Here is a scenario I see all the time.  Someone posts a discussion about the massive long-term failure rate of dieting, including a number of studies that have found that most people are able to lose weight in the short term but most gain it back within a 5 year period.  Someone responds “You just have to [insert tired dieting /crappy dieting program/ that we’ve all heard a billion times here].  I’ve been doing it for 6 weeks and I’ve lost 10 pounds. ”

Even if the person really doesn’t understand the difference between 6 week and 5 years this is still highly problematic.   I don’t know what I would pay to never have to read something like that again, but I know it’s a lot.  When I was still in the thrall of dieting and I used to hear about somebody’s recent weight loss my immediate thought would be “how did you do it?”  Now that I have done the research and become disenchanted, my first thought is always “talk to me in 5 years” because most people gain their weight back between years 2 and 5.  This is beyond “everybody knows” which is annoying enough – this is the suggestion that no amount of careful scientific study can stand up to one person’s random experience.

Just like no person is an island, no person is a statistically significant well-run scientific study.  Studies show that only a tiny fraction of people successfully lose weight long term.  So there are a tiny fraction of those who engage in intentional weight loss who will have lost weight and maintained that long term.  That doesn’t even begin to prove that weight loss is possible for everyone, or even a simple majority of people.

The idea that “if I can do it so can you” is prevalent and frequently false.  People who use this logic when dealing with weight loss like to act as if all fat people are alike – the idea being that if one fat person can maintain weight loss then all fat people can.  The trouble with this is that fat is a single physical characteristic and not a magical determiner of a person’s abilities.  It’s like saying that if one tall person lived through a skydiving accident even though their parachute didn’t open then all tall people can do it. That’s ridiculous and ignores hundreds of other variables to simply suggest that if two people have a single physical characteristic in common then they have all the same capabilities.  That’s just not the case.

The problem occurs when we try to make sweeping generalizations based on size. Because of society’s fascination with weight loss and the current campaign against fat people, people are willing to suggest that a tiny fraction of people who have successfully lost weigh proves that weight loss is possible for everyone, and simultaneously say that no amount of people regaining their weight proves that most people regain their weight.  The truth is that weight loss hardly ever works, people have lots of different sizes for lots of different reasons and our individual experiences tell us more about ourselves, but nothing about other people – we are each a point, not a pattern.

Like the blog?  Here’s more of my stuff:

The Book:  Fat:  The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

The Dance Class DVDs:  Buy the Dance Class DVDs (hint:  Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)!  Click here for the details

Become a Member, Support My Projects, and Get Special Deals from Size Positive Businesses

I do size acceptance activism full time.  I created a membership program so that people who read the blog and feel they get value out of it and want to support the work I do can become members for ten bucks a month  To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.

The sun revolves around the Earth.  Thalidomide is a great treatment for morning sickness.  Heroin is a non-addictive substitute for morphine.  Lysol is a fantastic douche.  Everyone who tries hard enough can lose weight.

These are all things that science believed at one time.  Three of them used to be the basis of healthcare advice.  One of them still is.  Sometimes science gets it wrong and there’s no crime in that – it’s the nature of science.  The problem starts when science isn’t willing to admit that it’s gone really far down the wrong road.

That’s the situation that we find ourselves in when it comes to the “obesity epidemic.”  A panic around fat people has been trotted out by the media to the multi-billion dollar profit of the diet and pharmaceutical industries.  Now some researchers, including David B. Allison, director of the Nutrition Obesity Research Center at the University of Alabama at Birmingham, have come clean about the prevalence of myths that are floated by people in the field as fact.

Commenting on the article, Dr. Jeffrey M. Friedman, an obesity researcher from Rockefeller University said , “there is more misinformation pretending to be fact in this field than in any other I can think of.”

Some of the myths mentioned are :

• Walking a mile a day can lead to a loss of more than 50 pounds in five years.
• Diet and exercise habits in childhood set the stage for the rest of life.
• Add lots of fruits and vegetables to your diet to lose weight or not gain as much.
• People who snack gain weight and get fat.
• If you add bike paths, jogging trails, sidewalks and parks, people will not be as fat.

