Fat Chicks Rule

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.

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.

 

Is the Faux Epidemic Over?

Fatness among 3-5 years old has dropped 43% and fat adults and kids over 5 and adults have stayed the same and have been for the past decade. Not just in the US but the world.

Paul Campos writes: As Michael Gard notes in his recent book The End of the Obesity Epidemic, data from all over the world indicate that, over the past ten to 15 years, obesity rates have leveled off or declined among adults and children.

Does this mean the epidemic is over? No, because the epidemic of fat hatred isn’t over. A few years ago I breathed a sigh of relief when multiple studies came out showing that overweight people lived the longest (longevity didn't decrease until your BMI reached 37 and even then it wasn't that bad) and the 400,000 people who died of fatness was revised to 25,814 http://www.obesitymyths.com/myth2.2.htm . For a minute I thought that we finally won. We finally proved that fat does not equal death and making fat people thin was not a cure. Maybe it was time to move to HAES(tm) and that instead of focusing on large bodies, we could focus on getting all people to eat right and find enjoyable movement.

Then the diet/medical/drug industry reared its ugly heads. We were bombarded with “studies” proving WLS cured everything; more infective diet drugs hit the market; the American Medical Association called us a disease; we are penalized for not joining “volunteer” workplace wellness. And anytime an actual study came out saying fatness is not in fact unhealthy, those studies were raked over the coals (Any study claiming fatness is bad is never questioned.) When the study came out claiming fatness among young children dropped 43% Forbes was quick to point out it went up first before going down a mere 14% (Although Paul Campos agrees with their assessment.)

Regardless of the drop, this fake war on children needs to end. There is nothing wrong with children enjoying movement and eating delicious and nutritious foods, but when you single out the fat kids, you cause eating disorders, low self-esteem and bullying. According to School obesity programs may promote worrisome eating behaviors and physical activity in kids Report: 

30% of parents of children age 6-14 report worrisome eating behaviors and physical activity in their children.

7% of parents say that their children have been made to feel bad at school about what or how much they were eating.

 

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.

Still not a disease

As I talked about a few months before, the American Medical Association decided that fatness is a disease, whether you're healthy or not. They are ignoring all logic and science. Some fat people are metabolically healthy while in some people fat is a symptom of disease. The gist is they want to try to impose same solution "Make the fat person eat less" that has never worked in the long run.

Why would the AMA do that? Could it be that the Affordable Health Care allows treatment of fatness that includes paying for diets, diet pills, and surgery.

Defining obesity as a disease should encourage more doctors to offer treatments like surgery and medication, Hamdy says. Two new obesity drugs, Qsymia and Belviq, were recently approved by the FDA

Qsymia is an appetite suppressor. It goes back to same fucking "cure" of eating less. And it has a mile long list of side effects. Of course you can say all meds have side effects. They do. However, why take a drug with terrible side effects that won't work? 

And Belvig was proved to not work even before it was released. 

The AMA's classifying the fatness as a disease opens up a lot of money to the diet industry. It will continue to work on the faulty assumption that we must make fat people eat less. The weight loss/gain cycle will continue. 

Even this doctor in this TED video who is  not being fat positive agrees that the issue isn't EATING TOO MUCH but metabolic issues that cause fatness in SOME but not all people.

Essentially stop trying to cure the fatness, instead cure the actual 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.

Maybe we're just normal.

I remember when Leptin was touted as the hormone that would cure fatness forever. There would be drugs to fix fat and you would become slim, trim, and be able to live like a first class citizen. 

When it turned out that Leptin wasn't the fat hormone but the starvation hormone, and  only worked in a small amount of people it, vanished as a miracle cure. Although if you search Leptin in Google, you'll find a bunch of leptin diets.

Now the new leptin is gut bacteria. Researchers took gut bacteria from two twins, one thin, one fat and injected it into lab mice . 

Researchers found pairs of human twins in which one was obese and the other lean. They transferred gut bacteria from these twins into mice and watched what happened. The mice with bacteria from fat twins grew fat; those that got bacteria from lean twins stayed lean.

The thin mice were then adored about their mouse peers as being healthy despite all the cheese they ate. 

The next step, transferring thin people's shit into fat people.

“I’m very excited about this,” he added, saying the next step will be to try using gut bacteria to treat obesity by transplanting feces from thin people.

I had to double check to make sure the article wasn't the Onion. New York Times? Check. Written by Gina Kolata check. Based on a study in Science, check. 

Zoe Williams of the Guardian points out the crazed obsession  with "curing" fatness as a moral issue:

Other people's weight became all our problem when we started a) calling it an "epidemic" and b) totting up how much it costs the NHS. This is illogical.Malnutrition costs the NHS significantly more and yet no moral judgment accrues around people who are too thin or, for reasons of incapacity, aren't being fed properly by the people who should be caring for them...

 

Except there is one more issue. The mice with the thin bacteria were put on diets. 

The team also showed that a “lean” microbial community could infiltrate and displace an “obese” one, preventing mice from gaining weight so long as they were on a healthy diet.

Diets usually work in the short term. This is no different than diet pills. All of them require you to also do a low calorie diet and pills will help you lose a little more weight. But none have proved to work in the long run.

Sometimes it gets tiring to be experimented on. To be given pills, surgery and shit in hopes that I conform. Instead of treating all disease as  weight loss, why not look into actually curing the disease?

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.

