"Notes from the Fatosphere" via Fat O'Sphere in Google Reader

I Am NOT a Disease

2013-06-19T08:45:07Z

One of the things about being a highly visible, deeply combative fat activist is that everyone seems to think you’re made of steel. That you are so strong and confident, that nothing ever hurts you or makes you feel bad. Nobody believes that you have bad days, that there are times where the fight just goes out of you and you can’t face another moment of trying to claw your way out of the hatred and stigma that surrounds fat people.

But that’s not true. It’s not true in the slightest. Even the most radical fatty, the most sartorially brave, the fiercest fighter, the strongest critic of the dominant paradigm around fatness struggles. Every single one of us have those times where we just run out of oomph.

I am having one of those days today, and have been really struggling all afternoon. You see, the American Medical Association today declared obesity as a disease despite a report from their own council on science and public health urging them not to. According to the AMA, we fat people are no longer just people, we are diseased, defective, damaged, broken. We are officially diseases to be cured, prevented, eradicated. And this news has shaken me to the core. I simply feel so defeated right now, like all the work that I and many other fat activists have done, and are doing to claw back our rights and improve our quality of life has just been taken away from us.

Rationally, I know why the AMA has made this ruling. They’ve done so because big pharmaceutical companies, the weight loss industry and big health insurance companies, have lobbied, threatened, bullied and bribed them to do so. Rationally I know that the reason these big corporations have done this is because it’s in their best interest financially to do so. After all, they’re raking in HUGE amounts of money by convincing society in general that appearance = health, and that if you don’t meet the arbitrary levels of appearance that you must be sick, and surprise surprise, they have a drug, or a surgery, or a device, or a diet plan or an extra expensive health insurance plan to sell you to fix it. The weight loss industry alone was worth almost $800 million just here in Australia. That’s about 35 million dollars per person per year. THIRTY FIVE MILLION DOLLARS PER PERSON. Can you imagine what could be done for 35 million dollars per person in this country? We could all have completely free health care for every Australian, more than we would ever need. People with disabilities could have all of the equipment that they would ever need, and any support and care they would ever need. No human being in Australia would go without food, water or housing. Education would be free for our whole lives, from kindergarten through any university studies that we would care to take on. Medical research into every known actual disease, from the common cold to cancer could be funded fully.

All this just from the money that the diet and weight loss industry is worth in a single year, and there would be change. In fact, if we only took their profit margin for ONE year, approximately $63 million dollars, and applied that to public funding annually – we could fund a lot of the things I’ve listed above. And that’s just here in Australia, a country of only about 22 million people. In the US, the weight loss industry is worth 66 BILLION DOLLARS. Let alone the cumulative value of the rest of the world’s weight loss industries.

There is NO WAY ON EARTH that the weight loss industry is not behind this ruling from the AMA. They have $66 billion dollars worth of power per annum in the US alone. $66 billion dollars they can spend on lobbying, propaganda, graft, legal threats to anyone who opposes them, you name it to make sure the ruling falls the way they want it to.

Rationally I know this. I know the facts. I’ve done years of my own research into this because what I was being told about my fat body wasn’t matching up to reality.

But despite that knowledge… I feel so defeated today. I feel so disheartened. I feel so cheated. I feel like I’m being marked as inferior, defective, broken. Simply because my body happens to fall on the far end of a bell curve of diverse human bodies. Simply because my body doesn’t fall in the small peak of the bell curve, the median of human bodies, a tiny arbitrary band of people who are granted the “normal” status just because they’re in the middle statistically.

But being at one end of the statistics doesn’t reflect who I am. It doesn’t reflect how I feel. It doesn’t reflect what my body can do. It doesn’t reflect my value as a human being. The AMA doesn’t know what it feels like to exist in my fat body. They don’t know what it’s like in my body to wake up after a deep sleep, stretch and feel that stretch go down to my toes and up to my outstretched fingertips. They don’t know what it feels like in my body to go swimming, feeling the cool water soft and cocooning around my body, and the wonderful sleepy feeling I get afterwards. They don’t know what it feels like in my body to walk along the waterfront near my house on a windy but crystal clear winters day, with the sun warming my back as the wind nips my nose and fingertips. They don’t know what it feels like in my body to laugh with my friends, my belly rocking, tears rolling down my face and my ribs hurting from giggling so hard. They don’t know anything about what it feels like in my body. All they know is that I am at the far end of a bell curve, and that someone out there can make money from making me hate myself and by encouraging society to hate me, and to repeatedly attempt to move myself to another point on the statistical bell curve, something we scientifically know fails for 95% of all attempts. And with that they have marked me, and people like me, as diseased, defective, broken.

The only time I feel diseased, defective, broken is when society repeatedly pushes me down because of how I look and what numbers show up on a scale when I step on it. I don’t feel those things unless I am taught to feel them. Not even when I actually suffer illness or injury.

How is simply declaring me as diseased based on statistics, and despite how I feel or the quality of my life, good for my health?

How is that good for anyone’s health?

The inimitable Marilyn Wann has started a petition against this AMA ruling here. Please sign.

Filed under: American Medical Association, depression, discrimination, fat shaming, fat stigma, health, obesity, prejudice, quality of life, war on obesity, weight loss, wellbeing

AMA Says Obesity is a Disease

2013-06-19T08:21:21Z

A year ago the American Medical Association charged its Council on Science and Public Health with studying whether or not obesity should be considered a disease. Today they ignored that council’s recommendation and now, per the American Medical Association, Arnold Schwarzenegger, Tom Cruise, Barry Bonds and I all have the same disease.

So does that mean that Tom Cruise needs to start diet pills? Does Barry Bonds have to sign up for Weight Loss surgery? After all, they are obese by the clinical definition and obesity is a disease per the AMA So you can see why the Council on Science and Public Health thought this was a bad idea. The “disease” is a body size, the “cure” is to change the body size and nobody has to take any health measurements at all. This does not have the feel of sound science.

But really it’s just the Council on Science and Public Health and what do they know about ~~science and public health~~ making a profit for pharmaceutical companies?

“Companies marketing the products will be able to take this to physicians and point to it and say, ‘Look, the mother ship has now recognized obesity as a disease’” says Morgan Downey, a self-identified advocate for obese people and publisher of the online Downey Obesity Report. I’ve got to say, with advocates like this, who need detractors. Morgan gets paid to consult for organizations that represent companies that market these products, so it’s a good day for him.

In a blatant attempt at “if wishing made it so” the AMA resolution stated hypotheses as if they were facts:

Whereas, Weight loss from lifestyle, medical therapies, and bariatric surgery can dramatically reduce early mortality, progression of type 2 diabetes, cardiovascular disease risk, stroke risk, incidence of cancer in women, and constitute effective treatment options for type 2 diabetes and hypertension;

It’s important to note that there is not a single study that proves this. They forgot the last sentence which is “We guess.” They also ignore the fact that many obese people never develop these issues and plenty of thin people have them. Not to mention that one reasons that good research doesn’t exist is that so few people have lost weight long term that there aren’t even enough to study. That’s because there aren’t any weight loss methods that are shown to work long term for more than a tiny fraction of participants, and studies don’t have a success criteria that included a change in BMI, often the “successful” weight loss amounts to 2-5 pounds. There’s weight loss surgery but that has a high rate of weight regain and may have a 700% greater chance of dying in the first year alone and no proof that those who underwent the surgery have any better health outcomes than they would have if they had skipped the surgery and practiced healthy habits, so that’s questionable at best.

So against their own recommendations the AMA declared body size – including my body size – to be a disease. No actual health measurements necessary, just a quick ratio of your weight and your height and they’ve got you diagnosed. They aren’t the first, the NIH has considered me, Mel Gibson, and most NFL linemen to have a disease for a while now. No matter how many organizations say it, I don’t think it’s medically and scientifically sound. I do think it’s profit driven.

I’m still going to the doctor’s office as the CEO of my healthcare team. I’m still going to say the same things at the doctor’s office, I’m still going to insist on appropriate, evidence-based health care. I will continue to defend my amazing body from any and all attacks. So bring it on AMA, I’m a fat woman, but I will not be your cash cow.

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Cesarean Scar Pregnancy: Another Complication on the Rise from High Cesarean Rates

2013-06-19T04:07:00Z

Cesarean Scar Pregnancy, Kung 2006

As a follow-up to Cesarean Awareness Month, we have been focusing on some of the rarer possible downstream complications of cesareans. Today we discuss Cesarean Scar Pregnancies. Warning ─ this one's not for the faint of heart.

Again, I would reiterate that many cesareans are truly life-saving and necessary, and many others are probably prudent. However, cesareans are not without risks and should not be done lightly. The extremely high cesarean rates in certain areas of this country and around the world has very distinct public health implications, both in the immediate period around the cesarean and for years afterwards. In particular, the long-term implications of cesareans are under-recognized.

We've already discussed abnormal placental implantation (placenta previa, placenta accreta, placenta increta, placenta percreta), which is one of the most significant risks to future pregnancies after cesarean section. As a follow-up to this, we also discussed placenta previa in more detail.

Another potential very serious complication of pregnancies after prior cesarean is an ectopic pregnancy in the cesarean scar itself.

Cesarean Scar Pregnancy

An "ectopic" pregnancy is one that implants outside of the uterus. Most often, ectopic pregnancies are tubal (in the Fallopian tubes), but sometimes they occur outside of uterus in the abdomen, in the cervix, etc.

However, with the rise in cesarean rates, care providers are now seeing an increase in the previously extremely rare situation of an ectopic pregnancy implanting in the cesarean scar.

This is called Cesarean Scar Pregnancy, or CSP.

The main symptom is usually vaginal bleeding during early pregnancy; sometimes this is painless and sometimes it is accompanied by significant abdominal pain. Very high hCG levels are another symptom that raises the suspicion for CSP. However, some women with CSP have no obvious symptoms at first.

Since many pregnancies experience early spotting, most women don't take vaginal bleeding in the first trimester too seriously. However, women with a prior cesarean and significant bleeding/abdominal pain may want to consider an early vaginal ultrasound, just in case, especially if it is accompanied by very high hCG levels.

A few care providers feel that every women with a prior cesarean should have an ultrasound in very early pregnancy to check for CSP, although this is by no means standard. The downside to this, of course, is that any prenatal testing carries with it potential for false positives and unnecessary worry.

If you do choose to have an ultrasound in early pregnancy after a prior cesarean, certain things should be checked for. According to a recent 2012 review, the following sonographic findings should raise the suspicion level for a Cesarean Scar Pregnancy:

No fetal parts in the uterine cavity or cervix
A thin myometrial layer between the bladder and gestational sac
A triangular-shaped gestational sac
A gestational sac that is close to the bladder and uterine wall
Presentation of arteriovenous malformation in the area

Because the non-sonographic symptoms are unclear and easy to ignore at first, many cases of CSP go undetected initially. Even when the patient presents with symptoms to a care provider, the diagnosis may be missed; the 2012 review found that about 13% of CSP are missed or misdiagnosed at first.

Thus, some CSP patients only get recognized once the uterus has ruptured and they are in hypovolemic shock. Many of these patients have to undergo a hysterectomy to stop the bleeding.

Bottom line, the longer a Cesarean Scar Pregnancy continues, the worse the outcome in most cases. Therefore, most resources agree that it's important to recognize and deal with a CSP as early as possible. If the CSP is caught early, outcomes improve and fertility can often be preserved.

Transvaginal ultrasound is usually reasonably accurate for diagnosing CSP, although the diagnosis can still be missed even with ultrasound. Often color flow Doppler imaging is helpful. Occasionally an MRI may be used if other results are ambiguous.

Prior cesarean is not the only risk factor for Cesarean Scar Pregnancy. A history of uterine infections and prior D&C procedures are also risk factors, as is a short inter-pregnancy interval after a cesarean. Treatment with In Vitro Fertilization may also be associated with CSP, although this is not clear. Some authors have speculated that recent uterine suturing technique changes (single-layer, various suture materials) may also have an effect, though there is little data to support or refute this.

Obviously having a prior cesarean scar is the most important risk factor for CSP.

Ethical Dilemmas

When CSP occurs, nearly all clinicians believe that there is little choice but to end the pregnancy because the growing pregnancy will quickly become life-threatening to the mother, and the fetus is extremely unlikely to survive anyhow. This places parents in the very difficult position of having to make a choice to end a pregnancy in order to save the life of the mother.

A few providers have managed a Cesarean Scar Pregnancy expectantly. This has been done for those who object to termination under any circumstances, in parents who hope to avoid the difficult choice to end a pregnancy, or in hopes that the pregnancy will move into the uterus with time and become viable.

Since a Cesarean Scar Pregnancy is rarely sustainable and will often miscarry on its own with time; some parents hope that taking a wait-and-see approach can relieve them of the difficult choice to end a pregnancy. However, this approach does present significant risk to the mother.

There have been a few extremely rare instances of Cesarean Scar Pregnancies that resulted in viable infants. Usually these are pregnancies where the gestational sac grows towards the uterus, eventually becoming mostly intrauterine pregnancies. Even then, most doctors recommend a planned cesarean at 28-30 weeks as a precaution against later uterine rupture, and usually assume that placenta accreta accompanies the CSP (making hysterectomy a distinct possibility).

Continuing the pregnancy in hopes of being the rare exception that results in a live baby is understandable but risks life-threatening complications because uterine rupture is very common as a CSP progresses. The 2012 review notes that patients advised to take a "wait and see" approach often ended up with an emergency hysterectomy and infant death anyhow.

There are no easy choices here. Women need to know that the further a Cesarean Scar Pregnancy progresses, the riskier the outcome. As one study points out:

It is likely that if a developing pregnancy in a caesarean section scar were to continue to the second or third trimesters, there would be a substantial risk of uterine rupture with catastrophic haemorrhage, with a high risk of hysterectomy causing serious maternal morbidity and loss of future fertility. There is also a danger of invasion of the bladder by the growing placenta. A pregnancy that protrudes through the scar, if viable, can implant on other abdominal organs and continue to grow as a secondary abdominal pregnancy.

As a result, women may experience uterine rupture, major hemorrhages, and internal damage to nearby organs. Many lose their fertility permanently via hysterectomy. Occasionally, women have lost their lives with a Cesarean Scar Pregnancy, although this is very unusual in developed countries now because of the use of ultrasound for early detection.

Clearly, this is a dilemma with far-reaching consequences and there are no easy answers.

Treatment

Cesarean Scar Pregnancy Diagram, Zhang 2012

Most clinicians believe that the only reasonable treatment for a Cesarean Scar Pregnancy is to end the pregnancy, but the best method for that is still being debated.

There are a wide variety of treatments used for CSP, including D&C, systemic methotrexate, local injection of methotrexate, Uterine Artery Embolization, laparoscopic or hysteroscopic surgical treatments, and others. The relative rarity of CSP makes it hard to know which approach is best and therefore the standard of care on this is still evolving.

A 2012 survey of case reports in the medical literature found that there has been a huge variety of treatments for Cesarean Scar Pregnancies, but that many resulted in significant morbidity (44%). They reviewed the various treatments used and analyzed the results.

According to the 2012 survey, D&C (Dilation and Curettage) was the most common treatment used for CSP, but it was associated with high rate complications (nearly 62%), and often resulted in hemorrhage. The authors concluded that this was not a good choice for treatment of a CSP.

The authors also found that giving methotrexate systemically to the mother was associated with a 62% morbidity rate. This was because secondary treatments were often needed and these had a high complication rate. The authors recommended against this treatment too.

In Uterine Artery Embolization (UAE), an interventional radiologist inserts a small catheter into an artery in the leg, runs it up to the arteries that feed the uterus, and injects small particles to reduce blood flow to the uterus. UAE had a complication rate of 46%, so the authors recommended against UAE as a single treatment for CSP. However, UAE is often used in conjunction with or after other therapies to help reduce severe bleeding.

Operative hysteroscopy (examination of the inside of the uterus with a fiber-optic tube inserted via the cervix, then surgical intervention as needed) had a much better complication rate of 18%.

Injecting methotrexate directly into the gestational sac was the treatment associated with the least maternal morbidity in the review. When combined with an intramuscular injection of methotrexate, the complication rate was slightly less than 10%. After this injection, the body slowly breaks down the leftover tissues, so treatment must be followed long-term to be sure everything is resolving fully, but there is less need for surgical intervention and all its risks.

One problem was that many care providers did not realize that methotrexate treatment results in a temporary increase in hCG levels, leading them to use secondary interventions that led to complications:

Many of the complications reported in the literature review resulted because clinicians were not aware that increases in hCG concentrations could be expected with the treatment, Dr. Timor-Tritsch noted.

"Many secondary treatments were triggered not by bleeding, but by the observation of a post-treatment increase the hCG cycle and vascularity," he said. "The treatments often resulted in escalation of the critical situation and often hysterectomy."

"Knowledge of the naturally occurring increase of the hCG volume in blood vessels with a slow resolution could have avoided a secondary resolution," Dr. Timor-Tritsch said.

Other treatment options include laparotomy or laparoscopy. This is a surgical excision of the gestational sac and repair of the uterus via opening the abdomen up (laparotomy) or doing the surgery through a small hole in the abdomen (laparoscopy).

After a cesarean scar pregnancy, it may take a while for the mother to recover. Bleeding may continue off and on for quite a while. Treatment with methotrexate often takes several months to resolve the situation ─ in some reports, it took up to a year. Often follow-up testing is needed. And of course, emotional support is needed, since the parents have just been through a very difficult ordeal.

Although most women with a CSP do not choose to have another pregnancy, some do. If the CSP was caught early enough and their uterus was able to be preserved, subsequent pregnancy is certainly possible. Researchers generally suggest that the mother wait a good while before trying to conceive again, since closely-spaced pregnancies may be a risk factor for CSP. Furthermore, if methotrexate or other drugs were part of the treatment, it may take a while for all traces of these drugs to be out of the mother's body. So waiting a while before attempting to conceive again may be a good idea.

Although there are risks, outcomes are reasonably good in pregnancies after CSP. Most authors recommend careful early surveillance of a post-CSP pregnancy in case of repeat Cesarean Scar Pregnancy or abnormal placentation. There is a somewhat higher rate of miscarriage and repeat CSP, and the risk for uterine rupture and placenta accreta is also higher. Case reports have occasionally recorded deaths in mother and/or baby due to uterine rupture in a pregnancy after CSP, so careful monitoring of the pregnancy may be appropriate.

Many post-CSP pregnancies are delivered by planned repeat cesarean section because of the perceived potential for uterine rupture, although it is difficult to estimate the actual risk for uterine rupture under these circumstances. On the other hand, some authors advocate for vaginal birth in order to avoid further scarring of the uterus. The number of pregnancies after prior CSP is so small that it's difficult to draw any conclusions about the best course of action.

Incidence of Cesarean Scar Pregnancy

Although Cesarean Scar Pregnancy is thankfully still rare, it is on the rise, and likely will continue to rise in parallel with cesarean rates.

Of course, it's important to note that absolute numerical risk of this complication is low. Very few women with prior cesareans experience this complication. Therefore, as an individual mother, it's unlikely that you would experience a cesarean scar pregnancy.

However, from a public health point of view, it's also important to note that the more cesareans that are done world-wide, the more women are susceptible to this problem and the more cesarean scar pregnancies we will see, even while they remain a rare risk for any one individual.

The incidence of Cesarean Scar Pregnancy (CSP) is difficult to pinpoint because of its relative rarity and the diversity of baseline cesarean rates in various areas. This is also a fairly new area of research, with mostly case reports rather than population-wide studies.

But its increase can be noted if you look closely at the research. One 2002 study notes, "Only 19 cases have been reported in the English medical literature since 1966."

However, a 2004 study, only two years later, looked for case reports that were made after 2002, and found 66 new case reports in only two years. A recent 2012 survey of the literature found 751 case reports. Obviously, the incidence appears to be on the rise.

The increase in case reports may be partly due to higher cesarean rates, but also is probably due to increased awareness of CSP and a willingness to document them as a complication of prior cesareans. But there's little doubt doctors are seeing them in greater numbers than in the past.

Exact numbers will depend on the study and the underlying risk factors of the population, such as how high its cesarean rate is, how many women have been exposed to D&C (another risk factor for CSP), the usual parity of the population etc. Even so, some general numbers can be found.

One review found a rate of 1 cesarean scar pregnancy per 1800 - 2200 normal pregnancies (all pregnancies, prior cesarean or not). Another study found a similar rate of 1 CSP per 1800 normal pregnancies.

However, that doesn't tell you what your risk for CSP is if you've had a prior cesarean.

An Israeli study found the CSP rate more along the lines of 1 CSP per 3000 normal pregnancies, but this dropped to a rate of 1 CSP per 531 pregnancies in women who had had cesareans in the past.

Rounded up slightly, about 0.2% of women who had cesareans experienced a Cesarean Scar Pregnancy in a later pregnancy.

