Fat and Health

So how fat is your state? The Robert Wood Johnson Foundation and the Trust for America’s Health released another pointless report this week ranking the fifty states by fatness. The article points to an overabundance of food, aggressive food marketing, poverty, and low levels of education as significant causes, which I suppose is a slight step up from the usual disgust and personal blame. The education thing sticks in my craw though, because it implies that if we fatties only knew better, we just wouldn't be fat. Please, thin Americans, TEACH us to overcome our body's genetic tendencies. For the love of god, won't someone tell the fatties about calories in vs. calories out?? They just don't know!


Then we have this gem, about how, chemically, being fat means that you can't resist cupcakes as well as thin people do. Again, thanks, but your study involving ten whole fat people isn't really enough to convince me that the entire fat population's brains work this way, not to mention that you don't even really know what these results mean. My favorite part of the article is as follows:

Some of the most intriguing imaging studies have peered into the brains of people who have lost significant weight and kept it off through diet and exercise alone—although researchers say they're hard to find. "They are very controlled individuals, and they are very rare. We had to fly some in from Alaska," says Angelo Del Parigi, a neuroimaging scientists who finally located 11 "post-obese" subjects who had dieted down to the lean range.

You don't say? People who have lost weight and kept it off aren't just coming out of the woodwork? Can we not maybe draw a conclusion here?


Finally, I'm sure you've seen some of the hullabaloo about the new diet drugs being tested and submitted for FDA approval. It looks like as of this morning the FDA has rejected Qnexa, which is shocking news in and of itself. Could it be that someone over there finally cares about side effects? Did they actually learn something from the whole Fen/Phen tragedy? If so, it's not stopping pharmaceutical manufacturers from trying again. Arena Pharmaceuticals is working on a drug called lorcaserin which, according to MSNBC shows "promise" and "little risk". It also shows little effectiveness, as study participants only lost an average of five percent of their body weight. That's about twenty pounds for a 375 lb gal like me. Given the risk for side effects, especially the ones they don't know about yet, I wouldn't say lorcaserin is a worthwhile bet. Seems to me that maybe we should divert those pharmaceutical resources to working on cancer or AIDS instead of trying to make the population slightly less fat and potentially harming them in the process.

But anyway...Happy Friday!

I'm going to start with a quote from Ginia Bellafante's New York Times review of the new ABC show "Huge," starring Nikki Blonsky. First, she describes a "gainer" who writes a blog, and then she says:

...Gainer blogs are an offshoot of a fat-pride movement that has bubbled up in response to what its proponents consider to be a pointless and hysterical national fuss over obesity. In this view fat is a form of social protest, an outcry against the manipulations of a diet-industrial complex. Fringe movements don’t often find an arm in the form of hourlong dramatic television, but “Huge,” beginning Monday on ABC Family, stands in some sympathy with a rebellion mounted against so many hours of “The Biggest Loser.”

I don't know who she thinks represents the "fat-pride" movement. Since she's talking about blogs, maybe she means the fatosphere. There are many fine, fine blogs on the fatosphere. They represent a range of opinions and experiences. But one opinion I've never seen expressed on the fatosphere - on Shapely Prose, on Big Fat Blog, or on any other blog - is that feederism and deliberate weight gain are a good idea or are acceptable in the context of fat acceptance. NEVER.

Fat acceptance is not about trying to change your body. It's about taking joy in the body you already have. Fat acceptance isn't a rebellion against "The Biggest Loser." The movement has been around for forty years, and it's about social justice and about valuing human diversity. Fat acceptance is not about trying to be fat. It's about not hating our already fat bodies, and about fighting anti-fat stereotypes, prejudice and discrimination.

Of course our bodies change when we age, when our lives and our habits change, and for other reasons, and that's fine. It's fine when we get smaller and it's fine when we get bigger. But, we don't try to get smaller or bigger. If there's only one thing that everyone in the fat acceptance movement agrees on, it's social justice. If there are two things, the second is that deliberately trying to lose or gain weight is contrary to size acceptance principles. Gainer blogs are not an offshoot of this movement; in fact, most of us would agree that they're in direct opposition.

I've been involved in the fat acceptance movement since the early nineties. If someone said to me that there is a "pointless and hysterical national fuss over obesity," then I would nod my head in agreement.

However, it's my understanding that most deliberate weight gain takes place within the context of feederism, I am not down with feederism. Feederism is a sexual fetish. Normally, my feeling about sexual fetishes is "live and let live; do it if it works for you." However, feeders apparently get off at least partly on the helplessness of the feedees. Given that many people gain weight easily and find it next to impossible to keep weight off once they've gained it, this can amount to trapping someone in a dependent situation, which is typical of abusive relationships.

But what about the guy that Ms. Bellafante describes in her first paragraph? I looked at his blog, and it appears that the idea of becoming fat turns him on primarily, although his partner is fine with it. He’s gone from 180 to 250 pounds in three years, and it appears that he’s not going to gain much more weight. In addition, he’s staying reasonably fit. He’s hardly helpless, and for him, being strong is an important part of being big. In his case, the weight gain attempt does not appear to be abusive, but it still has nothing to do with fat acceptance, as the blogger himself points out. It's still primarily a sexual kink.