It’s a good start in breaking down supposed “healthcare interventions” that make sweeping health generalizations based upon a single physical characteristic.  But we’re not all the way there.  They also includes some “facts” that I think warrant a closer look:

• Weight loss is greater with programs that provide meals.
• Some prescription drugs help with weight loss and maintenance.
• Weight-loss surgery in appropriate patients can lead to long-term weight loss, less diabetes and a lower death rate.

Though weight loss may be greater with programs that provide meals in the short term, long-term weight loss does not go up – there is no study of any “lifestyle intervention” where more than a tiny fraction of participants maintained their weight loss for 5 years or more and many of those had weight loss from 2 to 5 pounds.  Not for nothing, but I could exfoliate and lose 5 pounds in 5 years, and I wouldn’t have to eat highly processed food that comes in a baggy to be microwaved to do it.

As for drugs and surgery, there is no drug that has shown long-term success for weight loss, and some diet drugs have been taken of the market because they had a pesky habit of killing people so I’m not sure that this is a bandwagon on which fat people should be prepared to jump.

Weight loss surgery is nowhere near the panacea we’ve been promised.  Whether it’s stomach binding or stomach amputation there are major risks, awful complications (anal leakage anyone?) and serious ethical questions. As Linda Bacon points out in her book:  Dr. Edward Mason, who developed gastric bypass surgery said “For the vast majority of patients today, there is no operation that will control weight to a ‘normal’ level without introducing risks and side effects that over a lifetime may raise questions about its use for surgical treatment of obesity.”

Why does he say this?  As Dr. Bacon explains, maybe it’s because almost 3% of the patients died after the first year, and 6.4% die at the end of the fourth year. Sandy Swarze a science blogger at Junkfood Science found that “By best estimates, bariatric surgeries likely increase the actual mortality risks for these patients by 7-fold in the first year and by 363% to 250% the first four years.”  And among those who don’t die, many regain their weight.  In the case of those who’ve had a bypass, they will never regain their ability to properly process nutrients since a surgeon has redesigned their innards to optimize weight loss over digestion.

Still, “everybody knows” is powerful and if you don’t believe me you can check out the comments on this article (provided you’ve been banking your Sanity Watchers points of course).  Though these researchers are trying to explain that the sun does not revolve around the Earth,  commenters help play out this modern-day Galileo story and would have them made to recant and put under house arrest if they could just for suggesting that what “everybody knows” isn’t true.

People of all sizes deserve evidence-based healthcare and the right to informed consent.  Fat people have been the victims of experimental medicine pretending to be evidence based medicine for far too long.  This confession is, despite its flaws,  at least a step in the right direction.

Correction:  I originally mis-identified Dr. Jeffrey M. Friedman as the author rather than just someone commenting on the article. Thanks to readers Deb, Atchka, and Pearlsong Press for pointing out the mistake!

Like the blog?  Here’s more of my stuff:

The Book:  Fat:  The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

The Dance Class DVDs:  Buy the Dance Class DVDs (hint:  Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)!  Click here for the details

Become a Member, Support My Projects, and Get Special Deals from Size Positive Businesses

I do size acceptance activism full time.  I created a membership program so that people who read the blog and feel they get value out of it and want to support the work I do can become members for ten bucks a month  To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.

One of the ways that our healthcare system massively fails people is when healthcare providers presented with a patient who has a health issue focus on whether or not the issue is the patient’s fault.  This is something that happens to a lot of fat people.  Though thin people get all the same diseases as fat people, when a fat person goes to the doctor they can often expect to  hear a lecture about how their health issue is all their fault, or how they would be easier to treat if they were thin – sometimes in lieu of actually receiving treatment for their health issue.

