Fat and Health

Check out this article on Japanese attitudes towards weight. I feel almost like the author is saying "Gee, if Japanese women can lose weight and keep it off, what's wrong with Americans?"
They say the rates of anorexia and bulimia aren't any higher over there than they are here, but I have to wonder if that's because the idea of an average-sized woman not eating because she wants to be thinner is so widely accepted as normal. Certainly the act of specifically not eating or eating only vegetables when you are hungry for more is something of a disorder, whether it's officially anorexia or not.
Anyone have any other ideas about what might cause the disparity between our attitudes toward weight and that of Japanese women?

This is the question posed in the Nightline debate linked to in withoutscene's posting below. The way I see it, when we ask "is it okay to be fat?", we're really asking a bunch of other questions:

• Is a person allowed to have and maintain a body that is larger than average?
• Is being fat a health problem?
• Is a person with a health problem allowed to choose to not treat that problem?
• Is fat caused by lifestyle choices?
• Is a person in a group health plan allowed to make choices that might cause them to need more health care in the future?

When you break it down to what we're really talking about, I don't see how any rational person could conclude that it is not okay to be fat. What are your thoughts?

Here's another great discussion on obesity, health and environmentalism at Sociological Images. What I love about reading the commentary at SI is that the point of that site is to look beyond the surface of the messages communicated to us by the mainstream media. The commenters there seem to be more willing to question their own beliefs and the result is some very thoughtful commentary. Enjoy

This humble article on The Adipositivity Project over at Sociological Images has spurred a hell of a good discussion on fatness. There are a few folks beating the fat=unhealthy drum, but there are so many other thoughtful comments it's totally worth it. Check it out!

{Promoted from the forums - CarrieP}

The BBC is reporting that a group of Cambridge researchers have discovered a genetic factor common to a number of children and teens labelled as 'severely obese'. They also seem to have identified further links between these 'copy number variants' and the regulation of blood sugar levels and appetite, concerns frequently discussed over the years on these very boards (far be it for me to suggest that people in the FA movement have long known what others have persistently refused even to attempt to demonstrate). Worryingly, several of the study's young participants had already been placed on local authority child protection registers 'on the assumption that their parents were deliberately overfeeding them'; the research findings are apparently sufficiently robust that those participants who were previously slated for intervention or removal by the social services have now been deleted from the database and their parents presumably exonerated.

I give this news a cautious welcome, for the 'may' of the headline is not by any means a 'will' and the enormous moral panic and incessant misinformation of the last decade have left us with a metaphorical supertanker of ignorance and prejudice to stop and turn around before the social work and child health professions begin to realise that a child's size may be as natural as their height and entirely unrelated to parental immorality, abuse or neglect. After all, last month's effective admission by a major obesity research institute that their initial apocalyptic predictions, on which much of the policy and media overreaction seen since in the UK have been based, were way off the mark has so far failed to have much by way impact on those policy makers and the government approach to the 'issue' and indeed was quickly shunted from the front pages.

However it is an important step forward which I am hoping that, given the esteem in which the University of Cambridge is held, will maybe encourage more researchers to break from the consensus and have the courage to challenge the assumptions about over-eating and lack of exercise (and perhaps even the scale of the 'epidemic' itself) without fear of censure and dismissal. Most importantly, tonight maybe Britain's fat children and their entirely blameless parents can sleep that little bit easier in their beds as a result of this good work by Dr. Farooqi and her team. I hope that David Rogers, the Local Government Association public health spokesman who called for a nationwide policy of taking obese children into care a couple of years back, sees this and eats his words, and that lawyers acting for the Dundee family, whose teenage son and daughter remain in the hands of the local authority, are paying attention.

ETA: more about the story here, from AOL via the NAAFA blog (whatever you do, don't read the comments on the AOL link!).

Rose tipped me off to some fat discrimination going on over in North Carolina. According to this policy document, the North Carolina State Health Plan (for teachers and state employees) will soon be divided into two sections: one for the "good" folks who don't smoke and have BMIs under 40 and one for the "naughty" smokers or people with BMIs 40 or above. Of course the good folks will receive more coverage at less expense than the naughty ones. Participants in the health plan are required to fill out a form every year that attests that they fit into the good group and they also agree to be subjected to mandatory random screenings for smoking and for BMI.