Interestingly, this is beginning to approach the incidence of uterine rupture in spontaneous labor among women with a prior cesarean (which is generally around 0.4 - 0.5%).

Interestingly, about half the time Cesarean Scar Pregnancy occurred in a woman with only one prior cesarean. It is not clear from research whether multiple prior cesareans increases the risk for CSP, but it is clear that when CSP does occur, it can happen in women with only one prior cesarean.

That's why preventing every unnecessary cesarean matters.

Conclusion

Cesarean Scar Pregnancy is an extremely serious problem. Although rare, its incidence is on the rise in parallel with the high rate of cesareans being done these days.

Because it is rare, this is not a complication that individual mothers with a history of prior cesarean should lose much sleep over. However, from a public health point of view, it is a concern.

Because many cesareans are done because of VBAC bans, out of fear of liability, for convenience, as a routine repeat cesarean, or for other questionable indications, the increasing rate of Cesarean Scar Pregnancy is a sadly avoidable nightmare in many cases.

This is yet another reason why it's so important to care providers to make sure that Vaginal Birth After Cesarean remains accessible, and why they need to prevent as many unnecessary first cesareans as possible.

References

General Resources on Cesarean Scar Pregnancy

Increased Incidence of Cesarean Scar Pregnancies

Obstet Gynecol Surv. 2002 Aug;57(8):537-43. Ectopic pregnancy within a cesarean scar: a review. Fylstra DL. PMID: 12187153

Implantation of a pregnancy within the scar of a previous cesarean delivery is the rarest of ectopic pregnancy locations. Only 19 cases have been reported in the English medical literature since 1966. If diagnosed early, treatment options are capable of preserving the uterus and subsequent fertility. However, a delay in either diagnosis or treatment can lead to uterine rupture, hysterectomy, and significant maternal morbidity. Although expectant and medical managements have been reported, termination of a cesarean scar pregnancy by laparotomy and hysterotomy, with repair of the accompanying uterine scar dehiscence, may be the best treatment option.

Hum Reprod Update. 2004 Nov-Dec;10(6):515-23. Epub 2004 Sep 16. Ectopic pregnancies in a Caesarean scar: review of the medical approach to an iatrogenic complication. Maymon R, Halperin R, Mendlovic S, Schneider D, Herman A. PMID: 15375087

...Sixty-six new cases were reported since 2002, possibly reflecting the increasing number of Caesareans currently being performed as well as the more widespread use of the transvaginal scan allowing their earlier detection. Analysis of these women's obstetric history revealed that those at risk for pregnancy in a Caesarean scar appear to have a history of dilatation and curettage, placental pathology, ectopic pregnancy, and IVF. Twenty-one out of 39 for which this information was available (54%) had undergone multiple (> or =2) Caesareans and 13 had previous dilatation and curettage, which might also be an associated factor....

J Ultrasound Med. 2012 Sep;31(9):1449-56. Cesarean scar pregnancy: sonographic and magnetic resonance imaging findings, complications, and treatment. Osborn DA, Williams TR, Craig BM. PMID: 22922626

A cesarean scar (ectopic) pregnancy occurs when a pregnancy implants on a cesarean scar. This condition is an uncommon but potentially devastating occurrence. The incidence is increasing as cesarean deliveries become more common. Early recognition of the salient sonographic findings is critical because a delay can lead to increased maternal morbidity and mortality. Magnetic resonance imaging is a valuable troubleshooting tool when sonography is equivocal or inconclusive before therapy or intervention. Early diagnosis by sonography directs therapy and improves outcomes by allowing preservation of the uterus and future fertility. We review the imaging features, differential diagnosis, complications, and treatment of cesarean scar pregnancies in the first trimester.

J Clin Ultrasound. 2007 May;35(4):212-5. Sonographic diagnosis of cesarean scar pregnancy at 16 weeks. Smith A, Ash A, Maxwell D. PMID: 17366559

Cesarean scar pregnancy is rare. However, there has been a rapid increase in the reporting of such cases in recent years. Most of the cases reported in the literature were diagnosed early in the first trimester. Possible management options proposed are pertinent to an early diagnosis. We present a case of a cesarean scar pregnancy diagnosed at 16 weeks that posed a dilemma with regard to management. The patient subsequently suffered a ruptured uterus, which was preserved at surgery.

J Clin Ultrasound. 2008 Oct;36(8):504-11. doi: 10.1002/jcu.20471. First-trimester diagnosis of cesarean scar ectopic pregnancy. Moschos E, Sreenarasimhaiah S, Twickler DM. PMID: 18393379

Once considered extremely rare, implantation of a pregnancy within the scar of a previous cesarean section is becoming more common. In fact, its incidence is now higher than that of cervical ectopic pregnancies. We identified 5 cases of ectopic pregnancy implanted in a prior cesarean section scar at our institution since 2004. We outline the criteria for the first-trimester sonographic diagnosis of cesarean scar ectopic pregnancy, including a new sign of lower uterine segment ballooning, which has previously not been reported. Clinicians must have a heightened awareness of this serious and potentially fatal pregnancy complication.

J Ultrasound Med. 2011 Sep;30(9):1179-84. Fertility performance and obstetric outcomes among women with previous cesarean scar pregnancy. Maymon R, Svirsky R, Smorgick N, Mendlovic S, Halperin R, Gilad K, Tovbin J. PMID: 21876087

...METHODS: We conducted a retrospective study in a large tertiary hospital in Israel. The study included 18 women with a diagnosis of cesarean scar pregnancy between 2000 and 2009. RESULTS: The incidence of cesarean scar pregnancy among our parturient patients was 1 per 3000 for the general obstetric population and 1 per 531 among those with at least 1 cesarean delivery. Sixteen were treated primarily with methotrexate. Two were treated primarily by surgery, and 2 more were treated by surgery after failed methotrexate treatment. After cesarean scar pregnancy treatment, 7 women conceived spontaneously, and 1 conceived by in vitro fertilization-intracytoplasmic sperm injection. The remaining 10 (55%) did not wish to conceive again. Two of the women who became pregnant (25%) had recurrent cesarean scar pregnancy. CONCLUSIONS: This study shows encouraging results for fertility performance and obstetric outcomes after treatment of cesarean scar pregnancy. Nevertheless, the risk of recurrent cesarean scar pregnancy is not negligible.

Obstet Gynecol. 2006 Jun;107(6):1373-81. Cesarean scar ectopic pregnancies: etiology, diagnosis, and management. Rotas MA, Haberman S, Levgur M. PMID: 16738166

...Fifty-nine articles that met the inclusion criteria provided data on the clinical presentation, diagnosis, and treatment modalities of 112 cases of cesarean delivery scar pregnancies. TABULATION, INTEGRATION, AND RESULTS: Review of the 112 cases revealed a considerable increase in the incidence of this condition over the last decade, with a current range of 1:1,800 to 1:2,216 normal pregnancies. More than half (52%) of the reported cases had only one prior cesarean delivery. The mean gestational age was 7.5 +/- 2.5 weeks, and the most frequent symptom was painless vaginal bleeding...Expectant management of 6 patients resulted in uterine rupture that required hysterectomy in 3 patients. Dilation and curettage was associated with severe maternal morbidity. Wedge resection and repair of the implantation site via laparotomy or laparoscopy were successful in 11 of 12 patients. Simultaneous administration of systemic and intragestational methotrexate to 5 women, all with beta-hCG exceeding 10,000 milli-International Units/mL required no further treatment. CONCLUSION: Surgical treatment or combined systemic and intragestational methotrexate were both successful in the management of cesarean delivery scar pregnancy. Because subsequent pregnancies may be complicated by uterine rupture, the uterine scar should be evaluated before, as well as during, these pregnancies.

Management of Cesarean Scar Pregnancy

Ultrasound Obstet Gynecol. 2003 Mar;21(3):220-7. First-trimester diagnosis and management of pregnancies implanted into the lower uterine segment Cesarean section scar. Jurkovic D, Hillaby K, Woelfer B, Lawrence A, Salim R, Elson CJ. PMID: 12666214

...The management of Cesarean section scar pregnancies included transvaginal surgical evacuation, medical treatment with local injection of 25 mg methotrexate into the exocelomic cavity and expectant management. RESULTS: Eighteen Cesarean section scar pregnancies were diagnosed in a 4-year period. The prevalence in the local population was 1 : 1800 pregnancies. Surgical treatment was used in eight women and it was successful in all cases. The respective success rates of medical treatment and expectant management were 5/7 (71%) and 1/3 (33%). Five women (28%) required blood transfusion and one woman (6%) had a hysterectomy. CONCLUSIONS: Cesarean section scar pregnancies are more common than previously thought. When the diagnosis is made in the first trimester the prognosis is good and the risk of hysterectomy is relatively low.

Curr Opin Obstet Gynecol. 2011 Dec;23(6):415-21. doi: 10.1097/GCO.0b013e32834cef0c. Caesarean scar pregnancy: a review of management options. Litwicka K, Greco E. PMID: 22011956

...CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility. SUMMARY: No universal treatment guidelines for the management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendations establishment.

Clin Perinatol. 2008 Sep;35(3):519-29, x. doi: 10.1016/j.clp.2008.07.003. Placenta accreta and cesarean scar pregnancy: overlooked costs of the rising cesarean section rate. Rosen T. PMID: 18952019

An unintended consequence of the rising cesarean section rate is abnormal placentation in subsequent pregnancies, leading to the clinical complications of placenta accreta and cesarean scar pregnancies. Both of these clinical entities are associated with high rates of maternal morbidity and mortality. This article reviews the potential mechanisms by which uterine scarring may lead to abnormal trophoblast invasion, the association of cesarean section with placenta accreta and scar pregnancies, current management, and suggestions for future research to reduce the incidence of these potentially devastating complications of pregnancy.

Am J Perinatol. 2010 Feb;27(2):111-20. doi: 10.1055/s-0029-1224874. Epub 2009 Jun 5. Cesarean scar ectopic pregnancy: case series and review of the literature. Sadeghi H, Rutherford T, Rackow BW, Campbell KH, Duzyj CM, Guess MK, Kodaman PH, Norwitz ER. PMID: 19504427

...We present four cases of cesarean scar ectopic pregnancy diagnosed within a 6-month period between 2007 and 2008. Their initial presentations and management are discussed, followed by a review of the published literature summarizing both diagnostic and management recommendations.

BJOG. 2007 Mar;114(3):253-63. Caesarean scar pregnancy. Ash A, Smith A, Maxwell D. PMID: 17313383

...Transvaginal ultrasound and colour flow Doppler provides a high diagnostic accuracy with very few false positives. A delay in diagnosis and/or treatment can lead to uterine rupture, major haemorrhage, hysterectomy and serious maternal morbidity. Early diagnosis can offer treatment options of avoiding uterine rupture and haemorrhage, thus preserving the uterus and future fertility. Management plan should be individually tailored. Available data suggest that termination of pregnancy is the treatment of choice in the first trimester soon after the diagnosis. Expectant treatment has a poor prognosis because of risk of rupture. There are no reliable scientific data on the risk of recurrence of the condition in future pregnancy, role of the interval between the previous caesarean delivery and occurrence of caesarean scar pregnancy, and effect of caesarean wound closure technique on caesarean scar pregnancy. In this article, we aim to find the demography, pathophysiology, clinical presentation, most appropriate methods of diagnosis and management, with their implications in clinical practice for this condition.

J Reprod Med. 2011 Jul-Aug;56(7-8):356-8. Cesarean scar ectopic pregnancy: a case report of failed combination local and systemic methotrexate management requiring surgical intervention. Stevens EE, Ogburn P. PMID: 21838169

BACKGROUND: Cesarean scar ectopic pregnancies have been diagnosed with increasing frequency in the last decade. There is no consensus of management for these pregnancies; however, prior reports have suggested best results using either combination methotrexate therapy or surgical excision. CASE: We present a case of failed systemic and local methotrexate therapy requiring operative management. CONCLUSION: Cesarean scar ectopic pregnancies can have disastrous outcomes, including uterine rupture, massive hemorrhage and maternal death. Although this is the first case to report a failure of the combination therapy, major morbidities did not occur. We believe this is due to our choice of expedient surgical management.

J Obstet Gynaecol. 2012 Oct;32(7):621-3. doi: 10.3109/01443615.2012.698665. Caesarean scar pregnancy: a precursor of placenta percreta/accreta. Sinha P, Mishra M. PMID: 22943704

In the last decade, diagnosis of caesarean scar (CS) pregnancy and abnormal placental invasion has gone up significantly. It appears that the history of previous caesarean section is the predisposing factor common to both conditions. Until now, these are treated as a separate entity and therefore managed differently. Recent available evidence suggests that these are not a separate entity but rather a continuum of the same condition. If the caesarean scar pregnancy is managed expectantly in the 1st trimester, most likely it evolves into placenta accreta. This leads invariably to peripartum hysterectomy for postpartum haemorrhage (PPH) and severe maternal morbidity. Early diagnosis and intervention may give a favourable outcome.

Ultrasound Obstet Gynecol. 2004 Mar;23(3):247-53. Cesarean scar pregnancy: issues in management. Seow KM, Huang LW, Lin YH, Lin MY, Tsai YL, Hwang JL. PMID: 15027012

...METHODS: During a 6-year period, 12 cases of Cesarean scar pregnancy were diagnosed using transvaginal color Doppler sonography and treated conservatively to preserve fertility...RESULTS: The incidence of Cesarean scar pregnancy was 1:2216 and its rate was 6.1% in women with an ectopic pregnancy and at least one previous Cesarean section...Patients were treated as follows: transvaginal ultrasound-guided injection of methotrexate into the embryo or gestational sac (n = 3), transabdominal ultrasound-guided injection of methotrexate (n = 2), transabdominal ultrasound-guided injection of methotrexate followed by systemic methotrexate administration (n = 2), systemic methotrexate administration alone (n = 2), dilatation and curettage (n = 2), or local resection of the gestation mass (n = 1). Eleven of the 12 patients preserved their reproductive capacity; the remaining patient, treated by dilatation and curettage, underwent a hysterectomy because of profuse vaginal bleeding. The Cesarean scar mass regressed from 2 months to as long as 1 year after treatment. Uterine rupture occurred in one patient during the following pregnancy at 38 + 3 weeks' gestational age. CONCLUSION: Ultrasound-guided methotrexate injection emerges as the treatment of choice to terminate Cesarean scar pregnancy. Surgical or invasive techniques, including dilatation and curettage are not recommended for Cesarean scar pregnancy due to high morbidity and poor prognosis.

BJOG. 2011 Aug;118(9):1136-9. doi: 10.1111/j.1471-0528.2011.02891.x. Epub 2011 Apr 12. Transvaginal removal of ectopic pregnancy tissue and repair of uterine defect for caesarean scar pregnancy. He M, Chen MH, Xie HZ, Yao SZ, Zhu B, Feng LP, Wu YP. PMID: 21481146

From December 2009 to April 2010, six patients with caesarean scar pregnancies (CSPs) underwent the transvaginal removal of ectopic pregnancy tissue and repair of a uterine defect. Transvaginal surgery was performed uneventfully in all cases. The operating time ranged from 45 to 80 minutes. Blood loss ranged from 50 to 150 ml. Serum β-hCG (β-subunit of human chorionic gonadotrophin) levels declined to normal levels within a month for all patients, and all patients recovered without complications. Our results show that the transvaginal removal of ectopic pregnancy tissue and repair of the uterine defect is effective, safe, and minimally invasive for patients with CSP.

J Obstet Gynaecol Res. 2007 Dec;33(6):873-7. Three-dimensional ultrasonographic diagnosis and hysteroscopic management of a viable cesarean scar ectopic pregnancy. Ozkan S, Calişkan E, Ozeren S, Corakçi A, Cakiroğlu Y, Coşkun E. PMID: 18001457

...No therapeutic modality is suggested to be entirely efficacious and safe for preserving uterine integrity. We present here a 29-year-old woman with vaginal bleeding and a gestational sac with a viable embryo of 6 weeks of age that was implanted in a cesarean section scar. Serum beta-hCG levels were 16 792 mIU/mL. Following an unsuccessful treatment course of systemic methotrexate, the patient underwent operative hysteroscopy. Minimally invasive hysteroscopic resection of the ectopic gestational mass without major complication appears to be an alternative therapeutic approach with minimal morbidity and preservation of future fertility.

Am J Obstet Gynecol. 2012 Nov;207(5):386.e1-6. doi: 10.1016/j.ajog.2012.09.012. Epub 2012 Sep 17. Bilateral uterine artery chemoembolization with methotrexate for cesarean scar pregnancy. Shen L, Tan A, Zhu H, Guo C, Liu D, Huang W. PMID: 23107082

OBJECTIVE: The objective of the study was to assess the efficacy of uterine arteries embolization (UAE) for the treatment of cesarean scar pregnancies (CSP). STUDY DESIGN: Forty-six women with CSP were identified between March 2008 and March 2010. All of the patients underwent UAE combined with local methotrexate. RESULTS: Forty-five patients were successfully treated. One patient had an emergency hysterectomy after 20 days because of massive vaginal hemorrhage. The mean time until normalization of serum β-human chorionic gonadotrophin was 37.7 days, and the mean time until CSP mass disappearance was 33.3 days. The mean hospitalization time was 10.5 days. The complications were mainly fever and pain, which were alleviated with symptomatic treatment. All 45 patients had recovered their normal menstruation at follow-up. CONCLUSION: Bilateral uterine artery chemoembolization with methotrexate appears to be a safe and effective treatment for CSP and causes less morbidity than current approaches.

Am J Obstet Gynecol. 2012 Jul;207(1):14-29. doi: 10.1016/j.ajog.2012.03.007. Epub 2012 Mar 10. Unforeseen consequences of the increasing rate of cesarean deliveries: early placenta accreta and cesarean scar pregnancy. A review. Timor-Tritsch IE, Monteagudo A. PMID: 22516620

...We reviewed the literature concerning the occurrence of early placenta accreta and cesarean section scar pregnancy. The review resulted in several conclusions: (1) the diagnosis of placenta accreta and cesarean scar pregnancy is difficult; (2) transvaginal ultrasound seems to be the best diagnostic tool to establish the diagnosis; (3) an early and correct diagnosis may prevent some of their complications; (4) curettage and systemic methotrexate therapy and embolization as single treatments should be avoided if possible; and (5) in the case of cesarean scar pregnancy, local methotrexate- and hysteroscopic-directed procedures had the lowest complication rates.

J Reprod Med. 2012 Jan-Feb;57(1-2):61-4. Late-first-trimester cesarean section scar ectopic pregnancy with placenta increta: a case report. Overcash RT, Khackician ZH. PMID: 22324271

...CASE: A 21-year-old, gravida 3 para 2 woman was diagnosed at 13.5 weeks' gestation by pelvic ultrasound and magnetic resonance imaging with a cesarean scar ectopic pregnancy and placenta increta. Surgical removal of the pregnancy via exploratory laparatomy with intraoperative use of vasopressin minimized initial blood loss. However, extraction of the placenta increta resulted in uncontrolled bleeding, requiring a supracervical hysterectomy. CONCLUSION: This is the first case report, to our knowledge, of a late-first-trimester cesarean section scar ectopic pregnancy with placenta increta. Early identification of the ectopic pregnancy may allow for more conservative, nonsurgical management. However, with a more advanced gestational age and placenta increta, surgical management is most appropriate to minimize associated maternal risks. A transverse wedge resection of the implantation site, uterine artery embolization, uterine artery ligation, endovascular balloon catheters, or uterine artery tourniquet may help decrease bleeding during surgical extraction of the pregnancy and placenta increta, and also may prevent a hysterectomy.

Reproductive Outcomes After Cesarean Scar Pregnancy

Hum Reprod. 2007 Jul;22(7):2012-5. Epub 2007 Apr 20. Reproductive outcomes of women with a previous history of Caesarean scar ectopic pregnancies. Ben Nagi J, Helmy S, Ofili-Yebovi D, Yazbek J, Sawyer E, Jurkovic D. PMID: 17449510

...METHODS: The study included those women who received treatment for their Caesarean scar pregnancies between April 1999 and October 2005. Their ability to conceive, the time it took to become pregnant and outcomes of subsequent pregnancies were all recorded. RESULTS: 40 women with Caesarean scar pregnancies were managed in our unit. The uterus was conserved in 38/40 cases. Follow-up data were available in 29/38 (76%) of women. Twenty-four out of 29 (83%) attempted to become pregnant. Twenty-one out of 24 [88%, 95% confidence interval (CI): 75-100] women conceived spontaneously. Twenty out of 21 (95%, 95% CI: 86-100) pregnancies were intrauterine and one woman (5%, 95% CI: 0-14) had a recurrent scar ectopic. Thirteen out of 20 (65%, 95% CI: 44-86) intrauterine pregnancies appeared normal. Nine out of 13 (69%) were delivered by Caesarean section. Seven out of 20 (35%, 95% CI: 14-56) intrauterine pregnancies ended in spontaneous abortions. CONCLUSIONS: Our study shows that reproductive outcomes following treatment of caesarean scar ectopic pregnancies are favourable. The risk of complications including recurrent scar implantation appears to be low.

