Dieting, Size Acceptance and Health at Every Size

This is not a blog about whether you can love your body and still want to lose weight,  the brilliant Deb Burgard already tackled that one in The Health at Every Size Blog.  This is about how these groups interact with each other.

First, I take great pains never to tell anybody else how to live, but I  make an exception when it comes to civil rights.  I think that everyone should be for Size Acceptance, regardless of their size, the path to health that they’ve chosen, or the path to health they think is best for others.  Civil rights are not up for debate or determined by a majority vote, or by how important those rights are to you individually.

Bodies are not barometers for health, intelligence, value, work ability, or anything else.  We have a right to life, liberty and the pursuit of happiness and that doesn’t start 50 pounds from now for me, even if you decide that it starts 50 pounds from now for you.  I would not personally recommend it or choose it, but I support people’s right to choose dieting. I can’t argue to limit their choices while simultaneously arguing that my choices should not be limited. By the same token I think that even fat people who don’t want to be fat and are actively trying to be thin should be for Size Acceptance.  True power is in having the right and choosing whether to exercise it – it’s not about taking rights away from others because you don’t want them for yourself.

So let’s talk about how HAES and Size Acceptance people interact with dieters.  I know that there are SA and HAES advocates who tell dieters, online or in person, that what they are doing is unhealthy and that they should stop dieting and do what HAES says is right, and they  say that they tell people this for their own good.  I’m asking those people to consider stopping that behavior.  If the message sounds familiar to you, it’s because it’s the exact same thing that fat people who practice Health at Every Size get from those who think we should try to lose weight; and we RAIL against these messages and their messengers, flatly stating that they have no right to tell us what to do with our bodies.  So how about we avoid looking like, or actually being, hypocrites?  I hate it when people come to my blog and preach dieting,  so I would never, ever go to someone’s blog about dieting and preach HAES.

Please understand, I believe that weight centered health and Health at Every Size are two completely separate paradigms and I’m not suggesting that they “kiss and make up“, I’m working for a paradigm shift here.  I’m just suggesting that we stop attacking individuals who make different choices than us, using tactics that we don’t like having used on us.

We don’t need to resort to that because we are not a Potemkin movement. We have evidence, experts, and success stories on our side.  So let’s keep getting our information out there.   Let’s comment on news stories and get our experts in the media and create our own news.  Let’s create our own spaces on the internet and in the world to present our beliefs, explain them, and support them with evidence. (While I wouldn’t go to someone else’s site and talk about the dangers of dieting I sure as hell do it on this blog.)  Let’s get into debates and mix it up and let people hear what we have to say.  Let’s make sure that if people choose dieting it’s not just because they never heard of Health at Every Size or Size Acceptance.  And let’s make changes at an institutional level – get the medical community and the media on our side.  Let’s work to end the constant stream of body hate that so many people try to change their bodies to avoid.   But let’s commit to never bullying people the way that we’ve been, and continue to be, bullied.

While we’re talking about this – bashing thin people:  Not ok, not ever, not for any reason.  It’s wrong, wrong, wrong, wrong.  Let’s just put an end to all the body snarking and make room for everyone on the Size Acceptance Ark.

There are so many choices when it comes to prioritizing health, paths to health, food and movement etc. I am not interested in convincing everyone do what I think is right.  I am interested in all of us having the right to make our own choices about our bodies and  health, and in our ability live in our bodies and with those choices without losing civil rights, job opportunities, access to good healthcare or life, liberty and the pursuit of happiness as a consequence.  I’m also interested in working to make sure that everyone has access to all of the information, foods and movement options that they require to implement and support their choices, which I will respect as I want my choices respected.

This blog is supported by voluntary reader subscription rather than corporate ads.  If you feel that you get value out of the blog, can afford it,  and want to support the author’s fat activism, please consider subscribing.

Success and Progress

Remember our petition asking NEDA to end their partnership with the STOP Obesity Alliance?  I got an e-mail from NEDA saying “The National Eating Disorders Association (NEDA) does not have any ongoing partnership with George Washington University’s program, Strategies to Overcome and Prevent (STOP) Obesity Now Alliance.”  They have removed the STOP Obesity Alliance partnership from their website.  NEDA did the right thing, and they did it with class. They do important, difficult work and I have tremendous respect for them as I stated in the petition. If this is a victory it is a small one,  I’m just happy that we got it done. Huge thanks to everyone involved!  The experience brought up some interesting things for me:

When I started this petition I got plenty of private e-mails saying one of three things:

  • They agreed with me but were afraid to get involved because they feared that NEDA would become upset with them and that it would hurt their careers.

I can understand this.  Fearing for your livelihood is a big deal.