I am both appalled and terrified by this idea and the precedent it creates. First of all, does this mean that an NCSU employee is subject to being weighed and measured at work whenever HR deems it necessary? What about personal privacy? What about a person's body being their own property and not for their employer to judge? What about an employee being compensated on their performance and NOT their body size? Because no matter how this policy was initially intended, this ends up being another way to pay fat people less for doing the same job, as if that weren't happening enough already.

I hate the idea of the smoking thing as well on the grounds that what I do in my off time shouldn't be any of my employer's business, but at least that's a behavior that can be stopped. A fat person can't just stop being fat, despite the world's erroneous belief that all you have to do is just try a little harder to eat less and exercise more and the pounds will magically melt off. No one has been able to find a method of weight loss that works permanently for more than the tiniest percentages of people, which means that fat people are likely going to stay fat no matter how many crunches they do.

Let's not forget that the mainstream jury is still out on fat and health anyway...even Newsweek isn't sure whether fat=unhealthy anymore. Even if it was proven beyond a shadow of a doubt that fat people are definitely going to get sick, the whole point of a group health plan is that some people are going to get sick and some aren't. By buying into it you acknowledge that you are going to pay the same amount whether you get sick or not and whether other people get sick or not. If we're going to just weed out the people we think are going to get sick, what's the point of group health then anyway?

On TOP of that, what this plan is doing is funneling the people who are (supposedly) the most likely to get sick into a group that gets less coverage! Those who will likely need health care the most are all of a sudden going to get the least amount of assistance from their health insurance company! If this doesn't prove clearly how much more interested health insurance companies are in profits over actually providing health care, then I don't know what will.

Thanks Rose!

This article just broke my heart. Samantha Clowe didn't want to be the dreaded "fat bride", so she dutifully got permission from her doctor and started following the LighterLife diet plan. It certainly seemed to work...in her eleven weeks on the diet Samantha decreased her BMI by two whole points. Then she collapsed and died.

My heart goes out to Samantha and her family. I can only imagine the thoughts that might have driven her to choose the plan, like longing to fit her body into society's favored mold, the idea that whoever she was now wasn't good enough to stand up in front of her friends and family and get married. Maybe, like many dieters, she believed that this fat thing was only temporary and if she could just find the right plan and just try hard enough, she could finally be "normal" and, therefore, "happy".

I will confess, I have had these thoughts too. Some not even all that long ago. You know why Samantha and I and millions of other people have felt this way? Because somewhere along the way as we were growing up, enough people told us that our bodies were wrong that we started to believe it. Some of us believed it so much that we tried whatever we could to make our bodies behave and were thwarted when they fought back and grew even bigger, further outside of the realm of okay. Eventually, some of us were so freaked out by being fat that we gladly paid someone to cut into our bodies and mess with the way our digestive systems worked, all so we could finally be..."normal". The thing is, there are a million different kinds of bodies out there. "Normal" doesn't really exist.

The thing that really incenses me about this article is that the LighterLife people are blaming Samantha's death on the fact that she started out all deathfat so she was probably just a ticking timebomb anyway. So it seems we are doomed to death even if we go along and do as we're told to conform. What a load of crap.

Samantha was only 11 weeks into the program but on the LighterLife website they say women should do it for 14 weeks or even more if they want to lose more weight at the end of that time. This is at least the third death linked to LighterLife. I wonder how many more people have to die while following their program before someone finally shuts them down.

Update: As suggested by MichMurphy, I've started a photo gallery for fat brides on flickr. Feel free to join, post any and all fat bride photos and pass on the link to all of your fat bride friends! Here come the Fat Brides!

I am in love with this photo gallery at Newsweek.com. I would like to squeeze it all over and marry it and have little blogger/photo gallery babies. Check it out!

Also here's Athletes of Every Size which is the same basic idea but, you know, not on Newsweek.com.

