Things to Read

Some links I thought worth sharing:

Lara Frater on the word “fat”.

Grief moves at its own pace, despite the “rush to normal” common in our society.

You know how kids will bulk up a little before a growth spurt?  That’s now a strange thing to be studied, not a normal thing.

Swimming laps & self-acceptance.

On the US government, but likely applies to others: Fewer secrets would also be smarter secrets.

Anyone have others to share?

Weight Loss Myths

Shakesville posted about this Gina Kolata NY Times piece already, but I wanted to highlight this:

David B. Allison, who directs the Nutrition Obesity Research Center at the University of Alabama at Birmingham […] sought to establish what is known to be unequivocally true about obesity and weight loss.

His first thought was that, of course, weighing oneself daily helped control weight. He checked for the conclusive studies he knew must exist. They did not.

“My goodness, after 50-plus years of studying obesity in earnest and all the public wringing of hands, why don’t we know this answer?” Dr. Allison asked. “What’s striking is how easy it would be to check. Take a couple of thousand people and randomly assign them to weigh themselves every day or not.”

Yet it has not been done.

And, in the meantime, you have parents, doctors, families, and friends advising people to follow these myths. You have weight-loss companies making money from these myths.  And they don’t work. Or, they work for some people. Or, they work temporarily before all the weight comes back (plus more).  Feel like hitting one of the lying liars who lie and mislead people into putting all that time and energy and work and money into eventually gaining even more weight yet?

From Allison’s study abstract: 

Many beliefs about obesity persist in the absence of supporting scientific evidence (presumptions); some persist despite contradicting evidence (myths). The promulgation of unsupported beliefs may yield poorly informed policy decisions, inaccurate clinical and public health recommendations, and an unproductive allocation of research resources and may divert attention away from useful, evidence-based information.

What sort of myths?  Back to Gina Kolata, here’s some weight loss ideas that have been proven to not work, yet are commonly preached to people everywhere:

  • Small things make a big difference. Walking a mile a day can lead to a loss of more than 50 pounds in five years.
  • Set a realistic goal to lose a modest amount.
  • People who are too ambitious will get frustrated and give up.
  • You have to be mentally ready to diet or you will never succeed.
  • Slow and steady is the way to lose. If you lose weight too fast you will lose less in the long run.

Kolata also highlights some ideas that have not yet been proven true OR false:

  • Habits in childhood set the stage for the rest of life.
  • Add lots of fruits and vegetables to your diet to lose weight or not gain as much.
  • Yo-yo diets lead to increased death rates.
  • People who snack gain weight and get fat.
  • If you add bike paths, jogging trails, sidewalks and parks, people will not be as fat.

…and yet, again, these are in diet books, diet programs, and in the last, calls to change how cities are laid out.  (Not to say that bike paths, jogging trails, sidewalks or parks are bad. Just that they won’t automagically make people thin.)

Why is this?  Doctors believe that being fat is terribly, horribly bad.  They want to give people something concrete to do.  And, often, doctors aren’t educated about nutrition or obesity research.  We end up with these myths being repeated over and over, endlessly, and people blame themselves when they don’t work or don’t work long-term. Or they figure it probably works for most people, just not me.   Even the list of “Facts – Good Evidence to Support”, which starts with “Heredity is important but is not destiny”, makes me wonder how much of it suffers from the “must hold out hope of weight loss!” bias.  Especially when the article notes that losing 10% of their weight is typical, and very few lose more.

Overall, the NEJM paper is a call to improve the research.  Even so, they’re not tackling the big “weight loss improves health” idea, or how much of its support comes from short-term studies that include exercise as a component (and never mind that exercise can improve health on its own, independent of weight loss).  Even the reference to most weight loss being in the 10% range will likely not burst the FOBT.

As Liss notes, “What a different culture it would be if fat people weren’t a problem to be solved.

