturgeon’s Law, we see we have no excuses for our failures, including our diet failures.
Studying failures is not an excuse for failure. Studying failures is a warning for us not to follow the footsteps of those who fail. Once we’ve examined the don’ts of the failures, then we must study the dos of the successes.
To find how to be successful at killing our Inner Fat Person, we can return to Alexandra Sifferlin’s essay “The Weight Loss Trap.” Sifferlin points out that there are some people, over 10,000 in fact, who successfully lose their weight. Their success is recorded in The National Weight Control Registry, headed by Brown University professor Rena Wing and obesity researcher James O. Hill from the University of Colorado. To be a member of the registry, one has to have lost 30 pounds and have kept it off for at least a year. Registry members don’t all stick to one diet. They have different diets, but the one common denominator is that whatever diet they’re on, the new diet is making them mindful of what they’re putting in their mouth. They also exercise regularly. So against the odds, thousands of people are losing and keeping their weight off.
What separates the successful dieters from the failures is consistency, mindfulness of what they’re eating, and a realistic approach so that they don’t get discouraged and burned out over the long-haul.
Another success factor is to find a reliable mentor, either a person you know or an author whose realistic dieting goals can stick with you for a lifetime.
I have an exceptional mentor, Max Penfold, who embodies the “craftsman mindset” described by Cal Newport.
Max Penfold is a United States powerlifting champion, former Navy Seal, and executive chef for arguably the most disruptive tech company in the world.
Also Max Penfold has lost 70 pounds, and he has kept if off for seven years. That qualifies him for membership in The National Weight Control Registry.
If I lose just five more pounds and keep it off for a year, I too can enter the realm of success.
I say the hell with failure.
The hell with the doomsday prophets who say failure is inevitable.
And the hell with my Inner Fat Man.
"Why I'm Giving Up on Preventative Care" by Barbara Ehrenreich
One. Is BE committing a Straw Man in the first paragraph? ("You don't have to get sick and die." Who promised that?)
In the last few years I have given up on the many medical measures—cancer screenings, annual exams, Pap smears, for example—expected of a responsible person with health insurance. This was not based on any suicidal impulse. It was barely even a decision, more like an accumulation of micro-decisions: to stay at my desk and meet a deadline or show up at the primary care office and submit to the latest test to gauge my biological sustainability; to spend the afternoon in faux-cozy corporate environment of a medical facility or to go for a walk. At first I criticized myself as a slacker and procrastinator, falling behind on the simple, obvious stuff that could prolong my life. After all, this is the great promise of modern scientific medicine: You do not have to get sick and die (at least not for a while), because problems can be detected “early” when they are readily treatable. Better to catch a tumor when it’s the size of an olive than that of a cantaloupe.
No one promises you won't get sick and die. Rather, the probabilities are in your favor if you get early detection and pursue preventative care.
Two. Is BE committing an either-or fallacy and non sequitur in second paragraph? (Does responsible preventative care exclude testing for lead? Are the two problems even related or is BE posing a non sequitur?)
I knew I was going against my own long-standing bias in favor of preventive medical care as opposed to expensive and invasive high-tech curative interventions. What could be more ridiculous than an inner-city hospital that offers a hyperbaric chamber but cannot bestir itself to get out in the neighborhood and test for lead poisoning? From a public health perspective, as well as a personal one, it makes far more sense to screen for preventable problems than to invest huge resources in the treatment of the very ill.
That BE's clinic offers dubious services such as a hyperbaric chamber and is not addressing lead poisoning in the community is a good point for an essay, but not this essay. She seems to be using a non sequitur that does not support her thesis, which is that preventive care is overrated and based on false promises.
Her thesis suffers in several ways. Here are two:
One, not all preventative care is the same.
Two, some people need more preventative care than others based on their family history.
Three. Does BE commit fallacies of ad hominem and Straw Man in third paragraph, and if so, what happens to her ethos? (Are people responsible for their preventative care "boasting" and delusional about living forever?)