So, Ms. Bellafante, gainer blogs have nothing to do with fat pride. The New York Times has misrepresented our views, and they should print a retraction.

Added...

Brian of Red No. 3 has really nailed this issue here and here.

(please send us other good links on this topic, and we'll add them)

By now you might have heard of the study where data analysis found that, no matter what your starting BMI, losing a certain amount of weight (in some cases as little as 5%) can increase your risk of mortality. That's a grim result in a culture where we're all told repeatedly that fat can't possibly be healthy and that losing weight is the only way to save ourselves. In her Huffington Post article, Harriet Brown aptly calls this situation "The Obesity Paradox" because really,what's a fat person to do? Either we're killing ourselves by quietly remaining fat or we're killing ourselves by going all good fattie and attempting to lose weight.

I feel like we need more information here than is being given in the study. For one, what methods did these people employ to lose weight? Were they doing it on purpose or did they just discover a previously unnurtured love for vegetables or pilates? Because I've experienced Health At Every Size-related weight loss and I'd really hate to think that some incidental weight loss that happens because of an adoption of healthier habits could be affecting my body as negatively as weight lost doing Jenny Craig or juice fasting.

Maybe the answer is to just ignore ALL of the studies -- the ones that tell us to lose weight and the ones that tell us to never lose weight -- and focus on enjoying whatever life we doomed fatties have left. Isn't that what HAES is about anyway?

Sure, death is an easily predicted outcome of what some people are calling 'the new lobotomy', but it still saddens me to read about it nonetheless.

Promoted from the forums

The Daily Express has reported on an Ohio State University study that disputes the accepted wisdom that the 'obesity epidemic' is responsible for various health conditions and that we should all "curb our obsession with dieting". It uses NHANES III data and claims that there are few health differences between 'normal weight' and 'obese' indivisduals under age 40, and thereafter only in the proportion of medication use (which could demonstrate an increased tendency on the part of physicians to pathologise and hence over-prescribe to those in this group). Says researcher Brant Jarret:

“There is a myth going on. Our findings show being overweight is no different from being what we believe is a healthy weight and this is across a person’s entire lifespan. For college-age adults, this should help them realize that they don’t have to worry so much if they have a BMI of 27 or 28. Some young people with these BMIs feel like, ‘I’m going to have all these problems, I need to try 50 different diets.’ And what is all that stress and dieting doing to your body? Probably more damage than the extra 15lb. Being obese before you are 40 has no correlation to your health either. The risk that people are told about does not exist.”

There's nothing here we don't already know, but it's good to see it on the front page of one of the same national tabloids that up until now has been instrumental in the process of 'frightening' fat people into thinking they are ill. Of course there's the obligatory disclaimer about 'gross obesity' (nice!) still damaging health, and the usual comments claiming anyone daring to even think about questioning the party line is a dangerous heretic bent on undermining the war on fat people (damn right!) as well as a couple of sensible ones, but overall it's a surprisingly balanced article. More please!

Promoted from the forums

The DSM-5 is the latest version of the American Psychiatric Association's "Diagnostic and Statistical Manual of Mental Disorders." It's used by mental health professionals in the U.S. to diagnose mental health problems. It is also used to categorize patients for research purposes. The DSM was originally published in the 1950s; the last major revision (the DSM-4) was in 1994.

You may be aware that obesity, binge eating disorder, and "overeating" were up for inclusion in the new edition. The good news: binge eating disorder made it in and obesity and overeating didn't.

Binge eating disorder is a widely recognized mental health issue. We've talked about it at BFB before. It is characterized by episodes of eating a very large amount of food until over-full without enjoying it, and while feeling out of control. The diagnostic criteria are in the article I linked to, and they sound reasonable to me. Of course, I'm not an expert.

Until now, binge eating disorder has been included in EDNOS: Eating Disorders Not Otherwise Specified. Now it has its own category. This will make it easier to diagnose and treat and will make insurance coverage more likely for people seeking help. Most people will probably agree that this is a good thing.

In contrast, obesity is defined by BMI, which is basically a weight/height ratio. It is influenced to some extent by behavior, but is 40-80% a result of genetics. Also (and this might be what made the difference) the obesity label doesn't distinguish between muscle and fat. So, while most fat people are classified as obese, so are many bodybuilders and professional athletes. And, of course there's a huge middle range of people who are varying degrees of muscular while also being varying degrees of fat. The idea that all of these people have a mental health problem that can be defined by their BMI is completely absurd. I'm glad that this was ultimately recognized, but I'm also stunned that adding obesity to the DSM-5 was even considered.

I'm not sure how they were defining "overeating," but I suspect that they wanted to use it as a behavior-based proxy for obesity and then discovered that according to the research, the two are either weakly or not at all linked.

So an old friend of mine from high school gained a lot of weight and decided that gastric bypass surgery was the best answer to her weight-related concerns. She's been facebooking about it for months now and this week she finally had her surgery. I've been watching her progress with an uneasy curiosity since she announced she would have the surgery, wanting to tell her just how effed up I think the whole thing is but also recognizing that she is an adult and has to make her own decisions. Anyway, she has a blog where she has been documenting the process and I was just struck by this entry about how restrictive the pre-surgery and post-surgery eating requirements are. If you've ever spent one second of your fat life thinking "maybe I should consider that gastric bypass surgery", this will make you glad you passed it up. Check it out.

