Rebecca Puhl on Chris Christie & Weight Bias

Rebecca Puhl is the director of research at the Rudd Center for Food Policy & Obesity at Yale.  The Rudd Center is pro-weight loss, which can be disconcerting to run across on their website. Nonetheless, they do useful research on weight discrimination and health, not to mention writing articles for CNN on how weight discrimination affects the news coverage of NJ Gov Chris Christie.

How common is [weight discrimination]? It may seem less significant compared with discrimination on the basis of gender or race, but it is rapidly increasing and no less important. Research shows that weight discrimination in the United States has increased by 66% over the past decade. It is now the third-most common type of discrimination reported by women, and the fourth most common among men. Recent estimates even show that weight discrimination is comparable to prevalence rates of racial discrimination.

Weight discrimination is especially common in the jobs setting. Decades of research have shown that overweight and obese employees are much less likely to be hired than thinner employees (even with identical, or better qualifications), they receive lower wages, are less likely to be promoted and are more likely to be fired from their jobs, compared with thinner employees.

Criticism of Christie’s weight suggests this prejudice exists even if the job under consideration is at the highest levels of government — and it isn’t the first time. Surgeon General Dr. Regina Benjamin’s excess weight was publicly censured and critiqued in the media discussion over her appointment, often eclipsing consideration of her impressive credentials, awards and accomplishments. […]

Dr Puhl also attacks the “but what about his health” worries:

We cannot make assumptions about Christie’s health status, let alone the health status of other thinner political candidates. There are many overweight individuals who eat a balanced diet and exercise regularly; there are many thin individuals who smoke cigarettes, drink too much alcohol, eat poorly, have high blood pressure and are sedentary. Being thin is not an automatic indicator of health, and neither is being overweight. If Christie’s health status is to be scrutinized, then the health status of his political peers should be scrutinized as well.

To be clear: There is no reason to assume that a person can’t be an effective political leader simply because of his or her body weight. Discounting an individual’s credentials, training, abilities or accomplishments because of body weight is discriminatory. And it communicates an unfair, harmful message that a person’s talents and contributions to society have lesser value if that person is obese.

As a bonus, I was pleased to see that Dr Puhl did NOT say anything about whether Gov Christie should attempt weight loss  — quite refreshing in an article of this type.  Whether an individual, including Gov Christie, chooses to attempt something as risky as weight loss is nobody else’s business.  

(Even if Gov Christie attempted weight loss, he would not necessarily have immediate or noticeable results, so guess what?  Other people might not notice … and again, it’s not any of their business. )

Not Doing Everything

Unvirtuous Abbey (“Digital monks praying for people with first world problems”) tweeted this week:

For those who have to carry the burden of what they see but are limited in what they can do, we pray.

That … says a lot, actually.

For many of us worldwide media means that we see much more than we can act upon.  So many causes.  So much suffering.  So much.  Toss in a 40+ hour-a-week-plus-commute job, a house, a parent needing care, and … it’s a bit more than I find easy to cope with.

Lately I’ve almost felt like I was drowning.

I’ve pulled back a bit, been online a bit less. This weekend I focused a family member’s birthday and some around-the-house tasks.   Tomorrow I go back to work.  I’m planning focus on getting to bed earlier this week and planning lunches instead of relying on beef jerky and dried fruit.  Wish me luck…

Thankful Thursday

[an occasional exercise in gratitude]

  1. My father has been in his new Adult Family Home for over a week and is doing well.
  2. The political-bloggers-with-zombies novel Feed that I’ve been compulsively re-reading for the last year did not win the “Best Novel” Hugo but it came in second.  Feed and its sequel Deadline are by Mira Grant aka Seanan McGuire.
  3. While I did not get to Worldcon this year, I do get to enjoy this ustream of the comedic “Just A Minute” competition, including discussion of various Apollos, the seven dwarves, parallel universes, what’s wrong with steampunk, and Seanan McGuire requesting a big boo for Bill  Willingham.
  4. I am getting better at enjoying things without feeling that I have to own them.  For example, a password book, a typewriter bookend, or a Crayola rollerball pen, or the entire ThinkGeek “Geek Toys” catalog (including an Adipose stuffie!)
  5. Cooking at home and relaxing with the man of the house.

How’s the week going for you?

