Fat Chicks Rule

Finding blame and paying more

At one of my physicals, the nurse taking my vitals wanted to weigh me. I don't get weighed at the doctor's office and told her so.  (If the doctor really wants to know my weight, I'll be willing to be weighed by him in private as long as the number doesn't go into the chart. That hasn't happened.) She said that some insurance companies want the number. I told her that that was one of the reasons I didn't want to get weighed.

I get my insurance through my job and at the moment there are no extra charges for perceived health issues. There are discounts to diet programs and gyms. I worry constantly that this will change. Other places already are looking to hit people while they're down.

For the past few years, companies have experimented with tying health insurance premiums to people's health. Here's how it works: Employees go through medical and biometric testing as part of their health insurance open-enrollment process. They are weighed, their height and blood pressure are measured, and their blood is drawn. Those with high scores on cholesterol, glucose and blood pressure -- or with chronic conditions like diabetes -- are told they will have to pay higher premiums unless they actively try to address any risky conditions.

One of the reasons I am very pro-universal health care is that when we have for-profit system of health care, people who tend to be genetically prone to certain diseases will be charged more or denied coverage. It's a slippery slope that this will condemn all fat people regardless of their health.

Meanwhile UCLA Professor Abigal Saguy points out in her op-ed about fat prejudice.

Despite the fact that body weight is largely determined by an individual’s biology, genetics and social environment, medical providers often blame patients for their weight and blame their weight for any health problems they have. 

Health insurance isn't like car insurance. Driving a car isn't a right: you need to demonstrate your competency through your actions. Health insurance means that you don't go broke for an illness, acute or chronic. I don't get the logic of telling people they need to get healthy before being allowed access to health care. 

The good news (for the US) is that in 2014 you cannot be denied health insurance based on health status. It also means there are affordable health care options. This is good news for fat people who often are either denied health insurance or given outrageously high priced options.

Health insurance companies offering coverage to individuals and small employers will only be allowed to vary premiums based on age, tobacco use, family size, and geography.  Basing premiums on other factors will be illegal.

 

New England Journal of Medicine - Don't help.

Recently the New England Journal of Medicine came out with a "Study" showing seven myths and six assumptions about "obesity" Although not a single one is a myth or presumption about fatness, say how the obesity epidemic is overblown, how being fat doesn't affect your mortality except for the supersized, or how everyone ignores the rise of dieting came with the rise in fatness. Instead every single one is about weight loss/ dieting. Some of it is fairly harmless like sex only burns about 14 calories compared to 300, or that breast feeding doesn't make your kids thin. Please don't stop having sex or breastfeeding because of this study as both have health benefits. Others aren't as helpful, that gym classes don't make you thin. That's right they don't, regular exercise for most people despite their size makes them healthy, not neccessarily thin. 

Normally I would say this is a positive article because it shows that healthy habits don't actually mean weight loss. 

Until I got to one of the myths.

Within weight-loss trials, more rapid and greater initial weight loss has been associated with lower body weight at the end of long-term follow-up

Essentially the "Myth busted" is that rapid weight loss works better than steady weight loss. The authors point out that some people have been successful at it. Depends how you define success. In 1999-2000, I was a success. I lost 35-40 pounds (I was still fat) in about 6 months and while I never got to a goal weight, I kept the weight loss for another year. But a year after that I was back to my original weight. A number that I've hovered within 10 pounds of for the last 10 years. I never said people can't lose weight, I said they can't keep it off in the long run. Whether they lose it slowly or quickly. 

Rapid weight loss can lead to gallstones, and loss of vitamins and minerals.  Most rapid weight loss comes from very low calorie diets either liquid diets or weight loss surgery which means you aren't eating enough for your body to function properly. 

I think Marion Nestle hits the nail on the head on the reason for this "study".

"I think it’s weird.  I don’t get it," said Marion Nestle of New York University. "I can’t understand the point of the paper unless it’s to say that the only things that work are drugs, bariatric surgery, and meal replacements, all of which are made by companies with financial ties to the authors. " She noted that the researchers who signed the paper also provided a long list of companies they have been paid to work with. 

If you read the affliations, you get big food, big pharma, and the diet industry. As mentioned last week, the diet industry is expected to make 66 billion in 2013.

Not surprising that they want you to not eat healthy food and exercise (To be honest they don't actually say that) and instead to take drugs, get surgery, and go on crash diets. 

 

Fat, Happy and Fly like the Wind!

Scientists in Canada have discovered that those with the dreaded horrible obesity gene have yet another added benefit of being protected from depression.

But the genetic findings challenge that thinking, Meyre said, since those with the genetic mutation predisposing to obesity were protected from depression.

