I am often asked if it’s ever ok for people to want to diet, or get plastic surgery, or change their bodies.

The short answer is that it’s none of my business. I respect the decisions that other people make about their bodies just like I want mine to be respected.

But I understand that the question is deeper than that.

Weight loss is a good example – no matter how much we love our bodies, we are still stigmatized for our size and would get much more approval from society if we were thin.  I wonder sometimes:  If this stigma/approval situation didn’t exist, would people still try and fail at dieting many times?

At any rate, I can understand the desire to want to lose weight for aesthetic reasons – I just think it’s important for people to have access to information not paid for my the diet industry.  Information regarding their odds so that if their attempts fail it softens the self-esteem blow.  And information about the health issues linked to weight cycling. I don’t think that they are required to do the research or justify their choices, I just think that they should have access to the information.

Plastic surgery is the same way: The more we conform to society’s standard of beauty, the more approval that we get from society. But people should be able to easily ascertain both safety data and efficacy for previous clients who wanted to make a change for a similar reason.

Another example would be people who believe that being thin is the key to health, and feel that they need to lose weight for health reasons. They should have access to true and correct data about health and weight.

No matter what change you’re considering making, my suggestion would be to consider why you want to make the change, and then make sure that’s really ok with you.  So let’s say that you decide that you want to have botox so your co-worker stops talking about your wrinkles.  Is that ok with you? What if once you’ve filled your wrinkles she starts in on your nose?  You’ll have to decide how far you want to go.  It’s always your choice. I do think that no matter what you choose it will work better if you start from a platform of loving yourself as you are.

Social change is more important to me that societal approval.  I think that the cure for stigmatization is to change culture and end stigma, not to insist that members of the stigmatized group change themselves so that they can get the approval of the stigmatizing group.  If they offered me a pill that would make me into the perfect stereotypical beauty I wouldn’t take it.  I’m happy with my body and my health and I see no reason to change.  That doesn’t make me worse or better than those who make different choices. Our bodies – our choices.  I don’t see how we can ask for our choices to be respected unless with we respect the choices of others.

So maybe our new motto could be:  I love me, I’m perfect, now choose…

Study finds Fat Acceptance Blogs Can Improve Health Outcomes, or so says the headline.  The study looked at a sample of 44 fatosphere bloggers and sought to determine how their involvement in the FA movement had affected them. (Just to clarify – I was not one of the bloggers studied. But the very awesome Fat Heffalump was and her beautiful picture is on the article – double awesome!)

This study has its limitations –  44 people do not a statistically significant sample size make, there doesn’t appear to have been a control group etc.  Still, I’m quite happy that people are studying this, as one of the researchers pointed out that “We saw there was a lot of opinion about the movement but very few people had actually studied it.”

I think that’s a significant thing to realize, that the backlash against the FA movement is not based in research or science. So what is it based on?

Why is there so much push back against a movement that simply says we won’t hate ourselves?  Is it that people have been inundated by the message of the diet industry that they have to be thin to be healthy; so they are starving themselves, restricting food and working their asses off trying to be thin and most of them are failing and blaming themselves and trying again repeatedly. Thus when a community that says “we won’t buy into this cycle”, there is a backlash?

Maybe it’s because people have allowed themselves to be fooled by marketing that says that fat is the same is lazy, unhealthy, unattractive, unloveable etc. and so they think that fat people should believe that drivel about ourselves?

I don’t know what the answer is, but I’m not surprised that the study found that people who took part in a movement that supports them overcoming stigma and liking themselves had better health.  Among all of the ridiculous diet headlines I’ve never seen a single headline that reads “Self-loathing Proven to be Key to Health” or “Five Quick ways to Hate Yourself Healthy” or “Study Shows That Constant Stigmatization Leads to Better Health Outcomes”.  Not to put too fine a point on it, but I’m believe the word that we’re looking for here is DUH.  I’m incredibly glad that people are studying this because somehow we’ve lost whatever bit of common sense would tell us that people have better health outcomes when they don’t hate themselves.  My guess would also be that people take better care of things that they like, so liking our bodies probably gives us a better chance of taking care of them at any size.

So, Dr. Danceswithfat says “take two blog posts and call me in the morning”!

I’m completely frustrated with the idea that anyone who doesn’t try to make fat people hate themselves and their bodies is somehow “encouraging obesity” or “promoting obesity”

Showing a fat person being successful at anything other than weight loss.

