The eating disorders community has a serious fatphobia problem and it’s harming people of all sizes. The Academy for Eating Disorders recently made that abundantly clear.
Moving to a Size Acceptance and Health at Every Size paradigm is required if we truly want to prevent eating disorders and allow for full recovery.
I recently wrote about the need to end Fatphobia in Eating Disorder Treatment and Recovery for The Mighty, so I wanted to share it here. Here’s an excerpt:
“We prescribe to fat people the same things that we diagnose and treat in thin people.”
The first time I heard this statement was from Deb Burgard, PhD, FAED, a psychologist who specializes in eating disorder treatment. As someone who is both fat and has recovered from an eating disorder, it resonated immediately. Even when I was being actively treated for my eating disorder, doctors were suggesting I engage in the exact same behaviors that those treating me were trying to help me stop.
There’s a grave misconception in the medical community that weight-loss behaviors are a path to health for fat people…
Was this helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)
Like this blog? Here’s more stuff you might like:
Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective. This program can be used by individuals, or by groups, including as a workplace wellness program!
This e-course that includes coaching videos, a study guide, and an ebook with the tools you need to create a rock-solid relationship with your body. Our relationships with our bodies don’t happen in a vacuum, so just learning to see our beauty isn’t going to cut it. The world throws obstacles in our way – obstacles that aren’t our fault, but become our problem. Over the course of this program, Ragen Chastain, Jeanette DePatie, and six incredible guest coaches will teach you practical, realistic, proven strategies to go above, around, and through the obstacles that the world puts in front of you when it comes to living an amazing life in the body you have now. Price: $99.00 Click here to register
($79.00 for DancesWithFat members – register on the member page)
I got an email from someone who had just completed another round of weight-cycling (losing weight, then gaining it back – often gaining back more than was lost.) They understood that there was almost no chance that they would become thin – especially since they have repeatedly failed.
They understood that the research is clear that the outcome they experienced – total weight regain – is the most common outcome of any weight loss attempt. They were clear that they can pursue health without pursuing weight loss (and understand that health is not an obligation, barometer of worthiness, or entirely within our control.) But they still want to lose weight both because they believe that they’ll have trouble finding a romantic partner, and because they just want life – shopping for clothes, flying in a plane, etc. – to be easier.
If you feel this way I want you to know that you are not alone, this is a very common experience. The fact that we understand that dieting almost never works (and that the chances of success can drop even lower on repeated attempts) doesn’t change the fact that we are a fat person, living in a fatphobic world.
Fatphobia, weight stigma, and weight-based oppression are not in our heads – they are real and fat people experience them constantly in everything from fashion, to travel, to the working out, to medical care and more. The more fat we are, the more oppression we experience and things are even worse for those who are part of multiple marginalized groups.
Still, in my experience, hanging on to the fantasy of being thin (and, at least subconsciously, the idea that I could move myself out of the oppressed group) kept me aligned with diet culture and made it impossible for me to move forward with my life.
One good way to start to take control of this might be thinking about some questions, like:
–Knowing that I will probably always be fat, do I want to believe that the problem is fatphobia, or do I want to believe that the problem is my body?
–Knowing that the most likely outcome is a lifetime of weight cycling, do I want to try to continue to fight my body in the hopes that I can someday be successful in appeasing my oppressors?
–Would I really want a partner who only wanted me if I was thin?
–If being thin wasn’t an option, what would I want to do moving forward?
For me, my life turned around when I realized that the problem is fatphobia and not my body. As a person who is both queer and fat, I think it helped that I could see parallels between the way that I’ve been treated as a queer person with the way that I’ve been treated as a fat person. This includes the suggestion that these states are changeable, and that the solution to the oppression I was experiencing was to change myself to make my oppressors happy. Completely rejecting these suggestions has made my life immeasurably better.
When I realized that the world is fucked up and my body is fine, it was liberating. I no longer pursue weight loss. I no longer have lists of things that I’m going to do/start/be once I get thin. I no longer participate in my own oppression. I choose to fight my oppressors rather than spending my time, energy, and money trying to submit to their demands.
Was this helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)
Like this blog? Here’s more stuff you might like:
Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective. This program can be used by individuals, or by groups, including as a workplace wellness program!
This e-course that includes coaching videos, a study guide, and an ebook with the tools you need to create a rock-solid relationship with your body. Our relationships with our bodies don’t happen in a vacuum, so just learning to see our beauty isn’t going to cut it. The world throws obstacles in our way – obstacles that aren’t our fault, but become our problem. Over the course of this program, Ragen Chastain, Jeanette DePatie, and six incredible guest coaches will teach you practical, realistic, proven strategies to go above, around, and through the obstacles that the world puts in front of you when it comes to living an amazing life in the body you have now. Price: $99.00 Click here to register
($79.00 for DancesWithFat members – register on the member page)
I’ve been seeing ads for Noom all over social media for quite a while now. They claim to be a new way to lose weight that can help you keep the weight off for life.
