Just a quick link. Yesterday, CBC Radio's Ontario morning had a piece on HAES featuring Jacqui Gingras, a professor at the Ryerson School of Nutrition. It's upbeat and encouraging.
You can listen here.
Favourite quote: In answer to "How do you determine what is healthy for you?"
Healthy... is being able to eat according to hunger and fullness, the signals inside our bodies... our ability to move in an embodied way; to move freely, without pain... to feeling good about ourselves, trusting ourselves, trusting our bodies to know what we need.
Lynne Gerber's new book, "Seeking the Straight and Narrow," subtitled "Weight Loss and Sexual Reorientation in Evangelical America," is now available from US booksellers, from international booksellers, and from Amazon.com.
Here's an excerpt from the University of Chicago Press's description of the book:
Losing weight and changing your sexual orientation are both notoriously difficult to do successfully. Yet many faithful evangelical Christians believe that thinness and heterosexuality are godly ideals—and that God will provide reliable paths toward them for those who fall short. Seeking the Straight and Narrow is a fascinating account of the world of evangelical efforts to alter our strongest bodily desires.
Drawing on fieldwork at First Place, a popular Christian weight-loss program, and Exodus International, a network of ex-gay ministries, Lynne Gerber explores why some Christians feel that being fat or gay offends God, what exactly they do to lose weight or go straight, and how they make sense of the program’s results—or, frequently, their lack.
Lynne has also contributed a piece, weigh in, to "freq.uenci.es, a collaborative genealogy of spirituality." The article focuses on First Place, a Christian weight loss program, and the relationship between the spiritual and physical demands of the program.
I haven't read the book yet, but the freq.uenci.es article is engaging and insightful. As someone who hasn't been involved in a church, I found Lynne's analysis of how spiritual and physical goals interact in the program really interesting:
First Place’s range of commitments reflects a central ambiguity in the program’s purpose: whether First Place is a weight loss program whose value is enhanced by the inclusion of spiritual practices or whether it is a spiritual program whose value is enhanced by the inclusion of weight loss practices... Ostensibly, the program positions itself as the first: as a weight loss program that is enhanced by spirituality. First Place is effective at weight loss, they claim, because it focuses on the whole person, integrating spiritual concerns into the heart of its practice. The absence of God is depicted as the problem in secular weight loss programs and First Place presents itself as filling that crucial void.
Yet there is reason to see First Place as primarily a program of Christian discipleship that instills spiritual practices by linking them to the popular goal of weight loss. Spiritual changes are often the changes celebrated in First Place literature and its spiritual disciplines inculcate Christian practices that are deeply valued yet quotidian in the evangelical subculture...
Most of the time this ambiguity is not an issue. Within this self-help landscape, weight loss aims and spiritual aims are seen as so vitally interconnected, so conflated, that there is no need to distinguish between the two. Thinness is God’s desire, and godly devotion will effect weight loss. But when the judgment of the scale threatens to reveal possible tensions between First Place’s spiritual and weight loss projects, distinguishing between the two can be helpful...
Lynne also has a website,pondering the body in American religious life, where you can find links to other articles she's written.
I should probably note that anyone who's very sensitive to the discussion of weight loss dieting may find both the book and article triggering.
New Year’s Eve is here, and for at least 3 weeks now we have been subjected to the annual bombardment of fat hate messages designed to send us keening into the unloving arms of Jenny, and WW, and all of their friends. The Very Serious Media (such as NPR and my hometown paper – New York Times) tart it up in pretty colors and words of concern and false empathy, but it’s the same stuff. Here are some examples. Don’t read the comments if you don’t want to come away with your sanity points in the red.
NPR clearly got itself a shiny new toy of some kind (crystal ball? Roulette wheel? Gatling gun?) and has been at the forefront of the barrage since much earlier this year with seriously biased information woven through the totality of its reporting on obesity. Here’s a link to its articles over the past 30 days for your perusal. Peruse at your own risk. Full disclosure – I support my local NPR station, but have been screaming at the radio for months now in the mornings when I hear some of this stuff.
The NYT – the Gray Lady – has some great writers. Gina Kolata, for one, has written about the topic of food and obesity extensively, sensitively, and accurately. Tara Parker-Pope really did try with one article, but it was a swing and a miss in my opinion (although many seemed to welcome it). The rest of them… Complete insanity. One of them (in the No Shit Sherlock department ) talks about how (horrors!) children are discarding “healthy” lunches and creating a thriving black market of junk food in schools. Wow… Who knew?
In a non-Times article which Mark Bittman to in his collection of Solstice links) the writer takes to her bed with the vapors because Mrs. Obama’s “Let’s Move” initiative is now focused more on exercise than dieting. Never mind what science tells us… Kids must diet. I could go on and on about all these links, including those castigating Black women ( of whom 50% are obese – we are told )... And these are just articles in “serious” media. The year-end weight loss adverts on TV have been going on since before Thanksgiving. There is material out there from the last 30 days to keep a Fatosphere blogger busy for a year and a half!
So what are we to do in the middle of this onslaught of disinformation? Well...
Yes, siree, it is the Health At Every Size® New Year’s ReVolution. We need to get the HAES® message out there to counteract the torrent of disinformation being put out there by a 60 billion dollar per annum industry which is BUILT upon the knowledge that diets don’t work. Here is how to join:
Have a look at the New Year’s ReVolution Resources website . Here you can learn how to participate by:
• Changing your profile picture on your favorite social networking site to promote the ReVolution
• Dedicating your Facebook status on January 1 to the ReVolution
• Posting about the ReVolution on Twitter using the hashtag provided
• Passing along the Lose the Hate, Not the Weight press release
• Sharing your ReVolution story at PDA Nation
• Following the website and contributing your ideas to get the message out there! For instance – getting a larger number of Google-hits, getting the message to new venues or new audiences…
Everything you need to ReVolt against the diet establishment is there. Check it out! Join in! Let’s make sure the word makes it out far outside the Fatosphere, where someone today might need to hear the HAES® message.
PS -- edited to remove a repeated phrase and a messed up link
And of course hope you had or are having a Happy Eid, Hannukkah, Diwali, Winter Solstice, etc.
and Lo Saturnalia!
and Lo Saturnalia!
A solid (and seldom mentioned) point in favor of Health at Every Size (HAES) is that being physically active and maintaining a high, stable weight results in a different type of large body than yo-yo dieting; a stronger body.
Yo-yo dieters lose fat and muscle and gain back mostly fat. The heart is a muscle, and it shrinks during weight loss. So, when weight is regained without anything being done to recover strength and maintain stamina, the heart stays small and the skeletal muscles don't redevelop. And weight regains are almost always done in shame, in self loathing, and in denial. When people who have previously lost weight are regaining it, we generally blame ourselves for everything - it's what we're told to do - but take no responsibility for the large body that's reemerging. Why would we take care of something that we hate and see as proof of our failure and weakness? How can we stay active when we - reinforced by society and the media - are telling ourselves that we have no self discipline and no self respect?
I've seen this happen to family and friends and it has happened to me too, on a lesser scale. I tend to lose and gain smaller amounts of weight, and never really on purpose either way - but I've fallen into the trap of not taking good care of my body when it's at its largest.
So, when saw this article: Weight Regained in Later Years Has More Fat, subtitled "Study: If Postmenopausal Women Lose Weight, They're Better Off if They Keep It Off," I had a completely different take on the study's results than the Rita Rubin, the author of the article. I would have called it something like "Yo-yo Dieting Cycle and Resulting Psychological Shit Storm Lead to People Neglecting Their Bodies When They Regain Weight."
The study of postmenopausal women suggests that when they regain weight -- and previous research suggests about 80% of dieters eventually do -- they don't recover as much lean mass as they lost. As a result, they end up with more fat, even if they're about the same weight as they were before the diet.
People lose lean tissue as well as fat when they shed pounds, the authors of the new study write. In fact, they write, studies have found that lean tissue represents roughly a quarter of total weight loss. Because the loss of muscle and bone can be especially detrimental to older people, "it is important to examine whether the benefits of weight loss outweigh the risks in this population."
