We Love to Watch You Try

I’m back in Austin from San Francisco (I will be posting all about the trip, but not today).  I literally just arrived (driving 14 hours on Saturday, sleeping, then starting again at noon yesterday and ending now).  Normally I would just go to bed and blog whenever I get up, but I was checking my e-mail at a red light on the way home and after reading a comment I decided that I had to get this off my chest before going to be for what I can only assume will be a very long time.

The comment said “Oh Ragen I adore you.  Of course we’ll never change things but I think I speak for everyone when I say how much we appreciate that you try”.

She started off well (from my, admittedly biased, perspective) but then took a wrong turn at Albuquerque.  This is the second comment that said something like this that I’ve received in the last few days and I’ll admit that the first thing I thought when I saw each of them was “haven’t you seen Newsies?”  Seriously though, I know that both of these commenters had the best of intentions, but I really struggled with the comments.

I think part of it is because of my business history. In my consulting career I did a fair amount of turnaround (going into a business that is failing and attempting to turn it around and make it succeed). This often presents as a near impossible task. Once the turnaround team decided that a business was salvageable we did a lot of analysis, change implementation, change management, planning, goal setting etc.  in order to succeed.  You know what we never did?  If you guessed “say that the task was impossible” give yourself 5 points (or a cookie, your choice).  Because there’s nothing to be gained by predicting failure except feeling better about failing which nobody on any turnaround team I’ve ever been on was interested in.

So that’s where most of my initial reaction to the comment came from, but there’s another layer.  And that is the fact that for me there is no alternative than to try to change the status quo.  The more I see fat people stereotyped, recieving subpar or no medical treatment, being made to pay higher insurance premiums, having people claim that our body size constitutes a disease diagnosis or proof of a mental illness (more on that tomorrow) etc. the more it reinforces to me that this is a civil rights movement. And it doesn’t matter if it’s a fat person who is happy with their body and size or a fat person who wants to change their size and/or shape. We all deserve respect in the bodies that we live in right now and that doesn’t change even if our body size does.  I absolutely believe that we’ll see substantive change in my lifetime, but even if I didn’t believe that I would continue what I’m doing because when it comes to fighting for civil rights, the odds just don’t matter and history is on our side. People can say “that’s reality, deal with it fatty”, but we know better than that.

I was originally planning to re-post last years Halloween post and fortuitously it turns out that last year’s Halloween blog is highly applicable to today’s topic so here it is:

Fair warning – this  starts and ends with Halloween but the middle bits strayed a little…

I was shopping for Halloween Costumes yesterday.  There was one that said “One Size Fits Most”.  In small print it said that it fit women’s sizes up to 14.

That really made me think.  Every time I turn around, I hear that 60+% of Americans are overweight or obese, so shouldn’ t the tag read  “One Size Fits Less than One Third”.

Let’s be clear, I seriously question the validity of the percentage of overweight and obese Americans  because the standard for what constitutes “overweight” was set by diet companies.  But let’s pretend that it’s a true statistic.  In that case, we’re the majority in this country and yet we’re still not treated very well.

If we’re really 60+%, then why don’t lobby the media:  We want to see more positive representations of ourselves and less body hating and photoshopping or they’ll lose 60+ % of their customers?  This doesn’t just affect fat people either, studies show that 8 out of 10 women are dissatisfied with their bodies.  As the majority, I think it’s time we stand up for our thin body-dissatisfied sisters and say that enough is enough – we aren’t buying any more magazines that promise “our best bikini body in 15 minutes”.

At 60+%, we control to vote in the United States, but 25+ states have considered or are considering taxes on fat people –  despite the fact that nobody has any proven way to lose weight.  It doesn’t even matter that I have perfect health at my current size.  My picture of health doesn’t fit my state’s frame so I could get taxed for my size.

At the end of the day, if we want change then we have to take responsibility for claiming our power as the majority, or (just in case those numbers are as wrong as I think they are) a community. Many people of size choose to buy into the idea that their size determines their worth and that they don’t deserve to be treated well.  It’s an easy thing to do –  we are constantly told that we are lazy, we are unhealthy, we are costing billions in healthcare and lost work.  When you look into those studies you’ll find that there are some serious questions as to their validity.  For example, the Congressional Budget Office released a report saying that Obesity WAS NOT the reason for the rise in health care costs  Using that article as a basis, the Boston Globe published an article called “Obesity’s Punch to the Gut” where they said that Obesity WAS the cause of the rise in health care costs.  How did they get from point A to point B?  They left out words in quotes, and they used those partial quotes to construct a message that was polar opposite from the source material.  I have no idea why they would do that, but they weren’t the only ones who did.