I don't like to be called a mutant. Just because a gene makes you undesirable from the mainstream doesn't mean it's a mutation.  On the other hand, without genetic mutations, we'd still be unicellar beasties living in slime pools, so I guess I can live with it.

Here is yet another benefit of being fat. Of course if you're depressed don't gain weight. This just means that if you have genetic disposition to be fat, you may also have protection against depression. 

Speaking of depression, exercise has also been proved to help with depression. It release happy fun endorphins. Just because you are fat does not mean you don't deserve it.  

In Denmark, a racer is doing a 132 mile trek. Jarmo Pitkanen also happens to be fat and he wanted to do the race to show a he can be fat and finish it. 

But by completing the multiple-day competitions as an obese athlete, he is doing a small part in changing the perception of overweight athletes, doctors said, although most physicians have long warned that obesity can lead to an array of health problems, including diabetes, high blood pressure and heart disease.

One thing mentioned in the article is that Pitkanen tries to gain weight before doing competitions so he'll be fat when he finishes. I don't agree with that, because I've always been an advocate of eat well and move and let your weight fall where it should. However, it show that body size shouldn't matter when it comes to fitness. 

“Fat doesn’t play as much of a role in fitness as people think,” said Dr. Linda Bacon, a physiologist and member of the National Association to Advance Fat Acceptance. “Some people who are really fat exercise regularly. We see top athletes perform well in fat bodies. Times are changing. The population has gotten bigger, so we’re going to see more fat athletes out there.”

Not everyone can do a 132 mile trek or in my case the mile swim race I hope to do in the summer, the most important thing is we listen to our genes and be as happy as we can. 

 

Food waste, Let's move and Environmental justice

This week I want to talk about food waste. I recently read a book called Greenwashed, which, while the author had no problem with CSAs, local or organic, her primary concern was food waste. (Of course according to stereotypes if you're fat no food goes to waste.)   April Herndon of Psychology Today criticizes Let's Move for the same reasons I have. We need to encourage healthy eating and movement for all children (not just fat ones) and have access to food.

Given that we can all probably agree that children deserve access to a variety of foods and the ability to play and be active, why the focus on obesity? Because obesity has become a convenient means of motivating people to care about issues like nutritious food and safe neighborhoods and playgrounds for children who are members of marginalized groups, groups that mainstream America may not care about otherwise.

Let's say in 30 years Let's Move had increased fitness and access to nutritious food but we still have fatties. The program will be a failure. Exactly as 1994 version of "Let's Move" Called "Shape Up America" which is almost 20 years old and yes, there are still fatties.

Two recent studies have shown that Food deserts may be a myth. 

But two new studies have found something unexpected. Such neighborhoods not only have more fast food restaurants and convenience stores than more affluent ones, but more grocery stores, supermarkets and full-service restaurants, too. And there is no relationship between the type of food being sold in a neighborhood and obesity among its children and adolescents.

What does this have to do with food waste? I have also mentioned before that starvation kills more people than obesity ever will.  The United States has high rates of food insecurity (i.e. we aren't starving to death but we aren't getting enough food). Many of the states with high food insecurity also have high rates of fatness.  Most of those who have dieted know you lose weight then gain it all back plus more. (I'm fairly certain I weight about 50 lbs more than I should because of dieting.)  Could it be possibly that people in food insecure households are technically suffering from the dieting/binge cycle? We also waste food, up to 30% in the USA and up to 50% worldwide which is a travesty.

We again view fatness in simplistic terms. No matter what, fat is always going to be labeled as eating too much, that's it end of story. No one looks at other issues, for example  food insecurity, and say other things such as poor medical care or how about pollution? Poor neighborhoods often find themselves near pollution sources.  Parts of the Bronx have high asthma rates because they are near expressways.  There are now links between pollution and diabetes AND air pollution and fatness. (Oh and Diabetes and stress as well.)  We don't really look at medical care, food insecurity and pollution because these are complex situations that require actually hard work. It isn't easy compared to telling the nation to stop being so fat.

Diabetes, Autism and Pepsi oh my!

This starts with two facts,

1. Just because you are diabetic doesn't mean you are fat;

2. Just because you are fat doesn't mean you will get diabetes. 

I felt the need for these two facts to be fresh in people's minds for the two infuriating stories I am covering today. 

No one knows for sure what causes autism. It could be anything, genetics, low birth rates, later in life pregnancies and better diagnosis (autism may have been diagnosed differently in the past as retardation or bad behavior). Now comes a new study saying fat mothers are bad because they are giving their children autism. After all every single autistic child has a fat momma right? Right?  

 

As far as fat women and autism, there could a host of reasons for the increased rate including: dieting, weight loss surgery, poor prenatal care (Fat women often do not get the best of care), and the high rates at which doctors perform C-sections on fat women.