I think that the concept of “fault” is sometimes used to veil fat bigotry in healthcare.  For example, when I go to the doctor now – no matter what my issue is – it is typically suggested that whatever the issue is, it comes from being fat and so it’s my fault since I ‘let myself get fat.”   Interestingly, when I was thinner I had any number of  injuries, all of which were “my fault” since nobody needs to do the jump splits, or play multiple sports, or train to run a 5k, or ski, or do anything athletic.  But no doctor ever suggested that since my injury was my fault I didn’t deserve treatment.

Here’s the deal – unless your doctor is The Doctor and has mastered time travel during your appointment which takes place in a Tardis, then as far as I’m concerned it doesn’t matter why someone has a health issue, it matters what healthcare the doctor is planning to give the patient going forward.

Assigning blame and fault have no place in healthcare and serve only to increase bias, and negatively impact healthcare treatment for the people being speculated about.

I think healthcare providers should treat the patient in front of them for the healthcare issue that they have using evidence based medicine and informed consent .  I would hope that healthcare providers who don’t have what they need to properly treat fat people would be on the forefront of activism to get the tools that they need to help their patients, not trying to hide their fat bigotry in talk about whose fault fat people’s healthcare issues are or how they could treat them if their bodies were smaller.

When you go to the doctor I suggest that you interrupt conversations about whose fault something is and instead ask that your doctor focus on providing you with evidence-based healthcare for the issue that you are presenting with.  Some phrases that I find helpful at the doctor are:

• Do thin people get this health issue?  Can I get the treatment protocol that they get?
• Can you help me understand how suggesting that I should be blamed for [my health issue] is part of your plant to help me get better? or I disagree that suggesting that I should be blamed for my health issue will help us to treat it so let’s please move on.
• Can we please skip over who is to blame and focus on how we’re going to treat this issue?
• Can you give me the name of a study of a weight loss intervention where the majority of people have lost the amount of weight that you are recommending that I lose and kept it off for the long term, as well as a study that shows that doing so would have long term positive effects on my health?
• Studies from Yale have shown that over 50% of doctors have some prejudice against people of size – do you consider yourself part of that group of doctors?

Regardless, if you go for healthcare you deserve to get care for your health, not suggestions of fault and lectures.

Like the blog?  Here’s more of my stuff:

The Book:  Fat:  The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

The Dance Class DVDs:  Buy the Dance Class DVDs (hint:  Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)!  Click here for the details

Become a Member, Support My Projects, and Get Special Deals from Size Positive Businesses

I do size acceptance activism full time.  I created a membership program so that people who read the blog and feel they get value out of it and want to support the work I do can become members for ten bucks a month  To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.

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We’ve been receiving lots of diet books for the Size Diversity Task Force’s project to create a Guinness World Record paper mache sculpture.  As we’ve been sorting books and counting pages I realized that I haven’t read a diet book in quite a while and in that time I forgot about the endless promises of “A New Me” and “A Perfect Me.”

I remember when I used to buy into that.  My pursuit of thin was, at many times, based on these promises – every new weight loss attempt was the start of a “new me” on the way to being the “perfect me.”

Now that I’m removed from this it’s hard to believe that I bought into it. But then it seemed so natural to allow someone to sell me a product based on the idea that who I was needed to be changed – that I needed a new me.  As my friend CJ Legare says, I let them take my self-esteem, cheapen it, and sell it back to me at a profit. Except their destined-for-failure product meant that I would have a hard time holding on even to my newly cheapened self-esteem.

Then there was the idea that being thinner would make me perfect – there was a time when I believed that this was true.  That being skinny would mean that all my problems would go away, I wouldn’t have any more bad hair days, and I’d stop leaving cupboard doors open.  So I wasn’t just waiting for another body to come along, I was waiting for the solution to everything to come along with my new body.

The diet industry has been very clever about its marketing – it’s pretty difficult to make more and more money with a product that almost never works without some very good marketing.  The diet industry is happy to tell us anything we want to hear no matter how completely far-fetched.  They say that being thin will make us new, perfect, practically immortally healthy.  And then they tell us that their product will make us thin.  Each claim is more ridiculous with less of an evidence basis than the last.