I also understood that I was going against the grain for my particular demographic. Most of my educated, middle-class friends had begun to double down on their health-related efforts at the onset of middle age, if not earlier. They undertook exercise or yoga regimens; they filled their calendars with upcoming medical tests and exams; they boasted about their “good” and “bad” cholesterol counts, their heart rates and blood pressure. Mostly they understood they the task of aging to be self-denial, especially in the realm of diet, where one medical fad, one study or another, condemned fat and meat, carbs, gluten, dairy, or all animal-derived products. In the health-conscious mind-set that has prevailed among the world’s affluent people for about four decades now, health is indistinguishable from virtue, tasty foods are “sinfully delicious,” while healthful foods may taste good enough to be advertised as “guilt-free.” Those seeking to compensate for a lapse undertake punitive measures like fasts, purges, or diets composed of different juices carefully sequenced throughout the day.
BE uses some logical fallacies here: Not all health seekers behave the same. Some behave stupidly; others behave smartly. BE shouldn't lump them altogether with a few caricatures. For example, I exercise and watch what I eat, but I don't boast about my amazing healthy lifestyle. Nor do I think I will defy death.
Four. Does she commit another non sequitur in paragraphs four and five with her fatalism about death? (Since we are going to die and since there is so much we can do about the aging process, are we just supposed to say "the hell with it?" Does it follow that the inevitability of death compels us to give up on preventative medical care at some point?)
I had a different reaction to aging: I gradually came to realize that I was old enough to die, by which I am not suggesting that each of us bears an expiration date. There is of course no fixed age at which a person ceases to be worthy of further medical investment, whether aimed at prevention or cure. The military judges that a person is old enough to die—to put him or herself in the line of fire—at age 18. At the other end of life, many remain world leaders in their seventies or even older, without anyone questioning their need for lavish continuing testing and care. Zimbabwe’s former president, Robert Mugabe, recently turned 90, and has undergone multiple treatments for prostate cancer.
If we go by newspaper obituaries, however, we notice that there is an age at which death no longer requires much explanation. Although there is no general editorial rule on these matters, it is usually sufficient when the deceased is in their seventies or older for the obituary writer to invoke “natural causes.” It is sad when anyone dies, but no one can consider the death of a septuagenarian “tragic,” and there will be no demand for an investigation.
Just because BE feels "old enough to die," doesn't mean her position is embraced by everyone else. Her personal decision, in other words, is not some universal wisdom to be imposed on the rest of us. If you're done, BE, that's your business.
Five. While I see flaws in the beginning of the essay, there is a point where BE begins to win me over.
BE seems to be advocating a balance of quality of life and common sense vs. hyper vigilance or fanatical attention to one's health, which becomes oppressive.
BE makes the correct observation that there is a point where invasive medical procedures compromise our quality of life and offer little in the bargain; in fact, some procedures may present even more harm than good and cause us to question the medical establishment's financial incentives.
Once I realized I was old enough to die, I decided that I was also old enough not to incur any more suffering, annoyance, or boredom in the pursuit of a longer life. I eat well, meaning I choose foods that taste good and that will stave off hunger for as long as possible, like protein, fiber, and fats. I exercise—not because it will make me live longer but because it feels good when I do. As for medical care: I will seek help for an urgent problem, but I am no longer interested in looking for problems that remain undetectable to me. Ideally, the determination of when one is old enough to die should be a personal decision, based on a judgment of the likely benefits, if any, of medical care and—just as important at a certain age—how we choose to spend the time that remains to us.
Six. BE raise important question: Are health providers basing procedures on profit motive?
At the same time I had always questioned whatever procedures the health care providers recommended; in fact I am part of a generation of women who insisted on their right to raise questions without having the word “uncooperative,” or worse, written into their medical records. So when a few years ago my primary care physician told me that I needed a bone density scan, I of course asked him why: What could be done if the result was positive and my bones were found to be hollowed out by age? Fortunately, he replied, there was now a drug for that. I told him I was aware of the drug, both from its full-page magazine ads as well as from articles in the media questioning its safety and efficacy. Think of the alternative, he said, which might well be, say, a hip fracture, followed by a rapid descent to the nursing home.
Seven. Is health care industry wrongly calling natural conditions of old age "disease"?
