Let’s back up for a moment to detail my reasons for drinking coffee. Reasons which, I think, probably apply to the vast majority of coffee-drinkers.

• I like the taste.
• I like the caffeine buzz.
• I like the ritual, and the emotional comfort of it.

You notice what’s not on that list?

Antioxidants.

That’s why it tripped me out to notice the big label on the can.

I mean, it’s been there a while. Sure, I’ve noticed it before. But I never really noticed it until that morning.

Inspired — and in a half-awake undercaffeinated haze — I decided to grab the nearest thing and look for a similar label.

Since we ran out of milk the day before, and since we drink Canadian-style wussy coffee (meaning with milk or cream, plus sugar — black coffee is an abomination unto the Lord and shall not defile this house), the nearest thing was a delicious powdered non-dairy creamer. Which we keep as back-up to avoid a potential coffee crisis.

(Priorities, people. We have them.)

So I grabbed it, and guess what?

CHOLESTEROL FREE, YO.

Which, you know, I suppose is useful information if you have significant dyslipidemia (that is, high blood cholesterol levels) and are sensitive to cholesterol in food (which not all people are, especially not at levels as low as a spoonful of cream or milk in your coffee. Saturated fat is now pretty well-known as the culprit in raising people’s blood cholesterol, and it’s been established that the dietary cholesterol panic of the 80s turned out to be misguided.)

The lactose-free label, well…I take no issue with that. It’s something useful to have, front and centre, if you want to expand your market to include the many folks wishing not to endure a torrent of gaseous mishaps in the course of enjoying their morning brew.

So, quick analysis, what’s up with these largely irrelevant labels on things? Especially things that I wouldn’t really think of as “food” in the first place, and which don’t contribute significantly to your total intake? (I mean, coffee is largely non-nutritive, and a teaspoon or two of fake coffee creamer is pretty damn close to non-nutritive. And, in any case, most people don’t drink more than one or a few cups of the stuff in a day.)

My hypothesis is that, rather than the default cultural attitude toward food and food-like substances being “it’s fine to eat this, and it probably has things in it which are good for me, or, at least, are not actively harmful” we’ve reached a point, collectively, where our default attitude tends to be, “Should I eat/drink/ingest this? Is it poisonous? Am I allowed?”

Coffee (and caffeine itself) has become a particularly loaded substance in certain dietary circles. When I was dieting, I also avoided drinking coffee…for no specific reason I’m aware of. Because it was The Thing to Do. Because coffee was vaguely regarded as A Bad, Unnatural Thing.

Part of the package of virtuous self-denial included giving up coffee (and diet soda, and and and…whatever not-particularly-harmful or not-particularly-nutrition-impacting thing someone enjoyed just for the sake of it. Because food had become a tool, and only a tool. Everything consumed required instrumental justification.)

That’s a whole lot of anxiety to carry around. Enough that it’s going to make you second-guess your habitual purchases. Which is not very good for the folks who sell instant coffee.

So, what can the food-industrial-complex use to smuggle its products through the barbed-wire fence of ambivalence erected by its twin sister, the diet-industrial-complex?

A label.

A label that, despite seeming to give you straightforward, useful information about antioxidants and cholesterol, is actually telling you, “Just this once, you’re exempted from guilt. You are granted permission to drink this coffee for Specific, Nutritional Benefits — not for the evil caffeine buzz, not for the comforting emotional associations. Not just because it’s enjoyable. Because it has antioxidants, and it’s cholesterol free.”

In short, it’s a Get Out of Jail Free card. From a jail I believe they helped build.

To you, the guilt-ridden consumer, from the food industry with love.

ETA: Awesome reader Bookwyrm made an equally awesome Get Out of Jail Free card. Read it and weep.

And telling people to eat whatever they want is…well, it’s incredibly controversial.

It’s just not done.

You know why I think it’s controversial? Not just because we live in a culture that’s messed-up, food-wise, but because we, as a culture, seem to take the worst possible view of human nature.

Let me explain.

It should come as no surprise to anyone reading here that our culture views food as a moral issue. A potentially dangerous moral issue. And, setting aside the very-interesting-but-not-to-be-had-right-now discussion of ethical and religious foodways, food just…isn’t.

Food isn’t moral. It’s not immoral, either. It’s morally neutral.

But, sadly, we live in a time and a place where it seems Twinkies = Eternal Damnation. (Notice, here, how the supposed moral value of food pretty snugly overlaps its supposed nutritional value. This is not a coincidence.) And we tend to take the most pessimistic view of human nature.

So, when I say “Adult human beings are allowed to eat whatever, and however much they want,” what people actually hear is: “GO OUT AND CRAM YOUR FACE WITH BAD, BAD TWINKIES!!!!!!”

I’m here to plead with you on this: first of all, people aren’t stupid. Please stop thinking that — it’s unkind and incorrect. Also, Twinkies aren’t bad. Even if they were, they couldn’t make you bad by association.

You know what else? This may come as a huge surprise, but if you’re willing to let go of those negative assumptions about human nature for one second, you might realize that pretty much no one wants to eat that way, anyhow.* Or not for long.

We’re animals, which means we’re pretty highly motivated to stay alive. We want to stay alive, okay? Which means means:

We want to be healthy.

We want to eat food that’s good for us.

Those desires, being tied to the ultimate desire — to survive — are pretty damn strong.

But you know what we want more than either of these? To be free. To not be told what to do. To not be bossed around as though we are perennially six years old. To not be manipulated, coerced, or condescended to.

Being un-free is a fate worse than death to an animal. It means either you will be killed, or you will be tortured and then killed, or your entire life and all of your efforts will be used exclusively in the service of someone else’s desires. And that service is probably going to be pretty unpleasant and continue indefinitely, until you die (see: tortured and then killed.)

Ever wonder why animals are willing to gnaw their legs off to get out of a trap? Why prisoners are willing to risk death in order to escape?

We’re all sensitive to threats to our freedom, even if, practically speaking, those threats don’t seem as bad as being trapped or imprisoned. We’re able to detect the merest whiff of a threat to our freedom, and we respond appropriately. To a strong and imminent threat, we’ll fight to the death. To a threat that’s just a whisper of a shadow of a threat, we’ll dig in our heels a little bit. Stop listening. Roll our eyes and take a step backward. Procrastinate.

In the case of rewards and punishments used to induce certain behaviours, there’s a distinct manipulation at work. Freedom is taken by force or given up willingly in exchange for some savoury reward. But, either way, it is lost, whether you gave it, or it was taken from you.

We don’t like this. Even if we think we do at the time. Even if we go along with it.

I won’t go off on my whole long tangent about intrinsic motivation again, except to say: there is a body of research showing that humans acting under the threat of punishment or the promise of reward do sub-par work.

Whether that work is solving puzzles or learning information or exercising and eating well, the fact that an external, overriding consequence is actually the driving force behind the behaviour — rather than one’s own intrinsic desire — means that that behaviour is not actually free. It is coerced and manipulated and induced.

And going through the motions in order to reach the carrot or escape the stick actually takes something away from the benefit of those motions.

Exercising to lose weight makes fitness not as fun or useful.

Eating to lose weight makes nutrition not as fun or useful.

And, when things are not fun (meaning, intrinsically rewarding), it’s pretty much guaranteed that you will stop doing them, rendering your time “on the wagon” pretty much a loss. Because you’ll lose whatever long-term, intrinsic benefits might have come from doing those things voluntarily.

Besides which, who wants to ride a shitty wagon that keeps throwing you off? You’re better off on foot. (Maybe rollerskates.)

So, when I say “Eat food. Stuff you like. As much as you want,” I don’t believe you’ll dive into a vat of Twinkies. Or, if you do, it’s only going to be to see what it would be like to dive into a vat of Twinkies.

I trust that you’ll climb your way out again.**

The bottom line is — freedom is important. In fact, it’s necessary. Without it, you can’t sustain anything that’s supposed to be good for you. Therefore, freedom is good for you.

And because I believe humans are reasonable beings who care about their own health and survival, I trust you to decide what you eat.

What if you’re not reasonable, and don’t care about your own well-being? Well then, my friends, not only is it still not my place to tell you what to do — telling you what to do wouldn’t fucking work in the first place.

Readers have been clamouring a bit for me to just tell them how to eat already. And while, yes, I have a very specific training and a very specific set of beliefs about how to approach food, my first job is to clear the slate, set aside all the rules we’ve been handed about food, and establish a foundation of trust — trust that I am not going to take away your freedom, or your food, even when I have suggestions about what might be a good thing to try.

Trust that, ultimately, you’re the one who must decide what to do.

So, in the service of that, I offer you this:

Far from being irresponsible, this is, in fact, the only unsolicited advice anyone has any business to offer another person.

And until you’ve accepted it as your irrevocable right as a human being, my opinions on nutrition don’t really matter much.

*Barring some kind of underlying medical condition or eating disorder, in which case a weight-loss diet is the last thing you need, anyhow.

Fucking artificial pancreas, my friends. This is the natural evolution of the insulin pump. I am wondering if eventually they’ll be creating an artifical pancreas that also secretes glucagon. I used to have these conversations with people at work, because do you know how many people we saw suffering from diabetes? And not just the high blood sugar, no no no, but more often, the low blood sugar. Which can kill you right away, at worst, or just make your life fucking miserable at best. Which the artifical pancreas seems to have reduced by half.

The not-awesome

Let’s define more Canadian kids as fat! Based on WHO standards that are not always appropriate for North Americans. And not at all in response to recent stats showing that the “obesity epidemic” among children has probably leveled off, thus causing people with a major financial stake in treating childhood obesity to probably shit themselves during their tortured night sweats. Nope, not at all.

Let’s use surgery to combat social stigma! Because reducing stigma itself wouldn’t actually, you know, make money for anyone. Because that would involve making physical objects more universally accessible and teaching people not to be so fucking cruel to people who don’t look like them. Instead, kids who’ve already survived brain tumours should probably just suck it up and have some more surgery.

Let’s pretend that sugary drinks cause pancreatic cancer! Except the researchers go on to say that the association only existed among people who drank soda pop, and likely because people who drink that amount of soda pop probably have other, not-so-great health things going on. People who drank other sugary drinks (i.e. fruit juice) didn’t have the same risk. Also? The study didn’t control for smoking. In case you hadn’t heard, smoking probably causes cancer. Lots of types of cancer. One of which is pancreatic cancer.

That sound you just heard was me smacking myself in the face and falling off my chair.

Do you think, perhaps, drinking soda pop could be associated with smoking? I don’t know. What I do know is, if I were researching the link between pancreatic cancer and sugary drinks, I’d probably fucking look into it.

When you needed food, you felt hunger, thought of food, and cried or reached out for it in one motion. There was no ambivalence, no questioning your own motives, no shame. You needed something — end of story. And if you were lucky enough, you got it.

I look back on the time I was dieting as a period of falling-out with my body. We fell out of synchronicity, and out of favour, with one another. We were no longer on speaking terms. And though the diet was a dramatic physical manifestation of the rift that had formed between my mind and my body, I believe the fault that led to the rift started much earlier.

The fault began to form when I started to feel the gaze around the age of 10 — when I began viewing myself from an external viewpoint, filtered through the preferences of my culture, and learned to continually measure myself against that standard.

The fault deepened when I first encountered food rules. Whether they came from the USDA or my parents or the school lunch program, the message was the same: there is predefined, normative standard for what and how much to eat. Any deviance from that standard leaves you vulnerable to criticism, ridicule, forceful re-education — possibly even social ostracization and loss of love.

In short, there is a right way to eat. Anything that doesn’t exactly fit that standard is, by definition, wrong.

Right is good; wrong is bad. And so, by extension, are you.

Ellyn Satter is probably most famous for her theory of The Division of Responsibility. It applies to feeding relationships between parents and children, and it states that while parents are in charge of deciding where, when, and what food to provide, children alone must be in charge of deciding how much and whether they will eat from what’s provided.

As the American Dietetic Association says:

Perhaps the best advice regarding child-feeding practices continues to be the division of responsibility between adult and child advocated by Satter (64). According to this division, the role of parents and other caregivers in feeding is to provide positive structure, age-appropriate support, and healthful food and beverage choices. Children are responsible for whether and how much to eat from what adults provide.

It’s a profound concept — one that successfully negotiates the gray area between guidance and control, autonomy and anarchy. And, as it turns out, it can be applied to any relationship where there is some kind of power differential.

The thing is, when you step all over someone’s autonomy — someone’s right to choose how much and whether — you have breached their boundaries, and you have done them violence. They may react to this by rebelling or, as in many cases of abuse, by taking on the role of doing that violence to themselves.

One thing is for certain, though, whatever the response: trust is lost.

A rift is established. Your mind and your conscious will, those parts of you that are indoctrinated into society, separate themselves from the rest of you — the body with its physical needs, the unconscious will and motives. The mind reins in the body to secure safe passage through society, and to synchronize its efforts with the larger body of humanity. The body is dressed, trimmed, made presentable, and its needs are secreted away in the private pockets of life.

Rules that attempt to tell us how much and whether (FIVE A DAY!!!) violate our boundaries. We, in turn, rebel in a desperate attempt to regain autonomy, while simultaneously learning to flagellate ourselves, to take on the role of the abuser in our own minds, and to view our behaviours from an external vantage point — the gaze that continually judges what we eat against our culture’s ideal of the mythical, perfect diet.

The mind has overstepped its boundaries, aided and abetted by cultural pressures. You begin to monitor your eating in ways that go beyond providing pleasurable food and adequate nutrition for yourself, beyond choosing and then respecting mealtimes. You count calories, or assign points. You deny pleasure, and embrace nutritionism.

You hush your body’s cries of hunger and fullness and desire until, eventually, you may find yourselves no longer on speaking terms.

Your artwork is incredible. Your Aunt Audrey arranged it, so it’s well displayed. Ironic that you get your own little exhibit. It tears me to pieces that this will be your only one.

[...] planning your funeral meant going back through old pictures and skimming your books and music, and it made me reconnect a bit to the Kelsey who was my daughter. I had, if I am being really honest, lost sight of that person. I saw Kelsey the Disease mostly this last year. But, I remembered who you really were over the last few days.

I remembered how you mentored a learning challenged child in your elementary class without anyone asking it of you. I remembered you getting tossed out of a friend’s house for cleaning his room (of course, I never forgot that one because I was upset with his mother). I remembered how when you were 9 or 10 we had to get gym shoes for you and you announced to me that you would not consider Nikes because they used child labor.

I remembered, painfully, I might add, how you held my head when I had morning sickness when I was pregnant with your sister. You gave me the biggest, warmest hug right before I went to the hospital to have her.

I saw all these pictures of you with your cousins. You loved them, it was so obvious. That is who you really were.

~Kelsey’s mom

I told her how she taught me so much about words and literature and the beauty of the written language…how she, almost single-handedly, made me want to be a writer.

I thanked her for always inspiring me, for teaching me all that she has, for sharing her knowledge and wisdom with me so that now I can go out in the world and be wonderful.

I told her I’m going to write a book about her some day…a book about sisters, about MY sister.

~Marissa, Kelsey’s sister

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]]> http://www.fatnutritionist.com/index.php/she-would-paint-on-anything/feed/ 5 http://www.fatnutritionist.com/index.php/she-would-paint-on-anything/ http://feedproxy.google.com/~r/TheFatNutritionist/~3/ZBPx9bD0od4/ http://www.fatnutritionist.com/index.php/iron-rich-clam-linguine/#comments Wed, 03 Feb 2010 21:21:32 +0000 Michelle http://www.fatnutritionist.com/?p=2404 So, after having a brief conversation about iron-rich foods on Twitter (as you do), and sharing the amazing revelation that canned clams are richer in iron, ounce per ounce, than the reigning King of Iron Richness — beef liver — I agreed to post my favourite recipe involving canned clams.

We eat this roughly once a week. It’s cheap, it’s easy and fast, and it tastes really good (in my humble opinion.) It’s a classic “shelf supper,” meaning all the ingredients can sit on the shelf for a while, so that you can keep it on hand for when things get a little too busy.

I originally got it from a lovely and wonderful Canadian cookbook called Pantry Raid. Which is entirely about shelf suppers (and desserts.) Which is, I’m sure you’ll agree, totally genius.

The original recipe says it serves four, but it also makes a nice all-in-one dinner for two hungry adults.

Here goes:

12 oz (375 g) dry linguine
1 can (19 oz, 540 mL) of Italian-style stewed tomatoes
1 can (14 oz, 398 mL) of baby clams
1 tsp. balsamic vinegar
1/4 tsp. each of salt and pepper
2 tbsp. finely chopped fresh basil (optional – or you can use a tsp. or so of dried basil, but the fresh basil tastes waaaay better)
1/4 cup grated parmesan cheese

Boil water for pasta. Meanwhile, bring tomatoes to a boil in a skillet over medium-high heat. Stir for 3-5 minutes, breaking the tomatoes up a little with your spoon.

Cook the pasta until al dente (usually right around 9 minutes for us.) While it cooks, drain the clams and stir into the tomatoes. Add the balsamic vinegar to the sauce, and let the sauce return to a boil. Then add the basil, salt and pepper.

When the pasta is done, drain and mix together with the sauce, cover with parmesan cheese and EAT.

According to the USDA nutrient database, the clams in this recipe alone should give you well over the RDA of iron. (And writing sentences like that is, without a doubt, the most boring part of my job.)

]]> http://www.fatnutritionist.com/index.php/iron-rich-clam-linguine/feed/ 27 http://www.fatnutritionist.com/index.php/iron-rich-clam-linguine/ http://feedproxy.google.com/~r/TheFatNutritionist/~3/EA1kdivDj0g/ http://www.fatnutritionist.com/index.php/some-lines-on-reading-a-weight-watchers-study/#comments Wed, 03 Feb 2010 00:29:18 +0000 Michelle http://www.fatnutritionist.com/?p=2170 So, the other night, I started reading this 2008 study, which looked at how well Weight Watchers Lifetime Members do at maintaining their weight loss for up to five years.

The first part of the paper, as usual, describes the set-up of the study, and the demographic details of the people who participated. This is a part of studies I always like a lot, because, if it’s an intervention study with both a treatment and control group, I like to see the wondrous effects of good randomization on the average profile of both groups. Because I am a nerd.

In this case, it’s not a treatment group vs. control group comparison, but a profile of your average Weight Watchers Lifetime Member, based on a nationwide sample. And here’s what we get:

(The red markings are mine.)

So, based on this sample, the average Weight Watchers Lifetime Member is a married female, 45 years or older, who started WW weighing 165 lbs. with a BMI of 27.6 (in the overweight range.) She has an income of at least $50,000 a year.

You probably already know that people with BMIs in the overweight range have the lowest relative risk of death:

Overweight was associated with a slight reduction in mortality … relative to the normal weight category.

…and that women tend to live longer than men:

Today, males have greater mortality than females throughout the world. The very few exceptions are in southern Asia where it has been demonstrated that females receive less food and health care than males. With relatively equal treatment, males universally experience greater mortality than females.

…and that people with more money tend to have better health:

The relationship between socioeconomic status and health outcomes is one of the most persistent themes in the epidemiological literature. The strong and growing evidence that higher social and economic status … are associated with better health has led most researchers to conclude that these factors are fundamental determinants of health.

…and that the average income of Weight Watchers Lifetime Members ($50,000 and up) is roughly at or above the median household income for the United States in 2008:

Median income (dollars) 52,175

…and that a higher BMI actually has a protective effect on mortality as people get older.

Which forces me to conclude that the people who become “successful” Lifetime Members of Weight Watchers? Not only are they not very fat to begin with, but also have few of the risk factors that contribute, systemically, to poor health and premature death.

So, for the purposes of this study, at least, we can dispense with the notion that people join Weight Watchers not to diet (since the word “diet” is now outré in diet advertising) — heavens no, but for the good of their health, darling.

One thing I dislike about nutrition is how often we discuss eating as though it’s something incredibly dangerous that people must do just right or risk INSTANT DEATH.

When society has become so risk-averse that we can’t even enjoy food, you know something is terribly out of whack.

Barring allergies, intolerances*, non-functioning organs, and foodborne illnesses, food isn’t going to hurt you.

Because food? Isn’t poison.

Even in those exceptional cases, it’s the microorganisms in the food, the immune response of the body, or the lack of some vital function that is to blame. Not the food itself.

The worst food-related thing that can happen to most people is not having enough of it. Or not being able to digest select types of it. Or somehow losing (through various bodily fluids I won’t itemize for you) what nutrients they do manage to take in.

That’s when people get very, very sick, because not only can not getting enough of a particular nutrient cause a deficiency, it can also cause you to get too much of another nutrient, since that’s the only one you’ve got handy.

Not having enough variety can make you sick. Not having clean, safe food can you make you sick.

In fact, plenty of non-foodborne diseases kill you by taking nutrients away from you. Cancer is one. Diabetes is another. Then there’s cholera and typhoid fever and all kinds of lovely things.

But food itself? Not inherently sick-making.

What else isn’t food? It isn’t medicine.

Eating certain types of it, or taking certain isolated nutrients, probably isn’t going to cure anything except an underlying deficiency.

But when does food masquerade as medicine? When you selectively take some of it away.

Taking food away is inherently risky, because your safest bet, mathematically, is to always get enough food with as much variety as possible. Selectively reducing that variety can cause nutrient deficiencies and excesses.

Whether you do it because you don’t have enough money, or because you’re just a picky eater who only eats the same six foods over and over again, or because of ethical or religious reasons, or because your doctor told you to, or because you’re trying to lose weight — selectively reducing variety carries an inherent risk.**

Fucking around with restricting your food intake, despite being treated by many people as a casual pastime, is not a totally benign endeavour.

It’s treating food like medicine, and medicine generally comes with side-effects.

Despite what the media and some healthcare professionals and the culture at large seems to think, humans actually have a finite capacity for consuming food.

Which is why it’s pretty rare that harm ever comes directly from eating too much food — harm usually comes from eating a particular food in such quantities that, by physical necessity, it displaces other foods that you need.

Not because that food is poison, or because you broke the universal law of How Much Should Be Eaten. But because you missed out on something else.

One of the riskiest things a dietitian can ever do to a patient is to take food away. It starts at a minimally risky, generally tolerable level with a mild therapeutic diet, and goes all the way up into the red at intravenous nutrition.

You only use intravenous nutrition when shit is seriously fucked up, and the patient can’t eat and absorb nutrients from the gut anyway. Why? Because it’s dangerous.

And why is it dangerous?

Because the patient is getting no food, which comes neatly packaged with enough inherent variety to naturally balance things out. Which means a dietitian had better do her math correctly, and better run labs on that patient constantly, to make sure nothing goes terribly wrong.

Can you get too much of a particular vitamin or mineral? Yes. But that’s not the same thing as eating too much food. If you have access to a decent variety of foods in adequate quantities, and your internal organs are more-or-less functional, it’s pretty fucking hard to eat enough actual food to give you a nutrient overload.

That’s why food, in most circumstances, is safer than taking supplements. Because there are built-in safeguards (distribution of nutrients in the food; nutrient density of the food; capacity of your own stomach) to keep you from fucking it up too badly.

If your body wasn’t adequate at regulating your food intake, and if foodstuffs hadn’t evolved that were good for humans to eat, we wouldn’t be sitting here in front of our computers in the year 2010.

We wouldn’t be alive to be as neurotic about food as we are. If food were poison, humans wouldn’t exist.

And I, for one, wouldn’t want to.

So, if food isn’t poison, and if it isn’t medicine, what is it? It’s food. It’s sunlight and air and soil and water and love, in edible form. It’s every creature that’s gone before you, and the thing you’ll be to those who come after.

It tells us we belong here — that we deserve to live, that we’re still here when we die.***

In short, it’s good. Food is everything that’s good.

*Which are very real, and very important, and you shouldn’t go around questioning people’s health conditions because it’s fucking rude.