I have a social disease

For days I couldn't believe my ears. My anger was so strong that I had to take a breath before I could say anything. 

The American Medical Association, in their infinite "wisdom" despite warnings from their science advisory board against the decision has doomed (trigger warning) all fat people with a BMI of 30 and above, regularless of their health, as having a disease. 

You can teach aerobics classes, swim, walk, run, eat your vegetables, only eat 2000 cal a day, be in perfect health but if your BMI is 30 and above, you have a disease.

Granted some diseases can cause you to gain weight (such as sleep apnea, diabetes, PCOS and hypothyroidism) and some diseases can cause you to lose weight (hyperthyroidism, cancer, some autoimmune diseases such as Crohn's and Celiacs) but in these cases being thin or fat aren't the disease they are a SYMPTOM.

Abigail C. Saguy points out: 

Yes, there are certain health risks associated with having an elevated BMI, such as Type II diabetes and heart disease. More broadly, a higher BMI is associated with a greater risk of cardiometabolic abnormalities, as measured by blood pressure, triglycerides, cholesterol, glucose, insulin resistance and inflammation. Nonetheless, almost one quarter of “normal weight” people also have metabolic abnormalities, and more than half of “overweight” and almost one third of “obese” people have normal profiles, according to a 2008 study. 

 My biggest issue isn't AMA's stupidity (actually it is), but that in the end they will push the same cure that doesn't still doesn't work and that is Dieting (Big d), diet pills and surgery.  In the end that this will lead in more pressure for fat people to get surgery, take diet drugs, do commercial diets such as Weight Watchers. Even though none of these have been proved to work and help in the long run for the majority of people (sure you're always going to find people who went from fat to thin and stayed that way, but they are the exception not the rule.)

This all goes back to one thing, the billion dollar industry. It really is the money. The biggest medical association saying obesity is a disease and giant check to the dieting, pharma, and bariatic surgeons.

As Marilyn Wann says:

This year, Americans will waste $66 billion on weight-loss products. The "weight-loss" industry is a misnomer: nearly everyone regains lost weight and up to two-thirds gain back more than they lost. Repeat customers are the business model of the weight-regain industry — an industry that expands every year, even during recession. (Which wouldn't happen if their products worked, right?) 

Marilyn has a petition urging the AMA to change their decision.

 

5000 steps to the new diet scam

I recently found out there are talks to change my health care provider and to introduce penalty based incentives to prove you are healthy enough for health care.  (A plan similar to needing to be thin to use the gym.) One of the penalty incentives floating around was that the person had to prove they exercised.

I had to snicker about that one. I do most of my exercise on my own and I wondered how I could prove it. Have my husband follow me around with a camera? 

 

What they really mean is the increasing costs of providing health care are cutting into profits. If we can get rid of people who may potentially get sick and have to use more health care, that increases profits. It's the sort of logic only an MBA can love. 

When people had to choose between paying up to 20 percent more for health insurance or exercising more, the majority of enrollees met fitness goals one step at a time via an Internet-tracked walking program... 

In other words, your job owns your life if you want affordable health insurance from them. If you are deemed "unhealthy" (i.e. fat or a smoker)  your life will be looked into even after you punch out. 

Blue Care Network created a buzz when it implemented one of the largest-scaled financial incentive programs in the country by requiring adults who were obese and in the Healthy Blue Living program to enroll in a fitness program to qualify for lower out-of-pocket health care costs. Enrollees could choose between several programs, including Weight Watchers and WalkingSpree, which uses a digital pedometer to upload walking data on a wellness tracking web site.

Transation: if you're a thin person who eats poorly and doesn't exercise, you won't lose your free time or your right to privacy and you don't have to pay anything extra. And if you are a smoker who lies, then you do can enjoy the affordable medical benefits of being thin. Sorry to say I can't pass for thin. And all the healthy habits I incorporated into my life after I stopped dieting will be meaningless because I am still fat. 

This has nothing at all to do with health. These companies don't care if you get healthy, they care about making money. They want to make sure they have cheap labor that won't get sick.

And Weight Watchers. That's what they consider healthy? A DIET program that has an average weight loss of 6 pounds. Where are the long term studies proving Weight watchers and WalkingSpree will make people thin in the long run? (Hint, there aren't any.)

These workplace wellness programs save such small amounts of money, it's better to just keep things they way they were. There's no privacy or penality issues in offering discounts on gym memberships, offering fitness class and so on. I don't care if you can get a discount on Weight Watchers, I just don't want to be forced to join it to keep my health insurance premiums from skyrocketing. 

The report's conclusions about the financial benefits of workplace wellness programs are also grim. In theory, the programs should reduce medical spending as employees become healthier and thereby avoid expensive conditions such as heart disease, cancer and stroke.

In fact, workers who participated in a wellness program had healthcare costs averaging $2.38 less per month than non-participants in the first year of the program and $3.46 less in the fifth year. Those modest savings were not statistically significant, meaning they could have been due to chance and not to the program.

The issue here isn't making employees healthy, this is a continuation of the dieting scam. For the last 30 years Americans have been dieting and gaining more weight. And they are starting to get to the point that people are becoming more accepting that not everyone belongs in the 19.5 - 24.5 BMI cookie cutter. Even thought dieting is still a 60 billion industry, most of it is DIY dieting which means that people just might be looking at dietary changes rather than weight loss.

So if people are no longer dieting, then I guess we'll have to be forced to.