“Light bladder leakage” and Hourglass Pads

Apparently Poise is thinking “light bladder leakage” sounds nicer than “incontinence”, and that framing its products as “feminine” will do better than as “geriatric”.   They are probably correct.

I do know I ran into one problem discussed in the industry. The New York Times quotes market researcher Rob Walker:

“[T]he biggest challenge for the industry is that vast numbers of sufferers are too embarrassed to raise the problem of incontinence with their health practitioner, or worse, even buy available products at a retail outlet.”

Or, in my case, to realize they existed. I initially assumed that if you leaked at all, you needed full-on diapers, which of course would not be available in my size.  It did not occur to me to even look for pads designed for stress incontinence.   I ran across Poise pads by accident one day when the local Rite Aid was reorganizing stock.

To address that, Mr. Walker added, “the commercial opportunity here is for the big international hygiene players to humanize (or even Viagra-ize) incontinence, making products as accessible, consumer-friendly and embarrassment-free as, for example, women’s sanitary protection.”

I first wrote about stress incontinence a few years ago in quite a bit of detail.   I haven’t been finding the “wings”, so I’ve been wearing “moderate” pads.  I will probably try the new “hourglass” shape.  FYI, Poise also has samples and coupons available at their site.

Very Fat Characters and Writing Difference

As Roxane Gay notes in her discussion of The Help,

Writing across race (or gender, sexuality, and disability) is complicated. Sometimes, it is downright messy. There is ample evidence that it is quite difficult to get difference right, to avoid cultural appropriation, reinscribing stereotypes, revising or minimizing history, or demeaning and trivializing difference or otherness. As writers we are always asking ourselves, “How do I get it right?”

Very fat characters can be hard to write authentically as well.  To this day I haven’t seen What’s Eating Gilbert Grape, because I just don’t want to have to process it.

So I was pleased that I could enjoy Kristine Kathryn Rusch’s short story The Case Of The Vanishing Boy (free at the moment on her site).  The main character weighs about 400lbs, but that is not all we are told about this character.  It affects some interactions — especially anything that could be seen as romantic — but not others.

I’ve seen Kris Rusch in person a few times at cons over the years and I wouldn’t pick “fat” as a descriptor.  She also wrote across gender in this story.

What fat characters have you enjoyed lately?

Medical Insurance Helps People Feel Better!?

On the one hand, it’s good to have actual research backing this up.  On the other hand, it’s insane that this didn’t exist before.  From the NY Times:

When poor people are given medical insurance, they not only find regular doctors and see doctors more often but they also feel better, are less depressed and are better able to maintain financial stability, according to a new, large-scale study that provides the first rigorously controlled assessment of the impact of Medicaid.

In other news, water is wet?  Not quite.

The study became possible because of an unusual situation in Oregon. In 2008, the state wanted to expand its Medicaid program to include more uninsured people but could afford to add only 10,000 to its rolls. Yet nearly 90,000 applied. Oregon decided to select the 10,000 by lottery.

Economists were electrified. Here was their chance to compare those who got insurance with those who were randomly assigned to go without it. No one had ever done anything like that before, in part because it would be considered unethical to devise a study that would explicitly deny some people coverage while giving it to others.

But this situation was perfect for assessing the impact of Medicaid, said Katherine Baicker, professor of health economics at the Harvard School of Public Health. Dr. Baicker and Amy Finkelstein, professor of economics at M.I.T., are the principal investigators for the study.

In good news, Oregon did end up finding the money to insure the other 80,000 people within 2 years.

Twitter Party

There’s a bunch of fat folks tweeting about “things fat people are told” – in twitterspeak, #thingsfatpeoplearetold. (The # before makes it searchable.)   Some examples:

You have muscle?

But have you really, really TRIED to lose weight?

You’re too fat to do yoga properly, so don’t think you’re REALLY doing yoga.

Your allergies (that you’ve had all your life) would go away if you lost weight.

To read more, check out the #thingsfatpeoplearetold search results page.

QOTD: Fitness and fatness

From Reuters, on a study in patients with coronary artery disease that looked at fitness levels and BMI:

[Heart specialist and study leader Dr. Francisco] Lopes-Jimenez said, the lesson for patients is clear: try to improve your physical fitness. “It is much easier to become fit than it is to become slim,” he said. “Anybody who has gone into an exercise program would agree with that.”