Obstet Gynecol. 2008 Feb;111(2 Pt 2):541-5. doi:10.1097/01.AOG.0000287295.39149.bd. Recurrent ectopic pregnancy in a cesarean scar. Holland MG, Bienstock JL. PMID: 18239016

BACKGROUND: Ectopic pregnancy in a cesarean scar is a rare but well-recognized potential complication of cesarean delivery. Multiple risk factors exist, including prior uterine surgery, a history of uterine infections such as endomyometritis, and a brief interval between uterine surgery and subsequent conception...CASE: This patient presented for a dating ultrasound examination at 4 6/7 weeks of gestation. Her history was significant for an ectopic pregnancy in her cesarean scar 3 years prior that was managed by surgical resection. The initial ultrasound examination was suspicious for a recurrent ectopic pregnancy in her cesarean scar. The diagnosis was confirmed on repeat ultrasonography at 6 weeks of gestation. She was treated with methotrexate, and the pregnancy resolved without complication. CONCLUSION: Ectopic pregnancy in a cesarean scar is an important diagnosis to consider in a woman who has had a history of cesarean delivery and whose early ultrasonography shows a thin, lower uterine segment or a low implantation site. If the diagnosis is not clear on initial ultrasound examination, the patient should be followed up with serial ultrasound examinations. Once recognized, patients with this complication may be treated either surgically or medically as indicated by the clinical situation.

In The News

2013-06-18T20:02:24Z

The AMA has endorsed the idea that “obesity” is a disease, not a “condition”. (Personally I consider it a characteristic.) Forbes states that this is “a move member physicians hope will spur better reimbursement for treating overweight Americans and create better health outcomes.” Exactly how it’s supposed to “create better health outcomes” when commonly prescribed treatments do not work long-term or create good health outcomes is not addressed.

In good things, Shakesville’s Fatsronauts 101 series continues to hit it out of the park.

The NY Times does a piece on Melissa McCarthy that doesn’t focus on her weight. That’s allowed?

The NY Times also reminds people go get some sleep.

Filed under: Anti-Obesity Programs, fat acceptance, FatnessInGeneral, News, Sleep

Don’t Know What To Wear? Check Out Pose Daily Fashion Forecast!

2013-06-18T16:44:20Z

Be Social!

Hi Friends!

Yes I know I have been MIA for the last two weeks. It’s summer and the Idaho mountains were calling name, so I had to take a little vacation time and work on my soul. But now I’m back and ready to rock n roll! Apparently i’m in to rhyming today…

Even girls with a passion for fashion, and closet as full as mine, can still be plagued by the same problem as millions of other women, and that problem is deciding what to wear. We have all been there, standing in our underwear, hair and makeup ready pulling item after to item out of our closet and trying them on only to moments later take them off in frustration and start the whole process over again. Whether the problem is an essential piece we can’t seem to find, a hamper full your favorite clothes that hasn’t made it the washing machine yet, or even the ever changing weather, getting dressed is a difficult task that can set the tone for your whole day. I know for me if I am running late after a million wardrobe changes, unhappy with my final look, or inappropriately dressed for the season, temperature or trends, I can easily turn my typically positive outlook into a grouchy, sloppy mess of overall yuck, and that is sooooo not pleasant for anyone.

While I may not have a solution to all wardrobe problems I have found a resource that serves as a tool to help make outfit choices based on your local weather, popular trends and lifestyle. One of my favorite websites and apps for fashion, Pose, has created a new feature Fashion Forecast! With the Fashion Forecast daily email Pose is curing closet paralysis like never before by generating a daily outfit recommendation, tailored to fit the weather conditions in your area, just for you. I signed up for my personal Fashion Forecast a couple weeks back and have been taking it for a spin, and I am honestly pretty pleased with this feature. In the morning I simply check my email on my phone and at my finger tips I have the weather report for the day, photos of some great looks from other Pose members (INCLUDING PLUS SIZED MEMBERS) and some tips for creating the perfect looks for casual and dressed up options. Pretty groovy huh?

The Pose Fashion Forecast Feature, and Pose in general is completely free to use and is a great resource for exploring fashion and style whether you are searching for the perfect outfit idea, or even to share your looks with others. What have you got to lose? CLICK HERE to sign up for your own Daily Fashion Forecast and make your mornings a bit easier! Oh and while you are at it make sure to follow me on Pose so we can connect!

xoxo

Stiletto

Be Social!

My first column for DIVA magazine is out!

2013-06-18T16:46:00Z

My first Seeing Queerly column for DIVA magazine is out! You can get it in all the usual magazine stockists, and directly via the DIVA website.

This month I'm talking about the weird world of the obesity expert, and how it differs from my queer world o' fat.

By the way, I'm an experienced and versatile freelance journalist and available for commissions.

Proudface, hehe.

You don’t owe life pretty

2013-06-18T16:19:29Z

On the Body Acceptance subreddit, we often get posts proclaiming that the poster is simply ugly. Sometimes they even post photos as proof and, to be honest, it’s almost always people who are conventionally attractive. And they get plenty of replies telling them so. I never reply with “oh you’re beautiful” or “there’s no such thing as ugly.” While these are popular replies and I know they have every good intention in the world, I’m not so sure they’re helpful. Because, here’s the thing. Life may often be treated like a beauty contest, but that’s the wrong way to look at life. You don’t owe beauty to anyone — not anyone.

This definitely applies to fat people, as we are very often seen as conventionally unattractive because of our fat. But we don’t owe anyone thinness — not a single person. Not our doctors, not our friends, not our family, not our loved ones, not even ourselves. What we do owe ourselves is self-acceptance and love and a path to taking care of our bodies if we so choose to do so.

Now, I hope as much as anyone else that one day our standards of beauty disappear completely. That every single person is seen as a unique and beautiful person because variety is so fucking awesome it’s unbelievable. I hope that fat people can be seen as beautiful, I hope that conventionally unattractive people can be seen as beautiful and I hope that everyone can appreciate the beauty that is difference. Mostly I think this will happen when we start learning to look at people, especially women, without objectifying or sexualizing them.

Let’s face it, conventionally unattractive men are seen everywhere on the arm of conventionally attractive women (several TV shows, movies, and cartoons come to mind). Whether or not we see these guys as gorgeous, we do see them as complex human beings with their own bodily autonomy and the ability to succeed, find happiness and love, have friends, have sex, etc., regardless of how they look. Women? Less so. Almost everything about women is contingent on their appearance.

I believe that the objectification and over-sexualization of women plays a large part in life’s little beauty contest. After all, thin women get paid more than fat women (the same does not hold true for men). And hey, what about the multi-billion dollar beauty industry intent on selling us creams and makeup and weight loss products and eye lash lengtheners and hair removal products and all of the things that tell us we’re not smooth enough, we’re not thin enough, we’re not young enough, we’re not pretty enough, we’re not good enough.

My point is that until we do see an end to beauty standards completely and view people as individual, whole people, you don’t owe life pretty. You don’t owe anyone or anything beauty. Feel free to be ugly! Let that ugly flag fly because ugly people still find love, happiness, have friends, families and children, successful careers, etc. Ugly makes life harder, it’s true (although, again, I haven’t yet seen one of these people post who was conventionally ugly), but not because there’s anything wrong with being ugly. It’s because people are assholes.

It’s the same thing I argue for fat people. Yes, being fat is hard and almost every fat person wants to be thin, but not because being fat is so horrible. It’s because being fat in a world that idealizes thin is horrible, because people are horrible, because our culture of fat hate and discrimination and oppression is horrible. But fat? Ugly? No, it’s not bad. By itself, our looks don’t make life hard or hopeless. As soon as I learned that there was nothing wrong with me as a fat person and, hey, maybe not even that attractive according to a lot of people, my life got easier (I also stopped judging other people). Remember, it’s not you, it’s them. It’s our culture. It’s misogyny, looksism, fatphobia, ageism, ableism, racism and a dozen other things, but it’s not you.

Life is not a beauty contest. And you don’t owe life pretty.

Filed under: DW, Terrible Tuesday

An exercise

2013-06-18T14:33:44Z

Just as a change of pace, try the following. Take an article about the “obesity epidemic,” and substitute the word “sexiness” for “obesity.” Does that improve the article? Make it fun? Make it silly?

I tried it myself, and it really helped, up until the phrase “sexiness-related diabetes.” :(

First, Feed Thyself!

2013-06-18T12:00:29Z

(Trigger Warning: Food issues)

When I am not feeling like myself, as was the case yesterday (and really the day before as well), I have found that I also don’t treat myself as kindly as I should or would like to. I tend to let a lot of things slide. Specifically, eating food. Mind you, I’ll almost always manage to get some coffee/caffeine in me, but only to stave off the inevitable headache. Yes, I did not eat until 7:30 pm yesterday and of this I am ashamed. I know better. I had food in the house. I just wasn’t feeling well, and obviously not thinking straight either.

I recall the long ago days when I was 19 and 20 years old living on little more than Taco Bell, Lean Cuisine and Jose Cuervo. Blegh! I could never do that to myself again. I know I was so depressed and truly suffering through the worst of my PTSD at the time (though I hadn’t a clue then) but I also didn’t really know how to eat or care for myself, either. How could I? I know at one point my grandma was worried about me and would pack me lunches for work, even though I lived and worked twenty miles away. Gawd how I miss her. Not because of the lunches, mind you, but her caring and loving and sense of humor and hugs most of all.

It is when I am not taking care of myself that I am truly letting myself, and those I care about, down. My grandma would scold me for not eating all day like I did yesterday. I can picture the face she’d give me and then I know she’d dash into the kitchen and rustle up some combination of simple, filling and awesome. When my family had so little, we always had Sunday dinner at grandma’s house. I looked forward to it all week! My favorite was the simple little green salad she’d serve before the main course. I didn’t even know what courses were back then, but I knew salad was so special and rare and my favorite!

I suppose growing up in a food insecure household meant that continuing food issues would be inevitable. I hadn’t realized just how much of our childhoods affected us as adults, on this topic specifically, until two weeks ago when I literally had nothing to eat in the house and relied on B for dinner one evening and felt like utter shit for it. He made no bones about it, of course, but how I felt was so triggering and awful that the next morning I went to the grocery store and spent $100 on groceries just to be able to breathe again. *Sigh*

I think I have used not eating as a way of feeling as though I am in control of something in my life when so much is truly out of my control. Like this one thing? I got this! Ugh! This is not who I am or want to be. I have worked very hard to break these patterns and behaviors. So why does it pop back up so suddenly now? Really things are going great for the most part. I just need a job! That’s it! So simple, three letters, all the difference in the fucking universe! I would have at least some relief if I knew whether I’d be getting unemployment money coming or not. I should be getting the word any day now, but it’s killing me! I just need to know so I can find another means of paying my rent in time if need be. I don’t know how I’ll do that, but I’m sure I’ll hustle something up somehow.

I also felt like a big phony faker on Sunday night and I hated myself for it. I went to my BFF’s birthday dinner and felt lousy and truly didn’t want to be there. My boyfriend (OMZ! I cannot believe I have a boyfriend! Ha-ha!) was supposed to go with me, but had work stuff to tend to. It was nice to drive up with “Q” but I think even she could tell I wasn’t the usual me. I did my best not to show how yucky I was feeling, but inside I just wanted to run the fuck away and hide under the covers. But I missed Steph so much and so rarely get to see her and if I’d bailed this time I knew she’d hunt me down and kill me! Ha-ha! It wasn’t that I had a horrible time or anything, but I did have to sort of grin and bare it through the evening. I felt like an alien, to be honest. I felt like I was surrounded by all of these smart and put together people with cool jobs and awesome lives and adult problems and here I am barely able to hold it together. Ugh!

Today is a new day and I shall treat it as such. I know how to care for myself, certainly better than the last few days. I will be more mindful of how I am feeling and listen carefully to what my body needs. I distinctly recall three times yesterday where I heard my stomach growling and rather than paying attention and providing food/fuel for my body and brain I actually thought to myself, “Ugh! Why are you growling? Shut up!” Whoa! NOT ME! I guess I just needed some comforting and didn’t know how or who to ask for it. I mean, I don’t think anyone else even knew or could know at the time that I needed such a thing, maybe I didn’t even know. I know now. But I also know that I wasn’t doing much to comfort myself.

Self care takes many forms. First and foremost should be the basics like food and water. I have not struggled with that part in so long I guess I actually forgot for a bit there just how that felt and can spiral into worse. I am glad that I was able to recognize it before it got out of hand. I know that I used to starve myself rather than ask to borrow a dollar from a single soul back in those Lean Cuisine and Tequila days. Older and wiser, eh? Ha-ha! Okay, I can do this. I will do this…there is no try, only do!

the HAES® files: Finding the Compassion in our Peace Movement

2013-06-18T10:00:12Z

by Jenny Copeland, PsyD

As a size acceptance advocate – and mental health professional – defensiveness is no stranger to me. Human beings naturally resist that which is unknown or uncomfortable to them. For many of my HAES® colleagues, I am certain we can comfortably say we are met with strong resistance when introducing our principles to other professionals and when encouraging patients to step away from the scale. But it is not the resounding “NO!” I am concerned with today. It is the defensiveness.

The dictionary defines defensiveness as being “excessively concerned with guarding against the real or imagined threat of criticism, injury to one’s ego, or exposure of one’s shortcomings.” Sigmund Freud would describe it as an unconscious manner of protecting the ego – the conscious self. While resistance might imply keeping something at arm’s length, defensiveness implies a certain amount of fighting back. As a community, we as size acceptance advocates often note the extensive and elaborate ways in which the ‘opposition’ defends their viewpoint. As a community we are not immune to this. We become defensive toward others in our own community with different perceptions, different actions, different motivations. We defend the legitimacy of our suffering against others who have differently suffered. And in the action of defending our position, we breed conflict and divide our ranks.

Freud would call this “splitting,” a dichotomous style of thinking wherein we see things as black or white, all good or all bad. This ultimately produces an “us and them” mentality which generally weakens the size acceptance movement. What emerges are divisions of the privileged and the exploited, those learned and ignorant of the movement, those with an eating disorder and those without, and even the thin and the fat. As a community, we could argue whether one group’s experiences of weight or size stigma are more or less significant, or even more or less legitimate. What would be the point?

The Health At Every Size® approach has sometimes been called a peace movement, one of acceptance and reconciliation for the past wrongs we have inflicted on our bodies. At these times when we are split from within and have pushed each other away, I wonder where our peace is. Sometimes we fight so hard to have our voices heard that we silence others’ – sometimes even the voices of our fellow travelers in this journey.

Karen Armstrong, a pioneer in religious studies, put it this way: “Look into your own heart; discover what it is that gives you pain. And then refuse, under any circumstance whatsoever, to inflict that pain on anybody else.” How wonderfully simple. Recognize and acknowledge that which has hurt us, then refuse to pass that same hurt onto anyone else. Stop the bullying in its tracks. Armstrong founded The Compassion Charter with this in mind. Although its roots are in religious and moral diversity, I think the sentiment applies to size acceptance as well:

The principle of compassion lies at the heart of all religious, ethical and spiritual traditions, calling us always to treat all others as we wish to be treated ourselves. Compassion impels us to work tirelessly to alleviate the suffering of our fellow creatures, to dethrone ourselves from the centre of our world and put another there, and to honour the inviolable sanctity of every single human being, treating everybody, without exception, with absolute justice, equity and respect.

It is also necessary in both public and private life to refrain consistently and empathically from inflicting pain. To act or speak violently out of spite, chauvinism, or self-interest, to impoverish, exploit or deny basic rights to anybody, and to incite hatred by denigrating others—even our enemies—is a denial of our common humanity. We acknowledge that we have failed to live compassionately and that some have even increased the sum of human misery in the name of religion.

In its simplest form, The Compassion Charter is a resurgence of the Golden Rule: Do unto others as you would have done unto you. It is a value taught to many in their childhood, hopefully working to build regard and empathy for others. The question is, how does this apply to the size acceptance movement? There are different schools of thought for advocacy, whether we should take a ‘straight and narrow’ approach where we hold strongly to our ideals and refuse to compromise them in any shape or form. Others find value in the grey areas, working to reach those outside the community and gradually bring them into the fold. This is a debate for another time.

My question, then, is how do we best foster compassion for one another? How do we nurture our community and build relationships while still challenging each other to grow? I don’t think we accomplish this by saying some have suffered more or less at the hands of size hatred. I don’t think we accomplish this by saying the Health At Every Size approach is valid for some sizes but not for others. I think we can accomplish this by less defensiveness with one another. This would imply listening more often than we talk and finding space for every person in our movement – no matter what size, shape, gender, sexual orientation, race or ethnicity, socioeconomic status, level of privilege, age, ability level, knowledge level, and many other characteristics people may have. I think this happens through embracing the diversity within our ranks, recognizing each person’s unique experience as just that – unlike what we have personally encountered, but of equal value and legitimacy.

What do you think?

Tagged: community, compassion, compassion charter, defensiveness, diversity, golden rule, HAES, health, Health At Every Size, karen armstrong, peace movement, size acceptance, size hatred

We’re Gonna Need More Wars

2013-06-18T08:38:16Z

There is an argument that suggests that it’s ok to body police, bully, shame, stigmatize and have a war against obese people because being fat is an indication that someone doesn’t prioritize their health and that costs taxpayer dollars, and so prioritizing health is a social obligation and the punishment for not holding up our end of the bargain is that the government has declared war on us.

For today let’s set aside the fact that body size is not an indication of behaviors, health, or prioritization of health. Even if it were true that fat people don’t prioritize our health, the argument is still bullshit – a convenient lie used to justify indefensible bigotry. The way I know that is that if people truly believed the argument, there would be a lot more wars:

The War on Football Players: Football players, especially at the professional level, are absolutely not prioritizing their health. When their careers end their bodies are often in horrible shape – multiple concussions, blown knees, some players admit to having had over 50 surgeries after leaving the NFL. They retire at an average age of 28 years old with no salary, studies show that 78% go bankrupt within 5 years of retirement, but they don’t get insurance until they turn 50 and then only if they are vested and qualified. This sounds expensive, let’s get that war going.

The War on Insomniacs: Lack of sleep has been shown to be detrimental to people’s health. Studies suggest that most people are shown to need 7-8 hours of sleep a night. Sounds like we’re gonna need to gear up for a war on people who choose to sleep less than what is shown to be healthy.

The War on Rock Stars: The rock star life that we celebrate as a culture includes drugs, alcohol, and a schedule of, rehearsals, shows, and appearances that runs performers ragged. These people are clearly not prioritizing their health. Where’s the war?

The War on Unhealthy Thin People: This whole idea rests on stereotypes about fat people – that you can tell by a fat body that someone doesn’t eat well and doesn’t exercise enough. Of course that’s no more true then the idea that every thin person eats well and exercises. Everyone knows a thin person who eats a ton of “junk food” never exercises and remains thin. If we’re going to do this we’re going to need to have a war on those people too.

The potential list goes on – UFC fighters brag about not prioritizing their health, professional bullriders, X Games athletes, people who choose to work third shift, people who choose jobs with repetitive motion, people who climb mountains, Iron Man triathletes, people who don’t look both ways before they cross the street, people who buy cars that don’t have the highest safety ratings etc.

The truth is that there are many ways to prioritize and de-prioritize our health and none of them can be be judged by body size. People of all sizes prioritize their health at different levels for different reasons. Fat people simply make good scapegoats because we share a single physical characteristic that is easily picked out in a crowd. The prejudice is kept in place by “everybody knows” thinking, the frantic shouting down of good research, embarrassingly poor research done from a platform of confirmation bias or for profit, and lies about healthcare costs.

In what should be a blinding flash of the obvious (with a nod to my friend Stan), the solution is not to have more wars on more people. The solution is to end the wars.

I don’t believe that health is a moral, social, or personal obligation (you can choose to prioritize things other than your health just like professional bull riders, X Games participants, stressed-out sleepless executives, those who have elective plastic surgery, sky divers, and people who don’t look both ways before they cross the street). Also, let’s not kid ourselves – our health isn’t completely within our control. Health is multi-dimensional and includes genetics, access, stress, environment, and behaviors among other things.

It’s time to recognize that public health is not about making the individual’s health the public’s business. It’s about removing stress whenever possible (like, say, the stress of having the government fight a war against you or hearing politicians promise that in a generation they will have eradicated all the people who look like you) and providing information, access, and options to people of all sizes.

Those who disagree with that better be prepared to police EVERYBODY and fight a war on people who don’t prioritize their health on every imaginable front because it’s unacceptable to simply pick a group of people who can be identified by sight and start “calculating their cost” to support the idea of having a war to eradicate us.

