Fat Chicks Rule

More reasons that dieting doesn't work at all

Market Watch has a top ten list of what the Diet Industry won't tell you.

#2 is dieting makes you fat.

While the point of a diet is to lose weight, often the reverse happens: We end up fatter than when we started. “Diets don’t work long-term,” says psychotherapist and eating coach Karen R. Koenig...

I have been blogging for almost 10 years where I have repeatedly said dieting makes you fat. I have always believed that if I had HAES instead of a diet,  right now I would weigh less and love my fat body more.

The constant pressure to diet does nothing, and can even makes things worse. The only purpose of dieting is to lose weight. People don't go to Weight Watchers, Jenny Craig, do the Paleo diet or Atkins because they want to stay the same weight. They go to lose and when the weight loss stops, so does the diet.

Meanwhile Health at Every Size removes the weight loss component and focuses on health. Health can't fully be identified. As ASDAH defines:

The Association for Size Diversity and Health (ASDAH) affirms a holistic definition of health, which cannot be characterized as simply the absence of physical or mental illness, limitation, or disease. Rather, health exists on a continuum that varies with time and circumstance for each individual. Health should be conceived as a resource or capacity available to all regardless of health condition or ability level, and not as an outcome or objective of living. Pursuing health is neither a moral imperative nor an individual obligation, and health status should never be used to judge, oppress, or determine the value of an individual. 

ASDAH has updated the definition of HAES to further remove healthism (Healthism is the bias against a person because they don't fit the "picture of health". For fat people, a fat person who eats right and exercise is defined as morally superior to a fat person who doesn't).

The Health At Every Size® Principles are:

1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

As I mentioned last week (And many other times), the stigma fat people get just trying to exercise. Making fun of someone who is slow or can only manage a walk around the block does nothing to help them by healthy.

Result Still Not Typical

Weight Watchers Centers all over are preparing for the January rush. Every January people guilty due to overeating during the holidays will make it their New Year's Resolution to lose weight. Even though they did exactly the same last year. After they ditched their diet the previous year. Maybe they made it to March or even to Halloween. The halls of Weight Watchers usually empty after that because in reality WW isn't a lifestyle change but a diet. Something you can't stick to during the holiday months.

During my dieting years, I actually stuck with WW for the holiday season. Granted I had figured out patterns where I could binge eat, namely Thursday night right after the meeting. I think I managed to lose weight on WW only because I started when I was 16 and hadn't yet damaged my metabolism.

Now, I don't diet come January or through the holidays. Yes, I eat more. I won't deny that. I have a lot more parties to go to. There are leftovers, gifts of desserts, and after Christmas sales. What I make sure I do is to keep up my healthy habits. I make sure I eat my vegetables, I make sure that I move and I don't care if I've gained weight or not.

Resolutions to be healthier don't have to start on Jan 1 (or in dieter's cases Jan 3, after all the junk food is gone). When you want to do something for your body. Do it right now. In fact I'm just about to get it a cup of water.

Have a Happy New Year! Remember Results Not Typical. 

 

Still not buying it.

Every once in a while I’ll have a bizarre fantasy of what it’s like being thin. During my dieting days, I had this fantasy frequently. I would show off my thin and beautiful bod to the people who made fun of me. They would look at me with their mouths agape and beg to be my friend. I would laugh and shrug them off.

I don't have this fantasy as much because I accept that I'm fat and I no longer care what people think of me. I don’t want to be thin, except maybe while clothes shopping. With the exception of the Big Fat Flea and some of the plus size stores like Torrid and Lane Bryant, I find clothes shopping a level of hell. With an apple belly, large boobs and a rectangle side. I imagine what it would be like to walk into any store and have an abundant selection of what I need. Even stores that carry plus sizes often have such a small selection that I find nothing.

Mike Jeffries of Abercrombie and Fitch wasn't thinking about the future in 2006 when he said A&F was only for the cool kids (i.e. no fatties). He wasn't thinking there'd be a giant fucking recession and apparently retail clothing isn't as quite as niche a market as an exclusive night club. They find their niche has other crappy clothing stores to go too. Ones that have cheaper prices, aren’t run by assholes, and sell clothes that fit them.

"Students are looking for better prices," (Doreen) Burdalski says. "They may realize the quality of clothing isn't as good, but it serves their purpose for now. I think the price point is too high, they've been struggling since 2008. People are experiencing that crunch, college students included."

A&F has been suffering declining sales and have now realized that maybe they do need to actually sell some clothes to more than five people. They will be offering plus size clothes to women. I'm not sure what size they will go to. If they go to 2x I can possibly fit into their clothes.

