Conflating Dieting with Eating Healthy

[Feel free to skip if you don’t want to think about dieting right now.]

Image courtesy of the Rudd Center Image Gallery

Image courtesy of the Rudd Center Image Gallery

It’s January and there is the usual plethora of diet commercials extolling weight loss. Google “dieting” and up comes Special K’s “Healthy Eating Plan”!

That said, it is a bit refreshing to see someone write:

As a lifelong dieter, let me tell you from experience: A diet need have nothing to do with “eating healthy.”

[…] It’s possible to lose weight by eating more healthily. But losing weight and eating more healthily can also be two totally different goals.

The cultural conflation of “eating healthy” and “dieting” has a lot of built-in assumptions.

There’s certainly more (and I haven’t even gotten into all the debate over what “healthy eating” means).

One result of the end-of-year crunch at work is that I haven’t been eating lunch regularly.  I’m going to work on permission to eat what I want, and eating at regular intervals.  But I am still avoiding diet commercials.

Today in Don’t Read The Comments

Marilyn Wann takes on weight bias in healthcare in “Big deal: You can be fat and fit” on CNN.COM:

…People are telling their stories of weight bias in medical care on websites like First, Do No Harm, This Is Thin Privilege and Obesity Surgery Gone Wrong. The National Association to Advance Fat Acceptance has been speaking out on behalf of fat people’s civil rights since its founding in 1969.

Health professionals of good conscience are joining this effort in increasing numbers. They’ve developed an approach called Health At Every Size that is proving to be better for people’s health than weight-loss attempts. The Health At Every Size professional organization,Association of Size Diversity and Health, this week launched the project Resolved, a response to New Year’s weight-loss resolutions. It invites people to share stories about weight discrimination in health care and opinions about what needs to change.

Weight bias has been documented among doctors, nurses, fitness instructors and other professionals on whom a fat person might need to rely for help. Last year, researchers who themselves are part of an anti-“obesity” institution (Yale’s Rudd Institute) surveyed medical professionals who specialize in caring for fat people and found that they had high levels of weight bias, viewing us as “lazy, stupid, and worthless.”

Image courtesy of the Rudd Center Image Gallery

Image courtesy of the Rudd Center Image Gallery

Paul Campos uses the latest “obesity paradox” study with “Our Absurd Fear of Fat” in The New York Times to argue that policing fat is worthless:

The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals. If the government were to redefine normal weight as one that doesn’t increase the risk of death, then about 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead.

[…]

Now, if we were to employ the logic of our public health authorities, who treat any correlation between weight and increased mortality risk as a good reason to encourage people to try to modify their weight, we ought to be telling the 75 million American adults currently occupying the government’s “healthy weight” category to put on some pounds, so they can move into the lower risk, higher-weight categories.

In reality, of course, it would be nonsensical to tell so-called normal-weight people to try to become heavier to lower their mortality risk.  […T]iny variations in relative risk in observational studies provide no scientific basis for concluding either that those variations are causally related to the variable in question or that this risk would change if the variable were altered.

Both articles are well worth reading, but I would skip the comments on those sites. If you must discuss with someone, chat about it here ;)

Happy New Year!

Image of a fat woman talking on the phone in an office setting.

Image courtesy of the Rudd Center Image Gallery

Hello and welcome!  I’m back at work with my new cartoon-a-day calendar (New Yorker cartoons) and new wall calendar (Pacific Northwest landscapes).  I even cut off some of the photos from last year’s wall calendar to decorate my cube.  Ready to work!  (Yes, I know it’s Wednesday, but today feels like Monday to me.  Yay four-day weekends! )

I adjusted the layout, let me know if you can’t find things.  Also, let me know if you have additional topics or questions you’d like me to write about.

As for resolutions, well, there’s resolve and then there’s Resolve the carpet cleaner, (Two Lumps).  There’s also ASDAH’s Resolved: Addressing Weight Bias in Health Care Project, collecting health care stories in video or written form.  Please see their site to see what they are asking for and the submission methods.

