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Fat and Health

Skinny thighs bad

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...

Fat and the Fear of Movement

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 and America's Moral Panic

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?

MeMe Roth is Made of Crazy

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!

Logic? What's that?

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!

HAES is blowin up

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?

Fat and global warming

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

Wait...what?

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.

Many fat people "not that sick at all" according to Canadian doctor

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?

They want our brains!!!

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

Shout-Out: Linda Bacon's 'Health at Every Size'

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.

CNN: Obama talked with Sanjay Gupta for Surgeon General role

Ooof:

The Obama transition team approached Dr. Sanjay Gupta, CNN's chief medical correspondent, about becoming U.S. surgeon general, according to sources inside the transition and at CNN.

Via the LA Times through the Chicago Tribune:

More recently, Gupta -- the son of immigrants from India and Pakistan -- launched a nationwide campaign on CNN titled "Fit Nation" to highlight the dangers of obesity in children.

"We are told that the pitch to him has been that healthcare reform will be a top priority," [CNN's John] King said, "that wellness, fitness, obesity, the issues he has focused on often here at CNN, will be a top priority.

This seems like a really, really bad choice.

Solid TV Report on Fat Health Care

DebraSY pointed me to a great report from the Kansas City Fox affiliate on fat health care. The story is surprisingly good, and it's available in video form - definitely worth a look.

The narrative here comes from Ann Pei, whose sister Joyce was denied proper care due to her size.

Studies have found health professionals spend less time with obese patients and view them as less likable and more emotional. Young doctors claim medical school are addressing the issue.

"They always taught us to confront our own biases, not just about obesity, but all chronic health conditions. Confront your biases. That helps you meet the patients where they are," says Dr. Veronica Anwuri with Saint Luke's Medical Group.

Debra also notes that Laurie Todd, the first person interviewed in the piece, has started a group called Stay the Course KC "dedicated to bringing out fat people who have isolated themselves, and getting them reinvolved in the community and with one another."

This is a really straightforward piece overall and I'm most impressed at the lack of negativity here. It's handled with careful consideration and yet drives the point home nicely. Good stuff.

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