This is among the most ridiculous things that I’ve ever heard.  As if someone will see me dancing and think “I wish I could dance like that.  I guess I’ll gain up to 300 pounds and then go from there.”  It’s insulting to my years of hard work and training, and it’s insulting to your intelligence. Like’s it the new V8 commercial:  millions of thin people, who see the same 386,170 negative messages a year about fat people, will see one of us being successful in some way, smack their foreheads and say “I coulda been fat!” The end result of this is that fat people are robbed of representation and role models.

Suggesting anything other than weight loss as a valid life choice

Take my word on this. If, for example, you suggest that people who want to be healthy have the best chance of doing so (although obviously not a guaranteed chance) by eating nourishing food and moving their bodies- you better brace yourselves for a whole lot of ugly coming at you from a never ending parade of stupid (bonus points if you get the movie reference)   People will freak out on you. When you calmly ask them “So are you suggesting that I tell people to eat non-nourishing foods and not move their bodies?” in my experience they will suggest that you are too stupid to understand or just call you a “fat bitch”. Okie dokie then.

Asking that mental health be considered as part of overall health

Whenever someone suggests that shame and health do not go hand in hand, that people are unlikely to hate themselves healthy, or that living under constant stigma is not part of a healthy life, they seem to get accused of encouraging obesity.  I must have missed the study data that shows that self-loathing is causally (or even correlationally) related to good health.  I must also have missed the logical argument that suggests that telling people not to hate themselves is tantamount to telling them that they should attempt to be obese.

Making anything that accommodates fat people

If a business does anything to accommodate people of size – larger chairs, seat belt extenders, a policy of non-shaming, etc. people will say that it’s promoting obesity.  Because apparently creating a world where fat people can’t leave our houses is the beeline to a healthy nation.

Making attractive plus-sized clothes

A subcategory of the above – apparently making attractive clothes in larger sizes will cause thin women to say “Hey, that dress isn’t completely hideous and it only costs 3 times as much as what I usually buy. I’m going to try to be a size 26 so I give up shopping at almost any store I want with access to a multitude of styles and price ranges to choose from so that I can wear that one not-totally-ugly dress”. As if, since the size of my body doesn’t garner enough unfounded hatred and vitriol, I must wear ugly mumus like a Scarlet F to show my ultimate sin of having a body that others don’t approve of.  I simply can’t believe that wearing pants that actually fit me is going to make people think that it’s all fuzzy bunnies and unicorns on this side of the BMI chart and start guzzling whey protein weight gainer.

I believe that bodies come in lots of different sizes for lots of different reasons.  So I don’t think that making beautiful plus-sized clothing is encouraging obesity any more than selling petite clothes encourages shortness.   The only thing that discouraging obesity does is make people feel like they are less because there is more of them (thanks to reader Mari’s comment for that line).  The cure for social stigma is not weight loss, it’s ending social stigma. So stop hand-wringing and banshee wailing about encouraging obesity as if you know better than everyone else what their body should look like, and let fat people live in peace and clothes that fit us.

Like the blog?  Here’s more of my stuff:

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I was picked up on a “fat hate’ board again and somebody said, for the millionth time, that Health at Every Size (r) is just “taking the easy way out…”  Dude, are you serious?

Does anybody remember the movie The Truman Show?  Where a guy finds out that his entire life has been a TV show and that everyone except him knew it? In the show he leads a fairly ordinary life but what if the script was different?  What if, from the time he was born, the world was set up to tell him that he was unhealthy and unattractive? What if his whole life people, magazines, television shows and commercials told him that he was unhealthy and ugly.  What if doctors ignored his actual issues and said that just by looking at him they knew that he was unhealthy? What if the media reported stories that everyone who looked like him was sick and ruining the world?  If he was conditioned like this from early childhood, what kind of man do you think he would grow up to be?

That’s the show of my life.  And sometimes is just sucks, sometimes I get tired of it.  I never try to tell anyone else how to live but I find that I am rarely extended the same courtesy.  I’m more than confident in my decision that my best (but certainly not guaranteed) chance for health is healthy behaviors and not a smaller body. I’m also prepared and comfortable with the consequences if I’m wrong.  But my very own Truman Show (sponsored by the weight loss industry as it turns out) is set up to tell me every day in every way that the only path to a happy, healthy life is to change the size and shape of my body, no matter how unhealthy I have to be to get it done.   And the diet industry has done a great job of making other people into little marketing machines – running around telling the fatties that they know what’s best for us.

