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WLS: more barriers to rational decision making

Yesterday, I discussed some reasons why the FDA's approval of lap bands for people with lower BMIs is problematic, and I focused on medical blackmail and fat hate (both imposed and internalized) as issues that prevent people from making informed, rational decisions about weight loss surgery.

There are a couple of other factors that I didn't address directly, but it would be a mistake to think that they can't have a strong and sometimes dominant influence on decision making. I'm talking about doctors' advice and social pressure, both from peers and from the media. For people whose health may not be perfect, they become even more influential.

There's a lot of WLS marketing out there; a lot of positive buzz. The media loves a good weight loss story, especially if it involves some kind of penance: starvation, extreme and uncomfortable exercise, or (better yet!) actual cutting, which is ironically characterized as an "easy fix."

Since both they and, in the case of the lap band, drug companies stand to make a lot of money through weight loss surgery, doctors tend to be well informed on the (sketchy) conclusions of the short-term research that supports WLS and not so well informed on the research that hints at the its real risks and its increasing failure rate over time, both for weight loss and diabetes treatment. Their advice may also be influenced by fat hatred, the media, and industry marketing. In other words, it's likely to be biased. However, patients have reason to trust their doctors' advice. Doctors are experts on health, after all.

People who are only a few years past the surgery, who have had no immediate complications and are still alive, are often thrilled with the effects and have not yet had to deal with the long term problems. These people can be downright evangelical, and will encourage others to ask for the surgery. (My advice is to tell them "I want to hear your opinion about this in 5 or 10 years; then I'll feel better informed.")

If the media, your doctor, and your friends are encouraging you to get this surgery, you've been told that it will probably take you out of a group that's routinely disrespected and discriminated against, and you feel like your real life can't begin until you're thin, then it becomes difficult to say "no."

So, to summarize, it is difficult for people to make informed, rational, independent decisions about weight loss surgery because:

  1. Doctors sometimes withhold treatment pending major weight loss, effectively blackmailing people into WLS
  2. Because of internalized fat hatred, "Doing it for yourself" might as well mean "Doing it against yourself"
  3. Medical advice is commonly based on poor quality and biased research and may also be influenced by the profit motive
  4. Peer pressure from people in the "honeymoon period" after the surgery can be influential
  5. And of course, it's hard to resist the Fantasy of Being Thin.

(Did I miss anything?)

In theory, I think that people should be able to do what they want with their bodies. I really do. However, in today's social climate around weight - especially for women* - this is like legalizing heroin. It has the potential to do so much damage and ruin (even end) so many lives.

* According to this excellent article on Women's ENews, 80% of lapband recipients are women.

Some options, we can do without

I posted a few days ago about the FDA officially approving gastric banding for healthy people with a 35-40 BMI. And, you may ask:

"Why would you be against that? Shouldn't people be allowed to do what they want with their own bodies? It's just a new choice that people are being allowed to make. Nobody is forcing anyone to get a gastric band."

Unfortunately, it isn't as simple as that. Here's why.

First, there's what amounts to medical blackmail; doctors withholding treatment until a patient loses a large amount of weight. How can anyone be expected to do that with an efficient metabolism forged by yo-yo dieting and health concerns that may prevent strenuous exercise? WLS, of course! This effectively forces people into weight loss surgery, and it's unconscionable.

However, even people who clearly want WLS aren't on anything like a level playing field.

Living in this society, we learn to have a violent type of hatred toward our fat bodies. I understand the impulse. I've been there. Who among us has not at one time or another felt complete and utter despair about his or her body? "This isn't what I'm supposed to be like! Why do I have this horrible, disgusting body? This can't be me." To someone in that state of mind, their body is separate and despised, unruly and out of control, something to fight and force into submission. When you're at odds with your body, hating it doesn't feel like self hatred and self harm feels like fighting the good fight.

Why do so many people feel this way?

We're told over and over again that the substance and appearance of fat bodies - any softness or fullness, really - is something to be ashamed of and evidence of weakness and inferiority. We're also told that it's all our fault, all due to eating too much. If you're thinking about your body this way, you just want to be able to stop eating. You think that you deserve to starve, whether by will power or failing that, by brute force. You really do want to hurt your body; to force complience. And the people in authority agree. Doctors, reporters, the media: they cheer and facilitate any self-destructive action taken in the name of weight loss, because weight loss can never be a bad thing! Why, it's the silver lining on the dark cloud of depression and even cancer! This is in spite of the fact that the widely accepted assumption that fat people eat more than thin people has no evidence behind it.

And I should probably note that yes, these primitive bludgeons surgeries can sometimes help people who are very, very heavy, with compromised mobility, who just can't see any other way forward. But there should be a better way!

The question for fat people who aren't disabled by their size: Is the possibility of putting diabetes into remission (for the 8% of 30+ BMI Americans who have been diagnosed with it) enough to make up for vitamin deficiencies, brittle bones, neuropathy(!) and a heightened risk of suicide - not to mention the suffering related to the surgery and its intended effects?

It takes a special kind of blindness to disregard the problems with the evidence in favor of WLS: the short followups when the most widespread problem with the surgeries are nutritional deficiencies that become more and more harmful over the years; the high dropout rates, which are generally ignored (and I doubt the subjects who finish the studies are representative); the lack of meaningful control groups; the failure to acknowledge related deaths that occur more than a month or two after the surgery. (For examples, go to Junkfood Science and scroll down to the Bariatric Series on the right.) This shit is dodgy.

Gastric bypass has been around for 40 years and the lap band has been in use for almost 20. Why isn't the research on the long term effects of weight loss surgery more detailed and comprehensive?