Harriet Brown on Weight Bullying by Parents

Image courtesy of Stocky Bodies

Image courtesy of Stocky Bodies

[Discussion of bullying and weight punishments; feel free to skip.]

Harriet Brown has a piece in the New York Times Well blog on “Feeling Bullied by Parents About Weight“:

Parents and other adults who are “only trying to help” may do harm rather than good, as a recent study from the journal Pediatrics makes clear.

It is a good discussion and I’m glad to see it.  At the same time, it can be upsetting to see things you’ve lived with discussed dispassionately. Dr Rebecca Puhl, from the fat-phobic Rudd Center, appears, as does Ellyn Satter.

“There still remains the widespread perception that a little stigma can be a good thing, that it might motivate weight loss,” said Dr. Puhl, a clinical psychologist. (Medical doctors, too, fall prey to this misconception.) But research done at the Rudd Center and elsewhere has shown that even well-intentioned commentary from parents and other adults can trigger disordered eating, use of laxatives and other dangerous weight-control practices, and depression.

Hells yes, y’all, parents can bully their fat children.  Or maybe you don’t want to call it “bullying.”  Maybe you want to call it teasing, belittling, or harassing.  Oh, here’s one: providing incentive.  Maybe buying your kids clothes that “will fit when you lose weight” instead of now, or pointing out that the fat kid gets different (less) food than the rest of the family, is just something that “has to be done” too.  No, it’s not.  It is abusive. And you should not be surprised if the kids you reject for being fat reject you in turn.

Kudos to Harriet for broaching a topic that many parents like to pretend doesn’t exist.  Also for common sense suggestions, including

¶ Don’t blame your child for his weight. […]

¶ Don’t engage in “fat talk,” complaining about weight and appearance, whether it’s your own, your child’s or a celebrity’s. [….]

¶ Don’t promise your child that if only he lost weight, he wouldn’t be bullied or teased. […]

¶ Don’t treat your child as if he has — or is — a problem that needs remedying. “This will make him feel flawed and inferior,” says Ellyn Satter, a dietitian and therapist in Madison, Wis., and author of “Your Child’s Weight: Helping Without Harming.” Instead, she suggests, focus on a child’s other good qualities, and encourage traits like common sense, character and problem-solving skills.

I would strongly recommend NOT reading the comments in the Times. 

Fat Doesn’t Require Apology

You may have seen the video where WKBT anchor Jennifer Livingston responds to a viewer complaint about her weight.  In her response, Livingston thanks those who have come to her support.  She encourages people to speak against bullying and to think about what they say in front of  kids.

What she does not say?  Jennifer Livingston does not apologize for her size.  Livingston acknowledges her size and does not try to justify or explain it.  No “I’m working on it.”  No “I’ve tried to change it.”  She doesn’t even point out that being fat is not a “habit”.*   Her size is her size.  No apology.

I loved that she did not get teary. I loved that she spoke strongly and positively about herself and against bullying.  But the fact that she did not apologize or justify her weight struck me the most.

*As the Academy for Eating Disorders put it, “Weight is not a behavior and therefore not an appropriate target for behavior modification.”  Weight is also not a “habit”.

Junk Food In Schools Doesn’t Correlate To Fat

Remember how banning junk food in schools was supposed to make fat kids thin?  Guess what?  No,  it doesn’t.  At least not according to “Competitive Food Sales in Schools and Childhood Obesity: A Longitudinal Study” in Sociology of Education (January 2012).

But of course we should’ve thought it would, right?  It’s not like “Snack food intake does not predict weight change among children and adolescents” was published in International Journal of Obesity in August 2004, right? And there wasn’t any studies about “energy-dense snack food” not being correlated with weight gain in adolescents either…right?  Wrong.

Once again, America is continuing to do the same thing (that didn’t work) to try to prevent fat kids.  And yet, fat kids exist.  Time to ban fat marriage?