There is no such thing as a “healthy weight”  and that insidious little saying needs to be pulled from the collective vocabulary. We know that two people can fit the same profile – sedentary, non-nutritious diet, health problems – and one can be fat while the other stays thin. Ignoring that facts that healthy is multi-dimensional, not in our control and that other people’s health is not our business this is still problematic.  Even if you believed that people should be held fully responsible for their health, it’s a big, flaming sack of duh that it’s absolutely unfair to single out the one who is fat for higher taxes, workplace discrimination and poor treatment, while the person who remains thin doesn’t suffer any of those consequences despite the same lifestyle and choices.  You could say that’s all trick and no treat (you might especially say that if you were trying to fit this blog into the Halloween theme).

No matter what, you deserve to be treated well with respect and equality in the exact body that you have now.  So have a fun, happy and safe Halloween and at some candy corn for me, because I’m planning to sleep through the whole thing.

Whole Foods Half Brains

Whole Foods offers a scaled employee benefit system. In order to get the better benefits you must meet certain cholesterol and blood pressure requirements and not have nicotine in your system.  Once those are met, then your benefit level is based on your body mass index.  Their system is:

The program is optional.  It wouldn’t be optional for me though because whatever is below Bronze, I’m it.  Just call me level lead I guess.

It’s ridiculous at first glance because if they truly think that people with higher BMIs are less healthy, and if they are touting themselves as a health food store, and if they really [mistakenly] believe that thinner is healthier, then shouldn’t the fatties get the best discounts?

Bizarre pseudo-hypocrisy aside, let’s get clear on something:  Obesity is not the opposite of health.  The way I know that is that we don’t use the same scale to measure them and they are thus incomparable. Every time I see this done, it makes me want to scream.  This is not rocket surgery or brain science.  We measure health using measures of health, we measure obesity using a ratio of weight and height.  See what I mean – not the same thing at all.  Not for nothing, but if obesity was the opposite of healthy, the word “unhealthy” would be much less likely to exist.

I cannot image why we  are still using a mathematical formula that was created to look at the differences in body sizes of populations and was never intended to be used to measure the health of anything or any one to measure individual health, all the while acting like nobody understands the difference between correlation and causation, or why this is a terrible idea. It’s embarrassing. (Don’t just take my word for it though, see what Dr. Jon Robinson, PhD, MS thinks about it.)

Beyond all of that, I thinks it’s a truly terrible idea to start punishing people for things that can be beyond their control (and make no mistake, whatever spin they put on it that “it’s not a punishment for employees who don’t qualify, it’s an incentive for those who do qualify”, it’s a punishment when your groceries cost more because you are fat or have high cholesterol.)

Mostly, I don’t think that employee benefits programs should be built on a foundation of healthism.  Employees are responsible for doing the job that they were hired to do with reasonable accommodations and for doing that they should receive fair pay and benefits. They are not responsible for being healthy by their company’s definition and their compensation should not be size or health dependent.

Obviously given its policies I have no interest in working for, or shopping at, Whole Foods.  But let’s have a moment of silence for their tall employees (who we know get a skewed BMI) and for their athletic employees (whose musculature increases their BMI) and for employees who are being rewarded for being underweight due to eating disorders, and for employees whose natural cholesterol and blood pressure are higher than what the people at Whole Foods think is healthy, and for their employees who work just as hard as their co-workers who are thinner, and/or have lower cholesterol and blood pressure, but receive lower pay.

We’ve already seen evidence that there is bias in the hiring of fat people, and a pay differential when we do get hired, now they want to punish us with worse benefits as well.   Here’s a novel idea – maybe Whole Foods could reward their employees for doing good work with a paycheck and benefits package. be in the grocery business, and leave health care to the health care professionals.

NOTE:  I received a note from a reader saying that they thought that this program was no longer in effect.  Prior to writing the blog I had verified it with three employees and Mark at the main office.  Today I spoke with Kristi at the main office and she verified it as well.

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Embarrassingly Bad Science

Today’s blog is a re-post of a blog that I did about a year ago with some slight edits.  I wanted to repost it because I discussed it at my talk at Google today (see how I worked in that I gave a talk at Google today…) and I really think that it’s very representative of a huge problem that we have getting true information about our health and I have a bunch of new readers since a year ago so I wanted to give it a little more attention:

I read the headline “Obesity’s Hidden Job Costs –  73 Billion”.  I’m ginormous and as or more productive than anyone I know so  my first thought was “How did they come upon that number?”  I looked up a bunch of different articles online to make sure that they were all reporting the same basic thing, and they were.

So I went to the Journal of Occupational and Environmental Medicine and paid $20 for the article, which was titled “The Costs of Obesity in the Workplace.”

Allow me to attempt to elucidate, it won’t be easy because this study is kind of a cluster F&$#.  I’ll start with some basics, and include the longer more detailed nerdy explanation (that I love so much) at the end.

The study looked at three factors:  Medical Cost, Absenteeism (not showing up to work) and Presenteeism (being at work but being unproductive).  According to my spell check, presenteeism isn’t a word but we’re going to go with it for now.

According to the articles that I read online, the study was out of Duke University.  That’s true – the lead author is Eric Finkelstein, an associate professor at Duke-National University of Singapore.

