Stop Stepping on My Healthcare

It’s bad enough that I am considered “too fat” to get insurance, that no matter what healthy habits I choose the only way for me to currently qualify is to do something that research shows is very likely impossible.   But lately there have been a series of decisions that seem to be attempting to take our healthcare out of our hands.

I wrote about the controversy around religion and contraception for iVillage last week.  Now Sen. Roy Blunt, R-Mo. has offered a “rights of conscience” amendment that would let any employer deny any part of your heath care coverage due to ‘ religious beliefs or moral convictions’. The language from the full amendment reads:

“Nothing in this title (or any amendment made by this title) shall be construed to require an individual or institutional health care provider, or authorize a health plan to require a provider, to provide, participate in, or refer for a specific item or service contrary to the provider’s religious beliefs or moral convictions. Notwithstanding any other provision of this title, a health plan shall not be considered to have failed to provide timely or other access to items or services under this title (or any amendment made by this title) or to fulfill any other requirement under this title because it has respected the rights of conscience of such a provider.”

So I imagine it would be open season on STD screenings and treatment, treatment for HIV contracted by gay men, contraception for all women, and us fatties.  Fat has become a moral issue in society – despite a mountain of evidence to the contrary we are blamed for everything from any disease we happen to get, to healthcare costs in general, to global warming. So what happens when the CEO decides that all fat people are sinful gluttons and that we don’t deserve any healthcare except stomach amputations?

I received a response to the story on Fox News Atlanta about the Billboard Project from a person who said that he is a pediatric RN.  He asked:   “Why should responsible citizens have to pay for the healthcare of those that refuse to take care of themselves????”

The thing is that “Personal Responsibility” does not mean that we are personally responsible for doing what other people think we should and it’s quite a slippery slope when we start to decide whose healthcare we should pay for.  Should vegans only have to pay for the healthcare of other vegans?  I don’t drink, smoke or do drugs – should I not have to pay for the healthcare costs of those who do?  As a professional competitive dancer I train strength, stamina, flexibility, and dance 15 hours per week, should I not have to pay the healthcare costs of thin people who are sedentary?  What about people who choose stressful jobs and don’t get enough sleep? What about people who choose to mountain climb, BASE jump,  bungee jump, luge, or not look both ways before they cross the street?  What about people who speed, or chose cars that have less safety features?  Who deserves healthcare?  The answer is that we do our best to give people access to the foods that they want to eat,  safe movement options that they enjoy,  and appropriate evidence-based healthcare, and then back off and respect people’s choices as we want our choices to be respected.

 

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 Problem with The Voice

The voice is a singing competition with a twist.  There are four famous “coaches” (Christina Aguilera, CeeLo Green, Blake Shelton and Adam Levine).  Each coach picks a team during blind auditions- their chairs are turned so that they cannot see the person singing.  If they decide that they want that person on their team, based only on their voice and the crowd’s reaction to them, they press a button and turn their chair around.  If nobody presses their button at the end of the audition all the chairs turn around and they talk to the auditioner before sending him/her/them on their way.

When I first heard about this I loved the idea.  I’m tired of listening to singers chosen predominantly for their ability to dance and fit a narrow stereotype of beauty.  But I’ve noticed something disturbing while watching the show:

Often, when they turn around and find that the auditioner is stereotypically attractive they will say “Oh, I wish I would have picked you!”

And I have to ask why?  Regardless of what they look like, they still have the same voice that the coach didn’t choose 10 seconds before.

This is a corollary to ‘Susan Boyle Syndrome” wherein we’ve all bought so much into the idea that all singers are also  stereotypical beauties that when someone who does not fit the stereotype walks out onto the stage, we are actually fooled into thinking that their looks have something to do with the likelihood that they are able to sing.

This effect takes a severe toll on fat people.  It is assumed that we are not able to sing, dance, run, walk, climb stairs, work hard, cook healthy foods, be in love, have sex etc.  We have to look long and hard to find anyone in the media who looks like us and when we do we’ll find that they are constantly being attacked for their weight.