It’s difficult to buck that mainstream.  It can be terrifying to be the person who points to the evidence and says “you can excommunicate me if you want but the Earth moves around the sun and that’s a fact”.  It’s not easy to wake up in your own version of the Truman show and tell everyone that they can do whatever they want but you’re going off script.

So today I just wanted to take a minute to celebrate those of us who choose a Health at Every Size (r) model in a thin=healthy world.  Of course it’s not the only valid choice and it’s not better or worse than anyone else’s choice.  But you can’t really deny that it requires some serious guts. And today as I reflect on my amazing friends on this blog and in the HAES community I just wanted to give a hip-hip-hooray-kick-ass-and-yay for standing up for our truth in the face of a bunch of people who can’t seem to stop reading to us from an old script.

The August newsletter is out (hey, at least I got it out before September right?).  I’ve got someone’s awesome blog to recommend, more thoughts on the idea of one beautiful thing (thanks again to reader Emlys!), one of my favorite YouTube videos ever, and some other stuff.

Check it out here!

Tomorrow I’ll be back with your regularly scheduled blog!

One of my Facebook friends posted about her intentional weight loss.  Someone commented saying “You’re looking so great! Congratulations, keep working at it. And did I mention that you’re looking great!?”

I immediately fast forwarded to five years from now when there is a 95% chance that she will have re-gained the weight.  Then what is she to take from all of these compliments for her now former body size and shape?  How will she feel? Also, “keep working at it” seems to say “what you’ve done is not good enough”.  Yikes.

I have had friends and blog readers who’ve lost weight because they were sick, or stressed, who’ve said that this kind of compliment makes them cringe.   They couldn’t help but wonder how the person thought that they  looked like before.  And it made it awkward when they regained the weight.

I recently saw someone I know who had lost a huge amount of weight in a very short time.  She looked gaunt and her color was off.  I thought that perhaps she had been sick but I didn’t want to assume anything so I just asked how she was doing.  It turns out she lost the weight on purpose and is super happy with the results.  That’s absolutely her right, my goal is to compliment her in a way that will be supportive whether or not she keeps the weight off.  So when she said “I’ve been losing weight, don’t I look great!”  I went with “You’ve always been beautiful, I’m glad that you are happy.”

So compliments can be a minefield.  But they’re also awesome.  So what’s a girl to do?

Come up with a compliment guide, that’s what:

No Body Comparisons

Bodies are beautiful all the time.  Some people’s body size changes because they want it to, some people’s size changes because of extraneous, even undesired, circumstances.  Either way, it’s impossible to tell people that they look better without telling them that they looked worse, and that’s no good.  So, don’t do it. Try this:

• You’ve always been beautiful and I’m glad that you are happy.
• You are beautiful at every size

No backhanded compliments

This should be a “no duh” kind of thing but you’d be surprised. A compliment should never include:

• “For a” as in “You’re really athletic for a fat girl”
• “I guess”  as in “That dress is great I guess”
• “such, but” as in “You have such a pretty face, but you need to do something about your weight.”
• “brave” as in “You’re so brave to wear a sleeveless shirt”.

Drop the “for a” and “I guess”. Drop “such”, “but” and everything after, consider adding an adjective.

• That dress is great.
• You have a very pretty face.

Any mention of “brave” that is not followed by “for fighting off those wild animals” is a bad call.  Try “You look great in that shirt.”

Ah, that’s better.

No putting yourself down as part of a compliment

• You look great, I wish I had legs like that
• wow, great job, I could never press that much weight
• I love your hair, I could never pull that look off

It ruins the compliment the person feels like they have to make you feel better at the end of it.  Just drop the part about you:

• You look great.
• Wow, great job.
• I love your hair.

Easy squeezy.

So go forth and compliment fearlessly!

I’ve been watching The Glee Project.  (Go ahead and judge me if you want, that show is great).  In one of the episodes they use two of my favorite songs of all times and I couldn’t resist the opportunity to geek out with music lyrics as framework for my HAES (sm) journey.