Under “acknowledgments” it says “This study was supported by Allergan, Inc.”  It lists that as an acknowledgment, and that’s a problem for me because it should be listed as a conflict of interest. Why?

“Supported” here has the meaning of “funded by”.

Allergan is a pharmaceutical company.  They produce Botox, Latisse (it will grow your eyelashes and don’t worry, that eye discoloration is probably temporary) and…wait for it…the LapBand.  The item used to constrict your stomach as a weight loss surgery option.

Allergan is currently using this study from the good people of Duke Singapore to convince health insurance companies to encourage and pay for lap band surgery because it’s “cheaper than the loss productivity”.  Astonishingly [sarcasm meter is a 9 out of 10] according to this study, the cost of obesity per person was more than the cost of lap band procedures.  Let me muster up some shock…  Sorry – I’ve got nothing.

The study used two sources:

The 2006 Medical Expenditure Panel Survey where BMI data is self-reported, and the 2008 National Health and Wellness Survey which is a series of self-administered internet-based questions fielded by 63,000 members of an internet based consumer panel.  Every piece of information is self-reported and unverified. The $73 billion is an estimated projection based upon statistics that were created by doing computations with statistics and estimates, and statistics of other statistics. There are issues in the collection of data, the control of variables, the use of data (the study authors feel that the words “obesity” and “health problems” are scientifically interchangeable, that fat people’s health problems may be assumed to be caused by fatness, and utilizes BMI which has any number of problems as a statistic in and of itself which I talk about more here), and the conclusions that they drew.

The fact that news agencies reported this information as true without bringing up the limitations and issues is deplorable.  Studies are suggesting  that obese people already make less than their peers and are turned down for jobs based on prejudices about weight.  Now companies may think that they have scientific proof to back up their bias. How many of them are going to pay $20 to read and understand a complicated study? [Edit:  Since this was published friend of mine in HR have sent me e-mails from their bosses linking to an article about the study and asking “is it legal to just not hire fat people?”]

As always, may I suggest that you DO NOT  need to believe everything that you are told is science, and DO NOT need to take this personally or allow it to affect how you feel about yourself, your health, or your productivity in any way.

Here come the details:

Medical Expenses

The calculation of this is statistically complicated because of the data.  To speak in the vernacular of the peasantry, the data sucks. Basically they used a two part estimate that created four categories of overweightness (hey, if they can make up words so can I) based on the self reported weight.  “Normal weight” were the omitted reference group    They controlled for race, household income, education, insurance coverage, marital status and smoking. They subtracted the average predicted medical expenditures for obese individuals in each category from the average predicted expenditures for those of normal weight.  Then they multiplied that estimated number times the number of people in each category and added them up and extrapolated based on the estimate of obese Americans.


First of all, notice the number of times that the words estimate, average, and predicted appear in that explanation.  If I had more free time I would be doing a word count to give you an exact percentage of the number of words that are used in this study that essentially mean “um, maybe…”, there are many.

They also didn’t control for any genetic health issues, or health issues that aren’t even correlated to weight.  They appear to have assumed that any medical problems that obese people had over and above what normal weight people had were due to fatness.  They appear to have assumed that normal weight people’s health issues weren’t related to the same things that cause weight problems in overweight and obese people.  That’s just embarrassingly bad science.

Absenteeism and Presenteeism
This is my favorite.  These were measured based on two questions that asked people “During the last seven days, how many hours did you miss from work because of your health problems?” and “During the past seven days, how much did your health problems affect your productivity while you were working?”  Participants indicated their level of work impairment via a rating scale ranging from 0 to 10.  Each response was assumed to represent a percentage reduction in productive work.  Then they took a week’s data and extrapolated it to a year, multiplied it by the estimated number of obese working people, and then  monetized the predictions using wage data from the bureau of labor and statistics.


Respondents weren’t talking about  how much work they missed or productivity they lost due to their weight, they were answering about their health problems.  What they can reasonably conclude here is that people with health problems have more absenteeism and presenteeism than do people without health problems.  The study’s authors are basically substituting “obesity” (and by that they actually mean high BMI)  for “health problems” .  You can do that I guess, but you probably shouldn’t do it while calling yourself a scientist.

Then, they computed statistics using statistics, and statistics of statistics. Dude. They used a 7 day sample to calculate a year’s worth of data.   Once again, they assumed that any absenteeism or presenteeism over and above what normal weight people had was due to fatness.  Except that overweight men reported less presenteeism than normal weight men.  That was not reported in any news outlet that I could find  EXCEPT the study itself and they  gloss over it.

If I had turned this work in for my very first  intro level freshman research methods class I would probably have failed the assignment and possibly been asked to leave the program because of specific incompetence and general stupidity.  You don’t have to feel bad about yourself – you are fine.  Feel embarrassed for the scientists who put their name on this.  I hope that they are the laughing stock of Singapore.

The 4 Most Important Words

I was thinking today about how much of our world is based on fear.  Fear sells – if people are terrified of something they will pay money to avoid it.