Besides the opportunity to give a message against the shaming and stigmatizing messages of Strong4Life with the billboard I’m really excited about the bus shelter signs in the Georgia Campaign that will be using Marilyn Wann’s I stand photos and will put non-traditional bodies out there in the media in a positive light.

I think that one of the most powerful things that we can do is get ourselves out there. And I don’t just mean doing backflips or running marathons.  I mean images of happy fatties doing stuff – doing dishes, hanging out, playing board games, whatever.  And for those who love the spotlight, I’d love to see more videos and pictures of awesome talented fatties all over the internet, and I would love to see talented fat people flood auditions until our talent becomes unmistakeable and impossible to ignore.

The judges on The Voice are having a hard time letting go of their stereotypes, we don’t have to make the same mistake. There is nothing wrong with how we look, and there is nothing about how we look that says anything about what we can do.

GEORGIA BILLBOARD UPDATE

The billboards are up.  There was a slight problem with technology on two designs, as soon as that’s solved the voting will open but you can check out the new designs on SupportAllKids.com

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

Or we could teach them to fly

I am in the middle of a five and a half hour layover in an airport that is 2 hours from my house.  If I weren’t so tired I would rent a car but as it is I’m just going to hang out.  I was planning to catch up on e-mail and the first e-mail that I had was from a blog fan who was writing me because she is fat dancer who is conflicted about her day job.   Before I get into this I want to say to the person who wrote me that I’m going to very honest about this situation but I’m not angry with you – you have every right to do whatever you want for a job and I sincerely hope that you don’t feel that this is an attack on you, what you describe happens constantly and so made a perfect example, but for me this is about the situation and not you personally.  Cool?

Okay, she writes:

On the other hand, I am highly conflicted. For my day job, I work as a communications professional for a public health campaign. We focus on Preconception Health (getting women healthy before pregnancy, even if they are not planning) and for many years we focused on folic acid alone. Last year, we expanded our campaign to include other health messages that includes “Healthy Weight.” Our leadership decided that there are so many obesity programs out there, but they don’t do enough to to target women who may become pregnant. We had an MPH student research the relationship between weight and adverse outcomes for both mom and baby. When we started this whole “healthy weight” thing we looked for evidence-based programs that are effective in reducing weight. Guess what? There are none! However, we decided to plug away anyway.

The first problem with this is that there is a correlation vs. causation error.  Even if it’s true that fat women have worse pregnancy outcomes (and I’m not sure that it is, because often these studies are done by people coming from a place of confirmation bias – already sure that fat causes problems and just looking for proof), still even if it’s true that fat women have worse pregnancy outcomes, that doesn’t prove that making them thin will solve the problems.  It’s possible that the fat and the pregnancy problems are both caused by a third factor (for example, the stress of being constantly stigmatized).  It’s possible that the fat and the pregnancy problems are unrelated.

But the biggest problem with this situation is that it doesn’t matter if being thin would be better for women who want to become pregnant because there is not a single proven method to make them thin. If women with narrow hips have worse pregnancy outcomes the solution isn’t to try to make them have wider hips.  If short women have more negative outcomes the solution is not to try to make them tall.  It might also be better for pregnant women to be able to fly but nobody is running a “Flying Preggos Initiatives”.  Because there is absolutely no evidence that we can get any of those things done.  Just like there is no evidence that we can make fat people thin.

A tremendous amount of time, money (and confirmation bias) goes into researching why people would be better off thin.  What if we spent all this time and money trying to research how to make people’s (including fat people’s) lives better. It’s bad enough that programs like this waste time and money suggesting that people do something that isn’t possible.  What’s worse is that by far the most frequent outcome of weight loss attempts is weight gain.  So if it’s true that being fat is an issue for women who want to become pregnant, then suggesting that they lose weight means that the intervention will actually make the situation worse for 95% of clients.  Clients, by the way, who are under the impression that these programs are run by professionals who know what they are doing and wouldn’t set them up for failure.  How is that responsible? How does it meet the requirements for evidence-based medicine?