  • Telling me that it was impossible and a waste of time

This group I don’t get.  And I run into these people all the time – people who thank me for my work around fat rights then tell me that we’ll never make progress.  If you don’t want to try to make changes, that’s fine, I’m not trying to tell anybody how to live.  But if you think what I’m trying to do is impossible you can save yourself an e-mail because I don’t care.  My activism started in kindergarten when I was accused my Mrs. Neff of “leading small revolts” because I organized a group of students to protest the fact that we were spending too much time playing and napping and not enough time learning. That started a life of not being scared of power, and not just trying to do things that were possible, but doing things that I think need doing.

I know that we can make change.  Change that seems impossible.  On June 28, 1969 GLBT patrons at the Stonewall Inn fought back against persecution, oppression, and physical abuse that was not just government sanctioned but government sponsored.  A month ago I watched my best friend legally marry his wonderful husband in New York City.  If you are 41 or older that happened within your lifetime.  On August 28, 1963 Martin Luther King Jr. gave the “I have a dream” speech from the steps of the Lincoln Memorial.  On January 20, 2009 this country inaugurated its first African American President.  If you are 46 years old that happened within your lifetime.

We can make change, substantive change, seemingly impossible change and we’ve done it before in less than 50 years.  Things aren’t perfect for the gay community or the African American Community but they are better now than they were 40 years ago and people gave their lives to get that done.  Nobody is obligated to continue their work, but what good are you doing telling people who are already swimming upstream that the change they are working for is impossible? I’m happy to argue about the agenda and the message, but hope is not up for debate.

  • The third group said that what I was doing was “dangerous” and that I should be “careful” to not upset NEDA

I appreciate their concern but somebody has to be willing to stick their neck out.  A couple of days ago I announced that I was taking this blog to a voluntary subscription format and this is exactly why.  I got a bunch of e-mails asking why I didn’t just do ads.  It’s because I don’t want to be supported by corporations,  if I’m going to be supported I want it to be by the people who get value out of my work and feel that it’s worth their support.   The idea is that if you read the blog, if you think that you get $10 a month of value from it, and if you can afford it, you can choose to subscribe.  The subscriptions support the activism work that I do. I don’t have to worry about corporate affiliations holding me back from doing what’s right, the people who are supporting my work are the people whose opinions I actually care about.  This is what allows me to stick my neck out and do things that others think are dangerous.

Like the NEDA thing.  Again, a huge thank you to everyone who signed the petition, passed it along, or helped in any way on this.  People said that it was impossible and we did it. There’s no such thing as false hope.  It’s done, we won, what’s next…

It Gets Better?

I read this article today [Warning:  Triggering in almost every possible way]  A special needs student was repeatedly verbally and physically bullied in school.  Not by students, but by her teacher, Christy Wilt, and her teacher’s aide, Kelly Chaffins.  The girl’s parents hid a tape recorder in her clothes to get tangible proof.  The aide was fired but the teacher signed a statement that said that she “engaged in conduct unbecoming to the teaching profession when she made inappropriate comments to a student with disabilities and allowed a co-worker to make inappropriate comments to a student with disabilities.” She was given probation and has to take an 8 hour class on how to recognize child abuse and bullying.

We MUST do better by these kids. A teacher shouldn’t need an 8 hour class to know that it’s not ok to tell a kid that because she’s fat “No wonder nobody likes you.”  I’m a big fan of the “It Gets Better Project”. People create videos to give hope to GLBT youth who may be dealing with bullying from classmates, teachers, even their parents now, that it will get better.  But can we tell fat kids that it gets better? And if not, what can we do?

Bullying is Bad for Kids’s Health

I think that we need to decide that even if we’re not in agreement about what would be best for kid’s health, we are sure that making them feel bad about themselves isn’t it.  Kids live in their bodies 100% of the time and they don’t separate themselves from their bodies.  If you say “childhood obesity is a problem that needs to be fixed, let’s have a war on childhood obesity” they hear “I am a problem that needs to be fixed, they are fighting a war against me”.  In order to make good choices for physical health, it helps a bunch to be in good mental health and to feel like you are worth taking care of.

Food is Their Friend

Studies show that girls are starting to diet at 8 years old and that they would rather lose an arm, a parent, or get cancer than be fat. According to this report  in the peer-reviewed journal “Pediatrics” hospitalizations for eating disorders among children under 12 years old are up 119% in the last decade.  Research published in the October Archives of Pediatrics & Adolescent Medicine found that twice as many Canadian kids had eating disorders as had type 2 diabetes. I think that we can teach kids about healthy food without terrifying them about becoming fat.

Studies have shown that dieting is a predictor of weight gain, obesity and eating disorders, but not a predictor of weight loss or normal weight in later years. Childhood weight loss programs lead by the Child and Adolescent Trial for Cardiovascular Health and Johns Hopkins University (which were quite similar to the First Lady’s “Let’s Move” Initiative) were spectacular failures at creating thinner kids, but they did create healthier kids which, based on all of the above, might be what we want to focus on.