For All The Parents Out There…

Think about how you will react if your child is fat.  Over time, if you’re making it clear that you don’t want a fat son or daughter, well, your son or daughter may not be able to stop being fat.  But your son or daughter can eventually choose to stop being your son or daughter.  Imagine your adult child building a life with people who aren’t nagging about weight loss, or who can enjoy doing something physical without making it about weight loss, or who can eat a meal without it being about weight loss.  Calling home?  Not required.  Spending time together?  Optional.  Listening to lame weight jokes?  Optional.

There are certainly other issues that can cause this sort of distrust.  It didn’t help that my parents’ reaction to my dating a woman was insist I not tell any other family members and then studiously not  want to talk about her much less meet her.  It didn’t help that my father drank large amounts of beer daily for the first 20 or 21 years of their marriage.   A lot of things didn’t help.   But it’s generally expected that drinking or rejecting a child’s sexuality is going to be harmful to the relationship.  Giving kids shit for being fat is practically a requirement of “good parenting” these days.

My dad periodically asks why he can’t move in with my husband and I.   Frankly?  I don’t want to provide day-to-day care for him.  I distanced myself for my emotional safety.   I wouldn’t want him as a roommate, much less as a semi-disabled adult I’m caring for.  My emotions are tangled on this, but my want is for him to live happily ever after … without needing me.

Things to Read

As others have noted, Paul Campos’ piece on how the US “Let’s Move” campaign aids and abets bullying is worth reading.  Besides noting that advocating for “child obesity to be eliminated” paints a “pick on me” sign on anyone who isn’t model-thin, Campos also cites studies that have tried healthy interventions with children in the past.  Result?  The kids got healthier.  They didn’t get thinner.

Consider the first lady’s major policy goals: She wants children to eat a healthy balance of nutritious food, both in their homes and at school, and she advocates various reforms that will make it easier for kids to be physically active. These are laudable goals in themselves, but there is no evidence that achieving them would result in a thinner population. Indeed ambitious, resource-intensive versions of Mrs. Obama’s initiatives have been implemented on a smaller scale, for example by the Johns Hopkins University Pathways program, which attempted to improve the diets and increase the activity levels of Native American children in three states, while educating their families about health and nutrition. The program had some success in all these areas, but it produced no weight loss among the children as a group. The same basic results, improved health habits but no weight loss, were obtained in the Child and Adolescent Trial for Cardiovascular Health, a similar program involving thousands of ethnically diverse children in four states. Pursuing comparable initiatives at a national level might be worthwhile—these programs did, after all, result in improved health habits among the children who participated—but there is no reason to think the kinds of reforms Mrs. Obama is advocating will make American children thinner. The perverse result could be that an initiative that might have been judged a success had its primary focus been on producing healthier children will instead end up being used as another example of a failed Big Government program, simply because it did not produce thinner ones.

[Links from the original; emphasis added]

Campos also points out that dieting is often linked to long-term weight gain.

…and on a less serious note, Seanan McGuire wrote a brief description of sci-fi conventions and 10 tips on how to cope with one.  Whether you’ve been to a con or not, it’ll likely make you smile.

QOTD: Why Stigmatize Fat Kids?

From Pattie Thomas’ post at Psychology Today in response to a “Cease to be obese crusade” billboard on how kids should exercise:

Why do you have to promote weight loss in order to promote exercise? If you really believe in the calorie in/calorie burned model, promoting exercise and healthy eating for every one would automatically solve the “obesity” problem, would it not? Is it necessary to promote hatred of a fat  body in order to get someone to lose weight? Is it not important to promote play, movement, and sportsmanship among all all kids? Why single out obese kids?

I think the most telling thing about those who are promoting the “healthy children” initiatives that this billboard represents is that the promoters do not trust the calories in/calories burned model.

Pattie Thomas also goes on to note that if it’s really about health, good nutrition and exercise should be the point.   Apparently it’s not.