While Lopes-Jimenez seems to presume his patients want to exercise (or otherwise take action to improve their health) it is radical to see a heart specialist stating that a person can improve their fitness without being slim.  Or that exercise doesn’t automagically cause slimness.  Or that it can be easier to become fitter than to become thinner — which has certainly been true in my case.

Ah, The Fat-Phobic Media

The headline: “Are the Religious Prone to Obesity?”

The facts: A study finding that those who attend religious services most frequently tend to gain more weight in middle age.  Those who attend religious services most frequently also tend to be healthier.

What I consider fat-phobic: The “healthier” is seen as despite the weighing more in middle age, even though other research found that weight in itself isn’t always indicative of problems.   It’s suggested that religious groups can use this research as a reason to encourage their members to “slim down” and “prevent obesity.” There’s speculation that those who attend services more frequently may be more sedentary or eat more.

What do I consider interesting: That this population is both slightly healthier and slightly (32% of those who attend religious services frequently vs 22% of those who didn’t) fatter at middle age.  The frequent-attendee group also happens to smoke less — and smokers both have more health problems and weigh less.

What do you think?  Did I miss something?  Am I overreacting?

Music Monday: Tanglewood Tree

…featuring New York Times Bestselling author Seanan McGuire (blonde) with Vixy (redhead) & Tony (guitar), Betsy Tinney (cello) and Amy McNally (violin).  Recorded at a bookstore event for Seanan’s first novel Rosemary and Rue.

(Music starts about 30 seconds in.  A studio recording of  Tanglewood Tree with many of the same performers is also on Seanan’s latest CD.  Song lyrics and chords are here. Late Eclipses is Seanan’s first book to hit the New York Times list.)

Heart Risk – BMI Not Useful

Or as Reuters put it: “[T]he best predictors of future heart risk are measures of blood pressure, cholesterol and history of diabetes.”

According to a paper in The Lancet:

BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not importantly improve cardiovascular disease risk prediction in people in developed countries when additional information is available for systolic blood pressure, history of diabetes, and lipids.

Researchers looked at height, weight, hip, waist, blood pressure, cholesterol and other data from more than 220,000 adults — who had no previous history of heart disease – and tracked them over time to see who had heart attacks.   Once they controlled for age, sex, smoking, baseline systolic blood pressure, history of diabetes, and total and HDL cholesterol, they found that BMI or waist-to-hip ratio didn’t add much information.

The headlines and articles focus on how this refutes the notion that “pear-shaped” fat people are at less risk of heart disease than “apple-shaped”.    I wonder if this implies that thin people who have high cholesterol, high blood pressure or diabetes (all of which can be affected by family history) might have their risk factors ignored because they’re thin.

Plus-Sized Athletes (with heads)

There’s a story making the rounds on “plus-sized athletes” reacting to the US “Let’s Move” campaign.

The fitness community has embraced the first lady’s ‘Let’s Move’ program, but many health experts balk at equating improving health with lowering weight.

Fat aerobics instructor Sandy Shaffer and physical trainer GeMar Neloms are interviewed.  Dr Kenneth Cooper, a longtime supporter of measuring fitness independent of body weight, comments.  All suggest that body size is a poor measure of health. One bit of wording I found curious was “a robust body need not mean poor health”. Robust is an adjective meaning:

  1. (of a person, animal, or plant) Strong and healthy; vigorous.
  2. (of an object) Sturdy in construction.

What does it say that “strong and healthy; vigorous” or even “sturdy” is assumed to mean poor health?

The Age in Australia went a step further and paired the story with a photo of plus-size women (with heads) doing aerobics.

Fat women doing aerobics

Image from The Age

What’s the fattest country in the world?

Well, one question is, who cares?   Okay, we know the media cares, and legislators, and Michelle Obama’s “Let’s Move” campaign.

Dr Samantha Thomas recently posted about some myths popular in the Australian press, including that Australia is the “fattest country”.  (Hint: it isn’t.)   She also linked to some statistics, ranking countries by the percent of the female adult population that is officially obese (BMI > 30).   Oddly enough, to those who read the American media, the US isn’t at the top of the list either.  It’s not even in the top ten.