The End of Dodgeball as We Know It

We need to design physical education programs that give kids a chance to develop a lifelong love of movement and pride in their bodies.  In school we can look at PE with options – you can walk around the track, take yoga, or play basketball for example.  After school we can start fun movement programs and  sports leagues for competitive kids and sport leagues for kids who just want to play around.  We can provide safe places for kids to play, community centers with free, low cost, and sliding scale options.  Everybody giving them the message that the best thing that they can do is find some movement that they love (rather than telling them that they need to punish their bodies with exercise because they’re too fat or might get fat).

Role Models

After a dance competition once a fat little girl came up to me with her dad in tow.  She told me that she didn’t take dance class because her dad told her that she was too fat to dance.  I said that her dad was wrong.  Her dad then apologized and said that she would be starting dance classes on Monday.  That was one of my happiest moments as a dancer.  But I and several of my friends who do talks about Health at Every Size have been invited into schools by a teacher and then had the school cancel because administrators are scared that seeing us be athletic will promote obesity.   Mary Lou Retton is a very popular motivational speaker but nobody’s afraid that she’s promoting shortness. (just to be clear, I’m not IN ANY WAY comparing myself with Mary Lou Retton, just making a point.)

It is foolish to think that we can give fat kids a constant message of “Your body is wrong, you’re lazy, you’re unhealthy, you’re unattractive”, then never let them see anyone who looks like themselves being active, and expect them to believe that health is possible for them.

Let’s keep working until we can say that not only does it get better, but that it IS better.

Fat People Are Not Idiots

It seems that whenever someone brings up the concept of Health at Every Size® or suggests anything other than our current concept of weight-centered health, they are met with the ridiculous:

If we don’t tell people what to eat, they’ll just eat Twinkies all day!

What if they think that getting their oil changed regularly means that they are living a Health at Every Size life?

You can’t tell people to do movement that they enjoy, they’ll think that doing dishes is the same as taking an aerobics class.

This kind of attitude doesn’t do anyone any good.   In the 1850’s William Banting started the first low carb craze, the Grapefruit Diet was introduced in the 1930’s.  In the 40’s and 50’s, the first “ideal” height/weight charts were introduced.  What I’m trying to say here is that we’ve been at this weight loss thing for some time and there are serious, valid questions about efficacy.  If you aren’t sure what the Health at Every Size concept is then ask.  If you have actual questions then let’s have a real dialog, but acting like fat people will not be able to tell the difference between a Twinkie and a Veggie stir fry is not bringing anything to the conversation.

This is a serious conversation for serious people.  Our health is at stake.  If people are confused about what foods to eat, I would ask if the diet culture might be to blame?  Diets that tell people to eat restrictively 6 days a week and binge eat on the 7th. Diets that tell people to eat cabbage soup and only bananas on Tuesday, and cabbage soup and only steak on Wednesday etc.  The cookie diet.  Snackwell’s.  Low fat, low cal.  Low carb, high fat.  Vegan.  Gluten free.  No processed food.  All processed food. It’s incredibly difficult to get true information about health separate from weight loss because people get paid so much to sell weight loss.

We can’t get away from the incessant message that we’re experiencing a panic-worthy rise in the rates of obesity. However in his book The End of the Obesity Epidemic,  Australian scholar Michael Gard points out that obesity rates for people of all ages leveled off or declined all over the world, including in the United States, over the last decade.  He also points out that life expectancy rates have risen in line with obesity rates.  But if you say that to people you get shunned because “Everybody knows that 99% of Americans are going to be obese by next week and we have to treat fat people like they are complete morons because they haven’t become thin.”

And don’t bring up the fact that since 1959 all the data suggests that only 5% of people are physically capable of changing their body size long term and a number of those people are on their first diet.   And don’t mention the research that shows that early dieting attempts predict weight gain, obesity, and eating disorders but do not predict weight loss, because people will accuse you of being unable to ascertain the health benefits of doing dishes versus going on a brisk walk.

The Cooper Institute for Aerobics has been looking at fitness since 1970 and they say “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.”  However studies also show that working out doesn’t lead to weight loss and so I have seen articles in major news media outlets suggest that we skip physical activity, even though it is proven to make us healthier, because it’s not likely to make us thinner. What are we doing?

Instead of acting like anything other than a weight-centered health paradigm will lead to massive Twinkie eating cults of doom, can we all agree that our goal is for people to have access to everything that they need (information, foods, safe movement options that they enjoy) to make choices about their health; and then can we have an evidence–based conversation about what that means and how to get the information out?  That would be great and I hope to be at the table for that talk. In the meantime would suggest Ellen Satter’s work as a great place to start.

 

Exercise of the Day: Common Sense

There’s a lot of confusion about Size Acceptance, Health at Every Size® (HAES), and those of us who promote one or both. Here is my understanding:

What Size Acceptance Says

Size Acceptance says that body size should not be used as a barometer for a person’s value.  It states that people’s body size is their business and that it’s nobody’s job, and is in fact inappropriate, to judge people or discriminate against them based on size. It’s not a health practice, it’s a civil rights/anti-discrimination movement.