When I think of what we could do with the $60,000,000,000 that we give this industry every year in exchange for lying to us about anything and everything it makes me frustrated, but it also makes me hopeful.  Sooner or later the world is going to call the diet industry on the fraud that they’ve committed and then we can start having actual evidence-based conversations about health, happiness, and how awesome the current, non-perfect us actually is.

Like the blog?  Here’s more of my stuff:

The Book:  Fat:  The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

The Dance Class DVDs:  Buy the Dance Class DVDs (hint:  Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)!  Click here for the details

Become a Member, Support My Projects, and Get Special Deals from Size Positive Businesses

I do size acceptance activism full time.  I created a membership program so that people who read the blog and feel they get value out of it and want to support the work I do can become members for ten bucks a month  To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.

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When I heard about Golda Poretsky’s new master class on body positive dating, I was really happy – I think it’s a subject that doesn’t get talked about enough and can be really tricky.  I get reader questions about it  from time to time but I’m the opposite of an expert when it comes to fat dating – I’ve managed to luck my way into an amazing relationship but it’s not because I have any game, or any expertise when it comes to dating.

For me the difficulty with dating fat was that it wasn’t just about my body acceptance and how I felt about myself.  As a fat woman my potential partners live in a culture that tells them that my body is not just completely unattractive but in fact a moral failing and that to choose to date me is to open themselves up to the same social stigma with which I am currently .

That sucks, but it’s important to remember that there is a nothing “wrong” with our bodies that a little culture shift can’t fix (which is to say that there is nothing wrong with our bodies at all) – and that the cure for social stigma is ending social stigma and not weight loss.  Still here we are, with a dating pool inundated with the message that fat=bad.

Social stigma related to dating has something in common with all social stigma related to being fat – it is highly profitable for the diet industry.  The fear of not finding a mate sometimes means that people who might otherwise look at their abysmal success rate and take a pass instead go back again and again.  I have definitely wondered how far this idea that you must be thin to get a mate sets the Health at Every Size movement back?  I know people who have chosen to do what they consider to be unhealthy things to their bodies to be thin, even temporarily,  in the hopes of finding a partner.  (Knowing that if they succeed they may be setting themselves up for heartbreak in 2-5 years when they’ve gained the weight back ).

Then there are our own standards when we decide who we date.  I’ll speak for myself on this one.  I refused to date anyone who is interested in me in spite of my body.  (I inadvertently did it once and it was a disaster.)  I was also once part of a dating experiment that a grad student was doing and we self-selected into one of three groups.  A group who made being fat the first thing that they talked about on their profile, a group who made it part of the profile but not the first thing, and a third group who avoided telling people that they were fat until it became unavoidable.  In discussions that we had, the women in group three believed that their only chance was to get someone to fall in love with their personality enough to overlook their bodies.

If it works for them that’s completely cool, but I was committed that before I would date someone who felt that my body needed to be overlooked, I would get a bunch of rescue Great Danes and grow old as the weird dog lady.  On the other hand I was not willing to date someone who only loved me for my body.  With some regularity I get e-mails from guys (I’ve so far only received them from men) saying something to the effect of “I didn’t read the blog but I saw your picture and you are just so damn hot, let’s get it on”.  Um, no.

Obviously dating is not necessarily a walk in the park at any size,  I had to acknowledge that being fat may indeed have made dating more difficult. But looking at it logically my options were: to date someone who was willing to “overlook” my body, or to try something that fails 95% of the time in the hopes of attracting a mate who wouldn’t consider dating me as I am now, and then rolling the dice that they won’t leave me if I am one of the 95% who gains their weight back (As I had been so many times in the past), or to hold out for someone who was interested in all of me.  I chose option three.  I know I am extremely lucky to have found such a wonderful partner, but my choice also included an  understanding that I agreed with the old adage “better alone than in bad company.”