Absent any evidence that we can make people thin, it’s time to stop researching if fat people’s lives/health/whatever would be better if they were thin.  Let’s just figure out how fat people can make their lives better and healthier if they choose.  If you are interested in information about fat pregnancy, check out The Well Rounded Mama, her work is awesome!

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

Gambling with Other People’s Health

A friend of mine alerted me to this article (trigger warning – weight loss talk, conflating weight and health etc.) The article tells two stories.  The first is of a women who is using a blog to keep her “accountable’ while she loses weight.   The article talks a lot about the bullying she’s undergone and how that motivates her to want to lose weight. Of course this woman is allowed to choose dieting, but as a society we need to understand that the cure for bullying is not weight loss, the cure for bullying is to stop bullying. Basically this is the typical weight loss story and obviously she’s just starting and we have no way of knowing if she is one of the 5% of dieters who actually maintain their weight loss.

The second story is about Priscilla Allen who lost weight when she stopped secretly binge eating and started exercising. It’s been 10 years and she has maintained the weight loss. Sometimes that happens, I’m glad that she is in a better place with her health, but this thing takes a pretty odd turn.

First of all the article says that she is now at “an extremely healthy weight” and I’d like to thank the article’s author for illustrating the ridiculousness of the concept of a “Healthy Weight” which in reality does not exist. I guarantee that there are people at the same weight as this woman who are extremely unhealthy.  If we weren’t so quick to conflate weight and health we’d stop making this dumb mistake.

Next it talks about how she is helping people lose weight, I did some digging and it looks like she is a certified personal trainer, although it doesn’t say who qualified her (there are vast differences in various programs.)

The article says that “Allen believes weight loss for many people is 80 percent emotional.”

This entire sentence sounds like the product of a rectal pull.  How many people is “many”?  How did she arrive at 80%?  Why does she have a precise percentage for the emotional component to weight loss but no idea how many people to whom that precise component applies?  Where is her research with a statistically significant sample size and properly controlled variables that proves the validity of her method?

I see this a lot – somebody loses weight and now they are a weightloss guru.

It interests me because I am a metabolically healthy obese person – statistically about 33% of obese people are metabolically healthy and we are considered “anomalies”.  Only 5% of people are able to maintain weight loss long term, but they are considered experts who can teach other people to lose weight. What the hell? Makes me think I need a bumper sticker “Stop losing weight now, ask me how!”

In order to believe that success at weight loss makes one qualified to help others lose weight, one would have to make the mistake of believing that all fat people are fat for the same reason, that this person’s ability to lose weight means that everyone is able to lose weight, and ignore the fact that we don’t even have one study showing a weight loss intervention that works for a majority of people.  Her method seems to be just another take on the “eat less exercise more” that has been such a spectacular failure in research.  Like so many interventions her advice would be good if it didn’t include the “…and then you lose weight” component, but because of the inclusion of the weight loss component it doesn’t meet the criteria for being an evidence based intervention.

However well intentioned they are, people who lose weight and then become “weight loss coaches” based on the idea that their experience can be everyone’s experience are gambling with other people’s health. And often they don’t even have a clue about the odds.  Their followers will lose weight at first but most of them will gain it back subjecting themselves to the health risks associated with weight cycling. Typically the guru will claim that their method works but that their clients failed, even though a thorough review of the evidence tells us that weight regain in 95% of people is exactly what we should expect, and that a focus on health is much more likely to produce a healthier body than a focus on weight.

This problem wouldn’t happen so often if we, as a society, hadn’t grossly overblown the health risks associated with obesity thus creating the mistaken belief that that the danger of being fat somehow outweighs the danger gambling with fat people’s health using completely unproven interventions (like creating billboards that shame kids under the guise of helping them be healthy – just as a random example…).  I vehemently disagree with this practice, hence my Behavior Centered Health lifestyle.  If I were to be looking for a weight loss solution (you know, in opposite world) I would certainly want to see some real scientific proof before I would allow someone to play roulette with my health.

