Big Fat Blog - The fat acceptance weblog.

The Long-term Consequences of WLS - Rich & Heather's Story

richie79 — Sun, 24 Feb 2013 11:16:15 -0500

My name is Rich, but I may be better known to some of you as richie79 of the UK who used to post prolifically here on Big Fat Blog and elsewhere in the Fatosphere for many years. Don't know if any of the old faces are still around but I wanted to share my wife Heather's story and felt this was maybe as good as any a place do it. If you believe otherwise, please let me know and I'll remove it.

In February 2005 a pretty girl with big brown eyes by the screen name of 'sweetheather86' sent me a 'smile' through a plus-size dating website of which we were both members. At the time I was at a low point following the failure of a previous long-term relationship. Heather and I hit it off almost immediately despite her being in the US and at 18, almost 7 years younger than I. Looking forward to daily emails from one another quickly progressed to a first nervous long-distance phonecall, nightly 4-hour chat sessions on MSN and before either of us knew it I'd booked a ticket to Boston. Two incredible weeks on from our first shy meeting at Logan Airport I knew this was the one person I wanted to spend the rest of my life with.

The only cloud on the horizon was the gastric bypass Heather underwent just two weeks after we first made contact. Even then I knew of the horrendous risks of these operations but although I had already fallen for her, didn't feel i knew her well enough to ask her to delay or reconsider it. She came from a long line of big women and had herself been fat throughout childhood, resulting in numerous failed diets and all the bullying and self-loathing that accompanies being a fat child / teen. At the time the media was full of stories of this 'magic bullet' and several of her family members had undergone the surgery with dramatic initial results. She told me that she wanted it done so that she could have all the things in life she had been convinced were not available to people of her size - someone to love her, a home and a family, access to nice clothes, and not to be abused and harassed in public. Tragically she later told me that she opted for the bypass as unlike the lap-band it was irreversible (the stomach is cut in two and 18" of small intestine removed and discarded) and therefore offered no opportunity to back out at a later stage.

Our relationship continued to blossom even as her health began to deteriorate. Each of us crossed the Atlantic to spend long periods together in one another's countries and during this time we crammed in as many activities, visits etc as many couples do in a lifetime. In September 2007 I proposed to her and she accepted tearfully and without hesitation; we were married two years later almost to the day and having obtained a spousal visa, in July 2010 she finally moved to Leeds in the UK to live with me full-time. By this point she had lost around 200lb and gained back almost 100lb of that. She was on a cocktail of drugs, could eat very little, suffered from constant dumping syndrome and was developing problems with joint pain, blood sugar and constant fatigue, all of which were exacerbated by a revision to the original surgery to repair the staples but which further reduced the range of foods she was able to eat.

In October 2010 Heather gave me the news that she was pregnant. Our joy at this was tempered only by concerns about her deteriorating health. Fortunately apart from having to be artificially rehydrated several times (she suffered from such debilitating nausea throughout the pregnancy that she was at times unable to keep down fluids) her pregnancy passed largely without serious incident. Our son Ben was born in June the following year; despite several attempts to induce her at term plus two weeks she never progressed to active labour and had to undergo an emergency Caesarean section on one of the hottest days of the year in an overwhelmed Leeds General Infirmary where she was treated like an inconvenience by several of the medical staff.

Her surgeon in the US had recommended a UK counterpart in our city who might have been able to help but NHS rules decreed she would first have to see a dietician. As was often the case I went along with her as she was rightly worried that this would be used as yet another opportunity to shame her about her weight; predictably the dietician told her that on her sub-1000 caloric intake it was 'impossible' for her to be maintaining at 320lb and that there must be something she wasn't telling her (because *everyone knows* that fat people always lie about their eating habits). This was followed up by a barium swallow which suggested she may be suffering from a stricture (narrowing) of the digestive tract and the prospect of further investigation, though subsequent events meant this never ultimately took place.

On the weekend of 8th February 2013 I went to visit friends in another city an hour away from home. Heather had encouraged this rare weekend away, as we took it in turns to give one another breaks from the stresses of young parenthood when possible. She waved me off at the train station with hugs and kisses and called to tell me goodnight later that evening. That would be the last time I ever heard from her. My attempts to contact via text and phone throughout Saturday went unanswered and, knowing how out of character this was, my friend drove me home. Unable to gain access to the house, which she'd locked from within the previous night, I frantically called the police, who broke in through our basement and found her collapsed in our bathroom. I was told that she'd been gone for some hours. Our little one was fortunately still upstairs in his crib and none the worse but for need of a clean diaper, a good feed and a cuddle.

Initially we thought the cause may have been related to a persistent headache she'd been complaining of but which her doctor had failed to take seriously. The results of the post-mortem however showed the truth to be far worse. Unbeknown to anyone she'd developed a fistula at the site of the gastric bypass surgery. This had suddenly ruptured causing, as the report put it 'destruction of chest cavity and diaphragm through discharge of gastric material'. I don't even want to imagine the discomfort my poor sweet girl likely suffered in her last hours, or to think that the surgery on which she'd once pinned her hopes of acceptance (and subsequently come to regret when she realised that her happiness was not weight-dependent) had been a ticking timebomb from the very outset of our relationship.

Heather was without a doubt one of the sweetest, kindest, most loving people I have ever had the privilege to know. In a world beset with so much cruelty and unpleasantness she was a revelation of tolerance and humanity. For the first time in my 33 years she made me comfortable in my own skin, gave me confidence to be myself and become a stronger person through my recent diagnosis with Asperger's Syndrome, a strength that only left me two Saturdays ago. Our long-distance relationship was forged in patience and anticipation of better days ahead, giving us a depth of connection that is all too rare and making us soul mates in every sense of the word. Heather loved me for my differences and quirks rather than despite them, as I loved hers and trusted her implicitly. In turn she told me that my unconditional love for her had finally given her the contentment and safety she craved when so much of her life had been marked by pain and unhappiness. She often said 'I'll always be your girl', over the years it became our little refrain that she would add to the bottom of cards and emails and tell me last thing at night. My life, Ben's life, those of all who knew her and the world at large will be all the poorer for her absence from them. Rest in peace forever sweetheart, know no more pain or torment, and I'll be counting the days till I'm back at your side.

(Cross-posted as 'Rich & Heather - Love Can Bridge an Ocean' to 'First Do No Harm' blog at www.fathealth.wordpress.com, WLS Uncensored Yahoo group and my personal FB page).

NWSA 2013 Fat Studies Interest Group Call for Papers

withoutscene — Fri, 08 Feb 2013 13:04:50 -0500

NWSA 2013 Fat Studies Interest Group Call for Papers
November 7-10, 2013, Cincinnati, OH.
Papers on any topic at the intersection of women's studies/ feminism/ womanism/ gender/ sexuality and fat studies will be considered.

At minimum, your submission should fall under one of the following themes for NWSA 2013:

* The Sacred and the Profane
*Borders and Margins
*Futures of the Feminist Past
*Body Politics
*Practices of Effecting Change

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

While this is an open call, topic suggestions from last year's meeting include:

-Defining and Refining Fat Studies
-Fatness and Beauty Ideals/Beauty Privilege
-Women of Color and Body Size/Fatness
-Fat Intersections (including race, nationality, disability, sexuality, appearance/beauty)
-Teaching Fat Studies (professorial bodies, student bodies, resistance)
-Fat Feminist Research Methods (including role of the researcher body)
-Fat Feminists Theorizing the Body
-Fatopias/Fat Utopias
-Transnational Fat Bodies (immigration, globalization)
-Knowledge-sharing/de-colonizing
-Fat Performance/Performing Fatness/Fat Icons
-Fat Activism & Feminism/Fatosphere

If you are interested in being a part of the 2013 Fat Studies panels at NWSA, please send the following info by February 13, 2013 to NWSA Fat Studies Interest Group Co-Chairs Michaela A. Nowell and Candice Buss: (michaela.nowell@uwc.edu and cdbuss@uncg.edu). Please make sure one of us confirms receipt of your submission.

Your submission should include your:
*Name, Institutional Affiliation, Snail Mail, Email, Phone.
*NWSA Theme your paper fits under (and fat studies topic area/s if yours fits any of the above).
*Title for your talk, a one-page, double-spaced abstract in which you lay out your topic and its relevance to this session.
*AND a 100 word truncated abstract (NWSA requirement).

Each person will speak for around 15 minutes, and we will leave time for Q&A. In order to present with your name in the program, you must become a member of NWSA in addition to registering for the conference.
_____________________________________________________________________
If you submit a fat studies related paper or panel, you can tag it with the keyword 'fat feminisms,' and likewise search the 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.

Conflicting research on fat kids and their health

vesta44 — Fri, 21 Sep 2012 15:19:48 -0400

I have three articles for y'all today, all of them about children's health, and all of them seem to be conflicting with each other (but then, what else is new with obesity research in general, right?).
The first article is Overweight Teens Typically Eat Less Than Normal-Weight Peers. This one seems like a no-brainer to me, since it's also true of "overweight/obese" adults and studies have proved that time and time again. The thing that's infuriating about the article is that it's blaming these teens for being fat in the first place because - wait for it - they overate as toddlers/young children. What it doesn't take into consideration is that maybe, just maybe, these teens are eating less than their peers because of the bullying they face for being fat, the blame and shame they face every day from every source there is because they don't fit society's "ideal" body shape, or the blame and shame they get from their doctors who ignore their metabolic health in favor of that dreaded number on the scale.
The second article is Taste Buds Less Sensitive In Obese Kids. This study has all kinds of problems with it, that I can see, anyway. First of all, 85% of the fat kids were from lower socioeconomic classes, they didn't control for gender differences, and the only thing they really did control for was whether the kids were fat or "normal-weight". The conclusion they reached was that fat kids have trouble identifying the intensity of sweet and salty until something is either very sweet or very salty (ergo, that's why fat kids eat too many sweets or too many salty snacks and are fat, I guess).
All of these kids were between the ages of 6 and 18, so I'm wondering how many of them had been on diets (and since they all came from the hospital's pediatric obesity center, you can almost guarantee that most of them have dieted at least once. So did the researchers take into consideration how that affects one's sense of taste? Did they take into consideration what the children normally ate on a daily basis? That can affect one's sense of taste. There are just too many variables to know if this study has any value.
The third article is More Exercise Cuts Kids' Diabetes Risk. The problem I have with this study is that they're saying that 28% of these kids were pre-diabetic and the aerobic exercise lowered their insulin AUC by "2.96 mU/mL relative to control in the low-dose exercise group and by 3.56 mU/mL versus control in the high-dose group". Without knowing what they considered pre-diabetic (the starting diagnostic for insulin AUC), I'm not sure I'd consider that a significant drop (going from 100 to 97 isn't a big deal with a fasting blood sugar, and if 95 is the number at which they say you're not pre-diabetic, is this really a big deal after all?). And one semester of activity, with no follow-up? WTF? Are they really aiming to improve these kids' health, or are they just using them as guinea pigs to prove a point? Because if the activity isn't continued, the improvements aren't going to be maintained, and where does that leave these kids, health-wise? Sure, their insulin AUC improved for a while, and they lost some visceral fat, and improved their aerobic fitness, but if they don't continue the activity sponsored by the research, all of those improvements could be lost. I really don't see a school continuing a sports program where movement for movement's sake is the goal, rather than winning at any cost, do you? And that was the carrot to get these kids moving - participate in the sport whether they were good at it or not, have fun with it, and who cared about winning or losing as long as they played. That's not the way schools do sports.

Man fired because of his size wins lawsuit

DeeLeigh — Fri, 27 Jul 2012 04:48:23 -0400

The Houston Chronicle reports that a man who was fired from his job solely because of his size (his performance reviews were excellent) has been awarded compensation by the local district court. The July 25th article, Fired obese worker will get $55,000, details the court case and the circumstances surrounding it.