The scientists analyzed the body composition of 78 non-active postmenopausal women, ages 50-70, before and immediately after they'd completed a five-month-long diet. The researchers then weighed the women six and 12 months after the weight loss trial ended and analyzed the body composition of those who regained at least 4.4 pounds.
Most Regained Some Weight
On average, the women had lost about 12% of their body weight. By the six-month follow-up, about two-thirds of the women had regained some weight; by the 12-month follow-up, about three-quarters had, including 11 women who had gained more than they had lost.
After one year, 84% of the regainers had put on more than the benchmark of 4.4 pounds. Those were the women whose body composition was analyzed.
The women had lost twice as much fat as muscle when they were on a low-calorie diet. But afterward, they regained more than four times as much fat as muscle.
Previous studies of weight cycling were done in younger people, who tended to regain fat and lean tissue in the same proportion as they'd lost it, says researcher Barbara Nicklas, PhD, professor of geriatrics and gerontology at the Wake Forest School of Medicine.
(I have to admit that I doubt the validity of the studies mentioned in the last paragraph. I suspect that younger people who regain weight also end up with a higher fat percentage. I've seen it in action.)
When I think about these issues, I do like to try to understand the reasons for things; what about our bodies is in our control and to what extent. I think that for most people, the weight regain is difficult or impossible to prevent, but that individuals have a much higher level of control over our physical activity and therefore our strength, stamina, balance, and flexibility.
Now, some people may say "Fitness is not a priority for me." Fair enough. But, for myself, I've found that being at least minimally active really adds to my quality of life, and nobody should deny themselves a basic level of fitness because they don't keep weight off. Very few people can maintain large weight losses. Most people can fit in 1/2 hour a day of walking, a bit of swimming, a recreational sport, some yoga or pilates, a few dance classes a week - and will enjoy both the activity and the benefits it brings.
If I found myself gaining weight for whatever reason - normalizing previously restricted eating, a prescription drug, a medical condition, menopause, whatever - I hope that I would be able to create a strong, balanced larger body with good posture and the ability to do everyday things like stair climbing, fast walking and short jogs without undue strain.
The lesson I'm taking away from this study is to avoid yo-yo dieting by not dieting in the first place. However, people who have already dieted or who feel they must make the attempt may find that it's a good idea to keep fit regardless of what's going on with their weight. I think that this lose-muscle-gain-back-fat effect could be mitigated if yo-yo dieters kept up some physical activity during the regain part of their cycle, and I think that people whose bodies have already been affected by this and who are now fat accepting can reverse it by easing their now-loved and accepted fat bodies into a higher level of fitness, if they choose.
In a way, the article's author is both too optimistic and too pessimistic. She thinks it's reasonable to tell middle aged women to keep off weight that they've lost while dieting, but treats the net loss of muscle in the yo-yo cycle as permanent and inevitable. I think she's got things backwards.
It's interesting to note that the researchers themselves present the study's results in a neutral way, at least in the abstract. The study is called Is lost lean mass from intentional weight loss recovered during weight regain in postmenopausal women? The first and last authors are Kristen M Beavers (it's her paper) and Barbara J Nicklas (it was produced in her lab) and it was published in the American Journal of Clinical Nutrition in September 2011.
Salon.com posted an article today, "Why Women Need Fat,", subtitled "Evolution shows that women's dieting beliefs aren't just unrealistic -- they're unnatural. An expert explains," by Hannah Tepper.
It's a review of a new book called “Why Women Need Fat,” by Steven J.C. Gaulin, an evolutionary biologist, and William D. Lassek, a retired doctor of public health at the University of Pittsburgh. The article features some nutritional theorising (omega 6 acids are the villain), and the idea that Americans as a group are heavier than we should be is dutifully reinforced.
Be that as it may, set point theory - the idea that our bodies have a certain weight or weight range that they tend to gravitate toward - is presented as a well supported idea among evolutionary biologists and it's acknowledged that human beings naturally have a wide range of set point weights. While it seems that the book is aimed at women (because we are more likely to indulge in weight loss dieting), it's hinted that the author has a slightly different take on men and fat.
Many M.D.s have bought this fallacious line that the optimal weight for women in terms of their health is what M.D.s call normal weight, a BMI between 18.5 and 25. And they have thought this to be true because women with higher BMIs exhibit a series of physiological measures that are indeed risk factors for disease in men. But they are not systematically risk factors for disease in women. If you actually look at the data from the National Health and Nutrition Examination Survey and data from studies done in other countries, the optimal weight for women who have had a kid is what doctors currently call “overweight.”
The next line? "I’m not saying that obesity is optimal..." Well, we certainly wouldn't want to promote obesity! However, implying that a 30+ BMI can be natural and healthy is not at all the same thing as saying "obesity is optimal." Given anti-fat bigots' typical (lack of) reasoning skills, I guess he had to cover his ass on that one.
The term “Processed Foods” is one that we frequently treat as one that is universally understood and defined, or one that is “we all know” - rather like Justice Potter Stewart’s famous phrase concerning pornography – “I know it when I see it”. Truth, however, is more complicated than that.
When one person talks about processed food, they may be talking about anything that is not in its whole state before it is cooked (for instance, white rice could be considered processed food in that context). When another person talks about processed food, they could be talking about frozen, microwave-ready meals made for the purpose of dieting. There is a lot of daylight between those two extremes. In order to discuss food and processing meaningfully, we need a new framework and an agreed terminology.
What I will do in this post is lay out the terms of the discussion – the framework for talking about food, processing, and fat. I will talk about why and how food becomes ‘processed’ and the reasons why humans ‘process’ food. I will also define the common terminology we can use to talk about fat within the context of food and ‘processing’. Finally, I will show how this coalesces into what I call the hierarchical ideas about food which become the stick with which to beat fat people.
The first beam in this framework is the definition of a processed food. What is almost always missing in conversations about “pure” or “processed” food is an understanding of what constitutes a processed food. For the purposes of the discussion over the entries in the series, I won’t take the very nerdy and picayune position that chewing food or cooking food is processing food – while technically correct it is needlessly confrontational. I intend to be as descriptive as possible when discussing a food which has been altered from its original form in any way. In that way, it will be easier to tease out which kinds of processing are meaningful in a discussion of fat and which are not meaningful. Thus a definition of ‘processed’ food is meaningless absent a discussion of why food is ‘processed’ and how this is accomplished.
The Means of Processing Food
For as long as humans have been on Earth, foods which have been altered from their raw state (whole grains or plants, milk and honey as taken from the animals that produce it, or raw animal flesh from butchered animals) have been part of the food ecosystem. They were necessary to feed and nourish people throughout the year (for example, pickling), or for other reasons (shelf stability – the food can be kept on the shelf at room temperature without getting rancid or spoiling). These methods of processing were developed in response to these needs in addition to those of averting vitamin deficiencies, feeding of military forces, and food transportation needs.
Our modern society is so far from its roots in agriculture that we frequently forget the original purpose of food preservation which was to get through bad harvests or the non-growing seasons, while also preserving vitamins in the food to prevent disease. We needed to make foods stable so that an oxcart, or a rail car, could get them from point A to point B without refrigeration to retard spoilage. In place of these very basic requirements a new need (real or perceived) has arisen (convenience and speed of preparation) which accounts for the rise of the prepared frozen meal or the convenience food.
The latter are the ones who have caused the most recent concern, yet the food scolds and wags often point to foods preserved using techniques which are old as time, and offer instead foods of which we should be suspicious. For instance, we are told we should prefer a “sugar free”, 100-calorie pack of cookies over a strip of bacon, because the bacon (in their minds) is the evil source of salt and fat.
Traditional food preservation and preparation methods are frequently unlovely, but they are most effective. Smoking and salting food go back as far as the earliest human settlements. Bacterial and yeast action give us fermentation of milk products as well as fruit and grain (think yogurt, wine, and beer). Our Asian ancestors developed tempeh (fermented soybeans), and tofu. Our European ancestors gave us bacon, and ham, and aged beef, and smoked or dried sausages. Salted and brined foods abound in Africa. Beer was brewed in Mesopotamia. White flour was developed to prevent milled wheat from going rancid in a short time, and was then fortified to address the vitamin deficiency this causes. In all cases the needs of humans to preserve their food drove the development of methods that were achievable and cost effective for the time and the culture.