If you’re thin they try to make you scared of getting fat. If you’re fat they try to make you scared of being fat and staying fat.  They try to make everyone scared of their own body.

I spoke at a lovely event centered around body love recently and one of the booths was about proper nutrition.  She had the same plastic models of food that we used in the eating disorder facility where I taught dance, and little test tubes filled with the amount of sugar that’s in various things.  I was trying to block it out but her voice would penetrate my consciousness “This is how much sugar is in just a half cup of JELLO” she would say in the same voice that you would use to tell scary stories around a camp fire.  Because making people terrified of some Jello is definitely the key to health.

When it comes to health it’s as if people think that we’re too dumb to make choices that are in alignment with our priorities and support our goals.  Like we need to have someone tell us what we should want and then terrify us into doing what they think will get us there.

Of course this ignores the fact that people get to choose how important health is to them, and that health is not entirely within our control and is not a binary state.  It’s not just healthy or unhealthy, health is a spectrum and very few people fall  all the way on either end.  It also ignores the fact that stress is a major predictor of poor health so having people walking around terrified of jello or that they’ll eat more broccoli than was represented in the plastic broccoli replica is counter-productive.

So I think that the four most important words that any of us can speak right now are:  I am not afraid.

I am not afraid of food.  I eat often to support my body and sometimes for my pure enjoyment and I am comfortable with that.  I know that being afraid of food will do nothing to make me healthier – mentally or physically.

I am not afraid of  fat hate.  As my Mom told me – never wrestle with a pig, you’ll both get dirty but the pig is used to it and won’t mind.  I know that allowing haters to stress me out is bad for my health and I will not allow them to affect my health.  I will ignore them or I will mock them as I see fit but I will not give them power over me.

I am not afraid of movement.  I do movement that I enjoy and I honor my body and its signals.  I don’t see my body as a limitation to be overcome but as a constant friend and companion.

I am not afraid of my fat body. My body is beautiful and amazing and perfect just as it is and if it changes tomorrow if will be perfect then too.  I am not afraid to be in my body in public, to ask that my body be accommodated or to have my body viewed and appreciated.

I’m thinking about this whole fear thing a lot because I resigned from my CEO job. It was great money and I loved the staff but for certain reasons that you’ll have to buy me a drink to hear about, it was the most stressful experience of my life.  And that stress took a major toll on me over the last year – I got sick more in that year than I have been in the last 10 years.

There was a crossroads and I took the road away from that life for the sake of my mental and physical health and to do things that I’m absolutely passionate about. Immediately I feel better, and now it’s time to see what’s next.  For now I have some money in the bank, a couple of consulting clients, a world speaking tour happening, a book in the works, and some other super secret stuff.  If the diet industry can make 58 billion dollars a year with a message of self-hate and a product that only works 5% of the time, you would think that some of us could make a living supporting people in loving and appreciating their bodies and giving options that the diet industry doesn’t want us to hear.  I don’t know what’s in store but I know that I am not afraid.

For a little inspiration, here is one of my favorite YouTube videos of all time:

Personal Trainer Misses the Point

Thanks to the more than 20 readers who sent me this article [trigger warning for all the things I’m about to mention].

Basically Drew Manning, a personal trainer, has gained 70 pounds on purpose. He decided to “spend six months (he has about 4 weeks left) eating  unhealthy food and not exercising, then he will take six more months to get fit again. Why? To experience for himself what it’s like to be overweight, how tough it is to lose weight, and ultimately show others how to get fit.”  What the…

I truly want to believe that he has good intentions, but even so this is deeply problematic.

First of all, being overweight means that in the equation of your weight in pounds times 703 divided by your height in inches squared, the result is greater than 24.9.  And you know what conclusions we can draw from this formula?  That the result is 25 or more.  That’s all.  It tells us nothing about the person’s health, eating and exercise habits, intelligence or anything else. The result is 25+, end of story. People get all caught up in the idea that since it’s math it must be scientific.  But then start to ask yourself why do we square the height?  If we wanted  a ratio couldn’t we just use weight and height?  Why are we using a formula made up by a statistician for the sole purpose of studying body sizes in large populations as a way to study health in an individual.  That’s like trying to use the quadratic formula to solve for the hypotenuse of a right triangle. The formula was not meant to do that so you can plug in some numbers but the result will be useless. (And can I get a gold star for pulling those concepts out of my back of my brain where the math from 15 years ago lives?).

Of course, people have a right to eat whatever they want and move their bodies, or not, however they want, and it’s not anybody’s job to judge that.  But to say that eating unhealthy foods and not exercising for 6 months is experiencing being overweight is ludicrous.

Being overweight is not a single way of eating and exercising and this idea that all fatties eat the same way, exercise the same way, and think the same way is as widespread as it is ridiculous.  There are people of all shapes and sizes who eat vegan diets and there are people of all shapes and sizes who eat processed food based diets.  There are sedentary thin people and highly active fat people. We need to examine our history and realize that this kind of stereotyping of a group of people never works out.

