Nobody panic, I’m not pulling a Jess Weiner or anything.  One of my readers asked me to respond to this blog [Warning:  triggering in many ways]. Basically, it is the response of a blogger who does a weight loss challenge on her blog, to one of my readers who suggested that she educate herself about the Health at Every Size(r) concept.

I have a policy of not going to other people’s blogs and trying to convince them that they are wrong.  My work is more about creating a safe space here where people can come for support, information, a point of view outside the mainstream (that is not funded by corporations) and respectful discussion (one of my favorite things about this blog is how respectful the regular commenters are).  I did find the blog interesting and so, in keeping with my policy, I’ll blog about it here.  If you want to skip the possibly triggering bits you can skip the indented material and just read my responses:

What is HAES (Healthy at Every Size)?
From the website and an excerpt from Health at Every Size: The Surprising Truth About Your Weight by Linda Bacon, PhD:

” Let’s face facts. We’ve lost the war on obesity. Fighting fat hasn’t made the fat go away. And being thinner, even if we knew how to successfully accomplish it, will not necessarily make us healthier or happier. The war on obesity has taken its toll. Extensive “collateral damage” has resulted: Food and body preoccupation, self-hatred, eating disorders, discrimination, poor health… Few of us are at peace with our bodies, whether because we’re fat or because we fear becoming fat.”

We’ve lost the war on obesity so is she saying we should just give up? I don’t agree with that philosophy at all. However, I do agree “food and body preoccupation, self-hatred, eating disorders, discrimination, poor health” are the results of being obsessed with losing weight and trying to be thinner. But believe it or not, I don’t believe the diet industry is the root cause. It is certainly a huge part of the problem, but I personally feel all of it has deep roots in patriarchal society. The problem is that we are trying to fit an ideal that doesn’t exist and that was originally created by men. Women buy into it and perpetuate it. We absolutely should work on accepting ourselves as we are, building self-esteem, and loving ourselves. But that does that mean that we stop improving ourselves? Of course not. We need to do it for ourselves. Not for society, or a man, or because we think we are supposed to look a certain way.

This issue I have here is the confusion of the concept of “improving ourselves” with the concept of weight loss.  The scientific truth is that weight loss has an abysmal success rate.  It doesn’t matter if you’re doing it for yourself, society, a man, or to meet expectations.  It doesn’t matter if you call it a diet, a lifestyle change, an eating plan or something else.  Almost everyone who attempts weight loss fails at weight loss and the majority end up heavier than they started within a few years.  I’ve talked before about the idea of HAES as “giving up”.  In a way it is.  It’s giving up the goal of being thin, giving up on a fantasy that leads to exactly the opposite of what we are trying to achieve most of the time and, instead, choosing a goal of better health which is possible for almost everyone.  (Since health is multi-dimensional and not entirely within our control, we can never guarantee health with our behaviors, but we can give ourselves our best chance for a healthy body with healthy behaviors.) Although I am a fan of  Linda Bacon I’m not a fan of the phrase “we’ve lost the war on obesity”.  I think the truth is that there is no real enemy to fight and we never should have had a war on body sizes, and that we will win the “war on obesity” in the  exact moment that we stop fighting it.

[From Dr. Bacon’s book]”Very simply, it acknowledges that good health can best be realized independent from considerations of size. It supports people—of all sizes—in addressing health directly by adopting healthy behaviors.”

I agree that adopting healthy behaviors is the most important thing you can do for your body and yourself, regardless of size. I agree 100% that you should focus on adopting healthy behaviors first and worry about losing weight and getting thinner second. However, I do not agree that you should just give up on reaching a healthy body weight and a healthy body size.

Again here she is conflating the concepts of weight and health.  There is no such thing as a healthy weight or healthy body size.  There is no weight or body size that you can attain that will assure your health.  Thin people get all of the same illnesses that fat people do and so being thin is neither a preventative nor a cure.  Knowing that healthy behaviors are our best chance for a healthy body, and knowing that the most common outcome of weight loss attempts is actually weight gain, it does not make sense to focus on weight if your goal is health.

