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XXL: Obesity and the Limits of Shame (U of T Centre for Public Management Series on Public Policy & Administration) Paperback – March 12, 2011

2.5 out of 5 stars 2 customer reviews

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Editorial Reviews


'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)

‘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

(Christina Beaird University Press Books for Public & Secondary School Libraries, 2012)

‘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.


Product Details

  • Series: U of T Centre for Public Management Series on Public Policy & Administration
  • Paperback: 192 pages
  • Publisher: University of Toronto Press, Scholarly Publishing Division; 1 edition (March 12, 2011)
  • Language: English
  • ISBN-10: 0772786275
  • ISBN-13: 978-0772786272
  • Product Dimensions: 6 x 0.5 x 9 inches
  • Shipping Weight: 2.4 ounces (View shipping rates and policies)
  • Average Customer Review: 2.5 out of 5 stars  See all reviews (2 customer reviews)
  • Amazon Best Sellers Rank: #4,543,757 in Books (See Top 100 in Books)

Customer Reviews

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Top Customer Reviews

By C. Cornell on December 3, 2013
Format: Paperback
This book is not without merit, and it may be a decent introduction for those new to the field of obesity research in the public health sector. But this work is seriously lacking in academic rigor and makes unqualified, sometimes downright strange statements.

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.
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Format: Paperback
One of the problems of the current obesity epidemic is a lack of self-control. This manifests itself in the all too oft seen excuse of "it's not my fault", with the admonition that if it weren't for the `bad genes', `unavailability of good food', `unavailability of time to make better choices', etc, etc, the weight could be lost.
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.
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