Drew’s eating and exercise habits do not give him the experience of being overweight, his eating and exercise habits give him the experience of eating a diet of processed foods and not moving his body.  The “experience of being overweight” is an individual one, and I would say that it’s much more about what it is like to move through society in a body that people think they have the right to stereotype and judge than it is about a way of eating and exercising and I think it probably takes more than 6 months for that experience to sink in.

He is eating “sugary cereals, granola bars, juices, white breads, white pastas, sodas, crackers, chips, frozen dinners, mac n cheese, etc.” and not exercising at all.  He says “I’m to the point where I feel lethargic and uncomfortable.”

Well, Drew, how about you eat a giant bowl of No Shit Sherlock Flakes.  You have found that eating a diet of entirely processed foods and not moving your body leads to lethargy and discomfort.  That is not news.  It’s also not about being overweight.

Unsurprisingly, his metabolic health markers have changed with his change in habits.  Drew says ” I want to show people how living a healthy lifestyle can change all of those risk factors.”

If his healthy lifestyle changes his risk factors but does not lead to weight loss, then Drew will be having my experience of being overweight and I’d like to hear about how he would deal with that. In truth, what he will prove when he changes his habits is what happens when a body with an excellent baseline of fitness returns to a lifetime of healthy eating and movement after a six month sabbatical.

He does say “I know I’ll never know exactly what it’s like for every person that’s overweight and I don’t claim to, but at least I understand better than I did before when I never had to struggle with this.”  So he sort of gets it.

Again, I really do want to believe that he has good intentions but that doesn’t stop this from being incredibly insulting and offensive.  I rarely compare my experience to the experience of other minorities because I like to stay away from the Oppression Olympics, but the best comparison I can think of is putting on blackface and engaging in stereotypical behavior to try to experience what it’s like to be African American.  Especially considering his before picture where he is smiling, hyper-tanned, hairless and flexing hard, and his after picture where he is frowning, pale, hairy, purposefully hiding any muscle tone.  None of those are bad, they’re just very different than the before picture.

I think the best way to understand a population is to realize that they are more competent witnesses to their own experience than you could possibly be and check your own assumptions, beliefs, and prejudices against what they tell you to be true.

When We Lost Our Damn Minds

In the future a group of kids of all sizes will be sitting in health class.  Their teacher will be explaining about eating a variety of food, and how it’s important that you keep listening to your body when it comes to what you eat and what kind of movement you want to do.

One of the kids says “My great grandma was talking about being on a diet. What’s a diet?”

The teacher explains “That comes from the time when people decided that all bodies should be thin. Trying to get their body to be a different size than it was naturally, people decided to feed their bodies less than what they needed to try to make them smaller”.

Another kid asks “Why?”

The teacher explains “People got confused and thought that the only way to be healthy was to be thin.”

The kid asks “Did it work?”

The teacher sighs “No, not at all. It turns out that dieting actually often made people’s bodies bigger than they were meant to be permanently and messed up their metabolisms.  Some people were able to lose weight in the short term but almost nobody succeeded over the long term and a lot of people ended up less healthy after dieting.  Also, people who had larger bodies were tremendously stigmatized by everything from magazines to doctors and for a long time large-bodied people were treated like second class citizens – people assumed that they were lazy, weak-willed, even less smart than thin people –  and the stress from that lead to a lot of diseases that got blamed on those people’s body sizes by the people who were stigmatizing them.”

“Wow” a little girl with a larger body will say, “I’m glad I didn’t live then.”

I believe that in the future of public health, this time in history will become known as the time when we lost our damn minds.

If you can step back from this you’ll see how ridiculous it is.

The assertion that human bodies are the only thing in nature that doesn’t come in a variety of sizes.

Pathologizing body sizes, asserting that someone’s weight in pounds times 703 divided by their height in inches squared constitutes a health diagnosis, instead of just doing the simple, inexpensive tests that actually measure our health.

The First Lady giving talks against bullying while simultaneously waging a national war against children who are fat.

Companies trying to convince us that permanent or even temporary stomach amputation will make us healthier.  These same companies becoming entrenched in the public health sector doing everything from convincing the NIH to lower what is considered a “healthy BMI” to holding contests to win free stomach amputations and commissioning studies with horrible research methods to sell more of their product.

Yesterday in the comments of this blog a woman who self-identified as a Registered Dietician, Certified Diabetes Educator, Master of Public Health, and Licensed Dietician/Nutritionist tried to make the argument that because diabetes and obesity are correlated you can say with no question that being obese increases your risk of diabetes.  (If you’re not sure why that argument is flawed, check it out in the comments from yesterday’s blog.)

I write a blog that suggests that if people want to be healthy their best chance is to eat well and move their bodies.  I make it a point in the blog to never tell anyone how to live or what choices they should make. And I get death threats.  I have so much ridiculous hatemail that I made a separate page for it.  (Of course I happily admit that writing the replies is cathartic and it makes me happy that their hate supports my work.)