Wikipedia says:

The major components of HAES, as described by Jon Robison, are:

1. Self-Acceptance: Affirmation and reinforcement of human beauty and worth irrespective of differences in weight, physical size and shape.
2. Physical Activity: Support for increasing social, pleasure-based movement for enjoyment and enhanced quality of life.
3. Normalized Eating: Support for discarding externally-imposed rules and regimens for eating and attaining a more peaceful relationship with food by relearning to eat in response to physiological hunger and fullness cues.

I absolutely love the idea of promoting self-acceptance and I will admit that I felt I did not focus enough on that during the first round of this challenge. I fully intend on making self-love and acceptance part of the challenge in the future rounds. As a pagan and a feminist, this is a significant part of my philosophy. But at the same time, I believe that wanting to be thinner doesn’t make you bad or wrong. Maybe it’s just me, but I feel like HAES wants me to feel shame for wanting to be fitter and thinner.

I can’t speak for every HAES practitioner but I don’t know any who believe that wanting to be thinner makes you bad or wrong and I don’t know anybody who would want anybody to feel ashamed of wanting to be thinner.  In a society where being fat comes with a tremendous amount of stigma, and being thin comes with a tremendous amount of privilege, it makes a lot of sense to want to move out of the stigmatized group. I’ve been very clear about my support of people’s right to choose dieting.   All HAES does is offer an alternative based on the facts.  I want to be able to fly but that’s not currently possible so I’m not going to spend my time throwing myself off of buildings and flapping my arms really hard.   If you want to be thin you should know that the research says that it’s probably not possible and that it’s likely that your attempts will leave you fatter than when you started, you then get to to decide if you want to spend your time dieting.

I have no issue with supporting social, pleasure-based movement for enjoyment. However, this is not the only type of exercise that I support. For example, I happen to like grueling weight training and I prefer to exercise in solitude. I truly enjoy challenging my body and feel that I am invoking the beautiful archetypical goddesses such as Athena, Artemis, and The Morrigan. When I am working out, I am not thinking “Wow, I’m going to look so hot in a bikini and I will get a great husband.” I am thinking “Wow, I bet this is what it is like to be strong and independent like Artemis.”

The idea that a workout can either be pleasurable or difficult is an often misunderstood part of HAES.  Evidence shows that we only need about 30 minutes of moderate exercise 5 times a week for health.  Most people are more likely to get this amount of exercise regularly if they do something that they enjoy.  For some people that is gardening or walking, for some it’s interval training and powerlifting.  HAES doesn’t preclude difficult or solitary workouts, it simply seeks to disabuse us of the incorrect notion that if you’re not miserable and killing yourself alone in the gym then you’re not contributing to your health.

What is normalized eating anyway? The fact that HAES even uses that word “normal” contradicts the entire philosophy! Why? Because they are claiming that the way they say you should eat is what is normal. Isn’t that the problem in the first place? That someone out there decided what is normal for us women? HAES is doing the exact thing they are criticizing everyone else for doing!

First of all, he does not say “Normal” he says “Normalized”.  This term, used in the HAES context, is about letting go of the idea that your information about eating must come from an external sources and instead encourages eating based on your body’s cues.  Normalized here relates to each person individually, not to everyone as a whole and speaks to the fact that due to dieting many people have lost connection with their internal cues.  HAES practitioners come to their eating a number of different ways.  Some work with a HAES based nutritionist, some use intuitive eating practices, still others have to account for allergies or a health diagnosis when they eat so their eating may be very different from someone else.  Normalized is used as opposed to the diet mentality where you ignore your bodies hunger queues and use external information (calorie counting, weight loss programs etc.) to tell you what to eat.

Health at Every Size: The Surprising Truth About Your Weight by Linda Bacon, PhD says in the manifesto:

Find the joy in moving your body and becoming more physically vital in your everyday life.

Eat when you’re hungry, stop when you’re full, and seek out pleasurable and satisfying foods.

Tailor your tastes so that you enjoy more nutritious foods, staying mindful that there is plenty of room for less nutritious choices in the context of an overall healthy diet and lifestyle.