What Health at Every Size Says

Health at Every Size says that weight shouldn’t be used as a proxy for health, and that weight loss shouldn’t be used as a proxy for healthy behaviors.  HAES acknowledges the fact that health is multi-dimensional, and includes not just our current and future behaviors, but also the effects of past behaviors as well as genetics, access, and stress.  So HAES says that healthy habits offer us the best opportunity for the optimal amount of health that is possible for us in the body we have and the situation that we are in; and that health problems should be treated with health interventions and not body size interventions.

What Nobody Says

Nobody in either movement is suggesting that not taking care of your body is a likely path to health.

Nobody in either movement is suggesting that it’s ok to bash thin people (and if there are, those people are hypocritical idiots.)

Nobody is saying that being fat is inherently healthy or unhealthy.  The point is that there are healthy fat people, there are unhealthy thin people, and everyone who wants to be healthy or healthier would benefit from healthy habits which may or may not lead to weight loss.

Of all the crazy hate mail and death threats I receive, the only thing that ever really upsets me is when someone says that I’m a bad role model.  It’s upsetting because it means that in these people’s eyes, despite reaching a level of fitness that very few people ever reach, and having worked very, very hard to have success in my sport and life, I do not deserve to be seen in a positive light because those things have not made me thin. The most ridiculous of these arguments being that showing a fat person practicing healthy habits promotes obesity.  I covered that in some detail here. I disagree, I get a tremendous amount of inspiration from seeing other fat people being athletic so if I can give that to someone else I’m going to do it.

But having this attitude means that these people think that fat kids and fat adults should never see anyone who looks like them shown in a positive light, and should never feel good about themselves, even for a minute, until they are thin.  It means that there are people who believe that fat people should experience a ceaseless stream of societal stigma and self -hatred until we get thin (which 95% of us are statistically unlikely to ever do)

It’s antithetical.  People don’t take good care of things that they hate. The message that we are getting is “your body is unhealthy, unattractive, and a problem that needs to be fixed, now go take good care of it”.  You can either promote healthy habits or you can promote body hate but you can’t do both and make sense.

Here’s how the typical discussion goes:

Weight loss proponents:  You need to lose weight!

Me:  How should I do that?

W:  Eat well and exercise.

M:  I’ve done that for a long time and it doesn’t make me thin. Now what?

W:  Um, do it better.

M:  What?  I told you, I’m practicing healthy habits.

W:  Are you just lying about your habits?

M:  No, and I’m healthy.

W:  You’re going to get sick if you don’t lose weight!

M:  Ok, what should I do?

W:  Practice healthy habits!

M:  Again, doing that already, still fat.

W:  … … .. … um, You have to lose weight!

M:  AAAARRRRRRGGGGGGHHHHH!

Promoting obesity isn’t real, but promoting thinness is, and it’s dangerous.  It is incredibly irresponsible to send the message that healthy habits don’t matter unless they make you thin. When people don’t get thin from the habits (as 95% of them won’t) then you’ve told them that there is no reason to keep up those habits and that’s incorrect, and dangerous, and will lead to the exact opposite of what you want to promote.

We’ve got to get together on this – healthy habits are our best chance for a healthy body no matter how fat or thin we are.  Telling fat people that their bodies are wrong, that you can tell that they are unhealthy by looking at them, that healthy habits won’t make them healthy unless they also make them thin, and making sure that they never see someone who looks like them being active and practicing healthy habits WILL NEVER HELP.  The first thing that we need to exercise here is some some common sense.

A Real Fat Intervention

The stress from constant stigma heaped upon us by society is correlated to the same diseases that obesity it.  So for our best chance at health, in addition to eating well and moving our bodies, we must also find a way to counteract the 386,170 negative messages that we are getting about our bodies each year.

I thought I would make some suggestions for ways to do just that.  Remember, it’s not just fun, it’s for our health!  (Thanks to reader Rebecca for the suggestion. Fyi, I’m not paid for any of the things I mention below, I just like them bunches.)

Put it in Perspective

They can’t stop telling us that 60% of us are fat  It that’s true then we’re the majority.  So there are a whole bunch of people working fat, dating fat, playing sports fat, kissing fat, driving fat, doing dishes fat, having sex fat, shopping fat etc.  There’s nothing wrong with your body and people of your size are already doing whatever you want to do so just do it!

Seek out pictures of people who look like you.

Again, we get completely bombarded with images that aren’t even representative of the people in the pictures let alone of us.  I have a friend who was a bikini model who looked at a magazine and thought that they gave her bikini to someone else.  One of her friends had to tell her that the picture was of her – she didn’t even recognize herself because of the photoshopping!  With a little bit of effort you can look at amazing, beautiful people who look like you every day.