Canning food allowed our more recent ancestors to have tomatoes in December, but the techniques used to put food in cans trace back their lineage to Napoleon’s need to feed his army during his empire-building campaigns. Napoleon’s campaigns and pretty much every war humanity has ever fought brought about advances (great or small) in preserving food – from (allegedly) wet soybeans turning into tempeh under a saddle, to pressure-canning for Napoleon’s boys. Frozen foods (developed in the mid-20th century) offered a superior way to preserve vitamin content and fresher taste, and enabled us to have such delicacies as summer green beans in February simply by investing in a freezer and the electricity to run it.
The foods resulting from these techniques (some of which are thousands of years old) are ‘processed’ foods. All of these were around during that blissful past that commenters in my hometown paper like to bring up as having “no” fat people (I love it when they say “look at the old movies there were no fat people”). Some were around even before that, so it is false to say foods were ‘unprocessed then’. Yet, we need to find words to distinguish these foods from those that some suspect are causing ill effects in the population.
A Common Terminology for Processed Food
As a general rule, I’ll use the following words for the remainder of this series:
Whole or Raw Food : A food which is as close to its original state as possible. A whole grain qualifies, as does a raw vegetable or raw meat.
Staples: Flour, salt, sugar, butter, oil… This category can get hairy, and play a large role in this discussion. For now, anything that you would not ordinarily eat as a food without further cooking is here. Rendered fats (such as lard) are here.
Traditionally-Preserved Food: This vast umbrella term will embody food that has been salted, smoked, brined, pickled, dried, fermented (except for fermentation intended to produce alcohol such as wine or beer). Anything “potted” (cooked then packed in fat or some other medium) would be included here, as well as food products or sauces made by including microorganisms such as molds (e.g.: some cheeses). This is not an exclusive list, however, because I cannot say that I know all the means humanity has ever used to preserve food. Humanity is endlessly creative when it comes to feeding itself.
Home-Canned Foods: Food prepared and canned in the home, using any standard method. Jams are in this category, as are any foods or produce put in cans by home-canning methods. This could mean apple-pie filling or meat sauce.
Home-frozen Foods: Whole foods (such as garden produce or raw meat) preserved at home by freezing in a home freezer.
Frozen Whole Foods: These include whole foods preserved commercially by freezing and marketing as such. Your frozen raw fish fillets (not breaded or otherwise altered), and your frozen mixed vegetables fit in this category.
Shelf-Stable Foods: A lot of what we call ‘processed food’ fits into this category. You can have blue boxes of macaroni with cheese powder stuff, biscuit mixes, muffin mixes, condiments, syrups, cereal. Peanut butter is here, as are canned soups and other ‘just add water’ or ready to eat foods. If you can take it off a shelf and mix it up and eat it (or eat it straight off the shelf) it lives here. These foods tend to have a bunch of additives to allow them to stay moist, fresh-looking or tasting, mold-free, and unspoiled for some long time.
Prepared Foods: Your frozen diet food is here, ice-cream, frozen hamburgers, frozen meals of any kind, prepared pies that you buy at a store, frozen cakes… Anything labeled “processed ____ food product”… These all belong here. This is the home of another large population of foods we call ‘processed’ today. Ditto on the additives here.
I have chosen these words because they are as close to morally-neutral as I can get where food is concerned. They are descriptive, they offer information, but they are not ‘dog whistles’ for those who consistently give specific foods any kind of moral label. Yet, for the purpose of discussing food and fat, we also need to face what I call the food hierarchy.
Hierarchical Ideas about Food
The second beam in the framework is an understanding of the Food Hierarchy which rules the public discussion about food. Understanding this hierarchy and how it works is important in separating fact from fiction and prejudice. This hierarchy of foods has taken hold of people’s imagination, and reflects perfectly the societal views of poor people and fat people and this is where we run into trouble. Foods, even if they belong to any of the ‘processed’ categories listed above, can be considered (magically) morally correct or morally suspect by their identification with either the “rich and thin” or the “poor and fat”.
When I read any article by specific food or health writers in my hometown paper, and also read the comments by fellow readers, I am struck by the implicit hierarchy that has developed, and that many have brought up in BFB and other blogs in a variety of contexts. I read these articles between the lines and I find the prejudice pretty easy to spot. For example:
• Why is tempeh superior to cheese? A food wag may tell you that tempeh is a vegan option which has protein and low fat and is kinder to the earth than cheese (which requires the existence of a cow). He or she will also tell you that it won’t make you fat and/or that it will help you lose weight (neither of which are true). The first objection actually makes sense, provided you are vegan or vegetarian (or want to be), and that you like tempeh (I don’t happen to, but many do). The second is just fat hate disguised as concern.
• Why is a Serrano ham superior to sliced ham? Both have been treated with salt, but one is an artisan ham. I think a Serrano has the superior taste, but I will also argue that someone else might possibly prefer a sliced deli ham and that preference is just as valid. A good whole Serrano will cost you well over $1,000 (and a good bit of that is importation cost). You need to be pretty well off to eat Serrano on a regular basis. This is less true of commercial ham products like sliced deli ham. Still, a Serrano ham sandwich on a good piece of baguette won’t send a food snob to bed with the vapors, but sliced ham on white will – and you will be told you will get fat for eating the second option. Even so, each is still a ham sandwich (much as I adore Serrano, I have to admit this).
Now, don’t get me wrong here. I’m not a great fan of tempeh, I like cheese, and I like both types of ham, and I appreciate the qualitative difference between the options. None of this is about the foodstuff in and of itself. It is what the foodstuff symbolizes in the minds of the writers and wags who are forming opinions about food, and particularly food that has been prepared or ‘processed’ in some way that is associated with a lower class of society. Somehow the cheese (particularly inexpensive cheese that is accessible to poorer people) or the deli ham becomes a symbol of that which makes people fat, it is “processed”. Then, in a feat of cognitive dissonance that would rival Superman leaping tall buildings, the more refined expensive foods seem to lose their ‘processed’ nature by association with the thin and the rich, even if a given cheaper alternative does not contain suspicious ingredients that adulterate the food and could conceivably cause a problem.
So now, I’ve set the framework that we will use to talk about the different types of food processed in different ways. I’ve pointed out the food hierarchy that serves to confuse the issue and reinforce stereotypes and societal prejudice. Next post I will talk about the changes we have seen in food preparation and preservation over 100 years, how some of that came about, and what that has meant for fatties.
In the meantime – are there any other categories we should consider? Would you have more categories or fewer? Would you describe them differently? I’m looking forward to hearing your ideas.
(Edited to correct a grammatical error -- I'm sure I will find more of them - and my husband did find another typo)
I just received a copy of Lesley Kinzel's new book, Two Whole Cakes - How to Stop Dieting and Learn to Love Your Body, and I must say, it's a very good reading experience. My uncorrected proof copy was 167 pages and I finished it over the course of 2 days (would have finished it in one sitting but we had one of our granddaughters over for the weekend).
One of the things in the book that really resonated with me was the part about how fat women are expected to look when we go out in public:
On the one hand, sweatpants and shirts with grease stains are a statement no matter who is wearing them. Their message is, "I don't care about how I'm dressed right now." The "right now" is important because one cannot always assume that a person who runs to the corner store in sweatpants and a soiled shirt necessarily dresses that way all the time. If the person wearing the clothing is otherwise slender and attractive, we're usually willing to imagine the reasons why: maybe she's sick, or maybe she's in the middle of writing a term paper, or maybe she's doing laundry. She must have a reason. But when it happens to be a fat person who is sloppily dressed, the stereotype kicks in: the sweatpants and stained shirt represent not only a disregard for fashion at a given moment in time, but a systematic failure to adhere to the most common standards of appearance. A fat person is believed to have little respect for her appearance in the first place, simply by virtue of being fat, so she cares nothing for fashion, and of course she has no regard for the tender eyeballs of those other individuals upon whom she foists her sweatpanted, stained fattery in public. She is a visual - and even moral - disgrace.