Well of course! This is common sense. I have been watching the diet and fitness industry for the last decade and while there are still snake oil salesmen out there, the fact is there are some very good fitness experts that are sharing this exact same philosophy! This philosophy is actually the mainstream now. Extreme dieting no longer is. I do not understand why HAES chooses demonize the entire industry rather than acknowledging that there is good, sound advice out there.

HAES criticizes the weight loss industry because they say the same thing that HAES does but then add “and then you’ll lose weight”.  Except that the vast majority of people will not maintain weight loss. Advice is neither good and sound if it is wrong almost all the time.  In fact, a study of fitness and fatness found that the obese people who did not have health issues “were more likely to be physically active and eat more fruits and vegetables” and “less likely to report engaging in weight loss practices.” (emphasis added)

In fact, Dr. Bacon tells all the experts in a message for fitness professionals that what they are doing is wrong and damaging their clients. She says tells them that everything they have learned may not supported by scientific evidence. This would be the equivalent of me telling everyone who reads my blog that “the way you have been practicing paganism may be wrong and I am here to tell you how to do it right.” Is that an extreme metaphor? I don’t think so. I don’t understand where Dr. Bacon gets off thinking she is the be all and end all to nutritional and fitness knowledge. Her holier than thou attitude is extremely off putting and arrogant. Why is she so angry and full of judgement? How ironic that she is trying to spread a message of peace, love, and self-acceptance.

I have trouble wrapping my head around this because I’ve met Dr. Bacon and she is one of the least arrogant, angry or judgmental people I have ever met.  I’m admittedly surprised that anyone would compare giving advice about religion (which is based on faith and unprovable) and giving advice about science (which is evidence-based and all about proof).  Do you feel that science teachers telling students that the Earth revolves around the sun and not the other way around is the same as telling them that they aren’t praying correctly?

Telling people that they are practicing their religion incorrectly is very different than saying that a health practice is not supported by research.  Would you have asked the doctors who pointed out that thalidomide causes birth defects why they were so “angry and full of judgment”?  Would have have called them “holier than though and arrogant”? Linda Bacon earned her doctorate in physiology, specializing in weight regulation. She also holds graduate degrees in psychology, specializing in eating disorders and body image, and kinesiology, specializing in exercise metabolism, and has professional experience as a professor, researcher, psychotherapist, exercise physiologist, and consultant, so when she gives advice it’s from a basis of an extremely highly educated expert who is steeped in the research around the issue.

While I agree with the overall message of HAES, I find the delivery quite disturbing. In fact, that is just one of the messages that she has. Here is an entire list of messages for different groups where Dr. Bacon proceeds to tell every person or group in the entire industry just what they are doing wrong. I’m sorry but her arrogance makes Donald Trump look humble.

Do you find Copernicus arrogant?  Galileo?  Mendel?  I observe that Dr. Bacon is part of a time honored scientific tradition of looking at evidence, observing that the popular opinion is not supported by that evidence, making that information known, and then being roundly criticized for it.  I guess we are lucky that she can’t be forced to recant and be put under house arrest like Galileo.

In my research, I have learned the the #1 cause of illness is stress. The media ignores this and chalks us up to New Age nuts. However, there are facts that cannot be ignored regarding obesity and health.

Some of these facts include:There is a very clear link between diabetes and obesity – 80 per cent of people with type 2 diabetes are obese. Hypertension is approximately three times more common in obese than normal-weight persons.

I take exception to these statistics but let’s just say that they are true.  First, we have to be aware that there is also a clear link between disease and the stress of constant stigma.  Further, doctors test obese people earlier and more often for these diseases and often ignore the symptoms in thin people erroneously believing that they are “immune” because they are thin.  If you have two groups and you test the first group earlier and more often for a disease and ignore the symptoms in the second group you cannot be surprised if the first group has higher incidence.  Finally, healthy habits have been shown to mitigate these risks whether or not the people lose weight and weight loss fails 95% of the time, so even if these statistics are correct, weight loss is still not the answer.

Obesity also interferes with mobility. Quite simply, extra weight makes movement more difficult and, often, uncomfortable. People who are obese often experience pain in the knees and back due to increased pressure on the joints and vertebrae.