I just came across this article at MSN describing a study that says folks with skinny thighs have a 50-100% higher chance of developing heart disease than their thick-thighed counterparts. Of course, they're quick to mention that this is not a "free pass for people who want to skip the gym", or, presumably, for fat people to start loving their fat thighs. Certainly they wouldn't want to give the impression that a nonskinny bodypart would be 'okay' and 'not deadly'...lord knows those fat people are just looking for an excuse to not lose weight.

The comments are somewhat fat-hating, as expected, but I also found it amusing that so many people were skeptical of the study's results. Wait, so the studies about how fat people are just going to drop dead are beyond reproach but this one is complete BS? Sounds fishy to me...

I want to direct your attention to this fantastic post at Fatshionista about how we as fat people cut ourselves off from sports and other physical activities because we see them as things fat people aren't supposed to do. I have experienced this a million times in my fat life and I'm betting some of you out there can relate. I can come up with a whole list of physical things I have avoided at times in my life because fat people "don't" or "shouldn't" do them:

Riding my bike (this is a big one that still gives me trouble...I have an irrational fear of being mocked on my bike)
Walking around my neighborhood
Running in my neighborhood
Swimming
Going to the gym
Joining a community sports team
Rock-climbing
Yoga
Learning to salsa dance

I'd like to say I've consistently ignored the fear and accomplished all of these things, but there are a few on the list I'm still a little reluctant to try because of those irrational thoughts. It's a process.

Are there things you have avoided or flat out not done because you are fat? Let us know in the comments!

Paul Campos gave a great interview over at The Atlantic yesterday, but what I found most interesting about the whole thing were the comments on the article. Almost every one is well thought out, literate, and full of good discussion about the topic at hand instead of devolving into 'fatties are stupid and gross and OMG should just lose weight' territory. I'm not saying they're all favorable or that I agree with all of them, but I find it so much more enjoyable to read a well-constructed point that I disagree with than what amounts to a handful of insults or ignorant BS one might find in comments on other articles.

Anyway, give it a read. A lot of commenters brought up the type II diabetes question which I couldn't immediately debunk in my head. Anyone have good information on the correlation of fat and type II diabetes and medical costs?

Look at this poor woman. Doesn't it look like maybe she needs a big ol' fat hug? I concur.

The thing I like about MeMe Roth is that she is such an easy target. She wears her hatred and her bigotry on her sleeve, has no good advice to give, and 99% of the time comes across to even fat-phobic reporters as bat sh*t crazypants. Aside from the fact that she is all about the fat hatred, there are two things I don't like about MeMe:

1. She gets a lot of attention from the media for her anti-fat blather
2. I am starting to really feel sorry for her

I mean, how could you not? She's so delusional! She insists she's not anorexic, in fact says she's "never been on a diet", but then in the next breath talks about how she doesn't eat breakfast, forces herself to work out before eating during the day, and finally admits that, the day of the interview, which occurred at 3:30 PM, she hadn't eaten at all! Sounds like disordered eating to me.

The article says her (fat) family finds her crusade to be hurtful, so I can imagine that family get-togethers are probably strained and uncomfortable for everyone involved. On second thought, I really feel sorry for her kids. MeMe comes across as so cold and controlled that I can't imagine she's all that warm of a mom. Not to mention what hell it must be to grow up in a house where no one eats. I hope I'm wrong about that, but I bet I'm not.

She just seems so intensely unhappy, so rigid, so devoid of joy that I can't help but feel empathy about the lifetime of hurtful experiences she must have gone through to get to this place. That woman does NOT like herself. Not even a little bit. Sure, I absolutely hate everything she stands for and most of the time I really wish she would just stuff a sock in it, but the sad little fat girl inside me recognizes that the sad little fat girl inside her really just needs some love. I hope one day she finally gets it.

Thanks Jenny!

Okay wait...so you're telling me that people who are fat in middle age and then lose weight have a higher risk for health problems when they're old? And it doesn't occur to you that the weight loss itself could be causing the health problems? Aren't you, like, a scientist? Cause and effect? Ring any bells?

Thanks Jean!

Hey BFBers, this is sort of an interim post, but there is some crazy-good HAES stuff going on lately.