So I grudgingly conceded that undergoing the test, which is noninvasive and covered by my insurance, might be preferable to immobility and institutionalization. The result was a diagnosis of “osteopenia,” or thinning of the bones, a condition that might have been alarming if I hadn’t found out that it is shared by nearly all women over the age of 35. Osteopenia is, in other words, not a disease but a normal feature of aging. A little further research, all into readily available sources, revealed that routine bone scanning had been heavily promoted and even subsidized by the drug’s manufacturer. Worse, the favored medication at the time of my diagnosis has turned out to cause some of the very problems it was supposed to prevent—bone degeneration and fractures. A cynic might conclude that preventive medicine exists to transform people into raw material for a profit-hungry medical-industrial complex.
My first major defection from the required screening regimen was precipitated by a mammogram. No one likes mammography, which amounts to a brute-force effort to render the breasts transparent. First, a breast is flattened between two plates, then it is bombarded with ionizing radiation, which is, incidentally, the only environmental factor known for sure to cause breast cancer. I’d been fairly dutiful about mammograms since having been treated for breast cancer at the turn of the millennium, and now, about 10 years later, the gynecologist’s office reported that I’d had a “bad mammogram.” I spent the next few anxious weeks undergoing further tests, in the midst of which I managed to earn a ticket for “distracted driving.” Naturally I was distracted—by the looming decision of whether I would undergo debilitating cancer treatments again, or just let the disease take its course this time.
It turned out, after I’d been through a sonogram and fought panic in a coffin-like MRI tube, that the “bad mammogram” was a false positive resulting from the highly sensitive new digital forms of imaging. That was my last mammogram. Lest this seem like a reckless decision, I was supported in it by a high-end big-city oncologist, who viewed all my medical images and said that there would be no need to see me again, which I interpreted as ever again.
After this, every medical or dental encounter seemed to end in a tussle. Dentists—and I have met a number of them in my moves around the country—always wanted a fresh set of X-rays, even if the only problem was a chip in the tip of a tooth. All I could think of was the X-ray machines every shoe store had offered in my youth, through which children were encouraged to peer at the bones of their feet while wiggling their toes. The fun ended in the 1970s, when these “fluoroscopes” were eventually banned as dangerous sources of radiation. So why should I routinely expose my mouth, which is much more cancer-prone than the feet, to high annual doses of roentgens? If there was some reason to suspect underlying structural problems, okay, but just to satisfy the dentist’s curiosity or meet some abstract “standard of care”—no.
In all these encounters, I was struck by the professionals’ dismissal of my subjective reports—usually along the lines of “I feel fine”—in favor of the occult findings of their equipment. One physician, unprompted by any obvious signs or symptoms, decided to measure my lung capacity with the new handheld instrument he’d acquired for this purpose. I breathed into it, as instructed, as hard as I could, but my breath did not register on his screen. He fiddled with the instrument, looking deeply perturbed, and told me I seemed to be suffering from a pulmonary obstruction. In my defense, I argued that I do at least 30 minutes of aerobic exercise a day, not counting ordinary walking, but I was too polite to demonstrate that I was still capable of vigorous oral argument.
Eight. BE makes convincing argument that in many cases medical industry subjects us to dangerous equipment and procedures that pose more risk than the very thing they're supposedly trying to find. This problem is explored in graphic detail in the Netflix documentary The Bleeding Edge.
It was my dentist, oddly enough, who suggested, during an ordinary filling, that I be tested for sleep apnea. How a dentist got involved in what is normally the domain of ear, nose, and throat specialists, I do not know, but she recommended that the screening be done at a “sleep center,” where I would attempt to sleep while heavily wired to monitoring devices, after which I could buy the treatment from her: a terrifying skull-shaped mask that would supposedly prevent sleep apnea and definitely extinguish any last possibility of sexual activity. But when I protested that there is no evidence I suffer from this disorder—no symptoms or detectable signs—the dentist said that I just might not be aware of it, adding that it could kill me in my sleep. This, I told her, is a prospect I can live with.
