All the Fun, Way Fewer Pants to Wash

I was talking to my new friend Dawn and she mentioned that the commercials for Meridia diet pills are what actually got her into Size Acceptance, because they were fat women with great clothes who looked like they were happy and having fun.  I laughed and said that was fantastic because the side effects of Meridia are …unpleasant… so the commercials helped her get all of the confidence with none of the anal leakage. It turns out that she skipped a lot more than that.

First of all,  I was wrong, extra laundry of the pants and panties variety is not a side effect of Meridia.  But these are (feel free to skim, it’s a long list):

dry mouth, increased appetite, nausea, strange taste in the mouth, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, or joint/muscle pain, fast/pounding/irregular heartbeat, numbness/tingling of the hands or feet, mental/mood changes (e.g., excitement, restlessness, confusion, depression, rare thoughts of suicide), change in the amount or color of urine, easy or unusual bruising/bleeding, black stools, vomit that looks like coffee grounds, yellowing eyes or skin, unexplained fever, shaking, unusual sweating, swelling of the arms/legs, seizures, chest pain, weakness on one side of the body, vision changes, trouble breathing. serotonin syndrome (for which there are class action lawsuits).

alli is the diet pill I was thinking of – the one that literally recommends wearing dark pants.   Side effects may include (feel free to skim, it’s a gross list):

back pain, sinus infection, soft stool, abdominal pain, fecal urgency, gas with a small amount of oil or stool, uncontrolled anal seepage, fatty or oily stool, spontaneous bowel movements, kidney stones, severe stomach pain, life-threatening liver damage (for which there are class action lawsuits)

I know that it’s just a homophone but fecal urgency is pretty far away from being an ally by my definition. And boy, to take on these risks a person might assume that  these must be some really damn effective treatments. How much weight can you lose? In studies Meridia helped people lose an additional 4.5 pounds a year.  Alli is expected to help people lose an additional 4 pounds a year (and it sounds like a fair amount of that leaks out).  If we pretend that I won’t gain the weight back, I’ll be in the healthy BMI category in just 35 short years. So for my 70th birthday  I can finally like myself, buy a bikini, and start dating.

No wait, screw a bunch of that.  I already like myself, I’m dating, and I’m not carrying around an extra pair of pants, or waiting on the liver transplant list.  Look, people are allowed to take diet pills if they want, but can we please not pretend that they are “medicine” that treats a “disease”.  Body size is not a diagnosis, and nobody is suffering from a Meridia deficiency or dangerously low alli levels in their blood.  These are for profit companies who are selling us drugs with horrible side effects and very little upside at a HUGE profit. The company that makes Meridia had over 25 Billion dollars in revenue in 2010.

One of the many massive problems with using weight as a proxy for health is that we then assume that weight loss behaviors are healthy behaviors, or that even if we use unhealthy behaviors to become thin it doesn’t matter because we’ll be healthier when we are lighter.  But that’s just not true. And for me, taking pills with life threatening side effects just to be four pounds smaller at the end of the year takes the fly-over past unhealthy behaviorsville and goes straight to what-the-hell-am-I-thinking town?

Instead of a New Year’s Resolution, I’m having a New Year’s Revelation this year.  I realized that in the past when I was trapped in weight cycling, my resolutions always involved being less and giving up:  weighing less, eating less, giving up soda, giving up sugar, no desserts.  Once I started working with Health at Every Size my resolutions became much more about adding and doing things: drink more water, eat more vegetables, find more movement that I enjoy.  My life is mostly an additive process now – being more instead of being less –  and I like it. Happy New Year!

This blog is supported by its readers rather than corporate ads.  If you feel that you get value out of the blog, can afford it, and want to support my work and activism, please consider a paid subscription or a one-time contribution.  The regular e-mail subscription (available at the top right hand side of this page) is still completely free.   Thanks for reading! ~Ragen

The Most Overlooked Aspect of Health

Me – 5’4, 284 pounds.  Suspended pull-ups courtesy of the coaching of Kate Wodash Catlow at The Mindful Body Center in Austin, Texas. For extra fun the thing my feet are on is suspended by springs so you have to hold the body up with the core or very bad things happen.