Yet, she also may be sick, or writing, or doing laundry. And even if she's not, even if she is simply a person not much interested in fashion, she should have the right to step out into public, fat and sloppily dressed, and not be forced to face candid disgust from strangers. What is she doing wrong? How is she hurting anyone? She may offend our delicate sensibilities but ultimately there is no real damage done, except to our expectation that people who fail to meet cultural standards of attractiveness should not offend our sight in public, that we should be protected from having to look at them.
There are so many more passages that hit home with me, and I think will hit home with any woman who reads this book, and it won't matter what size she is. If you've ever hated your body because it wasn't the right size or shape, Two Whole Cakes - How to Stop Dieting and Learn to Love Your Body is one of the books that should be on your to-read list.
This study isn't new, but it certainly gives good evidence that putting fat children into foster care isn't going to make them thinner.
From the journal Child: care, health and development November 2008;34(6):710-2.
Obesity in looked after children: is foster care protective from the dangers of obesity?
by SC Hadfield and PM Preece.
Unfortunately, the full article does not seem to be available for free online. However, here's the abstract:
Obesity in all age groups of children has become an increasing concern in recent years. Children looked after by the Local Authority (LA) should be protected from health problems while being accommodated. These studies assess the effect on weight of looked after children (LAC) in the care of a Midlands County Council. They assess the frequency of obesity or overweight problems in looked after children following receipt into care and review changes in body mass index (BMI) while in the care of the LA.
The height and weight measurements of all 106 children who had statutory health assessments while in the care of the LA between 1 January 2004 and 30 December 2004 were used to calculate their BMI. The data were plotted onto standard Growth Foundation charts and the International Obesity Task Force Paediatric cut-offs were determined to distinguish overweight and obese children and young people. The date that the child had come into the care system and the number of moves of placement was obtained for each child from the social care. This was related to the total group and the overweight group of looked after children.
Looked after children are more likely to be overweight and obese compared with standard norms, and there are a number of children (35%) whose BMI increases once in care.
Looked after care did not protect a child from the national problem of increasing weight gain and obesity.
Contrary to the common assumption, the families of fat kids may tend to be better at helping them learn to manage their eating and activity than a family who isn't used to having to worry about it. After all, the tendency to put on weight is highly heritable, and adults who have had to deal with it are likely to be more knowledgeable about how to mitigate it. And, of course, stress tends to cause weight gain (maybe even independent of emotional eating) and it's hard to imagine a worse stressor for a kid than being taken away from their family.
It's a small study, but the results don't surprise me.
Good ammunition for debates with people who think this kind of thing is helpful...
But I'm here to tell you about her new project: the 2012 FAT!SO? dayplanner. Full of quotes, art, factoids, and body-love events, it's available from Voluptuart, a fabulously fat-friendly shop. You can buy it here.
- Original art on a fat animal theme each month by Barry Deutsch, Jill Pinkwater, Les Toil, and more
- A built-in flipbook of national dance champion Ragen Chastain
- Body-positive tips and resources
- Quotes from fat pride and Health At Every Size® leaders
- DIY projects
- And it comes with a fat animal paperclip and surprise gifts!
This dayplanner is printed on 100% post-consumer paper by worker-owned collective. At 4.25" x 6, it has double pages for each month and week, lots of blank pages (lined and grid), and a sturdy cover.
All dayplanner sales support creation of the Weight Diversity Action Lounge, a community center, and it's priced at a very reasonable fourteen bucks.
This looks like it would make a perfect gift for all of your fat activist friends, or anyone who might benefit from some body positivity in their lives.
I moved to the UK a year ago, and I want to share the lowdown on clothes shopping here. In short? It's a veritable paradise if you wear a US or Canadian 14W-18W (maybe up to a 20W). This is because around half of normal British shops carry large straight sizes: 20, 22 and sometimes 24. Almost all of them carry sizes at least up to an 18.
Let me explain why this is a big deal to me.
I grew up in the US in the 1970s and 80s and lived there until 2003. Then I moved to Toronto and was unsurprised to find that Canada is just like the US when it comes to large sized women's clothing. Through my entire life until the past year, I've had to shop in plus-sized stores. I could never just walk into a department store and find something that fit me. I'd have to go to the fat lady section, hidden in the back of the top floor or the basement, with vastly inferior styles and quality and higher prices. Alternatively, I could shop at Lane Bryant, the Avenue, Ashley Stewart, Addition Elle, Pennington's or one of a very few regular stores that carry 16s and 18s in North America. The trendy shops have always been out of my reach.
I've worn between a 14W and a 20W (16-22 in straight sizes) all. my. life. Yes, it's been a good 30 years that I've been in that size range, ever since I got to be tall enough to wear women's clothing. Before that, I occupied an even deeper circle of sartorial hell: the boy's "husky" section.
I've always needed to shop in the plus-sized ghetto because the vast majority of American and Canadian clothing lines stop at a size 14. Now some people will say "there's been size inflation since you were growing up and US 14s are like British 18s." Well, as far as I can tell, size inflation in the US has been in waist measurement only. My waist has always fit into a smaller size than my hips; it's my hip measurement that's the deciding factor. With bigger waists, US clothes are even more ill-fitting on me than they used to be.
Additionally, British straight sizes are not two sizes smaller than US straight sizes. They are only one size smaller, if that (for me, anyway). They're two sizes smaller than US plus ("W") sizes, which run a size bigger than straight sizes. Got it? So I have UK 18s and 20s, US 16Ws, and US straight-sized 18s in my wardrobe right now. Complicated.
Let me tell you, most British clothes are cut more generously in the hips and chest than North American clothes. Women with pear and hourglass shapes, take note. They also seem to be proportioned for shorter women. I'm 5'-4" or 5'-5", and I never wear petites in the UK. I wear "mediums" or "shorts." Yes, they have four inseams on most women's trousers: tall, medium, short and petite. The petites are actually made for women who are around 5' tall, not for women who are really medium height, like me.
I freaking love British clothes. The 20s fit me. They really fit, almost perfectly. I can even wear an 18 in some dresses. Some brands are cut straighter through the hips and those aren't as good for me, but my god. I can walk into a department store and buy almost anything I want. A mini skirt? They've got it in my size. A cheap but decent looking suit? Ditto. A nice dress for a wedding? No problemo. I was looking for one, and I found 10 of them to try on at Debenhams. Ten that I liked and eight of them fit! It was the first time I'd ever been able to choose something based purely on style. In North America, I'd count myself very lucky if I could find something that fit, was appropriate, and didn't look cheap.
This isn't true at every department store, mind you. Marks and Spencer has up to a 24 in most things. Debenhams carries up to an 18, 20 or 22, depending on the clothing line. Monsoon has everything in their regular line up to a 22. Evans, the UK plus sized chain, goes up to a UK 34, and I wear an 18 or 20 there just like I do at the other shops. However, House of Fraser is hopeless (their clothes are cut narrow through the hips and end at an 18) and John Lewis seems to be as well (they don't have sizes on their hangers, so it's hard to figure out what, if any, ranges go higher than an 18).
SO... if you're in the US 14-20 size range and are thinking about visiting the UK, bring some money for clothes. If you wear a 14W, there will be very few places that don't have your size. Almost every UK shop goes up to at least an 18.
Here's me in some British clothes. Click on the picture to go to the description on Flickr:
The bad news? If you wear over a North American 20W or UK 22 then you'll find a better selection in North America. The UK has fewer plus sized shops because the smaller, more common plus sizes are easy to find at regular stores. I think we should have a shopping post for size 24+ Brits visiting the U.S. and Canada next.
When a person is craving weight loss, they are never craving weight loss. Weight loss in and of itself is meaningless. A person tends to crave weight loss because they believe that lost weight will change their life in some way. Hirschmann and Munter talk about this in their book When Women Stop Hating Their Bodies, saying that women tend to fall into the mistaken belief that you change your body and you change your life. Kate Harding pointed out in her landmark post on The Fantasy of Being Thin that we don’t imagine ourselves just as a thinner person, but as a different person. When a person wants to lose weight, they want something else to change.