But still I won't shop there. You see Old Navy, H&M, and Forever 21 all carry plus sizes but yet I don't step foot in them because I know I am but a token to them. Two-third of the US populatio are considered fat but you wouldn’t know it even from the stores that sell plus sizes. I won't find the same sizes, styles, selection as a thin person would. And unlike Torrid, Lane Bryant and the Big Fat Flea, I wouldn’t feel like a human being shopping in these stores. One time I went into the plus size boutique Lee Lee’s Valise, told the sales girl I need something for someone that has no waist and walked out with a kick ass dress.

I often state on my blog to never buy anything from a store that doesn’t carry plus sizes. My thin fantasy would end with the realization that no store that carried fat and thin sizes has ever been good to me. If I were thin I would have no where to shop.

I will continue to not buy A&F and laugh when they go under. I look forward to the same thing happening to Lululemon.

Fat Assumptions Kill

In a neighborhood not far from where I live, a little girl Claudialee was an active and imaginative six year old who wanted to be a vet when she grew up. She was also chubby. During a blood test Claudialee was found to have a high glucose level. Her doctor informed her mother that the little girl was pre-diabetic for type 2. He then told her mother that to fix this she needed to lose weight.

She was "prediabetic." During the next visit, Mercado explained to Irma that the results were nothing to be too concerned about. The girl just needed to lose weight. Diet and exercise. She handed Irma a sheet of paper with a food pyramid on it.

Turns out the girl had type 1 which cannot be fixed with diet and exercise. In 2010, she died.

I don't believe the doctor looked at this little girl and said "I sure hope this fat kid dies." However the doctor had worked in SUNY Downstate's Wellness program (To make fatties thin and diabetics not fatties I assume). I think all she heard and learn was the same rhetoric: all fat people become diabetics and if they just lose weight they'll be fine.

Other doctors apparently did not understand why this doctor ruled out type 1. Even with the evidence that most diabetic children under ten do not have type 2, the doctor stood by her diagnosis.

Even after it was clear that Claudialee suffered from type 1, Mercado stood by her diagnosis. When later questioned in court, she disagreed with the notion that type 2 diabetes is uncommon in young kids.

Here is a handy chart that shows the amount of type 1 and type 2. among children. Notice type 2 is a tiny sliver among children younger than 10. Even after ten type 2 is still less common (except among certain groups. Hispanics were half and half)

The doctor made a poor assumption on a six year old, where she saw fat as the culprit. Even the Village Voice article that reported this made a poor assumption because it said fat caused diabetes. (I wrote last week about a doctor who thinks this is backwards).

The worst part is this woman still practices despite financial judgements against her. When I saw the headline in the voice

Type Miscast: An Elmhurst Doctor's Type 2 Diabetes Misdiagnosis Results in the Death of a Six-Year-Old Girl

Without even reading the article I knew exactly what happened. I knew the girl was chubby and had type 1.

Any doctor who didn't even bother to figure out if this girl had type 1 shouldn't be practicing medicine. I'm not even a fucking doctor and I saw a child with elevated blood sugar, I would assume type 1.

This is another case of treating fat instead of the disease.

Stigma Hurts

This week is Weight Stigma Awareness Week. Weight Stigma often comes from assumptions. The strongest stigma is if fat people just eat less they will be become thin and healthy. It is at the bottom of every cure for fatness: diet pills, surgery, low calorie diets, lifestyle changes are all to make a fat person eat less. Bullies claim that fat people are lazy and lack willpower, the well-intentioned think it's not fat people's fault. Food is everywhere. Except that why don't thin people have the same problem?

Everywhere we are bombarded with hateful messages: (Trigger warning ahead.)

The second? Costco as much as anything else is why the land of the free and the home of the brave is also the trough of the tub o’ lard, our exceptionalism measurable by not only our G.D.P. but also our B.M.I. That’s body mass index, and our bodies are indeed massive.

So says Frank Bruni who has suffered from eating disorders and should know better.

Even when Fat people say enough, we are okay with our size, that no matter what our eating habits are, we don't deserve to be treated like shit, that some of us are healthy and fat, that many of us eat no more than thin people do, we are told we are delusional or making things worse.

Obesity is a class issue, like tobacco. People in every class used to smoke, rich and poor, educated and non-educated alike. But when tobacco was conclusively linked to disease, more and more educated people stopped, until the image of smokers reached a tipping point, and went from “cool” to “loser.”

Yes people with a lower SES are more fat, but it's more likely to do with bias in society rather than poor people eat too much. Being fat is not like smoking. Smoking is a HABIT, being fat is hugely genetic. And if the fat is a habit why do so many people fail to lose weight?

Even "Doctors" think it's okay to shame fat people. In Katz, D. L., Murimi, M., Pretlow, R. A. & Sears, W. (2012). Exploring Effectiveness of Messaging in Childhood Obesity Campaigns. Childhood Obesity 8(2): 97-105 (The article unfortunately is not available unless you subscribe) is filled with praise for programs who shame fat children. Many of the quotes are disgusting but I will share one.