Is it because the cost/benefit analyses being made by both doctors and potential WLS candidates are so loaded with societal baggage and negative emotion - not to mention profit motive - that the costs don't matter and any hint of a real health benefit is blown completely out of proportion? Is it because neither doctors nor surgery candidates really want to know the truth? Is it because the drive to make fat people thin actually has little to do with health and a lot to do with imposed and internalized hatred?

A Non-Dieting Vignette

Last night there was cake at my house. Different types of cake.

One of them was a kind I don't like. So I didn't have any, because I can have all the cakes in the world, at any time I wish to. The kinds I like. Having cake availiable is no longer something that you can't pass up on, regardless of whether you actually like that particular cake, because you just don't know when it will happen again, as it would have been in my dieting days.

One of them was a kind I like a lot. But I was full. So I set it aside for when I'd feel hungry. Having cake availiable, even a kind you like a lot, is not some magical "carpe diem" situation to make the most of in spite of your body's hunger cues, because I can have all the cakes in the world, at any time I wish to. This would never have happened in my dieting days, because, hey, it's cake! You don't know when you'll have cake around again, so have it right now! Before someone takes it away!

This is what fat acceptance, health at every size and stripping food of weight-related moral contents does for a person. And it feels so good.

Lapband Approved for Lower BMIs

(Correction: Allergen had aimed to get the lapband approved for healthy people with 35-40 BMIs, but it seems that part of their proposal didn't actually go through. The New York Daily News article I'd linked to originally wasn't entirely accurate. The link below now leads straight to the FDA press release. Sorry about that. Slowing learning how to do journalism...)

The lap band has now been officially approved for people with a 30-35 bmi and a weight-correlated condition or risk factor.

I've been thinking for a couple of weeks that I should post something on this topic. However, I just hate dwelling on it. It's so fucking tragic. I get angry.

Smart doctors and scientists know that weight isn't just calories in and calories out, but we still love the idea of starving the fatties, and that's what WLS is all about. It's crude and barbaric, like an invisible and intrusive jaw wiring. Weight loss surgery is one of the only medical procedures intended to damage a healthy, functional system and it can be deadly, both immediately and in the long term. Lap band-related deaths are being investigated in New York and in in California. For those who survive lap band surgery, there are significant long-term risks and complications that are the rule, rather than the exception:

Swiss researchers, who published a study in the medical journal Obesity Surgery, found that the complication rate skyrocketed to 74 percent over a 10-year period. Complications include leakage and infection along the Lap-Band, frequent vomiting, dysphagia (an inability to swallow), surgical revision, band erosion and slippage or failure.

A 2007 study funded by Allergan and published in the American Journal of Surgery found that up to 76 percent of patients developed complications over three years. Over a nine-year period, one-third of patients had their Lap-Band removed.

Stomach acid produced from excessive vomiting can erode the band, just one reason for device removal.

This is despite the fact that the lap band is marketed as safer and less extreme than other forms of WLS. Oh, and it isn't even all that effective for weight loss.

In the end, I just have to ask why it isn't obvious to everyone that the trend of approving weight loss surgery for ever younger and lighter people is coming from a very dark place, both on the part of the doctors marketing and performing the surgery and the people requesting it.

Lonie McMichael: Medical Rhetoric and Fat

Background:
• Post 4: Lonie McMichael: Love
• Post 3: Lonie McMichael: Resistance
• Post 2: Lonie McMichael: Internalization
• Post 1: Lonie McMichael: Intro & hook's ideology of domination
• BFB introduction and dissertation abstract.

_____________________

When we consider the inception and focus on the Obesity Epidemic, making fat about health instead of looks was an absolutely brilliant rhetorical move by the anti-fat industry. In the early 1990s, an anti-dieting movement started growing, emphasizing the fact that diets did not work, a fact pointed out by Laura Fraser in _Losing It_. Even a 1992 NIH (National Institutes of Health) consensus panel also found that weight-loss dieting does not work and was actually detrimental to the physical and psychological health of the individual, a statement that was later retracted and is no longer posted on the NIH consensus Website. The movement against dieting continued to expand through the early 1990s until the anti-fat community responded to this anti-dieting message with a vengeance. Researchers who had spoken out against dieting “found themselves once again underfunded” (Fraser). Another dazzling rhetorical move on the part of those making money from weight loss attempts, instead of arguing that weight-loss attempts worked the obesity researchers “raised the stakes by suggesting, with very sketchy substantiation, that obesity had become one of the nation’s biggest health problems – a “disease” (Fraser). Now, fat became about health rather than aesthetics.

By stating that obesity itself was a disease – rather than a genetic characteristic or an effect of other factors such as illness or prescription drugs – a number of groups were able to profit in some way from trying to contain that disease. Whereas beauty issues might not have appealed to certain groups, such as feminists or men, making fat about health made it a moral issue (Campos; Oliver). Oliver says that “we have created a disease out of a physical symptom that, in turn, we are unable to treat” and that “we are ascribing moral characteristics to what is largely a biological phenomenon.” This calling overweight and obesity a disease in and of itself creates a number of implications for the fat individual, implications that provide legitimacy to fat prejudice and discrimination and promote negative attitudes towards the fat individual. Whereas the proponents of Fat Acceptance believe that fat is just normal human diversity, calling fat a disease seeks to force the fat individual into a narrow ideal of what is “normal.” Since it is seen as a disease, it must be eradicated at all costs, making extreme measures such as enforced fat camps seem not so farfetched.