Things to Read: Scandals That Aren’t

This bit on Fast Food Restaurants Not Single-Handedly Ending Child Obesity is hysterical.   Yes, some fast food restaurants pledged to make “healthier” choices available, and yes, they make some “healthier” choices available.  Is it really a surprise that you might have to, gasp, order the milk and apple slices instead of pop and fries?

Hey, here’s another one: Instead of whining about TV ads, why not minimize watching them?  Unlike the world of 1984, televisions can be turned off; commercials can be muted, programs can be recorded and commercials fast-forwarded.   Teach the kids to help you make dinner or with the dishes — that’s teaching the kid an important life skill AND spending quality time together.   Or play a board game or read with the kids or watch a DVD or mute/fast-forward through commercials or, heck, let the kid watch the commercials and tell them “No” if that’s what you’ve decided.  I realize it’s radical to pretend you’re the one raising your own kid, but I won’t turn you in, I promise.

(Not that I think that turning off the TV or passing up a Happy Meal will automagically turn a fat kid into a slender one.  But it’s a lot easier to start learning to cook or do the dishes or handle “No” or amuse oneself without TV before you’re 25 or 30, so why not do your child a favor and teach them?)

Also in the “this is a surprise?” is  that the US Dept of Agriculture is promoting American-made cheese.  The Dept of Agriculture was founded with the aim of promoting US agriculture and has maintained multiple roles through its history — it regulates and markets US food, it promotes good nutrition and runs the Forestry Service.  It isn’t, in fact it really can’t, be a monolith.  Maybe I worked too long in a large (50,000+ employees) company, but it’s reasonable that people in the group that works to market the US dairy industry is not necessarily going to be worried about limiting dairy intake.  It’s also reasonable that the people who are worrying about ideal nutrition are in a different group from the ones marketing various types of food.   Yes, they have a point that the USDA is talking out of both sides of its mouth with “eat more cheese” and “eat less saturated fat, including less cheese” as messages, but — hello — the USDA didn’t stop subsidizing tobacco production until 2005 (and is still paying tobacco farmers to help them transition to a free market).   There is big money encouraging Congress to help market US agriculture, and don’t you forget it.

Now, if the NYT is looking for a scandal, the fact that the Dairy Marketing group continued their “dairy helps you lose weight” campaign despite the research they funded disproving it is a better target, I’d think.  Especially since the Federal Trade Commission got involved.  Or maybe it’s just that nobody really expects diet ads to have any basis in fact?

Doing the Same Thing, Expecting Different Results

Can you place this quote?

Just about everyone can list ways to fight childhood obesity: schools should alter lunch menus, teach nutrition and hold more physical education classes. At home, parents should be more diligent and the Xbox less available.

Here’s the problem: as logical as these suggestions might sound, when many of them have been subjected to the cold light of rigorous scientific study, they have fallen short. If nothing else, when it comes to fighting obesity, science teaches humility.

A major study published last week, for example, gave some researchers pause. Nearly 49,000 women were randomly assigned to follow a low fat diet or their regular diet for eight years while researchers kept track of their rates of breast cancer, colon cancer and heart disease. Not only did the diets have no effect on these diseases, they also had no effect on the women’s weights.

[…] In the 1990’s, the National Institutes of Health sponsored two large, rigorous studies asking whether weight gain in children could be prevented by doing everything that obesity fighters say should be done in schools — greatly expand physical education, make cafeteria meals more nutritious and less fattening, teach students about proper nutrition and the need to exercise, and involve the parents. One study, an eight-year, $20 million project sponsored by the National Heart, Lung and Blood Institute, followed 1,704 third graders in 41 elementary schools in the Southwest, where students were mostly Native Americans, a group that is at high risk for obesity. The schools were randomly divided into two groups, one subject to intensive intervention, the other left alone. Researchers determined, beginning at grade five, if the children in the intervention schools were thinner than those in the schools that served as a control group.