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The Tankini

2013-06-18T00:23:57Z

So it’s getting on summer (Although it doesn’t feel that way in NYC), and blog posts will be shorter and there will be no blog posts on the following dates: 7/29, 8/5, 8/12, 8/26^th. Normally I might take a summer break but fat hatred doesn’t. If I don’t post those days it’s not because I had a combo heart attack, diabetes, MS, plane crash, global warming catastrophe, I’m going to be on vacation, enjoying good food and fun exercise.

Last Sunday was the Big Fat Flea (Formerly the Fat Girl’s Flea). My favorite fat positive annual event. (Love it to be a bi-annual event, hint, hint). This year I paid $25 to get in a half hour early. And for $53 I walked out with: 2 pairs of pants, an awesome torrid dress, a hippie shirt, beads for my niece, sunglasses, a bathing suit, a swimming shirt, and tankini top. (I now have more tops than bottoms.)

Recently I joined an outdoor pool and despite the weather have been swimming 2-4 times a week. Unlike the once a week I was doing at the pool from hell. This meant a bathing suit upgrade from the 3 regular and one emergency bathing suit (the emergency suit was fraying.)

So off I went to Marshalls which has been going downhill for a while. I don’t blame Marshalls for the fact that two piece bikinis vanish after size 12, or that thin women’s bathing suits look like string and fat women’s a full-on evening gowns but I do blame them for their lack of inventory. Once we get pass the fat ceiling of size 16, selection and quantity becomes horrendous. I understand that not all fat women want to wear tankini, bikini and some even like the skirts but we are 2/3 of the majority, why do we have to get crap. All they had in my size was a few one piece dresses. I found one bathing suit, saw the long line and figured I might do better at Sears next door.

I did. Even though I call Sears the store of the most returns. If Sears didn’t have a better selection of bathing suits, I would tell them to stick to appliances.

Sears had tankinis, one pieces and skirts. But the tankini bottom and tops were sold separately and even with a half-off sale the pieces were $25 double than what the were in Marshalls. I ended up buying $125 worth of bathing suits. I'm not against spending more to get good quality, but I had a feeling that in one or two years I would be replacing them.

I thought about waiting for the flea to get my bathing suit but the one thing the flea doesn't have is quality control. It is all based on donations.

Doesn't mean I'm disappointed. I never am. I always find a great piece (This year being the Torrid dress) At the flea I got a bathing suit, a top and a swim shirt for $15. Two of them were from a sample sale and never worn. I also feel like I'm a person at the flea because I know that the organizers are looking out for us. They want shoppers to go away with that one or more great article of clothing.

Friends & Fun

2013-06-18T00:18:44Z

I had a whirlwind of a weekend. I had two lovely friends celebrating birthdays and wanted to do all I could to make sure they had a great one. I had no idea what was in store for me, but apparently I was game for anything. Ha-ha! I had a job interview and a quickie photo shoot on Friday. Both went splendidly, then I headed up to visit the lovely Laura in Northern California. She always treats me like royalty and I wanted her to feel as special as she always makes me feel.

We ate, we drank and we watched Casablanca. Okay, I watched Casablanca. Poor Laura was pooped and fell asleep a third of the way in. Ha-ha! We slept in and ate a wonderful breakfast from Black Bear Cafe and tried to make our big plans for Saturday night. Again, I had no idea what we would be doing, but I was ready for a good time! We talked about what she wanted to do but ultimately, we ended up going to a BBW club I said I would never return to (or support) again. What can I say, she’s a fantastic friend, it was her birthday and she literally begged me to go (and paid for me to as well). I couldn’t say no. (And for the record I loathe begging, but it was a special and sweet case.)

When the hotel turned out to be booked up for someone’s big 40th anniversary party I offered for these two lovely ladies to stay at my house if we got a cab to and from the club. I won’t lie, I was not looking forward to going, but I was happy to be in such good company and the cocktails sure helped! Ha! We primped and prepped at my place and laughed and drank and finally made it to the club around midnight (fashionably late?). I’d only just met Ashley that morning, but she and I soon became fast friends. As Laura was chatting and being the social butterfly that she is Ashley and I grabbed drinks and hit the dance floor. Well, the music sucked (as always, for real! Transitions aren’t that hard, yo! And let’s keep playing the same songs for life…NOT!) but there was a couple of gems and I got in one request in the end (though I asked the DJ myself I ended up having to get someone else to ask him again before it got played).

We got our dance on, our drinks on and Laura got some piercings on! Woooo! I won’t say what or where, but it was a piercing party and the birthday girl got treated to some bling. We closed the place down and shuffled our drunk asses outside. I was wearing this Eshakti dress in Red with a black petticoat from ChicStar.com underneath. I looked and felt like a doll! I love that dress and it was only the second time I’d worn it. While we were outside waiting for our taxi I suddenly felt the urge to lean and quickly found a little post to lean on. Then it was apparent that I wasn’t moving anytime soon, worse than that, it was all about to go downhill from there.

These two girls, my lovely friends, were so kind and sweet and caring and loving. I cannot sing their praises enough! They tried to get me to walk or drink water but I knew it was too late, I very quickly and pointedly threw up in the bushes. Luckily the sprinklers turned on literally the moment I puked the first time. It was kind of perfect! In the cab Ashley kept me steady and sane and breathing and lectured the driver on what “easy” means. Ha-ha! Had to pull over twice, sadly, but we made it back to mine in one piece, unscathed.

I do not know how I got so drunk, I didn’t think I’d had very much, but we were celebrating and I haven’t had much more than wine in quite awhile. And I broke my own 1/1 water/alcohol rule. Boo! I managed to not ruin or mess my dress and apparently was quite lady like throughout the entire thing. Sadly, I did throw up for hours, but I also woke up not feeling like death warmed over and for that I am eternally grateful to Laura & Ashley. Those troopers really took care of me. We all had a great time and that was what it was all about.

Sunday afternoon I got to spend some time with my favorite guy and see his apartment for the first time. Oh that boy! He turns my brains to goo, I tell ya! In my hilariously drunken state the night before, I’d come up with the perfect “move” for every scenario, if you know what I mean, but when I was in the moment, I was too tired and too chickenshit to do anything. Ha-ha! Just as well, probably. It was so lovely just to see him and hang out and stuff.

Then I had to dash off to my BFF Stephy’s b-day dinner with my other BFF “Q”. It was nice, but my stomach was not feeling good so I took it slow and made the most of it. It was super great to see Steph and her guy and just chat and chill. Haven’t done that in ages. Some quality time with her kitty Rocky was a delightful surprise, too. We all love that little guy, but he’s been very sick for quite awhile and we’re all worried about him. Got home around midnight and pretty much just crashed.

Today has been mellow…on purpose. I just need to like not do things today, ya know? I did take care of a DMV thing and applied to jobs and stuff, so I’m not completely irresponsible. But I’m still super tired and just need to take it easy and reset, so to speak. In the end it was a great time pretty much all weekend (except for those few hours of vomiting, Ha!) and I got to see so many people that I love dearly. All worth it, I’d say. Happy to be alive and well and live another day, that is for sure.

<3
S

Adipositivity 610: ANNIVERSARY MESSAGE from Substantia Jones

2013-06-17T00:00:00Z

AN ANNIVERSARY MESSAGE FROM SUBSTANTIA JONES What a week last week was. The Huffington Post, Bust Magazine, The Daily Mail, several other outlets, and a couplefew interviews for pending articles. All this attention not only blew sunshine up my skirt, but also resulted in gobloads of mail, much of it from folks for whom the concept of resistance against body shame is new. I find that exciting and energizing. Outreach overdrive! Also last week: The Adipositivity site was hacked and two years worth of photographs were removed from view. I was threatened with a team of lawyers, suspended from tumblr, and informed by my web host (honestly lovely people) that I need to rebuild the site elsewhere by June of next year. I was called a “fat piece of shit” on Facebook by a dude in a non-ironic trucker hat with a cover photo filled with rows and rows of beer cans. (I think he's single, Ladies!) God only knows what they’re calling me in the comments sections of the above media pieces. Aaaand my rickety old computer began taking its last few gasps. Yes, the computer where all the naked fat ladies live. With the positive attention comes the negative. I'm cool with that. But I think I had a headache for seven days straight. While going through each of the 600ish Adipositivity images to remove hacker code, I was reminded of the way things were when I started the project in ’07. Laurie Toby Edison's “Women En Large” was on many a fatty bookshelf, but Leonard Nimoy’s book didn’t yet exist. Nuded-up fatfolk on the internet? Rare. For the purposes of uplift and empowerment? Rarer still. The Fatosphere was new enough for me never to have heard of it. My idea of fat activism began and ended with Marilyn Wann and NAAFA. That was it. Look at it today. Not only can I not keep up with all that's written and produced, there are activism efforts of which I’m not even aware. This is delicious stuff. This is progress. Many more battles to wage, but I’m committed to hanging in there with the rest of you as long as I can. Hey, I tattooed my ass, didn’t I? (Answer: No.) Thanks, as always, for your interest in the project. And thank you, Adiposers, for six years of dropping trou for my camera. I’d better stop here, before I start using words like ‘journey.’ If you’d care to give to the Adipositivity Computer & Aspirin Fund, you may do so by dusting off the old 'donate' button down on the left. Your contribution will be smiled at, then put to adipositive use. In that order. ~Substantia Jones Adipose: Of or relating to fat. Positivity: Characterized by or displaying acceptance or affirmation. MISSION: The Adipositivity Project aims to promote size acceptance, not by listing the merits of big people, or detailing examples of excellence (these things are easily seen all around us), but rather, through a visual display of fat physicality. The sort that's normally unseen. The hope is to widen definitions of physical beauty. Literally. The photographs here are sometimes close details of the fat female form, often without the inclusion of faces. One reason for this is to coax observers into imagining they're looking at the fat women in their own lives, ideally then accepting them as having aesthetic appeal which, for better or worse, often translates into more complete forms of acceptance. The women you see in these images are educators, executives, mothers, musicians, professionals, performers, artists, activists, clerks, and writers. They are perhaps even the women you've clucked at on the subway, rolled your eyes at in the market, or joked about with your friends. This is what they look like with their clothes off. Some are showing you their bodies proudly. Others timidly. And some quite reluctantly. But they all share a determination in altering commonly accepted notions of a narrow and specific beauty ideal. Bookmark adipositivity.com and check back often, as new photographs are added regularly(ish). And please help spread the message. The Adipositivity Project: Changing attitudes about the aesthetic validity of big women, one fat fanny at a time. ABOUT THE PHOTOGRAPHER: Substantia Jones’ photography has been exhibited in galleries and museums throughout the US East Coast, and has appeared in The New York Times, Time Out New York, and some other publications she can’t recall at this time, but you probably haven’t heard of them anyway. She is biographied in the 2006 Who’s Who in America (though under the name her momma gave her), and back in the day, she won some photography awards which would sound somewhat Mayberry if listed here, but at the time, they damn near made her cry. Still kinda do. She lives in Manhattan, where she also sometimes steps out (more like lays around) in front of the camera, and on some of those occasions, the snapping is done by her trusty sidekick, Dr. H, who also fetches her banana popsicles and maintains her muse, a certain pancake colored dog who’s asked that his name not be mentioned on the Internet. Ms. Jones likes crispy calamari, Squidbillies, and the ika okonomiyaki from Otafuku in the East Village, if only the lines weren’t so long. Thou shalt not reproduce without permission. Except for babies. Make all o' them you want. © The Adipositivity Project 2007-2013

Hate Your Body? Take More Pics!

2013-06-17T15:05:21Z

My friends may have regretted letting me play their “reindeer games.”

I used to really avoid being in photos.

Until relatively recently, that was pretty easy to do. Before every cell phone had a built in camera, before selfies and instagram (follow me!), you could really get away with avoiding photos. Only photography nerds (like me) used to carry around cameras, and it was mostly for capturing the raw beauty of a dead pigeon on Avenue A.

Sometimes the fact that everything gets photographed or video-ed really bugs me. (I can’t be the only one who’s been at a concert and wanted to say to the tall dude in front of me, “Hey, how about putting your camera down and just watching the show right now?”)

And yet, I also see it as an interesting opportunity to reclaim your self image. If you sort of go with it, you can actually use things like selfies as a tool to improve your body image.

How To Improve Your Body Image With Photos

Action Step #1: Take Some Really Bad Photos Of Yourself On Purpose — Whip out your phone or camera, and take a ton of pics of yourself. I’m talking in the hundreds. Take them from weird angles. Make funny faces. You can do this with a friend too. You may even want to do this a couple of times over the course of a week or a month. Do not skip this step!

What This Does: When you take “bad” photos of yourself, you get used to your own image. You start to realize that “good” or “bad” pics are all about angles, lighting, expression and not really about you. (Remember, even when models are shot for print ads, hundreds of images are taken, then one is chosen and airbrushed to death.) When you do this process, you get less upset when someone else takes a less than flattering photo of you. You’ll be less triggered when you catch yourself reflected in a storefront. You may even have fun with your image for the first time.

Action Step #2: Take Some Selfies And Post Them — Now, try to take some “good” photos. Think about your “bad” photo experiment and avoid taking pictures from those weird angles. Give yourself time to play around with lighting, angles, makeup, etc. And then, post those pics! If you don’t want them to be public, use privacy settings so that only certain friends can see them. You’ll probably get a lot more positive comments than you expect.

What This Does: This does two things. First, it allows you to control your public image. You get to put out the world images of yourself that make you feel good. Second, you get positive feedback from friends who will cheer you on and, at the very least, “like” your image.

Click To Tweet This:
“Photos are about memories and experiences, not just how you look or what you weigh.”

Action Step #3: Join A Body-Positive, Photo-Sharing Community — There are so many great tumblrs of regular folks showing off fatshion, generally being body positive, outfits of the day (ootd’s), and just pics of themselves being fat and exciting. (And don’t forget about Fatshionable Apples!)

What This Does: Looking at tumblrs like this normalizes bodies that you don’t normally see in everyday media. It’s a wonderful counterbalance to the very thin images you see every day. And you get a wonderful sense of community by looking at and responding to posters’ images. You may find it empowering to submit your own images too.

Don’t Forget This Mindset Shift
Photos are about memories and experiences, not just how you look or what you weigh. When you look at your photos, don’t just scrutinize your face and body. Think about what you were doing, who you were with, what was going on in the moment.

When you’re more willing to join in pictures, not only do you get an opportunity to preserve a memory, but your friends and loved ones get that too. They want you in their pictures. You’re part of that memory. Let yourself jump in and say a big, cheesy, “Cheese!”

FYI: The Summer Of Body Love Starts TODAY! This is your last chance to get in on it from the beginning. Go here to check it out
→ http://everydayfeminism.com/summer-of-body-love/

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Golda is a certified holistic health counselor and founder of Body Love Wellness, a program designed for plus-sized women who are fed up with dieting and want support to stop obsessing about food and weight. To learn more about Golda and her work, click here.

(Listen to this post here, or subscribe on itunes.)

Hate Your Body? Take *More* Pics! originally appeared on Body Love Wellness (http://www.bodylovewellness.com) on June 17, 2013.

Fat, zazzly, and accomplished #truth

2013-06-17T14:52:20Z

A couple of weeks ago, a University of New Mexico professor named Geoffrey Miller tweeted a highly-offensive message about fat people who had the gall to think they would be dedicated enough to complete a PhD, implying that they shouldn’t even waste everyone’s time by bothering to apply in the first place. The tweet went viral — although I wonder whether the initial transmission was due to people who thought it was funny and passed it on. But eventually, people who used their brains to get their PhDs rather than to warm their assholes caught on, and there was a huge backlash.

One of the responses to the affair came from Cat Pausé, a fat activist and Fat Studies scholar in New Zealand. She had the idea of compiling an “open letter” of fat folks who were studying for, or had completed, a graduate degree. The project was called “Fuck yeah! Fat PhDs.” I was awarded my Master’s earlier this year, and am currently enrolled in a doctoral programme, so I definitely wanted to be a part of it. I just needed a photo.

Let me tell you a little story. A year or so ago I attended a workshop on body image. It was filled mostly by psychologists, therapists, and counselors with an interest in eating disorders. A few had come with colleagues, but most of us didn’t know each other. We were asked to get a piece of paper and write down our three favourite parts of our bodies, our three least favourite parts, the three parts we were most ashamed of and, finally, who in the room we would show that piece of paper to and why. I didn’t find the exercise difficult. I could readily scrawl down (1) smile, eyes, boobs; (2) backs of my arms, ankles, tummy; and (3) back fat, knee fat, tummy overhang. The telling part was number (4): Anyone — because it does not define me.

Since I discovered Size Acceptance, I have to say that there are a lot more photos of me than there have been in recent years. Whereas once I used to scamper for cover at the first sight of a camera lens, these days it doesn’t bother me that much. That’s not to say I always like the photographs, but, eh, whatever. I sometimes look back at other photos taken over the years. Some that I remember hating so much that I wanted to cry and never leave the house again, I look at now and think, Hey, they’re not that bad. Some are even quite nice. Some are still awful. But I’m not renowned for photographing well and I no longer let it define my self-worth if a camera has failed to capture just how special a moment was.

This is the picture I chose

But back to the Fat PhDs. I don’t have any graduation pics because I hate all that stuff and didn’t go to any of the ceremonies. But as a result of my new non-terror of cameras, I had a selection of recent photos to choose from. I spent a week in London a few months ago for a cousin’s wedding and there were a few pre-event shindigs that let me get my glad rags out. The photo quality isn’t great, but most of them are of me and hubby looking happy and spruced up. We polish up well. But as I was flicking through the photos to choose which one to submit, I found myself trying to choose the one I looked fattest in. Seriously. I didn’t decide to do that up front, but I suddenly realized that that was what I was doing.

And then it hit me: two years ago I wouldn’t be caught dead on the business end of a camera, and if a photo of me did emerge that I hadn’t managed to shred, delete, or burn, then putting it up on the internet for the world to see would not be high on my list of things to do with it. And here I was, two years into Size Acceptance, willfully picking a photograph that showed me to look fat (although, admittedly, also quite zazzly) to add to this official “Up Yours, Dr. Miller” gesture.

If any of you out there are thinking “OMG, I could never do that, I will never learn to love this body,” I have to say to you that I am not one of those Size Acceptance folks who has learned to revel in every roll of fat and believe that my body is a thing of beauty. I wish I were. Perhaps one day I will be, but I’m not there yet. What is different now for me is that the idea that my body is not a magnificent testament to womanly loveliness no longer makes me want to curl up in a corner and protect the world from my hideousness and shame.

And now I look at that open letter from Cat Pausé, with page after page after page of Fat PhDs, and actually find myself incredibly empowered by it. If I weren’t already studying for my own doctorate, I’d probably want to go out and start one. Several people have said the same thing. I found myself smiling as I scrolled through page after page of fat men and women who had gone the distance and gotten their graduate degrees. I felt a sense of warmth and pride welling up in me, even though I didn’t even know most of them. For what? For academics? No. I think what I was experiencing was the virgin glow of seeing dozens and dozens of happy, accomplished, positive images of fat people. My response, and others, to this visual testament of fat success just goes to show how devoid of such positive reinforcement our normal visual diet is. I’m proud to be a small part in that change, but damn, we need more of it. Fuck Yeah!

If you would like to submit your photo to the “Fuck yeah! Fat PhDs” project, just click here.

Filed under: DW, Manic Monday

New dangerous body image message from UK department store

2013-06-17T14:38:53Z

A disturbing new trend is on the rise in high street fashion. In the past, retailers have been rightfully criticised for using ‘size 0′ mannequins and promoting an unrealistic standard of beauty, likely to be emulated by impressionable young girls. The retailers have always argued that these representations are aspirational, and more importantly, clothes simply…

Hold the Concern Please

2013-06-17T13:31:44Z

I keep hearing people suggest that it’s their moral obligation to tell fat people that we need to lose weight, exercise more, or that if someone sees a fat child they need to say something to the caregiver. I’ve been part of any number of conversations where people who had no business or permission to talk to me about my weight or health (and let’s remember they are two separate things) did so.

First of all, we know that you can’t tell anything from someone’s body size other than what size their body is, and what prejudices you hold about that body. Even if these people’s assumptions about fat people were true, the behavior would still not be justified.

I often respond by saying, with finality,”I’m not taking unsolicited opinions about my health, thank you.” What I think in my head is more along the lines of No. No no no no no no no. No. First of all, how much of an idiot do you have to be to talk to me as if I’ve never heard that I should lose weight. Do you think I’ve never seen a TV commercial? Listened to the radio? Looked the hell around? Do you think I live under a very large rock? By my count I get about 386,170 messages a year that my body is wrong. I’ve been fat for at least 27 of my 36 years so that’s 10,426,590 times that I’ve been told that my body is wrong. If I was going to buy into that bullshit I would have done it already. So how about you trust me when I tell you that the 10,426,591st first time is NOT the charm.