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

Perception vs. Problem

I was flying today and I got stuck on one of those tiny two seater planes.  As I took my seat I had a conversation with the flight attendant, I was in the very back seat of the plane on the aisle so we had tons of time to talk while she was strapped into the jump seat (I don’t understand why they’re allowed to push around heavy carts full of soda while we’re in the air flying at 30,000 feet but when we’re on the runway they have to be strapped in like fighter pilots but some things are just not for me to know).  So anyway, the conversation goes like this:

FA: (in a conspiratorial whisper) Do you need an extender?

Me:  (in my normal speaking voice) No thanks I travel with my own [hold it up]

FA:  Why?

Me: It’s just easier and this way I don’t have to bother you and I can make sure that I have one if you run out.

FA:  Oh, I’ve never run out of extenders on a flight, even on a 747,  we never really need that many.

Me:  How many do you carry?

FA:  Three on each flight.

Me:  Even on a 747?

FA:  Yup, three.

I’ve had this conversation before with flight attendants.  For all we hear about how fat people are overtaking the airlines and making everyone uncomfortable, according to at least 5 flight attendants to whom I’ve spoken, no more than 3 people on each flight are actually larger than the plane’s seatbelts accommodate.  I started thinking about it and I realized that I was on over 100 flights last year and was never seated next to another fat passenger.  Guys with broad shoulders, guys who sat with their legs wide open in the middle seat, one douche who jammed his elbow into my side to work on his laptop , several people with cloying perfume/cologne that gave me a headache, people who reeked of cigarette smoke and gave me a sore throat, several people with strong body odor, several screaming babies, and one poodle in yappy distress for an entire cross country flight, but not a single other fat person.

So, I first have to ask how big a problem fat people on planes really is?  Is it overblown?  Is it actually that seats have become smaller and the rows have been compressed in a way that makes most average sized people uncomfortable, but they want to blame it on fat people?  Today the women who was supposed to be sitting beside me took an option to move up into a seat that reclines a couple of rows ahead of us.  I noticed that while she was freaked out about the idea of our shoulders touching, she was still touching the shoulders of the woman beside her and seemed to have no issue with that.

So is this really that big of a problem or is it a perception based on obesity hysteria – a general cultural prejudice that  fat is bad and so touching a fat person is gross, but touching a thin person is just part of being on a plane?  As I walked up the aisle of my second flight today I noticed how many people were touching the shoulders of the passenger beside them without any complaint, and without suggesting that they should both be charged extra because they didn’t have a complete bubble of personal space.

I couldn’t find stats of the number of people who marinate in cheap fragrance before heading to the airport, fly with angry puppies, eschew deodorant, or have loudly uncomfortable infants on flights everyday but unless I am the unluckiest flyer in the history of flying that number is high.  And I’m not complaining – challenging smells and sounds are all part of the joy of public transportation, people are not required to wear perfume to suit me, mom’s gotta fly and babies gotta cry.  I think that the whole flying fat people issue is unique because the problem is 100% solvable by the airlines.  They can’t make babies not cry, and they can’t make people skip the cologne,  but they could start to accommodate the simple fact that their customers come in a variety of sizes and they choose not to.

Airlines act like this problem is just so difficult as so be unsolvable but if they rarely need more than 3 seat belt extenders then how difficult would it actually be to solve it?

I don’t think that this is the only problem that has been overblown by perception (and sometimes for profit) when it comes to fat people.  Everything from how much we cost the workplace to the relationship between weight and Type 2 Diabetes, to how many of us there are.  So the next time you hear someone talk about a problem that is due to fat or fat people, take a step back and ask if this is a problem or just a perception?

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

Live to Comment Another Day

If you have been around the Fat-o-Sphere for long, you’ve probably heard the advice “Don’t read the comments”.  This is in reference to the fact that there are people who actually choose to spend their free time fat bashing on the internet, and that these people have a certain knack for making any article into a fat bashing fest.