Moreover, the anti-fat industry, this time working through the surgeon general and other government entities, again made a smart move by calling the increase in rates of overweight and obese individuals in the U.S. an epidemic, a rhetorical move that has incredible implications for fat individuals and for attitudes about fat in this country. Oliver claims that Dietz, the director of the Division for Nutrition and Physical Activity, started the idea of an epidemic; in fact, Oliver calls Dietz “patient zero” of the epidemic. By using a PowerPoint slideshow to reveal the growing “problem,” Dietz portrayed obesity as a disease slowly engulfing the U.S. Then, in 2001, a report, actually a high profile Call to Action, from Surgeon General David Satcher, reinforced this idea by declaring that we were indeed experiencing an obesity epidemic. Mitchell and McTigue state that the word epidemic “sounds an alarm bell” to the American people since it is a term “historically reserved for describing infectious disease outbreaks.” Epidemic has two potential meanings with two significant implications: the first being a medical term implying an infectious disease that can be transmitted causing quick and imminent death and the second being a rhetorical metaphor suggesting “the rising prevalence of excess body weight as a universal problem requiring collective response.” Secondly, using the term “epidemic” makes fat about public health, not about an individual’s wellbeing, and creates an atmosphere of urgency.

These moves provide legitimacy for practicing fat prejudice as a culture since people see this as a public health crisis that must be stopped.

Another Type of Love

So first from Lonie McMichael's post on Love:

In hooks’ ideals, everyone is understood, appreciated and valued. 'This vision of relationships,' hooks said, 'where everyone’s needs are respected, where everyone has rights, where no one need fear subordination or abuse.'

Lonie goes on to connect this type of love to self acceptance and the acceptance of fat people in general. However, what stuck me was that it applies on both larger and smaller scales as well: in individual relationships and in social justice as a whole.

The idea of intersectionlity has come up in the fatosphere before. One discussion that I particularly remember included interesting posts by Tara Shuai at Fatshionista, by Marinanne Kirby at The Rotund, and Fillyjonk at Shapey Prose.

Of course, it's striking how hook's definition is also the model for modern relationships. It's almost as if western society, at least since WWII, has been turning away from traditional power dynamics based on gender and social hierarchies and toward a more inclusive ideal, both in families and in the larger society.

But, can we do it, or are those power dynamics an inescapable part of human nature? When we suppress social power dynamics, do they just pop up in new places? Is that why the anti-fat thing has gone... yeah, viral? Because hate is more of an epidemic - a sickness - than a high weight/height ratio.

Oh, and I'd like to use this as an excuse to link to two of my favorite fatosphere blogs, both written by women of color: Red Vinyl Shoes and Nudiemuse. The topic of intersecting identities and social justice as a whole has come up more than once in their blogs - and they're just good in general. So, if you're not already reading them, check 'em out.

The Valentine's Day Post

Happy Valentines Day, everyone!

Yes, grumble grumble, I know it's a Hallmark holiday. I know it's a cynical attempt to increase the sales of red underwear - red underwear that may even be available in our sizes! - chocolate, and cut flowers. However, I'm always on the lookout for excuses to make a nice candlelight dinner with wine and have some fun my favorite person. So, I'm on board.

There were two things I've been thinking about touching on for the Valentine's Day post, and I don't think I'll come up with a clever way of tying them together in time. So I'm going to make two posts, today and tomorrow. Today, some thoughts on taking emotional risks and how it's worked out for me. Tomorrow, some thoughts on Lonie McMichael's newest post.

The Bitter Pill

When I was younger, I was terrified of emotional risk. I couldn't bring myself to take the first steps in relationships. Hell, I don't think I even knew what they were. Because I'd been a fat teenager, I'd missed out on learning the signals people send and how to respond to them. I assumed that nobody I was interested in could possibly be interested in me, and I completely missed the signs when they were interested. I should note here that I'm a straight woman. That should have made it easier. Everyone knows that men are easy, right? But I wasn't looking to be someone's fallback or pity fuck - and that's the only way I could see things progressing at my preppy high school and (for the first couple of years, anyway) at the "public ivy" I attended right afterwards. That's honestly how I saw my prospects, and it was pretty harsh.

I can think of several ways that the "spoiled identity" that Pattie Thomas talks about in a recent post undermines fat people - particularly people who grow up fat and have internalized society's negative messages - and this is one of them. It can be a difficult barrier to break through. Even if we relate comfortably to the people we're attracted to, even if we make friends easily, it can be hard to cross over into physicality if we've been taught all our lives that our bodies are ugly, disgusting, and asexual. If we've been brainwashed into thinking that ourselves, how can we expect better from our potential partners? And, if we're shy and have trouble connecting at all, it makes it that much harder.

The longer it goes on - not breaking through the fear of rejection, fear of being used, fear of putting your sexuality out there and having it laughed at or found repulsive - the more difficult it becomes. It's only now, with a 20 year perspective on it, that I feel reasonably comfortable talking about it. When it was actually going on and for years afterwards, it was just too painful.

Lessons Learned

This post is aimed at the people out there who might be where I was 20 years ago. I'd love to see comments from them, from people who managed to dodge it somehow, and other people who've gotten through it, especially people who may have had society even less on their side than I did (being not all that fat, being straight, being white, and being the kind of woman that make friends with men). Because, I fully realize that this was made easier for me by the extent to which I am conventional, conventionally attractive, and outgoing.

I wish I could say I'd beaten it through force of will and self confidence. But, it happened because someone took a risk with me, and then I took a risk with him. He was a new friend, he kissed me, and I sort of rejected him. A year later, I started something with him. It took me a year of occasionally thinking about our conversations and that kiss, and then randomly meeting him again, to decide that I was interested.

By the time I was available again, I'd gotten it through my head that although I'm not everyone's cup of tea, it's just not that big a deal. I'm attractive to a subset of men. Not a tiny subset, either. One that contains plenty of men who I could be interested in. But there are always going to be men who eliminate me from consideration because of my size, my personality; whatever. I don't find everyone attractive, so why would everyone find me attractive?