I think that when someone feels this strong of a need to “save a fatty”, it’s often really much more about their own ego than the person they are supposedly so concerned about. Like an ambitious relief pitcher, they want to get credit for the save. I call this “Pulling a Jillian” as in Jillian Michaels, ego maniac from The Biggest Loser, who can’t stop talking about how she’s saving lives and she’s making people healthy, she’s doing this and she’s doing that blah blah blah. Newsflash Jillian, if you really cared about people we would be hearing a whole lot less about you.

I am a grown ass woman making choices. That is my right. Just like other people get to make choices for themselves. You can decide that your path to health is a raw foods diet, vegan, vegetarian, liquid diet, whatever. I don’t get to decide how you live, it’s not my business. I get to make choices for my body and you have no right to question those choices. (And if you’re even thinking about making a “but my tax dollars pay for fatties” argument, head over here.)

The bottom line here is very simple: This is not a tree and I am not a kitten so you can put your ladder away. Thank you.

Like the blog? Here’s more of my stuff:

Become a member: Keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here for details

Dance Classes: Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details

“It gets better” is not enough

2013-06-17T01:48:00Z

I am sure that the people who say “It gets better” mean well. I am sure that they want to keep children from killing themselves. But “it gets better” doesn’t help a kid who is being teased mercilessly by his/her peers. If you’re 14 years old, and all your classmates have turned on you, what good is it to hear that things will be better in a year or more? I heard that sort of crap a lot when I was a kid, and I don’t remember it helping me much.

When I was that kid being picked on, what I learned was that adults can’t help, mostly because they don’t know how. I don’t know how well that has advanced, but I suspect it hasn’t.

To those who say “it gets better,” I’m sorry for disparaging your message. It isn’t wrong, at least most of the time. I was rocked with three emotional crises over a short period of time, but two years after the first one, I was a lot better. High school was still a trial, but it was better than eighth grade, and I did manage to gather together a group of friends. But “it gets better” isn’t much to offer a kid who is hurting now. Why can’t we make it better for that kid now?

The only thing I know is that, more than anything in the world, I want to help that kid who had trouble dealing with the torment. It seems to me that school administrators could do more to make their schools emotionally safe places. But maybe they don’t know how.

Public Health Does Not Make Me Public Property

2013-06-16T03:57:28Z

If I had a dollar for every time someone emailed me with some form of “But.. but… HEALTH!!” message in response to my fat activism, I would be a very wealthy woman indeed. I’ve heard it all when it comes to people trying to use health, either private or public, as a stick to beat fat people over the head with. To me it just boils down to one thing… no matter what a person’s appearance, weight, shape, level of health or physical ability, every human being deserves to live their lives in dignity and peace, without fear of discrimination or vilification based on their appearance, size, shape, body or health/physical ability.

Of course, to the essentialists out there who want to claim that fat activists are somehow anti-health, the idea of EVERYBODY deserving the same rights regardless of their appearance or physical state-of-being gets them into a right lather of outrage. There is this attitude that “public health” must somehow trump basic human rights for some kind of greater good. Of course, this is borne of decade after decade of big pharma, the media and the “beauty” industry carefully constructing a culture that equates health with attractiveness and thinness, and manoevering those measures of health to unattainable levels that very, very few people in the world actually come close to meeting, ie thin, white, able-bodied, heterosexual, cis-gendered, affluent, etc.

Fat activism, even those of us who actively call out healthism, is not an anti-health message by any means. In fact, it is quite the opposite. I believe that everyone, yes EVERYONE, deserves access to the same healthful resources. Clean water. Clean air. Safe spaces to engage in physical activity that is enjoyable and inclusive. Abundant, fresh, affordable, nutritious food. Compassionate medical care. Vaccinations against communicable diseases. Fair pay and working conditions. Comprehensive education for all. Mental health care. Accessible public spaces for all bodies. Affordable housing. Affordable and suitable clothing. All of these things contribute to improving the general health and quality of life of all people.

What I do not support is the idea that public health renders some people’s bodies as public property. Public health is important in our society, and I am all for universal health care (an imperfect version of which we are lucky to have in Australia). I am all for public health ensuring that our water is clean, that everyone has access to the medication and treatment they need, that people are aware of the importance of vaccination, that all people are encouraged and enabled to get outside into a clean, safe environment and enjoy moving their bodies, that public funding goes into curing disease and providing those treatments to all human beings and so on.

What I do not support from public health is the marking of non-normative bodies as “diseased” or “defective”. I do not support the removal of agency and self-advocacy from people with non-normative bodies. I do not support intervention into our bodies and health by public health organisations. I do not support the vilification of human beings based on their appearance. I do not support public health being driven by the diet, beauty and pharmacy industries, or the mainstream media, all of which have financial gain to be made in the othering of people based on their appearance. I do not support public health campaigns that mark some bodies as inferior, immoral or defective. I do not support public health campaigns that encourage friends, family, schools or other groups to intervene in to other people’s health. None of these things actually help improve individual health or quality of life, in fact they all impact both health and quality of life negatively.

Anything that renders human beings as vulnerable to any of the above is public shaming and public stigmatisation, not public health.

Part of living in a society is that we can all contribute to that society for the general betterment of all. Some people will need different resources and levels of care to others, because like any other living species, human beings are diverse. That does not make those people beholden to society in general to try to change themselves to meet the narrow band of “average” that is classed as “normal”. Instead, the responsibility is on society as a whole to include all people, rather than just the lucky few that meet some ridiculous arbitrary standards.

Filed under: fat stigma, health, othering, prejudice, public health, shame, stigmatisation

Fat Shamed by a 7 Yr Old

2013-06-14T14:00:00Z

Kids are weird; they're trying so hard to figure out how to be themselves, and behave properly, and learn all this stuff about what it means to be a person and an adult and all the rest that I'm surprised their heads don't explode. I have two of them, ages 10 months and nearly 7 years old, and they equally delight and amaze, and horrify me, almost on a daily basis.

Case in point; last Sunday we were getting ready to go out to Goldstream Provincial Park for the afternoon and Gabe decided to see if he could get a rise out of me by commenting on what I was wearing. I was brushing my teeth or doing my hair, something in the bathroom infront of the mirror at any rate, and he comes in, stands beside me and the following happened:

Gabe: Mom, you look really fat in those pants.

Me: ... Well, I am fat, so I'm going to look that way no matter what I wear.

Gabe: You shouldn't wear those pants. They make you look really really fat.

Me: ... I'm ok with that. I'm not going to get changed, I like these pants.

Gabe: No, mom! You look ugly. Don't wear those!

He seemed to be more upset that I wasn't taking the bait and getting mad about what he was saying than actually disliking what I was wearing. I'm not about to be fat-shamed and fashion police-d by my own kid, so at this point he got a 10 minute time out for extreme rudeness. It's my hope that by keeping my cool and not reacting in a big way that he'll realize that being called fat isn't an insult and not do it to other people trying to hurt them.

Pretty in Pink

2013-06-14T14:24:03Z

Tuesday afternoons, I sell my candy at a local-ish farmer’s market. Only, this past Tuesday it was so hot (over 100 degrees Fahrenheit!) I made the executive decision not to do that. At temperatures that high, there’s a serious danger of my caramels melting.

Since I had an unexpected afternoon free, I decided to make some cupcakes.

Just a cupcake, nothing special here.

It turned out pretty and tasty, so I thought I’d share what I did.

I found the recipe on Sally’s Baking Addiction, under Very Vanilla Cupcakes. I used sour cream where it called for Greek yogurt (as I didn’t have any yogurt in the house, time to make more!), and used one egg instead of two egg whites. Then I baked the cupcakes until done.

After the cupcakes were cool, I made the strawberry buttercream frosting.

Strawberry Buttercream Frosting

1 cup butter, room temperature (and yes, it MUST be real butter)
3 cups powdered sugar
2 tablespoon cream
4 tablespoons strawberry puree

Cream the butter for six to eight minutes. It’s very important to do this, as it’s what gives the very creamy, melt-in-your-mouth texture. Once the eight minutes are up, slowly add the powdered sugar, and beat until it’s stiff. Add the cream and strawberry puree and beat for about three or four minutes longer.

Put into a piping bag with a large star tip, and pipe onto the cooled cupcakes.

Take one large strawberry for each frosted cupcake, and slice it thin, but not all the way through. Fan the slices out, and stick them on top of the frosting, pushing them down a little.

Top it all off with some chocolate syrup. I made my own syrup, because I am just a bit crazy like that, but regular chocolate syrup is good too.

It tasted as good as it looks.

Let me know what you think of it if you try it out!

Filed under: Foodie Friday

Low Hanging Health Fruit

2013-06-14T13:14:25Z

I’m often asked what I think the first steps are to pursue health. First, to be clear, I don’t think that anyone is obligated to pursue health or healthy habits. I think that the decision of how highly to prioritize health and the path to take is an intensely personal one. I am also aware that, while there are things that are shown to help us play the odds when it comes to our health, there are never any guarantees.

Still, many fat people have been mislead to believe that dieting is the only path to health and that weight loss behaviors are the only type of healthy behaviors if you’re fat. Once they learn that weight loss hardly ever works and, even when it does it isn’t shown to lead to better health, people can feel completely lost. I remember being really scared in the time between learning the truth about dieting but before I learned about Health at Every Size that there was nothing I could do to help my health odds. Even when I learned about HAES I wasn’t sure where to start.

I’ve noticed that with a diet mentality the focus is often on what we are going to give up (I’m giving up this type of food, this drink, this food group etc.), and doing what we hate (Not a morning person? You are now! Not a runner? You are now!)

I’ve seen people be much more successful doing the exact opposite – making it an additive process and going after the “low hanging fruit” first.

There are any number of things that have been shown to improve our health – more sleep, less stress, fruits and vegetables, movement, water, and that’s just a start. We are never going to be able to do all of them all of the time.

So if you want to put more focus on your health and you aren’t sure where to start, consider adding more of something that you already like. If you love veggies, add a couple more servings in a day. If you hate veggies, leave that alone for now and pick something you do like/can do – get an extra hour of sleep, do some movement that you like, drink some water, hit a pillow with a tennis racket to relieve some stress. Consider laying off the sweeping declarations for now (I’m going to drink x ounces of water every day for the rest of my life! Five servings of fruits and vegetables each day or BUST!) and just make a decision in this moment to have some water or eat an apple. Celebrate every victory and have a ton of compassion for yourself.

Obviously this isn’t the only way, but for me part of rejecting the diet mentality was rejecting the idea that the path to health was paved with giving things up and doing things that I hated. I think there’s absolutely a better way and I think it’s worth it to find it.

Like the blog? Here’s more of my stuff:

Become a member: Keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here for details

Dance Classes: Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details

The Fitbit

2013-06-14T06:49:35Z

I’ve been seeing pedometers discussed a bit lately. In some ways, they get a bad rap; we’ve seen them [mis-]used in “wellness” programs and that accuracy varies. Although they can be amusing, as noted by one NY Times commenter:

Fitbit has a clip on model that I attach to the waistband of tights or to the center of my bra. I’ve had this one for a year and it’s gone through the laundry and still works…though it did count the washing and drying as 37 flights of stairs.

- comment from Karen in Chicago

Ana Mardoll, meanwhile, uses one to be sure she doesn’t walk too much.

As it happens, I’ve had a Fitbit Zip for about 6 months now. What does it say?

Graph showing daily average steps for every 7 days

The above graph the daily average steps for each week. There’s some variations, but it varies between 2400 and 5500 per day.

Daily average steps per month

The daily average per month graph, however, shows a much smaller variation – from 2950 to 3400. That’s a fairly narrow range. On average, the Zip says I’m walking about the same as I did six months ago.

What has changed?

I have become more aware of how much I walk. I thought I was more active on the weekends because I walk around the house more frequently than the office. Wrong! The house is more compact; I have to make an effort if I want to walk as much on the weekends as I do by just going to work.

I am more consistent in my walking routine. I had noticed before I got the Zip that varying between “not walking much” and “going on a hike” would leave me with aching knees. Now I have a higher “minimum” and I have a LOT fewer problems.

For the curious, the Fitbit Zip is pretty much a pedometer. It doesn’t do flights of stairs or track my sleep, like other models do. It uploads data to a website for long-term tracking. The website can be used with or without one of the trackers, if you’re into manually entering things. (Personally I just use the Zip.)

One gripe I’ve had about the “dashboard” is that it assumes I want to track my weight, calories, etc. No, I don’t want to log food. I don’t want to track my weight. I don’t care how many calories you think I’ve used….

Bonus reminder my Fitbit doesn’t track stairs.

There’s also a beta for a new dashboard, which is better at letting me hide what I don’t care to see.

Example new dashboard.

Personally I prefer the new one.

Overall, if you’re the sort of person who learned to disconnect from and distrust your body, this kind of tracker may be a useful tool. But like many things, your mileage may vary.

Filed under: Anti-Obesity Programs, Exercise, Walking

Fun With Photoshop

2013-06-13T15:45:40Z

What does it take to terrify millions of Americans with one ad campaign?

A poorly executed Photoshop, apparently.

There! Now she looks like Jiminy Glick’s granddaughter!

Recently, I’ve not had enough spare time or patience to even think about trying to dissect the thousands of things that are incredibly wrong about a Photoshop disaster of this magnitude, but I thought I’d try.

First off, I’m now refusing to believe that anyone is stupid enough to view an obesity warning (cloaked as a sort of public service announcement) with a crazy-ass doctored photo of an adorable kid drinking a vat of sugar as worth their time or effort.

I understand the outrage that people have about this whole thing, but seriously? Who the hell looks at this, runs home, gathers their children in their arms while sobbing “not my baby, don’t you TOUCH my baby obesity!” and then proceeds to gather up all foods not at the proper end of the food pyramid and toss them out the window into a raging bonfire in the front yard?

Secondly, this is probably the worst Photoshop job I’ve ever seen. I mean, as much as I detest the idea of models and celebrities being doctored to appear flawless in magazines and press shots, it actually IS an art form and the altering of a photograph takes time, skill and patience. The person who landed this particular assignment clearly had something better to do later in the afternoon because they managed to make the cutest child on earth appear fairly alien and ill, with bloated cheeks and a misshapen head.

My kids were chubby, and they looked nothing like the end result of this hack job, nor did I ever let them drink pure sugar for fun because that would’ve resulted in an evening of peeling them off the ceiling.

So, am I outraged that this whole thing took place and that kids were involved?

No, not really.

The ad campaign lost any steam it could have picked up by being mercilessly mocked on national television and proving the point that shaming children and their parents into some sort of vaguely defined action doesn’t really works.

The shape and size of people’s bodies will always spark debate. Are you fat? Are you thin? Are you healthy? What is healthy? These parameters are always shifting and changing with the times, and there will always be a contrarian to weigh down the opposite ends of the opinion scale, but for now I’d say to use your brain to toss dreck like this ad campaign into the waste bin in favor of bigger and better fights.

Filed under: DW, Themeless Thursday

Therapy for fat people and everybody else* now available via Skype

2013-06-13T14:50:00Z

Exciting therapy news! I can now offer counselling/psychotherapy sessions via Skype and I have some spaces available for new clients.

Skype therapy is for people who are time-pressured, who may not be able to get to East London very easily, who may prefer an onscreen therapist rather than someone physically in the room with them. There may be other reasons you might choose Skype too. Having therapy via Skype is the same as having face-to-face therapy in some ways (the things you can talk about, my professional service), and different in others (sessions take place in your own space, for example).

Please get in touch with me if you are interested in working face-to-face or via Skype. We can have a preliminary chat by email, and if you want to book a session I will talk you through the steps needed to set things up. My office is in East London, and the Skype service is available to anybody anywhere in the UK, or British people living abroad.

I work with people from all kinds of backgrounds and specialise in working with issues relating to fat and bodies in general, sexuality and social justice. I am an experienced and qualified therapist as well as a Registered Member of the British Association of Counselling and Psychotherapy.

Feel free to peruse the extensive Frequently Asked Questions section of my website, which gives plenty of background information, and drop me a line if you have any questions or comments.

* Yep.

They Are Our Bodies

2013-06-13T10:24:15Z

There’s a picture going around Facebook that suggests that the world is unfair because fat people get medical care but same sex couples can’t get married. Even if I wasn’t a fat queer woman who can’t get insurance or get married, this would royally piss me off. I’ve been looking for some response more eloquent than “fuck this bullshit” and this is the best I’ve got:

They are our bodies.

They are not a representation of greed or capitalism. They are our bodies.

They are not pictures without heads to accompany yet another OMGDEATHFAT article. They are our bodies.

They are not stand-ins for our health and well being. They are our bodies.

They are not for you to judge. They are our bodies.

Do you get it? They are our bodies. So back off.

Our bodies are far too valuable to be treated like a car whose worth is lowered because of some wear and tear. They are far too astounding to be a metaphor or a political statement. They are far too complicated to run on the same formula used to fuel a lawn mower. They are far too profound to be reduced to a ratio of weight and height. And they are far too amazing to be judged by anyone.

Because they are our bodies..

Like the blog? Here’s more of my stuff:

Become a member: Keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here for details

Dance Classes: Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details

Random & Meh

2013-06-13T00:21:10Z

I’m all full of blah this week, darlings. Well, part blah, part snark. It all began with hormones and all the feels and now I’m just sort of over it. I’m just plugging away applying to all the jobs that I possibly can and trying to not freak out or stress or anything. I haven’t had the inspiration or motivation to write and when I tried to exercize my tired brain by writing poetry? Well, this…

I am
busted seams
popped buttons
frayed edges
broken zippers
worn-through thighs

My thighs will destroy as much as they embrace
my breasts will heave and welcome as I breathe

Meh. That’s all. Just blah and meh. Ha-ha! This sort of sums up my week and yeah I know we’re only halfway through this shizz. It’s not like I have any plans for my weekend or anything, but that’s usually the only time I get to see some of my favorite people and that’s all I want right now.

Time is such a painful and cruel thing, ya know? I’m constantly waiting or being told to wait and be patient and I’m sick of it. I’ve probably said this a few times before (Ha-ha!) but damn, dude! I am excited for the NoLose.org conference in July. I’m looking forward to it for like a bajillion reasons! My BFF “Q” is driving up and staying with me and oh the shenanigans we shall have/accomplish!!!

I spent much of my weekend hiding and watching bad movies and feeling weird. Had an anxiety thing happen on Sunday that was not fun but I worked through it. So much time with my puggyman certainly did me a world of good. He is the most perfect pooch, I tell ya!

And then today I saw this crap commercial, “Hail to the V”?! WTF?!?!
Celebrate the most precious thing in the world…by washing your smelly cooch?!?! NO THANKS!

I guess I’m in a bit of an odd mood.

Whatevs.

Love you all!
<3
S

Glass Onion —

2013-06-12T16:13:18Z

Only seniors wrote for our high school paper, which made the editorial room primarily their domain. But as a freshman on the yearbook staff and the youngest brother of a senior on the newspaper, I spent a lot of time there. So it was my freshman year of high school in 1994 that I first found and fell in love with The Onion.

When I discovered the first one, I pored over it, cackling at every absurd claim made in starch-stiff journalistic prose. I instantly fell in love with every single person who contributed to that alternate reality, which became increasingly intuitive over the years.

In my opinion, The Onion has become a sort comedic conscience for the nation, particularly following its coverage of the September 11th attacks:

More recently, The Onion has provided a sorely-needed respite from the sorrow following the Colorado and Newtown mass shootings, including headlines that expressed our disbelief at this new American reality and our outrage at ongoing political inaction. But most of the time, when The Onion isn’t responding to overwhelming tragedy, it’s just plain funny.

Of course, everyone finds different things funny, and sometimes you find yourself laughing despite knowing that you’re going to hell. My senior year of high school, The Onion posted a headline that I’m equal parts offended by and tickled by to this day: “Alzheimer’s Sufferers Demand Cure For Pancakes.”

Two of my grandparents suffered from Alzheimer’s, and one had a particularly intense end-of-life struggle with reality, but our family coped with the grief by laughing about some of the most bizarre claims she made, like how the staff chased her around the nursing home with dogs at night after we left. That headline always reminds me of her and although I know I should be offended, I can’t help but feel they captured something that families of those with Alzheimer’s have lived through.

But that’s me. I realize others believe that headline mocks those with Alzheimer’s and that there’s nothing funny about it, which is what makes humor such a tricky area to debate: one man’s punchline is another man’s punch in the gut.

So when it comes to The Onion, I’ve learned to accept the good with the bad when it comes to fat jokes. And there’s been a lot of bad, like “Michelle Obama Shutters ‘Let’s Move!’ Program After Failed 3-Year Run”:

“Though I had hoped ‘Let’s Move!’ would promote healthier habits among America’s children, it turns out our young people simply aren’t interested in moving—at all,” the first lady told reporters. “Seriously, not even a little. When I visit these schools and talk about exercise, most of the kids look back at me with blank stares. And the ones who do attempt to exercise clearly do not like it and stop almost immediately.” Obama added that she expects to achieve far more success with her forthcoming “Fine, Let’s Just Sit Here Stuffing Our Faces Until We Drop Dead!” campaign.