Flickr Athletes of Every Size Photo Group

The Adipositivity Project (NSFW unless your W is super cool)

Corvetta Curves Photo Pages  (Again with the NSFW)

When you listen to songs, or read books picture them being about fat people

Since we don’t really see ourselves represented very much in television or movies, it can be easy to picture everyone else in the world being thin. If you’re one of those people who picture song lyrics, picture the people fat.  I’m pretty sure that Eric Clapton’s Layla was fat.   Delilah from the Plain White T’s song – fatty.  Jessie’s Girl shopped at Lane Bryant. You get the idea, same thing with books that you read, picture main characters fat.

Surround Yourself with Art that Makes You Feel Good About Yourself

There’s a fantastic list of fat positive art and artists here (I love it when someone’s already done the research!)

Leonard Nimoy did an AMAZING group of photographs called The Full Body Project.

I have personally bought a bunch of stuff from VoluptuArt  I just love having cute dancing fat girls all over my house.

My best friend got me the most amazing fat figurines, one is lounging in a bathing suit and one is lifting weights and they make me happy every day.

Get Involved on the Fatosphere

Check out the Blogs I Love page to get you started.

I read a ton of blogs every day and it’s time well spent earning the Sanity Watchers Points that I so desperately need to deal with the rest of the world!

Go Back To Basics

Read Linda Bacon’s Book – Health at Every Size, The Surprising Truth About Your Weight

Read Marilyn Wann’s Book – Fat!So?

Movement for us by Us

Heavyweight Yoga by Abby Lentz

Curvy Yoga by Anna Guest-Jelley

The Fat Chick Works Out by Jeanette DePatie

Get Involved with Activism

Not only can we create change, but we are already doing it.  The more time you spend on the blogosphere, the more likely you are to have chances to get involved with campaigns, petitions, fundraising etc. I believe that we can make change and I think that it’s more possible when more of us are involved.  If you’re looking for a way to get involved may I suggest signing the petition to ask the National Eating Disorders Association to end its ties with an organization funded by pharmaceutical companies that seeks to get obesity treated as a disease.  We’ve surpassed our original goal of 500, let’s see if we can get 1,000.  Some people posted their reasons for signing, some of my favorite are:

Just like body & scale obsession is unhealthy regardless of size, healthy behaviors are important at any size.  Focusing on my weight, rather than my actual health & my abilities, puts the priority on the wrong end.  This can lead to some very unhealthy behaviors, which I would think an organization like NEDA would already be aware of.  Don’t encourage the stigmatization of fat people by the very messages you fight against for the skinny people.

I am an eating disorder survivor, and I survived because I finally found a way to focus on my health and not my weight.  The perpetuation of the idea that weight is an indicator of health only feeds eating disorders.  Please stop the myth.

I am a fat person. I am also a person who is recovering from eating disorders. My journey to recovery was delayed for many years, my disordered and destructive behaviors were even encouraged encouraged, because I did not meet weight and BMI based diagnostic criteria for Anorexia, which later developed into Bulimia before I was able to obtain treatment.

Gang Up

So far, on my world tour stops, I’ve been doing a Fatty Meet-up and it has been amazing to be around people who are like minded and having amazing conversations about Health at Every Size and everything else.  If you can’t find them in person, find them online but find a group of people who support you with your goals.

I think there’s a reason that “happy and healthy” are so often uttered in the same breath but we don’t hear “miserable and healthy” very often at all.  If we want happiness then let’s go after it!

Obesity and Health Care Costs

Last year the Congressional Budget Office (CBO) released a report about the rising costs in health care, including the reasons. Media headline’s based on this report included “CBO – Obesity will Decimate Future Health Costs and Care” and “Obesity’s Punch to the Gut”.

You know, sometimes I feel like a tinfoil hat conspiracy theorist, but I’m pretty sure it’s not me –  The CBO report stated clearly that obesity was NOT a major cause for rising healthcare costs. So what in fat hell happened here?

CBO- Obesity will decimate future health costs and care

This article included a quote from the CBO report: “per capita spending on health care for adults would rise by 65 percent—from $4,550 in 2007 to $7,500 in 2020.”

The quote is accurate, but they cut off the last part of the quote which reverses the meaning.  The actual CBO report says:  ” per capita spending on health care for adults would rise by 65 percent – from $4,550 in 2007 to $7500 in 2020largely as a result of the continuation of underlying trends in health care that have led to rapidly increasing spending for all adults regardless of weight.” (emphasis mine) I have a hard time believing that this was accidental as that would require me to defend the idea that a professional journalist cannot tell when a sentence ends.