 

Or could it be that the study itself was based on fat women with metabolic disorders? Not healthy fat women. The gist is women with metabolic diseases might have a higher rate of autism but that doesn't mean fat mothers have more kids with autism (or even that MD have more autistic kids; the sample size was 1000 from California only and self reported). It is the false assumption that all fat women have or will get diabetes and hypertension. Diabetes is a complex disease. Merely simplifying it down to weight loss creates a horrific risk for thin people who have it in their family. 

 

And it is our irresponsible media that ran with "all the fat mother's fault", because in reality what they really want is fat women to stop breeding. After all fat parents are more likely to make more fat people and we wouldn't want that. 

I've spoken before on soda. It's a tax that doesn't affect me because I don't drink soda. I'm now perfectly willing to have a tax on soda as long as it's on Pepsi. Pepsico, yes the soda maker is now charging it's smoking and fat bottlers and drivers $50 more per month for health coverage. Yes,

Pepsico the makers of Pepsi, 7up, Mountain Dew, Lipton, Lays potato chips wants to charge "unhealthy" employees $50 more a month. What next? Is Marlboro going to charge more for smokers? (Also all these employees are unionized but union busting is another story for another blog.)

And when they talk about fat, they actually mean "Obesity related diseases" which at this rate is diabetes, hypertension, cancer, global warming, autism, plane crashes, stroke, car accidents, and plumber's crack. Now if you have one of these diseases, but are thin do you get $50 charge and if you are fat and healthy do you still get that charge? Targeting diseases is a horrific slippery slope that will lead to employers hiring only perceived healthy people, and firing anyone who gets a disease. It also faults diseases on those who got them. We need to learn that it's very rare that someone brings a disease on to themselves. 

So now I'm for a soda tax. $50 tax on all pepsi products to go into a fund to cover the employees forced to pay this ridiculousness. 

Show me the money

A recent NYT article shows an alarming number of potential conflicts of interest in US health care guidelines especially to do with obesity, cholestoral and hypertension. 

The Institute of Medicine reports recommended that those with industry conflicts of interest should generally be excluded, or limited to “a distinct minority of the panel.”

At least eight of the 19 members of the obesity panel have financial ties to a phalanx of private business interests, records show. GlaxoSmithKline, maker of Alli, an over-the-counter product, has made payments to four of them. Four have financial ties to Allergan, maker of the Lap-Band stomach device. One is paid to speak or advise 11 companies with obesity products. And others consult for companies like Nestlé or Weight Watchers. Dr. Ryan disputed the number of conflicts but would not elaborate.

I don't think having almost half a panel with a conflict of interest is fair and unbiased. Why do the foxes decide what's good for the hen house?  With the massive push on fat people to get surgery, take drugs, go on commerical weight loss plans, should the guidelines be pushed by people who make money off this? Especially when weight loss in the long has a high failure rate.

Please remember that Americans spent 60.9 BILLION dollars on dieting last year. That's quite a nice piece of pocket change. And weight loss surgeries which are pushed as easy quick fixes cost up to $25,000 and is now at 5.7 Billion dollar business. (The link will open to a word doc.)

Potentially corrupted guidelines can lead to healthism.  Like these companies who are trying to  charge fat people more for their health insurance, whether of not they actually costing more.

So now more employers are trying a different strategy - they're replacing the carrot with a stick and raising costs for workers who can't seem to lower their cholesterol or tackle obesity.

Meanwhile a study shows that you do in fact have a hormonal reaction after dieting that causes you to eat uncontrollably sometimes to at least a year after dieting. Great, thanks. I only figured that out about 20 years ago.

The findings suggest that dieters who have regained weight are not just slipping back into old habits, but are struggling against a persistent biological urge.

The study of course doesn't indicate we should stop pressuring people to diet but that they need to create long-term strategies to counteract this change may be needed to prevent obesity relapse. In other words, lose weight and then we swear to God we'll try to create a drug to stop your body from thinking it's starving.

And yes, one of the study's authors had financial ties to Nestle.

A grain of salt

First off a few weeks back the FDA rejected the diet drug Lorcaserin.  It's been a minor miracle that two drugs have been rejected and one removed. Is the FDA finally realizing that diet drugs don't work in the long run and can be dangerous?

The Atlantic Magazine has an excellent article about lies in the medical community.  A meta-reasearcher Dr. John P. A. Ioannidis who questioned in a 2005 paper Why Most Published Research Findings Are False. In the Atlantic article: "He charges that as much as 90 percent of the published medical information that doctors rely on is flawed... 