As soon as I reached the age of 50 physicians had begun to recommend—and in one case even plead—that I have a colonoscopy. As in the case of mammograms, the pressure to submit to a colonoscopy is hard to avoid. Celebrities promote them, comics snicker about them. During March, which is Colorectal Cancer Awareness Month, an eight-foot-high inflatable replica of a colon tours the country, allowing the anally curious to stroll through and inspect potentially cancerous polyps “from the inside.” But if mammography seems like a refined sort of sadism, colonoscopies mimic an actual sexual assault. First the patient is sedated—often with what is popularly known as the “date rape drug,” Versed—then a long flexible tube, bearing a camera on one end, is inserted into the rectum and all the way up through the colon. What repelled me even more than this kinky procedure was the day of fasting and laxatives that was supposed to precede it, in order to ensure that the little camera encounters something other than feces. I put this off from year to year, until I finally felt safe in the knowledge that since colon cancer is usually slow-growing, any cancerous polyps I contain are unlikely to flourish until I am already close to death from other causes.
Then my internist, the chief physician in a midsized group practice, sent out a letter announcing that he was suspending his ordinary practice in order to offer a new level of “concierge care” for those willing to cough up an extra $1,500 a year beyond what they already pay for insurance. The elite care would include 24-hour access to the doctor, leisurely visits, and, the letter promised, all kinds of tests and screenings in addition to the routine ones. This is when my decision crystallized: I made an appointment and told him face-to-face that, one, I was dismayed by his willingness to drop his less-than-affluent patients, who appeared to make up much of the waiting room population. And, two, I didn’t want more tests; I wanted a doctor who could protect me from unnecessary procedures. I would remain with the masses of ordinary, haphazardly screened patients.
Of course all this unnecessary screening and testing happens because doctors order it, but there is a growing rebellion within the medical profession. Over-diagnosis is beginning to be recognized as a public health problem, and is sometimes referred to as an “epidemic.” It is an appropriate subject for international medical conferences and evidence-laden books like Overdiagnosed: Making People Sick in the Pursuit of Health by H. Gilbert Welch and his Dartmouth colleagues Lisa Schwartz and Steve Woloshin. Even health columnist Jane Brody, long a cheerleader for standard preventive care, now recommends that we think twice before undergoing what were once routine screening procedures. Physician and blogger John M. Mandrola advises straightforwardly:
Rather than being fearful of not detecting disease, both patients and doctors should fear healthcare. The best way to avoid medical errors is to avoid medical care. The default should be: I am well. The way to stay that way is to keep making good choices—not to have my doctor look for problems.
With age, the cost/benefit analysis shifts. On the one hand, health care becomes more affordable—for Americans, anyway—at age 65, when a person is eligible for Medicare. Exhortations to undergo screenings and tests continue, with loved ones joining the chorus. But in my case, the appetite for medical interactions of any kind wanes with each passing week. Suppose that preventive care uncovered some condition that would require agonizing treatments or sacrifices on my part—disfiguring surgery, radiation, drastic lifestyle limitations. Maybe these measures would add years to my life, but it would be a painful and depleted life that they prolonged.
As it is now, preventive medicine often extends to the end of life: 75-year-olds are encouraged to undergo mammography; people already in the grip of one terminal disease may be subjected to screenings for others. At a medical meeting, someone reported that a 100-year-old woman had just had her first mammogram, causing the audience to break into a “loud cheer.”
One reason for the compulsive urge to test and screen and monitor is profit, and this is especially true in the United States, with its heavily private and often for-profit health system. How is a doctor—or hospital or drug company—to make money from essentially healthy patients? By subjecting them to tests and examinations that, in sufficient quantity, are bound to detect something wrong or at least worthy of follow-up. Gilbert and his coauthors offer a vivid analogy, borrowed from an expert in fractal geometry: “How many islands surround Britain’s coasts?” The answer of course depends on the resolution of the map you are using, as well as how you are defining an “island.” With high-resolution technologies like CT scans, the detection of tiny abnormalities is almost inevitable, leading to ever more tests, prescriptions, and doctor visits. And the tendency to over-test is amplified when the doctor who recommends the tests has a financial interest in the screening or imaging facility that he or she refers people to.