Maybe the person wants to lose weight because they want to feel better. Sickness and lack of energy are never fun. We have been told so often that the only way to feel better is to lose weight. Yet, many individuals in our community have found that they feel better when practicing HAES, whether or not they lose weight. And, people who practice HAES tend to stick with those healthy behaviors, while people who diet don’t tend to stick with it.
Maybe the person wants to lose weight because they believe they cannot have a relationship without it. What if your ideal partner likes bodies just like yours? People exist who like plump bodies, and people exist who like big fat bodies. For me, that belief that my body had to be a certain size for me to be lovable led me to two very nasty situations. First, I tended to get into abusive relationships as they used my insecurity to control me. Later, I could stay stuck being single. I didn’t have a relationship because of my body, not because I wasn’t ready for one. If your ideal relationship hasn’t come your way, then I suggest you think about these things: are you ready for a relationship? Are you open to a relationship? Does something need healed in your life before you can be in a healthy relationship? Do you like and love yourself? These kinds of questions are so much more important than body size when it comes to healthy relationships.
Maybe the person wants to lose weight because they want to be more accepted by society. Now, this is the hard one. On the surface, it is easier to change our bodies than to change society. Yet, to reach true acceptance we must change society (especially since changing our body seldom works in the long run). I know that some people just want the fat hate to end and don’t have the energy to fight it. I understand this desire for weight loss more than any other. However, I know that focusing on weight loss usually leaves the person with lower self-esteem in the end. A fat person who attempts weight loss to please society is more likely to believe they deserve the treatment they receive. Add that to the feelings of failure that dieting usually brings and these beliefs can have a devastating effect on self-esteem. I have found that the less I believe that I deserve mistreatment, the less mistreatment I get. So, changing our own attitudes about the fat body is the first step. Secondly, I have found that some kind of activism helps me deal with this lack of acceptance. It may be as small as telling a good friend about FA, but activism helps me feel less powerless when facing society’s fat hate. Besides, I firmly believe we will succeed in eradicating fat hate one day.
These three examples are just a few of the reasons people want to lose weight. The weight loss is always a means to end, however. And, the thing about weight loss, the individual can get stuck in trying to achieve weight lose weight and loses sight why they were trying to lose weight in the first place. Attempting weight loss is a great way to keep us spinning our wheels and going nowhere.
So, the next time you catch yourself thinking “I want a [smaller, different, thinner, etc.] body,” I encourage you to ask yourself, “What is it I really want?” Once you figure that out, focus on getting your true desires, rather than getting bogged down in weight loss. You are more likely to succeed in the end.
And, in other news, I have sent my first book off to my publisher, Pearlsong Press. Yay! Yay! Yay! The book, called Talking Fat, is about the rhetoric surrounding the push to eliminate obesity. It should be out before the end of the year. I will keep you updated as to its progress.
Before I move on to the rest of the series concerning food (as outlined in Beloved Fantasy of a Blissful Past) I want to take a small detour. I was overjoyed and inspired to see everyone’s family pictures in the comments to the post, and fate conspired to bring wonderful images of fat people into my life.
See, I had always wanted to go to the Hermitage Museum, but for a variety of circumstances have not been able to do so. This past week I was overjoyed that I was able to see some of the treasures even if I am not in St. Petersburg (Russia)! I happen to be home (Madrid, Spain) spending some time with family. Madrid is one of the world’s great cities, with lots to see and lots to do. One of my favorite spaces is the Prado museum. If you live anywhere near Madrid or if you can take a plane, train or automobile to get there and can find a place to stay, you need to see the exhibition Hermitage at the Prado Museum. Selected works from the Hermitage are being shown for a short time in Madrid. I can honestly say it was the best 12 Euros I have ever spent. I was so very anxious to see this exhibition when I found out it was here, I could not wait to go! I really did not know what to expect as I did not know what works were selected, but when I went there, I saw images that I really needed to see. My soul needed to see them.
I had been thinking all week about how I had grown up and what messages I had received throughout my childhood. For me, as for many of us, being with family brings up memories – very physical memories – of experiences that we ache to forget: thoughtless comments, snide remarks, bullying, and for some even worse. I remembered in my body all my experiences that led to dieting and its predictable sequelae, which I will not belabor as I do not wish to trigger anything for anyone. So… I was under some mental stress the afternoon I went to see the exhibition. I had to wait until the next showing (they only let in a certain number of people at a time). I waited outside, seated in a nice spot of sun poking through the clouds of the off-and-on rain. A busker was playing classical Spanish guitar compositions nearby and the setting brought peace, and I willed myself to live in the moment. It was a perfect respite, and balm for my stress. Soon, I was able to go into the exhibition.
As I passed the first sections featuring explanatory notes on the Hermitage, and saw the first works, I was overjoyed! One of the first pictures is of Catherine II, Empress of all the Russias, painted by Johann Baptist Lampi in 1793. Here is the link to an image of the picture (note – these links are to arthermitage.org – please see the pictures on their site):
I saw a beautiful, strong, intelligent woman who was also fat and was one of the most powerful people in the world at that time. She created the nucleus of what was to become one of the top art collections in the world (1).
One of the paintings in the exhibition which affected me most deeply is by Lorenzo Lotto, painted between 1529 and 1530. It is an image of the Holy Family (Mary, Joseph, and Jesus) pictured resting during their flight to Egypt after the birth. St. Justine is featured also in the work. The work itself is just beautiful, with its use of light and shadow and the folds of the clothing, but look at the image of Mary and that of the Child – they are round, plump, and healthy. If your culture tells you that the Holy Family is the image of all that is good, then you paint them with the attributes of what is good. Clearly, to Lotto fat is good and fat speaks of love. Even if you remove any reference to religion (pretty hard to do because St. Justine has the dagger of her martyrdom in her chest, but one can try) it is still a loving image of a beautiful family.
Another favorite was this beautiful painting by Pompeo Girolamo Batoni, painted in 1747 – Mercury crowns Philosophy, the Mother of the Arts. The theme of the work goes back to the idea current during the Enlightenment that Reason with the foundation of Philosophy, can build an ideal world. Art was a part of such an ideal world. The symbology of the work is dense, and a great subject for another discussion. Suffice to say that Philosophy, the central female figure who is also fat, holds a scepter which is a symbol of her power over Reason. Philosophy is beautiful, solid, powerful, fat… She is the foundation of a more perfect world. Right there, in a nutshell, the antidote to fat hate. It is the cooling unguent to heal the lashes we receive every day.
There are so many others…
The Portrait of a Scholar by Rembrandt from 1631
The Portrait of a Young Man Holding a Glove by Frans Hals (1649)
Picasso’s Seated Woman from 1908 (a powerful expression of womanhood).
We need to see these. We need to seek these out. We need to surround children who are fat with these positive images as part of an all-out effort to protect them from the haters. I fear for their very souls since the crusade against fat people now endangers their mental well-being, their soul, as well as their physical lives. The fat hate which is the destroyer of joy and innocence keeps growing and has insinuated itself into daily life in such a way that there is no longer an escape for a young person growing up today. We are fighting for our lives and, more importantly, we need to fight for children’s lives and their very selves
We need to approach the problem from many perspectives, and I believe providing a different image to counter what is offered by the fat haters is crucial. I do not claim that art appreciation is the solution to the entire problem, but I probably would have had a different outlook on life if someone had shown images like these and explained what I was seeing and their meaning.
What art, of any kind, have you seen lately which offers powerful and positive images of fat people? What images need to be created in order to reach today’s young people in a symbology and medium they understand and accept?
(1) I am sure that those well-versed in Russian politics and social history could take issue with much of what she did or what those who followed her did, but I am staying away from that topic on purpose – this is about her art collection and what it contains that we who are fat need to see.
(or: how to survive the holidays, family, and work as a fat activist)
Size activists are often put upon by trolls, ‘concerned’ friends and family, devout healthist employees and the like, who make it their urgent business to disillusion us happy cows as to our cow-icity. They make vague future death threats, evo-psych abstractions about how fat equals fewer erections and hence is objectively bad for the race, and how they saw a fat person once who wore a crop top that exposed her rolly middle and hence BAM! all fat people are delusional liars.