As usual, the garden party will be held in comments. BYOB.

A study just published in the Australian and New Zealand Journal of Psychiatry found that adults who were bullied as children were more likely than others to suffer from depression and anxiety, as well as a host of physical ills, including fatigue, pain and a greater susceptibility to colds.

Parents also need to remember to help repair the damage that bullying does to a child’s self-esteem, says Pollack. “You need to tell the child that this isn’t happening because there’s something wrong with him.”

In short, if your kid is getting bullied for being fat, putting him on a diet probably isn’t the best way to handle it.

I don’t know about you all, but I’ve often picked up on this kind of cultural attitude that says, “Well, I was bullied at school, and it sucked, but that’s just the way it is and you have to learn to deal with it.” And that bothers me.

Why? Well, not discounting the fact that sometimes people can turn horrid experiences into valuable lessons for themselves later in life, I don’t think bullying accomplishes anything. I don’t think anyone needs to be bullied in order to grow into a productive adult.

And it’s hell to go through.

So, to me, the idea that because kids have always been bullied, they should therefore continue to be bullied and just put up with it, is bullshittery of the highest order.

Just…no.

Kids benefit from being with other kids, yes. And, yes, using the public school system is a necessity for most families.

But putting kids together in great enough numbers that they can’t be properly supervised? That’s asking for all sorts of Lord of the Flies shit to go down in the margins.

And not because kids are naturally evil, but because kids aren’t born civil and socialized. Just like puppies aren’t born knowing not to eat your couch, or not to pee in your shoes. It takes years and years of learning.

If you want kids to grow up to be well-socialized, to be good citizens and adults, then they need to have enough contact with well-socialized good citizens and adults. Meaning, I believe there needs to be a higher ratio of adults to children than there currently is in places where kids are cared for, whether it’s school or daycare or maybe even home.

We both are, now, but I was BORN (and raised) IN THE USA!!! just like Bruce Springsteen.

And I love America, to be frank. I love it in a way I never loved it when I still lived there. I love it in its brashness, its tackiness, its cultural ridiculousness. I love it “in all the excellence of its excess.”

I love American news, American talk radio, American commercials, American flag stickers on cars, the Star-Spangled Banner, bald eagles. I love shit-slinging political chimpanzees. Just…everything. I think it’s amusing, yes, but at the same time, I love it in a completely unironic way.

Canadians…don’t. In fact, lots of Canadians are downright snotty about their disdain for Americans, mainly because they seem to think Americans are boorish, unfunny, and intellectually lazy.

Totally shocking, I know.

But I love this, because it gives me the opportunity to make people really uncomfortable simply by saying, “I’m American, you know.”

And they get all flustered and say things like “YOU’RE an American?” and “NO WAY” and “Well, I didn’t mean you.” And I heartily enjoy myself because, truly, I am an asshole through and through.

So, today, when an American said something about how THE WORLD MOCKS AMERICA BECAUSE WE’RE ALL SO FAT, my husband’s response was:

We don’t mock Americans for being fat. We mock them for electing Bush, for starting wars without UN consent, for being distastefully patriotic. Duh :-)

And it was just so…Canadian…of him. I love that.

My struggle with chemistry continues. It’s actually really fucking embarrassing, but I want to be up-front about it, mostly with myself.

Here’s the ironic thing: I actually like chemistry. Because I like learning. I like science. I like philosophy, and I see all the natural sciences as offshoots of philosophy.

I’m intimidated by math, but the part of my brain that does math actually works pretty well, when I’m not feeling intimidated by it. I can do long-division in my head in those few moments of twilight consciousness when I’m falling asleep.

I have a good brain.

But chemistry terrifies me. It seems to be the space where I have concentrated all of my fears and negative associations with school. I was harassed to the point of assault in school when I was younger. I only recently started dealing with those memories explicitly, and it’s stirred up a lot of emotional sediment.

I also have a mental illness that often, for lack of a better way to phrase it, kills people dead. I have learned, for better or worse, to live with it. I am still struggling to learn to live better with it, but I have thus far learned to survive. And that is good.

So here’s the rub — I’m scared to disappoint people. I am scared to not be loved. This fear manages to overshadow and spoil a lot of my natural curiosity and passion for school, because it feels like a manipulation: in order to be loved, you must do X, Y, and Z.

How do I respond to manipulation? Fuck X, Y, and Z.

And I get angry at school. I’m a resentful student, and I blame school. But the problem — as fucked-up as I know the carrot/stick school system is — is actually my own fear of being unloved. Of disappointing and therefore losing the love of people who now love me.

The problem is my belief that love is conditional. And that if I don’t pass chemistry, I will not be loved, and thus not deserve to live.

Inside of me, there is some kind of psychological pillar that stands there like a stone regent. This regent has one, ultimate power: to refuse. To say no. To stop all motion, to freeze time. To stand in place and be utterly unmoved.

I run up against this regent when I have been pushed to the limits of my emotional capacity. The regent, in practice, can ruin my fucking life and all my plans, but it is actually there to protect me. Because I am so terrified, as a human being, of saying no, of respecting my limits and protecting myself, of asking to be loved anyway — because, in short, I am incapable of handling my sovereignty as a human — The Regent takes over for me, as regents do.

The Regent says no for me by pinning me in one place and refusing to move. The Regent says I can’t do this for me by refusing to do anything at all.

Right now, The Regent is saying you must love me and I have reached my fucking limit and I have been battered by the world and need time to recover … by refusing to study chemistry.

In order to reascend my chair, as someone who likes and wants to learn chemistry, I probably need to start saying these things for myself.

In that vein, every year Frances M. Berg (a licensed nutritionist and author from North Dakota who founded the Healthy Weight Journal and wrote books like Women Afraid to Eat, which was one of the first HAES books I ever read and has an incredible list of peer-reviewed references for each chapter) publishes the Slim Chance Awards, which are sort of like the Razzies for terrible diet products.

Cited for “Worst Gimmick” in the Slim Chance Awards is one of my favourite (and by “favourite,” I mean “so ridiculous that I can’t help but laugh”) desperate late-night informercial products:

Worst Gimmick: Kinoki Foot Pads. FTC is suing the marketers of Kinoki Foot Pads with deceptive advertising for their claims that applying the pads to the soles of feet at night will remove heavy metals, metabolic wastes, toxins, parasites, chemicals and cellulite from people’s bodies. The ads also claim that the foot pads can treat depression, fatigue, diabetes, arthritis, high blood pressure and a weakened immune system. All this is based on the quack theory of reflexology, which holds that specific areas of the feet affect specifid organs and glands. Since the foot pads darken, this is claimed as evidence that toxins are being drawn out of the body, but investigators show the darkening is caused by moisture and has nothing to do with “toxins.”

I may as well out myself here as a skeptic. My education is science-based. I believe in the scientific method. And while I’d never discount the joys of the placebo effect, or of fun things that you do purely for entertainment or to gain some kind of spiritual/psychological/symbolic satisfaction, I do have a problem with placebos being marketed as actual cures. Or making claims that are patently false and easily disproved.

Two of my favourite skepty (yeah I just made that word up) blogs are Bad Science and Skepchick.

Tangentially, some people have wondered why, if this is the case, I choose to call myself a “nutritionist,” since that term has such scammy undertones, especially in the U.K. (Just to toot my own horn a little — I actually wrote a pretty scathing piece on Gillian McKeith back in March 2006, before I discovered Ben Goldacre and fell in love. I’ll dig it out of the archives one of these days.)

The short answer for now is: I’m reclaiming the word for people who, you know, actually understand science but who may not be Registered Dietitians (and, yes, there are respectable nutrition practitioners out there who aren’t RDs.) The long answer will come in its own post, later, along with more on Diet Apocrypha.

For now, just enjoy the humourous side of skepticism.

The Fat Nutritionist is taking a hiatus until February 5, because I seriously need to study some chemistry! And I keep getting distracted by interesting discussions and comments and whatnot.

So, keep talking amongst yourselves if you like. If your comment gets stuck in moderation, sorry — you’ll just have to wait till I get back for it to be approved.

See you in a couple weeks. And keep me in your prayers re: chemistry.

ETA: I’m also not taking questions at this time. But I wrote you a whole primer on how to find a dietitian in case you are in dire need!

Because obviously they just don’t know what they’re doing. And that’s why they eat so badly, and hence, why their health tends to be poorer!

And eureka! — you have a tidy solution that not only absolves financial and economic guilt, but, as a bonus, allows richer, more-edumacated people to assume the role of benevolent experts.

Here comes the part where I bust up that nice, warm bubble bath.

The reality is that people who don’t have enough money (or the utilities and storage) to buy and prepare decent food in decent quantities, cannot (and should not) be arsed to worry about the finer nuances of nutrition.

Because getting enough to eat is always our first priority.

That’s why Ellyn Satter (yes, her again) created the Hierarchy of Food Needs. Which looks like this:

The idea is that, before we worry about nutrition (i.e., “instrumental food”) we’ve first got to HAVE food. Enough of it. Consistently. And it’s got to be acceptable to us (which, for some people, might mean not coming from the garbage, or meeting certain standards of preparation) and it’s got to taste reasonably good. A little variety is nice, too.

These are not silly little preferences that can be brushed off lightly — even “tasting good,” which seems to always be the first thing thrown out the window when someone decides to change their diet For Health Reasons.

Tasting good is actually a function, biologically, of

1. food’s microbiological safety and freshness (meaning it’s not spoiled or contaminated with sick-making germs),
2. food’s caloric density (there’s that pesky ENOUGH FOOD thing again — because calories and water trump everything else, nutrition-wise, and hey, guess what?? Sweet, fatty foods are the order of the day when it comes to caloric density), and
3. food’s chemical safety (meaning, it’s not naturally poisonous, chemically adulterated, or containing some toxin produced by sick-making germs.)

Of course, flavour isn’t infallible — C. botulinum can’t be detected by taste, for example, and ethylene glycol, a.k.a. antifreeze, is apparently as tasty as it is poisonous — but there’s likely a strong evolutionary reason why we developed certain flavour preferences. And it’s not because we’re totally depraved and destined by our love of Twinkies to doggy-paddle the Lake of Fire forever and ever, amen.

It’s because, for the most part, those preferences kept us fed and out of trouble with food. And they still do.

For most of us, this becomes apparent for the second reason listed above — when we’re hungry. I’m sure you’ve noticed how cake and fried foods and whatnot become SUPER MASSIVELY APPEALING when you’ve either missed a meal or started a diet.

It’s not because you lack willpower or have an inborn preference for BAD, BAD JUNK FOOD — it’s because those foods are naturally jam-packed full of what you need right that instant: energy. Meaning, calories — most of them coming from carbohydrate (whether it’s starch or sugar) for instant energy, and fat for MOAR energy (and tasty, creamy mouthfeel, to boot.)

So, extend this to someone who doesn’t have enough food on a regular basis. In my neighbourhood, which is poor, corner stores sell Ensure and Boost individually for about $2, right up in a big display near the counter. You find empty bottles of the stuff laying around on the sidewalk next to smashed beer bottles.

It’s complete nutrition; it’s portable and requires no preparation; and it’s reasonably calorie-dense. Imagine being hungry and walking into that corner store with a couple of bucks in your pocket.

Sure, choosing the Ensure over a chocolate bar or bag of chips might make logical sense, and you might even do that sometimes to ensure you don’t end up with some horrific nutrient deficiency. But there’s one important point I forgot to mention about Ensure and Boost: not super tasty.

So, when it comes down to it, you’re likely to choose the tastier option — which is pretty calorically dense and provides some nutrition (as well as the satisfaction of chewing actual food) — more often than not.

And it’s not because you’re stupid, ignorant, lazy, or just a bad, bad person who loves bad, bad food.

It’s because other needs come first.

The following quote from this book sums things up nicely as it relates to what people really need when it comes to nutrition, and how nutritionists, dietitians, and social workers can best help:

Is it our role to teach the poor how to live quietly on less than minimum standards of health and decency and how to starve on minimum wage? Do we teach them how to budget malnutrition more neatly? Or is it our job to struggle for those minimum standards…?

I think you know what answer I’d choose. And once again, we’re back to the social determinants of health.

You want people to eat better? Give them enough money, a place for cooking and storage, and access to a decent variety of food.

Then you can worry about the finer points of nutrition.

That said, I will probably surprise myself with random posting at some point between now and then — never say never.

If you’re into this kind of thing, please feel free to use this as an open thread of sorts. Random questions and arguments always welcome.

I’ll get the ball rolling by extending something I was kvetching about on Twitter — that because a therapeutic diet is used for the treatment of a specific condition or disease does not mean it is therefore a healthy diet for most people. But I see this argument used again and again by people who’ve come to Jesus (figuratively) by finding a specific diet that helps or even cures their particular ailment, as in the case of gluten intolerance.

And to that, I say, fabulous! I’m glad you found the thing that works for you. Because, truly, different people have different nutritional needs. And it’s often up to us to figure out what those needs are, and what works best, for ourselves.

What I don’t say is, fabulous! Please continue proselytizing as though this diet is now The Answer to All of Humanity’s Ills.

What I also don’t say is, fabulous! By finding a diet that treats your condition, you have also likely stumbled upon the diet that would therefore prevent said condition from occurring in other people.

Cause it just ain’t necessarily so.

Thoughts? Examples? Swearwords? You know what to do.

This is my SURPRISED FACE. Especially since, in 1995, the World Health Organization identified poverty as “the biggest single underlying cause of death, disease and suffering worldwide.”

In a hilarious-because-it’s-sadly-true list posted to the Wikipedia article on the social determinants of health, a typical list of “lifestyle” tips for better health is contrasted with a list of socially determined tips for better health:

The traditional 10 Tips for Better Health ^[69]

* 1. Don’t smoke. If you can, stop. If you can’t, cut down.
* 2. Follow a balanced diet with plenty of fruit and vegetables.
* 3. Keep physically active.
* 4. Manage stress by, for example, talking things through and making time to relax.
* 5. If you drink alcohol, do so in moderation.
* 6. Cover up in the sun, and protect children from sunburn.
* 7. Practice safer sex.
* 8. Take up cancer-screening opportunities.
* 9. Be safe on the roads: follow the Highway Code.
* 10. Learn the First Aid ABCs: airways, breathing, circulation.

The social determinants 10 Tips for Better Health^[70]

* 1. Don’t be poor. If you can, stop. If you can’t, try not to be poor for long.
* 2. Don’t have poor parents.
* 3. Own a car.
* 4. Don’t work in a stressful, low-paid manual job.
* 5. Don’t live in damp, low-quality housing.
* 6. Be able to afford to go on a foreign holiday and sunbathe.
* 7. Practice not losing your job and don’t become unemployed.
* 8. Take up all benefits you are entitled to, if you are unemployed, retired or sick or disabled.
* 9. Don’t live next to a busy major road or near a polluting factory.
* 10. Learn how to fill in the complex housing benefit/asylum application forms before you become homeless and destitute.

So I guess we can all revise our New Year’s resolutions somewhat.

Now, of course, I’m not trying to be fatalistic, and I wouldn’t ever want to take away someone’s feelings of hope of what they can achieve, nor their sense of bodily autonomy — but the trick here is to remember, whenever you’re making “lifestyle” changes for the sake of improved health, keep the bigger context in mind.

Do a sound cost-benefit analysis before embarking on something you don’t enjoy, solely “for the sake of your health.” Keep in mind that certain changes represent only a drop in the bucket of your overall health, and that if something isn’t worth doing for its own sake (intrinsic motivation, remember?), then maybe it’s not worth doing at all.

That said, I’ve made a few…let’s call them “atypical” resolutions of my own — to work hard in therapy, to get better at understanding my limits and boundaries, to speak up when I need help, to work hard on the business-thing, to deliberately build pleasure into my daily life, and to remember that doing all of the drudgy housework-things is part of taking care of myself.

If I had the money and time, I’d add “take a ballet class” to that list, but since that’s not possible for me right now (don’t be poor!), I’ll work on figuring out some alternative. I know it sounds weird for a fat (and fat-accepting) person — particularly one who says “fuck” as often as I do — to be interested in ballet, but I’ve always been a study in contrasts and ballet has always appealed to me.

The idea that it might also be subversive for me now, given my fattitude, only enhances the appeal.

a fat ballet dancer from The Big Ballet

Any atypical resolutions to share?

This video shows Brigid Polk, one of the members of Andy Warhol’s Factory — a former society girl whose mother forced her to diet from a young age — describing how she uses speed instead of various reducing salons, yet insists on not being “uptight” about being the fat girl in a bathing suit.

Brigid is a rebel and a troublemaker, no doubt, but also someone who has obviously been victimized by a culture that demands the impossible from women.

As such, I offer this counterpoint — a clip from Jean Kilbourne’s Slim Hopes, which applies a serious context to every single one of these silly Diet Pop Culture posts.

The theme that underlies both Brigid’s experience, and the messages in Kilbourne’s film, is that women must be thin, must look a certain way, or risk losing love from their families and significant others, and acceptance from society as a whole. This kind of ostracism can be the kiss of death for social primates, like humans — naturally, we’ll do anything to avoid it.

Magazines are giving out advice on HOW NOT TO BE A TOTAL DISGUSTING PIG, YOU FUCKING SLOB.

Yessss.

Seriously, I wait for this all year. Like Christmas morning.

First up, from my lovely reader Maggie (thank you, Maggie, and wake up, please, I think Rod Stewart’s got something to say to you, and if you think that’s bad, try living with “Michelle, mah belle” for 30 years), comes Cosmo’s “How to Pig Out on Thanksgiving (But Without the Guilt.)”

And they pretty much give you a basic, average, low-fat kinda smallish meal on which you can totally PIG OUT, girlfriend!

Nary a mention of pie, mashed potatoes, gravy, or anything else that makes life worth living when you’re across the table from that beloved relative with the unfortunate spitting habit.

Because you should totally, totally feel guilty about food. Especially tasty food, and most especially on holidays where you’re supposed to be thanking your lucky fucking stars for even HAVING food in the first place.

Right-o, then.

Next up, we’ve got CBC’s “Go Healthy, Not Hungry for Holiday Eating.”

Which, you know, sounds like it’s going to be about moderation, and eating tasty-but-good-for-you food, and not trying to diet your way through two months’ worth of homemade cookies and seven-course meals…

…except it’s pretty much just a list of ways to avoid eating anything remotely holidayish. Plus some musty old behaviourist weight loss tricks.

Cause God forbid you should break out the real cream once a year! Or eat a meal that’s in any way different from your normal, weeknight meals during the motherfucking holidays.

And Holiday Eating Without the Guilt – or the Pounds brings the whole guilt aspect back into play. Because, really, what’s a holiday without the festive sprinkling of demoralizing shame?

The American Dietetic Association gets in on the act, too, with last year’s Health Tips for Holiday Eating, which is a litany of ways to avoid eating tasty food (including VERY SPECIFIC INSTRUCTIONS on how to dip your crudités in sauce), capped off with this inadvertent punchline: “Be realistic. Don’t try to lose weight during the holidays.”

All these various pieces of seasonal advice — and pretty much all nutrition advice, in general — seems to come down to one thing.

Which is:

Do I have a problem with that? Yes.

The problem I have with it is this little thing I’ve kinda-sorta hinted at in the past: intrinsic motivation.

Okay, story time.

A number of years ago, when I was a young housewife trying to figure out 1) how to lose weight, and 2) what the “right” way to eat was, I went to the library book sale and bought a well-used textbook on behaviour modification.

I read that thing cover to cover. Twice.

It was a revelation. It was the fulfillment of a long hoped-for dream, my original reason for taking psychology in 7th grade — to learn how to manipulate and control people.

(Yes, I was kind of a weird 12-year old. Shut up.)

And, in the same way Darwin believed that watching his baby son grow up was like watching a time-lapsed version of human evolution, I believe my experience there reflects something of the history of psychology. Because when psychology shifted from the primarily Freudian, psychodynamic approach into behaviourism — something with objectively observable phenomena, and ways to measurably change behaviour — I’m sure many a psychologist jumped in the air and clicked his heels at the prospect of actually being able to predictably influence another person’s actions. Of actually being able to, in effect, manipulate and control people.

So that’s what I set out to do, with my fat body.

Likewise, that’s what psychologists, nutritionists and doctors set out to do with their fat patients.

The only problem? By the late 1970s, even premier obesity researcher Albert Stunkard had to admit that it kind of wasn’t really working. I mean, the techniques all worked to some extent — everyone say this with me in unison — they all worked in the short-term.

But as we now know, over the long-term, homeostatic mechanisms, like weight, are pretty damn good at regulating themselves.

So good, in fact, that if you take the long view of things, measely attempts to control a homeostatic mechanism through behaviour modification seem…kind of ridiculous.

It’s like trying to keep a balloon submerged in a swimming pool — it’ll stay under for a little while, giving you the illusion of control. But if you lose focus for even a moment, or tire of the game even a little, that damn thing bobs right back up to where it started. Human efforts can’t override natural laws, not for long.

And the cost of eternal vigilance is, well, never again having a very good time at the pool.

But the seduction of control, no matter how short-lived, proved too much, and behaviour modification techniques didn’t stay limited to a few clinical applications. They sifted through the culture, into primary-school education, into smoking cessation programs, into diet tips and parenting advice and self-help books of every stripe…and, as you can easily see above, into diet tips.

Diet tips like “EAT FROM A SMALLER PLATE!!!” and “PUT YOUR FORK DOWN BETWEEN BITES!!!” and “REWARD YOURSELF FOR NOT EATING WITH A NICE HOT BATH!!!”

And, granted, some of these strategies might actually be useful for other applications (like, say, teaching someone to eat mindfully, or even dealing with binge eating), or else they can be used, as Ellyn Satter uses them, subversively as a way to teach people how to organize their eating.

But as a means to control people? To get us to eat less forever, ergo, to lose weight in the long term?

Nope. Doesn’t work.

If it did, none of us would be fat today. “Obesity” probably would have been “cured” by New Year’s Eve, 1969, and we’d all be living in some sort of fabulous, utopian, skinny future with perfect lives reflecting our perfect figures, and having no other problems whatsoever.

Ahem.

So, to get back to what I was saying about intrinsic motivation — why don’t attempts at behaviour modification work to get people to permanently lose weight?

Well, not only because it’s like trying to hold a balloon underwater for the rest of your life, but also because people are pretty fucking smart. We know when we’re being manipulated by external pressures. And when our behaviours are not rewarding in and of themselves, life kind of sucks.

And that’s not something anyone, short of a masochist, can sustain for very long.

It’s my belief that personal autonomy, agency, freedom, liberty, sovereignty — whatever you like to call it — is one of the strongest, most fundamental desires that drive us as human beings. Because, from a purely animal standpoint, not being in control of your own decisions and choices is potentially dangerous, even fatal. And it robs life of meaning — what’s the point of having your own life if someone, or something, else is calling the shots?

Alfie Kohn, whom I adore, has written a lot of books criticizing the educational system that relies on grades as a dual system of reward and punishment for students, presumably in the service of getting them to learn. He elucidates research which has shown that students’ learning actually suffers in the presence of external rewards and punishments, and that the quality of learning improves when those sticks and carrots are removed, and replaced instead with the students’ own genuine curiosity and desire to learn about the subject.

(Now, replace “Alfie Kohn” with “Linda Bacon” in the preceding paragraph, replace “educational system” with “weight loss industry”, “grades” with “weight”, and “learning” with “health”, and you’ll begin to see what I’m driving at.)

And, to plunge even deeper for a moment, what that comes down to is a basic philosophical choice about human nature: do you trust people to do the best we can for ourselves in our current circumstances, or do you not? Do you have a pessimistic or optimistic assumption about human nature?

This may sound awfully Anne Frankish of me. So be it — the world would be a better place if more of us were like her. And as such, I firmly believe in, and make the daily effort to reinforce to myself, an optimistic assumption about human nature.