 

In the meantime, some things to read / discuss if you wish – warning for fat hate:

People are living longer! I thought this would be a good thing. Oops! As Fatties United discusses, some people aren’t happy with this.

Since so many fat people have had the audacity to keep on living instead of dropping dead on schedule, Dr. Mokdad is predicting that all these fat folks will be old sick fat folks and require lots and lots of medical treatment.

Study results show that “normal weight” folks don’t live longer than overweight folks? (Again?) Oh noes, must include lots of fat panic in the news coverage!

Charlotte Cooper writes about The UK Royal College of Physicians and their concerned about obesity!  Oh dear.

Reading the report is like a journey into Opposite Land. The work is well-meaning, but it exists with a framework that is profoundly problematic. For example, it is hard to disagree that current service delivery for fat people is really poor, particularly for those who undergo weight loss surgery, and that there needs to be proper auditing, quality control and monitoring of all obesity treatments.

But the report, as is typical in a medicalised discourse of fat, is entrenched in a view that regards weight loss as the universal solution to the problem of fat people and health. The authors throw about “severe complex obesity,” a term they’re obviously pretty proud of, coming soon to a healthcare provider near you, and bound to further medicalise and stigmatise fat people. They make the crucial mistake of failing to question the effectiveness of weight loss at all, so it’s not weight loss surgery that ruins fat people’s health, it’s the fact that the care pathways surrounding the surgery need tweaking. This ties them up in all kinds of knots, looking for answers in the wrong places, for example suggesting that the UK needs a Michelle Obama figure to galvanise the population against obesity, even though her crusade in the US has been disastrous in re-stigmatising fat kids, and even though we’ve already seen Jamie Oliver screw things up over here.

Anyway, let’s be careful out there. Now, I’m going for a walk.

Things to Read

If you can (not allergic to eggs etc) get your flu shot. Yes, really.

The Kindle edition of A Year of Biblical Womanhood: How a Liberated Woman Found Herself Sitting on Her Roof, Covering Her Head, and Calling Her Husband “Master” by Rachel Held Evans is $1.99 right now. I enjoyed it, and not just for the debunking of the “Wives are required by God to appear pretty/sexy” meme.  (Rachel is also the author of “How to win a culture war and lose a generation“, “15 Reasons I Left Church“, and “15 Reasons I Returned to The Church“.)

Guns do kill people (at least in the US) in one graph.

How the late Jack Klugman helped people get needed medical care.

The Fat Nutritionist post on “Stuff people assume I believe vs. stuff I actually believe” is cool, but it’s sad that it’s needed.  (See also comments on how if I keep exercising I’ll lose weight.  No, not necessarily, and that’s not the point anyway.)

And check out Barry Deutsch‘s take on “Reality Television“.

Women standing up against a society [that bastardizes] thin and athletic women

[Discussion of fat hate & discrimination]

OK, I wanted to give people the benefit of the doubt.

When Lesley Kinzel wrote about the Kickstarter campaign to raise money for a to stand up for “thin and athletic women” who are oppressed by society’s expectations, I wondered if:

  1. The author of the Kickstarter campaign thought that using hyperbole about “a society that protects fat culture” would be eye-catching, and,
  2. If the author of the Kickstarter campaign had conflated society’s dislike of visible muscles on women as “pro-fat”.

The photo of the author on Kickstarter definitely shows visible abs definition, and yes, “feminine” usually correlates to “few or no visible muscles”.  Some women do fear gaining visible muscle and avoid weightlifting as a result.  Women bodybuilders are sometimes viewed as “masculine” or “freaky”.

From the Kickstarter description of the project:

Collection of images of women standing up against a society that protects fat culture while bastardizing thin and athletic women.

[…]

There are millions of women out there and im sure you know at least one looking for a voice , not from tvs and magazines, not from victorias secret.. but from the ground level , to speak up and tell them that its okay to want to be in better shape.