Their world is rife with wandering monstrosities of muffin-top and jiggly arms, made even more frightening when those same jelly bellies join the mating pool. And of course, we must think of the children, who are being force-fed donuts and video games at alarming and increasing rates until, you know, WALL-E. And the trolls don’t want to lose their bone density, see. It’s all the fault of the fatties and their fatty culture of sin.
Sadly, these angsty fellows and fellas are a higher percentage of the population than can be comfortably laughed at. They also come by their misinformation with usually no particular malicious intent, and their invectives are backed by the power of over 300,000 blinding suns—er, fat-hating messages a year. That level of propaganda is full-out cultural penetration. It’s like being an atheist in medieval Europe. You’ve got three options: shut the hell up, pretend to agree and privately subvert, or prepare for the guillotine.
Shut the Hell Up
This one’s a daily practice for many an enlightened fatty, and comes in several forms. My favorite form is to live life the way you would if you were thin(ner) while directing an extended third finger at the heckling crowd. When you come upon the twisted specter of discrimination, avoid it. Fighting a person bombarded with over 300,000 fat-hating messages a year is often an exercise in futility, leaving each party drained and the fat-loather further convinced of his paranoid vision of impending fat doom. Your links are never read, and the smallest particle of flab on your person disqualifies you from serious opposition, like having a fat body is a conflict of interest in arguing for fat rights.
- Pros: Peace, time to do things other than be an activist, keeping your ideals intact and unchallenged, setting an example for the open-minded, keeping your friends and family as they are.
- Cons: Guilt, a sense of disconnect from the community, wondering whether or not you could do more good through direct activism, missing the thrill of vanquishing a troll, allowing fat-hating people in your life unchallenged (unless you decide to avoid them altogether).
Pretend to Agree, but Privately Subvert
This one’s sneakier and comes with ethical difficulties. It’s not for the faint-of-heart. This is when you smile and nod over a coworker’s tireless talk-up of his regimen of Splenda-flavored air after you’ve pinned an HAES flyer to the company bulletin board. Or when you get a medical degree in which you’re forced to agree with the prevailing theory of fat (where ill-health is a function of fat-related hormonal overflow and weight loss is a viable prescription) in order to graduate, though you plan to start a kick-ass HAES practice upon graduation. Or when you massage the language of a grant proposal so it seems like you’re toeing the ‘obesity epidemic’ line though your research may very well show there is no such thing as the obesity epidemic, as such.
- Pros: You’re a sheep in the wolf’s den, dressed as wolf.
- Cons: You’re a sheep in the wolf’s den, for chrissake!
Prepare for the Guillotine
And in such a way activists are born, running from an angry mob nipping at their heels, into another angry mob waving firebrands and pitchforks.
There’s no escaping the 100% penetration of fat-loathing propaganda. It’s not just the pitter-patter of hate-droplets on a misty October morning, it’s the thud of golf-ball-sized hate-hailstones into you, your prized possessions, and everything/body you love. Those fat activists who prepare for the guillotine are out in that storm, bearing down under its destruction, that they might see a patch of blue sky in their lifetimes.
- Pros: The thrill of the maybe-martyr, being able to live by one’s principles (loudly), likely changing a lot of lives with a hit blog, book deal, performance, article, or study.
- Cons: Maybe martyrdom, hate mail, the very real danger of being stalked or receiving death threats, being seen as a whacko for holding non-mainstream views and hence having a difficult time getting conventional jobs/academic positions.
Your Turn: How do you argue with fat loathers?
Author’s Note: Certainly there are multi-faceted, nuanced and complex approaches to size activism not included in this largely (ha!) humorous post. I hope you enjoyed it anyway.
This post is a follow-up to The Edmonton Staging System: Post 1, Basics.
The stated purpose of the Edmonton Obesity Staging System (EOSS) is to predict early death and disease in fat people. It's an attempt to define clinically significant "obesity" without resorting to BMI. But, the conditions it's based on aren't necessarily causally related to weight, so it doesn't really disassociate obesity from BMI. Instead, it associates the diseases of ageing with weight when they occur in fat people. People with BMIs under 30 won't be classified according to the system, even if they have the diseases and conditions that define the stages.
Every disease that kills fat people kills thin people too. Thin people get type II diabetes. Thin people can have high blood pressure, high triglycerides and high cholesterol. Thin people get heart disease and die of heart attacks, all while having BMIs under 25. Many fat people never develop diabetes and/or begin to experience the diseases of ageing at the same time of life that their thin peers do. However, when fat people begin to experience health problems as they age, the Edmonton Obesity Staging System will associate those problems with their weight and consequently weight may be treated as the root cause.
The structure of the EOSS suggests that any health problem that's correlated to higher weight is part of a progressive syndrome called "obesity." In reality, causality is always more complicated than that. For example, family history may play a more important role than weight in diabetes and heart disease, and joint problems may be partly or entirely due to injuries. These factors shouldn't be ignored when another risk factor (high BMI) is present. The way the staging system is structured implies that fat people will inevitably advance within its framework. Conveniently, that's usually true. Why? Because the conditions and diseases associated with a high BMI are also associated with ageing. Almost everyone, fat and thin, moves through the EOSS stages as they age. However, fat people don't inevitably move through them more rapidly. There are fat people who stay at stage 0 or 1 for many decades: 30, 40, or 50 years. An unusually large body is not a progressive disease.
It's not all about weight. If weight were the main factor in health and life expectancy, then we would be seeing much bigger differences between fat and thin people in mortality and morbidity. Hell, thin people would live forever. In reality, fat people don't necessarily die earlier or use significantly more medical resources than thinner people. Maybe the EOSS is partly an attempt to resuscitate the weight based health paradigm in the face of evidence that body mass index (BMI) doesn't do a very good job of predicting mortality or morbidity for individuals - or even populations, except at extremes.
I don't want to get down on the doctors too much. They're not the only ones responsible for the weight based paradigm. In fact, I'm pretty sure that the medicalisation of body size arose in the early twentieth century largely as a response to women's demands for thin, fashionable bodies (and that's a series of posts - or a book - in itself).
To be fair, we're weird here at BFB and in the fatosphere. We're fat people who accept our sizes and want our doctors to do the same. But we are not the majority of fat people.
Many (perhaps most) fat people are desperate to get thin at any cost because of the social stigma, blaming and shaming they're experiencing. Doctors are usually happy to provide "health" as an excuse. The problem is, there is no safe, effective way for most people to lose a significant amount of weight permanently. Every weight loss treatment - from yo-yo dieting to pills to weight loss surgery - has a (sometimes devastating) impact on quality of life and carries significant health risks. The Edmonton Obesity Staging System provides doctors with a way to say "no" to dangerous weight loss treatments for healthy fat people. Why would you provide someone with a normal life expectancy with surgery that could kill her or pills that could damage her heart? This is actually very sane.
The problem is that the staging system creates categories for "good fattie and bad fatties" - it makes healthy fat people into exceptions. However, everyone is going to turn into a bad fattie as they age and nobody, whatever their age or state of health, deserves to have their health problems blamed on their weight and potentially be told to "lose 100 pounds and call me in the morning."
So, if the EOSS is meant to protect healthy fat people from dangerous (and expensive) weight loss treatments based on a rough cost/benefit analysis, then so be it. I just hope that nobody is intending to use it to limit access to treatments for health conditions that are correlated to high BMIs ("hypertension, type 2 diabetes, sleep apnea, osteoarthritis, reflux disease, polycystic ovary syndrome, and anxiety disorder"). Even when the statistics say that a person's BMI is increasing their risk of disease or early death, it doesn't say anything about causation and it doesn't mean that weight loss will have any effect. Sometimes the condition is responsible for the high BMI, not vice versa. And in any case, everyone deserves good medical treatment regardless or what they weigh and regardless of whether or not they lose any weight.