First of all, their commercials are chock full of diet advice that is as old as the hills and has no research to back it as actually creating sustained weight loss. (“Eat grapes instead of raisins, drink wine instead of beer, drink a glass of water if you’re hungry, blah blah blah) a lot of the program seems to be based on the old “eat watery, fibery, bulky food so you’ll feel fuller” advice that doesn’t work because your body is a sophisticated piece of machinery and not a lawnmower. 1987 called and it wants its shitty diet advice back.
Moreover, how can they claim to be brand new, while also claiming that they can help you keep weight off for life? That claim would have to be backed by some serious long-term research in order to be credible. I asked them for the research – I asked in e-mail, through their website contact, and on social media – including one memorable thread that had 758 comments, to which they replied directly to 757. Guess whose comment did not receive a response?
Text: Ragen Chastain: I’ve made several requests for the research to back up the claim that weight loss is maintained long-term, but haven’t received anything back. Noom, can you please help me get this information? Thanks in advance!
Spoiler Alert – they could not help me find that information because it doesn’t exist, but we’ll get to that in a minute.
I asked folks on social media to share their experiences and they were truly terrible. Especially for people who chose the option “get fit for good” (rather than “lose weight for good”) because they believed it to be a wellness program, only to be given extremely low-calorie diets, and eating disorder triggers from food moralization to being asked to literally pledge to weigh themselves every single day.
I decided to try their sign up process for myself. The first thing I found was that whether I clicked “Get Fit For Good” or “Lose Weight For Good” I was sent to the exact same process. Pretty disingenuous if you ask me, and another example of companies co-opting anti-diet language to sell diets.
As I went through the demographic questions, I was sad to see that this “modern” weight loss company only gave gender options for “Male” and “Female” completely erasing the existence of non-binary people.
I gave my starting height and weight as 5’3, 300 pounds. I gave my goal weight as 75 pounds as a test – hoping against hope that it would send up a red flag and recommend some kind of counseling. Instead, I got a page that said “You entered 75lb(s) for your ideal weight. This is your goal weight, not the amount of weight you’d like to lose. Would you like to edit your response?” I hit “confirm” and Noom moved me on through its process with no problem.
They showed me a slide that claimed that a study showed that 78% of users in 2016 had “sustained” weight loss over 9 months. It included a graph showing Noom performing better than “restrictive diet” though of course they never give any indication what “restrictive diet” means (and considering some of the people I heard from were given “plans” from Noom that included only 1,000 calories a day I can’t imagine what they would define as “restrictive.”)
There is also the fact that the research shows most people can sustain weight loss for 9 months, but the vast majority gain it back (many gaining back more than they lost) over the next 2-5 years. I would imagine the reason that they are still touting less than 80% of people managing to lose weight for 9 months in 2016 (rather than, say having followed people until now,) is that all those people are having the exact same experience of every other dieter – losing weight short term and gaining it back long-term.
But here is the blue ribbon loser question:
“Women in their 40’s who want to reach an ideal weight between 65 lbs and 85 lbs need a slightly different strategy depending on their current lifestyle. Which best describes you?”
I can best be described as slipping into a rage coma Noom, thanks for asking. Newsflash Noom: women in their 40’s who want to reach an ideal weight between 65 lbs and 85 lbs need a VERY different strategy than a weight loss diet!
Of course I didn’t sign up (the last thing I’m going to do is give them money,) and I thought it was done. Then, a few days later I received an e-mail, reminding me that:
From the information you provided, we’ve put together a custom course that will help you reach your goal weight of 75 lbs by June.
You read that right, Noom has put together a plan that will “help” me to lose 225 pounds in (checks calendar) 4 months. Yes, this definitely sounds legitimate and safe.
As far as I can tell, there’s literally nothing new about Noom, it’s the same useless-at-best, dangerous-at-worst shit, different name. Here’s the story in pictures:
I was really hoping that telling them that my goal weight was 75 pounds would throw up all kinds of red flags. Sadly, they were fine with it.
Newsflash Noom – women in their 40’s who want to reach an ideal weight between 65 and 85 pounds need a VERY different strategy than being encouraged to diet.
Try this – ask your job if you can get a promotion based on those 9 months that you worked really hard four years ago, even though you’ve done nothing but surf facebook since them. Let me know how it goes.
Noom e-mail telling me that they have developed a custom course to help me lose 225 pounds in four months.
Was this helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)
Like this blog? Here’s more stuff you might like:
Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective. This program can be used by individuals, or by groups, including as a workplace wellness program!