I trust that we inherently want to learn, want to improve, want to be better, want to be kind and do good in the world, and want to take care of ourselves. When we fail, because we all do at some point, I believe it’s not due to some character flaw or moral shortcoming, but because there are barriers. Sometimes those barriers are insurmountable and we are never able to get over them, to realize our potential, which can be tragic. But what it’s not is proof that we are bad or inferior.

How does this relate to nutrition, and holiday dieting tips, and eating? Well, I believe that all of us genuinely want to eat well. We want to do good things for our health. We want to take care of our bodies, and, a lot of the time, we even know instinctively how to do these things. But there are a lot of pressures and barriers in this world that get in our way, that confuse us, that distract us and attempt to control us in counterproductive ways.

When it comes to coercion and intrinsic motivation, even the most dedicated person can be swayed from their objective by someone coming along and bombastically demanding that they do the very thing they were about to do anyway.

When I was a little kid, I remember when I’d be psyching myself up to clean my room — and, at that very instant, my mom (hi Mom!) would invariably come along and say, in a very mom-ish tone, “Clean that room!” Thus utterly killing any natural desire I had to clean that room.

I’m sure this experience is damn near universal.

Our need to preserve some scrap of autonomy, even in the form of counterproductive, cutting-off-one’s-nose-to-spite-one’s-face rebellion, is far stronger than the initial impulse to clean our rooms.

So, naturally, after my mom told me to, I didn’t. Not without a lot of whining and struggle, anyway.

When it comes to grades, or eating, or whatever, the bottom line is that telling us what to do doesn’t work — even if we wanted to do it anyway (and most of us do, if you take an optimistic view of human nature.) Telling people what to do doesn’t work because it robs us of our dearest possession — the freedom to make our own choices, and even our own mistakes.

That’s why, when it comes to eating, I’m a bit more like:

And that’s because I believe:

In an unprecedented show of concern, The Academy for Eating Disorders (AED), Binge Eating Disorder Association (BEDA), Eating Disorder Coalition (EDC), International Association for Eating Disorder Professionals (IADEP), and National Eating Disorder Association (NEDA) have joined forces and are urging focus on health and lifestyle rather than weight as a measurement of well-being.

“There is concern that we have lost sight of avoiding harm in the process of addressing obesity,” AED President Susan Paxton, PhD, FAED states.

Eating disorders practitioners have long been, in my experience, proponents of body diversity and Health at Every Size approaches, since these philosophies are essential to helping people recover from eating disorders and body image crises. In fact, I often advise people who contact me looking for a dietitian or nutritionist to search for those who specialize in eating disorders. Why? Because they are more likely to be familiar with and supportive of Health at Every Size, and less apt to promote weight loss.

And because these organizations are well-known and respected, I am extremely pleased to see them coming out against programs like Lincoln University’s — which would require students with a BMI over 30 to either lose weight, or pass a “healthy lifestyle” class in order to graduate — and firmly in favour of valuing health over weight.

Five or six years ago, I spent a year volunteering at a local eating disorders community centre. As soon as I walked in the door and saw the murals on the walls, and the signs saying “Please don’t talk about your diet,” I felt right at home. It was the first time in my life I’d ever felt I was in an explictly size-friendly space. It was an experience that made a deep impression on me in my fledgling efforts at self-acceptance and activism.

Though I was surrounded mostly by thin people, I was never uncomfortable being the fat lady because I knew we all struggled with the same cultural pressures, the same messages, and we were rebelling against a common enemy — the forces in our society that tell us we are not worthy of food or self-love. There was a simultaneous feeling of subversiveness and support. We were in it together.

Make no mistake — these are our sisters and brothers, fighting a parallel battle.

“Easy to inflate.” Well, thank heavens for small mercies. Otherwise, you might never be able to realize your dream of sporting the WORLD’S LARGEST CAMELTOE.

And if that doesn’t do it for you, there’s also a long version:

ETA: The following is courtesy of Twistie, in comments: Monty Python’s Trim Jeans Theatre.

…we acknowledge that food is more than the mere sum of its constituent nutrients. We recognize that human bodies in health and illness are complex and contextual. Moreover, we recognize that the knowledge that enables us to understand health is socially, culturally, historically, and environmentally constructed.

Dietetics and the field of nutrition, being relatively new fields, are only just coming, in some ways, to reflect critically on their own place in the world: the places where we have succeeded as well as the places where we have failed, and our responsibility to social justice via the currency of health promotion.

(And by health promotion I mean the ENTIRETY of health promotion, as laid out in the Ottawa Charter, linked above — not merely rhetorical social marketing campaigns that sometimes consist of little more than ableist, boot-strapping propaganda.)

Aside from certain progressive sub-fields, such as food security and the emerging criticism of food production systems, I feel like nutrition and dietetics have been missing an important intellectual cousin, so to speak, in the form of critical analysis — using the knowledge and techniques available to us through many other fields of inquiry, such as philosophy, humanities, literature, art, and identity studies — of our own practices, beliefs and intentions.

To me, critical dietetics includes questioning definitions of health as they currently stand; questioning top-down approaches that rely on the hierarchy of practitioner and patient; being willing to shine light on where, exactly, dietetics has failed its own practitioners as well as patients; discovering where cultural bias has informed dietetic practice and public health policy, often without being questioned or challenged.

I’m sure you can see how important this is in the light of fat acceptance and Health at Every Size.

Either way, this dude — with his short shorts, his Nair-smooth legs, and his zinc-oxide lip balm — is basically my ideal man.

(Well…except for the shorts, the hairless legs, the lip balm, and the utter lack of human emotion in the face of his high technology lifestyle.)

Dear Fat Nutritionist,

Here’s a question from a first-time visiting guy: how would you rate your awareness that you’re so beautiful it’s kind of totally ridiculous? You know, on a scale from 1 for “totally oblivious” to 10 for “painfully aware, I get messages like this every day.”

Have an awesome week … and good luck with the site!

-Anon

Hey Anon,

I appreciate the compliment, and it’s charmingly stated. You probably intended it as a rhetorical question, but if you’ll indulge me, I’d like to tell you a story about my awareness of my own beauty.

When I was very little, I became aware that I was considered more valuable to other people when I looked a certain way. On days when my mother curled my hair and dressed me in ruffles, I was treated with a kind of fawning admiration by the adults I encountered. When she didn’t, and as I grew older, out of that perfectly sweet toddler age and into a considerably more awkward and willful one, the more invisible I seemed to become.

I proceeded through childhood seeing romantic movies, even cartoons, that depicted the lives and problems of conventionally beautiful people as more important, and endlessly more fascinating, than the lives and problems of the dowdy or traditionally unattractive.

Do you remember how, in ancient times, and even up through the past several hundred years, plays and novels and epics almost exclusively concerned themselves with the lives of royalty, the nobility, or, at least, the very, very wealthy? And have you noticed that now, in this supposedly classless modern society of ours, the stories of the rich and powerful have simply been exchanged for the stories of the young and beautiful? In 1847, Jane Eyre was considered a startling departure from this convention — and it kinda still is. I’m sure you’ve noticed. At any rate, from a very young age, I did.

I spent my girlhood, like many American girlhoods are spent, wishing fervently to become beautiful. When I was ridiculed in school, when I was ignored or picked on or called a nerd, I turned to the fantasy of sudden beauty as some kind of protector-saint, as though it could save me from the pain of being a human among other humans. Unfortunately (I thought) for me, I was an awkward kid, a tomboy with straight brown hair and glasses, and a pearish figure unaccommodated by the fashionable clothes of the day.

I began to seek beauty like a person possessed, starting around age 11. I read fashion magazines and bought makeup. I put the makeup on. I looked ridiculous, but I kept practicing. I bought clothes, and did it all wrong and got laughed at and made fun of, but I kept trying. I had a feeling that if I could just find the combination to this particular padlock, I would be liked by the right people, I would have the right sort of life, and I wouldn’t have to feel like an alien or an outcast anymore.

Once I hit puberty around 12, I basically looked like a grown-up and stayed that way. People thought I was an adult when I was still in gradeschool. Objectively, my looks did not actually change very much between the ages of 12 and 16.

So imagine my surprise when, one morning when I was 16, I got the combination right — the fucking padlock opened.

At that point, I’d actually sort of given up on the whole enterprise of becoming fashionable, and thought to myself, “Fuck it. I’m just going to do whatever I like.” Since I have a kind of eccentric personal style, this meant styling myself in a way that would have been right at home circa 1915. The previous evening, I’d bobbed my hair and received some new clothes in the mail. All the years of making myself look absurd with makeup had actually made me quite skilled with it.

I got dressed and went to school as usual — pleased with myself, but not expecting anyone else to give a rat’s ass. I walked into school where, just the previous day, I’d been ignored, completely invisible, and considered nerdy and unfashionable and weird. As the doors opened, the first thing I heard was, “SHE LOOKS LIKE A MODEL,” loudly stated by the most intimidating punk of the school to his entire group of intimidating friends.

I froze, half-mortified and half-transfixed. It was one of the few times I’d heard anyone comment positively on my appearance since I was a toddler. It was exactly what I’d been craving for so many years; how could I not feel at least partly pleased? But I was also taken aback — this was not, after all, what I was going after when I’d gotten dressed that morning. Still…it was not exactly a bad result, no? Surely my life would now get better?

Sadly, I realized too clearly that I was not, objectively, “beautiful.” I realized that beauty was not a static thing, not a fixed commodity, and that there were very few people in the world who rolled out of bed looking the cultural ideal. And I was certainly not one of them.

For me, beauty was a costume I put on in the morning and took off at night, when I was finally alone with myself. I knew this, and it made me nervous as all hell, frightened that someone would see through my disguise and take away the status I’d finally, accidentally, managed to achieve.

I began to feel an external obligation to put on my beauty costume, every single day. I was unbearably nervous to leave the house without it. Sometimes it took hours. Sometimes it meant getting up at 5am. Sometimes I rebelled — there was a period where I refused to wash my laundry, to do anything but lay in bed most of the day, and I would literally pick my clothes up off the floor and put them on, then tramp through the mud in my heeled oxfords and long skirts to school.

Pretty soon, I stopped leaving the house as much as possible.

There was another reason for this — when I reached puberty, but not quite fashionability, at age 12, I had my induction into the world of womanhood via the ritual hazing of sexual harassment. I was tormented, squeezed, hissed at, touched, groped, fondled, and pulled forcibly into people’s laps at school.

Do not misunderstand: this was not flirting. It was humiliation and cruelty. These people were not interested in me as a human being; they did not have crushes on me; they did not care for me. It was degradation, plain and simple. And I wanted no part of it. I physically and vociferously fought back. But I was confused — I did not understand why it happened, what I’d done to deserve it, and why no one came to my aid.

As bad as this was, it only got worse when I started dressing in beauty drag. I began attracting the attention of perfect strangers, of people much older than me, people who didn’t just mean to humiliate me, but who actually meant me harm. I went from feeling like an invisible person who was occasionally objectified for other people’s pleasure, to being a deer in hunting season. I was highly visible, something about me was now considered highly desirable, and I was no longer just vulnerable to attack — I was actively targeted because of the way I looked. My life and physical safety were threatened more than once.

My peers also seemed continually amazed to discover that I was intelligent, as though the previous ten years — when I’d been known by reputation as a school-nerd — were blotted out completely by my changed appearance.

Even so, boys at school wanted nothing to do with me — except to talk to their friends about how badly I needed to be fucked — and girls who weren’t already my friends started kissing up to me because my status was now higher. I rebuffed them. I told them to fuck off (in my head.) But I was desperately lonely.

As I mentioned, I started becoming afraid to leave the house. A computer nerd from way back, I started using IRC a lot in order to talk to people in a context where I could control how/when to reveal my sex and my appearance.

I had internet boyfriends, who sent me mix tapes, instead of real relationships because I thought I could keep myself safe that way. I was almost completely isolated.

I’d been depressed since about age 12 (SHOCKER), but I was finally diagnosed with depression formally by a therapist who told me, “You look like a Maxfield Parrish painting.”

My last year of high school, I started to fuck around with my beauty disguise. I played with the levels of visibility I could achieve, I suppose as some manner of taking back control over this thing that had gotten entirely out of hand. I dressed up some days, and then, other days, I’d wear running shoes, old jeans, my mom’s jacket and glasses.

Once, a kid I didn’t know approached me at school as I sat in my habitual spot in the commons, doing homework.

“Excuse me,” he said. “I have to ask — are you the same girl who normally sits here?”

“Yeah…?”

“I mean, you normally wear a long dress, right? And no glasses?”

“Yes.”

“You just — you look like a completely different girl. Wow. I thought you were someone else.” And he walked away, shaking his head a bit.

I was oddly pleased by this, but it also reinforced my knowledge that the beauty thing was just a disguise, a costume.

In college, when I was 18, I saw a boy in my mythology class who seemed interesting. He took absolutely no notice of me for several weeks, dressed in my jeans and army surplus jacket. I decided to conduct an experiment: for the next class, I would dress up and see what happened.

What happened was he came and sat by me, asked me if I was new in the class, then carried my books while walking me to my dad’s car when class was over. The only thing different was my mode of dress.

I am older now and a lot fatter, but I still can manage to put on the costume when I need to. I am conscious that I am treated differently when wearing beauty: better in certain circumstances, worse in others. I am sexually harassed more on the street, but receive better service and kinder attentions from people. I get more attention, but people, perhaps, take me less seriously.

I made the conscious decision, when I started this website, that I would use an attractive picture of myself on the front page. Because being fat in this world is already a black mark against me, I knew I would have to tap some of the status that my false beauty can afford to partially make up for that. I knew my writing would be more likely to be read, and people would be more interested in hearing me out, perhaps even giving me media coverage, if they thought I were beautiful.

The truth is the same as it has always been: I’m not actually beautiful. I’m simply and idiosyncratically myself. Beauty is a cultural construct designed to keep people balanced on a knife-edge of anxiety over the potential loss of status, and the rabid desire to gain it. That knife-edge is so slender that hardly anyone, as I said before, rolls out of bed in the morning and balances on it effortlessly. Those who do are highly paid to do just that.

There will come a time when this costume no longer fits, when I am old enough and changed enough that no amount of makeup, no hairstyle, no set of clothes will be able to obscure my nature to the extent necessary to imitate cultural standards of beauty. When that happens, I imagine I will grieve, but I will also feel relief.

So, to answer your original question, the answer is somewhere around 152. Not because I’m constantly showered in praise for my looks, but because I deliberately construct or deconstruct this papier-mâché facade in front of my mirror, depending on what needs to get done that day.

Oh, and I married the internet boyfriend who sent me the most mix tapes.

Warmly,
Michelle

P.S. I hope you don’t mind, but I’m publishing this email :)

This is an intensely personal thing to write about, and it’s something I usually avoid, because I absolutely believe that it’s no person’s — especially no fat person’s — obligation to disclose what they eat as a means of justifying their existence.

But because this blog is about nutrition, dieting, and normal eating, and because I’m positioning myself here as the “expert voice,” and setting something of an (anything but perfect) example — and not least of all, because I’ve grown gradually at ease with this space — I thought it might be useful for people to get a peek at some of the behaviours of a mostly-normal eater.

I say “mostly-normal” because I do have a history of disordered eating (which is distinct from a clinical eating disorder, but, I believe, falls along the same continuum), just as anyone who has ever dieted has a history of disordered eating. And there are still things I’m working on — I’m not perfect at feeding myself, and likely never will be.

But in the past eight or so years, I think I’ve come a fairly long way.

It occurred to me today that there are some things I do with food that, a few years ago, I would never have believed I would or could do, and which may prove interesting to people struggling to find a semblance of peace with food.

For instance, last night I went to a movie with my husband. Beforehand, we went out for drinks. My appetite has been very weak for the past few weeks, due to illness and side-effects of medication for that illness, and I’ve just not been very interested in eating. Whenever this happens, I find it mildly distressing, as I actually miss the pleasure of getting hungry and looking forward to food.

After drinking a beer, I felt a little hungry. I tend to get beer munchies. (In fact, I started rambling to Jeffrey about how they should serve beer to sick, malnourished patients in the hospital, if it weren’t for, you know, all the potential medical complications.)

I was excited to actually feel hungry again, so I ordered a cup of clam chowder. Jeffrey got onion rings, and I filched two of those as well, and was so pleased with the experience of not feeling indifferent to (or mildly nauseated by) food, that I bounced in my seat with happiness as I ate.

(Yeah. I do that sometimes.)

We next stopped at a drugstore to fulfill the obligatory tradition of buying verboten treats to sneak into the theatre. (I get a cheap thrill out of this, even if I’m not hungry.) I had a feeling that, once inside the theatre, I’d be jonesing for a snack, due to past associations if nothing else. I got Jr. Mints with M&Ms for backup.

(I should disclose right now that I really, really love candy. Like, a lot. A whole lot. This is sure to be a recurring theme on this blog. Consider yourself warned.)

We got to the movie theatre and the lobby was, of course, redolent of melted butter and toasty popcorn. It was lovely, but not very tempting — though I love hot, salty popcorn with my Jr. Mints and M&Ms, as salty + sweet + chocolate is one of the best flavour combinations OF ALL TIME (thank you, Kanye), my appetite just wasn’t up to popcorn, and I suddenly disliked the idea of getting my fingers greasy.

During the movie, I happily switched between Jr. Mints and M&Ms, reaching over frequently to throw some in Jeffrey’s open mouth.

As I ate the M&Ms, I discovered quite by accident that, for me, the absolutely ideal number to have in my mouth at once is three. Exactly three M&Ms. It allows the chocolatey flavour to spread evenly on all sides of my tongue, without being so overwhelming as to make my mouth feel sticky or dry, or to be laborious to chew and swallow.

Don’t ask me why I notice these things.

Partway through the movie and candy — maybe about 3/4 through both — I stopped. I put them in my purse. That was that.

I don’t know why I stopped when I did, exactly. As a person who previously had (and sometimes still has) a compulsion to eat candy until it’s gone, appetite be damned, I still find it mildly surprising when this happens. It was not an entirely conscious decision. I’d simply had enough — reached some kind of natural stopping-place, the end.

The movie finished and we walked home in the delightfully cold air, then slept till noon.

The next day, I had oatmeal for breakfast, and decided in the late afternoon to wander to a local coffee shop for some reading and thinking, as an excuse to put on proper clothes and get outside for a bit.The box of Jr. Mints were on the fireplace mantel, and I decided they would be a good accompaniment to coffee, so I took them with me.

After being greeted and teased by the barista, I sat and drank cappuccino and gradually ate Jr. Mints, one at a time, while alternately reading, highlighting, making notes and staring off into space.

Around 6pm, my prodigal appetite returned with a vengeance. My mouth kept having little fantasies of mashed potatoes, so I suddenly cleared the kitchen and set about making myself a meal out of the holiday ingredients that had gone unused during my illness.

I peeled and boiled a lot of potatoes. I chopped an onion, a pear, and an apple and sauteed them together in butter, to which I added salt, nutmeg, allspice, cinnamon, cardamom and black pepper. I defrosted some pork tenderloins, salted them, rubbed them in cinnamon and allspice, and cooked them with the fruit. Then I made some classic American boxed stuffing.

When they were soft, Jeffrey’s strong arm helped me whip the potatoes into smooth, fluffy goodness with no lumps, and we sat down to a miniature holiday feast.

My hunger was so intense that, after I’d finished about 3/4 of my plate, I went back for pre-emptive seconds — more mashed potatoes, more stuffing, and a second piece of pork. But just a couple of bites later, I was done. That was it.

We shared the leftover M&Ms for dessert; I put my full plate in the fridge; I washed the dishes.

Three hours later I was ravenous again. I reheated the plate of food and ate half of it, with two glasses of orange juice.

It was the kind of hunger that only seems to come after a long period of not eating quite enough — the kind that still gnaws a bit even after your stomach is physically full. To me, it’s the hunger of depleted nutrient stores, not the simple daily, rumbling-stomach kind of hunger. It seems to come only after days of living primarily on cereal and toast, broth and gingerale.

I know tomorrow will most likely be different. Different foods will seem appealing, and I’ll eat them in different amounts. I may know again with stark certainty where to stop — or I may not.

If not, I will remain assured, as I did today, that my body will make up for it. That my appetite will eventually compensate for whatever mistakes or miscalculations I might make.

No matter what changes, I’ll remain relaxed. If I like food, if I don’t like food that particular day, I’ll be okay. I’ll know that another day will come when things will be different, but unchanged in one vital way — I’ll trust myself.

And I’ll prove worthy of that trust.

How goes it for you? If you feel like it, leave a snapshot of your eating in comments.

I’ve set it to update every five minutes (rather than Wordpress’ depressing default of every 12 hours) and the link in the title now points to the actual feed instead of, rather mystifyingly, to my own website. Links to other blogs also automatically open in a new tab, so you can more easily keep your place if you get click-happy. (But if lots of people find this feature annoying, I can remove it.)

If you scroll farther down, you’ll also find the option to subscribe to posts by email. At least one person asked for this a while ago. And I aim to please — so please, go nuts.

I’ve developed a posting routine that works for me, after many weeks of writerly angst, so that should result in more regular posts.

In more boring news, I’ve moved archives and categories to the bottom of the page, because, frankly, there’s just more interesting stuff to have in my sidebar. But, never fear, when you’re at the bottom of a post or the front page, they will be there, comfortingly, just waiting for you to click and read more.

So, that’s it really. Let me know if you’d prefer other tweaks or additions, and I’ll see what I can do.

Let’s get comfortable, shall we?

I don’t know — if losing weight in the ’60s meant wearing a modified sporty beehive, some Keds, and a look that says “I’m about to win first place in a National Twist-Off!” while wiggling yourself into happy oblivion atop 90 ball bearings, then…maybe count me in.

It probably never did a damn thing to help anyone lose weight, but add a Tom Collins and some music, and you’ve got yourself a hell of a Friday night.

Dear Michelle,

I’m wondering what it’s like to be a fat nutritionist. Just to give you my background, I’m in recovery from an eating disorder. I’ve worked with two nutritionists. My first nutritionist was wonderful and taught me a lot about nutrition. My current nutritionist is absolutely mind-blowing and is the most talented eating disorders treatment provider that I have come across. I hate to admit this, but to be honest, my nutritionists’ weights had a big impact on how much I am able to trust them. This is also true for most of the other eating disordered people that I know. I know that this thinking is disordered because, rationally speaking, I really believe in Health at Every Size.

Have you found that your weight impacts your relationships with your clients?

Have you found that your weight has come under fire from others in the field?

Thanks,
Anon

Hey Anon,

I’ve been mulling over your question since yesterday, and I think what it comes down to is this:

People are comfortable with other people for lots of different reasons.

For instance, when I’m choosing a doctor, I have the choice to go with a man or a woman. If I don’t like the way the doctor talks to me, or something about her/his office, or receptionist, or, hell, even their clothing choice, I get to pick another doctor. And this is not only allowed, but tacitly encouraged by just about everyone.

After all, how can you be expected to be vulnerable and open, and to do good work with someone you’re not 100% comfortable with? Even seemingly “silly” reasons for discomfort may be getting at a deeper issue that deserves to be heard and addressed.

So, for that reason, I really don’t mind if someone chooses not to work with me due to my body size. That is absolutely their right.

On a personal level, yes, it would hurt if someone came out and said to me, “I don’t want to work with you because of the way you look.” But, luckily, the way it works out is, no one ever does that. They simply avoid me, move onto the next practitioner, and hope for the best. I never have to know people’s various reasons for not choosing to work with me.

And, especially for people with eating disorders who are at a certain stage of recovery, I can totally understand not wanting to work with a fat nutritionist, or doctor, or whathaveyou. It only makes sense, in the context of the disorder, and I don’t think I would feel particularly hurt by that — it’s the reality of that disease, unfortunately, but as people recover, I think they are likely to get past that kind of thinking.