It's good to know that larger Americans can turn to the court system when they are discriminated against by employers. However, Mr. Kratz hasn't found a new job since being fired in 2009. I hope that the sum he's been awarded by the courts helps him out, but this just underlines how pervasive size-based discrimination is in employment.

Talking Fat now available

loniemc — Mon, 23 Jul 2012 11:59:31 -0400

Talking Fat: Health vs. Persuasion in the War on our Bodies is now available from Pearlsong Press, Amazon and Barnes and Noble online. Amazon says temporarily out of stock because the book is print on demand. If you order it now, you should receive it in a timely manner (depending on Amazon).

I will be at the NAAFA conference. I will not be selling books there. However, if you get a book beforehand, find me, and I’ll gladly sign it for you. Feel free to come up and introduce yourself – I’d love to meet some of our readers! (Look for the tall, fat blonde with a long nose and a Texas accent.)

See you at NAAFA!

Study: Weight isn't the real issue

DeeLeigh — Fri, 20 Jul 2012 04:09:53 -0400

Big Liberty has already covered this on her blog, but I wanted to add a note about it here, too.

HAES advocates keep saying over and over again that weight isn't the real issue. If you have an issue with cardiac risk factors, then it's best to address those risk factors by tweaking your habits and, if necessary, using drugs. The same is true if you have an issue with high blood sugar. Control the blood sugar, and let your weight do whatever it's going to do in response to any changes you make. The number on the scale isn't the main issue.

Now, there's a study that strongly supports that view. It's a high quality analysis of population level data.

Anthony Jerant, Peter Franks. “Body Mass Index, Diabetes, Hypertension, and Short-Term Mortality: A Population-Based Observational Study, 2000–2006″ J Am Board Fam Med July-August 2012 vol. 25 no. 4 422-431

If you follow the link above, you'll find that the entire text of the study is available for free.

In analyses not adjusted for diabetes or hypertension, only severe obesity was associated with mortality (adjusted hazard ratio, 1.26; 95% confidence interval, 1.00–1.59). After adjusting for diabetes and hypertension, severe obesity was no longer associated with mortality, and milder obesity (BMI 30-<35) was associated with decreased mortality (adjusted hazard ratio, 0.81; 95% confidence interval, 0.68–0.97). There was a significant interaction between diabetes (but not hypertension) and BMI (F [4, 235] = 2.71; P = .03), such that the mortality risk of diabetes was lower among mildly and severely obese persons than among those in lower BMI categories.

Yes, not only were even the highest BMIs only weakly associated with excess mortality, fat diabetics are less likely to die than thin diabetics. This study also found that people with BMIs under 35 do not have an elevated mortality risk at all, not even when diabetes and heart disease aren't controlled for.

Interesting stuff.

Pre-diabetes: a fake disease?

DeeLeigh — Thu, 19 Jul 2012 17:32:16 -0400

Once again, I'm just putting this out there.

Diabetes, real diabetes, is a health condition that needs to be carefully monitored and controlled. The repercussions of not doing so can be pretty horrific.

However, what the hell is "prediabetes," and does it really mean anything? Is it just a way for the drug companies to make basically healthy people into patients and increase profits? It has to be asked.

Phamawatch Canada is asking, in "Manufacturing Diabetes":

The diagnosis of pre-diabetes is bad news for patients and their families, most of whom have no idea about all the drama in the background. But it’s also bad news for society as a whole because of the enormous costs associated with treating millions of people who do not have a medical condition. But for the pharmaceutical and diagnostic industries, it’s a great turn of events — and there’s little doubt that Big Pharma has influenced the lower thresholds that have been put in place.

Health News Review printed this follow-up which contains links to other articles that are exploring the question.

Diabetes is a chronic disease that should be taken seriously, but slightly elevated blood sugar doesn't have the same effects on health as full blown diabetes - and slightly elevated blood sugar levels do not necessarily continue to rise until they hit diabetic levels. Is pre-diabetes simply a conservative approach to diagnosis, or is it just a cynical strategy being used by drug companies to create more customers?

Debate: 'Is obesity a disease'

DeeLeigh — Thu, 28 Jun 2012 07:25:48 -0400

I haven't had time to watch this yet, but I'm just putting it out there for discussion. It should be interesting.

Dr. Jacqui Gingras is a HAES advocate and Dr. Arya Sharma is Alberta's leading expert on obesity. I think it's fair to say that Dr. Sharma is somewhat less enmeshed in the size=health paradigm and in social prejudice than many others in his field. I'm hoping that it's going to be a sane and reasonable discussion.

Joseph Abdulnour initially posted this on Obesity Panacea.

The YouTube intro:

Dr Arya Sharma and Dr Jacqui Gingras debate whether obesity should be viewed as a disease in Ottawa, Ontario on June 7, 2012. The event was moderated by Dr Mark Tremblay, and was supported by a Café Scientifique grant from the Canadian Institutes of Health Research as well as an event grant from the Canadian Obesity Network and in-kind support from the Healthy Active Living and Obesity Research Group at the Children's Hospital of Eastern Ontario Research Institute. To download the audio of the debate, visit http://blogs.plos.org/obesitypanacea/2012/06/13/is-obesity-a-disease-debate-r.... Video by Joseph Abdulnour.

WLS Surgeon Faked Data in Medical Studies

DeeLeigh — Sun, 24 Jun 2012 08:10:04 -0400

From Retraction Watch: Three more retractions for weight loss surgeon Edward Shang for making up data.

Edward Shang, the weight loss surgeon who lost his job at the University of Leipzig in May after it was revealed that he had made up most, if not all, of the patients in his research studies at the University of Mannheim, has retracted three more papers...

The authors of the above articles have requested their withdrawal, notifying the Journal that the clinical trials described in the articles were not conducted as written in the article. The Editor-in-Chief, the American Society for Parenteral and Enteral Nutrition, and the Publisher have determined to retract the articles.

The first paper has been cited three times, according to Thomson Scientific’s Web of Knowledge, while the third one has been cited 32 times.

Shang has already retracted a study in Surgery for Obesity and Related Diseases, and one in Obesity Surgery. A May 9 University of Leipzig press release refers to a total of six retractions, so there is apparently one more on the way.

Here are the three latest studies in question:

Pump-assisted versus gravity-controlled enteral nutrition in long-term percutaneous endoscopic gastrostomy patients: a prospective controlled trial. Journal of Parenteral and Enteral Nutrition, 2003;27:216-219.
Pump-assisted enteral nutrition can prevent aspiration in bedridden percutaneous endoscopic gastrostomy patients. Journal of Parenteral and Enteral Nutrition 2004;28:180-183.
The Influence of early supplementation of parenteral nutrition on quality of life and body composition in patients with advanced cancer. Journal of Parenteral and Enteral Nutrition, 2006;30:222-230.

UK Government criticises obesity epi-panic

richie79 — Wed, 06 Jun 2012 16:40:46 -0400

Just by way of an update, the All-Party Parliamentary Group into body image has now published the report of the inquiry discussed above. Considering this a Government document there's some really good, groundbreaking stuff in there, including acknowledgement of the limitations of the BMI, the role of constant media discussion of the obesity epidemic as being key to fuelling fear of fat in children, the prevalence and effects of weight stigma, the potential harm being caused by the National Child Measurement Programme, the need to re-frame the emphasis of public health messages away from the current focus of weight and obesity and even (and perhaps most controversially) the potential for legislative action against discrimination and prejudice based on appearance, effectively making weight a protected class in terms of access to employment, housing, goods and services.

On the downside (and not entirely surprisingly) the recommendations place a disproportionate focus on the role of the media over and above that of central / local Government and their often ill-advised NHS / Education Department campaigns which deliberately target children and problematise fat at an increasingly younger stage. They also take claims that there is an obesity epidemic or multiple crises of public health for granted and avoid examination of the evidence base for these, instead regurgitating the 'accepted wisdom'. Some of the language also leaves much to be desired. But all in all, it's a good start.

However as the group's primary targets the mainstream media, has unfortunately and almost without exception attempted to downplay, dismiss and put a negative spin on the group's findings in a thoroughly spiteful and apparently co-ordinated attempt to ensure that after a flurry of animosity toward fat people the report ends up being quietly forgotten about. The worst culprits were (as usual) good old Auntie Beeb with a piece which focused exclusively on the recommendation that public health messages be presented in weight-neutral language and twisted it into being about 'banning' the use of the 'overweight' and 'obese' labels (again).

Of course all these articles have comments enabled and if one were to take the balance of opinion expressed within at face value (which I long ago learned never to do) you'd be mistaken for thinking that denying the great British Public their right to bully and shame fat people was up there with ID cards and road pricing in the list of unpopular Government suggestions; as such expect to hear little more about it. When the UK press and media bare their teeth, woe betide anyone who resists.

"What is right is not always popular and what is popular is not always right" - Albert Einstein

Loving Your Body

loniemc — Tue, 22 May 2012 13:18:58 -0400

A very interesting conversation has been going on in the tumblrverse about the meme of loving your body. Marianne Kirby argues that this meme can be problematic. Kirby explained her issues with the concept on her tumblr page:

It’s very much coming from a place where people want to feel good about themselves and to help other people feel good about themselves, too.

But it homogenizes bodily experience and feeling - basically it dictates the One True Way people are “supposed” to feel about their bodies. And that skeeves me. Because there are lots of reasons people have complicated relationships with their bodies - from trans identity to disability to body dysmorphia in general and so on.

I also think that for someone just coming off dieting or an eating disorder, loving the body is far too tall of an order. I found loving my body to be unfathomable at first and not something I could force. Feeling love for the body can be incredibly challenging, and really is not necessary in my experience.

However, I found that accepting my body is very important. For me, the ideas expressed in the Serenity Prayer, popular in recovery circles, are applicable in this situation:

Grant me the serenity to accept the things I cannot change, to change the things I can and the wisdom to know the difference.

I spent many years hating my body and not accepting it as it was. I did myself a great deal of emotional and physical damage with that state of mind.

So, I had to make acceptance important. I could change some things such as becoming stronger or flexible. However, after 30 years of trying, I had to accept my weight as it was.

Additionally, I must accept my body as it is before I can make any improvements. I have to accept my current level of fitness before I can make progress, or I wind up injured and in worse shape. I have to accept my health where it is before I can address any issues, before I try to make it better.

To me feeling love for the body is not as important as accepting it and honoring it. Yet, I think accepting and honoring are forms of love – love the verb. We tend to think of love as a feeling – that ooey-gooey feeling we usually associate with the term. That feeling is wonderful, but fleeting even in the best of relationships or situations.

What is not fleeting is the choice to act lovingly, whether it be to ourselves or others. I can always choose to act lovingly towards my body, no matter how I feel about it. I can always choose to connect with my body. I can always choose to feed it and exercise it according to its needs. I cannot control how I feel about it.

So, in my viewpoint, trying to feel love for my body really isn’t important. Choosing to treat my body with respect and honor, to act lovingly towards it, is vital.

Marilyn Wann's two cents on Weight of the Nation

DeeLeigh — Wed, 16 May 2012 05:39:04 -0400

Weight of the Nation. It's the toxic new HBO documentary on how all of the disgusting and out of control fat people are going to bring down western society. Fuck you very much, HBO!

Marilyn Wann is on it in her latest SF Weekly column, Weight of the Nation Serves Up More Fat-Shaming. Marilyn reminds us:

I attended the first, government-sponsored Weight of the Nation conference in 2009. I didn't pay or anything self-defeating like that. I just walked in (with a brave friend or two) and delivered plastic-wrapped fortune cookies to the fancy luncheon tables where major stakeholders were about to chew on the alleged "obesity" problem. If the professional food scolds took a cookie, they got messages like these:

The war on "obesity" is a war on PEOPLE!