I think that spreading a positive Size Acceptance message around the internet is a valuable exercise, but I’m not willing to give up my sanity to do it. So I ninja comment (get in, don’t read the comments, leave a comment, get out, never go back).  I started a Facebook group called Rolls not Trolls based on the suggestions of people around the blog.  The goal of the group is to share links in internet discussions that could use a little body positivity.  Today someone on the group asked for coaching on how to leave these comments, so here we are.

Here are my best tips for spreading some love around the internet with your sanity intact, of course you can take them or leave them and feel free to suggest your own!

You do not have to read the other comments.  I rarely read the other comments.  If the link is from RNT I typically already know what’s going on from the post.  Otherwise, as soon as I read one negative comment I stop.

I  don’t go in to change anyone’s mind.  I’m leaving my comment for the person who is reading the comment thread and might be helped in some way by reading something written from a Size Acceptance point of view.

I don’t reply specifically to anyone, even though it’s tempting.  The reason is that if I respond to someone specifically it’s more difficult for me to avoid going back.  I’m not looking for a conversation here – I’ve found it takes too much of my mental energy for not enough benefit and there are other things that I would prefer to use that energy for.

Remember who you are dealing with.  These are the kind of people who think that it’s a good use of their time to fat bash on the internet, and that should tell you everything that you need to know about them. They are entitled to their opinion but I don’t have to care what it is.

If you want to back up what you’re saying with fact, some of the people on RNT have started a very cool document with links to various studies, papers and facts.  Once you’re a member of the group you can click on 1 document at the top.  Any group member can add to the document as well so feel free to jump in.

Here are some sample comments that I often use:

In response to general fat bashing

It seems fairly obvious that you can’t hate someone healthy.  It’s a shame that people’s idea of blowing off steam is to hop on the internet and treat people disrespectfully because of the way they look – I would hope that we would be past that by now.

In response to a “fat people are so expensive/tax dollars” argument

This strikes me as a thinly veiled excuse to fat bash and here’s why:  our tax dollars pay for all kinds of things that we don’t like and that’s just the way it goes. That doesn’t make it someone else’s right to say what size I should be any more than it makes it my right to tell people that they aren’t allowed to drink because my tax dollars will pay for their cirrhosis (even though I don’t drink), or that they can’t drive anymore because they don’t use their turn signals and my tax dollars pay for the stoplights that are damaged in the crash (even though I use my turn signals), or that thin people who eat poorly and are sedentary have to change their diet and start working out because my tax dollars will pay for their future diseases (even though I eat a healthy diet and exercise).   The fact that, out of everything someone’s tax dollars pay for, they have singled out fat people seems to me to basically say “I like to fat bash, and this excuse is flimsy but seems plausible enough to let me do it.”

When every commenter thinks that they are a medical genius

There is a mountain of research (Gaesser, Bacon, Wei et.al., Blair etc.) that shows that healthy habits are our best chance for a healthy body.  The use of weight as a proxy for health hurts everyone, since it misleads fat people into thinking that healthy habits don’t make us healthier unless they also make us thinner, and gives thin people the dangerous misconception that their weight makes them healthy regardless of their habits.  Health is multi-dimensional and not entirely within our control but the best thing that we can do for our health is practice healthy habits and let our body size take care of itself, and not be stigmatized by the people around us.

When people are commenting on a article about someone who challenges their stereotypes:

It’s always interesting to watch people desperately try to hold onto their prejudices, even in the face of direct evidence to the contrary. Thank you [person from the article] for giving people the opportunity to rethink their stereotypes and bigotry.  You are strong and beautiful and appreciated!

Of course you are under no obligation to join the fray, I didn’t for a long time and some days I just don’t feel like it and that’s totally fine. If you feel like doing some activism this is just one option!

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

Who’s Justifying Anything?