As far as my colleagues go, no — I’ve never had anyone question my competence due to my body size, and I’ve been hired for some pretty advanced jobs, given that I’m still a student. I worked in an outpatient diabetes clinic with very traditional, weight-loss-oriented dietitians, and they seemed to love me. They chose me over thin candidates who had their degrees finished. They never questioned me about my weight, and were willing to frankly discuss with me their concerns about their patients’ weights. They listened to me when I asked critical questions about the efficacy of weight loss treatments.

I’ve worked in various inpatient areas, and again, my weight never seemed to be an issue. I also worked in an outpatient cancer clinic — in both of these circumstances, the main point of my job was to encourage people to eat as much as humanly possible, because malnutrition was the biggest risk for these populations. I enjoyed it, and seemed well-suited to it.

I work in eating disorders occasionally, though not directly with the patients. I think that, more important than my body size, is my attitude toward food, and myself, and the world. I’m positive about food. I’m comfortable with myself. And I expect good things from the world. I think that, even in this rather sensitive area, these parts of my personality contribute more to my competence at work than my body size.

Anyway, thanks for writing and being so candid. Best of luck to you in your continued recovery. Don’t ever let the bastards grind you down.

As ever,
Michelle

That’s when it occurred to me — I was having a feeling.

It was a sad feeling. And I didn’t like that, not at all.

It seemed I was sad because of chemistry. Not my internal chemistry, but chemistry, the pure science course they make you take in undergrad. Which I have never been good at. It’s not one of those topics (you know, like biochemistry or organic chemistry or microbiology or clinical nutrition, apparently) that you can pass by cramming for at the last possible second.

And I’ve been so distracted this term — by travelling, by being sick as a fucking dog, by travelling again, and then continuing to be sick as a fucking dog, and then being injured on top of it — that I haven’t really studied. And I’m scared.

I’m tired, and I’m in pain, I’m hopped up on prescriptions, I’ve been sleeping insane hours, and I’m just scared.

I recently learned this weird habit of talking to my fear. Yeah, it’s kind of a hippy-dippy thing to do, but when you’ve got hippy-dippy emotional problems, you’ll try just about anything.

So, while drifting in and out of sleep this morning, I attempted to talk to my fear of chemistry.

Why is it so scary for me? Haven’t I taken lots harder courses and passed them? Haven’t I done surprisingly well at this whole “science” thing, given that I basically identified as “artsy” from the time I was an itty-bitty kid?

Well, yeah. But that didn’t stop the scared.

So, the scared started talking back to me a little. And it said, “I’m scared of chemistry because, when it’s over, the person I was is gone.”

Now, that streak of “artsy” — it’s a hyper-rational, pragmatic, no-bullshit kind of artsy. Symbolic, psychological woo-woo is not my usual thing. But, like I said, with the emotional problems and all, I’m willing to go with it.

I thought about it. And, weirdly, chemistry seems to represent something for me. It seems, for reasons I don’t understand at all, to mean saying goodbye to myself as I once was.

And I don’t want to. Even though I’m really not that person. Even though I haven’t been for quite a while.

From where I stand now, I can look at that girl — who detested herself so much, who wore her skin like a hair shirt — and see that she was lovely, even in her imperfectness. I can like her, smile at her awkwardness, endear her ignorance, sympathize with her (many, many) sadnesses, admire her ambitions.

And I can know with certainty that, because I never fulfilled those ambitions, because her future never materialized, because I went left when she pointed right, we two are not the same anymore.

And finishing chemistry will be the stamp on the postcard that says, “Wish you were here.”

This post represents one (of what is sure to become many) in which I talk to myself. Feel free to read or to skip. Comments on these posts are closed.

Because, you know, fat people enjoy making themselves sick just to annoy everyone, and to drive up healthcare costs. (It’s all part of the secret fatty agenda. If you haven’t been coming to the clandestine meetings, please email me.)

What we don’t often hear — because, at least up till now, it doesn’t seem to be as much fun, or get as much funding — are the other associations that can be drawn between fatness and health.

So, without further ado, I present you a few tidbits from this morning’s headlines:

• How income inequality leads to obesity – Researchers Kate Pickett and Richard Wilkinson have been studying income inequality for years. Their new book, The Spirit Level: Why Greater Equality Makes Societies Stronger, contains a hypothesis that recent increases in body weight could be due to increasing inequality.

• Indeed, food insecurity (a.k.a. “not getting enough to eat”), is often associated with obesity, especially among African- and Hispanic-Americans.

• And, at the same time obesity has been epidemicized, fad diets, and orthorexia in general, seem to have taken off. (Ignore the fact that Prof. Hawkey appears to be kind of a bonehead when it comes to “obesity,” and focus on the association he’s unwittingly drawing here, and his astute criticisms of apocryphal diets.)

• Oh, also, weight gain in adolescents is associated with drinking diet drinks. Yeah, diet drinks. I know. And they think it’s because diet drinks mean they were dieting.

So…yeah. Something for obesity researchers to gnaw on, HUR HUR.

(ETA: Also, sorry for spamming the feed this morning — I’m adding some old posts to my archive, and they all go out over the feed whether I like it or not.)

Lincoln University has a new policy whereby students with a BMI over 30 are required to either lose weight or take a “Fitness for Life” course. Since they’re obviously too fucking dim to understand anything about nutrition or fitness, given that they’re fatty-fatty-fat-fats. (Relevant MetaFilter post. And NPR blog post.)

Okay, I know you know this, but let me just state, for the record: I am really goddamn fat. I’ve also just completed about four years’-worth of classes that focus on nutrition and fitness. And, now that I know a thing or two about nutrition and health — I’m still really goddamn fat.

(Thank you to Charlene, who emailed this in.)

ETA: Here’s a more in-depth analysis of the school policy’s legality and implications.

A new study claims that “Self-control [is] key to preventing childhood obesity” – except what I think they’re actually talking about is promoting eating competence by not restricting children’s diets. But I’m sure measuring self-control is WAHAAAAY better for getting research funding.

(Here’s the abstract to the actual study. I need to read the whole thing still, but I reserve the right to be pre-emptively pissy about these things.)

And, lastly but not leastly, the mystifying “Stop picking on fat people” appeared in the Opinion section of the Wall Street Journal.

I read it and immediately thought, “Buuuuuhwhat?”

Like, I’m sure it means well, but there’s a lot of stupid shit in there, including many lulzy references to how much food fat people eat. (To wit: those fat people sure do eat a lot!) And the author compares fat people to “workaholics, alcoholics or garden-variety idiots.”

Awesome.

I first had to tell my husband and family I was quitting my diet, and all further weight loss attempts. That was a little hard, since I’d been such a devoted and obnoxiously voceriferous dieter (I’m sure you can imagine, given how obnoxiously vociferous a fat acceptance activist I now am. The more things change, the more they stay the same.)

Eventually, I got around to telling my friends, too. In the process, I discovered something that startled: every single one of my female friends had the same issues with weight, eating, and body image that I’d, until then, imagined were my own personal neuroses. I was floored to discover just how common these problems are, and how good we are at hiding them from each other.

I started writing online around 2002, in a personal journal-thingy, as I was discovering more of the literature on health and weight and dieting, and as I came to my decision to pursue a nutrition degree. I had catty drama-filled fights with pro-ana bloggers and with dedicated dieters, and we all did a lot of pearl-clutching at how insane we each thought the other was. Eventually, I realized that, despite appearances, we really were all on the same team, struggling in different ways, using different methods, with the very same problems.

The first time I spoke in public, to real, live people, about Health at Every Size and my own decision to accept myself was in the late summer of 2002. I nearly peed my pants before standing up in front of my biology class and saying loud and clear, I’m a fat lady and I think that’s okay. I thought I would be pelted with rotten tomatoes. Instead, people rushed to encourage and thank me. I was bowled over by just how needed the message of size acceptance was.

I then proceeded through school, writing papers about weight and Health at Every Size and body image whenever the opportunity presented. I did a couple more presentations where I talked frankly about how I’m a fat lady and I think that’s okay. Again, I never received the rotten tomatoes that I never failed to imagine I somehow deserved.

I wrote for and was active on Big Fat Blog for a number of years; I attended a conference about Fat Studies and met heroes — truly kind, scarily intelligent, morally advanced people.

And this has been an inventory of all the ways in which I didn’t hide.

But there were other parts of my life. There was work at the hospital, or rather, hospitals. Despite being a visibly, unapologetically fat person working in nutrition, I was hiding. I never told my bosses about my extracurricular activities, about my interest in fat acceptance.

The closest I came was when, once, my boss asked me what I was writing my term paper on, and I said, “Health at Every Size.” When another dietitian (who I love dearly) asked me how I felt about my own weight, I responded with a hedging, “As long as I’m healthy…”

I put a quote by Marilyn Wann on the wall above my desk, as a reminder of my principles in an environment that was sometimes hostile to my beliefs. It said, “You can’t hate people for their own good.” Sometimes my volunteers asked what it meant, and I mumbled something about prejudice and discrimination. I never explained it to anyone. I was hiding.

This September, I concluded my work as a diet tech at the hospitals. I had the good fortune to work in many areas (like eating disorders and oncology, and with frail, older inpatients) where my job was to encourage, not discourage, eating and enjoyment of food, where any focus on weight was more toward gaining than losing. This made me happy, and I believe my own comfort with food and my body gave me a special knack in this, because there was no inner conflict for me in encouraging people to eat and be satisfied with themselves. But still — I was hiding.

When I began this website and began using my real name in emails and when talking to the media, it scared the shit out of me. When I knew that I had to cowgirl up and actually start promoting myself, admitting to the fatosphere that I’m a nutritionist, and admitting to the nutrition world that I’m one of those fringe fat acceptance nuts, it scared the shit out of me. My cover was blown.

And, predictably, I took some heat for all that. It wasn’t unexpected, but it still scared the shit out of me. I also took a lot of sweetness for it, from people who have been encouraging and admiring and thankful. This, I wasn’t expecting — the sweetness scared the shit out of me, too.

I’ve been in the habit, for a long time, of singing in empty rooms, of reading my poems to no one in particular, of deliberately flying under the radar. It’s a comfortable place for me, for though I’ve always had a streak of the performer in me, I’ve also always abhorred a crowd, hated to have eyeballs on me unless protected by full costume and greasepaint.

To stand here, unaided by artifice, for people to yea or nay my value as a contributor to this world, has been unthinkable to me. I suppose because I take that vote seriously. I integrate it into my valuation of myself.

And now, here I am. Not only have I opened myself up for judgment, I have staked my professional reputation, and possibly the ability to feed and shelter myself, on my name, on this page on the internet. I have sworn like a sailor, I have proclaimed that a lot of nutrition is bullshit, and I have encouraged people to do the unthinkable by feeding their kids dessert twice a day. I’ve ruined the façade that I so carefully cultivated and conserved, and I’m not entirely sure, now, what to do with myself.

My only option remains to construct something new from these remnants.

But I’m struggling. I am not, by nature or training, a carpenter. I’m someone who sits at the back of the class, who covers her writing with her hand, who doesn’t answer the telephone — who, in short, keeps secrets.

But if I’m truly okay with who and what I am, there shouldn’t be a need for secrets, or to shrink from the yeas and nays. The referendum on my right to exist should be fixed, and I should have full right of veto.

Writing this blog is as much about helping people come to terms with their eating as it about helping myself come to terms with being visible. I apologize in advance that you will be exposed to a lot of the messiness and self-indulgence inherent in that process, but you can skip over those parts if you like. There will be times when it will seem like I am talking to myself, because, well — sometimes I am. It’s a habit that isn’t so easily extinguished. I suppose it’s a way of clearing my throat for the actual singing that must be done, whether I like it or not, before an audience.

Ellyn Satter said something this past week that made sense to me: “Somehow, going over and over a thing takes the bother out of it.”

So that’s what I’ll be doing here, taking the bother out of, finally, showing you my face.

Anyhow, I imagine I’ll have some interesting stuff to write about when I’m back, since I’m attending a training workshop called “Treating the Dieting Casualty,” which should sharpen my nascent counseling skills in normal eating. I’ll also get to meet Ellyn Satter, which I…can’t describe my excitement about.

Talk to you soon.

ETA: A while ago, I promised you tapeworms. So, behold — tapeworms:

First rule of nutrition: eat or die.

Second rule of nutrition: there are no other rules.

This is not something you are likely ever to hear from someone in my field, since we make our living by thinking up rules and then pretending they have been whispered in our ears by God himself, but nevertheless — it’s the truth, and I’m saying it.

Except for those of us who observe religious and/or ethical restrictions on the foods we eat, there really are no rules about what to eat.

I know this is disquieting, perhaps even frightening to you.

But, in fact, there is no stone tablet on which Jenny Craig or Dr. Atkins or Michael Pollan or whoever the fuck has etched any immutable Laws of Diet.

There are no Laws of Diet.

There is only one Law, which is this — eat or die.

That’s it; that’s all.

I could stop there, but I know that would upset people. We will now proceed to the hand-holding and handkerchief-wringing.

The words “rule” and “law” imply a directive that is established by a supreme, governing body (or deity), and which is imposed, sometimes violently, upon a population of lesser subjects.

Or, in the case of physics, a natural inevitability which occurs predictably under a given set of conditions.

And, except for eat or die, nutrition simply doesn’t work that way.

Here’s where I state the obvious: it doesn’t work that way because people are different.

Do we have ideas about what type of food is good for people with certain conditions?

Yes.

Do we have ideas about what type of food is good for the general population without said conditions?

Yes.

Do we know that over- or under-consumption of dietary components (vitamins, minerals, water, carb, fats, and proteins) can cause certain health problems?

Yes.

Can we treat or ameliorate some physical conditions through the application or restriction of dietary components?

Yes.

Do we have certain social norms and cultural preferences about what types of food to eat and how?

Yes.

Do any of these constitute authoritative, immutable, unchangeable, and inarguable rules governing what each individual must eat, think, and do, forever and ever, amen?

No.

No, they don’t — especially not among people for whom eat or die never enters once into daily thought. (I’m referring to you there, person in front of your computer wearing your favourite sweater, with a nice warm mug of preferred beverage at your elbow, and at least a vague plan of what’s for dinner? that doesn’t involve begging, a food bank, or hunting and gathering.)

If you choose not to abide by any of these rather rough and exception-pockmarked guidelines of how might be a good idea to eat if you’re a certain person in a certain situation, do the Food Police arrive at your door to arrest you?

No. (Not yet, anyway.)

Do you die instantly? Highly unlikely, severe food allergies excepted.

Because? There are no rules. Sing it with me now:

there are no rules

there are no rules

there are no rules

there are no rules

there are no rules

Now then.

Are there ways to eat which will (potentially) optimize your functioning while minimizing (your immediate and long-term risks of) certain diseases?

Probably.

Are there ways to eat which will (possibly) undermine your functioning while increasing (your risk of) disease?

Probably.

And why do I say probably instead of striking out with a sexy, definitive Yes?

Because, while these are likely results, they are not inevitabilities. They are not laws. This is not a² + b² = c².

It’s more like a² + b² = c ^{probably, maybe, if x, y, and z are also present}.

Because — let’s go back to being obvious again — people are different.

If you’re shopping for laws, try here. Take a good look. Notice there’s not one piece of dietary advice among them.

Why am I telling you all this? So you’ll have absolutely no idea now what to do with your eating, and throw your hands up in despair and head for the nearest Cinnabon, because, fuck it, there are no rules?

No.

(Though if you’re tempted to do just that, I’ll totally understand.)

I’m telling you this because it is crucial that you be the one to decide.

I’m telling you this because you are in charge of this particular voyage, cap’n.

I’m telling you this because it is critical that humans operate on the basis of autonomy.

And I’m telling you this because you make the rules.

That Ultimate Authority? That guru, or nutritionist, or Oprah-certified megalomaniac you’ve been searching for all this time? Because you’re that desperate for someone to tell you what to do?

I’ll just let that sink in for a minute.

You’re either bouncing with delight, or sweatily clutching the sides of your chair right about now.

And here’s why: either you’ve accepted the idea that both your desires and your ability to appropriately respond to those desires are inherent, internal fixtures of yourself…

…or else you’re convinced that, deep down inside, you’re all id, and that you absolutely rely on some form of external superego to rein you in.

Because you believe you are bound, fated, to go too far if left to your own devices.

Because you believe you are absolutely, inherently, unreservedly, out of control.

And I’m here to tell you that you’re not.

I’m here to tell you that, as an adult person of the human persuasion, you’re inherently responsible, reasonable, and (basically) rational. If you’re alive, breathing, reading and processing this information, your body is (basically) functional.

You are not broken.

You are capable of this. You are capable of choosing what and how to eat.

You can do it on your own (or, if you have a history of disordered eating or certain health conditions, you can do it with just a little guidance that will teach you how to do it on your own.)

And if, right now, you feel like you just can’t, that is not your fault. You live steeped in a culture that tells you, over and over again, that you’re out of control and cannot be trusted. That your desires are bad, bad, bad, that your tastes are suspect. That you require rules, which, of course, often come oh-so-conveniently attached to someone selling you something.

You have become confused, which is only natural.

In fact, it’s entirely reasonable. Because you, and I, and all of us, have been targeted.

There are entire industries profiting from our belief that we are out of control and must be led by the nose. These industries collect massive amounts of money by making up rules that don’t exist and selling them to people who don’t need them.

Obviously, the propaganda works. And if it works on you, you needn’t feel alone — it works on all of us, myself included. A sustained, positive effort is necessary to work against it.

This is where normal, dare-I-say-it, healthy eating starts. Not with rules. Not with food guides.

But with media literacy.

With skeptical inquiry and critical thinking.

And, lastly, with this whole self-determination thing.

These are the fundamentals of navigating nutrition in a world where people (sadly, not of the charitably disinterested variety) are telling you what to do with your body 24/7.

Because when it comes to nutrition, there are as many rules as there are people, which is to say: there are no rules, only exceptions; there are no laws, only choices — all of which we are condemned to make for ourselves.

And I know that’s fucking scary.

But it’s also kind of awesome.

I recognize this is a pretty radical way to talk about nutrition, and likely to spark a lot of discussion, disagreement, and possibly confusion. There are caveats and important distinctions to be made — and, as always, I’m totally willing to hash all that out in comments.

Includes an offensive Mr. Yunioshi-style cameo of a “Chinese” waiter, holy shit.

Try adding some fat to your fat — you’ll be so fat, you might just fat yourself.

I kind of didn’t know what to expect when I wrote it, but, as it turns out, I’ve had a lot of new visitors from Newsweek now, so hi. Good to see you.

(Though, I admit, I’m feeling some stage-fright here.)

For people looking to find out more about me and what I do (and maybe how much I weigh) the relevant links are at the top of this page. You can dig around in the (admittedly somewhat scanty) archives for more of my writing.

Sorry there’s not more — even though I’ve been writing for a long time, this site is new, and I wanted to use mostly-fresh material. There is more to come.

I’d also like to emphasize that, while I do welcome a variety of viewpoints here, I will be moderating the comments for anything beyond the pale.

If you’re having trouble figuring out what this whole “fat acceptance” thing is about, then I’d suggest you start here, and maybe here, just to pick up some of the general concepts.

Also — no polite questions turned away. So, if you’re confused about anything, please ask.

Edited to add: Please also feel free to leave your comments at Newsweek.

“Reach for a Lucky instead of a sweet” is probably one of the more well-known taglines in advertising history. That doesn’t prevent it from creeping me the fuck out every time I encounter it.

And you’ll never guess who the inspiration was for this little gem —

In the November 19, 1948 issue of Printers’ Ink, Vincent Riggio, President of The American Tobacco Company, relates the alerting story of one of the most famous of all sales-building cigarette campaigns –

“Some years ago, I was riding up town with George W. Hill, and we had gone about five miles through New York City without Mr. Hill having spoken one word. He was thinking deeply about something, and knowing Mr. Hill, I did not interrupt his trend of thought.

“This went on for a while, and we were obliged to stop for a traffic light. The car was standing there for a few minutes, and Mr. Hill grabbed me and said, ‘I’ve got it.’ Then, ‘Look,’ he said, pointing to a stout woman who was standing on the sidewalk waiting to cross the street. This woman had a big piece of candy in her hand and was eating it. A taxicab had pulled up between the sidewalk and our car, the occupant of which was a slender, nice looking woman smoking a cigarette. I noticed the contrast immediately. Mr. Hill said again, ‘I’ve got it…”Reach for a Lucky Instead of a Sweet.”‘

“Many in marketing today believe that campaign created more women smokers than any other single promotional effort.”

-Julian Lewis Watkins, The 100 Greatest Advertisements, 1959

– Some poor innocent bystander of a fat lady, who had the audacity to eat candy in public.

Naturally, the throat-soothing action of deliciously toasted tobacco is far more wholesome and good for the constitution than abandoning oneself to the horrors of corpulence.

I will now take the remainder of this post to qualify that statement.

Here’s what I mean: only in certain, limited contexts does WHAT a person eats play a direct role in their health. We’re talking deficiencies and diseases where the body’s storage and handling of nutrients changes radically.

In these situations, diet or nutrient supplementation needs to be controlled with varying degrees of precision, or, as we so often like to express it in this lovely fucked-up culture of ours, strictness.

I’m talking kidney disease. I’m talking diabetes. I’m talking recovery from cancer. I’m talking scurvy and beriberi and pernicious anemia — and plain old iron-deficiency anemia, too, for that matter. I’m talking inflammatory bowel disease, I’m talking recovery from trauma like surgery or burns or bad wounds or anything which renders you incapable of feeding yourself, thus requiring a tube and/or IV. I’m talking celiac disease and food allergies. I’m talking liver disease. I’m talking certain medications (like monoamine oxidase inhibitors) that don’t play well with certain foods.

And, as far as I’m concerned, these are the only types of situations in which WHAT a person eats takes primacy over HOW they eat it. And even then, in many cases, the WHAT is only just barely more important than the HOW.

Personally, though I’ve completed basic training in the WHAT at university, my interest has always been much stronger in the HOW.

The HOW we eat applies to all of us — disease or no disease, allergy or no allergy, nutritionist or pastry chef.

By way of explicit example: yesterday, I ate two cups of ice cream and a bunch of rainbow Twizzlers for lunch.

I wanted it, I had it, and I felt pretty good about it.

I functioned well physically for the rest of the day.

Later on, I had a bowl of bran cereal for dinner.

Was this balanced? Absolutely not. Was this “healthy” by popular standards? Not at all. Do I eat this way every day? Nope. Was it totally fine for me? Without reservation — yes.

Here’s what I believe: human diets (meaning in this case not “weight loss diets” but “everything one eats”) in their natural, un-fucked-up state are pretty chaotic. We eat a little one day, and a whole shit-ton another day. Using examples from my own life: we might eat a quart of strawberries per week in June, and then drink a quart of homemade Irish Cream in December.

The bottom line? If you’re not messed up around food in some way, it balances out over time.

This is part of the reason that dietetics is such an imprecise science. When you get a three-day food diary from a client and then analyze it for the nutritional breakdown, you’re only getting a snapshot of their entire diet.

Diets change seasonally and regionally by what’s available, they change by what’s on sale, by what you can afford, by what looks good to you on any given day. They change by your mood, since all human beings (since the beginning of time, probably) use food to comfort themselves or to celebrate.

And, lastly, yes — your diet also changes based on your changing physical requirements.

For the most part, a lot of our nutrition — which is to say, the molecules our cells use to work, and to produce the raw materials that comprise our bodies — is stored. And some of those stores last for decades. Or a lifetime.

For example, your skeleton? Yeah, it’s not just the handy-dandy coat rack that your organs hang from, and those chompers you use for donut-munching — it’s also your travelling calcium pantry for whenever your motor neurons need a bunch of calcium ions to work the chemical/electrical ju-ju that triggers a muscle contraction.