This e-course that includes coaching videos, a study guide, and an ebook with the tools you need to create a rock-solid relationship with your body. Our relationships with our bodies don’t happen in a vacuum, so just learning to see our beauty isn’t going to cut it. The world throws obstacles in our way – obstacles that aren’t our fault, but become our problem. Over the course of this program, Ragen Chastain, Jeanette DePatie, and six incredible guest coaches will teach you practical, realistic, proven strategies to go above, around, and through the obstacles that the world puts in front of you when it comes to living an amazing life in the body you have now. Price: $99.00 Click here to register
($79.00 for DancesWithFat members – register on the member page)
If you follow Bette Midler on Twitter, you know that she is known for biting political commentary against the current “administration.” But recently she used her feed to demonstrate exactly what not to do in the fight against donald:
Second, the answer to the white supremacy, racism, xenophobia, Islamophobia, anti-Semitism, ableism, misogyny, sexual assault, grifting, and all the other wrongs committed by donald and his regime is not to fat-shame them and call them names. Even if you agree with donald that name-calling is appropriate behavior, responding to this kind of horror and oppression with name-calling actually minimizes the offenses.
Adding in a bit of food-shaming to the fat-shaming won’t bother donald, but it can harm people of all sizes dealing with disordered eating and eating disorders.
Nobody is obligated to do activism, but if you’re going to be involved, please consider making a base-level commitment to not harm to marginalized groups through your work. The Divine Miss M needs to know better and do better.
Was this helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)
Like this blog? Here’s more stuff you might like:
Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective. This program can be used by individuals, or by groups, including as a workplace wellness program!
This e-course that includes coaching videos, a study guide, and an ebook with the tools you need to create a rock-solid relationship with your body. Our relationships with our bodies don’t happen in a vacuum, so just learning to see our beauty isn’t going to cut it. The world throws obstacles in our way – obstacles that aren’t our fault, but become our problem. Over the course of this program, Ragen Chastain, Jeanette DePatie, and six incredible guest coaches will teach you practical, realistic, proven strategies to go above, around, and through the obstacles that the world puts in front of you when it comes to living an amazing life in the body you have now. Price: $99.00 Click here to register
($79.00 for DancesWithFat members – register on the member page)
I get a lot of e-mails from people who need joint replacements, but whose doctors have refused to perform the surgery unless and until the person loses weight.
If you’re looking for the list of resources to help fight surgery denials, just scroll down!
Sometimes the doctor suggests that the patient attempt weight loss through diet and exercise. I would point out that even if diet and exercise might lead to short term weight loss (and even if they could manage exercise on a joint that requires replacement!) the most likely outcome, based on the research, is that they would gain the weight back, with many ending up heavier than they started, which begs the question: If you think that our size is the problem, then why are you are prescribing an intervention whose most common outcome is a larger body?
Now I’m hearing more and more from people whose doctor has claimed that knee surgery is “too dangerous” at their weight and has recommended … wait for it … weight loss surgery. You aren’t reading that wrong – doctors are refusing to fix someone’s knee until they are willing to have a surgery in which their perfect healthy digestive system will be mutilated to create a disease state, forcing them to starve – though most people who have the surgery still end up in the so-called “ob*se” category.
Suggesting these dangerous surgeries is an extraordinary breach of the promise to do no harm, since they are asking fat patients to risk their lives and quality of life by having a surgery that is a complete crapshoot in terms of outcome (some people are happy, some people die, some people have horrific lifelong side effects and people don’t know which group they’ll be in until they are in it) so that in theory, the doctor can perform an easier surgery and despite the fact that two surgeries are riskier than one. Jumping through hoops to receive knee surgery is bad enough, risking your life to receive it should be out of the question.
Even if you believe that fat people face additional risk from the surgery and/or receive less benefit, that doesn’t mean that the procedure should be denied. Less pain and more mobility is a valid reason for providing healthcare even for patients who are unlikely to have the absolute best outcome for any of many reasons (which is why so many other professional athletes have received these surgeries, even though it was their plan to continue the professional athlete lifestyle that trashed their joints in the first place.)
This study came out after I originally published this piece. “The literature does not show a clear relationship between weight loss and reduction in TKA complications,”
You can always use the resource bank (and the diagnosis specific sheets!) at HAESHealthSheets.com .
And Deb Burgard, PhD, FAED has created a list of research to help fat people and our advocates who want to fight joint replacement denials. She has graciously agreed to let me share them here.
Before I do, I want to be clear that none of this is to suggest that if you are refused joint replacement surgery you are under any obligation to try to change your doctor’s mind. That’s certainly an option (and for those who live in areas with limited practitioners and the inability to travel to see another doctor it may be the only option that works for them.) Many people have found that their best option was simply to find a more compassionate and talented surgeon who isn’t interested in simply cherry-picking only the easiest surgeries. It’s important to remember that, while this becomes our problem, it’s not our fault and we should never have had to deal with this in the first place.