Feel free to see this video to observe my mobility as a Type 3 Super Obese Person. We’ve talked about obesity and joint pain already. Thin people get joint pain and we treat it with health interventions.  Fat people get joint pain and we treat it with a rarely successful body size intervention. Regular exercise can help these issues and more fat people would probably get regular exercise if they weren’t stigmatized when they go, and if they could find appropriate affordable workout wear in their size, and if they didn’t give up because it doesn’t lead to weight loss which they incorrectly believe is the path to health.  Once again, dieting does not predict weight loss but it does predict weight gain and obesity so  encouraging dieting means that you put people at 95% greater risk of having any issues that are associated with obesity.

Obesity:

• raises blood cholesterol and triglyceride levels.
• lowers HDL “good” cholesterol. HDL cholesterol is linked with lower heart disease and stroke risk, so reducing it tends to raise the risk.
• raises blood pressure levels.
• can induce diabetes. In some people, diabetes makes these other risk factors much worse. The danger of heart attack is especially high for these people.

This is simply misinformation.  While these things have been shown to be correlated with obesity, they are not shown to be caused by obesity, reinforced by the fact that not all obese people have them and many thin people do.  As I mentioned previously, all of these issues have also been correlated with the stress of constant stigma.  Once again, a Health at Every Size approach where we remove size stigma and encourage healthy behaviors is a much better approach then to tell people that the way to be healthy is to try something that leaves them less healthy almost all of the time.  We do not know how to make people thinner (as much as we would like to believe that we do) but we do know how to make them healthier.

My conclusion about the HAES (Healthy at Every Size) philosophy is it has good intentions and some great aspects. It definitely deserves further study. However, the delivery of the message has underlying anger, judgement, and arrogance. In the end, it may also do serious harm by continuing to keep people in denial about the real state of their health. While they are “fat and happy” they may continue to be at risk of severe illness or death. Ironically, the natural effects of eating healthy and getting exercise that HEAS promotes is weight loss. The very thing it seems to be trying to avoid in the first place.

If the natural effects of eating healthy and getting exercise were weight loss, then we would not see a 95% failure in weight loss.  Weight loss is a possible (but not guaranteed), typically temporary side effect of healthy behaviors.  I also cannot imagine how someone would research HAES and come away with the idea that promoting healthy behaviors is tantamount to keeping people in denial about their health.  The tremendous amount of denial that I see is the fact that there are still people encouraging weight loss when we know that it almost never succeeds.

Research from the University of Minnesota found that “None of the behaviors being used by adolescents (in 1999) for weight-control purposes predicted weight loss[in 2006]…Of greater concern were the negative outcomes associated with dieting and the use of unhealthful weight-control behaviors, including significant weight gain. These findings demonstrate that these behaviors should not be viewed as innocuous and should be addressed in primary and secondary prevention efforts.”

“There isn’t even one peer-reviewed controlled clinical study of any intentional weight-loss diet that proves that people can be successful at long-term significant weight loss.  No commercial program, clinical program, or research model has been able to demonstrate significant long-term weight loss for more than a small fraction of the participants. Given the potential dangers of weight cycling and repeated failure, it is unscientific and unethical to support the continued use of dieting as an intervention for obesity.” — Wayne Miller, an exercise specialist at George Washington University (emphasis added)

You are the boss of your own underpants and I support everyone’s right to do what is right for their bodies.  However, I think that it’s absolutely irresponsible for anyone to promote weight loss without telling the truth – that 95% of people who attempt weight loss fail, that weight loss attempts don’t predict weight loss but do predicts weight gain, obesity and eating disorders; and that healthy habits have been shown to mitigate issues associated with being overweight and obese   even if they do not result in weight loss.

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If you are interested in being healthy/healthier and you start to do some research, you will find that there are currently two competing paradigms when it comes to health. One is a weight centered approach – the idea being that we can typically judge health based on weight and that health problems can be solved through weight loss.  The Health-Centered approach says that health should be looked at separate from weight, and that health problems should be solved through health interventions.