They were not. The students could, however, recite chapter and verse on the importance of activity and proper nutrition. They also ate less fat, going from 34 percent to 27 percent fat in their total diet.

This is from a 2006 New York Times article about a plan to ban whole milk from schools, called “Thinning the milk does not mean thinning the child“.  But the above quote could also be printed now, about the US government’s “Let’s Move” campaign.  But, unfortunately, facts don’t always change minds, so the same things that didn’t work before will be tried again.  And especially don’t try the division of responsibility with kids, because OMG what if the kid wants to eat more or less than is “officially accepted”, or worse, vary their food intake from day to day based on their own internal cues?  That could lead to rain of toads, dogs and cats, living together…mass hysteria!

Michelle Obama: Let’s Harm Fat Kids

If you haven’t read Kim Brittingham‘s piece on Michelle Obama’s “Let’s Move” anti-obesity campaign, you really should.

When we frame our battle for healthier children as a battle against fatness itself, we’re merely proclaiming open season on fat people. We’re encouraging an already fat-prejudiced society to further demonize those who bear the fat – worst of all, the children who bear it.

And:

Look at it this way. Let’s say you have a choice between:

a) standing up before a room full of children and encouraging them to exercise more, or

b) standing up before a room full of children and encouraging them to exercise more, and then throwing a handful of knives into the audience.

Why would you select b), unless you wanted to hurt someone?

You can read the rest here.

Wonder if Michelle Obama reads the New York Times

From a New York Times article on how some anti-childhood obesity funding is cutting into funding for anti-smoking efforts:

Jeffrey Friedman, an obesity researcher at Rockefeller University, notes that there are many assumptions about what will work — more healthful foods in schools, a soda tax, getting children to be more active. Yet no interventions, when tested in large studies, have caused a big difference in children’s or teenagers’ weights.

It is very frustrating how many people believe in the god of Weight Loss despite proof to the contrary.

Today’s Logic Fail

Researchers found that kids who have higher BMIs tend to do a little worse on treadmill tests than thinner kids…if they’re from “lower- or middle-income neighborhoods.”   The difference goes away if they’re from the more affluent neighborhoods.

Lead researcher Dr. Tajinder P. Singh, of Children’s Hospital Boston, speculates that

[K]ids from affluent neighborhoods have healthier lifestyles — better diets, more opportunities for exercise — so that even if they are overweight, they may be in good health.

Singh also points out that BMI just measures height and weight, and so it could be the more affluent kids have more muscle mass.  I recall that muscle mass can depend on genetics, but it’s also greatly influenced by exercise.   Ah!

So, logically speaking, does Singh then suggest that perhaps lower- to middle-income children could benefit from more opportunities to exercise?

Singh said they suggest that lower- to middle-income children stand to gain the most from losing excess weight.

Not exercise.

Even though they’re doing treadmill fitness tests, which are … exercise.

Measuring response to … exercise.

A response that improves with … exercise.

Gee.  If  ALL the kids from poorer neighborhoods had averaged lesser cardio fitness, would he have suggested they should move to the better neighborhood?

No, really?

USA Today discovered that — guess what! — fat kids are more likely to be bullied.

Researchers at the University of Michigan-Ann Arbor analyzed the bullying incidents of 821 children ages 8 to 11.

The study, reported today online in Pediatrics, found that obese children were more likely to be bullied than normal-weight peers, regardless of gender, race, socioeconomic status, school demographic profile, social skills or academic achievement.

“This study speaks to the deep prejudice against children who are obese,” says lead author Julie Lumeng, assistant professor of pediatrics at the University of Michigan. “They are viewed as lazy and lacking in self-control, but we know the reasons for obesity are so much more complex than that.”

Oh, and other studies show that obese kids that are bullied have more depression and anxiety than their peers.   Kind of like adults in that respect, you think?

I should note the article doesn’t, at least, encourage just adding a little diet or exercise to rub out that nasty fat.  But I’m sure lot of people will add that themselves.