If you’re in an awesome relationship then today might be a great day to leave a comment and tell us about it!  Also, check out the Museum of Fat Love.If you’re dealing with dating, then you might want to check out Golda’s Body Positive Dating Masterclass.

February Speaking Schedule:  If you are at Dartmouth, Mount Holyoke, Amherst, Smith, or UMass Amherst, I’ll be seeing you later this month – final schedules to be published soon. If you would like me to give a talk at your University or company just e-mail me at ragen at danceswithfat dot org. It’s totally ok if you’re not sure how to get it done, we can work through it together!

Like the blog?  Here’s more of my stuff:

The Book:  Fat:  The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

The Dance Class DVDs:  Buy the Dance Class DVDs (hint:  Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)!  Click here for the details

Become a Member, Support My Projects, and Get Special Deals from Size Positive Businesses

I do size acceptance activism full time.  A lot what I do, like answering over 4,000 e-mails from readers each month, giving talks to groups who can’t afford to pay, and running projects like the Georgia Billboard Campaign etc. is unpaid, so I created a membership program so that people who read the blog and feel they get value out of it and want to  support the work I do can become members for ten bucks a month  To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.

You may remember the Disney “Habit Heroes” debacle – a “ride” where bad habits were represented by fat people who kids defeated with the help of “Will Power” and “Callie Stenics” and the character played by the kids started out as a fat kid who got progressively skinnier as the game progressed.  In short, it was an unmitigated disaster.  The readers of this blog were part of a successful protest that lead to Disney closing the attraction for revamping.

The ride is now revamped and re-opened. The bad habits are now represented by cartoon icons – like flames to represent dehydration, Will and Callie are gone, as is the shrinking kid. Participants now work with Director Jin and her agents Fuel, Quench and Dynamo to fight bad habits with fruits and vegetables, activity, and water.

I see this as proof not only that activism works and that people are capable of hearing our message, but that it is possible to talk to kid’s about healthy habits in a way that makes it fun, and doesn’t shame kids for their bodies.

If you get a chance and want to thank Disney, you can shoot them an e-mail at TWDC.Corp.Communications@disney.com

While I’m doing updates, people of all sizes, ages, and fitness levels have pooled their miles and minutes of activities and the Fit Fatties Across America effort has reached Parachute, Colorado.  You can add your miles and or minutes of activity to help us get to Los Angeles…then see what happens next.  Check it out at the Fit Fatties Forum!

The Size Diversity Task Force’s project to create a Guinness World Record paper mache sculpture entirely out of pages from diet books is off to a big start.  Thanks to donations of books and money from around the world, including a big donation from Brenda Oelbaum, we have over 14,000 pages so far.  If this project strikes your fancy,  there are lots of ways to participate – even if you don’t have diet books to donate.  (And hey – you can also join the Size Diversity Task Force  – a member-run organization that advocates for equal rights and social justice for people of all sizes, weights, shapes, and abilities and believes that everyone has something to offer.)  Check it all out at www.sizediversitytaskforce.org

Like the blog?  Here’s more of my stuff:

The Book:  Fat:  The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

The Dance Class DVDs:  Buy the Dance Class DVDs (hint:  Free shipping was supposed to end on Monday but I haven’t had a chance to make the changes to the pricing so there’s still free shipping until I get it done)!  Click here for the details

Become a Member, Support My Projects, and Get Special Deals from Size Positive Businesses

I do size acceptance activism full time.  A lot what I do, like answering over 4,000 e-mails from readers each month, giving talks to groups who can’t afford to pay, and running projects like the Georgia Billboard Campaign etc. is unpaid, so I created a membership program so that people who read the blog and feel they get value out of it and want to  support the work I do can become members for ten bucks a month  To make that even cooler, I’ve now added a component called “DancesWithFat Deals” which are special deals to my members from size positive merchants. Once you are a member I send out an e-mail once a month with the various deals and how to redeem them – your contact info always stays completely private.