You know, so you can walk and talk and scratch your butt and stuff.

These uses for calcium are so effing important that your body is willing to raid that pantry — even weakening it to the point of physical collapse — so you can continue breathing at all costs, even if all your ribs crumble in the process. And that’s part of the reason we have such a GIANT FRIGGIN’ STORE OF CALCIUM in our bodies, enough that it would take years to use up entirely, even if you never ate another milligram of calcium again.

Now. I’m not suggesting that you should stop eating calcium and watch what happens, cause I can tell you right now — your bones are going to weaken as your body raids the pantry, and that’s not good for you. But I am saying that our bodies are pretty well set up to survive, even without food, for quite a while. (And, luckily, calcium is present in so many foods that it can be difficult to avoid.)

We’ve got failsafe upon failsafe upon idiot-proof failsafe working in our favour. And these’ve developed the hard way, by trial and error over hundreds of thousands of years.

So, if you’re like me and, I’m going to guess, like 99% of the people who:

• Have access to the computers and the internet and the basic literacy skills required to read this blog,
• AND if you have adequate access to clean drinking water and enough food so that you’re not constantly hungry,
• AND your food’s safety is regulated by an imperfect but basically functioning agency intended to prevent a huge and lucrative population of tax-payers and stuff-consumers from keeling over dead by the swath,
• AND you don’t have some disease or injury requiring direct and aggressive therapeutic nutrition intervention, then

YOU’RE GOING TO BE FINE.

You can stop obsessing about WHAT to eat now. You’re welcome.

Okay, so I know it isn’t that easy. Sure would be nice if it were, though, eh?

We’ll talk about the HOW next time.

Until then, please bitch me out or correct my horrendously simplified depictions of complex human physiology in comments.

I started it off by turning 30, which I was extremely excited about. I’m a bit sentimental when it comes to numbers, and I was doing the whole clean-slate-fresh-start thing in my head.

And there have been a lot of good changes recently, this website and the idea to strike out on my own as a nutrition renegade being not the least of them — but there’ve also been some hard things that I haven’t gone into detail about.

Now’s probably the time to remedy that.

I’ve semi-identified as a person with a disability for a few years now. I say “semi” because my disability is not visible — it’s “mental” or “emotional” in nature. (Except, because of my bias against such Cartesian dualism, I consider all mental and emotional problems as inherently physical, and all physical problems to carry some emotional/mental weight with them.)

This whole “I’m kinda/sorta/not-really disabled” thing is just now coming home to me in a major way, though I’ve kinda/sorta/not-really accepted it since 2005, when I first registered as a disabled student at my university.

To put it plainly, I have depression.

Yeah, it’s a boring thing to have, and I’m so sick of thinking about it that I can hardly even stand to type out the word. I’ve had it a long, long time, since childhood.

I’ve tried a lot of treatments for it — a fair bit of therapy, a fair number of drugs. None of them worked in any long-term, fundamental way. I’ve also done a lot of self-medicating in the form of, shall we say maladaptive behaviours, and experienced some hard-core avoidance that is more accurately described as TOTAL PHYSICAL PARALYSIS rather than “procrastination,” and SHITTING MY PANTS IN TERROR rather than “anxiety.”

So why bring all this up now?

This spring, I tried a new drug. It started really working for me toward early summer.

It was the first time I can recall feeling “normal,” mood-wise, since before I was about ten years old. It gave me so much hope. It realigned my vision of what life could be, of what it probably is for people without mood disorders. I woke up in the morning not wishing I were dead, and it was…it was…

…it was magic. It was falling in love. It was bringing the dead back to life. It was winning the lottery and the Miss America Pageant all on the same day. It was waking up from a nightmare and saying to yourself, “It was all a dream. It’s over.”

But it wasn’t over. The drug stopped working.

Within a few weeks, my stubborn, intractible brain managed to compensate for the new chemicals flooding it, to return to its cherished equilibrium-state of feeling like utter shit. Of fatigue, of tiredness, of hopelessness, fear and guilt.

My doctor told me I have treatment-resistant depression. I told her that I would rather die than accept that.

She told me to stop fighting.

I went home and bawled my eyes out.

For all my talking the talk about alternative definitions of health, of “inhabit, accept, and cope,” I haven’t been much walking that particular walk, except as it relates directly to being fat.

Depression has been different to me, somehow. For as (relatively) easily as I could accept that I was just going to be a fat lady, and buy fat lady clothes in fat lady stores, and never quite fit into certain social or physical spaces, and that I would commit myself to respecting my body anyway, and fighting for a culture than can similarly respect people’s bodies, it remained totally unacceptable to me that I would wake up every morning with this anvil of utter suck pressing down into my heart, hobbling me from doing the things I desperately needed to do and mocking me whenever I stumbled.

Case in point: it has taken seven years, thus far, to reach my fourth year in university. By the time I graduate, it will have taken me eight full years.

This is entirely because of the depression.

Yes, I have worked at the same time, and gained a lot of experience, and been accepted for jobs that students are not normally accepted for. But I did this as compensation for what I could not do at school, which was face my intense fear of judgment, of being graded, of being praised and shamed like a dog.

Even at my worst, I could function well at work — it provided an escape. School, however, became intolerable. It set me in a cage with my worst fears, and restrained me by the shoulders as they took turns socking me in the gut.

This summer, when the medication stopped working, I wasn’t even able to perform at work anymore. It took me an extra three or four hours each night just to complete my basic tasks. I no longer cared about anything — about being late, about getting things done, about what my boss wanted, about being the perfect little employee I’d been for the last five years.

And I realized the grip of this depression was getting tighter, closing doors and windows through which I’d previously been able to escape for a few blessed hours, in my white coat, to neat desks and the smell of disinfectant and tidy to-do lists and calorie counts.

In plain English, my functioning was getting worse. I was becoming increasingly unable to do basic tasks, and I could no longer avoid thinking about it. The typical treatments were not working for me, except as a temporary stop-gap, and I’d done them so many times that I was frankly exhausted.

So, now my doctor has verified my worst fear: I am stuck with this thing.

It is not temporary; it is not external; it is a permanent part of me.

As such, I am now slowly taking the steps required to accept this, much in the way I had to learn to accept my body.

I am disabled. I will have to learn certain kindnesses and flavours of compassion I previously had the privilege of eschewing, and I will have to practise them on the most unsympathetic character imaginable — myself.

Instead of fighting, we’ll have to make it up somehow. We’re roommates, not mortal enemies. There is nothing to be gained by dashing out my brains against this particular rock, and everything to lose by continuing to fight.

I’m going to work with it, live with it.

And I’m beginning to think that could be okay.

My first thought was, “What in the HELL is vitamin G?” Turns out that’s what they used to call riboflavin (now known as vitamin B2.)

Mmm, riboflavin.

My second thought was — “a shake for breakfast, a shake for lunch…and then a sensible dinner!” And this is from 1935, when, apparently, a sensible low-fat dinner consisted of 900 calories. Holy shit.

I mean, my breakfast this morning was likely 900 calories, but that was greasy-spoon diner breakfast. I can only imagine the volume of food required to make up a low-fat 900 calorie meal.

Not to squick people out with numbers and calories or anything. But these are things I think of, and numbers (oddly) don’t bother me anymore.

In other news, what a week it’s been. I ran around to three different hospitals, working 10-12 hours per day (mostly because I was feeling crappy, and everything took me twice as long as usual.) I saw patients, I wrote chart notes, I counted people’s calories, and I thought about food.

I thought about how much cancer sucks. And how much the treatments suck.

I thought about how scary it must be to be stuck in a hospital bed in a strange country.

I thought about how lonely it must be to have dementia and not know who anybody is.

I thought about how much it must suck to be terrified of eating.

As much as it also sucks to struggle with normal eating, with negotiating one’s way through a culture riddled with anti-body minefields, I couldn’t help but feel grateful for the health I now enjoy, and the relative ease with which I eat.

I also couldn’t help but feel that one day — maybe tomorrow, maybe in 50 years — I will be one of those patients.

I will have troubles of my own, and I will count on someone like me for help.

Also, now that the crazy-ass work week has ended, I go back to my largely-lady-of-leisure status. Which means writing some actual content-containing posts, and responding to people’s emails. So if you receive a random flood of emails from me in the next week, don’t be alarmed. I’m just getting caught up.

Me neither.

Making food unpalatable = instant willpower.

Or you could just move to a tiny apartment with three cats who share a litter box. And who have impeccable bathroom timing (i.e. mealtimes.)

WHY NO, I’M NOT BITTER.

Anyway, I’m working like crazy over the next week or so, but I will respond to everyone who’s contacted me very soon. Sorry for the delay.

Share your own ridiculous diet culture shit, or simply take part in the pointing-and-laughing in comments.

And I don’t intend these posts to come from a place of pure derision and bitterness, but actually just because I think this shit is funny, and some of it makes me feel nostalgic. I must admit to you now that I have a soft spot for old aerobics videos.

Let’s call this a semi-regular feature, and we’ll pretend like this is a real blog or something, okay?

So, my favourite exercise video of the day comes from the unparalleled genius of Everything is Terrible. Enjoy.

I even have quote in there!

God knows I never thought I’d see the day when I’d be saying “Hey, look, it’s a Fatosphere article in the New York Times!” let alone, “Hey, look, it’s ANOTHER Fatosphere article in the New York Times!” but, as we all know, things have changed a lot, at least online, in the last couple of years.

I’ve been writing online about fat stuff since roughly 2002, on a godforsaken online diary site where people would regularly come by to reassure me that I would die a horrible fiery death for “promoting obesity.” (That is, if simply being fat didn’t get me first.)

I’d quit dieting in 2000, after being made aware of the existence of fat acceptance in 1999 (from, of all places, reading Dean Edell’s book Eat, Drink, and be Merry, which had a brief blurb about fat ladies who formed a fatty swimming club together), and after developing some very dysfunctional eating and exercise patterns on the diet. As well as a nice case of pneumonia.

The book that finally sealed the deal for me was Laura Fraser’s Losing It. After reading it, I looked down at my body and thought, “This is a nice body. Why have I been abusing it? I’m sorry, body. Let’s stop this.” And I never looked back.

I decided to study and work in nutrition, as a fat lady. I wrote a bit for Big Fat Blog. When the Fatosphere and big-time bloggers like Kate and Marianne came on the scene, I was inspired to start my own Fatosphere blog. And now I’ve settled into what I think of as my permanent online home, still part of the Fatosphere, but, hopefully, taking up the topic of nutrition in a new way.

So that’s the completely unsolicited (and undercaffeinated) story of how I got here. And maybe of why you’re reading this.

Either way, it’s nice to see some fats in the New York Times. Again.

ETA: I don’t know exactly how or why this turned into a rambling, narcissistic recounting of me-me-me, me, and ME! instead of, you know, talking about the article, but I’m still blaming the lack of coffee. We can talk of things of substance in comments.

I work in healthcare. I belong to the Church of You Don’t Deserve This. I take care of alot of patients who, IMO, don’t deserve the medical care that I dispense. I know this is going to make me sound like a total and complete ass, but let me elaborate.

I take care of patients with kidney disease. Some patients got kidney disease through shitty genetics. Others through odd accidents or bizzare infections. Others through cancer. Alot of our patients (like my own father) got kidney disease from letting their diabetes go untreated for 20, 30 years. Regardless of how they got it, the vast majority of my patients refuse to take steps to prolong their life and improve their quality of life.

Dialysis patients, as a whole, are notoriously noncompliant. This is usually because they have a history of non-compliance which usually got them into their situation in the first place.

For example, dialysis patients shouldn’t really drink more than a liter of water per day. Yet we have patients who, as soon as they leave our hospital dialysis unit, go home and start chugging gallons of milk or juice. (And are consequently back in the hospital within a few days). We have patients who have two homes: their regular residence and the hospital. They treat themselves badly and then spend 1/3 of an average month in the hospital, racking up hundreds of thousands of dollars in Medicare bills over the course of a year.

You know what I think about these people? I think they don’t deserve my services. (yes this includes my dad). I think that my services are wasted on people who refuse take even basic steps to help themselves stay well. I think I’d rather focus my energies on the patients who recognize the seriousness of their condition and take an active role in their self-care.

If I were king of the world, I would tell these people, “Look, we’re giving you three months to turn your life around. Start taking better care of yourself, stop drinking yourself to death and take your medications as prescribed or else we’re going to withhold treatment until you do. There are alot of people with kidney failure who want to live and we aren’t going to divert scarce resources to people who don’t care one way or the other if they die or not.”

Thats what I would say, if I ran the world. The Church of You Don’t Deserve This.

That’s not what I say, however.

My profession demands that I dispense medical care to all who need it, regardless of my own personal judgments. My profession demands that I provide care to someone who treats their own body so badly that they have their own PO Box at the local hospital. My profession demands that I care for the unruly, the mean, the stupid and the non-compliant. My profession demands that I provide care for brain-dead patients who are just being kept alive by their families for the monthly social security cheque. My profession demands that I care for everyone who darkens the door at my clinic, regardless of whether or not they are saints or Dick Cheney. My profession demands that I do things, which, in a perfect world, I would be able to not do.

And yet I do them anyway, because it’s in the job description.

What a hero.

I apologize for my lack of analysis right now, and for my lack of recent posts, but I’m adjusting to new medication and basically have been sleeping my face off. In a few days, I should be back to my old self.

Allow me a moment of unmitigated cheesiness and affection, however, to say this: I love my commenters. You are all making this new website adventure a lot more fun than I thought it would be. I love what’s happening here, and I want it to keep happening.

So, yeah. I guess I kinda like you. That’s all. Don’t go spreading it around or anything.

Just the other day, I received the following wonderful letter, and nearly broke my spine tripping over myself to thank the writer for writing it:

Dear Fat Nutritionist,

I am trying to improve my diet by adding things to it, in recognition of the fact that one’s diet is a vital source of vitamins and minerals. So far I have added a daily serving of orange peaches (about the only thing from the orange-vegetables list that I like) and a serving of green vegetables, and I have been eating fish at least twice a week. (I’m giving myself a gold star for that, because it’s progress even though I have far to go. Seriously, eight servings of vegetables every day?)

What I’d like to know is whether there is any truth to the idea that nutrition-free additions to nutritious foods make them less nutritious. Is there something about pouring caesar dressing on a bowl of romaine lettuce that makes the lettuce less nutritious? Are chocolate coated almonds less almondy than unsalted ones? Does cooking my zucchini in butter make it less zucchiniful?

I know these things raise the count of calories and calories-from-fat, but these are things that I am deliberately ignoring.

Thanks Fat Nutritionist,
Bookwyrm

Dear Bookwyrm,

Wow. I’m actually really impressed with how you’re stretching your food-related horizons, especially with more “challenging” foods like fish and vegetables. I’m not a huge vegetable fan myself, so I know that can be a rough one. And as far as the eight-a-day goes, eeeehhh — I treat all those rules as more of a suggestion from a super-paranoid health-freak friend. Which is to say, with salt.

Lots of it.

So, in response to your question, “What I’d like to know is whether there is any truth to the idea that nutrition-free additions to nutritious foods make them less nutritious. Is there something about pouring caesar dressing on a bowl of romaine lettuce that makes the lettuce less nutritious? Are chocolate coated almonds less almondy than unsalted ones? Does cooking my zucchini in butter make it less zucchiniful?”

Basically — no.

Stuff doesn’t magically become less nutritious because you add butter or dressing. There are always tons of crazy nutrient-nutrient interactions, but many of them are so miniscule, or there are so many of them going on at once, that you’d drive yourself crazy trying to account for them all.

You can also always point out to any random nutrition police that, for every nutrient interaction that actively interferes with absorption (like calcium interfering with iron), there’s another nutrient interaction that enhances absorption (like vitamin C with iron.)

So, basically, let’s assume it all evens out. Roughly speaking.

The wider the variety of food you learn to eat, the better your nutrient intake becomes. So, whatever gets the food up off your plate and into your mouth is effectively enhancing its nutritional value.

Because:

1. You’ll eat it today, and
2. You’ll like it enough that you might eat it again another time, and
3. You’re going to be way more likely to stretch those food horizons even farther in the future, since you’ve had awesome experiences with, I don’t know, gravy on your broccoli.

And, going even further, a lot of flavour-enhancers (especially the fatty ones, like butter and oil and salad dressings) actually improve your ability to absorb nutrients in the food (fat-soluble vitamins A, D, E, and K.) What’s more, fat slows down food on its trip through your gut — meaning, your gut gets more time to absorb all the goodness.

Now, of course, it is true that cutting, mashing, and cooking vegetables (and other foods) can destroy certain sensitive vitamins, as does letting them sit in the fridge too long, blah-de-blah-de-blah-everything-you’ve-ever-read-in-a-dry-nutrition-advice-column-blah-de-blah.

But, honestly, it’s really freaking hard to come by food that is so totally bereft of nutritional value that this is going to make much of an impact — assuming you eat enough food to begin with, which most people living in rich countries do. If you’ve got a food-security problem, that’s a whole other ball of wax that needs to be addressed before you go around worrying whether your broccoli is is broccolicious as it can possibly be.

So, bottom line? If you’re eating actual food, and eating multiple food groups, and not starving or unduly restricting yourself, then yay. You’re doing well.

And anything you can do to make that food tastier, sexier, and more likely to end up in your mouth? Go for it.

Hope this helps,
Michelle

Join the FOOD-FIGHT!!!! in comments.

Sadly, I also think it’s wrong.

Why is it wrong?

Because, first of all, weight isn’t equivalent to health. And therefore, weight loss isn’t equivalent to automatically improving health. But I think we all know that.

More complicatedly, weight isn’t even the most important factor in determining a person’s health. And this is an idea that I think might encounter some resistance. But I’m totally serious.

(And I’m sorry if this is all a little too “Public Health 101″ for everyone, but bear with me. All that theoretical crap I learned in school actually DOES, it turns out, have relevance.)

I propose that the insistence on “obesity” as a personal failing, and even the conceptualization of “obesity” as a disease, is actually an artifact of an individualist perspective of health. Which is to say, because we tend to believe (as Americans, as North Americans, and sometimes just as humans) that health is an individual issue, not a social or public one, we revert to blaming individuals for all kinds of conditions and illnesses that do not jibe with our cultural ideals of What A Person Should Be.

But if you start to look at health as more than just a personal balance sheet of good behaviours vs. bad behaviours, and even look beyond genetic underpinnings, or plain roll-of-the-dice random luck, you’ll see that there are broad, societal patterns of who gets sick and who stays well. And thus, we run smack-dab into the concept of Social Determinants of Health.

If fat people experience poorer health than other people — and there are stacks of epidemiological associations that imply we do, the lower mortality risk of “overweight” people notwithstanding — then maybe it would be useful to put down the keys to the blame-mobile for just a moment and consider one question:

Why?

Now, if “obesity” were one of those things that had a single cause, and a single mechanism, and, subsequently, a single, reliable cure — then maybe it would be fair to jump instantly to the conclusion that being fat, itself, is the problem. (And, naturally, losing weight would be the magic-bullet cure.)

Except it doesn’t work that way.

At present, we’ve got so many hypotheses for why people get fat that you could drive yourself crazy trying to read it all. There’s, you know, adenoviruses, and some kind of woo-woo social transmission by which your being fat tacitly encourages your friends to get fat, and there’s the leptin-deficiency hypothesis which turned out not to apply as easily to humans as it did to specially-bred mice, and the whole food addiction thing, the obesogenic environment thing, the evil-carbohydrates thing, and then the genetic component (which, in itself, seems to implicate so many different genes that I don’t think you’d be able to find a police station long enough to accommodate a line-up.)

Fatness, it turns out, is a many-splendoured thing.

And, as a result, we’ve never found that wonderful magic-bullet cure I mentioned, even though people will swear up and down on their life, on their Bibles, on their mother’s-mother’s-mother’s grave, that we have.

In that case, I have only to ask: then why are so many of us — most of whom desperately don’t want to be — still fat?

Because there isn’t a single “Cure.” Because there isn’t a single cause or mechanism. And, not least of all, because fatness isn’t a disease.

A quote I love:

My definition of a disease is a categorization…that has predictive power and, in some cases, enables causal inferences to be made. There remains the difficult but not insoluble problem of distinguishing disease from social deviance.

-Ian R. McWhinney, CMAJ, VOL. 136, APRIL 15, 1987

I’m preeeeetty sure that the whole OMGBESITY CRISIS!!!! is actually more about policing social deviance than it is about concern for our health.

And even if fat people are at higher risk for certain diseases, I still contend that fatness itself isn’t the problem.

So what is?

I posit that the problem is social inequity. To wit: marginalized people have poorer health outcomes.

Are fat people marginalized? You betcha.

Does it affect our health? Quite possibly.

As always, let’s hash it all out in comments.

Which never happens.

Anyhow. I have the follow-up post to my last thing pretty much ready to go — just needs a bit of editing. But I’ve been busy working at yet another hospital lately, and it’s been good. Lots and lots of patients to see, which is the finest part of the job, hands down.

I’ve got flowers growing on the balcony, and even though I’m pretty sure I interrupted some kind of shady transaction going on in my backyard today, it’s a lovely day and Toronto is colourful, almost beautiful in the sunlight…

…or that might just be the GIANT coffee I drank this afternoon talking. Either way, I’ll take it.

I baked some bread yesterday for the first time in eons. I stopped baking it when I moved into my current apartment, which has a kitchen the size of a Band-Aid. But with the help of my MONSTER MIXER (700 watts, baby) and its dough-hooks, I didn’t knead anything, and the bread was righteously awesome.

If I do say so myself.

I’ve also been playing with my cat’s diet lately. Because, what are pets if not your own personal biochemical experiments?

I’ve had a couple of emails about specific nutrition questions, which I love, because it gives me the chance to dig through my old clinical nutrition notes and textbooks and brush up. Or to remind myself of how, exactly we did things back in some old clinic. So keep ‘em coming, if you have any questions. It’s good practice for me.

As future plans go, I’m going to let slip a little something I’m planning to do here. There’s a certain training I want to take in the fall, and said training will allow me to feel confident in offering nutrition counseling/coaching/cheerleading/hand-holding/helper-ing to people, either in person or at a distance.

I could do it right now, actually, but what can I say? I’m conscientious-beyond-conscientious, to the point where I will be the MOST RIDICULOUSLY OVER-EXPERIENCED DIETETIC INTERN EVAR!!! when I finally get there, since I insisted on working my way up the nutrition ladder by volunteering in eating disorders, and then working in food service, and then taking a (bizarre and disastrous) detour into real estate, and then doing clinical nutrition. Because I am insane and can’t just settle down and focus on getting a damn degree like you’re supposed to.

And even though I’ve got the whole nutrition care process thing down, I want more specific training. A method, to be precise.

So, I’m going to git myself some training, and then I’ll hang out my shingle, right here on this little ole website. And all six of my readers will have the chance to hire me.

Exciting, no?

Yeah, that’s what I thought you’d say.

Oh, and I discovered I’m an inch and a half taller since I last measured myself. Will wonders never cease.

But I’m wondering, what’s really the most important question here? Whether fat people are unhealthy? Or why fat people might be unhealthy, if they are?

I think you know my bias is going to tend toward the latter.

This is not just an academic question for me: I am a fat person. And not just a little fat; I’m the highest caliber of fat there is — Class III Morbidly Obese. For me, this is an intensely personal question.

Am I unhealthy? Are people who look like me unhealthy? Are we unhealthy in similar ways, and can any of those ways be blamed on our bodies? Can our bodies, subsequently, be blamed on our habits, or our morals, or our characters?

And I think you might also know that my tendency is to answer these questions with yet another question:

What is health, anyway?

The World Health Organization says:

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

Which, you have to admit, seems rather noble and inspiring.

My only problem is, according to this definition, who on earth has ever been completely healthy?

I would answer, no one.

