So, about this whole "fat" thing.

Being fat is, in some ways, like being black used to be. I like the fact that racial tolerance has reached the place that a black man can be a comedian without being "that black comedian." Don't get me wrong--I think that most comics are funny because they speak from experience, and being a black person in the world is part of some people's experience. However, it seems like 15 years ago, a black comic's routine HAD to center around being black, whereas now I think you can expect anything when the comedian you're watching happens to be black. If he talks about his experiences as a person of color, fine, but it's not obligatory.

In the same way, I would really like to see the day when a fat comedian can go onstage and not mention his or her weight. Self-deprecation, even weight-related self-deprecation is all fine and good, but at some point we become the Richard Pryors of the fat world, hamming it up to the thin, white audience. And while I don't think there's anything wrong (and, in fact, I think it's quite positive) when a fat comedian has a pro-fat subtext to what they're saying, I, personally, I would rather choose not to be defined by my body size.

But I do suppose that at some point I have to go "on the record" about the whole thing, and may as well do so now as at any other time.

I will never deny that being fat is unhealthier than being thin. Science backs this up, and I'm a big fan of science. However, I do not agree with the demonization of fat people, and find in almost all cases where the "unhealthy" aspects of being fat are referenced, it is as thinly-disguised excuse to justify bigotry and discrimination.

Many years ago, Scientific American published some research about homosexuality, and had several scientists offer reviews and comments. One of the scientists said, basically, that one had to be careful with studies into the "whys" of homosexuality, because the root question could be interpreted as, "Can they help it," which is loaded in and of itself, and he felt a corresponding responsibility in how the answer might be used.

In the same way, some people think that the question of "Can fat people help it?" should have the simple response of, "Why does it matter?" and I can certainly appreciate that.

However, unlike homosexuality, I'd say it's pretty safe to classify the general state of being overweight as being negative. Given the choice, I would prefer to be thin. I generally describe moving around easily, wearing stylish clothing, and walking upstairs without panting as "positive" experiences. The question is how to effectively go from a large size to a small one, when over 95% of people who try the only universally-approved weight-loss method--diet and exercise--regain all of the weight and then some within 5 years.

I used to work as a genetic researcher. What we were studying at the time was the genetics of dependency, and our lab, specifically, was in the Alcoholism branch of study. The tests themselves could be tedious and boring, but the work, on the whole, was fascinating to me.

There are two strains of mice (C-57s and DBAs) that approach AND process alcohol differently. Given the choice of pure ethanol and water to drink, one type will drink the ethanol exclusively until they die of dehydration. The other strain will avoid ethanol at similar cost to life.

It was discovered that ethanol consumption reduces core body temperature. There were two subsequent hypotheses: either the body loses its ability to thermoregulate, or the body's temperature set-point is lowered as a result of drinking. Tests were done, and it was discovered that the two strains of mice mentioned earlier differed in this physiological effect--one of them lost the ability to thermoregulate and the other still thermoregulated, but the alcohol caused them to have a lowered core body temperature set-point.

We were researching which genes were responsible for this alcohol/temperature link.

The lab was run by a really great physiologist whose area of expertise was thermoregulation. He is one of those people who remains an inspiration to me. In our discussions, he mentioned that the majority of the human body's thermoregulation is achieved through behavioural changes--that our bodies maintain a very precise temperature, usually of 98.6 F, by telling us to put on coats, or turn on fans, etc.

What does this have to do with weight and obesity? If you mesh all of the above together, you end up with two main facts: 1. the physical human body can and will induce behavioural changes in order to get what it wants, and 2. some substances, when consumed, are processed differently by different members of the same species.

I am a decent scientist, and I would never say that mouse-related ethanol research could be directly applied to weight loss research in humans. What I AM saying is that it suggests avenues of research. These aveneus have to do with the interplay between the metabolism of consumed substances, genetics, hunger signals, and physiological influences on food-related behaviours.

The problem is that when it comes to weight loss, we did some informal research years ago and discovered that our stored fat comes from the food we eat, and saw this as the end of the story. We concluded that the human body is little more than a combustion engine, and if you want to lose weight, you reduce the fuel and increase the output. At the same time, we decided that failure to do so is a moral failing. As such, no further research was deemed necessary.

However, is entirely possible that telling someone to lose weight is like telling them to lower their core body temperature. After all, 98.6 is just the average--some people have a higher set point, and some people lower. What would happen if we decided that having a core body temperature of 98.6 was morally wrong, and that everyone should lower theirs to 98.0?

We as a society can tell you to stop wearing a coat when it is chilly, and you may even be able to get yourself to do this for a short period of time. But is this a realistic proposition for long-term change? When you are fighting your body's natural set point, it can and will make you miserable until you comply with its demands. Odds are very high that eventually you will give in and grab a coat.

Realistically, if we wanted someone to permanently alter their thermoregulatory set-point, it would make far more sense to research the point-setting mechanism and alter it to the appropriate level instead.

It's much easier to talk about thermoregulation in these terms, because we do not have decades of emotionally-charged conversations about temperature control affecting our judgment. This is one of the reasons I think that a certain amount of fat-prejudice needs to be eliminated before we can expect real breakthroughs.

Some very lovely endocrinologists are finally researching the physiology behind a person's body weight, and learning things about ghrelin and leptin, and the processing of sugars (specifically HFCS) and fats. Unsurprisingly, early results indicate that people who weigh more react to food consumption physiologically differently from those who are thinner.

Amazingly, though, these scientists receive quite a bit of flak from people who insist on continuing to treat the body as a simple combustion engine, and further insist that the root problem is moral failure. It seems simple to people who have never been seriously overweight--after all, if they diet for a week, they take off that extra five pounds, so why doesn't everyone do this? Clearly the only explanation is that the obese are gluttonous and lazy.

Imagine, if you will, that we are all men living in a brothel. We noticed, at some point, that the (female) prostitutes were always getting pregnant, which was clearly a bad thing. We did a bit of research and discovered that prostitutes get pregnant because men have sex with them. Therefore, having sex with a prostitute is a moral failing and must stop. End of research, end of topic.

However, 1/2 of the male population is subsisting on a diet of viagra and aphrodisiacs.

Do you see what I'm getting at here? Fine. I will accept that, to a certain extent, calories in vs. calories out is the basis for how much someone weighs, with the actual numbers depending on that person's metabolism. However, as long as we view weight gain as a moral failing and therefore unworthy of further research, we are not going to see real solutions. Behavioural modification is just plain not realistic if there are underlying physiological triggers, end of story. As long as we react to tales of people taking weight-loss aids or having bariatric surgery as if they've just suggested continuing to having sex with prostitutes but using a condom, I'm afraid that our society is just going to continue getting fatter.

EDIT: I didn't go into too much detail on the research that has already been done on the endocrinology of weight gain. If you're interested, I recommend you do it yourself. In short, preliminary results indicate that obese people are leptin resistant and have abnormal ghrelin levels. These are hormones known to affect hunger and energy storage. Most endocrinologists liken these problems to those of diabetes. Really, look it up.