Sears: Good medicine means encouraging children and giving them the tools to get lean. An occasional child might be pushed over into anorexia, but I think the situation that you mention in Seattle is an overreaction and represents unwarranted fear.

Guess what? Teenagers who were formerly fat were found to suffer from eating disorders.

These problems may not be diagnosed quickly, because parents and doctors "think it's a good thing that these teens have lost so much weight," said lead researcher Leslie Sim, an assistant professor of psychology and an eating disorders expert at the Mayo Clinic Children's Center in Rochester, Minn.

I have mentioned before that some of the worst habits I've ever picked up came from dieting. The worst being the dieting/binge cycle. Thankfully I never do less than at 12oo cal diet but I did a lot of crazy things to lose weight. I think of all the people who starve themselves or have weight loss surgery and consume less calories than a normal person needs. Why isn't this considered anorexia? Just because they are fat?

Stigma also affects health greatly. Not just from the stress of being bombarded with messages that you are less than human if you are fat, but bias in even getting your health care.

Obese people are less likely to survive cancer, and one reason may be a surprising inequality: The overweight are undertreated.

Doctors often short them on chemotherapy by not basing the dose on size, as they should. They use ideal weight or cap the dose out of fear about how much treatment an obese patient can bear. Yet research shows that bigger people handle chemo better than smaller people do.

I have written before about doctors refusing to treat fat people or giving them surgery and treatments needed. I even spoke once to a supersized woman whose doctor refused to give her an lifesaving operation (the story has a happy ending, another doctor did the surgery).

When are "Doctors" and "Journalist" going to listen? Stigma against fat is stigma against the fat person. It will lead to poor health care, eating disorders and stress.

UCLA and Duke are late to the HAES Party

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.

Different Worlds

No Blog post next week. Second vacation coming up!

 

While doing research on plus size shopping for my book, I walked into a store looked at the outrageous prices, saw the look the sales woman gave me, the What the fuck is this fat woman without trimmed eyebrows doing in my store? and walked out. I hadn't been savvy yet of recognizing places by sight that don't have plus sizes. I'm sure if I had been buying something for a thin friend the sales clerk would have rather listened to nails on a chalk board than serve me.

 

Recently Oprah Winfrey,, who most of the planet knows, for some reason was not recognized in a store in Zurich. Oprah was looking at handbags, asked for a pricy one, when a clerk insisted she look at cheaper items. 

 

If I was ever mega wealthy, I wouldn't shop in stores that wouldn't have given me the time of day now and I would never buy a $38,000 dollar handbag unless it was an actual Bag of Holding (For non-gamers the bag of holding can hold large amounts of heavy items including swords, foods, mounts, potions, gold etc,).

 

Oprah felt that this slight was racial bias; Heidi Moore of the Guardian felt it was also due to her size.

Race is tied with socioeconomic status struggles; so is weight. There have been some studies of a link between a woman's size and her socioeconomic status, showing that women with low incomes tend to be of higher weight. There are many theories on this – because of unsocial working hours, lower availability of healthy food in poor neighborhoods, and other factors that may affect food choice and metabolism.

 

I think that these attitudes towards fat people aren’t necessarily poor food. If I was looking for a retail job, who do you think would hire me? The high end boutique or Walmart? Oprah’s talented, smart, beautiful, sand avvy, but she cannot be the only fat  black American woman who is. (She is the only black face in Forbes' Richest Americans list coming in at 152.)  As Moore points out:

 

Oprah was looking to buy a handbag, which has no size measurements, but the product is not the point: in an upscale boutique, all buyers are judged, in part, by their weight.

Claim denied

Short post today as I was away the entire weekend.

I have a handful of friends who either have no health coverage or limited health coverage. Their biggest issue isn’t being fat (some of them aren’t) but affordable access to life-functioning drugs.  I am very pro setting up universal health care. There is no reason a person shouldn’t go without the treatment they need without bankrupting them. I think the Affordable Health Care Act is a step in the right direction but it isn’t enough and there are issues concerning the treatment of fat people. 

Screening and counseling for obesity has to be covered with no patient cost-sharing (co-payments, co-insurance or deductibles) by most insurers under the preventive services benefit of the Affordable Care Act, says Susan Pisano, a spokeswoman for America's Health Insurance Plans, the national trade association representing the health insurance industry.

 This is a waste of time and money. No diet program has been proved to work for the majority of people in the long run. This is merely extra business for the diet industry.

Right now it’s just being offered. Companies like CVS, Michelin tires are showing that soon it will be mandatory to lose weight. 