I think that strength training may be the absolute most under-recommended part of health for people of size. I was at the front desk at a friend’s gym and beside me was a fat person having his first session with a personal trainer. They were talking about goals and he said “I just want to be in better shape – lift some weight, be stronger.”  The trainer replied “We’re going to focus only on cardio to get some of that weight off. We don’t want to bulk you up or put more weight on you.”  I almost bit through my tongue.

This is a huge mistake for every reason imaginable.  I would feel differently if the client said that he hated strength training or that his goal was something different but he was asking a professional and he got horrible advice. Far too often we blame mobility issues on being overweight when really it’s just as likely that we simply are under-strong – that we don’t have the strength to move our weight around.  People always ask me how I can move like I do at my size – obviously it’s not that the rules of physics don’t apply to me, there’s a bunch of dance training, there are my genetics, and there’s the fact that I’m strong enough to move my body around.  My ability to put on muscle is tied in to my genetics so your mileage may vary, of course, but there’s a far better chance of something getting strong long term than of that person losing weight.

The idea that people should do cardio at first to get weight off would be stupid, even if weight loss was possible for the vast majority of people, since additional muscle mass in theory raises basal metabolic rate and doing only cardio causes you to lose lean muscle mass as well as fat. The truth is that most people will never be able to achieve long term weight loss.  If you have a 400 pound object and your dolly will only hold 200 pounds without breaking, you don’t try to make the object lighter – you get a stronger dolly.  Considering the realities of weight loss it is super extra ridiculous for a personal trainer to purposefully not add strength to facilitate mobility in a larger body.

Similarly the idea of not wanting to “add weight” to the body with strength training seems to be based on the concept that smaller is always better if you’re fat, which is just modern mythology. I believe that fitness programs should be based around the client’s actual goals.  If you want to compete as an Olympic weightlifter your training program should be very different than if your goal is to be able to pick up your grandkid. Programs designed to just make people smaller are almost guaranteed to fail, and when they do, those clients won’t be any closer to any functional life goal. Also, strength training can be really good for people who don’t enjoy more cardiovascular-centered workouts, and weight training programs can be designed to create a cardio benefit without being anything like running or being on the elliptical or whatever.

For me being strong is about more than functionality too.  I like how I feel about myself when I’m strong.  I feel like I can trust my body and I feel more prepared to take on whatever might happen, I walk through the world differently when I feel strong.  I remember when Darryl first asked me to climb the Santa Monica Stairs for the film and though they looked daunting, I didn’t hesitate because I knew that my strength would allow me to do it.  Of course it’s not like that for everyone and I’m not saying that it should be, just suggesting that if you’ve never tried strength training you might give it a shot and see how you feel.

To be clear, strength is not an “if one person can do it anybody can” situation.  People’s genetics are different – some are built with the ability to put on more muscle, or more of certain types of muscle than others (most women do not have the genetics to become “bulky”).  And I’m not saying that my love of strength training overrides the studies that show that 30 minutes of movement a day gives you amazing health benefits.

The point that I’m trying to make is that if you are struggling with mobility, or with body confidence, and you feel like you would move better, or like your body more if you were lighter, then based on both science and hearsay you might consider putting some energy towards being stronger.

This blog is supported by its readers rather than corporate ads.  If you feel that you get value out of the blog, can afford it, and want to support my work and activism, please consider a paid subscription or a one-time contribution.  The regular e-mail subscription (available at the top right hand side of this page) is still completely free.   Thanks for reading! ~Ragen

Even Though It Doesn’t Make Any Sense

The New York Times ran an article by Tara Parker Pope called The Fat Trap.  In it she had some very interesting information that you don’t always hear in the mainstream about how unlikely permanent weight loss is, including new research   It’s an eight page article, but here are some of the highlights:

While researchers have known for decades that the body undergoes various metabolic and hormonal changes while it’s losing weight, the Australian team detected something new. A full year after significant weight loss, these men and women remained in what could be described as a biologically altered state.