We have lost our damn minds, and it helps me to remember that when all of the craziness that I just mentioned comes flying at me. It’s not me, it’s them.  And they can’t beat me down with all their crazy because I have hope!

World Tour Update

I’m headed to San Francisco next week where, among other places, I will be speaking at Google Headquarters!  I’m so excited!!!  If you are interested in having an event, or you live in San Francisco and just want to hang out while I’m there, let me know.  You can comment here or e-mail me at ragen at danceswithfat dot org.

There are a lot of places that want an event but can’t afford to pay even for travel and expenses. I’m trying to raise some funds so that I can get to those folks too.  If you are interested in supporting that effort, you can check out the Support the World Tour page.

And finally a little housekeeping…

At the request of a number of readers, I have overcome my tech-challengedness and added a search function to the blog (you can find it in the column on the right hand side under the subscribe box).  Enjoy!

Health Not Hyperbole

Question:  What do these phrases have in common?

  • eating too much salt gives you high blood pressure
  • most obese people get diabetes
  • eating sugar makes you sick
  • all obese people will eventually get sick

Answer:  They are all untrue.

Some are exaggeration:

Large-scale scientific reviews have found that people with normal blood pressure have no medical reason to reduce their salt intake.  Some (but not all) people with high blood pressure are “salt sensitive”.  For those people lowering sodium intake could help, but they could also choose to eat more potassium since it’s actually the balance of those minerals that is the important thing.

Some are completely untrue:
Most obese people will not get diabetes. Many thin people will.  Obesity is not proven to cause diabetes.  It is correlated with diabetes but so are high levels of stress – like the stress of constant stigma and being told that you are going to get diabetes.
Some are misinterpretations:
Sugar is believed by some researchers to suppress the immune system.  Other researchers assert that this isn’t true.  Even if it is true, to say that sugar makes you sick is inaccurate – it just suppresses the immune system but bacteria and viruses are what make you sick.
Some omit facts:
All people are going to die.  There is no magical weight that you can be that will make you immortal.  Some obese people will get hit by a bus when they are perfectly healthy.  Some thin people will be born sick and will never be healthy.   Some obese people will be healthy until they die of old age.  Weight and health are two different things.

In the pursuit of health well-meaning (and not so well-meaning) people can have a tendency to exaggerate, speak in generalities and repeat things without verifying them for themselves.

These things get repeated so many times that they become myths – the media writes about it (because “Salt Shown to Cause Hypertention” is a much sexier headline then “In some people with hypertension decreasing salt or increasing potassium may help”) then people can say “I read in a magazine…”.  Doctors exaggerate to scare patients or repeat myths because they don’t know any better and then patients go out and tell people that their doctor told them…  The diet industry will say almost anything to get us to buy their products and they’ll repeat it millions of times.  Next thing you know some jackass is telling me how my diabetes is going to cost them their tax dollars and even if they are open to a teachable moment I have to overcome a mountain of misinformation.

People say that being obese is harmful to society but I really think that the real harm is coming from the confusion of correlation and causation, the pursuit of public thinness instead of public health, massive misinformation campaigns by the diet industry, and myths spouted by people who don’t know any better – and some who don’t want to know any better.

Access is a major part of health. That includes access to a wide variety of foods, access to safe movement options that you enjoy, and perhaps most importantly, access to true and correct information about our health.  Unfortunately the last piece can be the most difficult, so I think that it pays to questions “everybody knows” statements, do research and make our own decisions.

The Fat Girl Who Can’t Move

The first stop on the Dances with Fat World Tour was wonderful!  I’ll have a full post once I have all the pictures and videos back.  I will say that in the last 72 hours I’ve crossed the country two and a half times, slept more hours on planes than in beds, been part of movie premieres on both coasts, saw my Best Friend get married and performed at the Austin NOW Foundation’s Love Your Body Day.

And there I saw an awesome woman who I had met on a couple of previous occasions.  She shared with me that she has been struggling with a health condition.  Of course, it took several tries to get properly diagnosed because the first few doctors gave her a diagnosis of fat and a prescription of weight loss.

Now there are restrictions on her movement that she never had to deal with before.  In the past she was an athlete and now she’s exploring movement again but with less options.  She mentioned that in my blog I talk about being fat and being able to be athletic and that she was interested in a discussion of what happens when you’re fat and can’t buck all the stereotypes.  It’s something I’ve been meaning to talk more about and she said it was cool if I use her story to frame the discussion.

I talk about the ways that I, as a healthy athlete, do not fit the stereotypes that our society has for fat people.  As we have talked about before, that opens me up to the Role Model Problem.  It also creates the possibility that people will misunderstand and think that I’m trying to say that I think it’s ok to judge people for their health, physical fitness and/or mobility.  Of course that’s absolutely not true.