The No. 1 threat to fat people? Your unexamined prejudice.

What's the word for science that serves bigotry? Hint: It starts with "you."

If you can't imagine fat people being healthy...that's YOUR pathology!

Tell people to lose weight if you want to endanger public health AND civil rights!

How many fat people must you starve, poison, slice up? Celebrate weight diversity now!

AND she includes this nice video from the Association for Size Diversity and Health (ASDAH):

But don't stop here. Check out the whole article.

There's a new issue of Vol•Up•2 online!

DeeLeigh — Tue, 15 May 2012 08:05:08 -0400

I wrote a BFB post on the first issue of Velvet L'Amore's incredible web magazine Vol•up•2, so it's only fair to give all of you a heads-up. A new issue is available! Even better, I've figured out how to embed it in this post.

However, WARNING, this is not safe for work. It contains artistic nudes.

So without further ado...

Open publication - Free publishing - More fashion

Chewing the Fat in the UK

richie79 — Sun, 13 May 2012 07:14:51 -0400

So spring is in the air and our old friend Jamie Oliver is back to his usual rabble-rousing with demands that academy schools must be subject to the same draconian school meals standards as LEA-controlled ones and the launch of a campaign, backed by an alliance of celebrities, footballers and obesity campaigners for compulsory healthy cookery lessons in schools. The second may be a laudible objective in its own right but of course he justifies it in the context of fighting what he describes in typically potty-mouthed fashion as the ‘biggest f**king obesity epidemic ever’. Ironically, the School Food Trust, a taxpayer-funded organisation set up to implement improvements’ to school dinners in the wake of Oliver’s first campaign in 2005, is now warning that many children are at risk of malnutrition as a result of inadequate portion sizes driven by requirements to reduce calorie contents, lack of cafeteria time and fear of weight gain.

Whilst a survey of British doctors and the claims that a majority support restricting healthcare to smokers, drinkers and fat people has been receiving a lot of attention from Fatosphere bloggers, another story involving doctors passed largely un-noticed. The Academy of Royal Medical Colleges, which claims to represent every doctor in the UK, has united in a ‘crusade’ against obesity, which it claims in predictably Chicken Little-esque fashion to be the biggest single issue facing Britain. According to its spokesman Prof Terence Stephenson the project will spend three months reviewing the evidence for different types of obesity interventions and strategies but the striking thing about this is how much has already been taken for granted; that obesity is a problem requiring intervention is never questioned and the familiar alarmist urgency of language abounds. Whilst it is pointed out that the recommendations are not final, the proposed inquiry seems to be something of a window-dressing exercise and I’ll bet my house there’s no mention of HAES or the counterproductivity of some of the more extreme proposals being mooted anywhere in the final report.

Meanwhile the latest salvo in Peta’s anti-obesity crusade has not been well received. A billboard depicting a coffin-shaped meat pie with the tagline ‘fight obesity, go vegan’ has invoked the ire of local people (the location was apparently chosen due to the opening of new crematoria capable of dealing with 50st cadavers) and, interestingly, Tam Fry of the National Obesity Forum. The hoarding was later defaced by vandals who tore away the ‘obesity’ section revealing a previous advertisement for McCain home fries. With food advertising next on the list of fat police ban targets, it seems that irony is rarely without a sense of humour.

Once again the language of the crisis has made the news. In an apparent rejection of a 2009 suggestion by the then opposition party that the word ‘fat’ should be used to shock and shame patients in preference to the more clinical ‘obese’ , a new NICE paper on fighting obesity in deprived communities advises against the use of the stigmatising O-word in favour of the (equally problematic from a FA perspective) phrase ‘healthier weight’. Woe betide any who suggest that fat people should be entitled to the use of respectful language, with the usual ‘antis’ dominating what passed for a debate in the mainstream media. British fat activist Kathryn Szrodecki pointed out on the BBC’s notoriously fat-phobic Breakfast show that whilst language is important in influencing attitudes, fighting the fat stigma that keeps fat people in their houses and avoiding the doctor should be even more of a priority, but was quickly drowned out with a rant from the obligatory ‘expert’. The Guardian’s take was typically puerile, with the implication that it was an instance of ‘PC gone mad’ more fitting of the Daily Mail, but even my city’s local newspaper covered the story, and with an uncharacteristically balanced piece.

Also in the Guardian ‘body image’ campaigner Suzie Orbach discusses the(really quite horrifying) findings of a British study into levels of weight-based discrimination in the workplace, Kevin Smith talks about his vilification and ridicule at the hands of the media following the Southworst sizism incident of 2010, and there’s a truly frightening demonstration of how fat hatred and rising levels of disability prejudice intersect over the issue of mobility scooters (or ‘obesicles’ as several commenters refer to them) and whether fat people without a specific diagnosis of a disability should now be prohibited from using them.

Elsewhere, rising rates of premature births and arthritis are the latest health crises to be blamed on weight, whilst a BBC report on a course for ‘fat food workers’ aimed at teaching them to cook healthier meals is also framed in terms of fighting obesity. There’s criticism of the sponsorship of the London Olympics by Coca-Cola and McDonald’s, renewed demands to replace the GDA method of labelling foods with a traffic-light system of ‘good’ and ‘bad’ items, another propaganda piece promoting WLS for kids and a study linking reduced testosterone levels to male obesity.

Oh, and yet another Channel 4 series, starts this week, this time claiming to tackle ‘Britain’s big fat problem’ with ‘secret eaters’ by subjecting ‘obese’ families to 24-hour surveillance in a chilling echo of the tactics employed by Social Services in the recent Dundee child protection case.

Whew. Now enjoy what’s left of the weekend...

Stories I've seen lately in my MedPage Today

vesta44 — Fri, 11 May 2012 14:18:16 -0400

I subscribe to MedPage Today and the following are some of the headlines I've seen in the last week:
Co-Sleeping May Protect Children from Weight Gain This one says

"The results may suggest that elements of parental social support or other types of positive psychosocial responses of being allowed to enter parents' bed during the night may protect against overweight, whereas types of negative psychosocial responses such as feelings of rejection when not being allowed to enter parents' bed may lead to overweight," Olsen said in a statement.

Not sure how I feel about that one, think more studies need to be done.

FDA Panel Gives Nod to New Diet Drug Lorcaserin hydrochloride, another drug that they don't know if it has any cardiovascular side effects yet, and has minimal effects on weight loss (3.3% difference between lorcaserin group and placebo group).

Big Midsection May Up Risk of Dying Suddenly Not sure what this is trying to say - are they talking heart attacks? If so, I thought they said fat people had a better chance of surviving heart attacks than thinner people. Seems contradictory to me, and in need of more study.

Program May Hold Promise for Teen Weight Control

A school-based anti-obesity program for adolescent girls from low-income communities cut down the time they spent glued to the TV or computer screen, researchers reported.
But although changes in body composition moved in the right direction, they did not differ significantly from those of girls in the control group, nor were there significant changes in physical activity, according to David Lubans, PhD, of the University of Newcastle in Australia.

The gist of the article is that BMI didn't change much (less than .2%) but the girls were more active and spent less time in front of the TV/computer. I'm assuming their health improved even though their weight didn't go down, so it seems to me that would be good, but the focus is still on weight loss instead of improving health. *headdesk*

IOM: Society Must Rally to Fight Obesity

"The costs [of obesity] have the potential to become catastrophic and unaffordable unless all sectors of society take the need for obesity prevention seriously and act responsibly," Daniel Glickman, JD, chair of the IOM's Committee on Accelerating Progress in Obesity Prevention, wrote in the 478-page report's preface.

Do I really have to dissect this? When are they going to admit that personal responsibility hasn't worked so far? If personal responsibility for being fat worked, all of those fucking diets that fat people have spent $60,000,000,000 on in the last year would have worked to make us permanently thin and there would be no fat people for them to get their knickers in a knot over.

Shedding Pounds May Hike Success of Fertility Tx And again, the problem with prescribing weight loss as a solution to a problem is that there is no way to guarantee that the weight loss can be maintained for long enough to do any good for the majority of people.

New Model Sees Smaller Uptick in Obesity Rates Methinks the CDC needs to get its act together - didn't they say obesity rates have been level for the last 8 or 9 years or so? Now they're predicting a smaller rise than was originally predicted? Which is it? Rates are either staying level or they're slowly rising - can't have it both ways, no matter how much you might want it.

Moms Often Blind to Toddler's Weight This one, well, this one is just outrageous fear-mongering as far as I'm concerned. Most mothers know very well if their kids are fat. Could it be that they know better than anyone how their children eat and how active they are and whether their weight is something about which to be concerned?

So that's the fat news round-up, have at it in comments.

HAES vs. Weight Management

DeeLeigh — Mon, 30 Apr 2012 05:02:46 -0400

An interesting thing has been happening lately. Some prominent doctors have started (at least occasionally) sounding like...

us?

I go back and forth on my opinion of this. Is our message being co-opted and twisted by the medical establishment, or are attitudes changing for the better? Is the weight centered paradigm finally shifting?

Here's something very HAES-like from Dr. Rick Kausman.

Dr Rick Kausman is a medical doctor who is recognised as the Australian
pioneer of the person-centred approach to healthy weight management. Rick
has written two books including the award-winning 'If Not Dieting, Then
What?', he is the creator of a number of other resources, and has had
several articles on healthy weight management published in peer-reviewed
journals. Dr Rick is a Director of the Butterfly Foundation and a Fellow of
the Australian College of Psychological Medicine.

He talks about "everyday foods" and "sometimes foods." He talks about "weight management" rather than "weight loss" (or HAES, for that matter). Part of me is really suspicious of that terminology, but I have to admit that it would be easy to frame the same behaviors I would call HAES as weight management, since for me, a fairly stable weight - over decades - has been a side effect of HAES. And to be completely honest, yeah. There are foods that I enjoy but don't eat very often or only eat in small quantites because my body doesn't feel good when I eat them or because they're very heavy. I guess those could be framed as 'sometimes foods.'

Anyway, this HAES/weight management thing seems like it might be worth discussing. The relationship between fat acceptance and weight management is complicated. I'm pretty sure that a significant number of people in the fat acceptance movement have been below their maximum weights for quite a while, but are still fat. There are many of us that sorta kinda manage our weight the way we'd be expected to if we were thin - just listening to our bodies and striking a balance. I call it HAES and I try not focus on weight or size, but I have to admit that it's convenient to have a stable weight and I'm glad it's a side effect of HAES for me.

In the end, the difference between HAES and "weight management" can be in the intent and the focus. The two can look very similar from outside. HAES is meant to be 100% weight-neutral, but in this society, 100% weight-neutrality is difficult. Is HAES-like behavior that's conceptualized as weight management really so different? Maybe it's not complete weight neutrality that's the most important; maybe it's simply the removal of weight or BMI-based goals. If mental health, energy levels, and medical numbers other than BMI are priortized and if the goal is not to reach a certain prescribed weight, then damn. It is indeed very close to HAES, and it might help a lot of people make peace with their bodies and find ways to feel better, both physically and mentally.

Then I remind myself that "health" is a social construct that's being used as a bludgeon in our society, and that maybe the people on the fat acceptance side who have an ideological problem with HAES ("Health At Every Size") have it for exactly this reason - that it can intersect with the softer side of the medicalization of fat bodies.

What do you think?

Feeding tubes? Really?

DeeLeigh — Tue, 17 Apr 2012 08:56:37 -0400

Google "feeding tube diet" or Ketogenic Enteral Nutrition (KEN) Diet. There are a whole bunch of neutral to positive, freak show style news items. Take your pick.