Here are 11 reasons why I think a Health Centered paradigm makes more sense (I know the graphic says 10 but you know that I like to give you all a little something extra – and since I can’t make this blog scented I decided to give you an extra reason instead!):

1.  It is observable

We know that there are healthy fat people an unhealthy thin people so weight=health does not hold up to simple observation.

2.  Thin people get all the diseases that are correlated with fatness

And since thin people get all of these diseases, then being thin is neither a cure nor a preventative. Further, since we treat thin people for these diseases we have treatment protocols that do not involve weight loss.  Those same protocols could be used on fat people who have these diseases – so that we are treating the actual disease and not just a body size.

3.  Correlation does not equal causation

Just because a disease is correlated with obesity does not mean that it is caused by obesity.  In some cases, sleep apnea for example, a condition is thought to cause obesity leading to a chicken and the egg problem. By focusing on the health problem instead of the weight we avoid this issue altogether.

4. Confirmation bias

We seek evidence that confirms our existing beliefs.  For example doctors test obese people earlier and more often for diseases thought to be correlated with obesity, thin people who have the symptoms of diseases that are correlated with obesity are often ignored because the doctors assume that thin people are “safe” from these diseases.  If you have two groups and you test one earlier and more often for a set of health problems, and subsequently ignore the symptoms of those health problems in the second group, of course the first group is likely to have a higher diagnosis rate.

5.  Third Factor Issues

One of the reasons that correlation does not imply causation is because the two thing could both be caused by a third factor.  It’s entirely possible that a third factor is responsible for both obesity and disease in which case weight loss attempts will do nothing to address the problem and may even exacerbate it.

6.  The wrong measurements

When people set weight loss as a goal, they are typically assuming that along with that weight loss they’ll get a host of metabolic health benefits: good cholesterol, blood pressure, triglyceride and blood glucose numbers etc.  So when, like 95% of people, they fail at weight loss they assume that they failed at all of the health outcomes as well.  But studies show that this isn’t the case.  Had they measured their metabolic health rather than their weight they are likely to have seen health increases, even though they would not be accompanied by weight loss.

7.  Confusing the standard of beauty with health

As a culture we tend to have a single standard of beauty (which is a whole other problem).  Unfortunately it is all too easy to assume that this single standard of beauty is also the single standard of health. That is simply not true.

8. Human diversity

We accept a huge amount of human diversity.  Large variations in skin color, shapes and sizes of feet, hands, and noses, heights, hair colors and textures etc. are all considered normal.  And yet we expect healthy bodies to conform to a narrow height weight ratio or we consider them “abnormal” or “unhealthy”

9.  The dieting effect

In studies dieting (particularly dieting young and/or repeatedly) predicts weight gain and obesity.  It makes sense then that as we have continued to diet younger and more often we see larger bodies. The solution is unlikely to be more dieting.

10. The Unlikelihood of Weight Loss

In studies since 1959 weight loss has shown a success rate of only 5%.  Doctors are prescribing a solution that only works 5% of the time to 60% of Americans. The diet industry makes 60 Billion dollars a year taking credit for their successes, and blaming their clients for their failures. Would you use birth control with a 5% chance of success?  Would you be okay with the company (and the world) blaming you if you were one of the 95% who got pregnant?

11.  The likelihood of increased health

We know that health is multi-dimensional, not an obligation or a barometer of worthiness, and not entirely within our control.  That said, studies show that most people will get a health benefit from participating in healthy behaviors (healthy eating and movement).  Studies also show that most of these people will not experience significant long term weight loss.  But, again, they will give themselves the best odds to support their health.

So there you go, 11 reasons why focusing on your health and not your weight makes the most sense if you want to be healthier.

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I think that the War on Obesity should come with a side effect warning:

Caution:  The war on obesity may cause issues with your hearing.  If someone says “Health at Every Size suggests that you eat healthy and exercise” and you hear “Health at Every Size suggests that you eat twinkies and sit around on the couch” you should stop participating in the War immediately.

The war on obesity may also cause issues with your vision. To avoid looking like an idiot, until you know how the war on obesity affects you you should avoid going to videos and websites of athletic fat people and claiming that what they do is easy or that they are lazy.