While blogging, I'm also having my "dinner". Tonight that is one cup of strained low fat cream of chicken soup. (Strained to get the chunks of chicken out!) My diet is extremely limited right now, which of course is to be expected. People are shocked when I tell them, but my tiny little stomach pocket just isn't up for too much yet! And since my understanding is that if I over do it the results will be quite uncomfortable for me, I'm not pushing it! (-:

The great news is that I am not feeling terribly hungry, and when I do feel slightly hungry, it is typically because it's time to eat something.

Here's the overall eating schedule that Dr. XXXXX requires:

2 weeks prior to surgery -- extreme low carbs -- max 20 carbs a day

day before surgery -- clear fluids only, plus Powerade with Miralax (bariatric colon cleanse)

day of surgery -- absolutely no fluids by mouth, later in the day got ice chips (was on IVs)

1st 2 days after surgery -- clear liquids only (broth, crystal light, sugar free popsicles, SF jello) -- in the hospital, they'd give me crystal light in medicine cups .... Here's one ounce of liquid, take 15 entire minutes to drink it.

Days 3-6 (where I am right now)-- Full Liquids (1% milk, low carb protein shakes, SF low fat yogurt, cream of chicken soup, plus all the things in clear liquids -- including SF jello, and SF popsicles) **now, the surprising thing here is the quantities... I should take a full hour to sip 8 ounces of whatever I eat/drink, yet I am to strive to consume at least 48-64 ounces of liquids over the the course of the day. Half should be clear liquids and half should be the full liquids, being sure to get protein in there.

Days 7-10 (begins Wednesday - woo, hoo!) -- Pureed/Soft Diet --- this is where my new magic bullet will be quite handy. See, my tiny new pouch isn't grown up enough to work as your stomach does.... using its muscles to break up and grind up the food we eat. So, for now, I gotta do that work before I eat something. Now, at this stage, I shall only eat 4-6 Tablespoons of food each "meal" and I should have 5-6 meals a day. I can add mashed potatoes, custard, and pudding, but I must be VERY careful to keep it really low sugar and really low fat. Otherwise, my tiny pouch will rebel and make me regret it. Other things, provided they are well cooked and blenderized, will be vegetables, scrambled eggs, LF cottage cheese, poultry, soups, applesauce, and stage 1 & 2 baby foods (but watch the sugar in those!). I must also be sure to remove all skins, visible fat, connective tissues, rinds, shells, seeds, etc.

Then, Days 11-30 (almost 3 weeks) -- Soft Diet -- Pretty much as above, but adding a few starches like cereal, crackers, and adding soft fruits (have to remove citrus membranes) and low fat cheeses. The instructions say "small distinct pieces of food that is tender and easily chewed. Begin with ground or flaked meats and chopped or mashed foods".

Then, Days 31-45 (two weeks) -- we continue as above, but get to graduate to 6-8 tablespoons per meal, 5 meals per day. Also can add some things like brown rice and whole grain pasta.

Then, Six weeks after surgery -- Healthy, Lifelong Meal Plan -- add a few tablespoons of food per meal, then after another month, a little more. Ultimately, the plan for post bariatric surgery patients, is to eat 3/4 - 1 cup per meal, and eat 4 small meals per day. Dr. XXXXX disagrees with the snacking throughout the day theory. Essentially, we'll need to add more fiber here, but be intentional about high protein, low fat, and lower carbs. We are told to stay away from everything High Sugar. My understanding is that high sugar will result in dumping syndrome, and that I will not like that one bit. (-; A few people have said, "yep, you'll only do that ONCE".

A few other things for post bariatric surgery patients, that are a little odd, are that we can no longer drink from straws or have carbonated beverages. Those put too much air in our pouches, and make us feel full when we aren't. Also don't want those bubbles to increase the size of the pouch, that would be dumb after having surgery, no!?

Another quirk is that we are NOT to drink while eating a meal. Yes, we must drink 48-64 ounces daily, but we must stop drinking 30 minutes before a meal, and not drink fluids again until 30 minutes after a meal. Our little pouches (can you tell I've grown attached to my little pouch already? (-: ) will tell us we've had enough to eat and we would not have. Or, the food will slide right through with the liquids, and we won't get the nutrition we need. Either way, that's bad. SOOOO, no drinking at meals!!!

Oh, and NO MORE NSAIDS. I know, what's that, right? No more aspirin or anti-inflammatory medicines like Aleve, Ibuprofen. EVER. They're bad for our little pouches. They can cause bleeding and ulcers, and bad stuff like that. Oh, except the chewable baby aspirin we take for the first month after surgery to prevent blood clots....

We must also take vitamins for ever and ever amen. Chewable Multivitamins with Iron and chewable Calcium with Vitamin D. And B-12. Can be shots or sublingual... I'll find out a bit more about that when I return to the doctor next Wednesday.