Done?

You may have noticed that this weight loss diet is so incredibly embarrassing and moronic that a Google search will turn up several negative articles on the first page of results.

Canadian obesity specialist Yoni Freedhoff, who is a bit of a nutritional puritan but who helped nix the Epcot Center's crap Habit Heroes exhibition, thinks it's medical malpractice. He skewers it in a post called "Church booked? Check. Flowers? Check. Feeding Tube? Check?" Well, yeah. Sounds like medical malpractice to me too. Thanks for pointing that out.
Google News has an item called "Feeding Tube Diet? Irresponsible Doctors Condone Anorexia". The fun thing about this article is that the author clearly finds the whole thing problematic - but only when it's used by people who aren't 'morbidly obese.' For very fat people, she thinks it sounds like an excellent weight loss option.

Much as I think that Freedhoff is an okay guy for a diet doctor, I've got to say that the Yahoo article is less hypocritical than his. Don't get me wrong. I agree with everything he says about the feeding tube diet. But, this is someone who is not terribly critical of weight loss surgery. A feeding tube is less invasive than weight loss surgery and it can be removed at any time. It seems likely that the only advantage that weight loss surgery has over a permanently installed feeding tube is that it's invisible. The fact that you're tampering with your body in order to physically enforce a starvation diet isn't apparent to every single person who looks at you. But really, it's not that different. In fact, the feeding tube is not nearly as extreme and risky. It is easily reversible and does not involve the ol' slice and dice.

The feeding tube diet is marketed as a quick and easy way to lose weight. Apparently it provides 800 calories a day with no carbs, and they claim that people don't get hungry. It would be nice for the dieters if that were true, because it physically prevents them from eating. Side effects may include bad breath, constipation, dizziness, acid reflux, and nausea.

In a society that thinks weight loss surgery is a good idea, why would anyone be surprised that people want a doctor to stick a feeding tube up their noses and down their throats to provide a minimum amount of nutrition and prevent them from eating? It makes perfect sense. Not-so-fat people who love the idea of weight loss surgery but aren't eligible for it must be delighted by this new option.

I'm not surprised by it, but it is still hard for me to understand (emotionally) why someone would do this to themselves. The old "easy way out" trope doesn't fit any better than it does with weight loss surgery. This is public. It is humiliating. It is physically unpleasant and disempowering. It seems to come from a place of deep frustration and an antagonistic mind-body relationship. I keep slipping into thoughts of masochism, penance, and the mortification of the flesh. It's a self destructive (or at least risk embracing) form of self punishment. The same human impulses have found a home in religion in the past. What are those impulses acting in service of here, and why are they such a persistent part of human nature? I obviously haven't thought this all the way through, but I'm putting it out there.

A few other thoughts...

As far as I can tell, there is currently only one American doctor who is willing to insert feeding tubes for weight loss. However, this is all over the North American news. It occurs to me that:

1. All of this news coverage is free publicity for this dumb idea and it will probably spread the word to every greedy and ethically impaired doctor in North America. Coming soon: a feeding tube diet doctor in your area!

2. The news coverage sure does support the "young women are stupid, lazy and vain" trope.

Study: the Biggest Loser increases weight bias

DeeLeigh — Wed, 04 Apr 2012 12:01:15 -0400

In January's issue of the Journal Obesity, a Bowling Green Department of Psychology study: The Effects of Reality Television on Weight Bias: An Examination of The Biggest Loser.

From the abstract:

Weight-loss reality shows, a popular form of television programming, portray obese individuals and their struggles to lose weight. While the media is believed to reinforce obesity stereotypes and contribute to weight stigma, it is not yet known whether weight-loss reality shows have any effect on weight bias. The goal of this investigation was to examine how exposure to 40-min of The Biggest Loser impacted participants' levels of weight bias. Fifty-nine participants (majority of whom were white females) were randomly assigned to either an experimental (one episode of The Biggest Loser) or control (one episode of a nature reality show) condition... Participants in The Biggest Loser condition had significantly higher levels of dislike of overweight individuals and more strongly believed that weight is controllable after the exposure... Exploratory analyses examining moderation of the condition effect by BMI and intention to lose weight indicated that participants who had lower BMIs and were not trying to lose weight had significantly higher levels of dislike of overweight individuals following exposure to The Biggest Loser compared to similar participants in the control condition. These results indicate that anti-fat attitudes increase after brief exposure to weight-loss reality television.

The Biggest Loser increases weight bias, especially among thin people. No big surprise.

And Michelle Obama is appearing on the show! I really want to think that Mrs. Obama means well. I want to think that she's a decent person, if a bit misguided. But the study above has been available for months, and even without it, isn't it obvious that The Biggest Loser is horrible? That the contestants are bullied? That the methods used to make them lose weight are unsustainable?

In the Huff Post, back in 2010: Michelle Obama On Bullying: Adults Need To Set Example. I guess she's changed her mind. If fat people are the targets, she thinks bullying is a-okay. What a disappointment.

More armchair quarterbacking

DeeLeigh — Tue, 03 Apr 2012 11:15:08 -0400

There been a lot of discussion of race and the Atlanta billboard campaign in the fatophere lately. I can't say that most of it seems to me as if it would be useful to someone struggling with the issue of how to be inclusive.

I've read the original thread that caused all the fuss, and in that thread, Atchka asks a few questions about what, exactly, he should have done or should do to include people of color in the fat activism surrounding the Georgia billboards. As far as I can tell, he has never gotten an answer from anyone.

So, although I'm probably the least qualified person to try to answer that question, I do think that it's sincere and that it really should be explored, so I'll give it a shot. I hope that others will also contribute their comments and ideas. Also, I'm pretty sure that at least some of this did go on behind the scenes, but I don't know the whole story.

But First...

I want to start by saying that this whole effort has been absolutely amazing and that I am blown away by what has been accomplished. Even though it may not have been textbook perfect (and what kind of grassroots project being done for the first time would be?) it has been well managed and effective beyond anyone's expectations. Sometimes when you see that something needs to be done, you just do it. I have become very cynical about human nature over the years, and this campaign has really lifted my spirits.

I also want to make it clear that I know I'm being an armchair quarterback. I knew about the anti-billboard campaigns from pretty early on, and I could have volunteered for a role doing what I'm about to describe. However, it just didn't occur to me at the time. The fact that we were non-local and were taking action on an issue that was local to Atlanta had occurred to me, but the full implications of it really didn't hit me, as I didn't give enough thought to the demographics. However, that's a poor excuse, because what we probably should have done first is...

1. Figure out exactly where the billboards are and who lives there.

When the effort to do something about the Georgia billboards first began to gel, there was an issue of context that (as far as I know) was never fully explored. This campaign is in Atlanta, Georgia. The majority of the children in the negative stereotype-based, fatphobic Strong4Life advertisements were either Black or Hispanic. In fact, according to Wikipedia, Atlanta is approximately 55% Black, 35% White and 5% Hispanic. In Georgia as a whole, the population is approximately 60% White, 30% Black and 5% Hispanic. These are the demographics of the people whose neighbourhoods are being polluted by the negative ads.

We could have made a map of the ad locations and then figured out the ethnic and economic demographics of the specific areas that were targeted.

In reality, I think there was some awareness of this issue, especially after the first of the "stage one" billboards were removed and Children's Healthcare of Atlanta began really obviously targeting poor Black neighborhoods. However, it may not have been acted upon strongly enough.

2. Look for links into Georgia-based, activist, African American and Hispanic social networks.

Some of this could have been done through our social networks. There are size positive bloggers and commentators who may be from Atlanta or have Atlanta connections - particularly activist, African American connections. Even a general call-out for volunteers may have drawn out people who could have helped link the fatophere campaigns to local Georgians, particularly African Americans, who were concerned about the effect of the billboards on their children.

I seem to remember that an Atlanta newpaper columnist wrote a piece that was critical of the campaign, early on. It would have been a good idea to get in touch and to see if there was anything they could do to help.

3. Seek out community groups local to the billboards

After reaching out with our social networks, the next thing we could have done was seek out local Atlanta groups who are already fat positive: the local NAAFA chapter (I think Marilyn Wann may actually have done that), local BBW groups, the local plus sized fashion community. Body image activists, feminists, and eating disorders groups share common ground with the fat acceptance movement and are often based in universities and colleges. I'd look specifically for educational institutions in and near the targeted neighborhoods, with diverse faculties and student bodies. We could even have looked for privately owned plus sized and big-and-tall shops and enlisted the owners' help.

We could have tracked down community groups and cold called (or e-mailed) them. Local chapters of civil rights organizations? Volunteer-oriented churches? People in those types of organizations are going to be just as likely to be fat-phobic as they are to be sympathetic to our cause. However, it's hard to believe that the Strong4Life billboards won't have offended people involved in social justice. If we'd taken the right approach (HAES and an acknowledgement of the racist aspects of the Strong4Life ad campaign), we'd have had a chance to win some allies there and to support people in those organizations who may have already been concerned about the billboards and thinking about taking action.

4. Listen to - and amplify the messages from - local people

We could have tried to find out what the people who saw the billboards every day were thinking about them; what effects they were having. We strongly suspect that the billboards are psychologically harmful and probably counterproductive as well. We could have strengthened that argument with real examples - written, audio and video testimonials from real local people, not actors with a message someone else wrote. Then we could have plugged the hell out of these messages on our blogs and social networks.

5. Partner with concerned organizations and individuals

"Do you think something should be done about those billboards? Have you got anything is mind? Is there anything we can do to help, or can we plan something together?"

And from there on in, hopefully the fatophere's efforts could have meshed with actions taken by local groups that reflected local demographics.

The Issue of Timing
Now, I want to emphasize that this is difficult stuff. It isn't "just Google it." There's social risk involved, there's the possibility of substantial delays, however...

The billboards had been up since May, 2011. Fatophere bloggers had been aware of the campaign for a long time. I remember that someone linked to this this April 2011 article on Sociological Images right after it was posted. However the fatophere campaign didn't start until January 2012.

It's true that all of the things I describe above would have slowed down the response. The fact is, we did it at the last minute anyway. There was no organized response from the fat acceptance community for the first seven months of the Strong4Life Campaign. If we'd been on top of the issue from the beginning, there would have been time to build a coalition.

I'm not blaming anyone, because I'd have to blame myself too. I wasn't a leader in the campaign, even at the rather late time it emerged. I just photoshopped a bunch of "I Stand" posters. That was my contribution. It's just how things worked out.

The fact that we accomplished something so solid and that so many people (of all backgrounds and physical descriptions!) were ready to put their money and their pictures behind it tells me that it was needed and that it was a good idea. The fact that it got done by a group of volunteers with absolutely no grants, public or private - only individual contributions - is incredible. I don't think we should be too hard on ourselves. BUT, if it had been organized sooner, there would have been more time to build alliances.

The Issue of Distance

There's also the question of whether or not it was appropriate to get involved in someone else's local issue. In this context, we were "people from the internet," an amorphous group of size acceptance activists with no particular tie to Atlanta, Georgia, taking action from a distance. I asked a good friend who isn't involved in fat acceptance (okay, my husband) what he thought. He said "Do you think it was wrong for people outside of South Africa to take action on Apartheid or people from outside Afghanistan to criticize the Taliban for how they treat women?" And he's right. When you can clearly see that something's wrong, then how is it wrong to speak out about it and take action against it? The thing is, doing it from a distance and in relative isolation was probably not the optimal way to go about it.