I think all fat people would agree: if we experience a health problem, we'd like our doctors to use the same treatment plan that they would if we were thin. Even people who think that their weight is a problem that can be fixed still don't want to be denied treatment based on it.
Instead of providing a blow-by blow of the research behind the EOSS and the media coverage of it, I'll leave the links with you. There's a lot more analysis that could be done, here. Hopefully these links will help anyone who's interested in following up.
Dr. Sharma's Blog
These are some of the main posts on the Edmonton Obesity Staging System. There are more.
- February 11, 2009: Edmonton Obesity Staging System
- July 28th, 2009: Obesity Classification: Time to Move Beyond BMI?
- August 15, 2011: Setting The Stage For Obesity Staging
- August 16, 2011: Health Is Not Measured In Pounds
- August 18, 2011Should Causality Matter In The Edmonton Obesity Staging System?
- August 19, 2011: Can The Edmonton Obesity Staging System Better Guide Indications for Bariatric Surgery?
- August 22, 2011: Can The Edmonton Obesity Staging System Provide A Path For New Anti-Obesity Drugs?
- August 25, 2011: Public Health Implications of the Edmonton Obesity Staging System
- August 26, 2011: Moving Forward With The Edmonton Obesity Staging System
- September 5, 2011: Bariatric Surgery For Osteoarthritis Of Hips And Knees?
- October 8, 2011: Clinical Assessment: Edmonton Obesity Staging System
- October 21, 2011: Should EOSS Guide Access to Obesity Surgery?
The Arya Sharma article: Using the Edmonton obesity staging system to predict mortality in a population-representative cohort of people with overweight and obesity, August 15, 2011.
The Steven Blair article: Edmonton Obesity Staging System: association with weight history and mortality risk, August 24, 2011.
And... here's the press coverage. The source for these articles will have been this press release from Canada's National Research Council, entitled "System lets health providers better predict which obese patients are at risk for death – and which ones don’t need to lose weight at all"
- Vancouver Sun: Heavy but healthy? New formula slims down definition of dangerously obese.
- City News, Toronto: BMI Not Enough: Edmonton Staging System Gets To The Heart Of Obesity
- Time Healthland: Study: A New Measure of Obesity Helps Predict Early Death
- National Post: Fat not necessarily fatal, new studies find
- CBC News: Obesity score helps predict death risk
We need a paradigm shift in our society – a complete and total change of our perception of fat. I know, I know – the idea is overwhelming. How on earth do we succeed in changing our entire culture’s viewpoint on fat bodies?
It is possible. We can look back at history and see paradigm shifts throughout: in science (from a flat earth to the earth revolves around the sun), in culture (from slavery as a way of life slavery is an abomination), in our society’s way of thinking (women should stay at home to women can have careers). However, to make that shift, it required people who were willing to fight for it. It did require those big movers and shakers. Yet, it also required people who were willing to wrestle for their beliefs in the little daily stuff.
Do not underestimate the power you have to change the world! And you change it one mind at a time. You change it by choosing to love your own body. You change it by speaking up for yourself. You change it by refusing to believe the paradigm – by making the paradigm shift in your own life.
We have some amazing people doing some big work: Marianne Kirby, Lesley Kinzel, Marilynn Wann, to name just a few. Yes, these big voices talking to lots of people are important and vital (and incredibly brave). We need them. And I personally honor them for their wonderful work. But we need you, too.
We need the quiet person who doesn’t want to talk to the world but tells their best friend about FA. We need the fat person who is willing to put on fashion that screams “I am here, and I won’t be ignored!” We need the people who will tell a doctor that fat is not an acceptable diagnosis and a diet isn’t an acceptable solution. We need the fattie who walks down the street with their head held high, knowing that they deserve a place in the world. We need each and every one of you.
It’s easy to think that you are not important if you aren’t a fat activist in front of the camera or a blogger telling the world that being fat is ok. But you are important – so very important. Though a speaker or writer may start the person thinking, what can really change their mind is seeing someone live it. Every one of you is a walking billboard for FA. That doesn’t mean you have to be perfect; quite the opposite in fact. We want to show the world what it means to be real, which means allowing our foibles out. What it does mean is that each time you choose to love a fat body, you change that paradigm just a little bit. Each time you refuse to drink the Kool-Aid, the power of that paradigm is weakened. Each time you speak up, someone is changed somehow. You are important in this fight against an oppressive paradigm.
In my research, I talked to people who wouldn’t claim that they were activists because they were only doing small daily stuff towards FA. I believe that those of you doing the small daily stuff may be the most important of us – because you are making the ripples that become waves that will change this paradigm forever. Every little thing you do is important. Every little thing you do pushes the paradigm just a bit more.
One day, if we keep doing the little things, that boulder will shift. One day, fat will be accepted and even honored – and you will have helped!!
Some time ago, speaking of matters of fat with someone very dear to me, she said something that gave me pause. We were discussing, in general, the Keys starvation experiment in Minnesota during World War II. You can find information on it here. I noted the absolutely princely number of calories allowed to the subjects compared to what dieters (particularly women) are permitted today. She was unaware of the studies (I sent her links later), but then she brought up that perhaps food was more pure and less processed then (with the implication that it was less fattening).
I get where she was going with that. High-Fructose Corn Syrup wasn’t around then (although corn syrup as well as sorghum syrup were widely used in cooking), and neither was Aspartame; and yet, it is never that simple. In that moment I felt like was like contemplating an onion, with its many layers, or the bulb of a tulip, planted for Spring. I wish we had been able to continue the conversation. That statement contains within it a very modern fantasy which contains some grains of truth. This fantasy, in the hands of the fat-hating intelligentsia and food cognoscenti (as usual) can become yet another stick with which to beat fat people just for existing.
I have kept thinking about the phrase since then and, as I keep reading fat-hating food and health articles and comments in My Hometown Paper (the New York Times) I have found the name for that tulip bulb of my contemplation: The Beloved Fantasy of a Blissful Past… a fantasy of a time when no one was fat… A time when all food was local and pure and unspoiled… A time when people ate their ethnic foods and the evils of the Western Diet were yet to claim their victims...
That time has never existed. It has no more existed than some alternate world in which elves and humans coexisted in perfectly magic harmony. It is a beloved fantasy which feeds the delusion that all ills can be cured if only we could go back to some never-specified time when these ills did not exist. In this fantasy, if only our food were more pure, more local, all cooked at home, and to paraphrase the words of Edina Monsoon (in Absolutely Fabulous) so fresh and organic it still has composted horse manure on it, we would stop being fat and all of our problems would go away (1). Our food would not be as fattening.
We cannot go back to a time that never was. Fatties would not cease to exist if one could only stop grocery stores from selling sugared cereal, or if a given fast food joint refrained from using soda with high-fructose corn syrup (HFCS). There is no silver bullet. The quest to eliminate fatness by returning to that imaginary blissful past is a quest that is born to fail, taking with it the health of fat people, because we could never be nutritionally correct enough to bring it to fruition (2) . It is another baseball bat with which to smite the fatties, another way to be “concerned” about fat people’s health. Our image, our very being, is used and will be used to illustrate what happens if we eat “processed” food and we ignore the call to return to the blissful past.
The problem is these messages are powerful. They are delivered by those who have been anointed by the press as the cognoscenti. They are delivered by those whose skill at food preparation is exceeded by their ego and fat hate. They are delivered by those who place themselves upon a pedestal of “common sense” (eschewing facts) and whose opinion about fatties is sought by the media regardless of their actual qualifications. We are demonized as symbols of all that is wrong with food – but we know it never is really about health anyway.
In a series of posts I’ll be talking about food in the U.S. and occasionally from others countries for context. I am doing this because I’m tired of getting beaten by the stick of food correctness. I believe we need to look at the facts about our food culture(s) to dispel myths and to stave off the messages that come from the fantasy of a blissful past. In the same way that we look at pictures of fat people to see that, yes, there WERE fat people back then, we need to look at facts about food in historical context to counteract the moral opprobrium that a can of mushroom soup will garner from the cognoscenti.
