Fat Chicks Rule

New Diet: Deny Drugs you need for Drugs that Don't Work.

The worst doctor I ever saw was an endocrinologist. I went to her thinking that I might have a thyroid condition as I was tired all the time. 

When I finally got into see her, I began to give her the talk about my dieting history, only to have her interrupt to insist I be tested for diabetes. When both my sugar levels and thyroid came back normal, she blamed my fatigue on being fat. (Apparently carrying around weight makes you work harder and tire out faster.)

Another horrible endocrinologist out of Boston is Dr Caroline M Apovian (I will refer to her as "Dr. A" from now on)  who has a horrible idea. Take potentially needed prescription drugs away from fat people until they lose weight with lifestyle changes and weight loss drugs.

I am not kidding.

Use of approved weight-loss medications is endorsed for people with a body mass index (BMI) of 30 kg/m and above or at least 27 kg/m with one or more comorbidities. The document "shifts the paradigm" by advising physicians to target the obesity itself first and thereby diminish its related complications — such as hyperglycemia, dyslipidemia, and hypertension — rather than aiming first to treat the comorbidities caused by the excess weight, she said.

Which means to me if you have hypertension, you should just have a stroke if you refuse to take diet pills (which is ironic considering that diet drugs in the past have caused heart disease related deaths.)

Now I'm not against trying actual lifestyle changes first before taking medications. I lowered my cholesterol with dietary changes and an increase in exercise, and if you watch America the Beautiful 2: the Thin Commandments, the director also avoided taking certain medications by becoming an active bike rider. In my case and his, indicators improved with miniscule weight loss. 

This is not the case with everyone, and sometimes people have to take medications. Dr. A not just against using medication for high cholesterol, hypertension, or hyperglycemia, she's against mental health drugs that make you fat.

For patients already taking insulin, sulfonylureas, thiazolidinediones, beta-blockers, or certain specific selective serotonin-reuptake inhibitors (SSRIs) like paroxetine — all of which can lead to weight gain — the document provides advice on how to taper patients from those medications and switch them to alternative agents that don't increase weight.

In my opinion, changing around a person's mental health drugs so they don't get fat is dangerous and a malpractice suit waiting to happen.

But what Dr. A does have for you is  diet pills.

"Medications do not work by themselves, but they can help people maintain a healthy diet by reducing the appetite. Adding a medication to a lifestyle modification program is likely to result in greater weight loss," said Apovian, who is also professor of medicine and pediatrics at Boston University School of Medicine.

And why is Doctor A. peddling dieting and diet drugs?

Dr Apovian serves on advisory boards for Amylin, Merck, Johnson & Johnson, Arena, Nutrisystem, Zafgen, Sanofi, Orexigen, and Enteromedics. She has received research funding from Lilly, Amylin, Aspire Bariatrics, GI Dynamics, Pfizer, Sanofi, Orexigen, MetaProteomics, and the Dr Robert C and Veronica Atkins Foundation. Disclosures for the coauthors are listed in the article.

Slow, Fast, or Steady, diets don't work.

No blog post next week. I will be away.

I've done all kinds of diets including lose weight slow and lose weight fast ones. They all ended up the same way. I'd regain all the weight plus more. Eventually I dieted myself to an extra 70 pounds.

A study in Australia showed that dieters who did crash diets (a very low calories one) not only lost more weight but stuck with it longer, compared to the ones who did plans with slow weight loss. Essentially in the race to lose 12.5% of your body weight, crash diets won!

However, the new study shows that "achieving a weight loss target of 12.5 percent is more likely, and drop-out is lower, if losing weight is done quickly," Purcell said.

12.5% is 15lbs if you weigh 200 lbs.

But before you makers of crash diets pat yourself on the back, the study found out one other thing.

 People in both groups regained about 71 percent of their lost weight by the end of three years, regardless of how fast they had slimmed down, the researchers said.

The gist is a crash diet resulted in quicker weight loss than a slow and steady one but 71% of both diets caused weight regain of all their weight within three years (and I bet that percentage will be higher within five years).

 Diets do not work in the long run for most people. It doesn't matter if you do it slow, fast, or on alternative Saturdays.

The Non-Diet Diet

You will not find Weight Watchers calling itself a diet, even though its main focus for you is not only losing weight but eating less calories than your body needs.
 
Many diets try to trick you by not referring to themselves as a diet. They may call themselves a lifestyle change, or they may seem not to focus on weight loss but there site is covered weight loss tools and their plan is usually the same: less calories.
 