In addition to these resources, you might want to check out these posts: Fat People And Our Knees
Trigger Warning: These studies used are not written from a Health at Every Size paradigm, and use terms like “ob*sity” and “overweight” that stigmatize fat bodies and may contain other triggering wording and weight stigma. The material in quotations under each study link was written by Deb.
Notes: Difference between flip of coin and screening for BMI>+40 was 6.74-5.05 = 1.69% = less than 2 percentage points. Positive predictive value is the number out of 100 who actually have the problem of the people who are identified by the screening – ie, there are 5 people identified by flipping a coin and 2 more identified by using BMI of 40 or more.
Obesity does not increase blood loss or incidence of immediate postoperative complications during simultaneous total knee arthroplasty: A multicenter study
Remember that you get to choose the path you take and that sometimes trying to access medical care in a deeply fatphobic society means doing whatever it takes to get the care we deserve.
Was this helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)
Like this blog? Here’s more stuff you might like:
Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective. This program can be used by individuals, or by groups, including as a workplace wellness program!
This e-course that includes coaching videos, a study guide, and an ebook with the tools you need to create a rock-solid relationship with your body. Our relationships with our bodies don’t happen in a vacuum, so just learning to see our beauty isn’t going to cut it. The world throws obstacles in our way – obstacles that aren’t our fault, but become our problem. Over the course of this program, Ragen Chastain, Jeanette DePatie, and six incredible guest coaches will teach you practical, realistic, proven strategies to go above, around, and through the obstacles that the world puts in front of you when it comes to living an amazing life in the body you have now. Price: $99.00 Click here to register ($79.00 for DancesWithFat members – register on the member page)
Eating Disorder Awareness Week is drawing to a close. As someone who has recovered from an eating disorder, and who is currently an official ambassador for NEDA (the National Eating Disorders Association,) this is an important week to me.
I’m glad that NEDA is working to correct the eating disorders community’s long history of excluding those who are not thin, white, cis, het younger women and I’m proud to be part of that work (especially considering the fact that fatphobic fuckery is still very much a part of the ed community.)
This week I was honored to be included in pieces from a couple of media outlets:
I was one of the people who shared my story with Patia Braithwaite at Self Magazine for an article called Important Reminder: Anyone Can Have an Eating Disorder (Quick clarification on this one – while I may have received a diagnosis of “atypical anorexia nervosa” today, my actual diagnosis at the time was EDNOS (Eating Disorder Not Otherwise Specified)
Everyone who is dealing with disordered eating and eating disorders deserves support, and the eating disorders community needs to fix its exclusion problems and it needs to fix them yesterday. If you are looking for support – from a screening tool, to a free helpline, to help with treatment options and more, here is a good place to start.
Was this helpful? If you appreciate the work that I do, you can support my ability to do more of it with a one-time tip or by becoming a member. (Members get special deals on fat-positive stuff, a monthly e-mail keeping them up to date on the work their membership supports, and the ability to ask me questions that I answer in a members-only monthly Q&A Video!)
Like this blog? Here’s more stuff you might like:
Wellness for All Bodies Program: A simple, step-by-step, super efficient guide to setting and reaching your health goals from a weight-neutral perspective. This program can be used by individuals, or by groups, including as a workplace wellness program!
This e-course that includes coaching videos, a study guide, and an ebook with the tools you need to create a rock-solid relationship with your body. Our relationships with our bodies don’t happen in a vacuum, so just learning to see our beauty isn’t going to cut it. The world throws obstacles in our way – obstacles that aren’t our fault, but become our problem. Over the course of this program, Ragen Chastain, Jeanette DePatie, and six incredible guest coaches will teach you practical, realistic, proven strategies to go above, around, and through the obstacles that the world puts in front of you when it comes to living an amazing life in the body you have now. Price: $99.00 Click here to register
($79.00 for DancesWithFat members – register on the member page)
The eating disorders community has a serious fatphobia problem and it’s harming people of all sizes. The Academy for Eating Disorders recently made that abundantly clear.
I got an email from someone who had just completed another round of weight-cycling (losing weight, then gaining it back – often gaining back more than was lost.) They understood that there was almost no chance that they would become thin – especially since they have repeatedly failed.
I’ve been seeing ads for Noom all over social media for quite a while now. They claim to be a new way to lose weight that can help you keep the weight off for life.
If you follow Bette Midler on Twitter, you know that she is known for biting political commentary against the current “administration.” But recently she used her feed to demonstrate exactly what not to do in the fight against donald:
Dances With Fat 