New Jersey Gov. Chris Christie acknowledged on Monday that he recently underwent lap band surgery to help him lose weight. The governor says personal health motivated his decision, but his heft—Christie reportedly topped 300 pounds—could also complicate a 2016 presidential bid. William Howard Taft was at least as obese as Christie. Did his doctors tell him to lose weight?
Yes. Doctors at the turn of the 20th century advised patients to carry a 20- to 50-pound reserve in case of prolonged illness, a reasonably sound recommendation at a time when pneumonia, tuberculosis, and diarrhea each killed more Americans than heart disease or diabetes. Extreme obesity, however, has long been recognized as a problem. Eighteenth-century medical journals associated obesity with drowsiness, gout, and difficulty breathing. Taft, who weighed as much as 340 pounds during his presidency, suffered from all three. Taft publicly acknowledged his weight problem—it was probably difficult to ignore after the president of the Massachusetts Society for the Prevention of Cruelty to Animals called on him to give up horseback riding—noting that “too much flesh is bad for any man.” (“Extra flesh” was the common euphemism for obesity at the time.) Taft implied that his ideal weight was 270 pounds, though, which indicates how much standards for body weight have changed. Even at that weight, a man of Taft’s height would today be considered severely obese according to his body mass index.
Much is made of how obesity used to be a popular sign of vitality, nobility, and personal wealth. There’s some truth to this generalization: The 25,000-year-old Venus of Willendorf figurine, which may have been a fertility charm, is a portly woman. The figures in many Rubens paintings are overweight by modern standards, as are the bathers in the Renoir painting of the same name. Doctors, however, have been concerned about obesity virtually since the beginning of serious medical writing. Hippocrates emphasized the importance of balancing the energy ingested with that expended. Pythagoras recommended moderation in diet. The ancient Egyptians possibly went too far in their quest to maintain a healthy weight, vomiting to prevent excess food from becoming body fat, according to the Greek historian Diodorus Siculus.
The link between obesity and specific medical disorders began to be recognized largely in the late 17th century. George Cheyne, a massively obese physician, noticed that patients with extra pounds suffered from ailments such as skin rashes, poor circulation, and lethargy. By the 19th century, a handful of publications had linked obesity to diabetes and heart disease, but it would be another century before the connection was firmly established. (In fact, the current package of symptoms and disorders known as metabolic syndrome—obesity, high cholesterol, diabetes, and high blood pressure, among other things—didn’t come together until the late 1980s, when endocrinologist Gerald Reaven described what he called “Syndrome X.”) The insurance industry can also take credit for connecting obesity to ill health. Between 1900 and 1920, statisticians at Metropolitan Life and other major insurance companies used actuarial studies to prove that obese people die younger. The actuarial findings, as much as any medical breakthrough, helped turn the health care industry against body fat.
While Taft-ian body shapes have virtually always been considered unhealthy, it’s impossible to say with precision what a doctor would have considered a healthy weight 200, 800, or 1,000 years ago. The medical community didn’t become serious about obesity until the early part of the 20th century, and it wasn’t until 1985 that the National Institutes of Health decided to use the body mass index to set national standards for obesity.
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