If you're both picky and not-conventionally-attractive, then you've really got to put yourself out there and meet a lot of people in order to find good matches. And you've got to be ready to reject people - kindly - and to handle being rejected with grace and understanding; be prepared to be (or at least seem) cool about it. I realized that when it comes to emotional risks, I have to accept them consciously and to think about the worst case scenario and how I'd handle it - what I'd say, what I'd do - before the fact. And, it's generally something that can be managed. Hiding from risk is often worse than than handling the fallout when things don't come out the way you'd hoped.

The Heart-Shaped Candy

Taking a series of scary and difficult (to me) social risks led to meeting and getting together with my husband. I moved to a new city by myself. I showed up at a coffee shop for a "New in Town" meet-up and didn't see any sign of it. It occured to me that there might be other people wandering around with no way to recognize each other, so I thought "What the hell? Who cares if I look like an idiot. Nobody knows me here, anyway." and I took a piece of paper out of my purse, folded in in half, wrote "New in Town Meetup" in black pen on both sides, and sat down at a large table by myself with it in the middle. Fifteen minutes later, there were ten people sitting at the table. Three years later, I was married to one of them.

My husband and I hung out with that group of people for a while. We went out and did a lot together as friends, and after a while I got to be very attracted to him and was pretty sure that he felt the same way. Birds sang. Flowers bloomed. The sun shone bright on the skyscrapers. And I pretty much propositioned him.

He almost feel over from shock (because women aren't supposed to do that, I think) and then he was elated. And it went from there. He was the one to propose, unexpectedly, so I guess traditional gender roles were eventually satisfied. We galloped off into the sunset together and are still having adventures in new places, still very happy and in love, still feeling very lucky.

Back to Basics

But I remember being young but feeling old and far behind everyone else; thinking of myself as damaged goods and not being able to see the way forward in my personal life. Learning to take the risks I needed to in order to change that was difficult and scary, but the rewards were huge.

If you're stuck and scared, but wanting to have sex / be in a relationship / whatever, like I was so many years ago... my advice is to think through the risks and how to manage them, and then put yourself out there.

If you're alone tonight? Dance to or just listen to some music you love. Take a nice bath. If you drink, have a glass of bubbly or a cocktail. Make yourself a lovely dinner. Wear something that makes you feel good. Call an old friend. Go for a walk somewhere beautiful. Hell, buy a new sex toy. Pay attention to your own wants and needs and resist to urge to hide in fiction, in work, or in routine.

If you're fortunate enough to be in a loving relationship, consider putting aside any cynicism and having a cheesy, sexy good time tonight.

We're a 'Tsunami' now

So, there's a new study out that you've probably heard about on the news. Depending on the mood you were in, you may have either shaken your head sadly or fallen over laughing.

Agence France-Presse (AFP), a news service, reports on it here: 'Tsunami' of obesity worldwide: study.

So, okay. The real name of the article is "Stemming the global tsunami of cardiovascular disease," and it was published in the medical journal The Lancet earlier this month.

The news release sums it up in a single sentence:

High-income countries have... seen a drop in cardiovascular diseases since 1980, despite high levels of obesity.

So, how does this translate into a 'Tsunami' of either heart disease or obesity? Well, apparently, we're all gonna keel over any minute now, folks. There's no data to support it, but surely it will happen soon, because there are so many bad, bad unhealthy fat people out there. Booga booga.

There's a good post about this wonderfully sound-bitey yet logic-challenged study over at Nicholosophy.

And now, please enjoy this awesome video of Jimbo Pellegrine. He's ready to ride that Tsunami!

Lonie McMichael: Love

Background:
• Post 3: Lonie McMichael: Resistance
• Post 2: Lonie McMichael: Internalization
• Post 1: Lonie McMichael: Intro & hook's ideology of domination
• BFB introduction and dissertation abstract.

__________________________________

Love.

hooks says that love is the solution to domination. This isn’t the warm fuzzies like we tend to think of the feeling love. Rather, this is a force – a change in actions, a paradigm shift – that fights against domination. In hooks’ ideals, everyone is understood, appreciated and valued. “This vision of relationships,” hooks said, “where everyone’s needs are respected, where everyone has rights, where no one need fear subordination or abuse.” The resistors’ job, hooks argues, is to create “a critical discussion where love can be understood as a powerful force that challenges and resists domination.”

So what would hooks’ vision of love, this choice to connect, look like in terms of fat acceptance? Specifically, love in fat acceptance calls for all individuals, but most especially fat individuals, to accept their bodies while asking, even demanding, that fat individuals be treated with respect and value along with their thinner cohorts. In my work, I saw evidence of this in the Fatosphere and Fat Acceptance in a number of ways: how to love the fat body, how Health At Every Size is a form of love in action, how fat acceptance holds implications for everyone in American society, how the online environment acts as a safer space, and how self-love and activism can interact.

The fat individuals I studied found that loving the fat body can be a place of empowerment and strength. Though loving their body didn’t offer the fantastical panacea that dieting used to promise, it brought about true change for the individual. Many participants found more serenity in their daily lives, a stronger ability to stand up to the dominant ideas, and more compassion for themselves and other fat individuals.

hooks says that such transformation must take place in both the dominators and the dominated. When fat individuals fight to accept themselves and their bodies as they are when considered so very socially unacceptable, they provide an excellent example of body acceptance to those who may struggle with body issues at a smaller size since non-fat individuals are harmed by fat hatred as well. Fat activists argue against seeing skinny individuals as the enemy repeatedly, claiming that thin bashing is part of fat hatred. hooks (1984) emphasized that the idea is to move beyond contention to connection, where “dehumanization that characterizes human interaction can be replaced with feelings of intimacy, mutuality, and camaraderie.”

The Fatosphere has been a source of fuel for the Fat Acceptance movement and a source of love for the fat individual. hooks’ idea of love gets acted out in this conglomeration of blogs and discussion groups. Overall, this digital environment creates a safe space, or at least a safer space (Kirby & Kinzel), for fat individuals to come to understand fat from a different point of view and to find support for facing life in a fat-hating culture. Love also appears in the form of support for the fat individual within the Fatosphere and Fat Acceptance. Such love creates a positive upward spiral: being part of a community provides individuals the power to fight internalization which in turn helps the individual resist the dominant rhetoric.