For years, the advice to the overweight and obese has been that we simply need to eat less and exercise more. While there is truth to this guidance, it fails to take into account that the human body continues to fight against weight loss long after dieting has stopped. This translates into a sobering reality: once we become fat, most of us, despite our best efforts, will probably stay fat.

Amen sister, you hit the hammer on the nail with that one.  Then she shares her own struggles with weight cycling and discusses several studies which have suggested that the tendency to gain weight is hereditary.  She talks about how fat loss appears to change muscle fibers, causing them to burn less calories, about how after people lose 10% of their body weight they are metabolically different than those who started at that size, how weight loss changes the way that the brain responds to food.   She discusses how difficult it is to maintain weight loss:

Kelly Brownell, director of the Rudd Center for Food Policy and Obesity at Yale University, says that while the 10,000 people tracked in the [Weight Loss] registry are a useful resource, they also represent a tiny percentage of the tens of millions of people who have tried unsuccessfully to lose weight. “All it means is that there are rare individuals who do manage to keep it off,” Brownell says. “You find these people are incredibly vigilant about maintaining their weight. Years later they are paying attention to every calorie, spending an hour a day on exercise. They never don’t think about their weight.”

While I was excited about the article, each time I turned the page I braced myself for it.  The “even though it doesn’t make any sense” section.  This is the section at the end of almost any article that shows fat people in a positive light, or dieting in a negative light, where they basically negate everything they’ve just said.  It’s why a news interview with Darryl Roberts and I talking about healthy habits ends with a picture of someone stuffing their face with cake and a voice over that says “of course, common sense should tell you that this is a bad idea.”  In this article, the transition to this section is stark:

Nobody wants to be fat. In most modern cultures, even if you are healthy — in my case, my cholesterol and blood pressure are low and I have an extraordinarily healthy heart — to be fat is to be perceived as weak-willed and lazy. It’s also just embarrassing. Once, at a party, I met a well-respected writer who knew my work as a health writer. “You’re not at all what I expected,” she said, eyes widening. The man I was dating, perhaps trying to help, finished the thought. “You thought she’d be thinner, right?” he said. I wanted to disappear, but the woman was gracious. “No,” she said, casting a glare at the man and reaching to warmly shake my hand. “I thought you’d be older.”

I wish fat people would stop being embarrassed by other people’s poor behavior.  If it were me I would be embarrassed FOR my date, not by him. If this kind of thing happens to you, I suggest a phrase like:  “I’m sure you’re embarrassed to have said something so stupid, don’t worry about it for now  we’ll talk about it later.” Or you can say (in your head if necessary) “That’s not mine, you can keep it”, but you don’t need to be embarrassed because other people behave like idiots. The cure for social stigma is not weight loss – it’s curing social stigma.  Next she says:

If anything, the emerging science of weight loss teaches us that perhaps we should rethink our biases about people who are overweight. It is true that people who are overweight, including myself, get that way because they eat too many calories relative to what their bodies need. But a number of biological and genetic factors can play a role in determining exactly how much food is too much for any given individual. Clearly, weight loss is an intense struggle, one in which we are not fighting simply hunger or cravings for sweets, but our own bodies.

This paragraph is a little from column A, a little from column shit. Hell yes we should rethink our biases about fat people. but not because of the science.  It doesn’t matter why people are fat, or whether or not they could be thin.  Every body of every size deserves respect.  If you’re wondering why someone is fat you can feel free to file that away in the None of your Damn Business folder while treating them with basic human respect.  And here’s the paragraph that made me swear at my computer:

But with a third of the U.S. adult population classified as obese, nobody is saying people who already are very overweight should give up on weight loss.