The wonderful Deb Lemire, President of ASDAH, let me know that some people have missed the point of Marilyn Wann’s beautiful I Stand Campaign People have put these brave, beautiful people on their websites (like Tumblr and Pinterest) and written rants about how Health at Every Size doesn’t work, talking about how it’s all about justifying fatness and bad behavior, and saying all manner of ugly things about them. I want to talk about how to deal with this practically because the more we put ourselves out there and challenge people’s prejudices, the more this is going to happen.  But before I get to the practical responses, I hope you’ll allow me a paragraph to rant.

How over-exaggerated must these people’s sense of self-importance be to think that we are putting our pictures on posters as a way to justify ourselves to them? Bitch please.  That is some ego run amok right there.  We aren’t seeking the approval of anyone  – we are giving them the opportunity to see that they are operating under prejudice, bigotry and stereotypes and to stop doing that. They have so thoroughly missed the point that I’m worried about their reasoning abilities. If you are one of these people and you are reading this, let me break it down:  We are saying “I Stand for myself and others” not “I kneel for your approval”.  Where you got the idea that anybody needs to justify anything to you I don’t know, but you’re dead wrong.

So what do we do about it?  I can speak from my experience because unfortunately this happens to me all the time  – I’ve had my face photo shopped onto whales and elephants, I’ve had someone diagram my body with all of their perceived “flaws”, I’ve had my image captioned to say a bunch of really unfortunate things.  It’s not something that I’ve gotten used to, it hurts my feelings every time.  It doesn’t make me feel bad about my body, but it does make me feel sad to live in a world where this is how people spend their time. There are several options that I use to handle this type of thing (if you have others it would be awesome if you would drop them in a comment below.)

Ignore it completely. I often choose this if it’s in one of the forums that exists for the purpose of fat hate, where a core belief is that fat people aren’t human. These people have chosen the path away from intelligent dialog and I have no interest in engaging them.  I know that other people do choose to engage them and that’s awesome, it’s just not for me.

Appeal to humanity:  I often do this if someone is talking about me as if I don’t deserve basic human respect.  Often I’ll send an e-mail or leave a comment that says something like “Hi, I’m the person in the picture.  You may not know that I’ve recovered from an eating disorder, or that I chose Health at Every Size as the best path to health for my situation based on extensive research.  While I’m always happy to share my research and answer questions, I would never tell anyone else what they should do for their health.  I think it’s fine that we disagree, but I’m still human.  I think sometimes the internet makes us forget that there is a real person on the other end and that’s how I felt you treated me.  That’s all I wanted to say, best of luck to you.”

Education: I use this if someone is giving their opinions as if they are facts.  I say something like “Hi, I’m the person in the picture. It’s ok if we disagree but I wanted to point out that there are definitely two sides to this story.  Many highly educated people think that Health at Every Size is a valid and successful lifestyle choice.  Some places to start are http://www.haescommunity.org/ (created by Dr. Linda Bacon, a Ph.d with three post graduate degrees), http://ije.oxfordjournals.org/content/35/1/55.full (an article written by five experts).  Again, I completely respect if you don’t choose HAES for yourself but I wanted to let you know that it is based on solid research.”

Rant:  See above.  I typically confine this type of ranting to my blog – If I don’t feel like I can open some kind of decent dialog I typically don’t bother giving fat bashers my time or energy.

Get Help:  If you see this kind of thing online another option is to let the Rolls not Trolls Facebook group know about it.  We are a group who make fat positive comments on fat negative articles and comment threads (with an emphasis on ninja commenting – get in, don’t read the comments, leave your comments, get out, never go back).  The goal isn’t necessarily to change the mind of the person who wrote the article or left the negative comments, but for the person who is reading through and might be affected by seeing another point of view. You are welcome to join the group or you can send the link to me and I’ll post it.

Most of all remember that it’s not you, you are amazing and beautiful and worthy of respect and love – I know that for sure.  Whatever their intentions might be, these people are living from prejudice and stereotypes and bigotry that is causing them to be misguided in their action, but you don’t have to buy into that, and you don’t have to justify yourself to anyone.

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