Love can overcome fat hatred in so very many ways. This is a force that is embodied by the very nature of fat positive communities – communities that are succeeding in overcoming domination with love.

Linda Bacon's Newest Paper

Linda Bacon and Lucy Aphramor have recently published a new paper on the failure of the weight-based paradigm and the positive effects of a non-weight based approach to health (HAES, or Health at Every Size) in The Nutrition Journal.

The abstract is here and you can also access a provisional pdf of the full study, Weight Science:
Evaluating the Evidence for a Paradigm Shift
. Sometime soon, a more polished version will be available through the link on the abstract.

I'll let the press release speak for itself:

Dieting and other weight-loss efforts may unintentionally lead to weight gain and diminished health status, according to two researchers, including a UC Davis nutritionist, whose new study appears in the Jan. 24 issue of the Nutrition Journal, an online scientific journal.

Rather than focusing on weight loss, the researchers recommend that people focus on improving their health status.

In the new study, co-authors Linda Bacon, an associate nutritionist in the UC Davis Department of Nutrition, and Lucy Aphramor, an NHS specialist dietician and honorary research fellow at the Applied Research Centre in Health and Lifestyle Interventions at Coventry University, England, cite evidence from almost 200 studies.

“Although health professionals may mean well when they suggest that people lose weight, our analysis indicates that researchers have long interpreted research data through a biased lens,” Bacon said. “When the data are reconsidered without the common assumption that fat is harmful, it is overwhelmingly apparent that fat has been highly exaggerated as a risk for disease or decreased longevity.”

Bacon noted that the study findings do not support conventional ideas that:

• weight loss will prolong life;
• anyone can lose weight and keep it off through diet and exercise;
• weight loss is a practical and positive goal;
• weight loss is the only way overweight and obese people can improve their health; and
• obesity places an economic burden on society.

“The weight-focused approach does not, in the long run, produce thinner, healthier bodies,” said Bacon.

Updated to link to this, more comprehensive post on Living 400 Pounds.

The BBC is at it again

The BBC's propaganda war against fat people has recently intensified with a sudden flurry of articles, news reports and segments decrying the extent and implications of the 'obesity crisis.' Employing a 'them and us' approach, the BBC seems bent on whipping up outrage and mobilizing negative public sentiment. Every story that can support an anti-fat angle is reported with a biased editorial tone and elevated to the top of the news agenda.

Top news on Thursday's BBC radio

You would think that the National Health Service buying uprated ambulances and medical equipment to better serve the British public and help to protect health professionals from injury would be good news. Instead, the BBC presents it as the newest evidence that fat people are costing the good, up-right, THIN taxpayers money (because *everybody knows* that no fat person ever contributed to the public purse). Shocking!

The upgraded vehicles and equipment are mainly the result of changing health and safety at work policies and disability discrimination legislation intended to benefit NHS staff. Perhaps the BBC would rather ambulance crews injured themselves dealing with fat people (so that they'll have another reason to resent and hate us) or leave patients at the side of the road to die for want of the proper equipment.

This is particularly disturbing because it suggests that the BBC made a conscious decision to divert funds from an under-pressure news and current affairs budget to make a freedom of information request to every ambulance service in the country demanding details of the amount spent on 'bariatric' equipment. Quite apart from the way in which the information was presented as some sort of injustice to the privileged thin, there's the question of the extent to which news organisations should be setting and manipulating the news agenda rather than merely reporting events as they happen.

Related Articles on the BBC Website

Then there's a related piece on how the 'whole world' is having to change to accommodate us. This uses the uprated ambulances story as a springboard to highlight how fat people are destroying the airline industry, ruining historic theatres and stadia, bumping up prices for thin people, and costing local authorities a fortune in uprated crematoria (in the UK, due to lack of burial space, most people are cremated rather than buried). Again many of these improvements - particularly to venue seating - are also intended to benefit taller and disabled customers, but by making it about fat, they have turned attempts by businesses to accommodate a greater range of customers into another piece of sizist propaganda intended to generate resentment by suggesting that fat people are somehow being 'favoured'.

Yet another article focuses on claims that 10% of the world's population are now classed as obese (as always, the importance of 'classed as' isn't discussed or examined). Despite continuous increases in longevity, morbidity, various 'numerical' indicators such as cholesterol, blood pressure, survival rates etc, (again, good news) it is the obesity statistic which is deemed most worthy of comment. This is a common tactic by the BBC and the press in general - emphasis on obesity as a negative to the detriment of the positive news at the core of the story.

The BBC's Rule of Thumb: Health=Weight

That's leaving aside the way in which the O-word is dropped into almost every other health-related article irrespective of the topic. A piece on breast cancer rates emphasises 'rising obesity' as the driver and again skirts around improvements in survival rates (which don't fit the 'public health crisis' narrative). Dementia is being increasingly recast as 'lifestyle-related'. Everything is being presented as the result of not maintaining a 'healthy weight' with the corresponding and utterly nonsensical implication that those who do will never become sick or die - unless they meet with an accident, of course.

Investigative journalism used to be 'in the public interest' and focused on uncovering corrupt politicians and revealing dubious business practices. Now it would seem that it's become the latest weapon in the ongoing dirty propaganda war against Britain's new folk devil underclass. It dismays me endlessly to see the once respected BBC stoop to such repulsive tactics.

(edited by deeleigh)

HAES article in 'Psychotherapy Networker' magazine

Judith Matz has written an article for the newest issue of Psychotherapy Networker: "Recipe for Life: Is Attuned Eating the Answer To Diet Failure?"