Oh what in fat hell?!  You just spent 7 damn pages talking about how unlikely weight loss is – citing a variety of experts, how the weight loss registry shows that 10,000 out of tens of millions keep weight off and they do it by obsessing about their weight (and it stands to reason that there are some people who obsess about their weight and STILL can’t keep it off).  And even if you’re not, lots of people are saying that we should give up on weight loss, they include medical doctors, Ph.d’s, and people who can do math. There are lots of reasons to choose Health at Every Size – here are 10 of them and  here are 11 more.

She concludes by saying:

Even though all the evidence suggests that it’s going to be very, very difficult for me to reduce my weight permanently, I’m surprisingly optimistic. I may not be ready to fight this battle this month or even this year. But at least I know what I’m up against.

Let’s look at quotes from some of the people in Tara’s own article who “successfully” maintain weight loss:

  • “It’s something that has to be focused on every minute. I’m not always thinking about food, but I am always aware of food.”
  • Since October 2006 she has weighed herself every morning and recorded the result in a weight diary. She even carries a scale with her when she travels.  She also weighs everything in the kitchen.  If she goes out to dinner, she conducts a Web search first to look at the menu and calculate calories to help her decide what to order. She avoids anything with sugar or white flour, which she calls her “gateway drugs” for cravings and overeating. She has also found that drinking copious amounts of water seems to help; she carries a 20-ounce water bottle and fills it five times a day. She writes down everything she eats. At night, she transfers all the information to an electronic record.
  • Because she knows errors can creep in, either because a rainy day cuts exercise short or a mismeasured snack portion adds hidden calories, she allows herself only 1,800 daily calories of food. (The average estimate for a similarly active woman of her age and size is about 2,300 calories.)
  • Today, she’s a member of the National Weight Control Registry and maintains about 140 pounds by devoting her life to weight maintenance. She became a vegetarian, writes down what she eats every day, exercises at least five days a week and blogs about the challenges of weight maintenance. She has also come to accept that she can never stop being “hypervigilant” about what she eats.

Tara is allowed to choose weight loss and be optimistic about it – just like I’m allowed to choose to focus on health and be optimistic.  I’m just wondering how, as a society, we got to a place where living with a food obsession that shares many characteristics with an eating disorder seems like the best idea.  Especially when we know that exercise mitigates the risks associated with being fat, without “dedicating your life” to maintaining a weight.

Also, it is too much to ask for more balanced reporting? If we have to have the “even though it doesn’t make any sense…” paragraph section at the end of any article that talks about the mountain of scientific evidence against weight loss, I would like to see a similar section at the end of any article that talks about weight loss in a positive light, maybe something like:  “Even though we’ve talked around it here, the science overwhelmingly agrees that weight loss is impossible for most people, and that 95% of people end up as heavy or heavier than when they started, and subject to the health risks of weight cycling.”

Oh, I totally spaced it yesterday, but the winner of the Marilyn Wann Fat!So? Dayplanner from Ask Me Anything Day was Ealasaid!  Thanks for your question and congratulations, you’re going to love the dayplanner – it is super awesome! If you didn’t win, you can still buy one of your very own, the proceeds to go Marilyn Wann to support her Weight Action Diversity Lounge which is going to be amazing!

This blog is supported by its readers rather than corporate ads.  If you feel that you get value out of the blog, can afford it, and want to support my work and activism, please consider a paid subscription or a one-time contribution.  The regular e-mail subscription (available at the top right hand side of this page) is still completely free.   Thanks for reading! ~Ragen

The H Word

One of the things that I really struggled with when I first came to the Health at Every Size(r) concept was the word health. Maybe I’m the only one but for so long “healthy” had been synonymous with “weight loss” that I had a hard time not rebelling against the concept wholesale.

As I’ve always said on this blog – I do not believe that health is a moral, personal, or societal obligation.  I believe that everyone gets to choose how highly they want to prioritize their health and what path they want to follow to get there. People are allowed to jump out of helicopters wearing skis and they are allowed to be sedentary and eat a diet of fast food,  Also, health is demonstrably multi-dimensional and not all dimensions are within our control.