You may lose the ability to do math.  Call your local Health at Every Size Practitioner if you start to think that dieting’s 5% success rate and 95% failure rate seem like good odds.

In extreme cases the war on obesity can lead to a complete loss of your ability to treat people appropriately or make good choices.  Discontinue the war immediately if you find yourself spending time looking for fat people on the internet to make fun of them, claiming that “Eat healthy and exercise” is an irresponsible message, or claiming that the research doesn’t matter because Dr. Oz is just so inspiring.

Contact your local Health at Every Size Professional if you have a fat hating episode lasting more than four hours.

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

Last night was the Chicago premiere of America the Beautiful 2 and it was fantastic.  I met so many amazing people.  I got to see other cast members again (and their friends who are awesome, Hi Mama Laura), I got interviewed by rollingout.com (I’m in the video at the bottom of the article – I even got say “This is Rolling Out” which I was far too excited about).  A bunch of people came up afterwards to say that they liked what I had to say, that it made them think – some people even apologized to me for the way that they treated fat people in the past and promised me that they would do better.  My absolute favorite were four little girls (all traditionally thin).  The two youngest (who were braver) ran up and said that I was their favorite thing in the movie and asked me if they could hug me. As we started to talk and the other two came up they told me that they have formed several bands and even made their own music video.  One of them said that I was her hero and they all agreed hugged me again.

I asked them how old they were and two of them were the same age as the boy we talked about a couple of days ago.  He was an honor roll student who participates in school activities and whose only health problem is controlled sleep apnea, who was taken from his family because his obesity meant that he is “failing to thrive”. And that started me thinking about this whole idea of thriving because a whole lot of people are putting a whole lot of effort into making sure that kids don’t grow up to be like me.  I’ve worked my ass off and have had an amazing life so far – I’ve played Carnegie Hall, been the CEO of a million dollar company, been in a movie, and received thousands of e-mails from people who tell me that I’ve inspired them, and I just turned 35.  How did I become the nightmare scenario?

That’s the message that they try to give fat people – we are “failing to thrive” unless we are thin, unless we have a body that fits the social beauty norm.  All of the interventions put in place to “save” us failed (or we squandered them).  Nothing we do will ever be enough to make up for our fatness, we couldn’t possibly be truly happy living outside the cultural beauty norm.  We can’t possibly be comfortable at our size, some people can’t even process what we do because of their own prejudices and preconceived notions (someone who reads my blog called me lazy today, it’s not the first time.  The answer is in front of you, open your damn eyes!)

Some of it is guessing, some is projection, some is bullying, some is just BS but let’s remember that we don’t know why people are bigger now than they were (we have guesses, but nothing proven) and we don’t now how to make them smaller and our obsession with thinness has become a train wreck whose fiery explosion destroys more people every day, so now is probably a dandy time try sometime else – like focusing on healthy behaviors that we can control rather than just body size.

Regardless, nobody gets to decide what “thriving” means for us.  Let’s Occupy our Fat, Thriving Underpants. Being fat is not better or worse, it’s just one of many body sizes and every body is amazing.  Four little girls get it, why can’t everyone else?

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

I watched the 4 part videos of Dr. Oz with Dr. Glenn Gaesser as his guest and I was so annoyed that typing couldn’t do it justice – so I took out my frustrations on my Flip Camera.

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

Taylor Mali is a slam poet and a number of years ago his poem “What Teachers Make” served as my  introduction to slam poetry. I fell in love with the style and with Taylor Mali’s voice. (I’ve embedded all of the poems that I’m about to discuss at the end of this blog).  “I’ll Fight You for the Library” currently has 249,052 hits and it’s entirely possible that 100,000 of them were me and that 50,000 of those were in a row – this poem makes me want to be a better activist and a stronger person. “Totally Like Whatever” influenced the way that I communicate.  “Tony Steinberg:  Brave Seventh Grade Viking Warrior” makes me cry every time I listen to it, and still I click to listen. Taylor Mali is, for me, a clarion voice articulating the case for valuing education and for everyday activism. He has made a career out of speaking his truth and inspiring others to action.  He is a hero of mine.