Psychotherapy Networker is the most widely read magazine for U.S. mental health professionals.

This article should help to educate therapists on some of the real reasons for the failure of diets (it's not just psychological; it's physiological) and on the principles of HAES and attuned/intuitive eating. It even gives good advice for helping diet-scarred clients.

Hopefully it will make it easier to find mental health practitioners who aren't biased by questionable assumptions about fat people, our character, and how fatness may (or may not) relate to mental health issues.

It's a good article, very comprehensive and well supported, and definitely worth a read.

Shrink-seeking fat people: you might want to arm yourself with copies of this.

Call for Papers: Fat Studies @ the National Women's Studies Association 2011 Conference

This year the NWSA Fat Studies Interest Group is having an OPEN call for papers for the 2011 NWSA conference to be held Nov. 10-13 in Atlanta, GA. Papers on any topic at the intersection of women's studies/feminism/gender/sexuality and fat studies will be considered.

At minimum, your submission should fall under one of the following themes for NWSA 2011:

* The Politics of Crisis
* Subverting the “Master’s” Tools?
* Deploying Feminisms
* Women’s Studies without Walls
* Creative Interventions

For more information on the themes, visit: http://www.nwsa.org/conference/cfp.php

While this is an open call, topic suggestions from last year's meeting include: Fat Chicana Studies, Fat & Aging, Intersections of Fat & Disability, Transnational Fat Studies, New Scholarship on the Body: Regulation of Appearance, Fatness in Media Culture, Fat Feminist Activisms, Fat Studies and Pedagogy, Fat Studies Professionalization, Fatness and the Internet, and Fat Studies and Eating Disorders.

If you are interested in being a part of the 2011 Fat Studies panels at NWSA, please send the following info by February 13, 2011 to NWSA Fat Studies Interest Group Co-Chairs Joelle Ruby Ryan and Michaela Null: (Joelle.Ryan@unh.edu) AND (mnull@purdue.edu):

Name, Institutional Affiliation, Snail Mail, Email, Phone, Theme your paper fits under, Title for your talk, a one-page, double-spaced abstract in which you lay out your topic and its relevance to this session. Each person will speak for around 15 minutes, and we will leave time for Q&A.

As a side note, at the request of the Fat Studies Interest Group, NWSA has added 'fat feminisms' as a key word for the program. This means that if you submit a fat studies/fat feminism related paper or panel, you can tag it with the keyword 'fat feminisms,' and likewise search the 2011 program for 'fat feminisms' to find relevant panels. If you submit a paper or panel on your own, we encourage you to use this keyword if your paper or panel fits the bill. We thank NWSA for adding a keyword that helps conference attendees locate fat studies panels.

Lonie McMichael: Resistance

Background:
• Post 2: Lonie McMichael: Internalization
• Post 1: Lonie McMichael: Intro & hook's ideology of domination
• BFB introduction and dissertation abstract.

____________________________________________________________________________________
Added to the difficulty in resisting the internalization, resisting external forces can be a frustrating, exasperating, and even treacherous situation for fat individuals. Nevertheless, succeeding at resisting the external oppressor can be an empowering and liberating experience.

One of the primary ways in which fat people resist the dominant rhetoric is by being visible, an idea that is championed by bloggers Marianne Kirby of The Rotund and Lesley Kinsel of Fatshionista. Being visible “is the single most important thing we as fat individuals can do” to fight fat oppression, Kirby asserts. Being visible includes just being seen in public, eating in public, exercising in public, wearing bright colors or bold accessories, etc. Kirby argues that such visibility aids in normalizing the fat body.

One of the most powerful ways to resist fat oppression, some fat individuals are changing how they talk about fat – an idea that is right up my alley. hooks maintains that language plays an important part in the effort to resist: that we are rooted in words, that oppressed individuals must create a shared language, and that such a transformation requires a paradigm shift, a new way “to talk – to listen – to hear.” Language as resistance takes on two different aspects within my study: how individuals within the fat acceptance communities talk among themselves as well as how fat individuals talk to the “status quo.” These individuals within the Fat Acceptance Movement and the Fatosphere have used language to resist fat prejudice by redefining terms for themselves (such as what “health” means), by reclaiming the word “fat,” by coming out of “the fat closet,” by resisting medical rhetoric and by employing humor.

Humor is perhaps the greatest tool for resisting oppression used by individuals on the Fatosphere. Interestingly enough, hooks never mentions humor as a way to undermine oppression. However, especially in the Fatosphere, humor is proving to be an incredibly powerful tool against fat-hating forces.

Fat activism is another form of resistance, though there exists a great deal of confusion on exactly what fat activism is. Some individuals felt like they were not a fat activist because they only talked to family and friends about fat acceptance; others felt like they were an activist because they talked to family and friends about fat acceptance. Blogger fillyjonk notes that there is disagreement on what exactly fat activism means, “both what it should mean for the community, and what it means for us personally,” yet speaking up for one’s self is important in any situation.

I also found that conflicts within the fat acceptance movement reveal just how powerful the dominant rhetoric is while showing the success of the movement as well. Regular conversations on “good fatty vs. bad fatty,” “inbetweenies vs. deathfat,” and dieting show not only the natural conflicts within a social justice movement, but also reveal how hard it is to move past the idea that fat is bad.

hooks asserts that the responsibility for resistance lies with those who are oppressed; that the margin is a space of “radical possibility.” By this belief, fat people are those who should be speaking up, speaking out against fat prejudice. However, fat individuals can find this to be very difficult since they are often perceived as lazy and slovenly; resistance for fat hate can be seen as an excuse not to lose weight. Fat individuals who choose to resist the dominant ideals must be aware of such undermining tactics. For example, we have seen numerous attempts from the diet industry to appropriate fat positive ideas and make them into “love yourself thin,” what paul of BFB called “fat acceptance lite.” Weight Watchers’ claim that it isn’t a diet and Kellogg’s use of the Yay! scale are great examples of this undermining.