First, if you haven't already joined Linda Bacon's HAES community, you should totally do it! And sign the pledge! For those of you who don't know, Linda will be speaking at the NAAFA conference in Washington D.C. this year.

Second, this article by Lucy Aphamor in The Guardian rocks my socks! Thanks to Beanietude for bringing it up in the forums. Lucy says:

The hardest leap for practitioner and client alike can be the idea that all bodies are worthy of respect; that it is permissible and important to appreciate and care for the body you live in, whatever size you are; that bodies should not be disliked or despised for their lack of conformity to a particular size or shape.

This is a "HAES 101" that kicks ass and takes names. It's nothing most of you haven't heard before, but that's okay. If it's too 101 for you, post it on Facebook/Twitter/whatever or keep it in your file to send to someone if you get a chance to educate someone on HAES. I do wish that general HAES articles would do a little more to address class and race issues because they are, let's be honest, very central to the way that fatness/nutrition gets discussed and anti-fat arguments get deployed.

Also, Charlotte Cooper gives us the news that HAES UK was launched this weekend! (Lucy Aphramor also links to it in her Guardian article.) Did anyone go to the event? If so, please report!

Finally, how should we react to all this HAES stuff becomming more mainstream? Are you seeing this reflected in your every day lives?

When I first read this article I had an odd sense of déjà vu. Then I realized why: it's not a new story! Not only that, but every time this subject has come up, the same people seem to be behind it. Ian Roberts wrote the original diatribe in 2007, he and Dr. Phil Edwards wrote a letter to the Lancet in 2008 with the same message, and now they've published a study along these same lines. The thing is, all of their research is based on the same faulty assumptions: that fat people consume more energy by eating and driving more. Even this new "study" draws conclusions based on these assumptions. For instance:

Since it can be assumed that energy expenditure is approximately balanced by energy intake, it follows that total food energy consumption increases as BMI increases.

So, we're going to assume that each step up the BMI ladder means more food consumption? There have been studies to refute this, but even if you disregard them and assume that I, with a BMI of 60+ eat THREE TIMES THE VOLUME OF FOOD as a person with a BMI of 20, what about the one in four people in the UK who are on a constant diet? What about the 45 million Americans who go on diets each year? Some of those folks must be fat, yes? So right there you can see it's ridiculous to assume that every fat person eats more than someone with a lower BMI. If it were true, the diet industry would crumble.

To estimate the GHG emissions due to car travel by each population, we assumed that all individuals with BMI < 30 kg/m2 use an average small car (e.g. Ford Fiesta) and that individuals with BMI 30 kg/m2 use a car with more internal space (e.g. Ford Galaxy). The Ford Fiesta weighs 1530 kg and produces 147 gCO2 per km, whereas the Ford Galaxy weighs 2415 kg and produces 197 gCO2 per km.

So for the purposes of this study, we're just going to *assume* that all of the skinny folks drive tiny cars and all of the fat folks drive bigger cars. What about all of the skinny SUV drivers? What about the fat folks who drive hybrids or smaller, more fuel-efficient cars? What about all of the poorer fat people who don't even have their own car and instead take public transportation?

The increase in energy expenditure with increasing body weight should prevent further weight gain in a negative feedback loop but with rising BMI people are likely to move less, particularly those who are substantially overweight

Of course this part ignores the active fat people and imagines that all skinny people are active. It also incorrectly assumes (again) that the amount of walking a person does correlates somehow with their BMI. Furthermore, when I was digging for info I came across this article that states that driving might be better for the planet than walking anyway.

So Dr. Phil Edwards and Ian Roberts, here's some advice: no matter how many times you interpret and reinterpret these data, you're still starting off with a bunch of flawed, unproven assumptions that, despite the moderate media interest, add up to nothing more than fat-bashing, sizeist nonsense. Your "research" is focusing attention on fat people instead of the actual changes that need to be made to stop global warming. Do the planet a favor and kindly knock it off.

Thanks to DC and Marilyn for the tip

According to this article, studying ten people for three days is enough to generalize about the behavior and activity level of an entire segment of the fat population.