Yesterday I heard a poem of his called “An Apple a Day is Not Enough” about kids’ health.  As soon as I saw the topic I got that twinge of worry- because for some reason we don’t seem to be able to get it together enough to be for healthy kids without being against fat ones.  As the poem went on I began to get excited as he talked about healthy foods and exercise and treating health as a skill. It made it sound a little bit like health is entirely within our control which of course isn’t true but I was thrilled to hear someone talking about healthy behavior instead of body size. Then it happened.  “What does it matter if we try to increase our scores in math and reading if scores are dying before their time because they got fatter and fatter.”  And my heart broke just a little as it does when it feels like a hero of mine has let me down.

I went to his website to see if it had an e-mail address listed.  It did.  And then I hesitated.  I’m obviously nowhere near as well know as Taylor Mali but I get e-mail everyday from people who don’t like my work and it’s not that fun so I was hesitant to become just another person criticizing his work. As an artist I was also hesitant to ask him to change his work of art.  But babies are being starved by parents so that they don’t become obese and fat kids are being bullied and stigmatized by everyone and so if a hero of mine thought of me as a nuisance or an idiot then that’s a small price to pay for standing up for those kids. I sent the following:

Mr. Mali,

I have been a fan for quite some time.  Today for the first time I came across the poem “An Apple a Day”. As the poem developed I was really excited that someone was talking about health for all kids, and then you said “Fatter and Fatter”.  I wish you would reconsider this.  We can be for healthy kids of all sizes without being against fat ones.  Hospitalizations of kids under 12 for eating disorders are up 119%, a study from Canada found that twice as many kids had eating disorders as type 2 diabetes.  Fat kids are bullied and stigmatized not just by their peers but by teachers and parents as well.  Kids don’t take care of things they hate and that includes their bodies.  As a healthy, athletic fat kid all too often the people I looked up to gave me the message that no amount of healthy behavior was enough if it didn’t make me thin and I ended up hospitalized with an eating disorder.

Now, as a healthy fat athlete I am a strong advocate for the Health at Every Size method which focuses on healthy behaviors rather than a number on a scale.

NAAFA has created a toolkit to help people working on children’s health, you can find it here if you are interested:   http://www.naafaonline.com/dev2/education/haesschool.html

If there is anything that I can do to support you please let me know, but let’s do better by our kids than to try to shame them healthy or hope that they hate themselves healthy.

Thank you for taking the time to read this,

~Ragen

Ragen Chastain

Dancer, Choreographer, Speaker, Writer, Fat Person

blog:  www.danceswithfat.org

 

I did not send it expecting a reply, nor did I expect to change his mind.  I sent it because I believed it should be sent.  So imagine my surprise 30 minutes later:

I totally see your point, and I wish I’d known that as I was writing the poem for Health Teacher. It was a commissioned poem so I had to use certain facts that they gave me. That’s my only excuse. You know the way the poem ends with the word “amen”? Some of the folks wanted me to take it out, afraid that it would insult Christians. So I’m afraid the poem as it exists on YouTube is a done deal. But I promise you, if I ever do the poem live, I will take out that line. Deal?

Metaphorically yours,

Taylor

P.S. Sent from the road so forgive odd spellings & apparent curtness.

I sent him an e-mail back thanking him and telling his that it was, indeed, a deal.  I have no idea if he ever plans to perform the piece live and I’m still not happy with it as it exists on YouTube but I am happy that I spoke up and I feel that this is another little victory.

So, let’s have a little victory sharing today in the comments. What have you done that you are proud of?  What victories have you had (big or small) post a video, post a link, write out your story whatever. Let’s inspire each other!

Here are those poems:

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You probably heard that recently a 200 pound 8 year old boy was removed from his home because he did not successfully lose weight.  The identities have not been disclosed because the country considers this a child abuse case.

I wonder if all possibilities for this child were exhausted.  How certain are they that it is a lifestyle issue?  What proof do they have the foster care is likely to help?  If he loses weight in foster care and is returned home and gains his weight back (as 95% of dieters do) will he be pulled again?

Also, it’s worth noting that he was taken away due to “imminent danger” and “Medical neglect” but his only health problem is sleep apnea which is well controlled through a CPAP machine. He is an honor roll student who participates in school activities.