[…]

But.. if it just makes it into the hands of ONE little girl who feels like she has to be overweight to fit in with the current 70% of the overweight population of America, and it gives her the strength to know that being healthy isnt a bad thing.

Then this whole project is worth all the time and effort i can possibly afford to put into it.

…. ah no.

Obese individuals are highly stigmatized and face multiple forms of prejudice and discrimination because of their weight (1,2). The prevalence of weight discrimination in the United States has increased by 66% over the past decade (3), and is comparable to rates of racial discrimination, especially among women (4). Weight bias translates into inequities in employment settings, health-care facilities, and educational institutions, often due to widespread negative stereotypes that overweight and obese persons are lazy, unmotivated, lacking in self-discipline, less competent, noncompliant, and sloppy (2,5,6,7). These stereotypes are prevalent and are rarely challenged in Western society, leaving overweight and obese persons vulnerable to social injustice, unfair treatment, and impaired quality of life as a result of substantial disadvantages and stigma.

— Rebecca M. Puhl and Chelsea A. Heuer writing in “The Stigma of Obesity: A Review and Update” published in Obesity.

Look, I get that nobody’s life is perfect.  There’s a reason the Romneys believed  their college years were a “struggle”.  There’s a problem with how our society regards bodies, especially women’s bodies, as open to public discussion.  But I have trouble believing that a thin, fit woman is going to be less likely to be hired than a fat woman with the same qualifications.  I have trouble believing that a fit, thin woman is going to be told to gain weight to when she goes to the doctor’s. And I certainly don’t buy this belief that women need to be told it’s okay to want to get into better shape when every women’s magazine assumes getting into better shape is every woman’s dream.

Reducing Heart Attacks

A Minnesota  county reduced heart attacks by 33%.   Was it due to a county weight loss campaign?  A “Let’s Move” push?  A trans-fat ban?

Nope.

The research, carried out by scientists at the Mayo Clinic in Rochester, Minn., found a 33 percent drop in heart attack rates in one Minnesota county after public smoking bans were enacted.   [The study] examined medical data in Olmsted County, which has a population of about 144,000, over two periods: the 18 months before the county banned smoking in restaurants in 2002, and the 18 months after it extended the ban to bars and all workplaces in 2007.  Dr. Hurt and his colleagues found that while rates of hypertension, diabetes, high cholesterol and obesity remained constant or increased after the bans, the incidence of heart attacks dropped sharply.

Source: The New York Times

Decrease indoor air pollution and suddenly there’s fewer heart attacks!!  It’s like pollution affects health or something!!

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”.

Day in the Life: the search term

One of the more popular search terms leading people to my blog lately has been “day in the life of an obese person,” leading to the series I did when I first started the blog. Being curious, I googled it. Some of the highest results? “News” stories about people in fat suits. Because seeing how a thin teen’s acquaintances react to their seeming to gain 80lbs overnight is so typical of the fat experience!  Not to mention wearing an unfamiliar, bulky suit is just like walking in your own body!  That’s why a 3rd grader on stilts moves and feels just like a 6′ tall adult! It’s much more “objective” than actually studying a broad sample of fat people – or even showing actual fat people (with heads) who choose to speak out.

I don’t think that every superfat person has the exact same experiences I do.  Far from it!  I also know there is a lot of myths about fat people out there.    I can’t speak for everyone, but I can speak for myself, and those myths do not apply.

If you’re curious, my day in the life posts are linked to https://living400lbs.wordpress.com/day-in-the-life/

O-Word For The “Win”

Ever notice how a news story will use “obesity” even when that’s not really the point?

Example: A study looking for correlations between cognitive decline and metabolic syndrome, explicitly calling out fat.  Headline? “Obesity ‘Bad for Brain’ by Hastening Cognitive Decline“.

At least one earlier study tied metabolic syndrome with cognitive decline, but didn’t explicitly called out “obesity”.  Marketing fail?