First, I do not believe that health is a personal, social, or moral obligation.  People don’t have to prioritize their lives the way that we think they should. It’s not our business.  Just like we get to prioritize our lives as we see fit and it’s not other people’s business.  I also think we forget that the current state of our bodies is not entirely under our control.  In some cases it’s almost entirely out of our control.  Our health, physical fitness, and mobility are the result of our genetics, environment, stress, access (to everything from healthy food to healthcare), past behaviors and current behaviors.  It’s ridiculous to pretend that our health is entirely under our control.

Dealing with a physical limitation of any kind can be really difficult, and those difficulties can be compounded when you are a fatty.  The messages that get put out there in our culture could make someone think that there is a magical body weight that assures health and immortality.  And that is a lie.  There are people of all sizes who have health, physical fitness and mobility limitations. But if you’re fat with a limitation then you know that people are going to blame it on your weight and judge you.  The stereotype telling you that you made yourself a fatty and that caused the mobility problem or health issue –  one or both of which can easily be untrue.

Then there are the internal emotional issues that you have to deal with…It can damage your relationship with your body, make you angry with it, feel betrayed.  Create all kinds of stuff that you have to work through.  Sometimes you have to make a change from what you enjoyed before, sometimes it means that you can’t try something that you want to try, and if you’re fat it can mean that you feel like you’re living down to the stereotype – you become the fat girl who can’t move.  This has happened to me when I’ve been injured.  Dancers get injured all the time but every time I’ve had an injury I have to work through the feelings of being betrayed by my body, and deal with being a fatty with a limp with all of the stereotypical cultural bullshit attached to that.

I think that in the end, it’s about realizing that our bodies are amazing and that they will change over time.  They are simply not comparable to other bodies or to themselves over time.  There’s no point in looking for ways that your body is better or worse than other bodies, or that it can do more or less than other bodies, or than it could at some other time in your life.  There are lots of ways to have a body and, as Hanne Blank said so beautifully, there is no wrong way to have a body.

Consider the possibility that your body is amazing just as it is, and that as it changes it will continue to be amazing in different ways. You are incomparable!

No matter what, remember that you can’t control how other people feel, but you are the only person in charge of how you feel about yourself and your body- you can choose to give that power away, but it’s always your body and your choice. I have found that shutting out the constant message that we get (mostly from people who want to sell us something) that our bodies are flawed is not easy – though it gets easier over time.  But having a healthy, happy relationship with my body is definitely worth the effort. I don’t know how my body will change over time but I believe that starting with a base of love and appreciation for what my body does for me will help work through it.

You don’t have to be scared

I do get a lot of feedback where people say that my work “scares” them. I received a comment that I wanted to respond to here because I think it captures the ways in which people hear my message and become uncomfortable:

I have just started following your blog because: I feel that loving your body and having a realistic and healthy body image in today’s society is incredibly important. I also agree with the healthy at any size movement.


However I have some concerns to raise with you, or perhaps a challenge. It seems from a lot of your writing that you are defending women who are more overweight than healthy(your mission)

You said that you agree with the Health at Every Size movement but I think you may be mistaken, or at least you are missing the point which is that weight and health are two different things. “More overweight than healthy” is a false comparison.  You can be heavier or lighter and you can be more or less healthy.  There are healthy and unhealthy people at every shape and size. Our culture erroneously started to use weight as a proxy for health and many people are now confused about it.

For example in this article you are defending the 60% fat majority in America, but how many of that 60% percent are large and healthy?

I object to the word defend because we have no need to defend or justify ourselves to anyone.  To answer your question, we have no idea how many of us are healthy since the medical care the we receive is often unbelievably poor – a diagnosis of fat and a prescription of weight loss.  I’ve had doctors try to prescribe me blood pressure medication BEFORE checking my blood pressure (which was perfect at 117/70)   We also don’t know how many of us would be healthy if we didn’t live under the stress of constant stigma.  We do know that:

“Women who say they feel they are too heavy suffer more mental and physical illness than women who say they feel fine about their size — no matter what they weigh…Stigma and prejudice are intensely stressful. Over time, such chronic stress can lead to high blood pressure and diabetes. – Peter Muennig, Columbia

You also mentioned in another article that you had plenty of studies backing the fact that overweight and obese people live just as long as others. I think the point here is not wether or not someone is physically alive with a heart beat and if this person is mobile, has joint, heart, and respiratory problems, if this person has diabetes, or many more weight-related issues.

You say “weight related” which is correct, but I’m not sure if you actually have an understanding of correlation vs. causation.  These diseases are correlated with obesity which only means that they sometimes happen at the same time and we don’t know why.  Obesity isn’t proven to cause any of them.  In fact most fat people will NOT develop Type 2 diabetes (according to the American Diabetes Association) and many thin people will develop it.  People of all sizes have issues with mobility, joint health and respiratory problems as well. The difference is that if you are fat, everything gets blamed on your fat (I’ve had doctors list my weight as a cause for issues including strep throat and a dislocated shoulder.) But saying it doesn’t make it the truth.  Research tells us otherwise:

“Consistently, physical inactivity was a better predictor of all-cause mortality than being overweight or obese.” -Annals of Epidemiology

“We’ve studied this from many perspectives in women and in men and we get the same answer: It’s not the obesity—it’s the fitness.” -Steven Blair, P.E.D., Cooper Institute for Aerobics Research

“Active obese individuals actually have lower morbidity and mortality than normal weight individuals who are sedentary … the health risks of obesity are largely controlled if a person is physically active and physically fit.”
-The President’s Council on Physical Fitness and Sports

By no means am I saying you need to be model thin, or that one will be riddled with health diseases if you put on a few pounds. In fact I think a persons actual weight is irrelevant but a woman should be big because she has a larger bone structure, or muscle, and not because she has masses of fat tissue clinging to her.