And that’s just one of many, many headlines:

Rarely, there’s a fat-related story that satirizes the culture’s contempt for fatties, rather than the fatties themselves, like “Should We Be Shaming Obese Children More?” or “Diet Book Author Advocates New ‘No Food Diet’.”

Currently, this is what you get with most fat jokes: 95% mocking fat people and 5% mocking the culture’s response to them. But it’s much easier to mock the gluttonous sloths than to take a step back and observe the cultural climate that fat people have to deal with. A lot of it has to do with the lack of empathy in general toward fat people, since they are always, ALWAYS responsible for their body size and shape.

Which is why it should come to no surprise when I saw the following front page on The Onion‘s website the other day:

The story basically mocks the idea that losing weight is more complex than calories in/calories out.

The study, conducted by scientists at The National Weight Control Registry, determined conclusively that shedding excess weight has never occurred, changing your appearance is impossible, and that it actually feels “pretty nice” to just give up and realize that you’re powerless to alter your body mass index in any way, shape, or form.

When I first saw this article, I immediately began to wonder which member of Fitness Circlejerk was a staffer at The Onion. It’s the kind of strawman that concern trolls love to knock down while grunting around the weight rack. Their interpretation of Health at Every Size^® says that caloric restriction will never, ever, ever lead to weight loss, which is not what any educated proponent of HAES has ever said.

Yeah, you can diet and exercise your way to a smaller size, but most weight loss research defines “clinically significant weight loss” as between 5% and 10% of their starting weight. Let’s say that guy in The Onion photo lost 10% of his body weight… assuming he’s the same size as me (265 pounds), that means that he’ll still weigh 238 pounds, which isn’t that impressive.

The Onion article mentions The National Weight Control Registry (NWCR) in an attempt to subtly undermine the satirical claims made in the article. Except you have to keep in mind that the NWCR is a self-selecting group of 10,000 successful dieters who have lost at least 30 pounds and kept it off for over a year. That seems like a fairly low bar for “success” in a country where tens of millions of people attempt to lose weight every year.

That’s why there’s one thing that separates Strawman HAES from Real HAES: long-term weight loss research.

Strawman HAES claims that “running on a treadmill every morning at 6 a.m. will not help anyone lose weight, and neither will cutting carbohydrates from one’s diet, eating smaller portions throughout the day, doing yoga, or hiring a personal trainer.”

Real HAES claims that while those things may lead to some weight loss, the vast majority of people who do so won’t lose much and most of those who do will ultimately regain the weight within five years. The difference between Strawman HAES and Real HAES is that Strawman HAES says it’s impossible, while Real HAES says it’s unsustainable for most people, according to the overwhelming body of long-term research.

Which brings us to the most interesting part of the article, where The Onion cites Rena Wing, who founded the NWCR with James Hill:

“Our findings indicate that if you’re trying to lose weight, you will fail — and that’s because you can’t, no one has, and you need to stop trying because it will never happen,” said Dr. Rena Wing, lead author of the report. “You could work out every day and eat nothing, and you still wouldn’t lose an ounce. And the sooner you throw up your hands and make peace with that fact, the better off you’ll be.”

The reason I find it so interesting is that the concern trolls I’ve argued with recently have cited Wing’s research to “prove” that long-term weight loss is possible. In this comment, I explain why Wing’s research is inadequate to this troll. In a nutshell, Wing’s proof relies almost entirely on phone surveys, which are notoriously unreliable compared to randomized, controlled trials where the subjects are actually weighed and measured. Also, Wing uses a five-year study to prove long-term efficacy, but only cites the results from the first year as evidence.

To a certain extent, comedy isn’t always about truth or nuance, it’s about saying what everyone else is thinking in a way that makes them laugh in recognition. In our culture, HAES is misrepresented as saying diets don’t work because of some mystical violation of the laws of thermodynamics.

In fact, even brilliant minds that are typically capable of nuance and understanding find this oversimplification easier to mock than the truth. Imagine my surprise when astrophysicist Neil deGrasse Tyson wrote the following tweet:

Say it ain’t so, Neil!

It was refreshing to see a sizable pushback from people who questioned his false equivalency to physics and his claim that the human body responds to fluctuations in energy predictably. Yet it still hurt to see one of my contemporary icons toss off such a glib and unsubstantiated “joke.”

Even the terms are troubling. As I responded to Neil, you can have two people who weigh 200 pounds and are technically overweight, but one has had a stable weight their entire adult life (let’s call him Bob) and the other could have lost 100 pounds in the last year (let’s call him Jim). Jim will have to eat significantly fewer calories just to maintain his 200 pound weight due to a process called adaptive thermogenesis, which I explain in detail here.

Now, if Jim eats the same amount of calories as Bob, he will put on weight. So who is “overeating”? Concern trolls would say, of course, that they both are because 200 pounds is too fat. Okay then, let’s have Bob and Jim restrict even further and get to 150 pounds, the same as Sam. Just to maintain their weight, Sam eats 2,500 calories, Bob eats 2,000 calories, and Jim eats 1,500 calories. Who’s “overeating” now?

These are the kinds of details that get lost in the gross oversimplification necessary to make jokes. But those jokes, whether from a satirical newspaper or a renowned astrophysicist, contribute to the public’s perception that anyone can lose as much weight as they want and keep it off indefinitely with enough willpower.

This is part of the reason why researchers have been attempting to dial down expectations for weight loss to no avail, as captured in this study from the Journal of Consulting and Clinical Psychology, which has the greatest title ever: “Great expectations: ‘I’m losing 25% of my weight no matter what you say.’”

Facts like this explain why you’ll never see The Onion make a nuanced joke about weight loss: the reality is far too depressing for those who depend upon the illusion for hope.

Filed under: DT, DW, EX, FH, FS, Weighty Wednesday, WL

Fat Gym – You’re Doing It Wrong

2013-06-12T12:01:45Z

Prospect High School has created a new PE program wherein students are tested on their physical fitness twice a year. Those who get a “high” score get to pick which activities and sports they want to do in gym class. Those who get a “low score” are forced to into separate classes where they do mandatory cardio, like running laps, three times a week.

Some of the students have called the lower class “Fat Gym.’ The stigmatizing of fat kids in is horrible, and is just the tip of the iceberg of horrible on this one.

Unless their goal is to make sure that some kids develop a lasting hatred of exercise, I submit that this program is a terrible idea. I am not against movement programs in schools. I do think that they should be created with primary goals of fostering high self-esteem, body confidence, and creating something on the spectrum of not being driven completely away from the entire concept of movement, to developing a lifelong love of movement by the time they get out of school. Where on that spectrum any kid lands will depend on the kid.

Of course to do that we would have to accept some basic truths:

Not every kid is going to excel in gym class and that’s ok.
Not every kid is going to be interested in gym class and that’s ok.
It’s very possible that the kids who don’t score well on the fitness test fall into one or both of the above categories, and forcing them do cardio while their friends play games isn’t likely to move them out of either category (which isn’t necessarily a worthy goal to begin with.)
As history is written by the winners, so gym class is often taught. Many gym teachers are people who were/are naturally athletic and they can fall prey to the dangers of confusing their experience to everyone’s experience.

We also have to avoid making the mistake of believing that if most of the fat kids are in lower gym, that means that their fat is to blame. Remember that fat kids are given the message from a very early age that they are lazy and un-athletic. They may not be asked to play by their peers, they may not be chosen for teams by adults, when they are on teams they may be automatically placed in the least athletic role without being given a chance to develop athleticism. In this way prejudice can be made into reality. Looking at a kid’s body size tells you nothing about their athletic ability or how much they like or dislike athletics, and all kids should be given every opportunity to find movement they enjoy while scrupulously avoiding shame or stigma around the concept of movement.

I’ve seen the argument that if you struggle with reading you are put in remedial reading, and so if you struggle at gym class you should be put into remedial gym class. Here’s the issue with that: Reading and movement are not equivalent. Reading is a specific skill, movement/exercise is a concept. To get the benefit of reading 6th grade books, you typically have to read at a 6th grade level. To get the benefit of movement kids simply need to raise their heart rates for a suggested 60 minutes a day. How they do that or how “good” they are at it compared to others their age is completely immaterial. Winning at dodgeball, hell, being any good at all at dodgeball, is not a requirement for kids to gain health benefits from movement.

My suggestion is this: Create several options for kids that change every six weeks, with walking being a constant. So this 6 weeks it might be basketball, dancing, dodgeball, and walking the track. Next 6 weeks it might be lifting weights, yoga, soccer, and walking the track etc. I’d love to see two sets of sports – one competitive and one that is just about participating and having fun (maybe we could redirect some of that $60 Billion that we give to the diet industry every year to pay for it?)

Even if one argues that none of those changes are possible, we can do WAY better than punishing kids who don’t score well on a fitness test by making them run laps while their friends play games. Any school that has created a PE program which kids are calling “Fat Gym” needs to go back to the drawing board, very quickly.

Like the blog? Here’s more of my stuff:

Become a member: Keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here for details

Dance Classes: Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details

Busy busy bee

2013-06-12T02:50:00Z

There's been a lot happening in JeninCanada land-we've found a new place to move to come July 1st, I started my new job and the kids started at daycare (well, Gabe is just after school for now) and it's hectic and we're sorting out the details right now on travelling to/from places. Hopefully I'll be getting my license the second week of July so that will help, but if not, things will be difficult until I do.

The other day I realized that I haven't had a full time job since my old call centre days when Gabe was barely a year old; then I went back to school to finish my English degree, then again back to school after teacher's college didn't pan out for my CESD certificate. Then we moved here and I worked only part-time for FedEx before this nearly 10 months of parental leave. Sure, it *felt like* I was working full time because of all the time I spent on the bus to/from work, but I was only there 5 hours a day. I've never tried to be a full time working mom before and I can already tell things are going to fall by the wayside, like writing and my Pagan activities. Between getting up early, still being up at night with Kat, getting home late and fighting to get both kids asleep by 9 so I can go to sleep by 10:30 or 11:00, there's not a lot of time in there for anything but keeping the house tidy, laundry and touching base with Ryan. Our already-precious one day off together on Sundays is going to become even more jealously guarded against encroaching activities, though I did go ahead and plan a summer solstice fire and get-together in two weeks.

There are some things I want to write about but I'm just too worn out right now. Once I get my feet under me and things settle down I'll be back on a regular basis. Let me know what you've been up too! Until then, take care of you!

More on NAAFA’s name

2013-06-12T04:31:26Z

Following on from a previous post on NAAFA’s possible name change, I found an article online that provides more insight into the NAAFA Board of Director’s point of view. The biggest surprise to me is that they are saying that most members are in favor of removing the word “fat” from NAAFA’s name. (This article also names Brandon Macsata, a friend of NAAFA for a few years, as the consultant who is working on the name change; the newsletter article simply states that NAAFA is working with a PR firm.)

I’d be interested to hear what people think given this additional info. But if you really feel strongly, click on the link in the original newsletter article and let NAAFA know!

New diet surgery

2013-06-11T15:38:35Z

Trigger warning: Incredibly disturbing new kind of weight loss surgery.

The way the medical world treats us fatties really astounds me. First, they put us on diets for our own good. Then, they misdiagnose us and blame everything from earaches to pneumonia to asthma to epilepsy on our obesity (this is my personal experience, people). I have had doctors think I was lying to them because I COULDN’T POSSIBLY have not eaten anything all day before having the seizure that sent me to the emergency room, although that doctor felt dumb when my 10-year-old set him straight, along with my blood work.

Then, we have the wonder-filled world of bariatric surgery. There are primarily two types of weight loss surgery done today and I, for the record, am against both of them since I have either lost someone or know someone who has ruined their lives on each of these procedures. In gastric bypass, a small stomach pouch is created with a stapler device,and connected to the distal small intestine. The upper part of the small intestine is then reattached in a Y-shaped configuration. The other procedure involves making a smaller pouch in the stomach for food to digest in either removing part surgically or else using the lap-band, which cinches off part of the stomach using a medical device, creating .

Well, a new surgurey is hitting the shelves in Venezuela (not yet readily availy in the US, but you know the lengths they want us fatties to go to). According to an article in Time magazine, this procedure involves sewing an abrasive patch of Marlex (used in both hernia repair and hula hoops) onto the tongue for a month at a time, rendering the consumption of all solid foods extremely painful. The idea was introduced in 2009 by Nikolas Chugay, a Beverly Hills plastic surgeon. He sees it as a way to help patients lose weight without the fully invasive bariatric surgery.

The patch certainly has its own downsides. Securing an abrasive foreign object to the tongue comes with plenty of side-effects. Patients can experience speech difficulties, while others have trouble sleeping.

“At the start you can’t even move your tongue for the pain. I’ve tried to eat solid food but it’s impossible,” says Yomaira, speaking from her family home in Charallave, an industrial conurbation on the outskirts of the Caracas. “It’s a huge inconvenience, but I’m doing it to feel better about myself. I was very fat.”

“It’s a good solution, I don’t see it as extreme,” says Alicia Zamora, Yomaira’s mother. “It teaches you to eat differently and proves that there are alternatives.”

God, when will these people learn that IF IT AIN’T BROKEN DONT FIX IT. Good God, we don’t need to sew velcro to our tongues just so we won’t eat. Just let me be, and believe me when I tell you what I ate today (which was some beans and a nice submarine sandwich, TYVM). Oh, and keep your surgery away from my fat ass.

Filed under: DT, FH, Terrible Tuesday, WL, WLS

Is size acceptance going mainstream?

2013-06-11T14:39:56Z

A bit ago I blogged here about NKoTB’s “Remix” video with the hot fatty. I forgot to mention Sara Bareilles’s “Brave” video, with a couple of fat dancers (and others) doing one person flash mobs. Is this a trend in videos?

If it is, it’s not new. Katy Perry had her “Firework” video a few years ago, featuring (among other things) a fat girl in a bathing suit getting the courage to take off her robe and jump in the pool. And there are certainly more that I’ve forgotten. (Feel free to suggest other examples, dear readers!)

My thinking is that, within the culture of music videos, a certain (you could say superficial) level of fat acceptance is part of that culture. Sort of like being politically correct, but less about doctrine and more about selling the song. If you want to create feelings that are uplifiting and inclusive, displaying fat acceptance is a good way of doing it. And I like that.

Why do you think some videos display fat acceptance? And do you think that’s a good thing?

Painting, Activism, Community and Fat Queer Feminists

2013-06-11T13:51:00Z

Ruth Angel Edwards 2013

Ruth Angel Edwards has produced an extraordinary painting that features an image of me, my girlfriend and some friends and acquaintances from London's queer community. The painting shows a group of people (feminists, women, queers) constructing a space out of wood amidst a forest against some mountains.

I came to be in the painting in a very informal way. Last summer, my friend Ele Cockerill (the one with the bucket) sent me a text to say that Ruth was looking for subjects on which to base a painting. I'd seen Ruth playing in a band called Covergirl and another called Yola Fatoush, and she is part of a scene of young artists, queers and musicians that has supported my own band. I didn't know she was a painter. We arranged to meet up with some other people I know a bit, and she explained what she was looking for. This would be a large-scale painting that referenced women's communities, back-to-the-land lesbian separatism, the physicality of building something yourself. She took some photographs of a group of us looking as though we were working and making something. That was that.

Michigan Dykes by Lynn Levy, 1982
Andrews-Hunt, C. (1983) Images of Our Flesh, Seattle: The Fat Avengers.

When I thought about the painting, I imagined a big landscape with small figures within it, perhaps looking like busy elves beavering away on a structure. I imagined myself as a stick figure far in the background and very inconsequential. I was amazed to see how the painting actually turned out. Far from being a marginal figure, my representation is central to the work. I feel simultaneously thrilled and shy about this, it's both unsettling and exciting to see myself in this way. It brings to mind the archival research I did whilst working towards my doctorate and my interest in the emergence of fat activism through lesbian feminist communities of the 1970s and 80s. I came across many photographic images of community where fat dykes were central and here I am, also central to this picture.

detail by Ruth Angel Edwards

Ruth has painted me as I looked on the day, in my Piggly Wiggly t-shirt and Birkenstocks, with my hair scraped back. You can see one of my tattoos, the grey along my hairline, my rosacea. You can also see a strong gaze, confidence, a powerful attitude. It's really flattering! As my friend Rachel Berger says: "She really captured you". It feels fantastic to see myself in this painting, as someone who is also constituted by a community of action and imagination, and that elements of my real community are here with me in the image, not least my fat girlfriend too. I love that this is a painting of (presumably feminist) collective action. It's not the structure that is central to the image, it's the people. I'm not a painter, but a piece of this scale and scope is, to me, about work and dedication, as is the image itself. It pleases me no end to see 'work' so much a part of the piece; things don't just happen, there is always work behind it all, often women's work, no matter how hidden.

This painting references a feminist past, and a present compellingly. I am probably the oldest one in the picture, maybe the only one to have had first hand experience of second wave feminist land-based organising in the 1980s. Many of my politics and values were established in that period, but I am also critical of it; it was often a terrible time in feminism for queers like me, for trans people, for people of colour. The painting represents a lesbian feminist utopia in some ways, but I feel that my critical presence undermines that somewhat. My boyfriend is out of the frame, for example, but was there when the reference photographs were taken, and is also part of this social group. I hope the inclusion of me enables younger feminists to resist adopting the more problematic aspects of vintage fundamentalist feminism unchecked, and to develop more progressive politics.

Pinky by Sadie Lee

Ruth's painting has made me think about other queer representations of fat in modern painting (which, sadly, excludes Allyson Mitchell, queer fat artist par excellence). By queer I mean that either painter or sitter, or both, are queer, or where there is a queer sensibility infusing the work. Lucien Freud's celebrated paintings of Leigh Bowery and Big Sue spring to mind, but so too does Sadie Lee's paintings Pinky and Amy's Room. What's interesting to me is that the people painting them with love and attention are not fat. The same goes for Ruth. When you're fat it's often hard to imagine your physical presence being anything but abhorrent to someone else, especially thin people, and lord knows we encounter social messages like this every day. But these artists value fat people and our bodies, not as cute or pretty, or as the potential to be normal and nice, or in a traditionally socially sanctioned way, and far beyond a rhetoric of healthy/unhealthy, but as we are and as they see us. It is fabulous.

the HAES® files: History of the Health At Every Size® Movement—the 1970s & 80s (Part 2)

2013-06-11T10:00:51Z

by Barbara Altman Bruno, Ph.D., LCSW

In response to requests from our readers, the Health At Every Size Blog is honored to reprint Barbara Altman Bruno’s history of the HAES movement. Most of the installments of this history have been previously published in ASDAH member newsletters. This post is Part Two in a series.

The 1970s saw the building of feminism, iconoclasm, introspection, a peace movement regarding Vietnam, and mounting pressure on women to be thinner.

The social construction of weight concerns was examined in different ways by New York and London- based psychotherapist Susie Orbach, a group of women in Los Angeles, and a medical anthropologist in the San Francisco Bay area.

For Orbach, white, middle-class women’s eating problems were the result of their subordinate status in society. These “compulsive eaters” would get caught up in a repeated diet/binge cycle, which Orbach attributed to their ambivalence. She explored these ideas in Fat Is a Feminist Issue. She and Carol Munter recommended stopping dieting and listening to one’s own hunger/fullness cues, as well learning to use one’s own voice (rather than the body) to express difficult feelings and ideas.

Fat feminists Vivian Mayer (also called Aldebaran) and Judy Freespirit, women in the Los Angeles chapter of NAAFA, presented the following to the women of the Los Angeles radical therapy collective:

Biology, not eating habits, is the main cause of fat
Health problems of fat people are not inherently due to fat, but the result of stress, self-hatred, and chronic dieting
Weight loss efforts damage health, almost never “succeed” except temporarily, and should not be used
Food binges are a natural response to chronic dieting
The role of a radical therapist is to help fat women feel good about themselves as fat women and stop trying to lose weight. To accomplish this, radical therapists should learn and teach accurate information about fat women’s health and nutrition. They should provide emotional support for women on binges to continue eating and stop feeling guilty (1)

Lynn McAfee

Aldebaran subsequently published two articles about psychology, health, and fatness in radical therapy journals. The Fat Underground formed and included, among others, Lynn Mabel-Lois (subsequently called Lynn McAfee). They published a brochure, “Before You Go On a Diet, Read This.” They were validated by sociologist Natalie Allon and by psychologists Susan and O. Wayne Wooley, who published research incorporating fat feminist writings in professional journals.

Another academic, medical anthropologist Margaret MacKenzie, noted that in societies where larger women were accepted, such as Samoa, their blood pressure was normal.