"...But these studies often sharply conflict with one another. Studies have gone back and forth on the cancer-preventing powers of vitamins A, D, and E; on the heart-health benefits of eating fat and carbs; and even on the question of whether being overweight is more likely to extend or shorten your life. How should we choose among these dueling, high-profile nutritional findings? Ioannidis suggests a simple approach: ignore them all."

The Medical community while may contain many things to benefit humankind. Drugs, surgerical procedures, preventive care that save lives. Several members of my family are alive today due to life saving drugs, procedures and early diagnosis.

However even if Dr. Ioannidis is only half right, that is still a lot of false information. There isn't always a lot of consumer protection, so you best bet is to be educated when dealing with the doctor. If you decide to take a pill, get surgery, get preventive care make sure you fully inform yourself about it.

Less than Human

A while back I had been prescribed the anti-depression drug Wellbutrin. It was supposed to help with depression (and not cause me to gain weight.) It didn't and I had a bad reaction to the drug in general. Several years after that a doctor convinced me to give it another try, saying she would give me a mild dose. Guess what? Same bad reaction. I didn't learn it right the first time.

Case in point, the rehashing of the same useless and sometimes deadly diet drugs. The FDA has new diet drugs up for review namely Qnexa which is actually two other drugs put together: The "safe" part of Fen-phen Phentermine and the anti-seziure drug Topamax. And include such side effects as cardiovascular problems, birth defects, psychiatric issues among many others. Thankfully the FDA rejected this drug which to me is a miracle because it seems like every single fucking anti-weight loss drug is approved despite often deadly side effects.  The other drug is supposedly the new miracle drug (despite no long term studies): lorcaserin (which is a similiar drug to fenfluramine the deadly part of Fen-phen).

WLS is still being pressured for a cure all to diabetes. Even people not that fat. 

And now the US wants to include an Obesity Rating in electronic health records. Do these people not understand the purpose of electronic records? They aren't supposed to be your health nanny. They are supposed to be a method to reduce mistakes and the easy transfer your medical records to another doctor or hospital.  They also still think a BMI is a good way to measure it. (Congrats to Brad Pitt on being an honorary fattie.) My obesity rating? Fabulous!

So pressure to take dangerous drugs that don't work, risky surgery and a scarlet letter O in our health records, wouldn't that make a person feel like they are worthless, a second class citizen, and less than human?  I don't think the motto of the US is life, liberaty and the pursuit of happiness unless your fat.

Losers, Obliviously and Lincoln U.

First off, please pledge money, loving and support for the documentary "Fat Girl's Float." 

And Lincoln University has changed their fat discrimination policy, sort of.  Fat people will no longer be forced to take a "Fitness for life" class, but it will be rolled into one course for *all* students.  Many colleges require some kind of PE course (as I mentioned last week, I aced the course I took in college.) Even though the head of the college and the head of their gym wanted to keep it, faculty overwhelmingly voted to get rid of the requirement, calling it discriminatory. That being said, Fat students will still be targeted.  So there will be no more outright discrimination but expect a fair amount of bullying in the form of help.

Apparently 1 in 10 fat people either don't know they are fat or think they are okay at their size (the horror!). Actually what I think is that 1 in 10 of their subjects have body image disorders. They wanted to be a thin person, so they saw a thin person.

So are the Biggest losers actually winnersr? No. One "winner" not only regained the weight but admitted to using unhealthy methods to lose weight. He probably wasn't the only one.  I found the Biggest Loser stupid, insipid and dangerous. Even if you are pro-weight loss, most weight loss experts think that healthy weight loss is at 1-2 lb per week.

Who is right? Who is wrong? Who cares.

You think that maybe the obesity naysayers would have calm down by now.  After all three major studies (including two by the CDC) have proved overweight people live the longest and that even being in the obesity range doesn't cut your lifespan that much or that doctors don't know what causes you be fat, it isn't just about eating and moving.

Or that scientist have proved that diets consist of reducing caloric intake. It doesn't matter if you cut the carbs, the fats or the protein, short-term weight loss comes by reducing calories.

You think they would stop: diets don't work, no one knows why some people are fat while some are thin, diets are the same thing just in different packages. 

Lancet has a study that "proves" that fatties live a shorter life.   I'm not a doctor or scientist, I have read the study and admit that I didn't quite understand all of it.  I did understand that there wasn't one large test group, that the scientists took the information from 57 other studies, that dieting was never looked at, that 35% of the study were smokers, at least 3 of the studies were self-reported and the study tried wave away people dying with BMI under 22 because more of them smoked.

Do I have a point?  It's pretty simple.  No one really knows anything.  No one is sure is fat causes or helps fight diseases or if fat is a symptom not a cause of heart disease or diabetes.  That is the issue, that is my problem.  I'm sick of seeing articles that automatically assume fat causes X,Y,Z when there is research out there that states otherwise.