I don’t believe anyone living now, or anyone in the past, has ever enjoyed such a rarified state of ideal physical, mental and social perfection. At least not for longer than, say, about ten minutes. On the most perfect day of their entire lives. Which also happened to be their sixteenth birthday. And the first day of spring. And the day when Kevin Garnett of the Boston Celtics professed his undying love for them . . .

. . . with an ice-cream cake.

And while I understand the rationale behind putting forth lofty mission statements for organizations, such as the WHO, whose reason for existence actually is the attempt to eradicate all threats to well-being, and to optimize all people’s health, I don’t believe such mission statements make appropriate aphorisms for the individual to live by.

We are, after all, individuals. So this matters.

And this is why, in my second or third year of university, I proposed another definition of health, based on the work of John Kabat-Zinn, who pioneered the mindfulness-based stress reduction approach, which has subsequently been applied to all sorts of therapies for mental, as well as physical, illness.

I wrote:

I sense a flaw within [the WHO's] definition of ideal health. It’s the silent assumption that anyone experiencing less than ‘ideal’ health is not only possibly to blame for their predicament, but that their lives are tainted, somehow broken, and possibly less meaningful than the lives of the ‘healthy.’

I propose that our definition of health should have less to do with how sick or well we are, and more to do with how we live inside and with our unique physical condition.

A person’s state of health is what it is, and the thing to strive for is not less disease, or even longer life, but the ability to inhabit, accept, and cope with what is.

We can focus on using our skills [as healthcare practitioners] to help individuals live meaningful and worthwhile lives, no matter what their physical condition, alongside treatment and our search for cures.

And we can revise our definition of health to mean having the skills to face and live with challenges, and call people ‘healthy’ who manage to enjoy meaningful lives in the face of pain, illness, and mortality.

See, the thing is, health and illness, as concepts, are socially constructed.

Meaning — reality is messy. There are no clear lines of demarcation between healthy and sick. We decide — humans decide — how to label each other. And in that deciding, we reveal our biases and our unspoken assumptions about how other people live, and how worthwhile their lives are.

This is not all just pretty talk. The definition of health is at the base of how we structure not only our healthcare system, but also how we structure our society with regard to impairment, illness, and death — all of which are inescapable facts of human existence.

And while I would never propose that we stop treating illness, or ending suffering, or curing actual diseases, I would like to see these things happen within a conscious awareness of where our ideas of illness come from, in the first place.

Who gets treated, and to what end?

Are we banishing disease and improving quality of life, or are we blindly, almost compulsively, seeking to bring people in line with powerful, if latent, cultural ideals?

Why must everyone’s BMI fall within a certain, narrow range in order for us to feel comfortable?

Is this truly a risk-reduction strategy, predicated on the notion that the associations between weight and health are purely causal in nature, as well as reversible if we could just figure out how to turn down the goddamn dial on weight?

For health practitioners, particularly those enamoured with biochemical indices and relative-risk reduction strategies, the notion of one, simple solution to a myriad of chronic diseases — and possibly to mortality itself — is eminently seductive.

Sadly, I also think it’s wrong.

Next, I’ll talk more about why. In the meantime, click on comments, and let ‘er rip.

And I thought, this is a good bunch of people.

We talked about healthism, and expectations of dietitians’ bodies, and feminist theory, and critical theory, and disability, racism, exclusion, food systems, agriculture, hunger, food insecurity, activism, queer theory, poetry, the environment, and just…everything. We laughed, we ate, we commiserated, we congratulated, we drank beer. Some of us even cried a little.

And it reaffirmed my faith that I belong in nutrition, even when — maybe especially when — I feel like an outsider and eccentric.

Because we need outsiders and eccentrics, or we don’t make progress.

For one of the very few times in my life, and the first time in a group of other nutrition people, I was able to openly say that I believe in fat acceptance and health at every size. And people just nodded and said, “Cool.” No raised eyebrows. No clucking. Just genuine interest from allies of every stripe.

It felt like we could talk about anything, and it felt like something new was born, right there in front of me — a movement toward expanding nutrition outward from its compact singularity of vitamins and chemistry, into a vivid universe capable of encompassing the messy realities of human lives and human cultures. Critical dietetics. Radical dietetics.

I was lucky to be there. As one of the participants said in his talk, “I have found my people.”

And it turns out that my people are outsiders and eccentrics, like me.

And what kind of asshole would I have to be to turn down free books?

As I read through it, I dog-eared each page that mentioned anything about food. That book is now double the thickness it was when I started, because damn near every page mentions something about food.

In case you weren’t aware, Monica Seles is a former professional tennis player — a spectacular one. She won the French Open when she was 16, and was ranked No. 1 in her sport for three consecutive years — in total, winning nine individual Grand Slam tournaments by the time she was 19 years old.

When she was stabbed in the back.

Literally. With a knife.

A man described as stocky and balding leaned over the three-feet-high (91 cm) barrier and stabbed her from behind. Miss Seles let out a scream, clutched her back and stumbled on to the court.

The attack took place in full view of the 6,000-strong crowd watching the match.

“He held the knife with both hands as he stabbed her in the back,” said one eyewitness.

~BBC News, April 30, 1993.

Following this traumatic event, the tennis world rather ungraciously left Monica behind as she struggled to recover, physically and emotionally. She lost her ranking and her sponsorships. Then her father died.

And in the course of dealing with all of this, her natural love of food was replaced by disordered eating — namely, binge eating.

She gained a significant amount of weight, and the press responded to this with the classiness and sensitivity one might expect. Which is to say, none whatsoever.

Monica Seles has got her appetite back, and not just for tennis. A frisky wind in Florida shows how she is piling on the pounds. Thunder thighs Monica, 23, made heavy going of her latest match…

~The Mirror (London, England), March 27, 1997.

The book details her attempts to get back into the game of tennis — attempts that would, ultimately, only deepen her disordered eating, as she fought against her body to lose weight and whip herself into competitive shape.

Surrounded by an entourage of trainers and nutritionists, who eventually became both food-police and babysitters, Monica seemed to have lost touch with not only her phenomenal athleticism, but with her body as a whole.

The turn comes when, surprise-of-all-surprises, she chucks the rules, chucks the diets, chucks the insane pressure, and decides to live her life.

She figures out food, and grief, and how to be in her body. In the process, she loses the weight she’d gained. She feels better about herself; she feels like she’s come home.

And that’s all very nice for Monica Seles.

The thing is, I kind of wish the weight loss thing wasn’t emphasized so much. There’s even an iconic too-small dress that she uses as a symbol of her progress. But, really, I believe weight changes are secondary to whatever is going on with one’s eating and health in general.

Besides which, if she hadn’t lost any weight, but still managed to figure everything else out, should she then consider herself not to have gotten a grip? To be, for all intents and purposes, gripless?

I think you know my answer, which is a resounding naaaaaaah.

At any rate, I am happy for her. I am always relieved and gladdened to hear of any woman negotiating her way out of weight obsession and dysfunctional eating. And though it’s not going to be winning any Pulitzer, this was an engaging book that exposed me to a surprisingly interesting world I hadn’t ever thought much about — the world of the professional athlete and tennis player.

Though I’m assuming it was ghostwritten, Seles’ playful — one might almost be tempted to say bubbly — personality comes through in an appealing way. Right along with her wildly enthusiastic love of food, which I can totally get behind.

There’s also an unconfirmed report floating around that I may have cried once while reading it. Yeah, just don’t go around telling people.

And I didn’t write anything, because, naturally, that’s what you do when you’re gripped with an irrational fear of putting yourself out there.

Last night, I finally took some time to sort things out, do a little housekeeping, light a candle on my desk, and make the attempt to reclaim…what? I’m not sure. My space in the world? My mental happy place?

Something like that. Only pretend I used less cheesy terms than I just did, okay?

I’ve got a million things going on right now that all feel like they’re pulling me away from myself, and I’ve always resented that feeling. I’ve got a class I’m taking (disability studies FTW!), and hospital work to do, and some sort of volunteerish stuff, and maybe writing a Big, Important Paper with someone I admire.

And as much as I truly want to do all those things, and freely chose to sign up for them, when they start becoming The Enemy and I start feeling like The Captive, I know I’m in trouble.

Incidentally, this is all related to that intrinsic motivation thing I mentioned the other day. And to the whole making-friends-with-yourself thing, which is sort of the whole raison d’être of this blog.

So, I recognize that it’s time to get reacquainted with my reasons for wanting to do these things — just as it might be periodically advisable to get reacquainted with your reasons for, say, eating well, when you start to slip back into authoritarian mode and getting all “shouldy” and finger-pointy with yourself.

We all do it.

My first step in the reacquaintancing, as it were, is to remind myself: I don’t have to do this. In fact, I don’t have to do any of this. If I look at things realistically, there are very few things in this world I have to, absolutely have to, do.

One of them is breathing.

Another one might be eating and imbibing fluids — and even then, it’s just enough to get sustenance into my mouth. There are no rules about how well I have to do it. Just enough to stay alive is good enough (and you’d be surprised — I once lived through a period where I basically just ate hashbrowns, toast, and milk. And another period of frosted strawberry Poptarts. Not that I’m recommending this course of action — I’m just sayin’.)

And then there’s sleeping and going to the washroom.

Anything else? No, not really. This is the bare minimum required to sustain existence. So, what I’m saying to myself, which I find comforting at times like these, is I DON’T HAVE TO DO JACK SHIT except survive. I could dump all my “obligations” tomorrow, in the most unceremonious fashion possible, and I would still be a human being who deserved to live.

I start to feel better almost instantly.

Now, since most of us are interested in something more than rudimentary existence — if you’re not, I’ll gently suggest you may want to seek some kind of counsel. I’m a little more well-acquainted with mental illness than I’d like to be, and I can tell you that this is one of its distinctive calling cards — the second step is to take stock of what on earth you’re doing.

I mean, do you have a reason for being here?

Do you have something that makes your heart beat a little faster, just thinking about it? Are there people you love, things you want to see, art you want to create, or just little ineffable ripples you want to send out like Morse code across the big old pond of human affairs?

I do. First, I have a sort of working morality that’s developing as I blunder clumsily through my days. There are people I love, many of whom are far away in a place I’d like to get back to. There’s my husband, who is my buddy and my co-pilot and co-philosopher and co-conspirator all rolled into one. Then there’s writing, which I can’t even explain my attachment to, except to say that without it, I don’t think I’d be fully me, and I seem to crave doing it every single day.

And then there’s the fat nutritionist thing.

I’m passionate about nutrition, which is pretty weird for someone who thought seriously she’d be either a theatre major or a fiction writer someday. I’m passionate about helping people get to the happy place with food and their bodies. I’m committed to it, and it’s become incorporated, inextricably, into who I am.

These are the things that matter to me. And every one of the things I’ve decided to do with my time contributes to one of these things. In addition to being satisfying in and of themselves.

I want to do these things. They are not the enemy.

And I don’t have to do everything at once. I don’t have to write every blog post in the world at once, or have all the research for the paper done instantly, or take on every job remotely related to mine at the hospital. I don’t have to do all the readings and complete all the assignments for my course RIGHT NOW.

I just have to keep the pins in the air, like a juggler. Touch one spot, do one thing, write one thing on a list, move forward an inch. Be in the process.

Plan a good meal. Read a new recipe. Wash a dish. Get reacquainted with the good things you’ve chosen to do for yourself.

But take a breath and be there for it.

I took this picture on Sunday. I like the bee.

It’s going to take me a little while to get caught up on responding to comments, but thank you so much for the enthusiastic response and encouragement. It means a hell of a lot to someone as petrified as I have been lately.

I’ve just had a letter from a dear reader who shall remain anonymous.

Dear Fat Nutritionist,

I am fat and short — just over five feet and around 225 pounds, to be exact. My husband is medium height, muscular, and not fat, around five feet and eight inches, and around 155 pounds. My question is about our daughter.

She appears to take after my husband in body shape and eating patterns. She is around the 50th percentile for height and the 25th percentile for weight at four years old. Right now, she looks healthy, muscular and lean, with a little bit of a tummy (very kissable).

She loves to eat a variety of things, usually not a whole lot at once, but more in the form of snacks and small meals. We offer her a variety of foods and she eats a good diet, overall, but she also loves ice cream and cake. Aside from the ice cream and goldfish crackers, most of what she eats is homemade.
My question is this (and it feels so neurotic to ask it): Is it possible that I could make her fat, when she doesn’t seem to be destined to be?

I worry about giving in to her desires for a serving or two of ice cream each day, or homemade unfrosted cake. I don’t want to create power struggles over food. I try to have things around that she likes, or we make them for her from scratch, so that they don’t become “forbidden foods.” Thanks mostly to her dad, she does associate some foods with feeling better if she is upset, but generally, I’ve tried to set the example that food is mostly for helping us to have energy, to grow, to thrive, and sometimes also to have fun or celebrate, or enjoy time together.

I let her know all of the time how beautiful she is. How amazing her body and her mind and her whole self are. I do not put myself down in front of her. If she is predisposed to be fat, I think I can be a good role model for her, overall, of good body image and health at every size, but if she has a chance to avoid becoming fat, I want that for her. Oh, this just sounds so neurotic.

So, is there something I need to be doing differently? I am working on my own issues of being a fat kid and fat adult, and try my absolute best not to project this on to her. If I feed her well, teach her to honor her body’s hunger and drive for movement, model showing respect to my own body, provide her with opportunties for creativity and tons and tons of parental love, will she turn out okay on the body image and health front? I thought I had rejected the obesity crisis crap — but when it comes to her, it goes right to my guilt center.

Signed,
Am I Making Her Fat?

Before I begin, let me say, wow. You obviously — and pardon the expression, please — love the shit out of your daughter. What an incredibly lucky girl she is to have someone like you looking out for her.

Now, I think you know all of the things I am about to say. Nevertheless, I think it will do you good to hear them anyway. If only for your own peace of mind.

First, you can’t make someone fat against their body’s will.

And even if you could, as soon as they were removed from your fatty influence, they wouldn’t stay fat. If everything in their genetic makeup resisted fatness, there is nothing you or I could do — short of strapping a person down and giving them a 24/7 IV drip of whipping cream and Hershey’s syrup, and probably not even then — to make them permanently, irrevocably fat.

The rub is, a hell of a lot of us seem to have a genotype that supports weight gain, even if not all of us actively express it. And that, of course, is where things get tricky. But this is an important philosophical point to make, especially if you believe in natural selection — if there were not a decided survival advantage to having the potential to gain weight and become fat, balanced against comparatively minimal risk, then that genotype wouldn’t exist, except as a rare medical anomaly. It certainly wouldn’t be as prominent as it appears to be currently. As things are, most of us seem to have the ability, even the propensity, to gain weight in an abundant environment.

Like many people, your daughter very well might have a genotype that supports weight gain, given the right environment.

Which brings us to our second point: why the hell shouldn’t she?

From her body’s point of view, the trendy moral panic of the day doesn’t matter. What matters are the odds of survival and reproduction. If you’re a betting woman, I’d advise you to go with Mother Nature on this one. You obviously love and want to protect your daughter — luckily, so does her body. You’re on the same team. Go team.

The third thing is, I can totally understand why you’d worry about this.

No one in this culture wants their kid to be the potential victim of fat-bashing. Just as no parent wants their kid to be the potential victim of gay-bashing. Parents have a visceral urge to protect their children from a cruel culture by helping them fly under the radar. It’s understandable.

The problem with this is — what if your kid is destined, against all contrary efforts, to be fat? Or gay?

Trying to cloak them from the radar denies the basic fact of who they are. It tells them, in no uncertain terms, that they are not okay. And the problem is, a kid might not be able to parse the distinction between you trying to protect them from a culture that finds them not okay, and you, yourself, thinking they are not okay.

That’s exactly what you don’t want. Fat or thin, you’ve got to love them anyway.

To get to some of the more practical parts of your letter, AIMHF, do you need to do anything different with regard to feeding her? I don’t know. It sounds like you’re doing pretty well, actually.

My own tendency is to suggest people have regular, sit-down mealtimes and snacks.

And to practice the division of responsibility, meaning — the parent decides what food gets served, where, and when, but then leaves it entirely up to the kid to decide how much to eat.

The dessert question can be a tricky one. And, given that I don’t have children myself, I can’t give full credit to the intricacies of dealing with this in real life. But, theoretically, the idea is to serve dessert as part of the main meal.

Set a serving of dessert at everyone’s plate along with the meal, and don’t give “seconds.”

But don’t take this as a license to get too restrictive — I don’t mean, give her a teaspoon of ice cream once a day and then say “NO MORE FOR YOU, FATTY!” when she asks. I mean, give her a little bowl of it. Depending on how old she is, and how much capacity her stomach has, I’m sure you can trust yourself to pick out what you think of as a “normal” amount.

Another thing about sweets and desserts — there’s a reason she likes them so much, and it has nothing, necessarily, to do with her future as a Confirmed Fatty. You already know this, AIMHF, but I’m going to say it for the sake of my readers: little kids are metabolically active. Meaning, their energy requirements, per unit body mass, are huge. Meaning, they naturally seek out energy-dense foods — like concentrated sugars and fats. Meaning candy, cake, and ice cream.

Meaning, kids are perfectly normal for liking, even for obsessing a little, about these things.

The way to deal with it, in my opinion, is not to make it a big deal. It’s part of a stage they’re going through physically, as well as mentally. Their bodies want the stuff, badly, and their mind is learning what their physical limits are, what makes them feel good, and what makes them sick. This is a valuable learning process — one that I don’t think any child should be denied.

My thought, then, is this: on a daily basis, give your kid dessert in the way I’ve described. Maybe give a dessert at BOTH lunch and dinner, if you like. But feed it along with the meal, like it’s no big deal, it’s no different from other foods. If asked, the only reason seconds aren’t given is because desserts are really filling, and you’ve got to save room for the other foods that give you other nutrients you need. And we’ll have dessert again at dinner. And tomorrow. And the next day.

But, periodically (Ellyn Satter suggests at some snack times), perhaps on holidays that feature sweets as a centrepiece, give your kid the opportunity to eat more liberally. Not because WOOHOO WE HAVE TO CELEBRATE HOLIDAYS BY MAKING OURSELVES SICK, but because I strongly believe that many kids will learn about how to balance their eating by, occasionally, totally messing up. Just like part of learning to ride a bike is, occasionally, totally falling off.

Plan for these occasions, if you can. And make them time-limited. Don’t encourage bingeing, God forbid — in fact, don’t say anything about the food, unless asked. And then just say, “Yes, you may.” And let her test the waters on her own. Be sympathetic if she gets a tummyache. Don’t be overbearing. Let her figure it out — she will, I promise.

I was a kid myself, not so very long ago. It only took once or twice for me to figure this one out.

If she’s anywhere near as smart and wonderful as you are, AIMHF, she will figure it out too. And you’re not neurotic for worrying about this — you live in a messed up culture, and you’re swimming against the current to do everything you can for your daughter.

Keep swimming, and you’ll both be fine.

Much love,
Michelle

Please feel free to send in letters and questions either in comments, or by emailing michelle at fatnutritionist dot com.

Since I believe in kindness and compassion, for other people, as well as for oneself, I decided to figure out what was going on with me.

The thing is, I set up this website, like, a metric eon ago, and I haven’t worked much on it since. I’ve tweaked some settings here and there, and I’ve gazed at it, and I’ve wondered about what to put on it, and I’ve had a million ideas that stayed in my head.

In short, I’ve worked myself up into a state of near-panic about it. Rather than just being excited and happy about having a THING that’s all mine, that can be a blank canvas I colour in as I like.

So, naturally, I haven’t actually been writing anything for it.

When I get scared, the second thing that happens is, I become paralyzed. And whatever is HIGHLY IMPORTANT that I do at that moment, whether it’s studying for an exam or going to bed at a decent time, is exactly the thing I cannot seem, with any amount of force, to actually do.

It’s gotten to the point where I damn near have a phobia about stuff like schoolwork. I actually cannot remember the last time I studied properly for an exam — I take them all by the seat of my pants, just because I find it too scary to study. Talk about conterproductive.

But, as it turns out, this morning I figured out what purpose this paralysis serves. And its purpose, apparently, is to 1) protect me from the scary, scary thing, but more importantly, 2) to act as a signal that I have lost touch with my intrinsic motivation to do whatever that thing is.

And this is the part that’s so very important, and so very relevant to this here normal eating blog.

Intrinsic motivation, to my understanding, is basically the natural reward inherent in a behaviour. Whether it’s eating, or going to the bathroom (eew, I know), or doing one’s homework. It’s the natural high you get from doing those things, because they are somehow gratifying in themselves.

Food tastes good, and it feels good when you’ve had a varied and nutritionally-dense meal that meets your needs. I get a calm, fluid feeling right in the centre of my chest when I’ve eaten a good homecooked dinner. Like my soul is letting out a big, satisfied sigh. Ahhhhhhh.

And peeing when you’ve super-gotta-go provides an immediate, and if you’re honest, heady sense of relief. Ahhhhhhh.

And doing one’s homework is gratifying because, not only might the content be interesting and relevant to you personally, if you can focus on the joy of learning rather than the threat of a bad grade — but also because it contributes to the life you’ve chosen for yourself.

Ahhhhhhhhhhhhhhhh.

In short, the only real reason you or I do any of these things is because they are a kindness to ourselves.

But if you get caught up in a sense of competition, or wanting to impress other people, or even trying to prove your worth to the world, it can majorly undermine that intrinsic pleasure.

It might not happen today, maybe not even tomorrow, but, eventually, if you’re anything at all like me (read: rebellious and stubborn), you might find yourself completely paralyzed, some part of you totally unwilling to take another step forward until you’ve straightened your shit out.

Because forcing yourself along for years and years with carrots and sticks is exhausting, humiliating, and, at its base, actually kind of cruel.

Well, homey don’t play that shit.

Being cruel to yourself, even for the stated purpose of doing something “Good for you” is counterproductive. And it’s shitty. And don’t do it.

So, you might be wondering how I’m going to tie this to normal eating. Well, even though I struggle mightily with schoolwork, the one thing I no longer struggle with is eating. So, in order for me to understand stuff, I often filter it through an analogy of how I eat.

This morning I realized — what I’ve been doing to myself with trying to force myself to work on this or that, to get the highest grade, or compete with people in the business world (okay, so that one’s mostly in my head, but still), is not so very different from what I did when I was dieting — taking something (eating) that IS already inherently pleasurable and a good thing, and using an external motivator (weight) to suck all the joy out of it. And eventually ruin it for myself.

In short, to flagellate myself. With something that is actually supposed to contribute to my well-being.

And how messed up is that?

So, writing this blog is hugely important to me. It’s contributing directly to the life I want to live (maybe I’ll tell you about that later. It’s pretty beautiful, and damn near inspiring, if I do say so myself.) And because I like myself, because I’m pretty good buddies with myself, making the effort to contribute to that life is so totally worth it.

So, hi. I’m here now. And I’ll be here for a while, building cool shit for myself. I hope you get something out of it.

I’ll put some old entries about eating up in the archives. Feel free to poke around and ask questions.

So, I’m working on this thing I like to call my Unified Theory of Kicking Ass. What that means is, I’m reading and learning stuff about normal eating and nutrition and how people change their behaviour.

I have a pretty decent understanding of this stuff already, since I’ve almost finished my nutrition degree, but I’m looking for something more.

Something that will really help people. Something that will totally kick ass.

The thing is, there are a lot of useful theories around. There’s intuitive eating, and eating competence, and demand feeding, and health at every size, and various non-diet approaches to good nutrition. And we’re going to discuss them all on this blog.

They’re based on solid evidence. They work. And a lot of people really, really like the idea of putting them to work in their own lives.

But that can be really, really hard to do.

I know because I went through it myself.

I had a serious Dieting Incident that really messed me up. It took me five years to relearn to eat, and move, and feel normal with my body again.

