To the editors:

The concluding paragraph of Hot Type [December 11] (“It’s true, we are no longer governed by a mayor whom we elected to that office. But there is one person to blame, not 50. That person is Harold Washington, for not watching his weight”) reflects several common misunderstandings about the role of obesity in heart disease like that of the late mayor.

Mayor Washington died because his arteries were clogged with fat. This put strain on his heart and eventually killed him. He could have been thin–as are many people with the same condition–and been at much the same risk. His condition was caused by years of eating high-fat, high-cholesterol foods and getting insufficient exercise. If current research is correct, there was probably also a genetic factor at work.

The same eating patterns that put Mayor Washington at risk also contributed to his obesity. That is not the same, however, as saying that his obesity caused his heart attack (unless you stretch the definition of obesity to include fat inside the arteries, as well as fat on the outside of the body). Much of the late mayor’s weight gain occurred after he quit smoking about a year ago. In most cases, this is a healthy trade-off; numerous studies have shown that even extremely obese nonsmokers have lower death rates than smokers of average weight. Given the already weakened condition of the mayor’s heart, of course, the extra stress brought about by the sudden increase in body weight certainly complicated matters. It was not, however, the primary cause of his death.

There are a lot of common misconceptions about obesity; many people subject themselves to unhealthy diets and unnecessary worry and self-doubt because of these misconceptions. In Mayor Washington’s case, some of the same behaviors that caused his weight gain also caused his heart attack. But to say that he died because he was fat is roughly the same thing as saying that a malnourished alcoholic died because he was thin.

One more point: The tone of that final Hot Type paragraph unnecessarily furthers a common bias against the obese, laden as it is with the implication that obesity is somehow sinful or immoral, and thus deserves to be punished. As I’ve tried to explain here, that notion is far too simplistic. It is also cruel and harmful to the self- image and even the civil rights (employability, access to health insurance) of the vast majority of obese people who are normal and healthy in every other way.

David G. Whiteis

N. Leavitt