I will draw from what I’ve learned from the impressive record left behind by American and English homekeeping authors of the 19th and 20th centuries (who were often learned in home economics and nutrition) who documented in a way that no statistic could the challenges that people had getting food on the table and how the fortification of foods along with new processing technologies and growing techniques helped our civilization to do that. I will also draw from my own experience as a person existing essentially within two food cultures, and what that has meant for me. What I aim to do with this framework is to offer into our evolving conversation a historical and cultural point of view about the American food culture as it evolved that can help dispel the myths about processed foods, while leaving room for exploring what some of the more modern developments in food processing may have reasonably have meant for human digestion and nutrition. I’ll also talk about the grain of truth that gives the fantasy its power.
In the meantime – what is your food culture and what might the term “processed food” mean within its context?
How would YOU define processed food within the American food culture?
Have you encountered the Fantasy of a Blissful Past and, if so, how?
See you in the comments!
(1) See Kate Harding’s very seminal essay on the ”The Fantasy of Being Thin” . She describes precisely the fantasy that if we could only lose weight, all the problems in our life would magically go away.
(2) A number of posts and comments on BFB, as well as a number of blogs in the Fatosphere have brought up the fact that you can be a perfect vegan and still be fat.
Some of you may have heard of the Edmonton Obesity Staging System. It’s gotten nods from size acceptance activists on social media sites because with its Stage 0 classification, it acknowledges that it’s possible to be fat and healthy and at a point where losing weight my any means necessary may not be advisable.
This is actually not a new idea. American guidelines dating back to the 1990s say the same thing. The National Institutes of Health Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity In Adults, The Evidence Report, published in 1998, only advises weight loss counselling for people who have a Body Mass Index (BMI) greater than 30, two other risk factors, and a desire to lose weight (chart, page 20). I can remember how happy I was when it first came out. It gave me something I could cite when doctors tried to push weight loss programs on me, when I had no risk factors other than a high BMI and no interest in dieting.
What is the Edmonton Staging System?
The Edmonton Staging System is chiefly intended to be a tool for rationing health care services in Alberta’s Health Care Insurance Plan. That’s Alberta’s single payer public health care system established under the Canadian Health Act.
What kind of health care services will be rationed? That's the big question. The most obvious are expensive weight loss treatments that may have a high net cost to the health care system; weight loss surgery in particular. However, this is a question that I'll revisit.
Who Designed it?
The Edmonton Staging System was developed by Dr. Arya Sharma and his colleagues at The University of Alberta. Steven Blair has also been involved in the research for the Edmonton Staging System. Dr. Blair is well known in fat acceptance circles for having done groundbreaking research for the Cooper Institute for Aerobics Research in Dallas in the 1990s; research that strongly indicates that activity level is a more important variable in health and fitness than BMI.
Dr. Sharma is a bariatric specialist and the founder and Scientific Director of the Canadian Obesity Network. On his blog, he questions the common beliefs about eating, activity level and weight, referring to the ubiquitous advice to lose weight by "eating less, moving more" as "the Nightmare on ELMM Street." He acknowledges that weight loss dieting is usually ineffective and sometimes counterproductive, long-term. However, it's important to remember that his career and livelihood are based on the idea that fatness is a disease that needs a medical cure.
Dr. Sharma and Dr. Blair may be more rational and compassionate than most people in the anti-obesity establishment, but they are not fat acceptance advocates.
So Without Further Ado, Here It Is
Stage 0: Patient has no apparent obesity-related risk factors (e.g., blood pressure, serum lipids, fasting glucose, etc. within normal range), no physical symptoms, no psychopathology, no functional limitations or impairment of well-being.
Stage 1: Patient has one or more obesity-related sub-clinical risk factors (e.g., elevated blood pressure, impaired fasting glucose, elevated liver enzymes, etc.), mild physical symptoms (e.g., dyspnea on moderate exertion, occasional aches and pains, fatigue, etc.), mild psychopathology, mild functional limitations and/or mild impairment of well-being.
Stage 2: Patient has one or more established obesity-related chronic diseases requiring medical treatment (e.g., hypertension, type 2 diabetes, sleep apnea, osteoarthritis, reflux disease, polycystic ovary syndrome, anxiety disorder, etc.), moderate functional limitations and/or moderate impairment of well-being.
Stage 3: Patient has clinically significant end-organ damage such as myocardial infarction, heart failure, diabetic complications, incapacitating osteoarthritis, significant psychopathology, significant functional limitations and/or significant impairment of well-being.
Stage 4: Patient has severe (potentially end-stage) disabilities from obesity-related chronic diseases, severe disabling psychopathology, severe functional limitations and/or severe impairment of well-being
A Few Thoughts
I'm not going to be one of the people cheerleading for this system. I have some serious reservations about the Edmonton Staging System's weight-centric view of health. It could easily be (mis)used to ration care for any type of condition that can be linked to weight, for anyone with a high BMI.
I think its use should be limited to weight loss treatments, and I think that Dr. Sharma and Dr. Blair are capable of much more insightful work. It's just a new format for a way of thinking that's been around for decades, and it reinforces the weight centred paradigm that's (ready?) epidemic in the medical establishment right now.
Next week, I'l post links to some studies that explain the reasoning behind the Edmonton Staging System and links to some posts that discuss how it can or should be used. I'll also look around for media coverage.
This article at MedPage Today started out pretty good, but ended up with the usual fat-phobic cautions that we always see when researchers find that being fat isn't really the danger they thought it was. Keep in mind that the number of women involved in the study is very small - 241 "overweight" women, 221 "obese" women, and 475 "normal-weight" women, not really enough to draw valid conclusions from, I would think.
If I'm reading this article correctly, infertile women who have a BMI over 25, over 30, and even over 40 don't have any more trouble conceiving, staying pregnant, or delivering when treated at fertility clinics than women who have a BMI between 18.5 and 24.9 (the differences quoted in the study are within the margin of error for such studies).
Among 241 overweight women with a body mass index of 25 to 29.99 kg/m2, the ongoing pregnancy rate was 44.4%, compared with a rate of 40.6% among 475 normal-weight women (P=0.26), said Kim Parker, BS, a medical student at the Regional Fertility Program in Calgary, Alberta.
The rate among 221 women with body mass index in excess of 30 kg/m2 was 41.4% (P=0.90 compared with normal-weight women), Parker said at her poster presentation during the annual meeting of the American Society for Reproductive Medicine.
According to the above, “overweight” women do better than “normal” weight women – 44.4% vs 40.6% (but still within that margin of error). And “obese” women do better than “normal” weight women – 41.4% vs 40.6% (still within the margin of error).
"Overweight and obese patients do not have reduced clinical pregnancy rates, implantation rates, or ongoing pregnancy rates when compared with normal-weight patients," Parker told MedPage Today.
Now, if that's the case, why are doctors at fertility clinics refusing to treat infertile fat women? It can't be that they think they are wasting their time trying to help these women get pregnant, that fat women can't get pregnant even with help, nor can they not stay pregnant if they do happen to get pregnant – this study shows that not to be so. Of course, you can show people facts until the cows come home, but that doesn't mean they will believe those facts or act on them.
Parker noted that the study did not take into consideration possible pregnancy-related complications that might have been caused by excess weight. Parker said that the study is continuing.
While the study did not appear to show problems with higher body mass index, Parker and colleagues recommended that "patients who are obese should be encouraged to reduce their overall body weight and have a return to health before attempting to become pregnant."
And of course, the article has to end with the usual fat-hating cautionary canard – pregnancy-related complications caused by excess weight (never mind that those same complications can be found in “normal-size” women).
And it also has to throw in that fat women need to be “encouraged” to reduce their weight and “return to health” before attempting to become pregnant. Never mind that fat women can have normal blood pressure, normal blood sugar, normal cholesterol, and be physically fit, just like their thinner sisters. Talk about conflating size with health – what started out to be a fair article for helping infertile fat women become pregnant ended with the usual fat-phobic nonsense.
Making fat visible is something I am way into, but I don't really have any lofty aspirations that I can topple fat stigma and invisibility just through my pen. That's why I am really passionate about encouraging other people to draw, write and take photos of themselves if they want to, so all our seemingly small acts of representation can join together to do the counteracting.