Since health is important to me,  I had to get myself to a place where health is not a dirty word (I should have known since it has 6 letters and not 4).  I had to disassociate it from my weight loss days.  In order for me to get okay with the H word, I first had to come to it on my own terms.  In that process I realized that each of us gets to decide for ourselves what our definition of health is.  I think it starts with a baseline – the things that we can’t control – diseases, disabilities whatever.  And, at the risk of sounding a little after school special here –  it starts with realizing that our baseline health is unique to us and doesn’t make us better or worse, just different. Then you look at what’s possible starting at that baseline, decide what of that possibility you want to achieve, and then create a plan for how to get there.

For me there’s a lot less crazed perfectionism and obsession in health than there was in dieting because it’s on my terms.  I’m making decisions based on my goals, not for somebody else’s standards.  And I get to succeed early and often:  Eat some broccoli – success.  Go to the gym – success.  Eat some cake without guilt or shame-success.  (For me it’s a healthy behavior for me to sometimes eat for pleasure.  It is unhealthy to feel guilty or ashamed about it.)  Becoming ok with the H word has given me physical health, but something more as well.  It’s given me the mental health I need to continue to make good decisions that are in line with my goals.

If Obesity is a Risk Factor…So What?

This weekend I took my course and test to be re-certified by the Aerobics and Fitness Association of America (and I passed Yay!).  It was exactly as super fun as you can imagine (which is to say, not very super fun at all) but I was pleasantly surprised to find out that there was much more talk about healthy lifestyle than about weight loss.  One of the tools that I was tested on is the American Society of Sports Medicine’s Risk Factor Stratification.  This tool looks at the risk factors for Cardiovascular and Pulmonary Disease.

One of the risk factors is “obesity”.  I have an issue with this since I think that they are trying to use weight as a proxy for behaviors (specifically behaviors that are already covered by the tool).  But, for the sake of argument, let’s say that obesity is a risk factor.  Some of the other factors include age and heredity.  But unlike obesity, there isn’t a sixty billion dollar a year industry that tries to change our age or genetics because we know that, even if it would help, it’s not possible.  Intentional weight loss, and the diet industry as a whole, only make sense as a way to lower risk if they in fact succeed in changing the risk factor, in this case obesity.

That means that, for weight loss to be advisable as a way to lower the risk for cardio/pulmonary disease, the average obese person who attempts to lose weight would have to become and stay non-obese.  The problem, of course, is that the research doesn’t bear that out. Based on all of the science, only 5% of people will be successful at long term weight loss,  and let’s not forget that many of those people did not start off as obese, or lose an amount of weight that would change their BMI category at all.  So a 5% success rate does not indicate that even 5% of obese people can become and maintain a BMI-defined “normal weight” that would, in theory, lower their risk.  In fact most obese people who attempt to lose weight end up as heavy or heavier than when they started which means that their risk is as high or higher than it was to begin with, and now they have the added risks that come with weight cycling.  That does not sound like an advisable treatment plan.

Personal trainers are not instructed to give up on health just because someone’s age or heredity is a risk factor that can’t be changed.  By the same token, if health is a goal for you, there is no reason to give up just because body size is a risk factor that can’t be changed.  The good news is there are still a lot of risk factors that we may be able to control:

My point here is that obesity may be a risk factor for cardio/pulmonary issues but even if it is, evidence points to the fact that it is an unchangeable risk factor – like age or heredity. The fact that healthy habits are unable to change our age, heredity, or body size, doesn’t mean that they aren’t making us healthier or lowering our risk for disease. Indeed, the available science suggests that healthy habits are where it’s at if you choose health:

“Groundbreaking work on fitness and weight has been done by [epidemiologist Steven] Blair and colleagues at the Cooper Institute. They have shown that the advantages of being fit are striking and that people can be fit even if they are fat … and thus have lowered risk of disease. A remarkable finding is that heavy people who are fit have lower risk than thin people who are unfit.” -Dr. Kelly Brownell, Director of the Yale Center for Eating and Weight Disorder

“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

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

So it’s time to stop pretending  that if obesity is present than health cannot be, or that there is no point in healthy habits if they don’t make us thin.  It’s simply not so. Health is multi-dimensional and not entirely within our control, so all we can do is work on the things that we can control and then do our best to deal with whatever happens.