I’m not perfect by any means, but I’ve reached a place that is, apparently, enviable: I feel comfortable around food.

I don’t think of food as “good” or “bad.” I don’t see my weight as a reflection of my character. I combine what tastes good and what feels good without a lot of thought. I mostly get hungry at regular times, and I mostly eat until I feel just right. My weight is stable, finally.

I’m cool with food. And I’m pretty cool with my body, too.

Five years ago, I literally thought I would never get to this place. I cried just thinking about it. (Yeah, I’m emotional like that.)

But I’m here, and it’s every bit as awesome as I’d hoped. And the reason I’m writing about it is because, after being involved in the Fatosphere, and reading so many discussions about food and intuitive eating and whatnot, I know there are tons of people out there who feel like I did — that normal eating will never happen for them.

Well, I think it can. And I’m here to help.

Normal eating is what we’re born to do — and I truly believe we can relearn how to do it, if it’s necessary. (And it is.)

So, you’re here. I’m over the moon you’re here, because I really need your help with this.

I’ll tell you what I figure out along the way. I’ll bounce ideas off you. In return, I hope you’ll give me your suggestions, your thoughts, your stories and your support.

Help me develop this thing, this Unified Theory, and I’ll be your biggest fan. Seriously. How could I not?

In theory, I’m a food libertarian and don’t believe the state should take responsibility for curbing individuals’ greed.” [Emphasis mine.]

And her…colourful…use of hyperbole, which wouldn’t be entirely out-of-place in the opinion section of your local junior high student paper:

But it’s sad to watch already-chubby kids at the food courts eating hassock-sized cinnamon rolls, haystacks of french fries and stacked baseballs of ice cream. The kids may as well be wearing T-shirts proclaiming “Diabetic in Training.”

Whoa, Hoss, let’s tone down the outrage for a second there and consider things sensibly, shall we?

First of all, people don’t eat because they’re greedy. Greed, and the other deadly sins we hold so dear to our shrivelled, black hearts, has absolutely nothing to do with food. We eat because we’re hungry, or because something looks and smells delicious, and because we’re hard-wired to eat tasty food.

As much as is available.

This is a survival mechanism — because who knows when it’s coming around again, right? Particularly if you’ve ever survived a food shortage (or, the more likely case in North America, if you’ve ever survived a weight-loss diet.)

Hard to believe, I know, since humans obviously aren’t just animals who evolved from other animals, thus still having certain animal needs and certain animal behaviours. No, no — we’re all just greedy little fallen angels slavering with lust at the thought of buggering some poor, starving charity case out of his last can of Campbell’s Cream of Tomato.

So we can stuff it mindlessly down our gaping, triple-chinned maws…

Baconatorzzzzzzzz

Wait. Where was I again? Oh yeah, considering things sensibly.

Look. We’re human. We get hungry. Yes, we even crave and enjoy salt, sugar, and fat. Because those things (aside from representing two of the three existing macronutrients, and one of the most important micronutrients) are precious commodities to animals in the wild, and it makes sense to eat up as much of them as you can, and store that energy against a rainy day.

And, yes, becoming civilized little monkeys has changed our world, and that strategy is now a bit outdated. But the innate desires are still there. And yes, the food industry capitalizes on those innate desires and tries to manipulate our appetites for profit (want to talk about greed? *cough*)

But none of this should come as a big, nasty surprise to a society of educated consumers living in a rich country in the year 2009.

And none of this makes us greedy, gluttonous assholes — it makes us human beings.

The way to deal with this is not to point fingers at the fatties and shriek with moral outrage about their greed. The way to deal with this is not to conflate eating habits with body size, or to blame diabetes on those evil white foods.

Wacky as it may sound, the way to deal with it is to, first, calm the fuck down. And stop being such an asshole to people who don’t look like you. And stop attaching a moral value to food, or to health.

Maybe learn to take care of yourself with kindness instead of flagellation. You might find that all that hyper-processed stuff makes for a fun treat, but actual, ya know, food makes a far more satisfying and delightful staple. And you might learn to even enjoy it, rather than swallowing it whole out of some deranged sense of duty.

None of us, fat or thin, are such idiots that we can’t figure out how to eat appropriately for our bodies. And it really is okay to enjoy things that taste good.

It’s food. That’s what it’s for.

More To Love is by the same guys that do “The Bachelor” for ABC and is essentially the same show, except all the gals on the show are real girls with real curves.”

It pissed me off. And because this is my blog, I’m about to tell you why.

First, because it’s fucking patronizing.

Second, because it’s a sneaky little divide-and-conquer strategy, of the type commonly used to pit women against other women.

Third, because we’re ALL real women, you fuckwad.

There seems to be a common assumption that, if you’re fat and not particularly ashamed of that fact, you must, by default, HATE thin women, or find them ugly, or some other form of stupidness that can only be described as SOUR FUCKING GRAPES.

Not so.

I’m fat, and not particularly ashamed of the fact, and I also think thin women are just fine. I largely share the same aesthetic standards of my culture (with a few exceptions — most notably, the ones that allow me not to hate myself), and I often think thin women are just lovely. I also don’t feel particularly jealous, because why would I waste my time? They’re them, and I’m me.

I certainly sometimes sigh to myself wistfully about what it would be like to, say, have curly hair, or be blonde, or to be slender and model-perfect, but I don’t spend a lot of time on it. I recognize these moments for what they are: pure fantasy, a grass-is-greener kind of escape from reality. And then I go back to being me without a whole lot of fuss. I see certain pictures of myself, or put on a certain outfit, or flip my hair in a certain way that makes me think, “Yeah, other people are lovely. But I’m pretty alright myself.”

So then, why is it so impossible to believe that we can genuinely admire others, without simultaneously wanting to look exactly like them? We’re not all crazed bitches from some psycho-stalker horror movie here.

I’m going to steal your haircut, and then YOUR MAN. Fear meeeeeee.

ENOUGH already with all this real woman garbage. We’re all real women, for fuck’s sake — the thin ones, the pale ones, the dark ones, the hairy ones, the not-hairy ones, the short ones, the tall ones, the young ones, the older ones, the fertile ones, the sterile ones, and yes, of course, the fat ones. If anyone has the temerity to identify as a woman in this culture, I’m handing them over an Official Membership Card and inviting them to the pool party, since, you know, I’m a real woman and all. By the power vested in me, etc. etc. And because if you’re willing to put up with the bullshit women put up with every single day, then shit — you’ve earned it.

In closing, I’d like to say: you’re not fooling anyone, fancy-TV-producers-attempting-to-ingratiate-yourselves-with-the-fat-people-you’ve-used-as-the-butt-of-all-your-super-sophisticated-sitcom-jokes-for-so-long. You’re just pissing me off.

And you sound like a fucking squid.

Ah, content. The hard part. Well, anyhow.

In order to get said content, I’m busying myself reading a bunch of stuff about nutrition and HAES. Boring stuff, like journal articles and whatnots. And I’m trying to pick the little nuggets of pure-gold truthiness from them, and find something kind of interesting to say. Which brings me to today’s nugget of insightfulness: your body is your home.

I’ve wondered for a long time whether it was useful to think of the body in a sort of Cartesian dualist way. Most of us certainly seem to, without reflecting on why we seem to, why that’s the semi-default mode of thinking about the body (body vs. mind, body vs. soul, body vs. personality — whatever. You get the idea.) And I’ve always disliked this. Because it makes the body sound like something outside of yourself, a piece of machinery that you can tweak and control and bring under your submission.

Well, as most of us have probably figured out from hard experience, bodies don’t dig that kind of stuff. They fuss. They rebel. They infiltrate your mind until they get their way, one way or another.

And given what we now know about brain structures and neurotransmitters affecting emotions and thought and judgment, it seems more sensible to really see the whole thing — us — as an organic whole. Not one of those Star Wars AT-AT walkers with, like, a dude inside manipulating the controls and shooting at stuff.

Pew, pew, pew!

No. Rather, your body is the space within which you exist. It’s the material assertion that you have the right to exist in this world, that you have a place in it. It’s the concept of ‘home’ — not a house, a thing to be remodelled at whim, bought and sold — but a cherished, adored, childhood home comprising memories both sad and sweet. Something you will lovingly tend to and care for over the years, give fresh paint and make repairs to when needed, but whose fundamental essence you would never hope to obliterate — imperfect, even broken, as its assembled parts may be.

It’s an extension of yourself — not your whole self, but definitely an irreplaceable part of it.

And that is why we’re so sad when things change. If our bodies were just machines, just external armour, why would we care so much about suddenly looking different? Hell, I sometimes cry when I get my hair cut, and I know that shit’s growing back.

So, to bring this around to something resembling a point — why does it matter how we think of our bodies? Well, in my experience, treating my body like a machine has not ended well. Treating it like an expensive outfit designed to impress other people has not ended well. Treating it like an unruly child or pet who needs to be reckoned with and brought under submission has not ended well. And I’ve lived for long periods of time where it was as if my body and myself were no longer on speaking terms.

The only thing that seems to make sense, that brings some kind of contentment to my relationship with myself — my eating, my moving, and my relationship with the great big world around me — is to appreciate the thing that I am. This warm, pink, mammalian flesh gives me all the tools I need to negotiate a pretty spectacular and time-sensitive existence. I see, hear, taste, and feel, both tactilely and emotionally, entirely at the discretion of my architecture. It doesn’t just mediate my interaction with the world — it creates that world. It is the stuff of my existence. And it’s the one place I can always return to, when weary or tired, to recreate that existence.

So, we look out for each other. I keep its structure sound, and it provides the world to me. My body is far more than the circumference of my thighs, the completeness of my shaving job, or the size of my appetite — it’s my home. I carry it with me.

Stunning insights abound, such as:

Many people who meet the body mass index criteria for obesity “are really not that sick at all,” says Sharma, chairman for cardiovascular obesity research and management at the University of Alberta and scientific director of the Canadian Obesity Network.

‘Obesity was far less common when it was identified, and then obesity became this gigantic epidemic, with just the assumed outcome that everyone is going to be at risk for vascular disease and a whole bunch of other things,’ says Rachel Wildman, an assistant professor of epidemiology and population health at Albert Einstein College.

‘As it turns out, it seems not to be the case. There is at least a proportion of obese individuals who at this point don’t seem to be at elevated cardiovascular risk.’ Not only is their risk fairly minimal, ‘in some instances it’s better than individuals who are normal weight.’”

‘Treating obesity, like treating any other medical condition, takes resources, you never get it for free and if you’re asking people to do things where you know off the bat that most people are likely to fail then you’re really setting them up for disappointment,’ Sharma said.”

Wildman, of Albert Einstein School of Medicine, agrees that it may be time to deal with the obesity epidemic in a more nuanced way. For one thing, efforts to get everyone to lose weight are falling flat.”

Also, some good quotes from our friend Paul Ernsberger.

Really, I don’t mean to snark. This is a good article, and I’m glad to see the issue getting media play. It’s just that it all seems so fucking obvious.

On the scourge of OMGbesity:

“The claim that we are seeing an ‘epidemic’ of overweight and obesity implies an exponential pattern of growth typical of epidemics. The available data do not support this claim. Instead, what we have seen, in the US, is a relatively modest rightward skewing of average weight on the distribution curve, with people of lower weights gaining little or no weight, and the majority of people weighing ~3–5 kg more than they did a generation ago.”

-Campos et al, International Journal of Epidemiology 2006 35(1):55-60

On fat and mortality:

“Except at true statistical extremes, high body mass is a very weak predictor of mortality, and may even be protective in older populations. In particular, the claim that ‘overweight’ (BMI 25–29.9) increases mortality risk in any meaningful way is impossible to reconcile with numerous large-scale studies that have found no increase in relative risk among the so-called ‘overweight’, or have found a lower relative risk for premature mortality among this cohort than among persons of so-called ‘normal’ or ‘ideal’ [sic] weight.”

-Campos et al, International Journal of Epidemiology 2006 35(1):55-60

On fat and mortality, again:

"Overweight was associated with a slight reduction in mortality relative to the normal weight category. The impact of obesity on mortality may have decreased over time, perhaps because of improvements in public health and medical care. These findings are consistent with the increases in life expectancy in the United States."

-Flegal et al, JAMA. 2005;293:1861-1867

On increased life expectancy in the United States:

“Life expectancy for Americans surpassed 78 years for the first time in 2006, and life span increases occurred for both men and women, the National Center for Health Statistics recently reported. Although the results are estimated, the report found the average life expectancy for Americans born in 2006 was four months greater than for children born in 2005. Although (sadly) an estimated 2.4 million Americans died in 2006, there were 22,000 fewer deaths in 2006 compared to 2005, which is a statistically significant decline. Even infant mortality rates dropped more than two percent in 2006. For adults, the improvement is based on falling death rates in nine of the 15 leading causes of death, including heart disease, cancer, accidents, and diabetes. There was a drop of more than six percent in stroke and respiratory diseases, such as bronchitis and emphysema. Heart disease and diabetes deaths also declined by more than five percent in the U.S.”

-Medline Plus, July 2008

On the consequences of dieting:

“Even granting the existence of an association between increasing body weight and higher mortality, at least for younger people, it does not follow that losing weight will reduce the risk. We simply do not know whether a person who loses 20 lb will thereby acquire the same reduced risk as a person who started out 20 lb lighter. The few studies of mortality among people who voluntarily lost weight produced inconsistent results; some even suggested that weight loss increased mortality.”

-Kassirer & Angell, New England Journal of Medicine, Vol 338:52-54, no. 1, 1998

On the “success” rates of dieting:

“Using these figures, it appears that there are 76 800 000 people dieting…According to the NWCR Web site, there are currently 4000 people enrolled. So the researchers can demonstrate a “success rate” of 0.001%, which is not even close to the dismal 5% estimate cited in the scientific literature.”

-Ikeda et al, J Nutr Educ Behav. 2005 Jul-Aug;37(4):169.

(I did a similar bit of arithmetic in 2002, though the numbers I used were slightly different. Fat Fu did an excellent bit of arithmetic using Weight Watchers statistics.)

On fat people being gluttonous overeaters:

“Everyone knows what it feels like to skip a meal or to refrain from enjoying that alluring cheesecake. From this shared experience comes the conclusion that obese people restrain themselves less well than the lean. The problem with this view is that it ignores the basic neural system that controls the drive to eat and the variability of its potency in different individuals.”

-Friedman, Nature Medicine, 10, 563-569 (2004)

(My version of this same argument.)

On why we hate fat people:

“Weight is seen as controllable, unlike other stigmatized traits such as race and gender. Our subjects held a particularly strong explicit belief that fat people are lazy. This belief assumes that overweight individuals simply lack motivation or responsibility for a condition that is under their control.”

-Wang et al, International Journal of Obesity (2004) 28, 1333–1337.

On just how much we hate fat people:

“The prevalence of weight discrimination in the United States has increased by 66% over the past decade, and is comparable to rates of racial discrimination, especially among women. Weight bias translates into inequities in employment settings, health-care facilities, and educational institutions, often due to widespread negative stereotypes that overweight and obese persons are lazy, unmotivated, lacking in self-discipline, less competent, noncompliant, and sloppy. These stereotypes are prevalent and are rarely challenged in Western society, leaving overweight and obese persons vulnerable to social injustice, unfair treatment, and impaired quality of life as a result of substantial disadvantages and stigma.”

-Puhl & Heuer, Obesity (2009)

Some good books:

The Obesity Epidemic: Science, Morality and Ideology by Gard & Wright

And here’s the second thing: people are really goddamn preachy when it comes to taking the stairs. I was at work recently when an older man, likely in his 70s, made the morally reprehensible decision to take the elevator down one floor. And when he exited that elevator, the tidal wave of vitriolic spew that issued forth from my young, elevator-taking companions etched a new high-water mark on the jetty of my astonishment. Because an old man in the hospital had chosen the elevator over the stairs.

And a third thing: not only am I fat, I have a weird heart condition (since I was 15 — before I was fat, for the record.) It’s an apparently non-threatening arrhythmia that occurs randomly, and I went to the cardiologist when I was 18 (and still not fat, again, for the record), but no definitive diagnosis was given. Just that, you know, it hasn’t killed me yet, so that’s good. I was rushed to the ER for it a couple years ago, and again with chest pains a few months ago, which turned out to be a false alarm, but which I had to take seriously because of this weird heart thing.

Fourth thing? I just hate climbing stairs. I’ve had foot injuries, knee injuries, and just a plain lot of weight to haul around, such that, in addition to already taking the stairs daily because I live in a walk-up (with the laundry room in the basement), I am just not real enthused about forcing myself to take additional stairs at every opportunity in some bid for moral superiori — I mean, for the sake of my health.

Last semester, when I decided to walk up three large flights of stairs with my schoolmates to visit a professor, we all got to the top somewhat winded. I thought to myself, “Huh, I feel funny,” but I just caught my breath along with everyone else and carried on. Ten minutes later, I felt a sudden, chill-inducing thunk-thud in my chest. It was the familar feeling of my heart recovering normal rhythm. That’s when I realized — I’d been having a tachycardia episode and hadn’t even felt it (these things normally knock me backward, as though the wind has been punched out of me) and it was, apparently, brought on by climbing the goddamn stairs.

As it is, I have to climb a fair number of obligatory stairs each day. (If you live in a city as inaccessible as Toronto, you’ll understand what I mean by “obligatory stairs.”) Whenever I go home to visit my parents in suburban Oregon, I am amazed at how easy the life is. There’s no hauling 100 lbs of groceries home on foot and then carrying them up the stairs. There’s no sprinting for the subway or streetcar. There are no obligatory stairs to the bathroom in every restaurant. No eternally-broken escalators. No walking to work in 100 F heat/90% humidity, or back home in -20 F/three feet of snow. Whatever you want to do, wherever you want to go, you simply get into your car, drive somewhere, walk a few feet, and go inside. It’s the most amazing thing in the world, and as much as people complain about how bad being sedentary is for one’s health, I always feel about ten years younger when I’m there. I find myself running on the treadmill, or taking nature walks, or even doing calisthenics because daily life is not kicking my ass into the ground.

The life in downtown Toronto is just plain hard on me, and clearly, the stairs are not helping my heart. So I try to make it at least a little easier on myself by taking an elevator or escalator when convenient. I like to think of this as having compassion for my limitations, though I admit, I am often embarrassed to be standing by the elevator — even though I am registered as disabled at my school, and have to wear special orthotics in my shoes and blah blah blah. I am still embarrassed because I know what people must be thinking of me — the fat lady taking the elevator instead of the stairs.

In the back of my mind, I always have this episode of Mystery Diagnosis running whenever I’m confronted with too many stairs. (If you haven’t seen it, it’s about a woman with undiagnosed pulmonary hypertension who, in her chubby adolescence, became reluctant to climb stairs and run and things, because she felt instinctively that it would kill her. Naturally, they blamed this reluctance on her weight, shamed her for being lazy — and then she almost died from increasing her exercise.)

I feel this same reluctance when I have more than two flights of stairs to climb, especially if I’ve got textbooks on me. I feel trapped, pinned in a corner, and in grave danger. My heart simply doesn’t want to do it, and who knows — maybe the body has its own rationale behind making me fat enough to slow down my mobility when it comes to really strenuous pursuits, thereby keeping me safer.

So, when I see these little signs start to pop up around school or work, I inwardly groan. I can’t tell you how many times, aside from the episode mentioned above, I have heard people castigate others for not taking the stairs. I myself was harassed by a janitor as I waited for the elevator at my school (which has a large sign, mostly ignored by the other students, to please reserve its use for disabled students), and I had to calmly explain that it was hard on my injured foot to take the stairs.

I shouldn’t have had to.

With the coming of the signs comes the upping of the intensity of the judgments thrown at people who don’t follow them. Personally, I climb stairs (and a loft ladder) every single day in my apartment, but I must reserve the right to make my own judgment about when to conserve my efforts, when it is better for me, in fact, not to take the stairs. For the girl with pulmonary hypertension, stairs are potentially deadly. For one of my (very young, very fit) professors with knee trouble, taking the elevator just makes sense. But when it comes to public health campaigns of this stripe, there are no exceptions, no grey areas — there is only healthy or unhealthy, fat or fit, elevators or stairs, righteous or lazy. And I don’t like it.

One more reason I dislike this program? They measure the “health benefits” of taking the stairs solely in calories burned, not enjoyment had, or mastery gained, or strength attained. Lastly, there is, of course, no mention made of those who cannot or should not take the stairs — we simply do not exist. Maybe because, in some people’s minds, we’re already as good as dead.

Now, if my friends were the type who evangelized about diets, and overwhelmed every conversation we had with diet talk, or barged into fat-acceptance-land and started being all diety, and if I found it obnoxious and/or triggering of my own neuroses around food and weight, I think I’d start to care very much. But it seems my immediate reaction is curiosity — one of my friends said she was on Weight Watchers, and I felt compelled to ask, “Do you like it?” to which she responded, hilariously, “Well, no. I like to eat food.”

Similarly, if my friends went around bashing fat people and saying things that were patently offensive about fat people, or even just bodies and appearance in general, then I’d feel morally obligated to talk to them about that, and it might not always be while using my Inside Voice. I would expect the same from them, if I were to say something boneheaded about race or religion (which I have certainly done, and to which they have responded passionately, much to their credit.)

But I suppose I am lucky, because my friends don’t do those things. If they ever have, it was long ago, before they were aware of the existence of fat acceptance and my own involvement in it. And since I made them aware of my feelings about being fat and about how fat people are treated, they seem to have thought it over and decided, yeah, you know what? It’s not cool make nasty judgments about people based on the way they look.

Like I said, I am lucky to have awesome friends.

So, in those few instances where I overhear in passing that one of my friends is trying to lose a few, it really doesn’t bug me. I know they’re aware of my viewpoint, and I really don’t need to belabor the point — they get it, at least conceptually. I don’t expect them to line up politically with me, or to make the same personal choices I’ve made, or have a perfectly complementary worldview. I value having friends and loved ones with different opinions, as long as we can treat each other with respect.

(Now, other people in fat acceptance may not be comfortable having friends who diet, because it touches an area that remains painfully sensitive to them, and they may need to distance themselves from those friends — and that’s fine. That’s them. We do get to choose our friends, and people have varying levels of comfort for disagreement.)

Anyway, the thing I’ve noticed, once or twice, is that when a friend of mine does choose to purposely try to lose weight, I detect a — shall we say particle? — of defensiveness. That’s what I’d like to address.

Look, my very good friends who I’ve loved since childhood — you don’t have to justify your personal actions to me. You already know what I think about dieting, but this isn’t about me. Your choices are yours, and as long as they’re not harming other people, or impacting my sanity, or doing overt damage to your own well-being — (and there’s a fine line there, because you can be damned sure I’m sensitive to signs of eating-disordered behaviour if I know someone is unhappy with their body. I once had a boyfriend who claimed that it was perfectly normal to chew up tasty food and then spit it out while dieting! I had to tell him straight out, that? Is disordered eating. And he was massively offended, because eating disorders are for girls, but I wasn’t about to keep quiet on that shit) — then your choices are your own, they remain your own, and I’m not going to badger you about them.

Your shit is your shit to figure out, and sometimes the only way out is through. In fact, the way I came to the place of relative peace I now inhabit with my body was by experiencing dieting in all its fucked-upness. I am not about to take that learning opportunity away from you, if you feel you need it. And if, in the end, you decide dieting is really not a tool of the devil, and you have no particular problem with it? Then whatever. I still won’t have a particular problem with you, either, unless you make it my problem.

No, I don’t agree with it, but we don’t have to agree. We just have to love each other, and thankfully we really, really do.

fat /= healthy

fat = smoking (?)

