Living in New York City, I climb stairs. In my house, in the subway, at my job, and in random places you wouldn’t think would have stairs. Two months ago I climbed the Manitou incline which was like a giant staircase. I admit when I sometimes climb to the subway (I often take an elevated train), I get winded and going up the incline I thought my heart was going to explode.
Every day I take some kind of stairs, an while the exercise has done wonders for my legs, it has not made me thin. Riding my exercise bike 15-30 minutes a day has not made me thin, walking at least a mile or more a day had not made me thin, my daily stretches, my yoga, my summer swimming, my walks around the office has not made me thin.
There is a slogan: "Nothing about us, without us." which is often used among marginalized groups. It essentially means one group decides the fate/treatment of a marginalized group without their input. Fat activists see this all the time. "Obesity" organizations which decide on policy on how to make fat people thin don't seek input from actual fat people.
I have mentioned before that there is a constant assumption that if you are fat because you stuff your face and sit on the couch all day. Some organizations try to be gentle by saying “It’s not your fault you stuff your face.” Every single treatment for fatness is always the same: eat less calories than your body needs (aka a diet). It is the same treatment used in the last forty years and still hasn’t been proved to work in the long run.
If the people running this International Congress of Obesity would talk to an actual fat person (and not just try to treat them), they might figure out that taking the stairs will not make us thin.
When organizations pull stunts like this, the only thing at which they can possibly succeed is creating an environment that prevents people from, and shames people for, navigating the world in the way that’s best for them and their situation.
And shame on this Amanda Sainsbury who decided fat people must become thin or they will die and Health at Every Size is bad for encourage people to stay fat. But what can you expect from a person who writes diet books? (Even worse this quack is the editor in chief of the Journal of Eating Disorders).
While I certainly agree that it is possible to have healthy behaviours that provide health benefits at a wide variety of body sizes, I disagree that it is possible to be or to stay truly healthy at every size.
This is the second time I've seen someone add a Y to the end of health when referring to Health at Every Size. This, to me, changes the meaning. Even though HAES is more geared to fat people because of the discrimination we face in health care, HAES is meant for all body types. Healthy is an abstraction. You can't really define it because everyone has different ranges. My husband can get to the top of a mountain but put him in a lake, and I’m going to zoom past him. Are we both “Healthy” or “Unhealthy”?
It is thus not surprising that people frequently put off doing anything about excess weight until better conditions arise (e.g. when the children start school or leave home, when a better financial position or home is attained, after retirement, etcetera). The health at every size concept implies putting off doing anything about excess weight indefinitely, instead accepting a higher BMI and focusing on healthy behaviours.
Ironically here she accidently points out how HAES is better than dieting. People put off Dieting. They wait until January or when they have money. HAES you do every day, no putting off. No need for money. It's learning to be as healthy as you can in the body you have whether it be too fat, too thin, disabled, or suffering from a disease. You can do HAES if you walk the stairs, take the escalator, or jump up and down.
When I gave up dieting, I wasn’t fully into size acceptance. I realized dieting didn’t work and if I continued, I would wreck my body even further.
At first I worried I would gain an enormous amount of weight (this turned out to only be about five pounds). As I got more into size acceptance and loving my body, I was able to accept the occasional weight gain and loss. (Neither were dramatic. I went from a size 20 to a 22, and then back to a 20.) You may find that some changes will affect your weight: medications, exercise, stress, hormones, or dietary changes (Not for weight loss).
How can you deal with these fluctuations? When I was a dieter, I had an easy formula:
Weight loss =love myslf Weight gain= hate myself.
The diet I was most "successful" on, I lost 40 pounds and kept it off for 2 years. I never got thin, but the day I fit into a size 14 (mind you, I couldn't breathe but they fit), I was excited and happy for the rest of the day, convinced that thinness was just around the corner (turns out it was just the same old story, weight regain and bingeing).
When I gave up dieting and started to learn to love my body, I felt I had the right to that self-love from getting into a size 14. But I also had to figure out how to make my life so as not to be defined by a number.