On the other hand, I do see the negative Stand4Life campaign as primarily sizest and secondarily racist. The size issue is what's right out front. It was definitely not an inappropriate issue for fat acceptance activists to take a leadership role on. Some people might disagree, arguing that the ads are primarily racist because associating fatness with minority groups reflects badly on the minority groups (presumably because fat people really are - insert negative stereotype here). As someone who sees fatness as a neutral physical characteristic and fat people as a group that's in need of social justice, I am not on board with that, although I can certainly see how many people would view it that way.

In Conclusion

I think that what we did - especially what Regan Chastain, Marilyn Wann and Shannon Russell (Atchka) did, was spectacular and that it was absolutely a positive and worthwhile thing to do, even though sure, it could have been done better.

But maybe what we can start here is a list of ideas for how, specifically to establish partnerships with other community and social justice groups. And maybe the best way to reach out to people who aren't exactly like us but who share similar values right now so that we can share social networks and give each other help and support when it's needed.

Next

I think that for my next post, I'm going to start the work I talked about above, just to see how long it takes and how difficult it is. For example, is there an easy way to find out the locations of the Strong4Life billboards when you're not actually in Atlanta?

British police and press confuse BMI with fitness

DeeLeigh — Fri, 16 Mar 2012 05:30:52 -0400

The Daily Mail Fat Cop Crackdown: Police officers too unfit for the beat face pay cut...
The Evening Standard: Police face the sack for being fat
Daily News: Obese British police officers face pay cuts
The Metro: Overweight police officers who fail fitness tests to get pay cut
MSNBC: Unfit, overweight UK cops could be sacked, have pay docked
Yorkshire Post: Too-fat police could have pounds docked as fifth of Met men obese

It sounds like straightforward weight discrimination, right? British cops being fired or docked pay because of their BMIs?

No. That's not it at all. They're instituting an annual fitness test, and police officers that fail it three times in a row could have their pay lowered.

The problem here is that the press in the UK (and the US) think that being classified as "overweight" or "obese" is exactly the same thing as being physically unfit. The link between "being out of shape" and "overweight and obesity" is so strong in their minds that they are using the two concepts interchangeably in headlines.

The root cause: Reuter's inaccurately titled article, Obese UK police officers face pay cuts. Reuter's is one of the world's biggest news services, and many newspapers copy their articles without any further research, if not word-for-word. If you look up this story now, some of the headlines are a bit more rational. However, when this story first turned up on my newsfeed yesterday, the headlines were consistently as idiotic as the ones above. This is probably because the earlier articles were more heavily dependant on Reuters.

Based on these headlines, it seems that most members of the press don't understand what "overweight" and "obese" mean. "Overweight" is defined as a BMI between 25 and 30 and "obese" is defined as a BMI over 30. A 5'-8" tall person who weighs 165 (11 stone) is overweight. A 5'-8" tall person who weighs 200 pounds (14 stone) is obese.

There are plenty of people who fall into those categories who are very fit; not only strong, but capable of running fast over long distances. And guess what? People whose BMIs fall into the "normal" range and especially the "underweight" range can be very unfit. So, this isn't about being overweight or obese at all. It will (presumably) hit unfit, thin police officers just as hard as unfit, fat officers.

Now, I don't know the details of this fitness test. I hope that it takes more than just distance running into consideration, because let's be honest. Heavier people do tend to be stronger while lighter people tend to be faster, and both of those characteristics can be useful to a police officer. Fight and flight, right?

I also hope that they're taking age, experience, and the type of work these officers do into consideration. Some older officers may be less physically fit but have better judgement; better mental and emotional fitness for the job. Some officers may have old injuries that limit their performance on the fitness test, or they may have a physical disability. They may be working desk jobs rather than walking a beat. Officers need to be fit for their particular role.

More importantly, being a perfect physical specimen doesn't make up for being a dumbass, having poor judgement under pressure, being lazy on the job, being a bully, being a racist, or any of the other major flaws that have occasionally been observed in officers of the law. In fact, if the idea is to turn the British Police Services into an Order of Modern Supermen* then perhaps these issues should be even higher priority than physical fitness?

ANYWAY...

Having a regular fitness test for cops is not a crazy idea, as long as it's used appropriately and with common sense.

However, for Christsakes, people. Overweight/obese ≠ out of shape. The categories "overweight" and "obese" are based on weight/height ratios, not level of fitness.

*used in the generic, inclusive sense, of course.

Weight loss drug causes liver damage, loss of sleep, possible homicidal rage

DeeLeigh — Fri, 16 Mar 2012 04:39:21 -0400

In today's weight loss products to stay the hell away from, I bring you Hydroxycut.

Taken off the market in 2009 because of complaints of liver damage, it was "reformulated" and became available again. Last week, a woman who had been taking it and was sleep deprived went into a delusional, homicidal rage and killed her daughter with scissors. The original Associated Press article, Nev. mom kills daughter, 6, with scissors is propagating as we speak.

Did this horrible tragedy have something to do with the weight loss drug, or was this woman just out of her mind to begin with?

Who knows, but between the liver damage, the loss of sleep and the possible delusions, I'm thinking this is a drug to avoid.

Why Strong4Life is bad for fat kids

DeeLeigh — Thu, 08 Mar 2012 09:24:22 -0500

I'm guessing that most people who read BFB are aware of Children's Healthcare of Atlanta's crap anti-childhood obesity ad campaign, ironically called "Strong4Life." There's been a lot of talk and a lot of action going on in the fatophere and in the social media opposing this campaign. Regan of Dances with Fat is creating an ad counter-campaign. Marilyn Wann has made it possible to Stand visibly against the campaign and for more positive values, and Atchka of Fierce, Freethinking Fatties has been opposing the campaign on the ground, with Children's Healthcare of Atlanta and its donors. There's also a central site with up to date information called Stand4Everybody.com. It is really been an incredible show of community power and cooperation.

However, the majority of people still don't seem to get it. Children's Healthcare of Atlanta, when challenged, keeps citing undisclosed market research which they claim proves that only a small percentage of people find the Strong4Life campaign offensive. In a recent poll, 80% of respondents seemed to think that Disney's "Habit Heroes" exhibit at Epcot, which depicted fat people as embodiments of bad habits, was just hunky-dorey.

So, as a former fat kid, I'm going to talk about the specific reactions I think this type of campaign will trigger in fat kids and the communities surrounding them.

Fat children will respond to these ads in two ways, and it won't be either/or. They will disassociate, but they will not be able to avoid feelings of shame and lowered self worth. Additionally, the campaign will affect their peers and the adults in their lives, encouraging bullying and lowering expectations.

Disassociation

If they know deep down that they are healthy - they are strong and active and the doctor tells them all their numbers are fine except their BMI - fat children will think that they're exceptions to the rules. They'll think (and this is one place my mind went as a kid), "None of the things they say about fat kids seem to apply to me. I don't get winded easily. I'm not sweaty. I don't eat a lot of junk food. I can keep up with my thin friends. The doctor must be wrong. I must not really be a fat kid, or being fat is not the same for me as it is for other kids."

The thing is, I wasn't an exception. The vast majority of fat kids are healthy and have normal lives; the vast majority are exceptions to the stereotypes in these ads*. Notably, the child actors in the ads are all healthy, normal kids who happen to be larger than average. I suspect that most fat kids won't be able to relate to the ads and will disassociate themselves as much as possible. However, they won't be able to escape the fact that the ads are about them; that they are being singled out.
Shame and lowered self worth

If you tell children that they're unhealthy, they won't think of themselves as healthy. They won't play as hard. They won't push their limits. They'll start to avoid physical activity. Believing that you're unhealthy is not neutral. Just as there's a clinically significant placebo effect that kicks in when people are given an ineffective treatment that they believe is real, there is a "nocebo effect." If healthy people are made to believe they're sick, then they tend to get sick.

This works psychologically as well. If you tell kids that they're pathetic, then they may start to believe it. They may pull away from their friends. They may get depressed. With their self respect and their support systems under attack, they will get bullied.

Teachers and thinner children will be looking at these ads too, and the fat kids will get bullied more than ever and will have to deal with increased prejudice and lowered expectations. As the expectations of their peers and teachers increasingly match the stereotypes in the ads, how many fat kids will be able to maintain the feelings of competence and social normalcy they need to be successful in their lives? Even if they're able to maintain equilibrium in their own minds, they are going to be treated like damaged goods. Prejudice toward fat children has existed for a long time; at least since the fifties. But never has a respected organization so clearly told fat kids, their peers, and their mentors "Fat children are pathetic and diseased. They bring shame on their families. Fat kids: your bodies are unacceptable."

It will become clear to these children what others - even adults - think of their bodies. They will start wondering if it might not be worth it to starve themselves so that their bodies won't cause others to make negative assumptions about them and their parents. Alternatively, they may rebel or stonewall. Healthier habits are frankly the least likely thing to result from this.

*Oh, and fat kids who actually do have health problems associated with their size? They deserve respect and privacy, not public humiliation and condescending pity.

Velvet L'Amour's new web magazine - wow!

DeeLeigh — Wed, 29 Feb 2012 06:57:02 -0500

Have you ever wondered what kind of images could be created if art and fashion photographers worked with models who were not tall, skinny and young or anything close to it? Used the models' unique looks as ideals - as something to be emphasized and glorified, never hidden or shoehorned into the tall-skinny-young template? How powerful images like that would be? How they could completely expand and reframe our perception of what is chic and attractive?

I have. Although I enjoy creating and looking at grass roots fashion photography, both plus sized and general, I've always had a special place in my heart for photography that does more than just capture a person wearing a particular outfit. Good fashion images can be incredibly evocative. The lighting, the styling, the setting and the pose can trigger emotions; tap into archetypes and shared memories. Naturalism has its place, but I also admire art and style in fashion photography.

In the nineties, I read Elle and Vogue until they went over the top with herion chic. I loved the first year of Mode. They were starting to do the kind of work I wanted to see, but they pretty quickly caved in to the conservative expectations of their advertisers and started using six foot tall, size 12 models who looked... well, basically like (at least some) straight sized models should look but don't. What a disappointment!

What could be better than an arty plus sized fashion magazine with high production values that really pushes aesthetic boundaries? I'll tell you. An arty fashion magazine with high production values that is truly inclusive, where there's no one "ideal" look!

That is why I am in a state of total joy right now over Velvet L'Amour's new project, VOL•UP•2. It is difficult to express exactly how much ass this publication kicks: possibly more ass than any of us are sporting.

Be aware of some of the images are not even remotely work-safe for most people.
Click the picture of Velvet to go there!

Velvet L-Amour is a model and photographer in Paris. Here's her bio from the VOL•UP•2 press kit.

Velvet d’Amour (velvetphotography.com) is the only supersize-plus model ever to infiltrate the elite world of Parisian couture by walking the runways of both John Galliano and Jean Paul Gaultier and modeling for top fashion magazines, including French Vogue, Egoiste, WAD, Standard, and many others. Recently, Velvet was named a “Curvy Icon” by Italian Vogue. Her acting career landed her on the red carpet at both the Cannes and Tribeca film festivals for her lead in the French film “Avida.” Additionally, she raised 54,000 euros to help Missing and abused children through SOS Enfants Disparus as a result of her participation in Celebrity Farm, a popular French reality show. She has also appeared on Monique’s Fat Chance, ET!, The Insider, and CBS Sunday Morning and has been interviewed by NPR. Her photography has been celebrated internationally as refreshingly sexy, edgy and modern. As an outspoken feminist, Velvet’s insights on the role of popular notions in beauty have landed her in such magazines as Bust, on Jezebel.com and the Huffington Post as well as in innumerable blogs and online publications.