While I appreciate that the researchers doing the study seem to have reached the same conclusion that every HAES proponent has known for years, it annoys me that Reuters is choosing to frame the results as "big fat fatties are totally lying when they say they have healthy habits!" instead of "habits are better indicators of health than weight or size". Arg.

They should call the article "Ten very obese adults almost completely sedentary." That's some news there.

According to this article in The Vancouver Sun, at least one more doctor out there is finally starting to get that fat is not a definitive indicator of ill health.

After reading the article I Googled Dr. Arya Sharma and found his "Obesity Notes" blog. There were some interesting articles, and while I'm not convinced Dr. Sharma's views are entirely in line with my own (and those professed within the fat rights movement), he does tend to say some things that make me want to stand up and cheer. Notably:

Women are clearly far more susceptible to this “healthy-weights” messaging and at any given time are likely to show more dissatisfaction, concern and preoccupation with their weight than men. While most of this weight obsession may well be fueled by the unachievable “ideal” of body weight promoted by the fashion and cosmetics industry, it is not unusual to hear “better health” as a justification for openly engaging in unhealthy weight-loss behaviours.

and

Here is my message to all health professionals and policy makers concerned with obesity: let us define obesity in terms of its actual impact on health - let us not recommend weight loss to those, who have nothing to gain.

At this point, I'm cautiously optimistic that we may have another health professional ally in Dr. Sharma. What are your thoughts?

Zombies? No, obesity doctors. You read that right. Though they want in our brains, rather than eating them up. But part of me thinks they’d eat our brains if it’d “cure our obesity”—after all, it’s for our health!

On Tuesday Nightline covered a story about a woman, Carol, who agreed to be the second person in the U.S. to undergo “the most radical treatment ever devised for obesity,” a treatment called Deep Brain Stimulation. Basically, surgeons drill into her brain and carefully poke around, sending electric currents into her brain until they identify the part that controls her hunger, feeling of satiation, etc. And then they implant “two brain pacemakers” into her chest that will send those same electric currents to her brain. TWO!!! The currents are supposed to keep her, it seems, feeling full enough—meaning they are sending volts into her brain to simulate a feeling “just below [the] threshold of nausea.” According to one surgeon, this will “readjust her weight thermostat so that she can metabolize better and potentially eat less, if that’s what it takes.” Eventually they will have to dial it up a notch to keep her feeling full.

I respect this woman’s right to do this, but I do not respect the doctors/researchers’ endeavor to perform it, nor am I very satisfied with Nightline’s coverage. Martin Bashir doesn’t ask the tough questions, evaluate the risks of this radical procedure or the assumptions it’s based on, or even present more than a flittering critical thought throughout this report. It’s not that Bashir seems all that gung-ho about it, but in the end it is just another booga-booga-OMGtehFats puff piece, rather than an investigative report.

I tend to be long-winded, so I decided to at least organize my long-windedness and post a list of my objections...off the top of my head.

1. The contention that “obesity is the most painful problem in the world.” Now, I took that out of context. The actual quote is, “For Carol Poe, obesity is the most painful problem in the world.” If she said this and she feels it’s her biggest problem, I feel really bad for her and what she must go through...not that she’d be the only one who thinks being fat is The_Worst_Thing_Evar ™. We all know that people would rather die than be obeeeeese (or “overweight” or even a little fat); fatness is many people’s greatest fear. But this segment only reinforces the idea that it’s the worst thing that could happen to a person and that we should all be very, very afraid of the fats. The same news show would likely do a story on how young girls are so afraid of fat and not see the connection between girls’ fear of fat and their own reporting.

2. The doctors’ treatment of “obesity” as though fatness is a disease like Parkinson’s. Fatness is not a disease, people. Yet doctors think that since Deep Brain Stimulation worked on Parkinson’s (not sure how accurate that is) they can and should save the world from fat people—and fat people from themselves—using DBS.

3. That’s right, we can’t control ourselves, so they’ve gotta go into our brains and do it themselves. See how much work we make them do? If this procedure “works” (whatever that means), there may be a time when any “obese” person who doesn’t subject themselves to DBS and “brain pacemakers” will be seen as both socially and personally irresponsible. If so, at the same time we will still be lamented for our inability to control ourselves of our insatiable need for instant gratification. A judgment all based on weight.