It was easy in the beginning because my weight stayed the same. But as the hormones of getting older kicked in, my pants got tighter. I bought new pants but I had to figure out a way to not hate myself.
The first thing I did was end negative fat talk. This is when you look in the mirror and tell yourself "OMG, I'M FAT” like it's a bad thing. You need to look at your reflection and tell yourself "OMG, I'M BEAUTIFUL!" “OMG, I LOVE YOU, BODY!”
If you catch yourself telling your body bad things, tell that voice to shut up. Loving yourself is the most important thing you can do.
It's important that if there is weight gain to not go back to any kind of dieting. HAES and Intitule eating means you listen to your body cues. Forcing your body to eat less than needs is devastating instead of nourishing it.
On the other side is weight loss. Maybe you got sick and now your pants are loose. You still love your body but you may feel a little extra self-esteem, especially when other people around you compliment it. I deal with that two ways: I hunch my shoulders like I don't care or I try humor: Thanks! It was a stomach virus/mono/tapeworm. The most important thing is to still love your body and not to feel like you betrayed it for feeling a surge of self-esteem that years of dieting probably programed into you.
Still go to your mirror and tell yourself. I love my body no matter what!
Every once in a while, I get an email asking if I would host a guest blogger or if I would be interested in this infographic. Usually the blogger or infographic is completely inappropriate for my blog such as the evils of obesity, or has nothing to do with fatness at all. Depending on mood I will ignore or engage. When I engage, my response is usually "Have you even read my blog?" or "Why would I want your fat hating infographic?" Usually I never hear anything again and I assume this was spam. A mass email hoping that a few bloggers will post whatever product they are selling. When I got the last one (from a plastic surgeon service no less) I wrote back "Are you a spammer or an idiot?" expecting not to hear anything back.
I got a message not three hours later.
I am a spammer nor an idiot… (I think this was a Freudian slip.)
Obviously you are bitter though and not as optimistic about your disease as your blog leaves one to believe.
Best of luck with that shining attitude in the future.
The issue here is not this idiot or spammer (or both). But this damage the AMA just did to fat people by labeling all fatness as a disease. Even this moron thinks I have a disease. There is nothing wrong with getting help to fat people with diseases, but to just tell someone they have a disease when they are perfectly healthy is ridiculous.
The New York Times seems to think this is a good idea because it "supposedly" reduces body shame.
On the positive side, we found that the obesity-as-disease message increased body satisfaction among obese individuals, probably because it removed the shame of obesity as a moral failing.
Suggesting that one’s weight is a fixed state — like a long-term disease — made attempts at weight management seem futile, and thus undermined the importance that obese individuals placed on health-focused dieting and concern for weight.
The gist is, calling fatness a disease meant that people felt less ashamed because they had a disease rather than a moral failing. However since the cure for this disease is the same shit they've been touting for 50 years, people give up on any kind of weight management.
I don't mean to be a conspiracy theorist but since "Obesity experts" use correlation with causality, let's try it with the diet industry. Even though the diet industry still makes a good 20 billion, that shift is moving away from commercial dieting to Do it Yourself. DIY breaks up that massive pie in to tiny pieces. Meaning the big companies are not getting the money they once did. Weight Loss Drugs have been failing miserably for the last 10 years. Weight Loss Surgery is making a lot of doctors wealthy. So calling Fatness a disease means new money comes into these "Cures". Cures that I might add don't work for most people in the long wrong and can cause more harm than good.
Health at Every Size has no real profit margin and helped try to improve quality of life. It works to help people of all sizes enjoy eating, moving, and loving their body again. Nothing in HAES calls you a disease or says you have a moral failing if you didn't get a chance to exercise.
The best thing I ever did to reduce body shame and to work on my health was to stop trying to be thin.
And if any young fat activist wants to do a guest blog, I’m okay with that. If you want to sell your “Fat is bad product”. Go fuck yourself.