A new gimmick diet is out called Eat Like a Woman. Apparently it has nothing to do with eating more calcium or folic acid if you're pregnant. No, it you eat a certain wa- the female way--you too will lose weight and keep it off.(actually it's supposed to be a Mediterranean diet which does have heallth benefits, but not proved to be a long cure for fatness)
 
Except that it's still BS. It's just another fad diet pretending to be something else. Eat Like a Woman's slogan is Never Diet Again. Until you you get to the page about the book where it reveals (Horns playing)

Finally a Diet Designed for You.
 
I would laugh this off at another BS diet, if it wasn't for the name. Women are always told they need to eat less. They are given less calories than men, told to eat less as they get older. And now there is a diet program supposedly tailored just to them.  

I say enjoy food, enjoy how it benefits your body and soul and eat like a human.

Diet Drugs Still Don't Work

Bupropion aka Wellbutrin is an anti-anxiety/depression drug and Naltrexone is an alcohol and drug dependency (opioids) drug. Put them both together and we have another useless diet drug: Contrave

Ignoring the stupid and fat hating graphic of this article (A fat head eats a hamburger but resists pills), the author tries to figure out why people are not flocking to take Contrave or the other diet drugs on the market. (Except sales are projected to be 200 million)

Maybe people don't want to take diet drugs because you know heart valve disease and primary pulmonary hypertension.

Much of the resistance to the weight-loss medications stems from the disastrous safety record of diet drugs pulled from the market in the 1990s.

Or maybe it just doesn't work.

In clinical trials, for example, nondiabetic patients taking Contrave lost only 4.1 percent more weight than those taking placebos

Or maybe it has crazy side effects and a black box warning

The diet pill Contrave can also cause seizures, raise blood pressure and heart rates

CONTRAVE can cause serious side effects of suicidal thoughts or actions…(Read the entire three paragraph warning if you want at the Contrave website.)

Or maybe you still have to diet while using it.

All patients received lifestyle modification that consisted of a reduced- calorie diet and regular physical activity

Or perhaps there are no long term studies that Contrave causes you to be thin forever. The original study ran for only one year.

Or perhaps it works on the flawed presumption that all fat people are fat because we eat too much.

So Contrave is of the same bullshit as any other diet drug. It doesn’t really work in the long run and barely works in the short. My only hope is that it doesn’t kill people like Fen-Phen and Meridia.

Study Accidently Finds Out Dieting doesn't Work.

Researchers at Duke have put together a study to find out which diet (including drugs but excluding Weight loss surgery and Medifast, Optifast, and Slimfast) gives you more bang for the buck.

Finkelstein and research assistant Eliza Kruger first conducted a literature review to identify high-quality clinical trials of commercially available diet/lifestyle plans and medications with proven weight loss at one year or more. Weight loss was measured in terms of absolute change in kilograms lost compared to a control group in which patients underwent a low cost/low intensity intervention, or a placebo in the case of the pharmaceutical trials.

 The results for diet programs found that Weight Watchers gives you the best weight loss for your money and the drug Qsymia was the best drug. Jenny Craig had the most weight loss but it was the most pricey.

However,

Average weight loss at one year ranged from 2.4 kg (about 5 pounds) for Weight Watchers to 7.4 kg (16 pounds) for Jenny Craig. Those on Orlistat lost 2.8 kg (a little more than 6 pounds) whereas those on Vtrim and Lorcaserin both lost an average of 3.2 kg (about 7 pounds). Weight loss for those on Qsymia averaged 6.7kg (a little less than 15 pounds).

Essentially, weight loss on the diets they measured were about  5-16 pounds. Making Weight Watchers the cheapest at about $75 a pound.  I gain and lose five pounds during my period. I don’t need to pay for the privilege.

The authors tried to save face by comparing it to quality adjust life year (essentially saying that the whole five pounds you lost is worth it because now you are “healthier” and that five pounds will save you for the horrible diseases to kill slowy) but really all it proves is you spent a lot of money and didn't lose a lot of weight. The study doesn’t examine weight cycling which I believe to be more dangerous than being fat or does it look at weight loss five years from now. Weight loss diets tend work in the short term.  If you measure success in a year with a small amount of weight loss, than I’ve been successful on almost every diet I’ve been on.

The commercial diet industry is rapidly losing money to non-dieters and DIY diets and is desperate to make the money it formerly did. This is why it's focusing at pushing for coverage under the Affordable care Act and workplace wellness. No health insurance in its right mind would cover a program with a 95% failure rate that isn't even shown to be good at weight loss!

Oh and btw

Finkelstein (The author) has been a paid consultant for Jenny Craig, Weight Watchers, Takeda, Orexigen, and Vivus, Inc

Yet another useless Weight Loss Drug

No blog post next week, I will be away.