4. The “Fat Carol” to “Ideal Carol” digital transformation. Really? Like fat people don’t see enough of this on weight loss commercials. The fact that “before” and “after” pictures have become a staple in our culture is evidence that we have some real problems. When we set up any kind of “ideal” body shape/size, we have a problem.

5. This segment addresses nothing about health. No mention of measures of her health before or after. No mention of health other than the cursory mention of her mental health/anguish regarding her fatness and the implication that she is a compulsive eater paired the idea that her compulsive eating is what’s at the root of her “fat problem.” After all, they wouldn’t need in our brains if we could control ourselves. You wanna bet people still come away form the segment assuming this will improve her health? What happens if this woman actually ends up malnourished? This implant is manipulating signals sent to her brain about what her body needs; it completely suppresses any chance she would have of listening to her bodily cues regarding hunger and nourishment.

6. According to the segment, this woman is 230lbs. I think a simple WTF covers this.

7. Surgeon guy: “For some it may seem radical that electrodes should be put in the brain, that someone should be doing brain surgery for obesity. But I think we’ve gotten through that.” Me: Uh, no we have NOT.

8. This is not scientific, at least not in the sense that we can deduce anything whatsoever. (Though the fact that they know so much about the brain is pretty friggin cool, if scary.) There is no control group. She’s just one woman, and she’s doing things in addition to getting the DBS implants that might affect the outcome. Not to mention the possible placebo effects of something as serious as brain surgery. And on top of all this, we have just seen a snapshot of her experience. We in no way know what the future holds for her or whether eating less would make her thin or even “overweight.” And yet people will assume. And we will continue to suffer from their poor assumptions because when you are addressing OMGtehFatness you don't have to think critically, ask tough questions or give an accurate portrayal of risks and benefits.

Finally, I have been really trying to create “action steps” lately...but on this one I am not seeing a clear path. I did tweet Nightline a piece or two of my mind, not that they paid any attention. Maybe we should suggest that Nightline do a segment on weight discrimination and prejudice in health care and the real health consequences of both, or a segment on HAES. Any suggestions?

More info on this from Sandy Szwarc at Junkfood Science

I wanted to give a shout-out to Dr. Linda Bacon for her new book, Health at Every Size. The book's site includes an endorsements page that reads like a who's who within the fat community.

Linda was kind enough to provide a review copy for BFB (thanks again) - but I'm wondering if any readers have had a chance to read or start to read this book. Everything I've seen has been truly positive.

Ooof:

The Obama transition team approached Dr. Sanjay Gupta, CNN's chief medical correspondent, about becoming U.S. surgeon general, according to sources inside the transition and at CNN.

Via the LA Times through the Chicago Tribune:

More recently, Gupta -- the son of immigrants from India and Pakistan -- launched a nationwide campaign on CNN titled "Fit Nation" to highlight the dangers of obesity in children.

"We are told that the pitch to him has been that healthcare reform will be a top priority," [CNN's John] King said, "that wellness, fitness, obesity, the issues he has focused on often here at CNN, will be a top priority.

This seems like a really, really bad choice.

DebraSY pointed me to a great report from the Kansas City Fox affiliate on fat health care. The story is surprisingly good, and it's available in video form - definitely worth a look.

The narrative here comes from Ann Pei, whose sister Joyce was denied proper care due to her size.

Studies have found health professionals spend less time with obese patients and view them as less likable and more emotional. Young doctors claim medical school are addressing the issue.

"They always taught us to confront our own biases, not just about obesity, but all chronic health conditions. Confront your biases. That helps you meet the patients where they are," says Dr. Veronica Anwuri with Saint Luke's Medical Group.

Debra also notes that Laurie Todd, the first person interviewed in the piece, has started a group called Stay the Course KC "dedicated to bringing out fat people who have isolated themselves, and getting them reinvolved in the community and with one another."

This is a really straightforward piece overall and I'm most impressed at the lack of negativity here. It's handled with careful consideration and yet drives the point home nicely. Good stuff.