In 2002, I stopped dieting. For 17 years, I lost weight, then gained weight, plus more. I believe dieting caused my weight gain. When the diets failed me, I always ended up around the same number: 235. All attempts to change that set point either through “sensible eating plans” or crash diets had failed miserably.
All diets (including the sensible eating plans and the crash diets) had the same issues. I'd get bored, hungry, and obsessed with my food. During low-carb dieting, I dreamt about eating bread. On all diets, my self-esteem plummeted when I didn't lose weight. When the weight loss stopped, I would stop doing any healthy habits.
When I stopped dieting, I had no idea how to eat. I hadn't eaten intuitively since I was a child. When I was a kid, I ate candy but I also loved carrots, peppers and cucumbers and ran and biked like a maniac. I didn’t become aware of my food until I gained weight and the adults began chastising me for any junk food I ate.
Now I had to figure out how to eat healthy and move for my body rather than weight loss. I had to make sure that I didn't vilify foods. I had to ignore the scale for the first time in 17 years and eat and exercise not based on what it said.
Recently a pro-weight loss blog posted an article from an "anonymous commenter" claiming that those who preach HAES (tm) have disordered health, whatever that means, and that people who preach HAES is only meant for fat people.
The "community" has become less about health at any size. It has become "Only healthy at larger sizes". It was noted that people who gained weight for health reasons were OK (that intentional weight change is acceptable). People who benefited from weight loss, however, were villains, lying, or anomalies. (Their intentional weight change is bad, offensive, and "dangerous") Health concerns for people at smaller sizes were/are irrelevant.
I am a member of HAES community and I have find that while HAES tends to be more for larger people (As they are the most affected by the dieting/binge cycle), HAES is weight neutral. So if you happen to be anywhere on the BMI ruler: 17, 40, 37, 23 or 25, It’s not about losing or gaining weight, it’s about eating and moving for your body and loving yourself. The whole idea of HAES is to continue these good habits whether or not there is weight loss or gain.
I mentioned last week another study proving fit and fat. Literally on the heels of that study was another one that the media including NPR screamed "No, that's wrong. If you are fat down the line you will die of something."
This new study said that fat (only those with 30 BMI or over) people who were metabolic healthy were 24 percent more likely to be metabolically unhealthy 10 years later.
Of course when the media picks it up, they assume this must mean that you cannot be fat and fit.
The study didn't include physical fitness. The study didn't take into account fat people who were physically active. This means that they don't know if metabolically healthy fat people stayed that way if they were physically active. I have mentioned before on this blog that there are barrier to fat people exercising. Bikes aren't weight rated, fat people get starred at the gym, fat people exercising are told they aren't "Graceful" or how miserable we look.
That means NBC's headline -- "New Research Disputes Fat But Fit Claim" -- is simply wrong because the meta-analysis didn't take physical fitness into account, so "fat but fit" (where fit means being physically fit) was never actually tested.
The study also didn't include chronic dieting. Every single fat person I know (And I know a lot) except for one has a history of dieting. Before I did the Atkins diets, I was metabolically perfect. After Atkins my cholesterol went up to 232. To the point I had a doctor want to put me on drugs for it. Only through healthy eating and exercise was I able to bring it to almost normal with no weight loss. I find it terrifying that dieting history is often overlooked or ignored when doing studies on fatness.
"The study is silent on the health impact of pursuing weight loss, because it does not compare people who were fat who lost weight to people who are still fat," she (Deb Burgard) wrote. In fact, she continued, fat people who repeatedly try to lose weight are more likely to yo-yo diet, or weight-cycle, than they are to maintain weight loss permanently. And because weight-cycling has been linked to cardiac disease and other problems, overweight people who are metabolically healthy could increase their risks of the very diseases they tried to avoid in the first place if they lose weight and gain it back again.
It all goes back to the Flegal and similar studies. This study proved that people with normal and overweight BMI had the same risks.
NPR's is just inaccurate; in fact, the meta-analysis showed that overweight, healthy people's risks were so similar to the control group's risks that the difference was statistically insignificant.