How can you not love this song?  I think that the lyric that most speaks to me is:

I want to live, not merely survive
And I won’t give up this dream
Of life that keeps me alive
I gotta be me, I gotta be me

It’s how I think about Health at Every Size(r).  I believe that it’s my best chance for health, but beyond that, a life lived through HAES is life lived – being truly alive.  A life of dieting and trying to manipulate my body into a different size and shape is just surviving.  So even if I’m wrong, and to be clear I don’t think I am, I’d rather be truly alive for fewer years than have a longer life just surviving.

And then there’s Defying Gravity

This is probably my favorite song of all time. I love all of the lyrics but some of my tippy top favorites are:

Something has changed within me
Something is not the same
I’m through with playing by the rules
Of someone else’s game

This is exactly how I felt when I walked away from the diet industry.  The world was the same – still barraging me with messages that I had to be smaller to be healthy, or attractive, or worthy of respect.  But I was different, I had changed and I didn’t believe it anymore. To use another Wizard of Oz reference, it was like I had found out that the wizard wasn’t all knowing, it was just a sad guy behind a curtain.

I’m through accepting limits
’cause someone says they’re so
Some things I cannot change
But till I try, I’ll never know!

If I had a nickel for each time I did something that somebody said I had to lose weight to do, I could quit my job and blog full-time.  And about as many people told me that it’s impossible to change the thin-obsession of our society, to create a world where every body is respected. But I won’t know until I try.  I don’t do the right thing because it’s sure to succeed, I do it because I’m sure it’s the right thing.

Too long I’ve been afraid of
Losing love I guess I’ve lost
Well, if that’s love
It comes at much too high a cost!

For a long time I tried to make my picture fit other people’s frames. Once upon a time I tried to lose weight because I allowed myself to be sold the idea that nobody would ever love me or think I was beautiful until I was thin.  I’ve since found out that it’s not true, but even if it was, if that’s what it takes to be loved then it’s absolutely not worth it.

I think I’ll try
Defying gravity
And you won’t bring me down

Some days I just feel it all weighing down on me – the diet culture, the thin obsession, constantly being assaulted by people yelling that I can’t be healthy.  But when I was obeying those laws, I was miserable.  So I remind myself that I chose to defy gravity, and that I won’t let it pull me back down.

If you’ve not heard, a new book targeted at 4-12 year olds will be hitting the shelves in October.  It’s called “Maggie Goes on a Diet” and according to the blurb on Amazon.com, it’s about “a 14 year old girl who goes on a diet and is transformed from being extremely overweight and insecure to a normal sized girl who becomes the school soccer star. Through time, exercise and hard work, Maggie becomes more and more confident and develops a positive self image.”

Teaching six year olds that dieting is the way to like yourself and become popular? At first I felt sure that it had to be some kind of (really bad) joke. I did not think it possible that anybody would actually write a diet book targeted at first graders. Nobody could possibly be that stupid/cruel/desperate for a quick buck, right?

Wrong.  Paul Michael Kramer is. Sir, may I just say that this is sheer jackassery.

And Maggie might go on a diet, but Ragen is going on a rant:

He made sure that the book is “written in rhyme [so it’s] easy to read and fun to learn at the same time”.  And thank god for that, because I would sure hate for kids to have to struggle to learn to hate their bodies.  That’s definitely the kind of message that we want to be easy to understand and implement.  I think he’s going to have trouble with the sequel though, because not that many things rhyme with “treatment for anorexia”.

Like Michelle Obama before him, I’m reasonably certain that he’ll pat himself on the back for giving kids “real talk” in the face of a so-called “obesity epidemic”; never, ever taking responsibility for the issues of mental health, body image and self-esteem that arise, especially for the 95% of kids who are statistically likely to fail at dieting, and the disordered eating that results.

In no particular order, here are some things that make me wonder how the author can live with himself:

(For the record, it makes no difference if he doesn’t know these things since he’s the one who thought it was a scathingly brilliant idea to write a diet book for kids who have been potty trained for less than 5 years, based on his credentials of having written such scientific tomes as “Booger Bob” and “Louie the Lobster Mobster”.)

First let’s take a look at the positive, empowering messages that we get just from reading the blurb (if you have trouble catching sarcasm, this next bit is not for you):

a 14 year old girl

She’s a teenager, as a 6-12 year old all you want to do is be like the older kids, right?.  So put away those carrot sticks (too many carbs!) and bust out the Slimfast, you’re a big girl now!

who goes on a diet and is transformed from being extremely overweight and insecure

Do you look like the picture on the book cover?  Then you’re extremely overweight!  (It’s important to say extremely so that we can hide behind the OMGDEATHFATWON’TSOMEBODYTHINKOFTHECHILDREN panic when there’s a public outcry.) If you’re a fat six year old, ask an adult what “insecure” means.  If you aren’t that already, you should be.

to a normal sized girl who becomes the school soccer star.