This blog is supported by its readers rather than corporate ads.  If you feel that you get value out of the blog, can afford it, and want to support my work and activism, please consider a paid subscription or a one-time contribution.  The regular e-mail subscription (available at the top right hand side of this page) is still completely free.   Thanks for reading! ~Ragen

In Case of Emergency – Break Blog

If you are celebrating Christmas today then Merry Christmas to you! Many of my friends, of all kinds of faiths and non-faiths, are at gatherings today and I hope that each of those gatherings brings amazing memories of time spent with family and friends.

Just in case that’s not quite how they go, here are some thoughts:

Your body is amazing – it breathes for you, pumps blood around all the time and does all kinds of cool things.  It deserves respect and admiration. If people don’t recognize that, it’s 100% their problem and a big flaming sack of not yours.

Everything that people say to you is a reflection of where they are in their life – if they are engaging in body shaming, food policing or other inappropriate behavior, remember that it’s about them, not about you. You do not have to take it personally or internalize it.

That doesn’t mean that you have to allow it to happen either.  You decide how people treat you and then you teach them how to treat you that way.  Don’t be afraid to set boundaries and consequences and then follow through. It’s ok to stand up for yourself, it’s ok to leave the room, it’s ok to leave the State.  It’s also ok to just get through it, but if you take that path may I suggest that you spend a lot of energy making sure that you aren’t internalizing those messages.

Good intentions do not negate bad behavior unless you decide that they do.

It’s a feast holiday, so it’s possible that feeling guilty about eating defeats the point.

People are allowed to be on diets, but if they feel the need to be incredibly vocal about it consider that they may have some issues that they are dealing with.  Again, this is a big flaming sack of not your problem.  Other people’s choices do not invalidate your choices, and vice versa.  Some dieters have a hard time with this – they need everyone to buy into dieting so that they can feel comfortable about their decision.  That doesn’t obligate you to buy in.

Once more with feeling:  Your body is amazing – it breathes for you, pumps blood around all the time and does all kinds of cool things.  It deserves respect and admiration. If people don’t recognize that, it’s 100% their problem and a big flaming sack of not yours.

Here’s to a wonderful season of loving and appreciating your body.

Ask Me Anything Day + A Giveaway!

This blog is NOT [entirely] a cop out.  Sure It’s 2:42am and I’m working on renewing my AFAA (Aerobics and Fitness Association of America) certification and my brain is fried and annoyed.  BUT, I’ve also been wanting to do this for a while and with the whole giveaway thing today seemed like the perfect day.

Go ahead, ask me anything – I have no hang-ups and no filter so the only qualification is that you should only ask if you want an honest answer. Ask a question about me, ask me about a blog that you would like to see…whatever, it’s a free for all!   I’ll either answer it in the comments or create a future blog post out of it.

Plus, everyone who leaves a comment asking me something will be entered in a drawing to win a signed copy of Marilyn Wann’s awesome Fat!So? Dayplanner .  I already have mine and it is so awesome I can’t even tell you (and not just because I’m a flip book in it!)

I’ll announce the winner on Tuesday the 27th.  Ask away…

This blog is supported by its readers rather than corporate ads.  If you feel that you get value out of the blog, can afford it, and want to support my work and activism, please consider a paid subscription or a one-time contribution.  The regular e-mail subscription (available at the top right hand side of this page) is still completely free.   Thanks for reading! ~Ragen