This study only strengthens the Health at Every Size argument. You can make countless studies showing fat is evil and bad but with no method of weight loss proved to work in the long run for most people, it would be better to focus on increasing physically activity. Another study shows a change of healthy habits not weight loss is responsible for improvement in health indicators.
What’s more, the few health benefits they found appear to be the result of participants adopting specific healthy habits such as exercising and eating more fruits and vegetables. Weight loss—or lack thereof—was apparently not the defining factor.
I much prefer when "Obesity experts" focus on reducing stigma. You shouldn't have to be thin to exercise and you shouldn't have to eat less than what your body needs.
I'm not sure why I have to keep pointing out that stigmatizing a fat person does not make them lose weight. You see, no matter which avenue the "Obesity researcher" is coming from, they always come to the same conclusion: fat people need to eat less. Some of them try to be kind, saying its not the fat person's fault they stuff their face, they are just too stupid to understand healthy eating.
“It happens all the time,” wrote Dr Pemberton, who also has a
column in The Telegraph. “Patients who are not interested in changing
their diet in any way, demand to have their cake, eat it…and then pop a pill
so that the calories never touch their waistline.
As a veteran of countless diets, lifestyle changes, "healthy" eating and OTC diet pills, that resulted in weight loss, followed by massive weight gain, I can say Dr. Pemberton is full of shit. And considering that no weight loss drug has ever worked in the long run while some have been deadly, diet pills are not the easy way to lose weight.
It goes back to the same argument that all fat people overeat and if they stop they will suddenly become thin. I don't deny that sometimes when you stop eating junk food, you might drop a little weight or none at all. But that weight loss rarely makes a fat person thin. (And until we drop BMI as a primary health indicator, all healthy habits become pointless unless the person gets to the magic "normal" number.)
The people who come to your practice Dr. Pemberton, you might find out something if you listen to their words instead of looking at their fat. Chances are that by the time they meet you, they've already tried all kinds of diets and lifestyle changes and now they are getting desperate.
Last week I reviewed the book Shadows on a Tightrope. In it was an essay about a woman who got weight loss surgery (back when the death rates were 6-8%) purely because she couldn't deal with the stigma.
A good doctor would look at the entire health of the patient, listen to their stories. You might be surprised to find how good they were on their diet until the feelings of starvation took over and how willing they might be to be healthy if their doctor didn't try to shame them.
UCLA school of nursing has done a study showing that fat and thin children when doing lifestyle changes rather than dieting improved their health with very little weight loss.
"These findings suggest that short-term lifestyle modifications through changing diet and exercise can have an immediate impact on improving risk factors such as cardiovascular disease and diabetes," said Christian Roberts, an associate research professor at the UCLA School of Nursing and the study's lead author. "This work underscores the need to focus on changing lifestyle as opposed to focusing on body weight and weight loss.
Duke, instead of the usual banter of either get thin or die or lose just 5-10% is now on the "Just maintain."
"Many people go to great lengths to lose weight when their doctor recommends it. They may try a series of diets or join a gym or undergo really complex medical regimens. The complexity of these treatments can make it difficult for many to lose a sufficient amount of weight," said lead author Gary Bennett, an associate professor of psychology and neuroscience and global health at Duke who studies obesity prevention.
Neither are exactly Health at Every Size (HAES™). Duke completely misses the boat by still focusing on weight rather than health. While both bring us closer to HAES as the removal of weight as a health indicator, the weight factor is still there especially with the Duke study. People sometimes gain weight from stress, aging, hormones, and certain medications. For the UCLA study, it assumes that being unhealthy leads to being fat (Although there is a little disclaimer that perhaps it is metabolic issues that cause fatness not the other way around).
Unhealthy lifestyle factors that begin in childhood, such as physical inactivity, lack of exercise training, and diets that are high in refined carbohydrates and fat, contribute to both the development of obesity and other chronic diseases, but it is unclear whether obesity itself or the associated lifestyle factors are underlying causes of cardiovascular and metabolic dysfunction and the related development of chronic disease.