The decade of the 1980s was characterized in part by Reagonomics and a “greed is good” business ethos; the burgeoning size of Americans along with a greater societal focus on physical fitness; women increasingly entering and competing in the workforce; the emergence of AIDS; the explosive rise of personal computing, and the end of the Berlin Wall and the Cold War.

Questions were being raised about dieting. Bob Schwartz’s 1982 book, Diets Don’t Work, was based on his program of the same name. Schwartz noticed how people ate who were not worried about food and weight, and taught what would be later called intuitive eating. Molly Groger wrote a book about her training program, Eating Awareness Training, which also helped people return to intuitive eating. Both Groger and Schwartz however, suggested that by following intuitive eating, people’s extra weight would melt off over time.

Two other books raised major concerns about the ineffectiveness and harmfulness of weight-loss diets: The Dieter’s Dilemma by William Bennett, MD, and Joel Gurin, and Breaking the Diet Habit, by Janet Polivy and C. Peter Herman. Bennett and Gurin posited that nearly all people had setpoints, which regulated each person’s body fat and weight. Dieting resulted in lowered metabolic rates and rebound weight gain, and was all but useless. Polivy and Herman discussed the “natural weight” range, which varied by individuals in a species, and recommended intuitive eating (not yet named as such) and accepting one’s natural size, as an alternative to struggling with dieting. They also reframed dieting as “restrained eating,” wherein one ignored body signals and instead responded to external cues, such as the time of day or the amount of food on a plate. Another of their concepts was the “what-the-hell effect,” in which restrained eaters overate in response to having come off their diets.

Bennett, in a 1982 speech to NAAFA, addressed the medicalization (for profit and prestige) of obesity, and proposed “preventive measures – the kind of effort everyone, fat, skinny, or whatever, should be doing to maintain and improve general health.”

Feminist writers and thinkers like Kim Chernin (The Obsession: Reflections on the Tyranny of Slenderness) noted that as women increasingly competed with men in the work force, the societal imperative to be thin weighed ever more heavily on them, and there was a dramatic increase in eating disorders.

In 1984, Alice Ansfield began publishing Radiance: The Magazine for Large Women. Published quarterly for 16 years, “its purpose was to support women ‘all sizes of large’ in living proud, full, active lives, at whatever weight, with self-love and self-respect” (quoted from the website).

In 1985, the National Institutes of Health’s Consensus Development Conference on the Health Implications of Obesity, ignoring much of the evidence presented, declared, “The evidence is now overwhelming that obesity, defined as excessive storage of energy in the form of fat, has adverse effects on health and longevity,” and declared obesity a disease.

Researchers Paul Ernsberger and Paul Haskew wrote a very clear, well- documented monograph titled, “Rethinking Obesity: An alternative view of its health implications,” which was the Summer 1987 issue of The Journal of Obesity and Weight Regulation. Among many tables in the article were a chronology of hazardous treatments for obesity and a long list of health benefits of obesity. Obesity was associated with lower incidences of cancer, many cardiovascular, gynecological, respiratory, bone, and obstetric diseases, and lower mortality from cancer and infectious diseases. The authors panned the 1985 NIH Consensus Development Conference on the Health Implications of Obesity as drawing from biased information, mostly from the insurance industry, and rejecting the vast majority of epidemiological evidence. They predicted many of the problems with its anti-fat bias, and stated, “It is no longer appropriate to consider obesity a disease if it has benefits as well as hazards.”

Australian psychobiologist Dale Atrens, in his 1988 book, Don’t Diet, wrote a similar book for the lay reader. Among his statements: “There is no good reason to consider the general increase in fatness an epidemic. People are becoming taller, too, but nobody talks about a height epidemic. Nor is there any good reason to consider fatness a disease. The people of the Western world are both fatter and healthier than ever before.” (p. 238)

In the Midwest, nutritionist Ellyn Satter was working with parents and children, clarifying that children were responsible for what and whether they ate, while parents were responsible for what food they provided and when it was provided.

Francie Berg

Enraged at the way diet programs deceived and mistreated their customers, health writer and former home economics teacher Frances Berg began writing a weekly newspaper column, which would eventually become the Healthy Weight Journal. The journal – which evolved into the Healthy Weight Network – was dedicated to “exposing fraud and deception, and to reshaping society’s attitudes toward size and weight.”

In the field of psychotherapy, New England psychologist Marcia Germaine Hutchinson recommended “learning to love the body you have” in her 1985 book, Transforming Body Image. Psychotherapists Jane Hirschmann and Carol Munter viewed “compulsive overeating” as a soothing disorder, healed by legalizing all foods and tuning in to physical hunger, in their program and 1988 book, Overcoming Overeating. Oregon psychologist Nancy Barron founded and ran Ample Opportunity, a size acceptance organization for women which promoted active living, and published Ample Information. Their motto was, “A good life is the best revenge.” Psychologists Esther Rothblum and Laura Brown published Overcoming Fear of Fat, originally published as Women & Therapy in 1989, and including a chapter by Barron. The publication targeted fat oppression, rather than fatness, as the problem.

Budding psychologist Deb Burgard started a fitness program for larger women, called “We Dance,” in the early 1980s. Soon after, she met Pat Lyons, an RN and health educator who was researching fitness for larger women, and would go on to run the “Great Shape” fitness program for Kaiser Permanente. Lyons and Burgard published Great Shape: The First Fitness Guide for Large Women in 1988.

Lynn Meletiche, RN, NAAFA’s medical advisor, wrote the Declaration of the Rights of Fat People in Health Care in 1988. It included the right “to refuse participation in weight loss programs of all kinds, including diets, surgery, aversive psychological conditioning, and chemical regimes, without jeopardizing access to other treatment and care.”

References

(1) Shadow on a Tightrope. San Francisco: Spinsters/Aunt Lute Book Company, 1983.

Atrens, D.M. (1988). Don’t Diet. New York: William Morrow and Company.

Bennett, W. and Gurin, J. (1982). The Dieter’s Dilemma. New York: Basic Books, Inc.

Brown, L.S. & Rothblum, E.D. (1989). Overcoming Fear of Fat. Binghamton, NY: Harrington Park Press.

Ernsberger, P. & Haskew, P. (1987). Rethinking Obesity: An Alternative View of its Health Implications. The Journal of Obesity and Weight Regulation, 6.

Groger, M. (1983). Eating Awareness Training. New York: Summit Books.

Hirschmann, J.R. & Munter, C.H. (1988). Overcoming Overeating. Reading, MA: Addison Wesley. Hutchinson, M.G. (1985). Transforming Body Image. Freedom, CA: The Crossing Press.

Lyons, P. & Burgard, D. (1990). Great Shape: The First Fitness Guide for Large Women. Palo Alto: Bull Publishing.

Polivy, J. & Herman, C.P. (1983). Breaking the Diet Habit. New York: Basic Books, Inc.

Schwartz, B. (1982). Diets Don’t Work! Houston: Breakthru Publishing.

Tagged: aldebaran, alice ansfield, ample opportunity, dale atrens, Deb Burgard, Ellyn Satter, esther rothblum, fat acceptance, fat is a feminist issue, fat underground, great shape, HAES, health, Health At Every Size, healthy weight journal, healthy weight network, Judy Freespirit, kim chernin, Lynn McAfee, NAAFA, nancy barron, national organization to advance fat acceptance, overcoming fear of fat, Pat Lyons, Paul Ernsberger, paul haskew, radiance, transforming body image, vivian mayer

5 Ways to Improve Your Online Fat Hating

2013-06-11T08:10:45Z

Those who have the audacity to suggest that fat people are human beings who deserve to be treated with basic human respect tend to be the recipients of plenty o’ hatemail. I don’t know about the rest of you, but I often feel like my haters aren’t reaching their full potential, so I thought I’d help out. Here are 5 quick and basic tips to improve your online fat hating:

1. Lose and Loose – learn the difference. Lose is a verb that means to suffer the loss of. Loose is an adjective that means the opposite of tight or constrained. They are not interchangeable. Here’s a sentence to help you out: If one more person e-mails to tell me I need to loose weight, I’m going to seriously lose my temper.

2. Speaking of spelling, cunt is spelled C-U-N-T. The number of times I’ve been called a fat cnut is absolutely staggering. Apparently I’m not the only one, Clever Pie covered this issue in their fabulous song ‘Thank You Hater.” I’m just saying that if you’re going to use your precious, limited time on earth to send me an e-mail calling me names, at least take the extra three seconds to spell check that shit.

For the record I don’t feel any need to apply my grammar/spelling criticism consistently. I make plenty of grammar and spelling errors myself. If someone is trying to engage in actual conversation then I don’t care at all about their grammar and spelling. If someone is writing me for the purpose of spreading hate or attempting to make me hate myself, then I reserve the right to be offended that they didn’t at least take the time to use the spelling and grammar check.

3. Calling me a landwhale. I don’t mind this per se, I’ve even seen some pretty decent photo shop combinations with my body and a whale’s head, I am always impressed that someone took that kind of time on me. The thing is, there are fat animals that live on land and I feel like they’re not getting their due. There is just no need to make up animals when you could call me an elephant, hippo, or rhino. Or, go the extra mile and do some research (I mean, do you want to be just an adequate hater or do you want to really excel?) Did you know that the Formicium giganteum was an ant that was HUGE by ant standards – larger than a hummingbird. So you could call me Formicium giganteum or, since we know that spelling isn’t your strong suit, just call me Formi!

4. If you are going to make an impassioned and/or indignant assertion that you are just doing this to help me (incidentally I think that I’ll know when you’re being helpful because I’ll actually feel helped, but that’s a blog for another day), if you want to try to make the claim that you are somehow doing this for my own good, you might want to take a pass on mocking me for doing the very things you say I need to do – find a way to keep yourself from photo shopping a whale’s head onto a picture of me exercising, somehow find the restraint not to post videos of me dancing and then mock them. I’m only telling you this for your own good, since otherwise people are going to assume that you are a massive jackass.

5. Finally, the way that you are able to e-mail me and say “Ragen, You are a fat landwhale cnut who needs to loose weight,” attaching that picture you spent so much time photo shopping, is because I put my e-mail, picture, and name on this blog. Even knowing that I’m going to suffer abuse from bigots, I put my name on what I write. So if you’re going to sign that e-mail swolebro or whatever anonymous thing you use, then you are a coward. You can fuck right the hell off, at the very least until you locate your guts.

So there it is, a little dose of fat hater community service from danceswithfat. Those of you with your own haters know that there are many more areas for hater improvement, but I thought we’d start with the basics today and leave the rest for another time.

Like the blog? Here’s more of my stuff:

Become a member: Keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here for details

Dance Classes: Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details

About great achievements.

2013-06-11T00:05:43Z

Sometime after I earned my first Master's degree in Education, I had a thought. Here I was achieving a graduate degree that only about 8 percent of the US population have done. My thought was I could achive this, so why can't I be thin? After all there only about an 8% chance of losing weight and keeping it off, why should it be harder than getting a master's degree?

My first Masters had been difficult. I twice thought about dropping out. I got two low grades, I had second thoughts about going into teaching and later it turned out the thesis adviser was barely letting anyone graduate (She was eventually replaced and I finally finished.) Writing the thesis itself took all my free time and I lived in the library.

But all I thought about after this incredible accomplishment is why I couldn't get thin.

The first degree was a nightmare. I ended up never using it. I really didn't like teaching and I had trouble finding work.

So I got another Master's degree this time in Library Science. Getting was much smoother than the first one. When it was time to do my thesis, I was ready. I found two partners who wanted to finish in one semester. We all worked full time. So every single weekend and some weekday nights the three of us would hole up in a study room at the library and work on our research for hours. Imagine that, having the discipline to give up weekends (at the time I was recently married) to finish this paper.

During this degree, I was a "successful" dieter. I had being doing a low carb diet for almost a year, I had lost 40 pounds and kept it off. Eventually I stopped losing and started gaining. But for a while I thought I had it all: the education, the husband, and the weight loss.

Recently a visiting NYU professor tweeted: Dear obese PhD applicants: If you don't have the willpower to stop eating carbs, you won't have the willpower to do a dissertation.

The tweet was taken down quickly but the damage was done. The "professor" had to quickly backtrack his words, probably fearful of losing his job.

It's funny of all the unwarranted dieting advice he signalled out that fat people cannot stop eating carbs. Earlier tweets indicated he is a fan of the paleo diet fad (I can write an entire blog post about how incorrect it is and how our Paleo ancestors ate mostly vegetarian.)

I have previously written that when I gave up carbs completely, I got very ill. Even in the earlier low carb diets I did where the carb count was higher, I had heart palpitations, reflux disease, constant thoughts of food, dreams about cheating. I became pre-occupied with food, always thinking about the next meal. It turned out that low carb dieting is yet another low calorie diet.

I have to wonder how I managed to find the strength and discipline after all this dieting to finish two masters degrees.

And if you want to see more fabulous fat people with advanced degrees, click here.

Introducing . . . Fatshionable Apples!

2013-06-10T18:03:01Z

Hi everyone!

I hope you’ll take a moment to check out and follow my new tumblr “Fatshionable Apples.”

I started this tumblr because (a) I love clothes, (b) sometimes finding clothes and figuring out what to wear is especially hard for us “apple shaped” types and (c) I noticed that whenever I posted pictures of myself in various outfits on my Body Love Wellness facebook page, people really seemed to like it.

But I definitely do not want this blog to be all about me or pictures of me. That’s why I want you to send in your pics and tell me about your favorite outfits.

I love fatshion for fatshion’s sake, but I also love creating a space where other apple shaped fat folks can get inspiration for fat visibility. It isn’t always easy to be fat and visible, and I want to make it a little easier. I want folks to see this tumblr and think, “If this person can wear this awesome outfit and do this or that, so can I!”

With love,

Golda

Introducing . . . Fatshionable Apples! originally appeared on Body Love Wellness (http://www.bodylovewellness.com) on June 10, 2013.

Is Inhaling Alcohol the New Pregnant Woman Pee Cure for Fatness? (God, I Hope Not)

2013-06-10T15:41:35Z

Trigger warning: Discussion of idiotic weight loss technique.

I came across this article on CNN today. Here, let me give you a block quote. The emphasis is mine.

Nearly a decade later, clinicians are seeing evidence that the practice is gaining some traction — and not just among college kids and adolescent risk takers. It’s popular among people who want to lose weight and don’t want the calories that come from consuming alcohol. “People think it is a great way to get the effects of alcohol without gaining the weight because alcohol has an enormous amount of empty calories. You can’t be ingesting a lot of alcohol if you’re on a diet and want to lose weight,” says Dr. Deni Carise, the deputy chief clinical officer at CRC Health Group, a treatment- and educational-program provider for individuals struggling with behavioral issues, chemical dependency and eating disorders. “I think adolescents are also particularly susceptible to this because it is novel and exciting.”

So what’s so popular with people who want their buzz and their diet, too? Inhaling alcohol. Apparently this involves a fancy contraption or, if you’re more resourceful, either pouring it over dry ice and inhaling the fumes or using some Willy Wonka-like contraption involving a bicycle pump and a cork. You get the unmetabolized, pure effects of the alcohol with zero calories because it never hits your stomach.

Of course, you might also die.

Because we humans, we’re good at measuring with things like a glass or a bottle, but fumes? How do you know how many fumes you’ve inhaled from that bicycle pump? And without the liquid part of the alcohol, your body’s natural defenses against poisoning yourself with too many martinis are bypassed — you can’t puke if you haven’t put anything in your digestive system.

Also this:

“It’s also terrible for your lungs and nasal passages,” says Carise. “Your lungs are not meant to inhale something that can turn back into a liquid. When you think of liquid in the lungs, you think of drowning.”

Did you get that? The fumes could turn back into liquid alcohol. In your lungs.

I would assume that some risk-addicted kids are trying this just to be cool (if the cool kids were all drowning themselves in vodka fumes, would you do it, too?) or for the added high of getting drunk fast and flirting with death, I guess. But it’s particularly disturbing to me that this has started to catch on as yet another crazy, dangerous way for people to try to avoid The Fat.

The anti-fatty concern trolls are so worried about the health risks of being fat, but maybe they should think for a minute about the health risks of the insane things that people will do to avoid being fat. Or rather, to TRY to avoid being fat. People inject themselves with the urine of pregnant women, have things sewn onto their tongues, remove big chunks of vital internal organs, put themselves on a liquid diet that involves tubes up the nose 24/7 — there are people who will literally do anything to not be fat.

That article quotes a man who lost 80 pounds by giving up liquid alcohol in favor of fumigating himself. Maybe his risk of diabetes or heart disease is somewhat diminished (and maybe not), but he’s taking the risk of either drowning in reconstituted beer or killing himself with an alcohol overdose every time he wants a drink. What kind of a trade off is that?

If we catch up with that man in five years, will he still be 80 pounds lighter? Will he still be alive?

Do not inhale liquor fumes. I shouldn’t even have to tell you that.

Filed under: DT, FH, Media Monday, WL

Fatty Was Here and Still Is

2013-06-10T08:10:04Z

We’ve started watching a television show called “I’m Alive” about people who have survived wild animal attacks. It’s the kind of show where they mix interviews with re-enactments. I became aware of something super cool – in the re-enactments they really work to use actors who look like the actual people including their weight. So if someone in the actual situation was fat, so is the actor who plays them. I’m seriously excited about this, since I rarely see people who look like me represented on television. I even e-mailed Animal Planet to thank them (comments@animalplanet.ca).

While I’m excited and I celebrate the victory, it also brings the issue of fat representation into sharp relief for me. I read a quote today from Junot Diaz: “If you want to make a human being into a monster, deny them, at the cultural level, any reflection of themselves.” That is exactly what is happening to fat people right now.

Fat people rarely see ourselves represented in the media as anything other than a body without a head meant as a cautionary tale. Fat people are as different as any group of people who share only one characteristic and yet we see almost no evidence of that in popular culture, and in many cases we see the exact opposite.

First and foremost is the War on Obesity. I think the clearest way to see the issues with the war on obesity is to notice that a common and popular way for politicians to gain favor among voters is by promising to eradicate everyone who looks like us. There are major problems with the way that the “cost” of fat people is calculated but the biggest problem is that the cost is calculated at all. There is nothing ok about finding a group of people who can be identified by sight, calculating their supposed cost on society, and using those calculations to call for the eradication of everyone who shares that single physical characteristic.

Then there is the myth that showing fat people being successful at anything other than weight loss is “promoting obesity.” This is among the most ridiculous things that I’ve ever heard. As if someone will see me dancing and think “I wish I could dance like that. I guess I’ll gain up to 300 pounds and then go from there.” It’s insulting to my years of hard work and training, and it’s insulting to others’ intelligence. Like it’s the new V8 commercial: millions of thin people, who see the same 386,170 negative messages a year about fat people, will see one of us being successful in some way, smack their foreheads and say “I coulda been fat!” The end result of this is that fat people are robbed of both representation and role models.

And so we are made monsters – blamed by shocking shoddy research for everything from workplace costs, to healthcare costs, to fuel usage; unwilling combatants in a war by which the government seeks our eradication, preyed upon by a $60 Billion industry that sells snake oil in the promise of weight loss that will cure our social stigma by working the wrong end of the problem.

I think it’s fantastic when someone outside the fat community reads my work and gets something out of it, sometimes I get e-mails from people who tell me that my blog has helped them identify their own fat bigotry and I’m always happy about that. My focus, though, is that fat people knowing and remembering that we have the right to exist, that hating our bodies is not compulsory, that we are not required to be complicit in our own eradication, that we are the best witnesses to our experience and that we can demand to be treated with respect.

Sometimes I wish that I could put on some sort of fatty tent revival, I’d call it Fat, Fat, Fat Fest and travel from city to city and set up a huge tent, gather all the fatties that I can and have speakers, poets, and all manner of fat performers who help fat people know they have options, to let them see people who look like them being happy and successful (with their heads attached), to see people who look like them who love and appreciate their bodies and reject our culture’s fat bigotry and claim and own their right to life, liberty and the pursuit of happiness. You know, if I start now it could be my project for next summer….

Like the blog? Here’s more of my stuff:

Become a member: Keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here for details

Dance Classes: Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details

Update alert

2013-06-08T19:17:42Z

Whaliam here. I just updated the theme of this blog, from grid to . . . I forget what the new one is called, but it looks somewhat like the old one. The problem with grid is that it didn’t show the author’s name. The new one does that, but is a bit less compact looking, and doesn’t show the blogroll. So I’m not sure that I’ll keep it. Any suggestions?

Feelin’ Good

2013-06-07T22:36:12Z

I’m in a much better place, mentally, than I thought possible, all things considered. I’ve had such massive waves of insecurity I sort of worried if I’d ever feel like “me” again. But I do and here I am and I’m okay. Actually, I’m a little better than okay today. I’m feeling pretty dang good, both mentally and physically.