When did you get the job of telling other people what their bodies should look like and of what they should be composed? Was there a ceremony?  Was it nice?   You’ve already demonstrated a lack of understanding around the research about weight and health so honestly I don’t think you’re qualified to make predictions about will happen if someone puts on a few pounds, or decisions about what their bodies should be composed of.

I am scared that you are deluding unhealthy women into thinking that they do not have a problem. It should not be an incredible achievement for someone to play with their child, go for a walk, or climb a flight of stairs, that should be something every person expects from their body without any consideration.

Ignoring that fact that your comment is incredibly insensitive to people with any number of disabilities, and is also extremely healthist, now you’re also the achievement police?  What about if someone is injured in an accident and told that they will never walk again.  Would you allow them to think that climbing a flight of stairs would be an achievement?  This idea you seem to have that all thin people are energetic, mobile and healthy and that all fatties are unable to climb stairs or go for a walk or play with their children is something that you are making up in your head. We run marathons. We run triathlons, hoop dance, climb mountains and win National Dance Championships.  Image what we would do if we weren’t constantly told what we CAN’T do by people who have no actual idea.  Just yesterday I explained why I don’t believe that body size is a problem and  I believe that social stigma and access are problems.

Keep up your work with body image and health at any size, but please consider what you defend as healthy.

I will and I already have or I wouldn’t be defending it.  Please consider why you would ask me (well, actually you tried to tell me) to keep up my work with health at any [sic] size and then suggest that I should tell people that some body sizes are inherently unhealthy.  Also, please consider what assume to be true.

Also, why do you label yourself as fat if you believe you are at a healthy weight?

There you’ve missed the entire point again.  There is no such thing as a healthy weight. There is no weight that guarantees health – there are healthy and unhealthy people of every shape and size. I call myself fat because I am fat (I have a lot of adipose tissue) I call myself healthy because I am healthy (my metabolic markers for health are all in the healthy range, I have strength, stamina and flexibility in the top 5% of the country).  Were I to become unhealthy in some way, I would treat the health issue in the same way it would be treated in a thin person because if thin people get a disease then being thin cannot be the cure.

New Food Math

I got an e-mail today questioning my choice of intuitive eating over dieting.  It said “This idea that you eat what you think your body wants is horrible – being on a diet would tell you what to eat and how much and what is good or bad to eat.” That inspired me to do some new food math.

Food math for me used to be about obsessively counting calories, weighing food, calculating and recalculating my basal metabolic rate when I didn’t lose what I was “supposed” to based on the calories in/calories out model that I used to believe in.  If I spent half the time on calculus that I spent memorizing the serving size and nutritional information of almost every food that exists and calculating how that food would supposedly affect my body, I’d be working for NASA right now.

We’ve talked before about how our society is set up to create dysfunctional relationships with food.  I decided to try to quantify exactly how much that had affected me.  So I did some math. I’m 35 years old, assuming 3 meals a day I’ve eaten about 38,325 meals.  I spent a good 10 of those years dieting so that’s about 10,950 meals. And those dieting meals were not about health for me. They were about obsessing, about living with being constantly hungry, with giving my body less food than it needed and then overcoming the barrage of physical and psychological symptoms that my body activated to try to convince me to feed it appropriately. They were about eliminating entire food groups, and eventually about starving myself and ending up in a hospital bed. That was not physically healthy, and it sure as hell wasn’t mentally healthy.

So let’s just say that I live to be 80. That’s 49,275 more meals.  And if I’m going to do something almost fifty thousand times, I want to make it an experience that is going to be good for me both physically and mentally.  Therefore, dieting is out. Remember, I’m not trying to tell anyone else how to live, I am simply making choices for myself here.  Which, as the boss of my underpants, is my right.

I used to treat my fat body like it was a problem – a limitation to be overcome through mental toughness.  What I learned was that my body wasn’t the limitation.  Our cultural views of bodies and food relationships, our obsession with thinness and dieting were the limitations that needed to be overcome. My body was fine the whole time.  There was a time in my life when I lost my physical and mental health because I believed that I couldn’t possibly know what was best for me and that letting someone else tell me how to eat would guarantee my future health and a long life.  Now I know that there are no guarantees, and I believe in a new equation:

Nourishing my body + moving it in ways that I enjoy + loving and caring it = my best chance for physical and mental health.

That’s my new food math.