“Obesity’s Punch to the Gut”

The Boston Globe ran this headline and also used numbers from the report that seemed large out of context to paint a picture of obesity as the culprit for healthcare costs, thereby grossly misrepresenting the conclusions of the report.  It almost seems like they had decided what it the article was going to say before they read the report. Maybe they just didn’t want to give up this witty, witty headline. (sarcasm meter 10 out of 10)

McKinsey Global Institute (MGI) published a report called  “Accounting for the Cost of Health Care in the United States,”  Using a comparative analysis of the US with Germany, Japan, Italy, Spain, France, and the United Kingdom they found, among other things, that Americans are indeed fatter, but that we are not significantly sicker. We do spend a lot of health care ” $650 billion above expected, even when adjusting for the relative wealth of the US economy.”  So, was obesity the culprit?

Can we attribute this additional spending to the fact that the US population is less healthy overall than people in other developed countries?  Our analysis suggests that the answer is largely no. In fact, disease prevalence in the United States is slightly lower than in peer OECD countries despite an increase in the burden of chronic disease and growth in risk factors such as obesity.

Adam Carroll put information from that report into a very illustrative graph (obesity -which is not a disease- and diseases correlated with obesity are included in the blue section).

Also let’s remember that “costs of obesity” are not the same as costs of obesity hysteria and that many of the costs of diets are included in this figure, but that’s a topic for another blog.

If you are interested in where our healthcare spending goes, I highly recommend reading the report.  For now, remember that we know that no weight loss intervention ever studied has been proven to effectively get obese people into the “normal” BMI range longterm, we now know that getting them into the normal BMI range isn’t going to have a discernible impact on healthcare costs because fat people aren’t having a discernible impact on healthcare costs.  We know that obesity isn’t the reason for the huge rise in healthcare costs, we cannot even find a causal relationship between health and weight despite a mountain of attempts, and many studies tell us that healthy habits create similar health outcomes in bodies of a wide variety of sizes.

Yet outlets that call themselves “news” continue to lie to us saying that diets work if you try hard enough, that obesity is causing an insurmountable rise in healthcare costs, that we have to get people to lose weight or we’re all going to go broke paying for their healthcare, and that extra weight causes health problems.  Is it because they are getting ad dollars from people selling weight loss? Is it because people like to read about how fat people are the cause of all the world’s problems? Do they really believe what they write?  Are they substituting everybody knows” for actual facts? Are professional journalists really incapable of discerning between the middle and end of a sentence? I don’t know and that’s not what’s most important to me right now.

What’s important to me is that we can choose to stop buying these lies wholesale. We can stop shopping for our information at Merde Mart right now.  We are responsible for verifying our news. Often is doesn’t even take a huge effort, these lies are debunked by a simple reading of the CBO report.  We also need to consider that other people are being lied to and buying the lies.  This may include doctors, teachers, healthcare providers, your mother, and plenty of people who comment on this blog.  We are responsible for making sure that we get good information and unfortunately, that is not always simple or quick. We live in a 24 hour news cycle that produces some highly suspect news. I suggest that you verify your information because, whether accidentally or on purpose, the media is lying to us.

Join the Club…Support the work!

I do HAES and SA activism, speaking and writing full time, and I don’t believe in putting corporate ads on my blog and making my readers a commodity. So if you find value in my work, want to support it, and you can afford it, please consider a paid subscription (it’s like a fan club, you get bonus stuff, discounts, and you’re always the first to know about projects) or a one-time contribution.  The regular e-mail subscription (available at the top right hand side of this page) is still completely free. If you’re curious about this, you might want to check out this post.  Thanks for reading! ~Ragen

HAES When You’re Sick

I recently saw this question posed in an online forum.

I got the results back from my blood panel and aside from the high blood pressure, I also have high cholesterol.

I’ve sort of known this was coming for a while now. I have a family history of high cholesterol, hypertension and heart disease.

So my question is, what the hell do I do now? Is HAES irrelevant for me now? Is there a HAES approach to lowering cholesterol? It makes me wonder if HAES is best for maintaining health, rather than treating specific metabolic disorders, like high cholesterol or diabetes. Thoughts?

This is a really interesting question.  Before I get into it let me be clear that I’m not a doctor or nutritionist.  I’m just a girl with a blog and I encourage people to find practitioners they like and trust. I’m not trying to give any kind of medical advice here, but I do want to give my thoughts.

The first question I always ask when someone blames a medical issue on my weight is “Do thin people get this thing?” The answer is always “yes” so my next question is then “How do you treat it in thin people?” I want to try that before I try a risky prescription that has a 95% failure rate (which is exactly what dieting is).

Based on all the research I’ve seen the relationship between weight and health problems is correlational, not causational.  Therefore fat isn’t  proven to cause disease and weight loss isn’t shown to cure it. Health is multi-dimensional and includes behaviors, access, environment, stress and genetics. We can only control some of these and so my understanding of the Health at Every Size® (HAES) approach is that healthy behaviors, while they don’t guarantee health, are our best chance.