It’s important to understand that if your body doesn’t fit a very narrow proportion of height and weight then there is something wrong with you. (Please ignore the fact that almost everything in nature, including human feet for example,  comes in a variety of shapes and sizes. Our bodies must all be the same.) Also, we will encourage you to exercise to fit into that narrow range while simultaneously reinforcing the stereotype that you are not athletic.  That may be confusing or upsetting to you, but remember the solution is not for other people to say things that make sense. The solution, as always, is for you to lose weight.

Through time, exercise and hard work, Maggie becomes more and more confident and develops a positive self image.

Please be crystal clear that no amount of healthy living, exercise or hard work will ever be good enough unless you get thin.  You don’t deserve to like yourself or be proud of anything you achieve until you have reached a height weight proportion that makes you aesthetically pleasing to children’s book author Paul Michael Kramer.

Want some more reasons why this is absolutely ludicrous?

Dieting is the number 2 predictor of disordered eating. According to Lynn Grefe, the president and CEO of the National Eating Disorder Association:  “There are a lot of factors at play with an eating disorder, but they start with diet. There’s a lot more pressure on young girls now. And I think we have to be careful as a society in what we are doing here. We should be focusing on health, not size.” Thanks Lynn. Let me just chime in here, as I would have when I was 6, with a big “No Duh”.

If we were to stop panicking and think logically, (even if we set aside the fact that the most likely outcome of dieting is weight GAIN), we would come to the conclusion that we must start being FOR healthy kids, not against fat ones.  Once we start doing that, we will stop overlooking unhealthy kids with thin bodies, and we will give fat kids a chance at the kind of health (physical and mental) that can only be achieved when they are not constantly stigmatized, helpless combatants in a war being waged against them by some of the most powerful people in the world.  There is nothing that could possibly be accomplished by being against fat kids that can’t be accomplished by being for healthy ones. We need to get that message and we need to get it before we irreparably damage an entire generation of kids.

Mr. Kramer wrote another book called “Bullies Beware” in which a kid stands up to his bully. If you feel like giving that a try, you might consider:

E-mailing him to tell him what you think

Joining the discussion at Barnes and Noble

Joining the discussion at Amazon.com

Letting other people know that this is happening so that they can get involved.

I heard a discussion on a radio show [warning! – not size positive, could be very triggering] about a Delta airlines flight during which a thin woman had her seat encroached upon by a large passenger.  Delta refused to throw the large passenger off and eventually someone else volunteered to take a later flight and give the woman his seat.  The ensuing debate on the radio show was about whether the large passenger should have been asked to de-plane (according to this report he never was), and what is fair in the circumstances.

I understand the airlines’ position that they are selling space and so they feel that if you take up more space than you purchased you should pay more than others.  At the very least, if the airline wants to charge more for people who take up more than one seat, then that policy must be applied across the board – so if people’s shoulders are too broad or their legs are too long, then they’ll need to buy another seat as well. I do not, however, think that this is the only solution that we can come up with.

I’ll also say that I don’t know how much of a problem this really is – it might be one of those things that is used to stigmatize fat people even though it rarely comes up in real life.  (Which is not to say that it doesn’t cause a ton of stress for fat people worrying about it – just that it may be that people rarely complain.) I was flying recently and got into a conversation with the flight attendant about seat belt extenders.  She told me that they only carry 3 on the plane and that she’s never run out on a flight so it doesn’t seem like there are that many people flying who are of a size to encroach on the seat next to them (which is not to say that more fat people wouldn’t fly if it was so stressful.) I’m thinking that passengers with bad body odor, or too much perfume, or cheap cologne, or screaming kids, or who just won’t stop talking to us even though we’re reading a book and listening to our iPods while humming and pretending to sleep, probably cause far more discomfort than fat people on planes. I don’t love touching strangers either, but the public transportation system in New York City seems to be built around this concept so it’s not like it’s unheard of to be in close proximity to your seat mate in a public transportation situation.