Thankful Thursday

Things that I am thankful for:

1 The man of the house packed a yummy lunch for me today.  He also cooked each night I was home this week.
2 AC. Most houses in Seattle don’t have AC.  I don’t regret installing ours, even if we barely used it last year.
3 A job where showing up in shorts one day and a dress the next is fine.
4 A boss who reminds me that I have strengths, and who encourages me to use them.
5 Initial “let’s start probate” paperwork has been fixed for accuracy and ready to mail.
6 I fell in love with temperature-controlled computer labs in college one summer term when the temps were stubbornly sweaty &  sticky.  Except the minicomputer lab, which had to be kept cool per warranty.  All of which is to say, taking computer classes to help cool off has served me well & I’m glad.
7 Leg lifts are my friend.
8 Stretching makes me feel divine.
9 Chocolate covered espresso beans are yum.
10 So much enjoying Mira Grant’s book Blackout and how it improves my understanding of the prior two books.  (Feed, then Deadline. They are a trilogy, not a book & two sequels.).

God Should Look At Magazines to Know What People Should Look Like

I wish God would look at more magazines so he would know what people are supposed to look like.

 

Yes, it’s funny.

It also shows the disconnect between what we expect people to look like.  We expect people to look like what we’re used to seeing — and if we mostly see other people in magazines or on TV or in movies, that’s what we expect people to look like.

And when the movie’s over, we are surprised that reality hasn’t conformed to our fantasies.

I love fiction.  We call the living room of our house “the library” for good reason.  I not only go to fan conventions, I help organize them.   I also am aware that the near-homogeneous size of the actors on TV is as much fantasy as the huge sizes of the New York apartments or the never-ending variations of the characters’ wardrobes.  You think superheros are wish fulfillment, try civil servants who never wear the same clothes twice!

But we suspend our disbelief.  And then we feel unhappy with our bodies, our homes, and our incomes.  I don’t watch as much TV as most of my friends.  I avoid fashion magazines.  I don’t think I’m any less entertained.   I know I’m happier with myself.

QOTD: Health

The debate about what exactly health means goes back to ancient Greece. Does health just mean living a long time? Does it mean feeling strong? Are athletes the epitomy of health? In fact, athletes suffer more injuries and illnesses than the rest of the population because they push themselves so hard. So who represents health? What about spiritual health? Ethical health? It’s amazing how much we project onto body type these days, through our grossly oversimplified idea of health.

Ben Spatz

Things to read

From Jezebel’s Work-Life Balance Isn’t Just for Moms:

The basic point of all of this is that whether you have kids, have a partner but no kids, or are living alone, working too much sucks. It’s no way to live, and we’re not dummies. So at some point, most of us realize that we’d rather do something that allows us to actually have a life, rather than commit every waking hour to a job, no matter how fulfilling we find it.

This is why I’ve been avoiding startups.

Jezebel also had a good post from Lindy West on an Adipositivity Project  photo being used as “a joke”.

Can you believe fat people? Just existing willy-nilly all over the place, sometimes without even the courtesy to cloak their terrible bodies in heavy smocks and caftans.

Why, they even expect their copyrights to be respected?!?  It’s as if they think they’re people!

Why Obesity is NOT an Eating Disorder:

An ED is a serious emotional problem/illness and obesity is a measure of height and weight. …  The comparison between obesity and eating disorders is [akin] to comparing an apple with a chair. You can’t sit in an apple and you can’t eat a chair!

This sort of armchair misdiagnosing does not help anybody, especially not those with actual eating disorders.

OBESITY NIGHTMARE….

…or rather, a site is starting to show fat people’s reaction to America’s (drumroll…fanfare…lights…)

Obesity Nightmare 

It started with a Tumblr post, and has continued with photos from Brian (at Red No 3) and Turn It Over.

Why?

Because we do not exist to be the government’s or the healthcare industry’s nightmare.

We are people.

We are living our lives.

You want to know what we think of the “obesity nightmare”? Here is our response.

Our lives? Are our lives.  

Not yours.

I realize this may be a challenge to you.

We are not nightmares,

unless your nightmare is

people who aren’t afraid of being fat.