If you have a disease and it is to be managed, my understanding is that it’s managed through behaviors as well. And it seems to me that the recommended behaviors should be the same regardless of the size of the person with the disease. Even if weight loss weren’t statistically impossible for the vast majority of people, if thin people and fat people both get a disease, then being thin is neither a cure nor a preventative.

To me, following food recommendations to manage a health condition is at the very core of a Health at Every Size practice. You eat in ways that nurture you. Eating to manage a disease and eating to make your body smaller are two different things for me, and so eating to manage a health situation would fall well within my HAES practice, while trying to lose weight to manage a health situation would not.

I also think that we have to be careful of the information that is out there. In recent years what was considered “healthy” blood pressure has been lowered several times with the help of the pharmaceutical industry and “healthy” blood glucose levels have also been lowered.   John Hopkins-led research found that “High cholesterol levels in middle age do not appear to increase women’s risk of developing Alzheimer’s disease and other forms of dementia later in life, despite a body of scientific evidence long suggesting a link between the two.”  (See what I mean about correlation and causation…)  That article suggests that you should still worry about high cholesterol because of heart disease, but that has been questioned as well.

Also, it has been my observation that people test extreme diets to mitigate and manage disease, but do NOT test moderate ones. Recently, a study looked at reversing type 2 diabetes with a 600-calories-per-day liquid diet.  I wonder what would have happened if they had done things like eat regular small meals through the day and eat more whole grains? People seem to want to discover a “Break Through!” solution, not just “eat a little differently and move your body.”

In the end I think that we all have to decide for ourselves if, and how, we will use HAES to support us, and what health really means.

UPDATE! 

In our petition asking the National Eating Disorder Association to end is partnership with the STOP Obesity Alliance (an organization funded by pharmaceutical companies trying to get obesity declared a disease so that insurance will cover their products), we are at 567 signatures!  We’ve passed our original goal because you are awesome!!!!!  Now let’s blow the goal out of the water  –  please keep signing, passing it on and reminding people.  We cannot allow people to be declaring physically or mentally ill based on a ratio of their height and weight no matter how many pharmaceuticals it might sell or how many insurance reimbursements it might force.

Ask a stupid question…

I was thinking today of some of the absolutely stupid things that people say to us fatties.  Again, although this isn’t our mistake it becomes our problem.  In that spirit I offer some things to say when people say dumb things:

You have such a pretty face.

  • Sure, but wait until you see my fine, fine ass.
  • Thanks, it matches my beautiful body

Do you need to eat that?

  • I thought that you were an accountant, are you also a dietitian?
  • Yes, because dealing with your rudeness is depleting my glycogen stores at an alarming rate
  • If I want to talk to the food police, I’ll call 911
  • Thanks for trying to give me your insecurities, but I was really hoping to get a Wii for Christmas this year
  • No, but using my fork to eat helps to keep me from stabbing you with it

What are you doing about your weight?

  • Moving it through space with grace, power, and joy
  • Dressing it in fabulous clothes and taking it out on the town
  • My weight is fine, what are you doing about your rudeness?

Don’t you know that being fat is unhealthy?

  • Don’t you know the difference between correlation and causation?
  • Don’t you know what is and is not your business?
  • Show me your evidence or shut up.
  • No, I don’t and you don’t either.  It looks like you need to do some research.

This Health at Every Size® stuff is just fat people justifying people being fat.

  • My fat body is amazing and requires no justification. Your rudeness on the other hand is inexcusable.
  • Health at Every Size says that healthy habits are the best chance for a healthy body.  Are you suggesting that we should tell people to practice unhealthy habits?
  • It sounds like you are just trying to justify your fat bashing.

But [I, my sister, my friend etc.] lost weight and they are healthier that they were.

  • Did they change their behaviors to lose weight?  Then is it possible that the weight loss and the better health are both side effects of the behavior?
  • That’s fine for [him/her] but everyone does not have to choose the same path.
  • I’m happy for [him/her] but with only 5% of people able to maintain weight loss with no guarantee that it will improve their health, and the rest becoming less healthy with each new attempt, I still think that weight loss is too a dangerous choice for me.

People on Dancing with the Stars lose weight , why don’t you? (It’s possible that this one just happens to me)

  • People are able to appropriately interact with strangers, why can’t you?
  • People on Dancing with the Stars appear on television half dressed to detract from poor technique.  I don’t need to do that either.

All you have to do is eat less and exercise more and you’ll lose weight.

  • Right, and all you have to do is click your heels together and say “there’s no place like home” and you’ll be there.
  • Sorry, but that’s not what the evidence says.  Unless you have some proof you’d like to show me we’re done with this discussion.
  • All I have to do is eat healthy and do movement I enjoy and I’ll give myself my best chance for health and that’s much better than a 5% chance at being smaller than I am now.

You’re pretty for a fat girl.

  • I’m pretty for any girl.
  • That’s weird, I was just thinking that you are attractive for a rude person!