It’s not only a profit-hungry medical system that drives over-testing and over-diagnosis. Individual consumers, that is, former and potential patients, may demand the testing and even threaten a malpractice suit if they feel it is being withheld. In the last couple of decades, “patient advocacy” groups have sprung up to “brand” dozens of diseases and publicize the need for screening. Many have their own celebrity spokespersons—Katie Couric for colonoectal cancer, Rudy Giuliani for prostate cancer—and each sports its own distinctive colored ribbon—pink for breast cancer, purple for testicular cancer, black for melanoma, a “puzzle pattern” for autism, and so on—as well as special days or months for concentrated publicity and lobbying efforts. The goal of all this is generally “awareness,” meaning a willingness to undergo the appropriate screening, such as mammograms and PSA tests.
There are even sizable constituencies for discredited tests. When the US Preventive Services Task Force decided to withdraw its recommendation of routine mammograms for women under 50, even some feminist women’s health organizations, which I had expected to be more critical of conventional medical practices, spoke out in protest. A small band of women, identifying themselves as survivors of breast cancer, demonstrated on a highway outside the task force’s office, as if demanding that their breasts be squeezed. In 2008, the same task force gave PSA testing a grade of “D,” but advocates like Giuliani, who insisted that the test had saved his life, continued to press for it, as do most physicians.
Many physicians justify tests of dubious value by the “peace of mind” they supposedly confer— except of course on those who receive false positive results. Thyroid cancer is particularly vulnerable to over-diagnosis. With the introduction of more high-powered imaging techniques, doctors were able to detect many more tiny lumps in people’s necks and surgically remove them, whether surgery was warranted or not. An estimated 70 to 80 percent of thyroid cancer surgeries performed on US, French, and Italian women in the first decade of the 21st century are now judged to have been unnecessary. In South Korea, where doctors were especially conscientious about thyroid screening, the number rose to 90 percent (Men were also over-diagnosed, but in far lower numbers.) Patients pay a price for these surgeries, including a lifelong dependence on thyroid hormones, and since these are not always fully effective, the patient may be left chronically “depressed and sluggish.”
So far I can detect no stirrings of popular revolt against the regime of unnecessary and often harmful medical screening. Hardly anyone admits to personally rejecting tests, and one who did—science writer John Horgan in a Scientific American blog on why he will not undergo a colonoscopy—somewhat undercut his well-reasoned argument by describing himself as an “anti-testing nut.” Most people joke about the distastefulness of the recommended procedures, while gamely submitting to whatever is expected of them.
But there’s a significant rebellion brewing on another front. Increasingly, we read laments about the “medicalization of dying,” usually focused on a formerly frisky parent or grandparent who had made clear her request for a natural, nonmedical death, only to end up tethered by cables and tubes to an ICU bed. Physicians see this all the time—witty people silenced by ventilators, the fastidious rendered incontinent—and some are determined not to let the same thing happen to themselves. They may refuse care, knowing that it is more likely to lead to disability than health, like the orthopedist who upon receiving a diagnosis of pancreatic cancer immediately closed down his practice and went home to die in relative comfort and peace. A few physicians are more decisively proactive, and have themselves tattooed “NO CODE” or “DNR,” meaning “do not resuscitate.” They reject the same drastic end-of-life measures that they routinely inflict on their patients.
In giving up on preventive care, I’m just taking this line of thinking a step further: Not only do I reject the torment of a medicalized death, but I refuse to accept a medicalized life, and my determination only deepens with age. As the time that remains to me shrinks, each month and day becomes too precious to spend in windowless waiting rooms and under the cold scrutiny of machines. Being old enough to die is an achievement, not a defeat, and the freedom it brings is worth celebrating.
Sample Thesis Statements
Supporting BE
While BE's essay has a rocky beginning with some logical fallacies, her essay eventually makes the convincing case that the medical industry profits from promising unrealistic expectations about aging, subjecting us to invasive procedures that compromise the quality of our life, and packaging their "preventative care" to veil their true motive: profit.
Another Support of BE
While some medical care is invasive and unsafe, we can, like BE, do our due diligence to find the sweet spot of preventative care that works for us and repel those procedures that BE correctly observes are unsafe and profit-driven.
Refuting BE
While BE has resigned herself to dying and old age, it is irresponsible for her to play doctor and determine what procedures work and do not work for her and to then argue that we should follow her reckless behavior.
Recommended Sources
Bleeding Edge Review in Variety
Bleeding Edge Review in New York Times
Option M
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