Regardless, I think the main issue is that the whole thing is subjective.  You don’t know the situation until you get on the plane. You may be able to fly easily on the first leg of your trip, only to be told by a flight attendant that you are too fat for the second leg. Plane seats are different sizes, seat belts are different lengths.  It’s difficult to decide who actually “fits in a seat”.  A weight limit doesn’t work – I’m ginormous but my fat happens to go forward rather than sideways so I fit in a seat without encroaching on the seat next to me.  Hip and thigh measurements don’t really work for the same reason.  If they had a discreet seat that you could sit in at the airport like the thing that they use to test carry-on luggage that might work (and should also be used on the broad shouldered and long-legged) but you still wouldn’t know until you got to the airport.

So in the event that this is an actual problem and not another overblown piece of the Obesity Epi-panic, allow me to suggest some solutions:

“Sit Next to a Fatty” Option

If you are cool with sitting next to a passenger of size, you check a box when making your reservation.  Maybe they would get a small discount on your seat (although I think that the airline should absorb this cost since it’s their fault that they failed to plan for the fact that their passengers come in different sizes)

We Don’t Need No Stinkin’ Middle Seat

Especially considering that there are only three seat belt extenders it seems that, just on a couple of rows, we could remove the middle seat.  These could be given to passengers of size.  Or if they want to change they could charge 1.5 times the price of a regular ticket for these seats.  If they don’t sell out to fatties, broad shouldered and long-legged people, the airline could offer them as an upgrade at check in.

Row o’ Fatties

Stick all the fatties in the same rows.  We’ll snuggle.

Two Seats -Seriously

Airlines ask fat people to purchase two seats if they don’t fit into one.  But then they make it difficult if not impossible to do so.  I personally know people who’ve had to spend hours on hold to get the tickets purchased (because you can’t buy two tickets under the same name) only to be told on the plane that they had to give up their extra seat because the airline “needed” it, or to have their seats be non-adjacent.  If this is really such a huge problem then they should make the solution that they propose easy for us. And if the flight is not full, the money that we pay for a second ticket should be refunded.

First Class Fatties

This one will be controversial, but since the airlines fail to be able to accommodate passengers of size in coach, they could  offer a discount to fatties who want to fly first class.

This is just off the top of my head, I’m sure that there are other solutions.  I do know that the solution is not to tell fat people that they need to change their bodies – not just because nobody can prove that it’s possible for the majority of people, but also because weddings, family reunions, and vacations are happening now, not 50 pounds from now and we should not be in the business of telling other people what their bodies need to look like.

The bottom line is that (just like in healthcare) we need to start being fatties and airlines against a problem, not airlines against fat people.

You may have heard of the study by  Kuk et. al. on the Edmonton Obesity Staging System. I’ll give you the background first and then get to the interesting stuff and the swearing:

They characterized fat people’s health on a 4 point scale: “stage 0, no risk factors or comorbidities; stage 1, mild conditions; and stages 2 and 3, moderate to severe conditions”.

They found that:

Compared with normal-weight individuals, obese individuals in stage 2 or 3 had a greater risk of all-cause mortality and cardiovascular-related mortality. Stage 0/1 was not associated with higher mortality risk (emphasis mine)

The study has limitations in terms of statistical significance (the sample was mostly middle class white people for example), much of the data was self-reported and the authors are clear that further research is necessary.  Interestingly, in the conflict of interest section it states that two of the authors sit on Jenny Craig’s advisory board (although maybe not for long?) and one of those authors has research grants from coca-cola and Body Media (a weight loss product).

Some interesting tidbits:

Stage 0 or 1 participants were less likely to die from cardiovascular disease than “normal weight” individuals.

Stage 0 and 1 individuals were more likely to be physically active and eat more fruits and vegetables. Stage 0 or 1 participants were also less likely to report engaging in weight loss practices.

Hey isn’t there a name for engaging in healthy habits and not engaging in weight loss practices?  Wait a minute it will come to me…ah yes, it’s a Health at Every Size (R)* perspective!!!  I knew that sounded familiar!

According to this article, Dr. Pieter Cohen, assistant professor of medicine at Harvard Medical School and a general internist at Cambridge Health Alliance said:  It’s “absolutely” possible for people to be overweight or obese and healthy.

Harvard doctors making sense?  I may have to play the lottery today!

Dr. Sharma, chair for obesity research and management at the University of Alberta (who often makes sense) said: “The key message is I can’t tell you how healthy someone is if you tell me height or weight on a scale.  I have to do additional tests for other health problems.”