Weight loss drugs have a history of not working and/or causing dangerous and deadly side effects. This new one coming down the pipe doesn't look any better.

This new pill Gelesis100 (I kind of wonder what happened to Gelesis1-99) temporarily expands in your stomach, in theory making you eat less. Results have been disappointing. The pill caused a people to lose 6.1% of their body weight compared to the placebo of 4.1%. The makers, of course, call it a huge victory over the fatties!

Oh and they also had to diet while using it.

The study involved 128 overweight or obese Europeans who swallowed a capsule before lunch and dinner along with half a liter, or about 17 fluid ounces, of water. They were also put on a reduced-calorie diet.

And 24% of people who took the higher dose (Is this like a bigger balloon?)

Gelesis executives said that was probably because 24 percent of patients on the higher dose stopped taking the capsules...

Because

...could cause bloating, flatulence, abdominal pain and diarrhea.

Also

But Dr. Daniel H. Bessesen, an endocrinologist at the University of Colorado who was not involved in the study, said weight loss of 2 percent beyond that provided by a placebo was “very modest.” “It doesn’t look like a game changer,” he said.

So let's say it again kids, "No diet drug has been proven to work in the long run." This drug mixed with a low calorie diet is the same shit, different day.

And I'm really tired of these pill pushers that assume fat people are fat because we eat too much. Of course starving someone can cause weight loss but studies have shown this doesn’t work in the long run.

 

 

Zero Steps Forward and Eight Steps Back

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.

 

Case in point, this:#‎ICO2014‬

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.

 

Ragen Chastain says it best:

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. 

 

Related articles

Take the stairs. Or don't.

 

Nope, still not a disease.

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.

However...

 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.

Making Safe Space in Your Body

Ending dieting and embracing HAES has helped improve my health, but it’s still hard when I’m bombarded with messages that fat is bad. I need to do more about dealing with the stigma of having a big body in a fat hating culture. If I can’t make the world a safe space, the least I could do is feel at home in my own body.

The Rudd Center recently came out with a study showing that weight stigma affects the stress hormone cortisol. This is just the beginning of showing that some "fat-related-diseases" may be more related to the stress of stigma rather than being over some arcane number.

Exposure to weight-stigmatizing stimuli was associated with greater cortisol reactivity among lean and overweight women. These findings highlight the potentially harmful

physiological consequences of exposure to weight stigma.

Another study said that labeling fatness as a disease undermines health.

Specifically, obese participants who read the "obesity is a disease" article placed less importance on health-focused dieting and reported less concern for weight relative to obese participants who read the other two articles. They also chose higher-calorie options when asked to pick a sandwich from a provided menu.

Essentially fat people who saw themselves labeled as diseased didn't care about health when dieting and also ended up eating more.

I've mentioned it before. Dieting pushes weight loss not health as the ultimate goal. You diet, you lose some weight, then the weight loss stops and you go on a massive binge. When all that matters is being thin, health usually goes out the window.

Stigma causes stress and anxiety. Fat people face stigma either outright or even unintentionally: Small seats, labeled diseased, poor quality clothes, assumptions that you drink soda, or don't exercise.

All this could lead to body shame and a mistrust in yourself. I mentioned that when I was climbing the Manitou incline it was harder the closer I got to my goal. I didn't trust myself to make it. It disturbs me because it's been over 10 years since I stopped dieting and tried to work on loving my body and still I have doubts. I still sometimes look at weight loss “successes” (the exception, not the rule) and wonder why couldn’t I do that.

Stigma is hard to escape especially when you are bombarded with weight loss ads, and fat hatred. When you're patronized and told just to eat one less cookie. So how do you escape the stigma? Staying in your house without access to internet isn’t going to cut it.

We can, and have, changed the world to becoming more accepting that people come in all shapes and sizes. It’s slow but happening.

However in the meantime we need to think of ways to protect ourselves from fat hatred.

The best way to deal with that is improving your self-esteem. Names become meaningless if you feel you are better than them. Here are a few suggestions to help deal with stigma.

•   Love yourself and tell yourself of your achievements. Tell yourself you deserve it.
•  Write everyday things you are grateful for.
•  Meditate and do deep breathing. Try not to think about triggers. Empty your mind if possible and concentrate on your breathing.
• Take a nice relaxing bath and tell your body how much you love it. If they didn’t make a bathtub big enough for you, take a nice hot shower.
• If you are someone like me who blogs about fat hatred, give yourself a respite when you feel like you’ve had enough. Read a fat positive blog or book.
• Remember this is the only body you have. You need to trust it.

 

 

 

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.