Together, individuals in the Fatosphere and Fat Acceptance are learning to reinterpret the dominant rhetoric in a more fat-friendly light. My research shows resistance working in the lives of fat individuals: we are learning to resist the self-hatred of internalization; we are learning to resist the external dominant rhetoric; we are learning to use language and survival techniques to make this resistance possible.

New Paul Campos, Glenn Gaesser journal article

Paul Campos and Glenn Gaesser (et. al.), are making sense as usual, this time in Oxford's International Journal of Epidemiology: "The epidemiology of overweight and obesity: public health crisis or moral panic?"

I was going to quote from the article, but frankly, there's just too much well supported, well expressed awesomeness to fit into one, two, three or even four blockquotes.

Here's the full article. Enjoy.

Oh - and if you haven't read Paul Campos' "The Obesity Myth" (also called "The Diet Myth") or Glenn Gaesser's "Big Fat Lies," then check it out! These are absolutely essential for anyone who's interested in what medical research research and population data reveal about weight and health.

The Fatosphere's RSS Feeds

You may have noticed that the look of BFB's front page has changed a little over the past week. We've added links to Notes from the Fatophere, Fat Liberation, and Fierce, Freethinking Fatties at the top left (just click on the little icons - right click, control-click or option-click to open them in a new window or new tab) and a live Notes from the Fatosphere feed at the bottom left, under the recent front page comments. This is because BFB is part of a large and vibrant community of feeds and blogs that share our mission.

RSS Feeds are collections of blogs that are syndicated - grouped together - so that they can be read in a continuous stream. FatFu started compiling Notes from the Fatosphere in 2007. Today, it's hosted by Bri, and it's the oldest, largest, and most popular fatosphere feed. "Notes from the Fatosphere" is what people usually mean when they say "the Fatosphere." Over the years, however, other fat acceptance feeds have been created. The two I'm familiar with (both started by BFB members, actually) are Fierce, Freethinking Fatties and Fat Liberation.

Many of the Fatosphere's best and most popular blogs: Shapely Prose, The Rotund, and the Fatshionista blog, for example, are/were written by people who wear their leftward political bent on their sleeves. However, fat acceptance also has a libertarian contingent. Over the years, people who are outspokenly religious and/or politically conservative have felt a bit out of place in the fatosphere, and they (along with her fellow libertarians) have found a home on Big Liberty's Fat Liberation Feed.

The strict "no diet talk" rule on the Fatosphere and its "deliberate weight loss is always a bad idea" corollary are not universally agreed upon in the fat acceptance movement. Atchka's and company's blog, Fierce Freethinking Fatties (also featuring BFB regular Vesta) allows a little more leeway on these issues than the rest of the Fatosphere. FFF also has an energetic, activist bent. FFF hosts a whole suite of fat acceptance feeds, and we've linked to the aggregate feed on the sidebar.

UK parents 'do not recognise their children are obese' - BBC

Recently published on the BBC News website: Parents 'do not recognise obesity in their children'

Did you know that a healthy 10-year-old's ribs should be clearly visible? Many parents would consider that such a child was quite underweight....
Another reason for the lack of knowledge may be that the media often portrays and highlights extreme cases of child obesity. Most children identified by the National Child Measurement Programme do not look obviously overweight. By comparison to the images shown of very obese children in the media, they look slim.

I think the fact that our Government's top advisor on obesity policy believes a healthy ten year-old should be skeletally thin to the point you can play a tune on their ribcage is frankly terrifying and explains much about the British obsession with fat kids, not to mention the exponential rise in body anxieties and EDs. If a concave stomach is now the criteria for avoiding being labelled 'overweight' then no wonder the rates seem so exaggerated. It doesn't give me much hope for the contents of the forthcoming Obesity White Paper, that's for sure.
There's a good point in here (which has been raised on BFB headless fatty discussions in the past) about the distorted perceptions resulting from the over-use of extreme examples to illustrate media obesity articles. However the suggestion that children who appear thin or 'normal weight' are actually obese under the criteria of the classroom weigh-in regime (and the fact that the UK uses a much stricter definition of 'obesity' than the EU, which it also applies to much younger age groups including infants) demonstrates how the criteria have been manipulated to essentially manufacture a 'problem' out of thin air.
Of course anyone who tries to counter the extremism of the obesity panic merchants with these observations is inevitably derided as a denialist and accused of disregarding the health of The Children. Any flickerings of debate about the validity of weighing children in school or the implications of labelling those who don't 'measure up' are swiftly closed down by an immensely powerful lobby whose assertions are accepted without question at the highest levels of government.
It can surely only be prejudice which prevents some of these increasingly outlandish claims being subjected to the same level of critique as (say) those of climate change, alcohol or passive smoking researchers.

Revised membership text

I've recently rewritten the text that appears when people apply for BFB membership, and since it's only visible to them, I'm reprinting it here to let people know about it, and for discussion.

This piece, I suppose, serves as our membership standard. It used to be a couple of breezy paragraphs that focused on not dieting. Now, it talks a little more on what we do and who we'd like to have as members, and I guess it's a bit more serious as well.

My vision of what BFB could be (and already is) is this: an international community of people who are in favor of fat acceptance, including some people professionally involved in social justice, health, and sociology, that is tolerant of differing politics and points of view (but still debates them!) and that offers information on and critiques of fatness in the media, and occasionally of academic and scientific work as well.

BFB is an all volunteer operation that does not do advertising, so it's a community of equals; members and administrators all contribute. Hopefully members will continue to have informative and insightful pieces to add to the front page. It would be wonderful if qualified people would occasionally contribute critiques of the "all fatties are doomed!!!!!!" medical studies that are always appearing in the news, too.