Then there are some things that I almost can’t believe about this:

They list the health issues as “co-morbidities”, thereby making the unsupported assumption that obesity is a primary disease or disorder  when it’s really just a height/weight ratio.

The study says

Nevertheless, these factors, together, indicate that obese patients, particularly in EOSS stages 0 and 1, may be better served if physicians promoted weight maintenance, as opposed to weight loss, as it remains to be seen whether individuals in EOSS stages 2 and 3 will benefit from weight loss.

Yet the articles that I read are still recommending weight loss for patients who are at stage 2 or 3. This is problematic because:

1.  They JUST SAID  that weight loss attempts may well worsen health.

2.  They don’t know if losing weight will  help these people.  There is no solid proof.

3.  Even if they did have proof that weight loss would help, they have no idea how to get it done.  Prescribing something with an efficacy rate of 5%, especially knowing that the 95% who fail will likely end up less healthy than when they started, isn’t just dumb – it’s medically unethical.

4. I don’t know whether to make study author Jennifer Kuk the blue ribbon loser or winner for this quote: “the ranking system helps to identify who should actually lose weight and who are we torturing for no reason”

Ok Dr. Kuk. In addition to saying that you don’t know if weight loss will help, in your study you said

For the vast majority of obese individuals, lifestyle-based weight loss is not maintained over the long term (Wing et al. 1995).” This is particularly concerning, given that weight cycling is associated with greater weight gain over time (Van Wye et al. 2007) and potentially worse health outcomes, compared with individuals who may have maintained a stable body weight (Blair et al. 1993; Wannamethee et al.2002).

If you are:

• ruining people’s current quality of life by self-describedly torturing them
• under the auspices of possibly giving them better quality of life later
• all the while knowing that the most likely outcome is actually worse health

may I gently suggest that Ur Doin it Wrong.

Dr. Howard Eisenson (executive director of the Duke Diet & Fitness Center) totally doesn’t get it, but gets quoted in the CNN article on the subject anyway: “If we don’t intervene now [when someone is healthy, 25 and obese], by the time the person is 35 … maybe some damage has been done and the unhealthy habits are more established.”

Okay Dr. Einsenson, I need you to stay with me here, I’ll type slowly: Not all obese people practice unhealthy habits, you’re just making that up in your head. In fact the very  study upon which you are commenting showed that people who practice healthy habits and don’t attempt to lose weight (thereby ignoring the advice of the Duke Diet and Fitness Center) have better health outcomes. Also, see above on your complete inability to effectively create long-term weight loss.

(And not for nothing but why does every article about this study have at least three doctors offering a counter-opinion but Jess Weiner gets to mischaracterize the entire Health at Every Size(R)* movement to sell her new diet program, and nobody bothers to call any of us for a counter opinion? I’m just curious.)

Several articles suggest that the stigma that fat people face may be a worthy reason to lose weight even if their health is fine.

Oh, how can I put this delicately?

YOU HAVE GOT TO BE  FU#%ING KIDDING ME! The cure for social stigma is not weight loss, it’s ending social stigma.

Finally, there are the comments.  If I could give you a piece of advice, it would be not to read the comments.  All kinds of people who think that “personal responsibility” means that I am personally responsible for looking how they want me to look.  So many people who can bite me. But the message I’m taking away is that, as I’ve long suspected, these people don’t care about my health.  If they did there would be a zillion comments saying “wow, I really need to question my assumptions about weight and health”.  Alas, none that I saw, and perhaps that’s because they only actually care about having someone to whom they can feel superior.  But that’s just a guess.

It bears repeating that prioritizing one’s health is not a moral, social or personal obligation (you do not get to choose what is important for me and I don’t get to choose what’s important to you – that’s why we each have our own underpants to be the boss of).  Also, health is multi-dimensional, not all aspects are within our control, and it should never ever be used as a barometer for worthiness.  Knowing those things, I’ve said it before and I’ll say it again (today backed by research):  while health is never guaranteed, if being healthy is what we want, then healthy habits are our best chance for healthy bodies.

*You’re probably wondering why I’m putting at (R) after every use of Health at Every Size (R).  It’s because the awesome organization ASDAH has successfully put a copyright on the term so that it can’t be misused, and now there are a bunch of rules to follow. And you know that I think this is important because normally I reject rules.  That being said, if anyone knows how to actually make the trademark symbol in WordPress I’m all ears, or fingers, or whatever.