How much is that Swordfish in the Window? How we got here with our food – Part 1 – The Cost of Food

AndyJo — Sun, 26 Feb 2012 22:57:27 -0500

In the series on food and food processing I started by outlining the Beloved Fantasy of a Blissful Past (1), and then laid out a Framework (2) to discuss food processing itself and how we got here from there. In this post I will talk about one of the biggest drivers in the processing of food - the cost of food to the consumer, and what it meant for the development of our food environment. I will also take this opportunity to introduce one of the writers whose work I will outline to illustrate the changes over time – Ida Bailey Allen.

Those who fantasize about our Blissful Past frequently imagine some kind of pastoral utopia, where all food is produced locally, it is fresh, and Mom and Sis spend all sorts of time at home cooking from scratch and Dad and Bud sit at the table with Mom and Sis and Baby and eat this fresh food daily. Everybody looks like Katharine Hepburn and Clark Gable or Cary Grant (conveniently forgetting Mae West and W.C. Fields – but that is how selective memory works). Ummm… Not so much. Although there has been a great deal of change, that world of agrarian subsistence farming (to the degree that it ever existed) was destroyed with the birth of the Industrial Revolution. I will state this – that foods that would fall into the following categories of food processing and manipulation (categories generally considered “bad” or “linked” with obesity by the food nannies and wags) within our Framework (4) have been with us for the last 100 years (or longer in many cases):

Canned meats and vegetables (of all types)
Margarine (1871)
Non-animal shortening (like Crisco) – 1911
Dried soup or bouillon – 1908

This is just a short list. The development of each of these items responded not only to the need for shelf stability, but it also allowed the consumer to address the issue of cost in two ways. They lowered the cost to purchase the needed food (margarine and shortening are two examples as they replace both butter and lard) and/or retard food spoilage thus allowing the consumer to “stock up” when prices are lower and stabilize the cost of purchasing the food. Implicit in their use is also convenience – a home-made broth may taste better and could be more wholesome, but takes longer to prepare than bouillon. It might be more profitable (and cheaper) for an industrial worker to use the bouillon and work more hours than to spend the time making broth from scratch. So cost is an important driver of innovation in food processing (5).

The cost of food to the end consumer is of concern to everyone, because we all eat. Some of us might eat swordfish and others might eat potted canned meat, but we all need to eat so we can live. Economists pay close attention to the Consumer Price Index of which food is one component (3). Many organizations and professions pay attention to the cost of food for operational reasons (schools to budget for school lunches, and relief organizations to budget for relief operations – for example). Historians and economists who focus on the movement of consumer prices over the years look at the cost of food as drivers of human activity of all kinds. Scientists involved with food production (whether it is agriculture or food chemistry or food preservation – for instance) focus on how they can lower food costs through the use of technology. In short, the cost of food – whether in money or effort to obtain it – is a driving force in what we as humans do every day.

For the rest of this discussion, keep the following numbers in mind:

For the purposes of discussion here, I have held the dollar in 1935 as the constant (1935 dollars = 1 dollar)
A family budget of $9 per week for food for a family of 4 in 1935 was the equivalent of about $148 in today’s dollars
A family budget of $20 per week for food for a family of 4 in 1952 was the equivalent of $170 in 2011
The proportion spent on food by a family in 1952 was about 50%.
According to the Federal Reserve Bank of Minneapolis consumer spending on food in the lowest 20% of household income was 16.2% versus 11.5% in the highest 20% income quintile (2009)

A great many things happened to the price of food in the intervening years. In fact, the proportion spent on shelter now occupies the highest percentage of expenditure, whereas in years past it was not so. The effect of the cost of food on the American home budget, and in food and diet developments is something that can be seen very clearly in the works of one woman – Ida (Cogswell) Bailey Allen (6).

Here she is in her kitchen in 1924

And here is her publicity photo of 1935

Ida Bailey Allen was born in 1885 and died in 1973. During her lifetime she produced a plethora of books on cooking and home-making (even taking into account that many were new editions of previous works). Her 50 books sold 20 million copies. She pioneered cooking shows on radio and TV. She advised women on wartime cooking during both world wars, and her opinion was sought by many on topics of nutrition and diet. She was the food editor for the Ladies’ Home Journal. She established cooking schools in her youth, and home making clubs across the nation. She was the Martha Stewart of her time, lending her name to many companies such as Coca Cola, Nucoa Margarine, and The Golden Rule foods as endorsements and by editing cookbooks distributed by these companies. Her last book (Best Loved Recipes of the American People) was published in 1973 just shortly after her death.

Now, a number of writers have mentioned her role in gender-role enforcement, while others have (dismissively, I feel) short-changed her legacy. The 60’s and 70’s were not kind to her. James Beard and Julia Child took her place in the newly-affluent national food theatre, and she was said to maintain that “good home cooking was an antidote to the rising divorce rate” (7) – unflattering words which were quoted in her obituary. People – watch what you say or someone will put the silliest thing you ever said in your obituary. All of that aside, a closer look at her oeuvre belies her image either as a corporate shill, or an anti-woman crusader for what many may have considered the way things “ought to be”. She was a woman of her time, and needs to be considered within her social context.

The primary thrust of much of her work was focused on the home economy, and the proper preparation and utilization of food. Her training as a dietitian gave her the knowledge of food, its components and its utilization in the body. Her skill as writer and speaker allowed her to convey this information in ways her public could understand.

In 1924 she recommended to her readers ( 8 ) with a family income of $1,000 to $2,000 per year [$13,000 to $26,000 in today’s dollars using the Bureau of Labor Statistics (BLS) Consumer Price Index (CPI) calculator], a budget of 9 to 10 dollars per week to be spent on food for a family of four to five people. That works out to up to $520 dollars per year ($131 dollars per week or $6,840 per year in today’s dollars). That represented 52 to 27 percent of the family’s income. Today’s proportion is 25% or less. In 1935 (9), she presents a week of menus for 4 people at $9 per week. That is about $149 in today’s dollars.

In 1952, the picture changes considerably. Consider now that World War II has come and gone, but the Korean War is in progress. The pent-up demand for goods and services (including food) is working its way through the system, and the baby boom is in full swing. Food prices rise swiftly. So what starts to happen? Foods begin to be fortified, and new foods are created. Home freezers become more generally available, and commercially-frozen foods are increasingly available. At the same time, there is a rise in the availability of “convenience foods” (pre-cut, pre-packaged, and sometimes pre-prepared). Now her family food budget for a family of four is $20 to $30 per week (up to $254.65 per week in 2011 dollars). Her target families at this time were earning anywhere between $2,000 and $6,000 per year before all deductions. ($17,000 to $51,000 in today’s dollars). Most fell in between those two extremes, but as you can see we’re talking about the same social stratum here.

Her fundamental message in this 1952 book is one that would be fresh today – cook more, eat fewer convenience (pre-cut and packaged) foods, and pay attention to your food balance for nutrition. You can eat well for less. In this book, she sets forth – as is her custom – her concepts of balancing meals for optimum utilization of nutrients and calories. Yet she introduces concepts that have become business as usual for us today. For people who have very reduced food budgets, she advises supplementation (10) with Multi-Purpose Food , a soy product which was developed in 1937 to feed those who were to be refed from starving (from either famines or war – for instance). She claimed to have served it to enthusiastic gourmets at the Waldorf. She was documented to have served meals of leftovers at the Waldorf as well. These were publicity for her as well as public service efforts. Multi-Purpose food was around until 1980.

She also advocates for use of fortified flour, Cornell Formula bread (good stuff – actually), raw peanuts, and other fortification of foodstuffs either at home or purchased. She recommends advocating for food fortification in one’s area. In her milk budget section (11) (which was ‘out of control’ – her words - in some households with large numbers of children) she advocates dried milk as well as homogenized milk and milk products such as yogurt. This is also a departure from the pattern in other books, since technology had made available different milk “formats” than were available previously. For example, she talks about irradiated milk. Food irradiation was fairly new at the time. It makes us squawk with alarm, but at the time it was seen as a way to kill bacteria and pests to protect the purity of the food. Some still see it that way and advocate for it. I’m not going to reach for a warm glass of irradiated milk, but back then it was state-of-the-art for food preservation, and whether or not it is safe is really material for someone else’s web-page (though it would make for an interesting discussion).

So, the rising cost of food through the middle of the 20th Century drove changes in the types of foods available (greater number) with new developments in food science geared to maximize nutrition per dollar spent on calories. Ida Bailey Allen was not only a participant in these changes, but she advocated for the new foods in her home-making and cooking books. Specifically, and despite her advocacy of home food preparation and reduced use of prepared (pre-cut and packaged) foods, her readers also had another driver that pushed them toward the use of prepared and/or shelf-stable foods: time. I’ll discuss that in the next post, but I just wanted to leave you a treat to share with those who refuse to believe that there EVER was processed food in the past. In 1940, Ida Bailey Allen published a book entitled Ida Bailey Allen’s Time-Saving Cookbook. In it, there is a cool little recipe for Mexican Rice Timbales. They are shown as the cover art for the book. For your enjoyment, here is the picture and the recipe. It features pasteurized process American cheese: the cheese that isnot supposed to have existed “back then”. Enjoy!

Book Cover

Recipe

(Edited to correct odd sentence and some typos and errors)

-------------------------------------------------------------------------------------------------------------------------------

(1) In the post entitled Beloved Fantasy of a Blissful Past I noted that fat people DID in fact exist in times past, and that the question of whether or not processed food is the prime cause of obesity today is more complex than it appears.

(2) In the post entitled A Framework for Talking about Food and Processing, I laid out the following framework for the discussion:

The reasons why food is processed
How food is and has been processed and a definition of foods according to their level of processing as reflected in the following categories:
1. Whole, Raw Foods
2. Staples
3. Traditionally-Preserved Foods
4. Home-Canned Foods
5. Home-Frozen Foods
6. Home-Frozen Foods
7. Frozen Whole Foods (commercial)
8. Shelf-Stable Foods
9. Prepared Foods (includes whole meals ready to eat)
The Hierarchy of Foods – how today’s perception of foods as being associated with a higher or lower class within society imbues them by association with a tag of “processed” or not irrespective of reality

(3) You can find information on the Consumer Price Index at the Bureau of Labor Statistics web page. They also have a handy Inflation Calculator

(4) The food nannies, scolds, and wags usually go after Prepared Foods of all types, and Shelf-Stable Foods as their chief diet malefactors.

(5) War, as discussed previously, is another driver of innovation in food processing. I will likely do another post on that, because there have been some fascinating developments in the production of meals prepared for deployed soldiers.

(6) I’m a big fan of Ida Bailey Allen – I have amassed quite a collection of her books, booklets, and pamphlets. I use them for recipes all the time!

(7) From Ida Bailey Allen’s obituary in the New York Times, July 17, 1973.

( 8 ) Ida Bailey Allen, Home Partners or Seeing the Family Through. Privately printed, 1924; pp 12-13

(9) Ida Bailey Allen, Cooking within Your Income, published for F. W. Woolworth Co by W. F. Hall Printing Co. Chicago; p. 134.