Also, I know that there are many people out there who might occasionally feel inspired to write an interesting blog post on fat acceptance and who would like it to appear on the fatophere, but who don't have the time or inclination to maintain an active blog that focuses on the topic. (I was this person for years!) If this describes you, then by all means join BFB and contribute a front page post occasionally.

Oh - and I also want to thank the regulars who through their dedication, intelligence, and insight have kept BFB going through slow times and troll attacks.

Okay.. on to the text.

...and now that you've made it through the hard stuff, a little bit of explanation.

What BFB is
Big Fat Blog (BFB) is a site devoted to fat acceptance. We publicize and comment on issues that affect social justice for fat people:

  • Media trends and reporting;
  • Medical research;
  • Societal issues;
  • Stereotypes;
  • Body size in history and anthropology;
  • Fat people's experiences in the world, both positive and negative;
  • Social justice and fat activism.

BFB also has forums that are only accessible to members.
Whether you're just getting into fat acceptance or are a seasoned activist, a HAES-friendly professional, or an ally, we welcome your participation. We welcome people of all backgrounds, orientations, abilities, political persuasions, etc.

What Fat Acceptance is
Fat acceptance has two parts: the political and the personal. Politically, we seek to expose and oppose prejudice and discrimination against fat people. Personally, we accept our bodies and reject the idea that weigh loss is a positive goal. We address health and fitness directly, not by using weight as a proxy for health.
Some of us exercise regularly and pay attention to nutrition. That's called Health at Every Size, or HAES, and it often has a bit of weight loss as a side effect. We do not think that deliberate weight change is safe or effective for most people.

What BFB Isn't
BFB isn't a dating site. We don't care if you're attracted to fat people or not. If you need medical, legal, or psychological advice, BFB can't provide it. BFB isn't an open forum; it's for people of a specific ideological persuasion. We enjoy a good debate, but we are not interested in debating whether the basic tenets of fat acceptance are valid nor whether fat people who are self accepting have a right to exist.
Most BFB members are former dieters, weight loss pill-takers and/or weight loss surgery survivors. BFB is not a place for diet talk. When we do discuss deliberate weight loss, it's generally to provide a counterpoint to the common assumption that weight loss and weight loss methods are always beneficial or harmless.

Grey Areas
If you are in favor of fat acceptance but don't practice it in your own life, then we ask you not to discuss your weight loss attempts on BFB. As always, weight loss evangelists will be unceremoniously booted.
If you're not a fat acceptance person but want to write a guest post espousing a point of view or introducing an idea that might be interesting for us to discuss, then by all means, send it to the administrators via the contact form and we'll consider publishing it. No guarantees.

Finally...
You should take a moment to read our Community Guidelines as these guidelines are enforced! Also, please read our Privacy Policy to learn what information we keep on record.
You must be at least 18 years of age to register. Your application will not necessarily be accepted. Thanks to our pet trolls, our membership coordinator is grumpy and occasionally paranoid, and turns down applicants who fail to convince her that they'd make good additions to BFB.

Lonie McMichael: Internalization

Today, I am going to discuss bell hooks’ idea of internalization in terms of fat. When a culture has ideas of inferior and superior, those that are perceived as inferior often hate that aspect of themselves which is seen as inferior; they become self-hating. So, in the dominant American culture (the location of my research) fat individuals have a tendency to hate their fat – not really a big surprise.

My research revealed that the message that fat is not ok comes to the individual from many different locations: friends, family, the media, the medical community and the stranger on the street. After having the message that fat is bad inundate them from all sides, it is not surprising that fat individuals turn the message that “fat is bad” into the message “I am bad” and, in turn, hate themselves.

When the fat individual chooses to deny the belief in their inferiority and see themselves as worthy, it can be a hard fight. hooks says that the oppressed individual must first resist the “oppressor within,” the belief in their own inferiority. The idea, hooks says, is “to reclaim and recover ourselves.” The oppressed can do this by changing the way they think, talk and act about the quality which makes them oppressed. So, fat individuals can recover from fat hatred by changing how they talk about fat – we see evidence of this all over Fat Acceptance and the Fatosphere.

In my research, I saw the struggle to be ok with the fat self over and over again. Many individuals experienced this struggle as an arduous journey that included bouts of anger, grief and the cognitive dissonance of wanting to be smaller but knowing dieting won’t work. I also observed that many were succeeding in the struggle. Some of the solutions to internalized fat hatred included: being part of a fat positive community such as the Fatosphere, seeing positive fat body images such as those on Fatshionista, and treating the body and self with care.

Internalization is very powerful, and the fight to overcome it can be challenging. However, as I will show later, the rewards for doing so can be quite wonderful.

Background:
• Post 1: Lonie McMichael: Intro & hook's ideology of domination
• BFB introduction and dissertation abstract.

Some "Debate"

Check out this clip from the BBC. The "debate" is laughable. Fatima Parker tries to insert some common sense, but in the end there are two thin guys arguing about whether or not it's fat people's fault that we eat too much and eat the wrong way. They're both making the same bullshit assumption.

In reality, not all fat people overeat, and some thin people overeat. "Fat" does not equal "glutton". I've never heard of a scientific study that indicates that fat people eat more on average than thin people - and even if we did, that says nothing about a given individual's habits.

If the guests were referring to actual binge eating (the 20,000 calories a day that "Briton's fattest man" says he used to eat, for example) when they were talking about gluttony... well, calling an eating disorder "gluttony" is pretty ignorant. But, the vast majority of fat people are not binge eaters.

Fat people don't necessarily eat a lot of junk food. That's more about social class than size. Healthy food is always what middle and upper class people eat, isn't it?

Let's face it. Vast quantities of junk food? Mostly eaten by thin young men.

Reporting like this is just so frustrating.

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