Wednesday evening I was taken on an impromptu date to Taco Bell by my BFF P! We randomly wore the exact same color palette (black and red, yo!) and went back to his for fun cocktails and awesomely bad movies. He and I hadn’t hung out just the two of us in years and oh how I loved every minute of it! (We are also starting a movie review YouTube channel, so stay tuned for the hilarity!)

Yesterday…ahhh! Yesterday was sublime! (I don’t know that I’ve used that word much in my life.) The bf took the day off to spend with me and I felt like the luckiest girl in the world. We did so many fun things! My favorite though was going to Nickel City! It’s this arcade sort of place, but it’s all run on nickels ($2 admission) and a lot of the older arcade games are on free play (Tetris anyone?!). Ohmigosh! So much fun! We won a bunch of tickets from various games and cashed them in for a Spongebob puzzle and a couple of matching, silver, plastic dollar sign rings. It’s silly and tacky and hilarious and I think I’m in love with this ring! I want to wear it always! Mostly it was just lovely to spend so much time with someone I, well, want to spend all my time with. Ha-ha!

I went to bed smiling last night and woke up that way as well. It’s hot out and the birds are singing and I slept gorgeously (so needed). I randomly decided to wear this Torrid top I’d bought at least five years ago. I love this top, but have never worn it. I always put it on, then freak out about it and put on something else before going out. Ugh! It’s so pretty and I always thought I could wear it confidently, but that hasn’t been the case. I thought I could pair it with a smart shrug or something, but let’s face it, when it’s hot enough to wear this kind of top you’re so not wanting to layer it. Ugh! But today I felt great and it’s hot out and I thought, “Fuck it! I’m doing this thang today!!!” and so I did!

(Sorry, couldn’t get a full body shot, plus I’m just in my undies right now. Ha-ha!)

And a side note here, can I bitch for a moment about my Sally Hansen Gel manicure thing? Ugh! I’d wanted this thing for awhile and finally found a new one on eBay for a steal. I realize I didn’t pay full price, but I was excited to use this product. It claimed a long lasting (2 weeks) chip resistant manicure. ONE DAY!!! It last one fucking day! First thing yesterday on nail entirely peeled off (see pic above)! WTF?! The rest are all chipping and catching on everything. I’ll be taking it all off today, but seriously this is some bullshit! 1-2 days versus two weeks?! Not cool! I do not recommend this product at all. I expect more from Sally Hansen (for some reason) and cannot believe how much they’re charging (retail) for this crap. Ahem. *StepsOffSoapBox*

So, yeah, I’m feeling pretty good. Going to stay in today until it cools off. Have many jobs to apply to anyway. I’m waiting to hear back about my unemployment claim. Fingers crossed. I hope you all have a lovely weekend!
<3
S

Two Steps Forward —

2013-06-07T16:29:35Z

I’ve said it before and I’ll say it again: there are signs of social progress in the War on Fat if you’re looking for them.

Today, Erin reminded us of Geoffrey Miller’s douchetastic tweet on the inability of fatties to willpower their way to a PhD. This was followed by deleting his initial comment and excusing his asinine response by claiming that the original tweet “does not reflect my true views, values, or standards.”

Miller’s right. What kind of asshole assumes that the things we share on Twitter are a reflection of our true views, values or standards? Being an evolutionary psychologist, Miller’s most recent experiment was to give a thousand monkeys a thousand iPhones, and this is just one of the many unfortunate tweets he’s sent out in the name of science.

Setting aside the unintended bigotry of a thousand monkeys, there is much to celebrate about this moment.

First and foremost, Miller’s near-immediate deletion reveals an immediate sense of remorse. Now, that remorse may have been driven by his internal sense of shame (unlikely) or it may have been driven by his recognition that saying something so blatantly bigoted against fat PhD candidates might harm his own career.

Miller may have realized this latter possibility himself, or one of his colleagues or superiors may have informed him that saying such unfounded, ignorant nonsense could cost him dearly. But the fact that the tweet came down almost immediately shows that at least among academic circles it has become anathema to be openly shitty toward fat people. For further proof, check out the brief, but satisfying response from University of New Mexico’s Psychology Department Chairwoman, Professor Jane Ellen Smith.

At the end, Prof. Smith mentions Miller’s bizarre assertion that his tweet was part of some brilliant social experiment to see how people respond to “provocative tweets.” And yet, as several people pointed out in the YouTube comments, performing such an experiment probably requires an application to UNM’s Institutional Review Board.

UNM has an interactive Adobe Flash FAQ that helps researchers determine whether their research project requires an IRB review. The FAQ defines some terms, such as Human Subject Research:

A living individual about which an investigator (whether professional or student) conducting research obtains
a) Data through intervention or interaction with the individual, OR
b) Identifiable private information

The FAQ goes on to outline projects that should be reviewed by the IRB:

A project may require IRB review if it involves any of the following:

Systematic investigation designed to develop or contribute to generalizable knowledge
Obtain information about living individuals
Involve intervention or interaction with individuals
Obtain private and individually identifiable information
Research is conducted or supported by HHS or is covered by an application PHRP approved assurance

If Miller consulted the IRB, it should be easily discovered, but if he didn’t check with the IRB before conducting his social experiment, then even this weak excuse can lead to further trouble. My hope is that Prof. Smith will indeed follow up with a thorough investigation to determine Miller’s qualifications as a professor.

What this suggests to me is that Miller is desperately trying to transform his tweet from impulsive and ignorant into a carefully crafted academic exercise. But if Miller’s whole point was to be intentionally provocative and gauge the response, then why delete the tweet? Clearly he provoked people on Twitter, which was the whole fucking point, right? His experiment has been a rousing success!

This is the other hopeful sign I see in this incident: simply deleting the tweet and saying you’re sorry isn’t enough. In this particular case, fat hatred is not being treated as “just words.” Covering his tracks didn’t protect him. Now, Miller has to justify his words by making them seem like they’re part of some non-douchey plot to study our response to douchebag comments. That’s an airtight alibi if I’ve ever heard one. Hell, if only Miller’s “impulsive” tweet on poor impulse control had happened a few days later he could have blamed it on the NSA’s PRISM program.

Think back just five years ago: would Miller have caught as much flack as he did this week? Personally, I doubt it because there would not have been the public pressure to hold Miller accountable. Prof. Smith said that what brought this incident to her attention and what made her look into it were the emails she received from ordinary people.

This is progress.

This is hope.

This is change.

Perhaps it’s not the most glamorous payoff given the cultural groundwork that’s been laid by Fat Acceptance for decades, but it is a minor, yet gratifying, step in the right direction.

Filed under: DW, Fabulous Friday

Yet another chance for activism — Too fat for a PhD

2013-06-07T14:41:00Z

Ah yes, the elitist asshats who seem to think that fat = gluttony. Don’t believe the hype, buddy, don’t believe the hype. This time we have the ivory tower type of dickweed, Mr. Geoffrey Miller, a tenured professor at the University of New Mexico and who is teaching at New York University’s Stern School of Business.

On June 2, he tweeted the following:

It was quickly deleted, but the damage was done nonetheless. People online, especially social media activists, were calling for his job within hours.

Accused of fat-shaming, Miller has since backtracked on his statement multiple times and ways. First he was sorry, then he didn’t mean it THAT way. Finally, reportedly claims the tweet was part of a social research project he was doing.

“My sincere apologies to all for that idiotic, impulsive, and badly judged tweet. It does not reflect my true views, values, or standards,” Miller wrote on Twitter, according to The Atlantic. “Obviously my previous tweet does not represent the selection policies of any university, or my own selection criteria.”

According to the New York Observer, Miller will keep his job teaching at NYU, but his future at UNM is less certain.

“We are deeply concerned about the impact of the statement, which in no way reflects the policies or admission standards of UNM,” UNM said in an official statement issued on Monday. “We are investigating every aspect of this incident and will take appropriate action.”

There are two things we as activists and all around radical educated fatties can do to help.

Lonie McMichael
PhD, Texas Tech University

The first is an email campaign. Virgie Tovar brought it to my attention over at Facebook. It began as a phone-in campaign to UNM. She did so before I could get to it and let us all know of her semi-failure. She posted, “Called UNM to lodge complaint. It seemed they were not surprised! Receptionist recommended emailing chair: janellen@unm.edu.” That is the chairperson of his department. I’m sure a few thousand emails her way will at the very least make having him be an employee a hassle.

Cat Pausé
PhD, Texas Tech University

The second bit of activism you can do works only if you are a PhD. If you are, do us a favor. Take out that picture of your diploma, of you graduating, and publish it on Fuck Yeah Fat PhDs! That way we can PROVE to Miller, and every other elitist ivory tower asshat, that we’re fat, we’re smart, and we DO exist.

Filed under: DW, Frank Friday

The Lie of Just the Way It Is

2013-06-07T10:41:35Z

I got an e-mail today about the blogher Fat Talk survey results. I would first like to say that I wish they would say “negative body talk” instead of fat talk so as to avoid piling more stigma onto people who are fat. But that’s another blog. For now, I’m just going to refer to it as negative body talk.

I wish I were more surprised by the results. Seventy-four percent of women, across all age groups, engage in negative body talk. When asked why women engage in fat talk, answers included:

Because most women are not happy with their bodies.

In some ways, it’s bonding over a common interest. We all have things we don’t like about our bodies.

It’s the social norm. Sadly, it’s just part of life.

That reminded me of the blogger who is supposedly a health and beauty expert who, discussing her feelings toward her body said “And I’m female so I’m never happy!”

While a case could be made that negative body talk is currently a part of life, let me suggest something:

It doesn’t have to be a part of life. We do not have to talk badly about our bodies. Ever. We can simply stop. Maybe we’re not in a place where we love our bodies yet, maybe we aren’t interested in the concept of loving our bodies. But our bodies push air in and out of our lungs, blink our eyes, beat our hearts, and we do not have to talk badly about them as part of some horrible social norm. Many of the functions of our body are autonomic, but the way we talk about them is not.

We are each absolutely allowed to speak poorly of our bodies if we choose. But when we buy into the belief that negative body talk is some sort of unavoidable part of life, we are buying into a lie that has been foisted upon us and perpetuated by those who profit from it, whether it’s monetarily, socially, or emotionally. They are asking us to hate ourselves for their benefit. We do not have to oblige.

Of course this is easier said than done. We have been and continue to be absolutely indoctrinated with the idea that engaging in negative body talk is natural and normal, and that sucks and it’s not fair. But we are each the only person who can decide how we talk about our bodies. Women have everything that we need to end negative body talk- we can simply refuse to do it. We can refuse to talk badly about our own bodies, and we can refuse to talk badly about other people’s bodies. Nobody is obligated to do this, but it is an option that is available to all of us.

Of course it may take some, perhaps a lot, of work to kick the negative body talk habit- especially if its become ingrained. But I submit that it may be well worth the effort. I understand that for some people positive body talk feels like bragging so I’m not even suggesting that – that’s a blog for another day.

All I’m suggesting is we simply stop talking badly about our bodies. I’m suggesting that we can become conscious of our thoughts and words about our bodies and interrupt and redirect them. In the beginner version you just stop yourself and start thinking or talking about something else. In the intermediate version you might replace them with a simple thank you to your body. In the advanced version you state your intentions and then do either the beginner or intermediate version.

Here are sample scripts to get you started:

Beginner Version:

Ugh, I just feel so ugl….how about that local and/or college sporting team?

Tell me about it Pam, my stomach..Hey I meant to ask, did you see Michelle Chamuel on The Voice last night?

God I totally hate my… hey look, bundt cake! (Points for the knowing the movie reference)

Intermediate Version

Ugh, I just feel so ugl… hey body, thanks for breathing, you are kicking ass at breathing and I really appreciate it!

Tell me about it Pam, my stomach… Wait, have you ever thought about how much our bodies do for us? I think they deserve some love.

God I totally hate my…actually, I really appreciate my butt because if I didn’t have a butt where my butt is supposed to be, that would be very inconvenient. So thanks body, for having a butt where my butt’s supposed to be, rock on.

Advanced Version

Ugh, I just feel so ugl… No, I’m not doing this anymore. How about that local and/or college sporting team?

Tell me about it Pam, my stomach…actually, I’m going to interrupt myself because I’ve decided that I don’t want to talk badly about my body anymore – it deserves some love.

God I totally hate my…fuck this body hating bullshit, rock on body.

Seriously, you could make the decision, right now – right this second – that you are done with negative body talk. And then you can make it happen.

Like the blog? Here’s more of my stuff:

Become a member: Keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

The Book: Fat: The Owner’s Manual The E-Book is Name Your Own Price! Click here for details

Dance Classes: Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details

A Study of the Self

2013-06-07T04:45:28Z

Well hello! Welcome to the plethora of new readers I have gained recently. It’s so good to see that there are more people out there ready to think outside the dominant paradigm when it comes to bodies and weight.

Before I go on any further, a quick zine update – it’s shaping up nicely. I’m just waiting on a few artworks to come through, and then I can finish work on the layout, with production following after that. I shall continue to keep you all posted.

So today I want to talk about selfies. For those of you who don’t know, the word “selfie” is colloquialism for a self portrait, mostly these days taken by smart phone and uploaded to social media, like Facebook or Instagram. With cameras ubiquitous in phones, especially now that many have front facing cameras, and most of us having connectivity to the internet, selfies have become something of an everyday occurrence. I’m sure you’ve all seen one. If you haven’t, here’s one I took yesterday:

Freshly pink haired.

Selfies get a lot of criticism. They’re considered vain, posing or childish. They’re ridiculed, especially selfies of women, and in particular selfies of fat women. I know mine get stolen off my various social media sites and posted other places for ridicule, because “OMG look at the gross fatty, she thinks she’s people!!1!”

But that’s not going to stop me doing it. People have been taking self portraits of themselves for centuries – be they photographic or other media. Do I need to list some names of some famous self portrait creators? Frida Kahlo. Van Gogh. Rembrandt. Da Vinci. Warhol. Basquiat. Vivian Maier. The list goes on and on, and right back through history. Have a bit of a Google around and you’ll see everything from the brutally critical to the utterly whimsical.

Self portaits and self examination are important and powerful. There are several reasons why I take and share selfies.

Until a few years ago, I never allowed anyone to take photos of me. I was so used to being shamed by people for my weight that I believed I wasn’t worthy enough to be seen in photographs. Now I’m proud of who I am and am happy to participate in photographs (with my consent – taking photographs of me or anyone else without our consent is douchey, don’t do it) and part of that is from playing around with taking photos of myself.
I don’t see people who look like me in the media. Fat women are not represented in the media, unless it’s to vilify us. We’re not represented anywhere in a positive light unless we represent ourselves. As Junot Diaz wrote “If you want to make a human being into a monster, deny them, at the cultural level, any reflection of themselves.”* If posting my selfie on my Tumblr or Twitter or blog gives someone like me some representation, as a fat woman, then it’s worth it.
Looking at yourself a lot from different angles and in different lights and colours helps you remove self criticism. If you never see yourself, you never see yourself as “normal” (because as my dear friend Ian always says, “Normal is what you are.”), so seeing yourself helps you get used to yourself. I’ve found I’m far less self critical since I’ve been taking selfies than I was before.
My friends near and far like to see me. They like to see what my new glasses look like, or what colour I’ve dyed my hair, or just to see my face. Just like I love to see them.
It’s valuable to have a record of yourself through your life. It’s healthy to look at how you change and grow through your life. I look back at old selfies and I realise how far I have progressed in life, both externally, in things like my job and where I live and things like that, but also internally, how I feel about myself and how I present myself to the world. Selfies tell my story.
Because I discovered, on regular self examination in my self portraits, I’m kinda fucking awesome.

Self portraits, be they taken seriously with skill and care, or a spur of the moment capture of yourself for fun, are part of being human. Since we first worked out how to scratch on a rock face or in the dirt while looking at our reflections in water, we humans have been taking self portraits to tell our stories, to examine ourselves, to share with our loved ones, or just for fun. It’s not vanity to want to see yourself represented, either just for yourself, for those around you or in the world at large. It’s part of marking that you are a member of humankind.

Have fun. Pose. Share them with your friends or share them with the world. Get used to seeing yourself. Find your own awesomeness.

*Thanks Lonie for posting this one on FB this morning and reminding me of an awesome quote.

Filed under: photographs, representation, self esteem, self portraits, self reflection, selfies

Adipositivity 609

2013-06-06T10:42:06Z

Adipose: Of or relating to fat. Positivity: Characterized by or displaying acceptance or affirmation. MISSION: The Adipositivity Project aims to promote size acceptance, not by listing the merits of big people, or detailing examples of excellence (these things are easily seen all around us), but rather, through a visual display of fat physicality. The sort that's normally unseen. The hope is to widen definitions of physical beauty. Literally. The photographs here are sometimes close details of the fat female form, often without the inclusion of faces. One reason for this is to coax observers into imagining they're looking at the fat women in their own lives, ideally then accepting them as having aesthetic appeal which, for better or worse, often translates into more complete forms of acceptance. The women you see in these images are educators, executives, mothers, musicians, professionals, performers, artists, activists, clerks, and writers. They are perhaps even the women you've clucked at on the subway, rolled your eyes at in the market, or joked about with your friends. This is what they look like with their clothes off. Some are showing you their bodies proudly. Others timidly. And some quite reluctantly. But they all share a determination in altering commonly accepted notions of a narrow and specific beauty ideal. Bookmark adipositivity.com and check back often, as new photographs are added regularly(ish). And please help spread the message. The Adipositivity Project: Changing attitudes about the aesthetic validity of big women, one fat fanny at a time. ABOUT THE PHOTOGRAPHER: Substantia Jones’ photography has been exhibited in galleries and museums throughout the US East Coast, and has appeared in The New York Times, Time Out New York, and some other publications she can’t recall at this time, but you probably haven’t heard of them anyway. She is biographied in the 2006 Who’s Who in America (though under the name her momma gave her), and back in the day, she won some photography awards which would sound somewhat Mayberry if listed here, but at the time, they damn near made her cry. Still kinda do. She lives in Manhattan, where she also sometimes steps out (more like lays around) in front of the camera, and on some of those occasions, the snapping is done by her trusty sidekick, Dr. H, who also fetches her banana popsicles and maintains her muse, a certain pancake colored dog who’s asked that his name not be mentioned on the Internet. Ms. Jones likes crispy calamari, Squidbillies, and the ika okonomiyaki from Otafuku in the East Village, if only the lines weren’t so long. Thou shalt not reproduce without permission. Except for babies. Make all o' them you want. © The Adipositivity Project 2007-2013

I don’t want to be one of “the cool kids”

2013-06-06T14:00:13Z

Yours truly.

I reacted to the recent Abercrombie & Fitch controversy not with anger, but with apathy. It didn’t surprise me that a retailer that prides itself on catalogs featuring half-naked teenagers who look like they stepped out of The Vampire Diaries wouldn’t want fat people, perceived as “uncool and unattractive,” as customers.

Personally, I don’t see wearing a $60 t-shirt with the letters A&F on the front as being the epitome of cool, but that’s why I’ve never been part of the in-crowd. And that suits me just fine.

When I was a teenager in the early ’90s, I got flak for listening to disco and oldies; for wearing capri pants before they came back in style; and for preferring Star Wars and horror films to Wayne’s World and Die Hard II. I guess you could say I was “pre-hipster.”

I took it all in stride because I liked what I liked, and that was that. I never had a desire to be trendy. So it’s amusing to me to see a grown man talk about only wanting good-looking people buying his clothes and working in his stores, when most of the people I see wearing Abercrombie & Fitch probably wouldn’t pass his “cool” test. And that’s probably more satisfying than forcing a company to make sizes past “athletic XXL” when it clearly doesn’t want to.

I don’t want to be one of the cool kids. I don’t need to be one of the cool kids. I just want to be me, who at 37, still listens to disco and oldies (with a little bit of dubstep thrown in), still wears capri pants, and still prefers sci-fi (although it’s changed from Star Wars to Doctor Who) and horror films.

There’s nothing wrong with wanting to be cool and wear Abercrombie & Fitch, but I think it’s a lot more rewarding just being yourself. And possibly a lot less stressful and costly as well.

Filed under: DW, FF, Themeless Thursday

Thanks for your donations

2013-06-06T12:40:00Z

This is just a very quick post to extend my heartfelt gratitude to those generous people who have made donations over the past few months. You know who you are.

The guardians of the anti-obesity world benefit from funding by weight loss multinationals and Big Pharma, and access to places where many people listen to them. Academics who bring a critical perspective to fat stuff have the financial support of their institutions. Grassroots voices, like mine, operate on very modest means. In addition, we are often required to take great risks in speaking out, and in bearing the brunt of the backlash. Many of us regularly get hatemail and are targeted by trolls.

Every donation, no matter how big or small, helps keep me going and is greatly encouraging.

If you would like to help support my work on fat, including the writing I do for this blog, please use the PayPal 'Donate' button at the top on the right of the screen.