Seriously: Think about this.  If me living my employed, home-owning, happily married life without your intervention is your nightmare … why?

On the other hand, if your nightmare is fat people demanding to be treated as people without losing weight, then yes, I am your nightmare.

Want to join in?  Submissions are welcome. :)

Big Fat Sleep

No, it’s not news that lack of sleep is tied to fat.

What sleep researcher Dr. Orfeu Buxton found is more information on how this occurs.

The resting metabolic rate of the volunteers by the end of the five weeks was 8% lower than where they had started. […]  That could explain why night shift workers tend to gain more weight and have a higher likelihood of obesity than day workers; such weight gain is linked to an increased risk of diabetes and heart disease.

Wow, it’s like the number of calories burned isn’t standard across all bodies at all times!  Or not just affected by exercise!

The scientists learned something else interesting about another mechanism that put the disrupted sleepers at higher risk of diabetes: the combination of having their circadian clocks reversed (sleeping during the day and waking at night) and the poorer sleep they got as a result had an effect on their insulin levels. After three weeks in the lab, the participants produced about a third less insulin from the pancreas in response to meals; with less insulin available to break down glucose, blood glucose levels started to rise and three of the 21 volunteers showed high enough levels to qualify them as pre-diabetic.

Two things struck me about this.  First is that it occurred after 3 weeks.  Second is that only 3 of the 21 volunteers reached the pre-diabetic range, even though they were all living in the same lab undergoing the same regimen.  Again, it’s like they’re individuals or something.

Not News

The website Fark makes fun of news stories that are not, actually, news.

Example:  Students Discover Desks Have More Germs Than Toilets

Why isn’t it news?  Well, it’s a common story that pops up once a year or two, and relies on people not thinking about which is more likely to get janitorial attention.

Today my Google Health section looked a bit like Fark.

First: Paula Deen has diabetes.  Because she’s fat and publishes “unhealthy” recipes, she’s being blamed for “bringing it on herself” with unhealthy food.  Fat people being blamed for their health problems, gee, where have I heard that before.

( Never mind that Ms Deen is 64 and the American Diabetes Association states that the risk of type 2 diabetes goes up with age —  26.9% of people over 65 have it.   Or that the American Diabetes Association states that “Most overweight people never develop type 2 diabetes” and that eating sugar doesn’t cause diabetes.)

Second:  obesity rates?  Were leveling off in 2010.  And 2007.  Lots of stories about it in the last 4 years.   Um….

 

 

Vitamin B12 in the news

I’ve written about my vitamin B12 absorption problem before.  The NY Times recently posted a good primer on B12 deficiencies, including those at risk:

Natural plant sources are meager at best in B12, and the vitamin is poorly absorbed from them. […C]hronic users of acid-suppressing drugs like Prilosec, Prevacid and Nexium, as well as ulcer medications like Pepcid and Tagamet, are at risk of developing a B12 deficiency and often require a daily B12 supplement.

Stomach acid levels decline with age. As many as 30 percent of older people may lack sufficient stomach acid to absorb adequate amounts of B12 from natural sources. […]

Synthetic B12, found in supplements and fortified foods, does not depend on stomach acid to be absorbed. But whether natural or synthetic, only some of the B12 consumed gets into the body. Treatment to correct a B12 deficiency typically involves much larger doses than the body actually requires.

Free B12 from both natural and synthetic sources must be combined with a substance in the stomach called intrinsic factor to be absorbed through the gut. This factor is lacking in people with an autoimmune disorder called pernicious anemia; the resulting vitamin deficiency is commonly treated with injections of B12.

Although most doctors are quick to recommend injections to correct a B12 deficiency, considerable evidence indicates that, in large enough doses, sublingual (under-the-tongue) tablets or skin patches of B12 may work as well as injections for people with absorption problems, even for those with pernicious anemia.

The latter is something I make use of — I appear not to absorb much B12 from food, but the little I absorb of  “a lot” is enough.  I also like that supplements are over-the-counter and I can take them daily.  Shots would be prescription and often weekly or monthly.  :)