  1. Papua New Guinea  79.5%
  2. Tonga 70.3%
  3. Samoa 63.0%
  4. Nauru 60.5%
  5. Nicaragua 48.0 %
  6. Cook Islands  n/a (men’s is 40.6%, used to rank it here)
  7. Egypt 46.6%
  8. Niue 46.0%
  9. Qatar 45.3%
  10. French Polynesia 44.3%

Re-sorting the list by the percentage of men who are officially obese does put the US in the top ten, but not by much:

  1. Papua New Guinea 74.8%
  2. Nauru 55.7%
  3. Tonga 46.6%
  4. Cook Islands 40.6%
  5. French Polynesia 36.3%
  6. Lebanon 36.3%
  7. Qatar 34.6%
  8. Samoa 32.9%
  9. USA 32.2%
  10. Panama 27.9%

…and if I use the original list’s methodology of sorting on the opposite sex if only one sex’s data is available, Nicaragua is 3rd,  Eygpt is 5th, and US bumps to 11th.

The US has a greater overall population than these other countries, which affects absolute numbers – but not prevalence.

It’s also interesting how many countries have large discrepancies between men and women’s prevalences.   South Africa, for example, has a prevalence of 8.8% for men and 27.4% for women.   US is a bit of an oddball in that the men’s and women’s prevalences are very close to each other.   There are a few where the men’s prevalence is above the women’s, and those are mostly differences below 5%, with Malta and Greece being the outliers.

I certainly don’t consider this world-shaking, but it is interesting to have data instead of myths.

Sex or Thinness?

Obviously it takes a certain kind of mind to ask 2,400 women if they would sacrifice a full year of sex to be skinny.  In this case, the mind works at  Fitness magazine.

51% of the 2,400 women said “Yes”.

Now, I’m sure that some of those women interpreted “sex” to mean “sex with a partner”, are single, and figure they aren’t getting any anyway, so why not?  However, I submit that if you’re having orgasms then some kind of sex is happening … and I don’t see a reason why orgasms require the presence of another person. (Yes, the right partner absolutely adds a lot to the experience. The wrong one —and I’ve had a few — reminds me of why I was thrilled to discover Babeland (NSFW).)

Even so, I’m sure there were some women for whom this question caused some soul-searching.   Sexual pleasure, with its attendant health and emotional benefits?  Or societal approval, making life easier in hundreds of ways (even if it doesn’t measure up to your dreams)?

But I’m wondering, really, what this question being asked and it getting 51% says about our society.

Of course, other thoughts are welcome in the comments.

Ban Fat Marriage?

Yes, I know that Dan Savage’s screed on banning fat marriage is trying to illustrate the point that gay marriage bans are ludicrous.   Fellow Stranger writer Lindy West has already responded with a solid “why fat hate doesn’t work” aimed at those who don’t want to get it, and I don’t disagree with it.

However.

I do think Dan seriously missed the boat bringing up the silly “fat is contagious” thing.  It totally weakens his argument!  No, the better argument is this:

  1. Fat is frequently inherited, even among children who are raised by thin adoptive parents or twins raised separately.
  2. As anti-gay legislatures are constantly reminding us, only married heterosexual people have children.
  3. Therefore, to prevent fat people from passing on their fatness to children, we should not allow fat people to marry.

See?  Much more logical!

See also:  Parents-to-be shouldn’t diet.

PS: Brian at Red No 3 has a good post on this as well.

Culture Affects Science Reporting

The bare facts in this piece on breakfast size are simple:

German researchers studied the food intake of 280 obese adults and 100 of normal weight. The subjects kept records of everything they ate over two weeks, and were carefully instructed about the importance of writing down what they ate as soon as they ate it.

For both groups, a large breakfast simply added to the number of daily calories they consumed. Whether they ate a large breakfast, a small one or none at all, their nonbreakfast calorie intake remained the same.

What struck me as interesting was that the same results were seen in both groups.  Both the fat and thin groups contained people that ate breakfasts of varying sizes, or not at all.  Both found their nonbreakfast calorie intake remained the same.   (It’s almost like fats are people!)  But the idea that breakfast is “added calories” is seen as the primary news, because it contradicts the “eat like a king at breakfast and a pauper at dinner” advice.

Personally?  Maybe it’s strange, but I try to match my breakfast to how hungry I am.  I also decide whether my breakfast was good or not based on things like mood and energy levels.  I know, it’s crazy.