The part that shocked me the most was that it should take you an hour to drink 8 ounces of fluid. An HOUR. Also, four cups of food a day? How is it remotely possible to get the nutrients your body needs on four cups of food a day? And no straws?! That...ahem...sucks.

Anyone have any other thoughts on this? Is there anyone out there who has gone through this and can comment?

I saw an ad for this show Mike & Molly during How I Met Your Mother last night. At first I was excited...look! Actual fat people on TV! Then I read the premise:

"Police officer Mike Biggs knows his way around the Streets—and the donut shop. As a cop, Mike’s not scared of anything—except dating, so he’s joined Overeaters Anonymous® to lose those extra pounds and gain some Much-needed confidence. When he meets Molly at a meeting, the attraction is immediate, and suddenly Mike is excited about the prospect of a new life. But now he must find the willpower to give up his beloved junk food for the apple of his eye."

Oh BARF. Anyone seen any more of this tripe? Comments?

I know many of you have been following the Fed Up With Lunch blog by anonymous teacher Mrs. Q. The original idea of the project was to eat school lunch with the kids every day and document the foods that were offered, but the site has turned into a bit of a phenomenon, and, like the Jamie Oliver business, is making people really start to think about the nature of the food we are providing to our kids. Anyway, Mrs. Q recently posted an entry about obesity that I found interesting. It sounds like she already has some fat acceptance-versed commenters, but I still think it's a good opportunity for us to participate in a discussion about fat kids and fat adults from the perspective of trying to provide better nutrition overall. So have a look and join in, if you're so inclined.

Every so often I get an email from the contact/tip form about some new weight loss product or service that "really works" and that I should "tell [my] readers about". Usually I just roll my eyes and delete. You can imagine my surprise then, when I received a tip email from the proprietors of the Oakledge Wellness Retreat and it turned out to not be (as I assumed) another weight loss business. It looks really cool, actually. The program is based on the principles of Health at Every Size and stresses actual healthy behaviors rather than focusing on weight as a measure of health. It's not cheap, as you can imagine, but for a week in Massachusetts surrounded by HAES folks working out and eating great food, I bet it's well worth it. Cool!

My brother tipped me off to this article in the NY Times about doctors having trouble talking to their fat patients about losing weight. It cites a report presented by the STOP Obesity Alliance (which makes me question the veracity of the report, but anyway...) that says that doctors actually aren't talking to patients about weight loss. The reason? Gee, they just don't know how! Poor doctors. See again, this article gets really close to the actual truth but doesn't quite make the connection. Doctors don't know how to get patients to lose weight and keep it off because nobody does! I do like that the point is made that doctors have a misconception that fat people are weak-willed and self-indulgent, but in the end all this article does is shift some of the blame for fatness from fat people to their doctors. Meh.

Check out this article on Japanese attitudes towards weight. I feel almost like the author is saying "Gee, if Japanese women can lose weight and keep it off, what's wrong with Americans?"
They say the rates of anorexia and bulimia aren't any higher over there than they are here, but I have to wonder if that's because the idea of an average-sized woman not eating because she wants to be thinner is so widely accepted as normal. Certainly the act of specifically not eating or eating only vegetables when you are hungry for more is something of a disorder, whether it's officially anorexia or not.
Anyone have any other ideas about what might cause the disparity between our attitudes toward weight and that of Japanese women?

This is the question posed in the Nightline debate linked to in withoutscene's posting below. The way I see it, when we ask "is it okay to be fat?", we're really asking a bunch of other questions:

• Is a person allowed to have and maintain a body that is larger than average?
• Is being fat a health problem?
• Is a person with a health problem allowed to choose to not treat that problem?
• Is fat caused by lifestyle choices?
• Is a person in a group health plan allowed to make choices that might cause them to need more health care in the future?

When you break it down to what we're really talking about, I don't see how any rational person could conclude that it is not okay to be fat. What are your thoughts?

Here's another great discussion on obesity, health and environmentalism at Sociological Images. What I love about reading the commentary at SI is that the point of that site is to look beyond the surface of the messages communicated to us by the mainstream media. The commenters there seem to be more willing to question their own beliefs and the result is some very thoughtful commentary. Enjoy

This humble article on The Adipositivity Project over at Sociological Images has spurred a hell of a good discussion on fatness. There are a few folks beating the fat=unhealthy drum, but there are so many other thoughtful comments it's totally worth it. Check it out!

{Promoted from the forums - CarrieP}

The BBC is reporting that a group of Cambridge researchers have discovered a genetic factor common to a number of children and teens labelled as 'severely obese'. They also seem to have identified further links between these 'copy number variants' and the regulation of blood sugar levels and appetite, concerns frequently discussed over the years on these very boards (far be it for me to suggest that people in the FA movement have long known what others have persistently refused even to attempt to demonstrate). Worryingly, several of the study's young participants had already been placed on local authority child protection registers 'on the assumption that their parents were deliberately overfeeding them'; the research findings are apparently sufficiently robust that those participants who were previously slated for intervention or removal by the social services have now been deleted from the database and their parents presumably exonerated.

