At Dr. Robert Pretlow's childhoodobesitynews.com, two of Pat Hartman's recent posts are, "Is Fat a Four-Letter Word?" and "Is Thin a Four-Letter Word?" The point of the former is one I have explored — "In the area of childhood obesity, do we worry too much about hurt feelings?"

Hartman's summary of the latter includes ...

Sometimes it seems as if “thin” is equally reprehensible, because people object to the idea of children being told that thin is better than fat. ... But when children and teenagers totally disregard their overweight, unhealthy bodies, other things can happen that are just as ugly. Is it possible that we worry too much about hurt feelings, at the cost of hurt bodies, suffering from diabetes, or tempted into questionably effective surgery?

What these posts evoke for me is an evolution of perspective in which the key point is neither "thin" nor "fat," but "healthy." I concede that my evolution needs a lot more evolving, even if I'm also ahead of the curve on this idea.

Our thinking on this point is horribly muddled, as a result of a fatally fashion-focused perspective. A personal example: Coming from extreme obesity, I long considered anorexia as a better disease than compulsive overeating, on the grounds that if I was going to be sick around eating, couldn't I at least have the one that produced a more societally desireable body shape?

Sick with benefits, sorta. 

It's bullshit, of course. The desireable outcome is healthy, not a different kind of sick. 

Another version: Is it better if my dysfunction suggests that I've really got it going on (slim, sexy), or is it better if it declares my struggles? (Nope. Still, they both suck.)

The flip side is that although neiither "too thin" nor "too fat" equates to "healthy," they are often linked. Yes, there are outliers like Ragen Chastain, who weighs a lot more than I do but is 100 times the dancer I'll ever be. (Video of her in the studio is included in Darryl Roberts's film "American the Beautiful 2: The Thin Commandments," and she's impressive.)

But more common than 5-foot-4, 284-pound ballerinas are instances of people who undereat and overeat to the point of death. Anyone want to disagree with that?

So, OK. By itself, being fat isn't proof of poor health, and neither is being thin. But people whose body size may indicate unhealthy habits that could lead to degraded quality of life, greater incidence of serious health problems, and early death do not benefit when validly concerned family members and health professionals avoid discussing them, especially if they don't want to hurt feelings.