(10) Ida Bailey Allen, Solving the High Cost of Eating; pp 31-33

(11) Ibid.; pp 10-16

Fitness Epiphany

vesta44 — Mon, 20 Feb 2012 15:03:30 -0500

To people who know me, it's no secret that I have arthritis in my knees and it gives me screaming fits. I went to see my orthopedist on the 14th for my yearly SynVisc shot (it lubricates the cartilage and is supposed to slow down the wear and tear). He ordered new x-rays of my knees and I got to see them - the right one is much worse than the left one, which I knew, it's the one that hurts and swells when I have to walk or stand.
I was diagnosed with arthritis in that right knee when I was 34, after I fell on it and had to have it drained because it swelled so badly (they drained almost a cup of fluid/blood out of it). In the ensuing 24 years, I've been prescribed ibuprofen, Voltaren, Naproxen, and now Celebrex. At no time have any of the doctors I've seen ever suggested physical therapy or exercises to strengthen the muscles that support my knees. They have, however, every one of them suggested weight loss. And before I found FA, I thought they might be right, and I tried their diets (and we all know where that leads, right?). I even had a nurse practitioner who suggested WLS because (according to her) no surgeon would replace my knees at my then-weight of 350 lbs (and I believed her, did it, lost weight, gained it back plus some more, and got some lovely complications to boot).
Then I realized dieting/WLS wasn't the answer, was compounding the issues with my health, and started looking for different answers. I found fat acceptance, then I found HAES, and I started reading (what else do bookworms do when they find a subject that interests them and is going to have a huge impact on their life?).
The epiphany part of this whole story comes in when my orthopedist told me that every pound a person weighs puts 7 pounds of pressure on their knees, and that losing weight would help my knees. I told him I'd already dieted my way up to where I am now, and had WLS and "see how successful that was?" I'm thinking I have to be proactive here, he's not going to come up with any suggestions to help me, so I have to think of something, so I asked him "What about exercises to strengthen the muscles that support my knees? Would those help? Would that delay having to have my knees replaced?" Can you believe it? He actually said that it probably would, and he would write me an order for physical therapy so they could show me what exercises to do and how to do them.
Now, I've been seeing him for the last 4 years, why couldn't he have suggested this 4 years ago? That's 4 years I've not been working on making my muscles stronger, and it's 4 years that my knees have been getting worse - all because the only thing he could recommend was weight loss.
I went to physical therapy on Friday, talked to the therapist, she looked at my x-rays (I also have some bone spurs in there, no wonder my knee hurts). She gave me a list of 4 exercises to do, showed me how to do them correctly, and I have to go back in 2 weeks to check on my progress and see if we need to add more. I also found out that I over-extend my knees when I straighten them - a result of the degeneration from arthritis.
I didn't know how badly out of shape the muscles in my right leg were until I started doing these exercises - my left leg is fine, doesn't hurt when I'm done. But my right leg is another story, and I'm only doing 1 set of 5 reps right now (twice a day). As soon as the pain decreases, I'll increase to 2 sets twice a day, then I'll go to 2 sets of 10 reps twice a day.
Now, I hate exercise, I have to put that out there. I've started and stopped more exercise plans than I want to count, but every one of those plans was designed primarily for weight loss and if I didn't lose weight while doing it, well, that wasn't being successful. So these exercises aren't designed with weight loss in mind - strength is the goal, less pain is the goal - those are goals that are definitely more achievable than weight loss. That's something that should have been given to me 24 years ago, when I was first told I had arthritis in my knees - strengthen the muscles supporting the knees, and there will be less wear and tear, less pain, less need for medication. Why aren't doctors telling this to fat people? Why do thin people with arthritis get physical therapy and all kinds of other advice, but fat people with arthritis get told "Lose weight, it's all we can do."?

Warning: A new twist on fen-phen being prescribed as diet cocktail drug despite FDA concerns

BigLiberty — Fri, 17 Feb 2012 09:43:57 -0500

AndyJo and DeeLeigh alerted me to this story appearing in today's New York Times:

"U.S. to Review Diet Treatment Once Rejected"

Some of you might have heard about the combination drug talked about in this article, phentermine and topiramate. Phentermine, if you remember, was the phen half of fen-phen. That's not to impugn phentermine by association, since the major side effects of fen-phen were seen to be caused by fenfluramine half.

However, make no mistake about it -- phentermine is a stimulant, that acts to suppress appetite much in the same way as ephedra does (phentermine is a congener of amphetamine). It's speed, and carries a similar range of side effects as other amphetamines like palpitations, dizziness, heart valve damage.

Topiramate (Topomax) side effects vary, mainly neurological (like dizziness, and pins-and-needles). There have been some cases of severe ocular side effects like glaucoma.

As for how effective the topa-phen combination is, I'm having a hard time finding long-term studies that aren't paywalled. There was one at 6 months (hardly useful); another at one year -- funded by Vivus, the makers of Qnexa (also hardly useful/reliable), another at two years -- again, funded by Vivus.

Additionally, from what I'm scraping up from the studies I can actually read, the weight loss effects of topiramate may in fact be temporary. This one study, conducted on children, says that weight was regained after tolerance was achieved at about 12 - 18 months.

The NYT article itself uses the problematic language one comes to expect in weight-related articles, like the euphemistic and largely meaningless term "obesity doctor" for a person who is in fact trying to reduce the incidence of obese people (recall, 'obesity' is not a disease). It's like a women's doctor whose mission is to reduce the number of women, or a pediatrician whose mission is to reduce the number of children. Definitions and language is important -- propaganda and redefinition of terms is the grease of the wheels of a moral panic.

The most important thing to take away from the article, and from this post, is that regardless of whether the topa-phen combination is 'effective' according to whatever the arbitrary standards of the FDA regarding weight loss drugs is today or tomorrow or ten years from now, phentermine is only approved for short-term use. Phentermine is an appetite suppressant. As soon as phentermine is not taken any more the individual will eat normally and gain back most if not all the lost weight.

Starvation is not a 'treatment' for fatness, especially not short-term starvation. The only long-term 'treatment' that seems to work is daily privation and semi-starvation -- an activity that will consume as much time as a part-time job -- for the rest of one's natural life. In short, the life of an ascetic. Which is a fine choice if that's what you want. But to expect that all fat people should live as ascetics is monstrous.

What I'm most concerned with is the stamp of "FDA approval" being used as a proxy for a treatment's effectiveness or long-term safety. Basically these treatments are designed to meet the approval minimums for the minimum necessary length of time. Doctors and patients are fooled into believing something is effective because it has that FDA approval stamp -- but how often as a patient did your doctor mention your weight loss drug was only effective or safe in 1- to 2-year trials, or that it hasn't been tested in the long term at all, or after the year you take it and lose some weight you can no longer take it anymore?

Even in the article we have this story:

“I can’t tell you how many people I sent to him because they saw the success I had,” said Lynn Adams, a retired teacher, referring to Dr. Thomas Najarian, the inventor of Qnexa who opened a weight-loss clinic here in 2001.

Ms. Adams said she took the two drugs for a year and lost about 80 pounds. She has taken the drugs from time to time since then but is off them now and has gained about half the weight back.

Who wants to bet that she recommended her friends jump on this new diet drug bandwagon at the peak of her weight loss and not after she gained half of it back? And how in the heck is she still being prescribed topa-phen if phentermine is only approved for short term use?

And just so we can be very clear about the responsibility for what looks to be like the next diet drug disaster, the doctors and clinicians who prescribe topa-phen are acting like mindless pharma-pushing automatons.

Doctors are just as susceptible to corruption as anyone else. A doctor who founds his career on weight loss and eliminating fat people needs dramatic success stories to promote himself, and is much more willing to throw caution to the wind if it gets him a success story and more word-of-mouth referrals.

The main danger is: weight loss happens on a curve that bottoms out over a period of months, giving an illusory 'permanent' success that is can then be paraded around to friends. A walking advertisement that, once it's served its purpose -- getting more butts into a weight-loss doc's waiting-room chairs -- regains and fades back into the shadows. We've seen that pattern with popular diet programs. Trumpet some minor celeb's loss at the bottom of the cycle and pretend it's permanent, then ignore their inevitable regain and queue up the next minor celeb to do it all over again.

My prediction is the short-term effectiveness of the topa-phen combination (6- to 12- months) will be sufficiently pushed by Vivus studies to get FDA approval for something like Qnexa. Then, as people start regaining as they tolerate topiramate and no longer can take the phentermine (which is only approved for short-term use), they will regain the weight they lost (12- to 24- months).

It will be the same old sad story, with the same old speed-related heart valve damage in addition to neurological side effects caused by the topiramate. And the population becomes less healthy, yet again, in its quest for thinness as a proxy for health.

Readers, beware the topa-phen mixture. And tell your friends.

REFERENCES

1. L. Vijaya. "Topiramate induced secondary angle closure glaucoma." JPGM, Vol. 52, 2006.

2. P. M. Levisohn, "Safety and Tolerability of Topiramate in Children." J Child Neurol December 2000 vol. 15 no. 1 suppl S22-S26. link

3. K. M. Gadde et al. "Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial" The Lancet, Volume 377, Issue 9774, Pages 1341 - 1352, 16 April 2011 study funded by Vivus, makers of Qnexa link

Healing from Being Bullied

loniemc — Thu, 16 Feb 2012 10:43:50 -0500

The Billboard Project has been amazing to watch: 1010 donors and $21,721.20. People came out of the woodwork to donate. Many of them commented that they didn’t want today’s children to know the pain that they knew growing up. I understand this well. Watching this happen, I’ve been remembering a lot of the bullying and attacks I experienced as a child. Let me state from the beginning – this is a good thing!!

Last week, I wrote about feeling excluded. For me, those feelings came to a head because of the Billboard Project bringing up old memories. When I became aware of those feelings, I was able to heal some old stuff from the past. And, apparently, I’m not done. Now it is time for me to face some old anger and hurt from being bullied.

I’ve worked on healing some this stuff before when I decided to get over some old resentments, namely towards my parents. However, I don’t think I have ever really faced the bullying as a whole. Since I’ve worked through such things before, though, I do have a process that works.

Name it. I kept trying to forgive my parents and could not get there until I named my experience as child abuse (in the guise as punishment. My parents believed the Biblical line, “spare the rod, and spoil the child”). We call our childhood experiences bullying but the reality is I experienced VIOLENCE in the form of physical and emotional attack. I was hit, touched inappropriately, teased mercilessly, and humiliated. And not just from my fellow children – I had a number of teachers, namely coaches, who made fun of me in front of the class. One coach in elementary school would terrorize me during gym class, setting me up for painful and humiliating jokes.
Get mad about it. When I first dealt with my parental issues, I tried to skip the anger part and go straight to forgiveness. It didn’t work. I had to get really, really mad and work through that anger. Anger can be scary. Many of us have been taught not to be the angry fat person. Many of us have so much anger within us that we are scared that anger will rip us apart. I was scared of my own anger – what was I capable of in a rage? But I had to face that anger and work through it.

I have found that I need to move anger through my body; physical activity helps me work through anger better than any other process. I’ve beat pillows; I’ve gone on a power hike, stomping with every step; I’ve danced it out. Sometimes, I have to do it regularly for a time. To work through my anger at my parents, it took six months of concentrated effort. This leftover bullying stuff seems to have taken about ten days.

Forgive them. I fought forgiveness because I thought forgiving them said what they did was ok and that I deserved it. I’ve learned that forgiveness doesn’t mean it is alright. It doesn’t mean they should not experience the consequences of their actions. It does not mean I will put myself in that person’s power again. It means that I am choosing to set myself free from that anger and pain. It means that I am not willing to put any more time and effort towards those negative feelings. Now, I found forgiving my mom easy; she really did try and be the best parent she could be (she didn’t exactly have good role models). My dad, though, was a bully and a jerk. I had a lot harder time forgiving him. Along the same lines, I can pretty easily forgive the children who bullied me. Many of them were in abusive situations themselves. I have a harder time forgiving the adults; they should have known better.
Yet, I don’t want that ick inside me any longer, so I choose to forgive. I have found that forgiveness is a choice, one I can make at any time. When I choose to forgive, eventually, I will feel forgiving. I’ve made the choice to forgive those adults, though I don’t find it easy. I don’t have that forgiving feeling yet, but I know it will come in time.
Help someone else. I have found that sharing my healing stories can be of benefit to others and make me feel better about my past. Though I hate that I went through such things, I’m glad if my experience helps you. When I offer my experience, strength and hope, I am offering another person a possible way out. You may find this process works for you as is or with a little adjustment, or you may find it completely doesn’t work for you. Whatever the answer, you may have found out a little more about yourself in the process, and, for that, I am grateful.