You’re not fat! (As in, like those other stereotypical fat people)

  • I am absolutely fat, and there’s nothing wrong with that.  The problem happens when people decide that from looking at our bodies they know what we eat, how much we exercise, how healthy we are, etc.
  • You know, when you say that I’m not fat, when I obviously am, it makes it sound like you think there’s something wrong with the body that I live in all the time, there isn’t.

We can’t have you as a speaker because your lifestyle is obviously leading you to an unhealthy body and we don’t think you make a good example for our staff.  (again, this one might just happen to me)

  • Fuck you.  (Ok, that’s not really one I recommend)
  • Studies show that all it takes to get people to try something previously thought impossible is that one person does it. When I show up as a fat athlete, it lets other fat people know that athleticism may be possible for them to.  That’s important since they get the constant message that they are lazy, unathletic and that they are bad examples no matter what they accomplish.
  • You’ve had other successful athletes as speakers.  It’s interesting that you are comfortable ignoring all of my accomplishments because you can’t set aside your prejudice that I did those things in this body.

Are you being bullied about your weight?  Then do something about it.

  • The solution to social stigma is not weight loss.  It’s ending social stigma.

You can’t tell me that you’re comfortable if you’re fat.

  • You can’t tell me whether or not I’m comfortable since you’re not, you know, me.
  • I can and I am telling you that, despite your best efforts to make me uncomfortable, I am very comfortable being fat.

Selective Reality

On Facebook a woman named Misty responded to my post about Whole Foods horrible benefits by BMI program with the following (spelling and punctuation are copied verbatim):

“Bigger people do have more health issues. If they didnt docs wouldnt stress the importance of being thin. And michelle obama wouldnt be campaigning tn end obesiety.”

This perfectly frames the problem with our conflation of weight and health, and demonstrates the reason for the frustration that those of us who are actually looking at the research and drawing informed conclusions experience.

I can only imagine that this woman is insisting on bloodletting to cure her throat infections, taking thalidomide to cure her morning sickness, using the bumps her head to determine if she is a future criminal, and being treated as mentally ill for being a female who speaks her mind. Doctors have made all kinds of mistakes over time, however well-meaning, and it’s important that we realize that.

I like Michelle Obama, but I don’t think that she is infallible.  I believe that she was well intentioned but dead wrong when she chose to focus on children’s weight instead of on their health.  And I think she knows it.  She seems to have been making a concerted effort lately to talk about health instead of weight.  I appreciate that, it’s a step in the right direction.

But I wish that she would stand in front of the same press to which she called obese children a “problem” that “needs to be fixed”, and tell them that she made a mistake. I wish that she would say “In addition to teaching our kids how to be healthy, I think it’s important to teach them that when you’re wrong you admit it and change course. When I suggested a war on childhood obesity I did what I thought was right, based on the best evidence that I had at the time.  But I have since learned that focusing on their weight poses dangers to children of all sizes including increased risk of eating disorders, body dysmorphia, self-esteem issues, and bullying.  I’ve also learned that BMI is not a useful measurement of health and can cause confusion and harmful misunderstandings.  Our children are precious and they deserve our best efforts to support their physical and mental health.  So moving forward I am removing weight and BMI from the discussion of children’s health.  We are going to focus on providing education, access to healthy foods, and helping our kids develop a lifelong love of movement. And we are going to do it in ways that support kid’s self-esteem and mental health. “

That would be brave.  It would be noble, it would show integrity, and it would help our Facebook friend and people like her understand that First Ladies and doctors are fallible.  (If you are reading this from the White House and want to hire me as a  speech writer I can be contacted at ragen at danceswithfat dot org.  Just sayin’)

I know  that “reality” is a fluid concept.  (The Earth revolves around the sun and is round. Antibiotics are more effective than bloodletting for strep throat. We’re pretty sure that the heart, not the liver,  is what moves blood around the body.).  Therefore, I am extremely selective about the “reality” that I choose to accept and the “reality” that I choose to change.

What I hope fat people remember is that whether people are making the mistake of confusing weight and health because they are well intentioned or because it’s incredibly profitable for them, it’s still a mistake; and even if a million people are screaming a myth at the top of their lungs that doesn’t make it the truth, no matter how powerful or credentialed they might be.

Our weight is not a barometer for anything  – not for our health, value, intelligence, abilities, or anything else. From looking at our size, people can determine our size, and what their prejudices and preconceived notions about people of our size are.  Anything else they think they know is just them making stuff up in their heads based on those prejudices and preconceived notions.  That’s not our fault, though it does become our problem.  There are many ways to deal with this problem ranging from acquiescence to activism, at those are discussions for future blogs.  Regardless of how we deal with the problem it is imperative that we remember that the mistake theirs.

Speaking of activism, the petition asking the National Eating Disorders Association to end their partnership with the STOP Obesity Alliance now has 403 signatures, almost to our goal of 500.  You guys rock so hard! Thanks to everyone who has signed it and passed it along so far!