Instead of telling people to just maintain, or lose a little or focusing on weight at all, they need to remove weight completely as a health indicator. This means that everyone, fat, thin, young, old, learns to listen to their body, give it the foods it needs (without a moral implication of it i.e. good vs bad foods), and love it without worry that it doesn't fit in the ever changing society norms.
This is not a post about my favorite TV series Dr. Who and the sadness over the 11th Doctor Matt Smith leaving.
This post is about a study that shows fat people changing doctors more than thin people.
Overweight and obese patients are significantly more likely than their normal-weight counterparts to repeatedly switch primary care doctors, a practice that disrupts continuity of care and leads to more emergency room visits, new Johns Hopkins research suggests.
This made me think of my own history. I realized that over my lifetime I've had 3 different dentists and 3 different gynocologists but a whopping 12 primary care doctors. I dropped five of them for either pressuring me to lose weight and/or assuming I had "fat-related diseases".
Doctor#1: At 10, he was the first doctor to give me the fat talk.
Doctor #2: I asked him how to lose weight, he told me to eat less.
Doctor #3 & 4 were the first doctors I chose on my own and dropped because I moved. At the time I didn't really see doctors unless I was sick and I think I saw these two a total of 4 times over 2 years. I don't remember if they ever brought up weight, but if they did, I probably told them I was dieting.
Doctor #5 didn't bother me about my weight but I moved again. I remembered that he refused to drain a scary blister on my finger.
Doctor #6 was recommended by a thin friend as being holistic, except that I found that when she would go, he would recommend alternative medicine first and for me prescription drugs.
#7 and 8 were a husband and wife team. I left them when they kept insisting that I do something about the high blood pressure I never had.
#9 said my fat was the reasons my veins collapsed.
#11 was okay because by now I was into size acceptance. I left because I found a new doctor who could do blood tests on site. (#11 is still my backup).
#12 is the doctor I have now. He's weight neutral. He occasionally mentions my weight but he never refuses to treat me or push me to lose weight.
It's hard to find a doctor these days who doesn't parrot the diet industry and say all you have to do is eat less and exercise and you will be thin or has bad assumptions about fat people. A recent study showed 1/3 of medical students in North Carolina are biased (subconscious or otherwise) against fat people.
More than one-third of the students had a moderate to strong bias against obese people, as measured by the test, whereas only 17 percent had an anti-thin bias. Two-thirds of the students were unaware of their anti-fat bias.
With statistics like these, no wonder Fat people are doctor shopping which is yet another barrier to our health care.
I have some advice to try to avoid this but it may not happen. The doctor who recommended weight loss surgery was weight neutral.
#1. Your new doctor needs the fat talk. That's the talk where you tell him or her that you are aware you are fat, you don't wish to talk about weight-loss and you are following HAES (Bring Linda Bacon's book or study to show the doctor). When I told Doctor #12 that, he said "Okay." And he's been my doctor ever since. Once I saw a specialist I once saw interrupted my fat talk, and blame my ailments on being fat. I never went to her again.
#2 For every doctor you got to keep copies of all tests done. Keep them in a binder or folder and if you need to move doctors, at least you have a medical history to give them.
#3 Educate your doctor. I taught my chiropractor about Health at Every Size.
On Saturday I attended the Just Foodconference. It was a two day event Friday and Saturday. I couldn't go Friday because I had to work. Just Food's mission is to promote sustainability in regards to food and water as well as usage of local and organic foods. Just Food does a lot of work with CSA, Community Gardens, farm schools etc.
I joked with my husband that I hoped that I wouldn't hear the O word during the conference. He responded the first person who mentioned it I should go up and punch them.
It didn't take long (Not to punch someone, I had not intention of hitting anyone).
I discovered that I had missed a panel on Friday from the NYC Obesity Taskforce. Had I known about it previously I might have taken the day off and gone both days. This is how the panel is described in the program:
Curious about the New York City Obesity Task Force plan to prevent and control obesity? The plan includes the identification of 15 municipal sites suitable for urban agriculture projects throughout the City’s five boroughs, which will be made available through GreenThumb for the participatory installation of new community gardens. Come participate in design charrette of an example site and discuss design elements and site development challenges.