I give this news a cautious welcome, for the 'may' of the headline is not by any means a 'will' and the enormous moral panic and incessant misinformation of the last decade have left us with a metaphorical supertanker of ignorance and prejudice to stop and turn around before the social work and child health professions begin to realise that a child's size may be as natural as their height and entirely unrelated to parental immorality, abuse or neglect. After all, last month's effective admission by a major obesity research institute that their initial apocalyptic predictions, on which much of the policy and media overreaction seen since in the UK have been based, were way off the mark has so far failed to have much by way impact on those policy makers and the government approach to the 'issue' and indeed was quickly shunted from the front pages.

However it is an important step forward which I am hoping that, given the esteem in which the University of Cambridge is held, will maybe encourage more researchers to break from the consensus and have the courage to challenge the assumptions about over-eating and lack of exercise (and perhaps even the scale of the 'epidemic' itself) without fear of censure and dismissal. Most importantly, tonight maybe Britain's fat children and their entirely blameless parents can sleep that little bit easier in their beds as a result of this good work by Dr. Farooqi and her team. I hope that David Rogers, the Local Government Association public health spokesman who called for a nationwide policy of taking obese children into care a couple of years back, sees this and eats his words, and that lawyers acting for the Dundee family, whose teenage son and daughter remain in the hands of the local authority, are paying attention.

ETA: more about the story here, from AOL via the NAAFA blog (whatever you do, don't read the comments on the AOL link!).

Rose tipped me off to some fat discrimination going on over in North Carolina. According to this policy document, the North Carolina State Health Plan (for teachers and state employees) will soon be divided into two sections: one for the "good" folks who don't smoke and have BMIs under 40 and one for the "naughty" smokers or people with BMIs 40 or above. Of course the good folks will receive more coverage at less expense than the naughty ones. Participants in the health plan are required to fill out a form every year that attests that they fit into the good group and they also agree to be subjected to mandatory random screenings for smoking and for BMI.

I am both appalled and terrified by this idea and the precedent it creates. First of all, does this mean that an NCSU employee is subject to being weighed and measured at work whenever HR deems it necessary? What about personal privacy? What about a person's body being their own property and not for their employer to judge? What about an employee being compensated on their performance and NOT their body size? Because no matter how this policy was initially intended, this ends up being another way to pay fat people less for doing the same job, as if that weren't happening enough already.

I hate the idea of the smoking thing as well on the grounds that what I do in my off time shouldn't be any of my employer's business, but at least that's a behavior that can be stopped. A fat person can't just stop being fat, despite the world's erroneous belief that all you have to do is just try a little harder to eat less and exercise more and the pounds will magically melt off. No one has been able to find a method of weight loss that works permanently for more than the tiniest percentages of people, which means that fat people are likely going to stay fat no matter how many crunches they do.

Let's not forget that the mainstream jury is still out on fat and health anyway...even Newsweek isn't sure whether fat=unhealthy anymore. Even if it was proven beyond a shadow of a doubt that fat people are definitely going to get sick, the whole point of a group health plan is that some people are going to get sick and some aren't. By buying into it you acknowledge that you are going to pay the same amount whether you get sick or not and whether other people get sick or not. If we're going to just weed out the people we think are going to get sick, what's the point of group health then anyway?

On TOP of that, what this plan is doing is funneling the people who are (supposedly) the most likely to get sick into a group that gets less coverage! Those who will likely need health care the most are all of a sudden going to get the least amount of assistance from their health insurance company! If this doesn't prove clearly how much more interested health insurance companies are in profits over actually providing health care, then I don't know what will.

Thanks Rose!

This article just broke my heart. Samantha Clowe didn't want to be the dreaded "fat bride", so she dutifully got permission from her doctor and started following the LighterLife diet plan. It certainly seemed to work...in her eleven weeks on the diet Samantha decreased her BMI by two whole points. Then she collapsed and died.

My heart goes out to Samantha and her family. I can only imagine the thoughts that might have driven her to choose the plan, like longing to fit her body into society's favored mold, the idea that whoever she was now wasn't good enough to stand up in front of her friends and family and get married. Maybe, like many dieters, she believed that this fat thing was only temporary and if she could just find the right plan and just try hard enough, she could finally be "normal" and, therefore, "happy".

I will confess, I have had these thoughts too. Some not even all that long ago. You know why Samantha and I and millions of other people have felt this way? Because somewhere along the way as we were growing up, enough people told us that our bodies were wrong that we started to believe it. Some of us believed it so much that we tried whatever we could to make our bodies behave and were thwarted when they fought back and grew even bigger, further outside of the realm of okay. Eventually, some of us were so freaked out by being fat that we gladly paid someone to cut into our bodies and mess with the way our digestive systems worked, all so we could finally be..."normal". The thing is, there are a million different kinds of bodies out there. "Normal" doesn't really exist.

The thing that really incenses me about this article is that the LighterLife people are blaming Samantha's death on the fact that she started out all deathfat so she was probably just a ticking timebomb anyway. So it seems we are doomed to death even if we go along and do as we're told to conform. What a load of crap.

Samantha was only 11 weeks into the program but on the LighterLife website they say women should do it for 14 weeks or even more if they want to lose more weight at the end of that time. This is at least the third death linked to LighterLife. I wonder how many more people have to die while following their program before someone finally shuts them down.