The Cash Cow -- Moo

I wouldn't know even where to start to estimate about how much money diet industry had gotten from me. From the memberships at Weight Watchers and Nutrisystem, the gym memberships I gave up after 6 months, the diet soda, the diet foods, the diet books. I am guessing somewhere in the range of 2ok probably more.

My biggest consumption was diet coke. Diet coke was my beverage of choice through almost every single diet. From the ages 15 to 27 (Low carb dieting didn't allow diet soda)  I would drink two or three 2 liter bottles a week, not to mention cans and bottles form the vending  machines. I remember my excitement when Coke released diet cherry coke. One of my writing rituals was a bowl of popcorn and a glass of diet coke by my side while I wrote (today it's water or tea.)

I gave up diet coke when my low carb diet said it was a no-no. Except when I wasn't dieting, I would go back to drinking diet coke.

Diet coke was the last dieting product I had to give up. It had been my fair weather friend for so long. It remained with me after I gave up dieting, long after my book was out, long after I preached fat acceptance. I kept it as the one diet product I wanted to keep. I didn't drink it as I once did and I thought about giving it up for good. The last occassion was December 8, 2007. I only know the date I had been in Syracuse visiting friends and taking photos. After a long day with still more to do, I found myself tired. I asked my husband to go out and get me some tea or coffee or something with caffeine. At the time I didn't drink soda because I had made the association between corn syrup and feeling nausaous. He came back with a diet coke not realizing that I was thinking of giving up. I was so tired I drank it. It had been almost a year since I had one.

I couldn't believe how bad it tasted. Did I really drink this regularly for most of my young adult life?  I realized my biggest addiction hadn't been food (once I stopped dieting, the binging on sugar/salty snacks diminished) but diet soda.

The Wall Street Journal recently published a press release that the diet industry is currently worth $109 Billion and is expected to reach 137 billion in 2017.

The North America Weight Loss / Obesity Management Market was worth $104 billion in the year 2012 and is expected to reach $139.5 billion by 2017. U.S. is the largest market, followed by Canada. The market will grow at a healthy pace in the next five years due to the increasing number of lifestyle diseases such as diabetes and cardiac problems, increasing personal disposable income, government initiatives to increase awareness of health and fitness, and technological advancements.

This market includes: commercial diets such as Weight Watchers, weight loss surgery, pills, wellness plans, nutritional counseling, diet foods, books and yes diet soda. One of the companies highlighted as a big diet industry player is Coca-Cola. (And pepsi too.)

Now why do you think this press release was in the Wall Street Journal and not say the JAMA (It might be, I haven't checked) because dieting is a cash fucking cow. There isn't any money in telling people maybe they can eat a little better or move a little more or that they are perfectly healthy outside the arcane normal weight BMI. Or simple 

Do you think with all these billions that the diet industry really wants to you to be healthy and well? Or do they just want your money?

Workplace wellness, the new diet industry?

As I have mentioned before I have no problem with workplace wellness if it's a voluntary incentive based program such as discounts on gyms, smoking cessation programs, vitamins, and even useless diet programs. I have on occasion taken advantage of some of these programs. The problem arises when the program becomes mandatory or penalty based. I have already mentioned in past posts that stigma never works. I personally know that when I dieted and the weight loss stopped then came back on, it sent me into a depressive spiral where I would eat only junkfood and not move. And I have previously mentioned my biggest obstacle to full wellness has been the amount of time I work. If I just had an extra 2 hours a day I could have time to prepare meals and to exercise more. I've been swimming more this summer and often I have to choose between swimming and making lunch for tomorrow.

The Rand company recently put out a report that workplace wellness is a failure on all parts. Not just reducing weight, smoking and cholesterol but savings. The journal Health Affairs put out a similar study and found that workplace wellness did cut some hospitalizations but did not save money in the long run. 

According to a report by researchers at the RAND Corp, programs that try to get employees to become healthier and reduce medical costs have only a modest effect. Those findings run contrary to claims by the mostly small firms that sell workplace wellness to companies ranging from corporate titans to mom-and-pop operations.

Workplace wellness is a 6 billion dollar industry and growing. Like the diet industry it makes a lot of money with poor results. And like the diet industry I see it growing despite evidence it doesn't work. (I'm still waiting for blaming to fat people for being non-compliant.)

 It's hard to push back against this. Saying no to dieting doesn't hurt you financially (If anything you save money by not doing these programs that almost always end in failure) but saying no at work might mean a penalty. There is also a huge issue because the poor are often the ones who suffer more health issues and a penalty would affect them even more. I know people who ration their health care because they can't afford it. Asking them to pay extra would result in their health getting worse not better.

Again I am not against incentives. I would like to see those continue. I would love if my job had a yoga class.