Having read more than 100 articles on the subject it seems that doctors really have no idea what to do.  In some articles doctors say that he would need to weight 60 pounds to be considered healthy, in other articles doctors said that his target weight should be 150 pounds.  One article quotes the CDC as saying that it’s possible to get to and maintain a healthy weight but the research doesn’t support that.

The lawyer for the boys mother said that in his decades as a public defender, he has seen children left with parents who beat them or who had severe drug problems with the reasonsing that the danger didn’t meet the criteria of being immediate.  But this boy was removed from his home based on health issues that he does not actually have, but might get.  Does this mean that kids caught smoking will be removed from their homes because they might get cancer?  Where do we draw the line?  Already, even in the few cases that we have of putting kids into failure because of obesity we have one massive failure in the case of Anamarie Regino.  She was removed from home at 3 years old but it failed to improve her weight.  She was returned to her family and diagnosed with a genetic disorder that caused the weight gain.  Oops.

There are many concerns here:

It’s tricky to use body size as a diagnosis: 

• What about families where there are more than one child who eat the same diet but only one meets the definition of “extreme obesity”? Do they do interventions with all the children?
• The idea that you can tell how healthy a kid is by how much they weigh does a disservice to all kids, telling larger kids that they if healthy habits don’t make them thin then they can’t get healthier and telling thin kids that they are healthy because of their body size and regardless of their habits.

We don’t actually know that much  about childhood obesity:

Despite the fact that everyone and their overbearing mother thinks that they know exactly why we have a childhood obesity crisis, the truth is that nobody is sure.  There is considerable argument as to whether a crisis even exists. We don’t know if there are things in the environment that trigger some kids to gain a lot of weight, we don’t know if it’s that we have a fast food culture etc.  Nothing is proven here so no matter how vehemently someone says that they know, they don’t.  That makes it hard to find fault and place “blame.”

We don’t know how to make fat kids into thin kids:

• Every weight loss method tested shows a less than 5% success rate over a five year period.  This is particularly bothersome in situations where children are placed in foster care, lose the weight and then return to their family with a 95% chance that they’ll regain the weight and their parents will be labeled as repeat offenders.
• If they go to foster care and do not lose weight or gain weight, are the foster parents then at risk for being accused of neglect? What happens next?

Determining “Fault”

• The system already deals with “failure to thrive” cases in which parents are suspected of starving their children.  Even those cases are problematic because sometimes there is a health issue with the child (celiacs disease for example or food allergies) that are causing the issue.
• Unless the parents are force-feeding these kids, there are serious issues determining causality and fault to charge them with abuse.

Slippery Slope:

• Where are we going with this?  Who is next?
• What about smokers who raise kids?  Secondhand smoke contains more than 250 chemicals known to be toxic or carcinogenic (cancer-causing), including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide. Children who are exposed to secondhand smoke are inhaling many of the same cancer-causing substances and poisons as smokers. Do we remove the ones who develop asthma? The ones with elevated blood pressure? Those born pre-term or with low birth weight?

What I think we really need to get out of this is how important it is for people to have information and access to the building blocks of health.   Information about healthy eating and movement in combination with access to affordable foods and safe, affordable movement options that kids enjoy, affordable accessible preventative health care (not just reactive sick care).  PE in every school and options that encourage a lifetime love of movement, rather than a lifetime of bitterness about PE. Dodgeball should go the way of the dinosaur.  What if schools could offer more than just sports:  dance, walking/hiking, Kinect style video games that incorporate movement etc?   And not just during a PE hour but before and after school and during lunch and free periods, even on weekends? What if they offered busses and share-a-ride systems to the local YMCA or to the schools after-hours PE program? Wondering where you’ll get the money?

We’ve talked about this before but every year we give the diet industry $60 Billion dollars. Can you imagine what we could do if we could take that money out of their back pocket and use it to create access to food and movement options?  If we stopped body shaming and bullying fat kids, allowing them to have the mental health that can only exist when they don’t live in a constant state of stigmatization would they be healthier?  I think so.