Update: As suggested by MichMurphy, I've started a photo gallery for fat brides on flickr. Feel free to join, post any and all fat bride photos and pass on the link to all of your fat bride friends! Here come the Fat Brides!

I am in love with this photo gallery at Newsweek.com. I would like to squeeze it all over and marry it and have little blogger/photo gallery babies. Check it out!

Also here's Athletes of Every Size which is the same basic idea but, you know, not on Newsweek.com.

I just came across this article at MSN describing a study that says folks with skinny thighs have a 50-100% higher chance of developing heart disease than their thick-thighed counterparts. Of course, they're quick to mention that this is not a "free pass for people who want to skip the gym", or, presumably, for fat people to start loving their fat thighs. Certainly they wouldn't want to give the impression that a nonskinny bodypart would be 'okay' and 'not deadly'...lord knows those fat people are just looking for an excuse to not lose weight.

The comments are somewhat fat-hating, as expected, but I also found it amusing that so many people were skeptical of the study's results. Wait, so the studies about how fat people are just going to drop dead are beyond reproach but this one is complete BS? Sounds fishy to me...

I want to direct your attention to this fantastic post at Fatshionista about how we as fat people cut ourselves off from sports and other physical activities because we see them as things fat people aren't supposed to do. I have experienced this a million times in my fat life and I'm betting some of you out there can relate. I can come up with a whole list of physical things I have avoided at times in my life because fat people "don't" or "shouldn't" do them:

Riding my bike (this is a big one that still gives me trouble...I have an irrational fear of being mocked on my bike)
Walking around my neighborhood
Running in my neighborhood
Swimming
Going to the gym
Joining a community sports team
Rock-climbing
Yoga
Learning to salsa dance

I'd like to say I've consistently ignored the fear and accomplished all of these things, but there are a few on the list I'm still a little reluctant to try because of those irrational thoughts. It's a process.

Are there things you have avoided or flat out not done because you are fat? Let us know in the comments!

Paul Campos gave a great interview over at The Atlantic yesterday, but what I found most interesting about the whole thing were the comments on the article. Almost every one is well thought out, literate, and full of good discussion about the topic at hand instead of devolving into 'fatties are stupid and gross and OMG should just lose weight' territory. I'm not saying they're all favorable or that I agree with all of them, but I find it so much more enjoyable to read a well-constructed point that I disagree with than what amounts to a handful of insults or ignorant BS one might find in comments on other articles.

Anyway, give it a read. A lot of commenters brought up the type II diabetes question which I couldn't immediately debunk in my head. Anyone have good information on the correlation of fat and type II diabetes and medical costs?

Look at this poor woman. Doesn't it look like maybe she needs a big ol' fat hug? I concur.

The thing I like about MeMe Roth is that she is such an easy target. She wears her hatred and her bigotry on her sleeve, has no good advice to give, and 99% of the time comes across to even fat-phobic reporters as bat sh*t crazypants. Aside from the fact that she is all about the fat hatred, there are two things I don't like about MeMe:

1. She gets a lot of attention from the media for her anti-fat blather
2. I am starting to really feel sorry for her

I mean, how could you not? She's so delusional! She insists she's not anorexic, in fact says she's "never been on a diet", but then in the next breath talks about how she doesn't eat breakfast, forces herself to work out before eating during the day, and finally admits that, the day of the interview, which occurred at 3:30 PM, she hadn't eaten at all! Sounds like disordered eating to me.

The article says her (fat) family finds her crusade to be hurtful, so I can imagine that family get-togethers are probably strained and uncomfortable for everyone involved. On second thought, I really feel sorry for her kids. MeMe comes across as so cold and controlled that I can't imagine she's all that warm of a mom. Not to mention what hell it must be to grow up in a house where no one eats. I hope I'm wrong about that, but I bet I'm not.

She just seems so intensely unhappy, so rigid, so devoid of joy that I can't help but feel empathy about the lifetime of hurtful experiences she must have gone through to get to this place. That woman does NOT like herself. Not even a little bit. Sure, I absolutely hate everything she stands for and most of the time I really wish she would just stuff a sock in it, but the sad little fat girl inside me recognizes that the sad little fat girl inside her really just needs some love. I hope one day she finally gets it.

Thanks Jenny!

Okay wait...so you're telling me that people who are fat in middle age and then lose weight have a higher risk for health problems when they're old? And it doesn't occur to you that the weight loss itself could be causing the health problems? Aren't you, like, a scientist? Cause and effect? Ring any bells?

Thanks Jean!

Hey BFBers, this is sort of an interim post, but there is some crazy-good HAES stuff going on lately.

First, if you haven't already joined Linda Bacon's HAES community, you should totally do it! And sign the pledge! For those of you who don't know, Linda will be speaking at the NAAFA conference in Washington D.C. this year.

Second, this article by Lucy Aphamor in The Guardian rocks my socks! Thanks to Beanietude for bringing it up in the forums. Lucy says:

The hardest leap for practitioner and client alike can be the idea that all bodies are worthy of respect; that it is permissible and important to appreciate and care for the body you live in, whatever size you are; that bodies should not be disliked or despised for their lack of conformity to a particular size or shape.