When I first started dealing with my childhood issues, I could not do it alone – I had too much anger inside me, overwhelming me. I needed a good therapist who understood how to work through such issues. Today, I have the tools to do it on my own.

I have heard of many ways to work through anger and heal from the past. This is the one that worked for me. Have you worked through it in another way?

The whacked narcissism of self hatred

DeeLeigh — Wed, 15 Feb 2012 07:27:08 -0500

I was reading an article the other day, and one of the commenters accused people who say their love their bodies of narcissism. I thought that was interesting. Is loving our bodies narcissistic?

Maybe for a few people, but body hatred is more so.

When I think about the narcissism of body love, I think of the scene in a gym locker room in Toronto, described to me by my husband: naked (and probably gay - it was the right neighborhood) men posing and flexing in front of mirrors, showing off to each other. It sounded funny; maybe even a little sweet. Made me wish I was a fly on the wall. My husband, who is a small, non-musclebound dude and was just changing into shorts to play squash, did not feel judged or denigrated. It was a fundamentally a benign show of narcissism.

Meanwhile, I was in the women's locker room. While the men were loving their big, strong bodies, the women were not. Stepping onto the scale. Looking disappointed. Hiding behind towels and changing one half at a time to avoid nudity. Can you imagine women posing naked in front of mirrors, in public, silently admiring their bodies? I can't. Because although we women are socialised to be vain, we rarely view ourselves positively and if we do, there's a stigma against expressing it.

The thing is, negativity is stickier than positivity. Loving the way you look doesn't imply hating how someone else looks. Only a sad and paranoid person would hear "I hate your red hair" in "I love my brown hair." But when someone with thinner, leaner, firmer arms than yours says "I hate my arms! They're huge and disgusting. Look how they jiggle!" then it takes a strong person and a conscious effort not to hear the logical extension of that: "if my arms are ugly, your arms are unspeakably horrible."

Yes, yes. It's your issue, not mine. You were not thinking about my arms when you said that. You see your body in a more negative light than you see others' bodies. Of course, that's how it almost always is. That was almost certainly not a passive aggressive, indirect criticism aimed at me.

And it usually isn't meant as indirect criticism, but it certainly could be.

Negativity is sticky; it's adhesive; it gets all over other people.

Although applying a set of standards to one's own body, clothing, or even achievement does not mean that those standards are meant to be universal or to relate in any way to the standards others set for themselves, the language can tell a different story. It's difficult to use negative and judgemental language - even about ourselves - without sounding self righteous as well as insecure.

But we women tend to be perfectionists, we hate it when we don't live up to our own standards, and we almost never do. We see this in our mothers and other role models; this intolerance towards self; this idea that anything less than perfection (however that's defined) is unacceptable and makes us worthless. And at the same time, we're meant to be much more tolerant and understanding toward other people.

This is not a good thing.

We could blame it on the patriarchy. It definitely weakens women. It keeps us obsessed with insignificant details, and that prevents us from being as active as we could be in business, politics, and discourse. But, it is a form of self absorption, and it is narcissistic. Who are we to expect perfection from ourselves? Is being flawed human beings not good enough? So many women are so busy; so weighed down with responsibilities. There's a need to give ourselves some personal, mental and emotional space. Why do we wrestle these precious bits of time and attention from our busy lives, only to waste them spreading around this negative, self hating muck? And demanding perfection of ourselves gives the negativity so much more power.

Loving our bodies isn't necessarily vain. I've heard that the English language has too few words for love, and perhaps people associate the idea of body love with romantic love; starry-eyed new relationship energy. That does seem a bit over the top to me. But isn't body love - self love in general - more like loving a family member or a very old friend? There's familiarity, a deep history, tolerance for quirks and foibles, steady affection, and an ability to forgive. Mature love isn't about perfection or the elevation of an idealised object. It's about respect and understanding. Don't we all owe ourselves that?

Feeling Excluded

loniemc — Thu, 09 Feb 2012 09:56:12 -0500

I have had an interesting convergence of experiences lately which has led me to thinking about exclusion. First off, a few things have happened which have me feeling a bit unwanted in Fat Acceptance. Secondly, I have been editing the section of my book on the conflict between death fat and in-betweenies and how both sides can feel left out. The Billboard Project has been bringing up memories of shaming and bullying from childhood. Then, in listening to Golda Poretsky’s Body Love Revolution Telesummit" – amazing stuff! – I heard Marilyn Wann talk about exclusion.

It finally dawned on me what I was feeling: that old fear of being excluded. Growing up as the fat nerd with no social skills, I felt left out so very often. Whether it was being picked last, not invited to the party or being bullied, I had so very many experiences of not being wanted as a child that I can be thin-skinned as an adult. In the Telesummit, Marilyn noted that many of us feel this way, so we can be sensitive to such experiences in the Fat Acceptance.

When I figuratively walked into the Fatosphere, I felt included. Here are my peeps! They understand me. They know what I have been through. Suddenly, I had a place where I belonged, and, feeling like I belong is such a wonderful sensation. No one was looking at my body and saying, “we don’t want you here.”

The Fatosphere and Fat Acceptance are loving communities. We accept anyone who is willing to honor the boundaries of the community (like no body snarking), even thin people. We build each other up. We support each other. We remind each other that we are worthy. And that is the kicker, because, as Marianne Williamson says, “love brings up everything unlike itself.” In other words, by loving and being loved, by accepting and being accepted, our fears and wounds will come up to be healed. And so, my fear of being unwanted has once again surfaced.

Now, I have a choice. I can run from this fear and let it fester inside me, trying to avoid having it triggered yet again. That running would mean me leaving FA and hoping to find another accepting community where, chances are, that fear will once again be triggered. Or, I can face it and work through it.

What does facing the fear of exclusion look like? I can only speak for myself, but for me it means making a choice. It means choosing to support Fat Acceptance and the Fatosphere even when I’m feeling outside the circle. It means slogging through the controversies, again, and sticking around any way. It means recognizing that I will not like everyone in the community, and they won’t all like me. It also means we can set aside those differences to work towards a common goal. It means doing my best to make sure others don’t feel excluded; yet allowing them to heal from their own wounds, even if I find watching that healing painful. As a child, I was powerless to do anything about feeling excluded. As an adult, I get to make choices.

When I made that choice to be part of this community whether I felt included or not, a sense of freedom overwhelmed me. Now, it will not matter what others do or say – I have made a choice to be included. Now, even if some people have issue with me, I can support the community. I can take part in Ragen Chastain’s Billboard project or Marilyn Wann’s STANDards. I can always choose to be supporting, whether I feel supported or not.

And the result – today I feel like a part of this community; I feel like I belong. Maybe, just maybe, inclusion comes from our own actions rather than others actions towards us. Maybe, just maybe, if we choose to act inclusively we will find inclusion for ourselves. And maybe, just maybe, that old fear doesn’t have to mess with my FA identity any more.

So, how do you deal with feeling excluded?

Academia, Obesity Epi-Panic, and the Emperor’s New Clothes

AndyJo — Mon, 06 Feb 2012 01:15:36 -0500

A quick hit today with apologies to everyone since I have been completely overcome by work lately and unable to dedicate time to writing. I hope to have everything sorted soon so that I can continue the series on food and food processing. In the meantime, I want to talk about articles in the press, and commenters who bring joy by pointing out the naked emperors in our midst.

It is both wonderful and terrible to have the Newspaper of Record for these United States as one’s hometown paper. On the one hand, there is some VERY fine reporting in the paper. On the other hand, one has to contend with the Fat-Bash Olympics on a daily basis. I have been really fed up lately with the patronizing tone of some of the writers who address topics of health. It really has been worse than usual. And yet, a new crop of commenters seem less and less willing to remain silent, so they are pointing out the birthday-suited emperors running around in academic head-dress justifying their studies by bashing fat and fat people.

Most of the time, unfortunately, I have to say that the worst of the fat bashing contenders play on the Commenters team, not the Journalists team, in the contests. What I have been seeing more of, however is, a commenter such as the one (whose comment I will talk about today) who will distinguish him or herself by calling shenanigans on one or more aspects of an article, and showing very clearly and with few words the bias which underlies it.

One such article appeared last Tuesday in the Times. You can see the article here. It was written by Jane Brody, and it references primarily the work of Dr. Richard J. Jackson, professor and chairman of environmental health sciences at the UCLA. He works in the field of analyzing how the built environment (our cities, suburbs… our living environment in short) affect health. Well, so far so good. In these pages we have often commented upon this. What is unfortunate, however, is that this Dr. Jackson seems compelled to repeat the same shibboleths of the fat-hating academic tribes to justify his pursuits. Here is an example (emphasis supplied):

“unless changes are made soon in the way many of our neighborhoods are constructed, people in the current generation (born since 1980) will be the first in America to live shorter lives than their parents do.
…
“People who walk more weigh less and live longer,” Dr. Jackson said. “People who are fit live longer. People who have friends and remain socially active live longer. We don’t need to prove all of this,” despite the plethora of research reports demonstrating the ill effects of current community structures.”

If one were to remove the highlighted bits (please read the full article for the context), the good work that public health professionals concerned with our built environment would still be emphasized appropriately. The justification of creating environments where movement is possible, encouraged and supported would be maintained.

Why, oh why, does weight have to play a part? Are these academics concerned that their work will be invalidated if obesity is not highlighted as “the problem”? SHOULD they be concerned that their funding will be reduced if it is NOT thus highlighted? I really want to know. Perhaps if one of you academics is reading this you can enlighten us in the comments to this post.

The Comments Section for these articles is where we can feel the zeitgeist most clearly. These were actually (on balance) not bad in the case of this article. That is actually a welcome change. One comment, stood out for aiming a strong beam of light right at the implicit fallacies. The link I provided shows the comment and the responses to it (a fine recent refinement to the commenting process). A gentleman (to judge by the picture provided) writing as Kip Hansen (who I hope keeps commenting on these topics in the future) said:

“…Compare his dreadful predictions with the fact the average lifespan in the US continues to rise, year after year. Americans are healthier and live longer than ever before.

There is always someone who can drag out some 'purpose-chosen' statistics (doesn't that sound nicer than 'cherry-picked' ?) showing how this and that disease is on the rise (usually because we're living longer, and moire [sic] of us suffer the usual diseases and discomforts of older-age)...”

Some people who responded dog-piled on his comments saying that – of course – the increase in diabetes will not show up in death stats for years, and (I am paraphrasing here) that we are all just fat pigs. Yet the gentleman’s comment stands as a very clear counterbalance of common sense to the Obesity Panic-mongering that is de rigeur amongst academics working in public health. Perhaps it is my imagination, but I seem to see a larger number of comments such as Mr. Hansen’s showing up and being recommended by readers several times.

I know a number of regular readers of this blog comment on articles in their papers or on websites. If you do… What have your observations been in terms of the number of pro-HAES comments Have you encountered any great comments that pointed out some fundamental prejudice in an article? Do you have commenters that you consider favorites? What makes you decide to comment or to withhold your thoughts on any given article?

Looking forward to reading your thoughts…

A note to those who have been following the efforts to put up billboards in solidarity with the children of Atlanta who have been subjected to odious and shaming signs depicting fat children: You can follow the progress of the donations on Ragen Chastain’s page. There you will also find links to donate a dollar (or more) in solidarity. The effort exceeded original expectations, and is extremely close to meeting the requirement for a challenge grant from the More of Me to Love folks. Thank you if you have donated, and please donate if you possibly can. Every donation counts!