Then came keynote speaker filmmaker Bryon Hurt who directedSoul Food Junkies. I will make a disclaimer that I haven't see the movie yet (I intend to). The movie examines the director's father refusing to change his eating habits despite a diagnosis of aggressive cancer, the history of Soul Food, and access to healthy foods, particularly in minority neighborhoods. In his talk, something the director wanted to do was a movie like Food Inc, King Corn, Supersize me, The Future of Food, and Fat, Sick and Nearly Dead but with a focus on the black community. The director did make a point that he tries not to be judgemental in the movie.
But the real question is this: what happens when we remove the subject of fatness from both events? The first one no longer becomes a program of making fat people thin but creating community gardens. The second becomes a talk about getting people better access to health foods. (BTW one of the clips Mr. Hurt showed during his talk is of a woman complaining that the vegetables in her local market are "pathetic." She complained, she met resistance, the quality of the produce improved.)
Community gardens, healthy eating, access to health food is the focus of any coherent health plan for the country, or it should be. Once you remove that idea and limit your focus to making fat people thin, we lose everything.
According to The Huffington Post, Mrs. Obama told her hangout audience, "I have two young daughters. We never talk about weight. I make it a point. I don't want our children to be weight-obsessed. I want them to be focused on: What do I have to do, in this body --because everybody is different, every person's body is different-- what do I have to do to be the healthiest that I can be."
I have mentioned before that soda bans and taxes don’t affect me, since except for the rare root beer, I don't drink soda, diet or regular, large or small. I pretty much drink only water and tea. The only time I buy soda is the two parties I give every year. (And yes, because I love my friends, I even buy diet soda if they want it.)
You wouldn't know that from some of the comments on my blog. According to the trolls, I don't exercise and I eat only chips, pizza and burgers.
The issue is this. I often hear the statement "Fight fat, not fat people" by “well meaning” people who think that by saying hate the sin, not the sinner it absolves them from the pressure they put on fat people to become thin. However, since fat is genetic and losing it in the long run is near impossible for most people, how do you think fat people feel when they change habits, improve health outcomes and don't get thin? Do you still want to fight their fat?
A recent study done by Harvard shows that while the majority of people want interventions in childhood “obesity”, they don't believe fat people should pay a surcharge for health insurance (that's a relief. That makes only food the villain and not health care.)
Respondents were much more likely to support less-intrusive measures to curb obesity: 80 percent of those surveyed said the government should require calorie counts to be posted, 75 percent said they'd like the government to prevent the use of food stamps for soda and other sugary beverages, and 88 percent said they'd support requiring public school students to get at least 45 minutes of exercise daily.
By contrast, more drastic measures were less widely supported: Nearly two-thirds said they'd oppose a $50 annual surcharge on health insurance premiums for obese people, 80 percent opposed making soda or junk food possession a punishable offense in schools...
The issue here isn't healthy eating, the issue is that this is done solely because people are fat. It's our fault that you can't get a pitcher of soda with lunch; or your kids can't have pizza at school, or cupcakes for someones birthday party. Even if the whole world benefits in the long run, it's done because of us. It's our fault.
The problem is now that the meme of fatness equaling anti-health has been repeated so universally and so often, it might be impossible to separate them.
That's not actually the case, though. While "the obesity epidemic" may be a convenient catch-all for the illnesses and health problems related to our food chain, it's a lazy term and an inaccurate one. Are we actually worried about public health? Or are we offended by fat bodies that don't meet our thin ideals?
If the issue was that people in this country had horrendous eating and exercise habits but no one was fat, you wouldn’t see this. This is has nothing to do with ill health and everything to do with people being fat.
This is why we need to stop associating health with thinness. We need to stop fighting fat and accept that people come in all sizes and that when they eat healthy and exercise they may not become thin.