This is a "HAES 101" that kicks ass and takes names. It's nothing most of you haven't heard before, but that's okay. If it's too 101 for you, post it on Facebook/Twitter/whatever or keep it in your file to send to someone if you get a chance to educate someone on HAES. I do wish that general HAES articles would do a little more to address class and race issues because they are, let's be honest, very central to the way that fatness/nutrition gets discussed and anti-fat arguments get deployed.

Also, Charlotte Cooper gives us the news that HAES UK was launched this weekend! (Lucy Aphramor also links to it in her Guardian article.) Did anyone go to the event? If so, please report!

Finally, how should we react to all this HAES stuff becomming more mainstream? Are you seeing this reflected in your every day lives?

When I first read this article I had an odd sense of déjà vu. Then I realized why: it's not a new story! Not only that, but every time this subject has come up, the same people seem to be behind it. Ian Roberts wrote the original diatribe in 2007, he and Dr. Phil Edwards wrote a letter to the Lancet in 2008 with the same message, and now they've published a study along these same lines. The thing is, all of their research is based on the same faulty assumptions: that fat people consume more energy by eating and driving more. Even this new "study" draws conclusions based on these assumptions. For instance:

Since it can be assumed that energy expenditure is approximately balanced by energy intake, it follows that total food energy consumption increases as BMI increases.

So, we're going to assume that each step up the BMI ladder means more food consumption? There have been studies to refute this, but even if you disregard them and assume that I, with a BMI of 60+ eat THREE TIMES THE VOLUME OF FOOD as a person with a BMI of 20, what about the one in four people in the UK who are on a constant diet? What about the 45 million Americans who go on diets each year? Some of those folks must be fat, yes? So right there you can see it's ridiculous to assume that every fat person eats more than someone with a lower BMI. If it were true, the diet industry would crumble.

To estimate the GHG emissions due to car travel by each population, we assumed that all individuals with BMI < 30 kg/m2 use an average small car (e.g. Ford Fiesta) and that individuals with BMI 30 kg/m2 use a car with more internal space (e.g. Ford Galaxy). The Ford Fiesta weighs 1530 kg and produces 147 gCO2 per km, whereas the Ford Galaxy weighs 2415 kg and produces 197 gCO2 per km.

So for the purposes of this study, we're just going to *assume* that all of the skinny folks drive tiny cars and all of the fat folks drive bigger cars. What about all of the skinny SUV drivers? What about the fat folks who drive hybrids or smaller, more fuel-efficient cars? What about all of the poorer fat people who don't even have their own car and instead take public transportation?

The increase in energy expenditure with increasing body weight should prevent further weight gain in a negative feedback loop but with rising BMI people are likely to move less, particularly those who are substantially overweight

Of course this part ignores the active fat people and imagines that all skinny people are active. It also incorrectly assumes (again) that the amount of walking a person does correlates somehow with their BMI. Furthermore, when I was digging for info I came across this article that states that driving might be better for the planet than walking anyway.

So Dr. Phil Edwards and Ian Roberts, here's some advice: no matter how many times you interpret and reinterpret these data, you're still starting off with a bunch of flawed, unproven assumptions that, despite the moderate media interest, add up to nothing more than fat-bashing, sizeist nonsense. Your "research" is focusing attention on fat people instead of the actual changes that need to be made to stop global warming. Do the planet a favor and kindly knock it off.

Thanks to DC and Marilyn for the tip

According to this article, studying ten people for three days is enough to generalize about the behavior and activity level of an entire segment of the fat population.

While I appreciate that the researchers doing the study seem to have reached the same conclusion that every HAES proponent has known for years, it annoys me that Reuters is choosing to frame the results as "big fat fatties are totally lying when they say they have healthy habits!" instead of "habits are better indicators of health than weight or size". Arg.

They should call the article "Ten very obese adults almost completely sedentary." That's some news there.

According to this article in The Vancouver Sun, at least one more doctor out there is finally starting to get that fat is not a definitive indicator of ill health.

After reading the article I Googled Dr. Arya Sharma and found his "Obesity Notes" blog. There were some interesting articles, and while I'm not convinced Dr. Sharma's views are entirely in line with my own (and those professed within the fat rights movement), he does tend to say some things that make me want to stand up and cheer. Notably:

Women are clearly far more susceptible to this “healthy-weights” messaging and at any given time are likely to show more dissatisfaction, concern and preoccupation with their weight than men. While most of this weight obsession may well be fueled by the unachievable “ideal” of body weight promoted by the fashion and cosmetics industry, it is not unusual to hear “better health” as a justification for openly engaging in unhealthy weight-loss behaviours.

and

Here is my message to all health professionals and policy makers concerned with obesity: let us define obesity in terms of its actual impact on health - let us not recommend weight loss to those, who have nothing to gain.

At this point, I'm cautiously optimistic that we may have another health professional ally in Dr. Sharma. What are your thoughts?

Zombies? No, obesity doctors. You read that right. Though they want in our brains, rather than eating them up. But part of me thinks they’d eat our brains if it’d “cure our obesity”—after all, it’s for our health!

On Tuesday Nightline covered a story about a woman, Carol, who agreed to be the second person in the U.S. to undergo “the most radical treatment ever devised for obesity,” a treatment called Deep Brain Stimulation. Basically, surgeons drill into her brain and carefully poke around, sending electric currents into her brain until they identify the part that controls her hunger, feeling of satiation, etc. And then they implant “two brain pacemakers” into her chest that will send those same electric currents to her brain. TWO!!! The currents are supposed to keep her, it seems, feeling full enough—meaning they are sending volts into her brain to simulate a feeling “just below [the] threshold of nausea.” According to one surgeon, this will “readjust her weight thermostat so that she can metabolize better and potentially eat less, if that’s what it takes.” Eventually they will have to dial it up a notch to keep her feeling full.

I respect this woman’s right to do this, but I do not respect the doctors/researchers’ endeavor to perform it, nor am I very satisfied with Nightline’s coverage. Martin Bashir doesn’t ask the tough questions, evaluate the risks of this radical procedure or the assumptions it’s based on, or even present more than a flittering critical thought throughout this report. It’s not that Bashir seems all that gung-ho about it, but in the end it is just another booga-booga-OMGtehFats puff piece, rather than an investigative report.

I tend to be long-winded, so I decided to at least organize my long-windedness and post a list of my objections...off the top of my head.

1. The contention that “obesity is the most painful problem in the world.” Now, I took that out of context. The actual quote is, “For Carol Poe, obesity is the most painful problem in the world.” If she said this and she feels it’s her biggest problem, I feel really bad for her and what she must go through...not that she’d be the only one who thinks being fat is The_Worst_Thing_Evar ™. We all know that people would rather die than be obeeeeese (or “overweight” or even a little fat); fatness is many people’s greatest fear. But this segment only reinforces the idea that it’s the worst thing that could happen to a person and that we should all be very, very afraid of the fats. The same news show would likely do a story on how young girls are so afraid of fat and not see the connection between girls’ fear of fat and their own reporting.

2. The doctors’ treatment of “obesity” as though fatness is a disease like Parkinson’s. Fatness is not a disease, people. Yet doctors think that since Deep Brain Stimulation worked on Parkinson’s (not sure how accurate that is) they can and should save the world from fat people—and fat people from themselves—using DBS.

3. That’s right, we can’t control ourselves, so they’ve gotta go into our brains and do it themselves. See how much work we make them do? If this procedure “works” (whatever that means), there may be a time when any “obese” person who doesn’t subject themselves to DBS and “brain pacemakers” will be seen as both socially and personally irresponsible. If so, at the same time we will still be lamented for our inability to control ourselves of our insatiable need for instant gratification. A judgment all based on weight.

4. The “Fat Carol” to “Ideal Carol” digital transformation. Really? Like fat people don’t see enough of this on weight loss commercials. The fact that “before” and “after” pictures have become a staple in our culture is evidence that we have some real problems. When we set up any kind of “ideal” body shape/size, we have a problem.

5. This segment addresses nothing about health. No mention of measures of her health before or after. No mention of health other than the cursory mention of her mental health/anguish regarding her fatness and the implication that she is a compulsive eater paired the idea that her compulsive eating is what’s at the root of her “fat problem.” After all, they wouldn’t need in our brains if we could control ourselves. You wanna bet people still come away form the segment assuming this will improve her health? What happens if this woman actually ends up malnourished? This implant is manipulating signals sent to her brain about what her body needs; it completely suppresses any chance she would have of listening to her bodily cues regarding hunger and nourishment.

6. According to the segment, this woman is 230lbs. I think a simple WTF covers this.

7. Surgeon guy: “For some it may seem radical that electrodes should be put in the brain, that someone should be doing brain surgery for obesity. But I think we’ve gotten through that.” Me: Uh, no we have NOT.

8. This is not scientific, at least not in the sense that we can deduce anything whatsoever. (Though the fact that they know so much about the brain is pretty friggin cool, if scary.) There is no control group. She’s just one woman, and she’s doing things in addition to getting the DBS implants that might affect the outcome. Not to mention the possible placebo effects of something as serious as brain surgery. And on top of all this, we have just seen a snapshot of her experience. We in no way know what the future holds for her or whether eating less would make her thin or even “overweight.” And yet people will assume. And we will continue to suffer from their poor assumptions because when you are addressing OMGtehFatness you don't have to think critically, ask tough questions or give an accurate portrayal of risks and benefits.

Finally, I have been really trying to create “action steps” lately...but on this one I am not seeing a clear path. I did tweet Nightline a piece or two of my mind, not that they paid any attention. Maybe we should suggest that Nightline do a segment on weight discrimination and prejudice in health care and the real health consequences of both, or a segment on HAES. Any suggestions?

More info on this from Sandy Szwarc at Junkfood Science

I wanted to give a shout-out to Dr. Linda Bacon for her new book, Health at Every Size. The book's site includes an endorsements page that reads like a who's who within the fat community.

Linda was kind enough to provide a review copy for BFB (thanks again) - but I'm wondering if any readers have had a chance to read or start to read this book. Everything I've seen has been truly positive.