There’s the unspoken implication here that people will call up for support when they’re in the midst of restricting their food intake, and forcing themselves to do more exercise — because they’re hungry, sore, exhausted, demoralized, and they need a cheerleader to convince them to carry on. Which, to me, bodes…not well. If you’re trying to make a change that could be both physically positive and enjoyable, but treating it like it’s the incredibly unpleasant task of fighting an addiction, then you’re fucked. You’re not going to make it, because you’re turning what should be a positive, self-affirming experience into an onerous, burdensome chore.

And also, eating is not an addiction. Food can be used in pathological ways, and people might need support to change that behaviour (a.k.a. “disordered eating”) — but eating itself is not an addiction. Let me explain.

There exist very intensely pleasurable biological pathways to reward animals for survival-enhancing behaviours. Like eating food, drinking water, licking salt, and having sex. Addiction happens when a non-essential, and in fact toxic, substance insinuates itself into one of those pathways, replacing the life-affirming behaviour with something life-diminishing. Even in the extreme throes of an eating disorder, food is not an addictive substance, and eating is not an addictive behaviour. The behaviour may be pathological, like a compulsion — but a compulsion /= an addiction. I believe Linda Bacon will address this in her upcoming book, but this has always been my understanding of the issue.

On the surface, the shades of difference between “addiction” and “compulsion” may seem purely semantic, but I’m afraid that categorizing basic survival behaviours — even when they become distorted into pathological habits — as “addictions” can lead to a dangerously slippery slope. At the bottom of that slope lies fear of food, fear of the body, and the moralizing of fundamentally amoral behaviours. (Though, of course, I don’t believe addictive substances need be considered immoral either — it’s just that humans commonly use the short-hand of “bad” — morally bad — to describe things that are potentially harmful. And because the consumption of heroin or cigarettes is not fundamental to sustaining life, there’s really no harm in labelling these things as “bad.” But food? Categorizing food as “bad” — morally bad — can be very harmful.)

Let’s put it another way — an eating disorder is a symptom of an underlying problem, possibly biological, possibly psychological. It is not purely a function of the substance, food, or the behaviour, eating. An addiction (though these often do have underlying biological and psychological causes themselves) can come about simply from exposure to an addictive substance. An unborn baby, with no psychological issues or significant biological impairments, can become addicted to a narcotic simply by being exposed to it in the womb. That is an addictive substance.

Sometimes people with iron deficiency experience pica, or a compulsion to eat non-nutritive substances. It is their body’s messed-up way of signalling that there is a deficiency, that something ain’t right. These people will compulsively eat many different substances: ice, chalk, dirt, clay, even socks. Does this mean that socks are an addictive substance? Do they need to go to sock-detox? Or should they go on a low-sock diet, and maybe get some telephone support to help them stick to it, rah! rah!

No. They need to fix the underlying problem.

If someone has disordered eating — whether it’s an extreme eating disorder or a milder form of disordered eating, like overeating — they don’t need a diet, and they certainly don’t need a phone-line to encourage them to diet. They need therapy, training in some form of intuitive eating or demand feeding (possibly with some structure, as I’ve mentioned in the past — pure demand feeding doesn’t work for everyone), maybe medication, and they need Health at Every Size. It may not be a perfect, one-size-fits-all solution, but so far it seems to be the best we’ve got.

A phone call won’t stop the cycle. It’ll only give a push to another revolution of the diet merry-go-round we’ve been collectively riding for the last century. I don’t know about you, but that’s not the kind of revolution I’m interested in.

But I would also like to make it clear that I believe fat acceptance and the rights of fat people are in NO WAY contigent on believing in, agreeing with, or practicing Health at Every Size.

IN NO WAY.

Quick fat history moment:

I think it is very important that as a movement we do NOT adopt elitist attitudes which tend to weed out the very people most in need of what we claim to support. It is one thing to have as our goal the right of every person, regardless of size, to have access to the resources to become more physically fit. It is quite another to base the acquisition of our civil rights, individually or as a community, on being or becoming “fit”. To do this would be healthist.”

-Karen Stimson, 1983

Fat acceptance has been wrangling with this issue for a while now. However. I do think that, commonly, people who are uncomfortable with the idea of Health at Every Size, are likely uncomfortable due to a misunderstanding of one sort or another.

The misunderstandings are various, but include:

1) the definition of “health” itself — there actually isn’t an official, universally agreed-upon one, and I believe a fundamental aspect of HAES philosophy is to try to create a newer, more inclusive, more compassionate definition of health

2) the fear that HAES must be classist in its practical requirements (it doesn’t; I am dreadfully poor and would never be able to claim a HAES badge if I had to do certain things like join a gym or buy special foods)

3) the assumption that a certain eating style (most often classical ‘demand feeding’ or the newer concept of ‘intuitive eating’) is absolutely required

4) the assumption that a certain type or amount of exercise is absolutely required

5) the assumption that, if you have a limiting or pre-existing health condition of some sort, you are excluded from practicing HAES (most people I know who are HAES-boosters actually have fairly limiting health issues, myself included, in that I have a history of disordered eating which precludes me from practicing demand-feeding, and including my very good friend, aerobics enthusiast, and extreme heroine of all situations, Dee, who has a serious physical injury.)

In my opinion, the behaviours of HAES are much less important than the intentions and beliefs behind those behaviours. The behaviours are simply tools, and there are a plethora from which to choose. Many of those tools have been totally co-opted by the weight-loss establishment, and so have taken on a pungent flavour of negativity and neuroticism — but, if sincerely divorced from the context of weight control, I really believe some or all of them could be adapted and put to good use.

So, in rough format, the essential beliefs of HAES are as follows:

1) You are fat accepting — both of yourself and others. You may not be perfect at it, but you make an effort to be aware of your own biases and to challenge them, both in regard to yourself and other people. You value size diversity.

2) In view of item 1, you are therefore not making any intentional attempts to lose weight. There are situations in which a person might need to purposely try to gain weight (cancer, recovery from an eating disorder, post-surgery, etc.), and I do think this can be done within a HAES framework. But weight loss cannot be intentionally pursued within HAES. If weight loss happens (and it might), it only happens incidentally — NOT intentionally.

3) You are interested, within whatever physical or mental limitations you may have, in pursuing “health” — using a definition of health that means something like “the ability to live a meaningful life, balancing optimal physical functioning with optimal mental and emotional functioning, within whatever inevitable health challenges I will, at some point, have to face.” (I believe Jon Robison has a similar philosophy — “Health can be redefined as the manner in which we live well despite our inescapable illnesses, disabilities, and trauma.”)

It should go without saying that, if #3 does not apply to you, and if you are not at all interested in considering health, no matter what definition is used, then that is your entirely legitimate choice, and you are still eligible to have human rights, and to be involved in fat acceptance, and everything else. For many people, health is simply not something they are interested in thinking about, period. I was that way myself for many years, before I was clotheslined by a love of nutrition, and I can entirely understand and respect that choice.

But, if you sincerely believe in the above, and are not fooling yourself (and this can get tricky) about being on some kind of “HAES lifestyle plan” in order to lose weight — then I don’t really care what tools you use to help you eat and move in ways that work best for you, and that give you the best quality of life, whatever your limitations may be.

If you are diabetic, you may count carbohydrates. Even though this smacks of some kind of Atkins-style ridiculousness to the average fat activist, it is a legitimate tool for some people. If you never end up finding your hunger and satiety signals (and it can happen! It is hard to find them, especially if you’ve dieted for years!) and feel most comfortable using some method to estimate an intake that allows you to function physically without driving you crazy, mentally — then I don’t care. Only YOU can know what your true intentions are. Only you can decide whether you are interested in HAES, and whether or not you “qualify,” based on your sincere beliefs and intentions. Behaviours are, largely, irrelevant.

Everyone is limited, physically or mentally, to a certain extent. HAES must work within those limitations. And because humans come in all shades of disease — from Crohn’s, to diabetes, to cancer and chemotherapy, to eating disorders, to fibromyalgia — there is no tool that can be definitively excluded from being used within HAES.

But ANY tool, no matter how innocuous and HAES-friendly it seems, if used to flagellate yourself, becomes instantly outré. Even intuitive eating. Even yoga. Even anything, if done with the slightest shade of self-hatred.

I would rather someone count calories while truly believing in fat acceptance and HAES, than practice intuitive eating in the secret hope that they will lose weight, or in competition with someone they look up to as a perfect disciple of HAES, and beat themselves up when they ‘fail.’

HAES is a paradigm shift, not simply a new diet. Without the underlying beliefs, the behaviours alone are meaningless.

I am professionally involved in nutrition, so I have a good understanding of food and exercise. I walk at least two miles a day, in all kinds of weather. I don’t drive or take public transit. I eat a varied diet that balances immediate pleasure with longer-term well-being. And all of that is really no one’s business but my own. It represents a mere drop in the bucket — you’d be surprised how many more determinants of health there are than just lifestyle.

What really makes me healthy is that I refuse to allow my health status to be dictated by my weight. I don’t regularly weigh myself. I don’t diet. I don’t engage in punitive or boring exercise. I don’t read women’s magazines. I try to avoid influences, like advertising, that tell me I am not good enough as is, and need to buy X product to be a complete person. I believe in my own beauty aesthetic, and dressing in the way I like.

I’m a feminist and a believer in social equality, so I stand up for myself, and for other people. I don’t believe in blaming people for their own health problems, because even in the rare cases where someone may be at fault, it is not a useful or compassionate response. I believe in kindness not because I am wimpy, but because it is right. And I don’t believe people have a responsibility to anyone but themselves to manage their lifestyle and physical health as they see fit.

I’m healthy because I say so. In school, we studied the various definitions of health, developed over years by the World Health Organization, and then came up with our own definitions. Having worked in health care, I can tell you that a diagnosis of disease and good health are not mutually exclusive. I believe someone’s health is determined by how well they are able to cope with whatever life throws at them, with whatever circumstances they happen to be in. By my definition, people who are physically well, but continually worried about death and disease, are not healthy. Someone who lives with a disease, managing it and maintaining a meaningful and enjoyable existence, is far more healthy.

For a midterm I once had to write on the definition of health, I explained it this way:

I would wager a bet that no one — no one now, and no one at any point in history — has ever enjoyed perfect health. Yet we persist in dividing the population into sick people and healthy people. At any given point in history, and in any given culture, what constitutes illness is at the mercy of subjective interpretation. In reality, we are all ‘sick’ to some degree. The difference exists only in that we decide whom to call ‘sick’ and whom to call ‘well.’ Because of this rather arbitrarily placed point on the seamless continuum of health, I propose that our definition of health should have less to do with how sick or well we are, and more to do with how we live inside and with our unique physical condition.”

I believe this because physical health itself is often just a crapshoot. And I believe it’s a crapshoot not because I’m fat and it’s convenient to think so, but because I learned it the hard way, by working at a cancer hospital filled to the brim with young, formerly healthy people. People, who by most definitions, did everything “right” — and were rewarded for that with an agonizing, deadly disease.

That said, I have no diseases that I’m aware of. I’m young, able-bodied, and I live in a fabulously wealthy country with medical care and a food supply that is the envy of much of the world. I’m part of a privileged social class. I have a strong social support network that includes family, friends, and my husband. Aside from being fat, I have no physical traits that mark me for social censure. Being aware of how undeservedly fortunate I am, and working to make human society more equitable, keeps me healthy.

I don’t think BMI is flawed only because it fails to measure muscle mass, or only because it is a population-based epidemiological tool that has been inappropriately co-opted as an individual diagnostic, or because it insults attractive people by calling them ‘overweight’ — but because it reinforces a very destructive belief: that you can make assumptions about a person based on their body size. That you can assume they are unhealthy, or that there is a ‘correct’ size/weight to be, and the subtextual conclusion that weight and health status define a person’s worth. That people on the fringes of the chart are freaks, not even entirely human. That it is okay to diagnose people as ‘diseased’ for not meeting an arbitrary beauty standard. And that traits associated with disease, whether causally or not, can be legitimately treated as diseases in their own right.

Whether or not someone is healthy, and however much they weigh, however fat or thin they appear, they are human. They have rights, and they deserve compassion, or at least basic dignity. Humans are naturally physically diverse — it is a strength of the species that helps protect us from total extinction should some natural catastrophe come calling. We should not dedicate our time and resources to eradicating a certain group of people, or trying to eliminate the natural variation of our population. Simply put, to do so is not healthy.

You are under no obligation to be healthy.

And, as an addendum: even if you were, eating “well” and exercising wouldn’t guarantee your success. There. I’ve said it. And as much as this might chap the ass of every health promoter out there, I feel that personal agency and a basic sense of privacy are sorely missing from most conversations of health promotion, and from conversations of Health at Every Size.

Health at Every Size exists in order to address the health concerns of people who, well, have health concerns. It is not, nor should be, a vaunted ideal that everyone must strive to live up to. It is an alternative. To what? To weight-loss dieting, to punishing “health regimes,” to doctors whose anti-fat bias drives them to diagnose you as fat and send you limping off on a sprained ankle with a prescription for steatorrhea.

An alternative, not an obligation.

It’s sad that we’ve come to the point where this needs to be pointed out. But it seems to be the reality that health habits, and health status, are no longer private matters. When people believe that you are receiving health care services off their backs and their premiums, they believe it becomes their business to police your personal habits. When health becomes not just an indicator of damn good luck, but of social status — because only responsible, smart people know how to avoid getting sick, and have the money for all those special foods/supplements/alternative therapies you’re supposed to buy in order to be a worthy citizen of the health meritocracy! — people forget about respect for their own and other people’s privacy.

This, despite the fact that the definition of health itself has not even been definitively pinned down, that it has evolved through numerous variations through the years, and will likely continue to evolve. Despite that nutrient requirements are different for each person. As are genetic profiles, family histories, and every single one of the social determinants of health.

The factors that determine health are different for everyone — which means it is up to you to decide what to do. No one can do it for you.

But we live in an era, a really strange era, where our life expectancy is better than ever before, and where we have (arguably) adequate access to health care. But, in some kind of terror, we strive continually for a zero-risk situation — and we strive for it not by addressing systemic disparities in access, but through laughably insignificant personal attempts, and individual finger-pointing.

But there are no zero-risk situations. Even people who do everything “right” sometimes get sick and die. In fact, everyone eventually gets sick and dies. Despite attempts to the contrary, our mortality rate as humans remains stubbornly at 100%.

…my unwholesome fascination with this man.

Walk it out…

Then break it down.

I’d like to say something about how much fat people eat. I, personally, would be neither surprised nor offended if it were somehow proven that fat people, on average, eat more than thinner people. Of course, this hasn’t been proven, and if it were, there would be exceptions and outliers — but if it were found to be the general case, it wouldn’t surprise or offend me in any way.

I think I eat a fair amount of food, but I do not binge, and I do not habitually overeat. By its definition, overeating is eating “too much,” or an unhealthy amount. In our culture, this means “eating enough to get fat,” because fat is shorthand for “unhealthy” — and it suddenly becomes a lovely example of perfectly circular logic: overeating is what fat people do when they eat, whether it’s a two-pound steak or the parsley garnishing it. Therefore, if you are fat, you are fat because you overeat, else you wouldn’t be fat; and if you are fat, any act of eating you undertake is defined as “overeating” — because you are fat.

I’ll tell you what; I eat exactly the amount of food I want and need at any given time. This is not overeating. This is called Being a Grown-Up Human Being Who Can Take Care of Her Own Damn Self, Thank You Very Much. And if I found that I ate more than a thin person, or that the average fat person ate more than the average thin person, I wouldn’t be offended because I don’t think it’s morally wrong for different people to eat different food in different amounts. I wouldn’t be offended because I don’t think what a person eats reflects on their character. And I wouldn’t be surprised because, well, I am hungry.

I could go into the biological reasons for why I am hungry, into the fact that I support more fat mass than the average person, and to do that requires more muscle mass, more bone mass, more vasculature, more everything, and the fact that, beyond that, nutrient requirements are normally distributed — but I won’t, because there’s really no explanation necessary (and if you think there is, you’re well on your way to a bingo.) I am simply hungry, and there is nothing anyone can say to dissuade me from being hungry, or talk me out of being hungry, or trick me into thinking I am not hungry when I am, in fact, hungry.

I am hungry, and my body is a much better estimator of calories and portion sizes and even balanced nutrition than my head, or anyone else’s, will ever be. I eat exactly what I’m hungry for, and I do this because I learned how — something that many people won’t ever learn, because that is exactly how fucked-up our culture is over food. If I overeat, it’s an occurrence relative only to myself, not to the thin person next to me. And if I eat more than someone else, say, more than someone thin, it is not because I am stupid and they aren’t, not because I don’t understand nutrition and they do, not because I’ve never been read the Riot Act Obesity Act, and certainly not because I am an immoral, no-good, greedy, wanton symbol of evil Western imperialism and overconsumption.

It is because I am hungry, and I know how to feed myself so that I am no longer hungry. It’s something no one else can do for me; I have to do it for myself. And I thank the good Lord every day that I can, and do.

A famous actress was quoted in the newspaper regarding a role that required her to gain weight. Something about the quote struck me as odd. To paraphrase, she said, “Sure, it sounds great to gain weight. You can indulge all your fantasies of endless chocolate, unlimited pasta and garlic bread…but after a while your blood glucose goes crazy, you’re all over the place, and it doesn’t feel good.”

At first blush, the quote makes sense. It’s true; if you’re eating too much for your needs, or a diet nutritionally unbalanced for your needs, it’s not going to feel good — it’s going to feel gross. Fair enough. But the thing that stuck in my craw was the idea of someone even having fantasies about unlimited chocolate and pasta and garlic bread in the first place.

Now, food fantasies probably won’t sound weird to most people, because most people — and forgive me if this sounds mean — live with a slightly eating-disordered ideation about food, thanks to our culture. But in my experience, having these fantasies, and looking forward to any ‘excuse’ to indulge in them, is highly dysfunctional.

The fact is, a person who restricts their food intake, especially due to weight concerns (or the myriad related ‘health concerns’ that are just an attempted sublimation of the desire to lose weight, look better, gain social privilege, etc.) will have food fantasies. As the food restriction gets more severe, the fantasies get wilder, and the food behaviours more erratic. Remember the details from the Ancel Keys study, “The Biology of Human Starvation.” Recall the food compulsions reported among anorectic patients, people who are supposedly ‘not hungry’ (I assure you, they are, and they obsess about food more than they would if they actually ate it.) Think of the hot-fudge-sundae fantasies that most likely drifted through your dreams last time you were on a diet; craving pasta and potatoes during Atkins’; longing for cream sauces and marbled steaks on Pritikin.

Maybe it’s not enough to do damage, the type of moderate-to-mild food restriction that goes on commonly in the culture, prompting these harmless-sounding, Willy-Wonkaesque food fantasies. Maybe not. But maybe it is.

To divert for a moment, let’s consider the Willy Wonka river-of-chocolate, candy-growing-on-trees fantasy. Who is this designed to appeal to? Children.
Because their food intake is restricted? Well, perhaps in some cases, but I think the larger reason why the Willy Wonka fantasy appeals to children is that children are at their most metabolically active. They are growing; they have huge energy and nutritional requirements by unit body mass, much larger than adults, and in such a state, it’s natural that someone would fantasize about food, crave candy and sugary treats, adore birthday cake and cookies and, well, to do all the funny things with food (and particularly, sweets) that children are renowned for. Much the same goes for pregnant women, who are nourishing a rapidly-growing bundle of cells with their own bodies.

But is it normal for most adults — who should be in a metabolically stable state — to have these types of longings and fantasies and cravings? No. It is a sign that something could be wrong with your food intake and your nutritional status, or even out-of-whack metabolically, hormonally. Maybe nothing severely wrong, not yet, but definitely trending in that direction, and definitely taking away from your quality of life — even if it’s ‘just’ from your emotional well-being. The plain fact is, if you’re not getting enough to eat, it will eventually catch up with you. You will feel tired, hungry, or irritable. You will be distracted by food fantasies and maybe by the restrictive food rules you impose on yourself. You won’t be able to enjoy social meals as much. Your quality of life will suffer, and your performance in all areas of your life will suffer.

Any why infantilize yourself like that? Why subvert your real goals, your real life, to dream about food all day long? One of the first areas where a child learns to exert control is in eating. It is an area fundamental to the awakening of human autonomy. We are big boys and girls now; we get to choose what to eat, and how much of it.

In my experience, when you do two things — 1) stop food restriction, and mentally grant yourself permission to eat whatever you want, whenever you want, however much you want — and 2) pay attention to how eating makes your body react, so that you can balance short-term pleasure with longer-term well-being, so that you are nourished both physically and mentally — when you do these things (and they are not easy, not as simple as they sound, and can take years of effort), the food fantasies will end.

Because do you find yourself fantasizing about breathing air and drinking water on a daily basis? No? Enough said.

P.S. To bring this full-circle: when looking up “The Biology of Human Starvation” on Google Books, the first ad on the side of the results page said “How celebs stay thin.” Terribly apt.

Which is not only stupid, but impossible.

People age and change, and I want to be relaxed and happy with those changes. There was nothing wrong with me as a child when people told me I was ugly and misshapen and that I should be ashamed of myself; there was nothing wrong with me when one day I woke up looking more like the cultural ideal than I’d bargained for and was hunted like a deer in season by people who treated me like an orifice.

And there’s nothing wrong with me now, as I age and get fatter and, hopefully, wiser. The problem was never with me…it was with the ridiculous significance we attach to the way people look, and the arbitrary dividing lines placed between “acceptable” and “unacceptable.”

One day, I was unacceptable for wearing glasses and having straight hair. Another day, I was highly prized for wearing a different dress. One year, my rounded derriere was outré; the next, it was the height of fashion. I literally woke up one morning and changed my hair and put on new clothes like a costume or uniform or, more likely, armor, and the way people treated me changed 180 degrees — based entirely on my appearance. This severely undermined my already-shaky faith in humanity, and I’ve been suspicious of people ever since.

How about this: I have always looked basically the same, with slight alterations in hairstyle, clothing choice, and makeup. I am the same person, always, and my worth does not change based on the whims of fashion. And how about if it’s no one’s business to tell someone that she’s either in or out or ugly or beautiful — because all she is, all she has ever been, all she wants to be, is human?

Not a canary in the coal mine of cultural beauty.

These are the fat acceptance zealots — using fat acceptance and ‘in your face’ fat imagery and messages in order to shock the world into accepting their fat as meaning they are valid, worthy and ultimately just as healthy as the next person.

“And really fat people are valid and worthy, but as healthy as the would be if their hearts weren’t beating much harder in order to accommodate an extra 100lbs?

“No — this simply cannot be.”

–Weighted Long Enough

This is the writing of a woman who was once passionately involved in fat acceptance. Presumably, she still believes in basic tenets like, you know, appearance-based discrimination is wrong. But she got to a point where she felt her fat was detrimental to her health.

Now, I wouldn’t presume to argue with a person about their own experience, except to say that I believe directly addressing comorbidities associated with fatness is probably more effective than addressing the fatness itself, given that there are precious few (read: NO) permanent, safe methods of fat reduction.

But still, a person is allowed to be the expert on their own experience. If she feels that fat was causing her health problems, who the hell am I to contradict her?

This is where I believe Health At Every Size connects with the fat movement. The fat movement, as I see it, is primarily about politics and human rights, and well it should be. These are the critical, the most important, factors determining our experiences as fat people. But because fat is inextricably bound up in matters of health, at least from the perspective of our oppressors, the HAES component is a critical tangent of our movement.

See, the thing is, people who are involved in fat acceptance don’t always seem to fully understand HAES, and this concerns me. It concerns me because it is a useful tool that many of us seem content to toss by the wayside. This woman is a prime example of not understanding the basic structure of the HAES philosophy…the first being that “Health At Every Size” means health at every size for the population, not necessarily the individual.

If you accept the theory of set-point, as many fat acceptance advocates do, then you realize that an individual body has a preferred level of adiposity, for which a handy (though imperfect) proxy is body weight. This not only means that maintaining a weight lower than set-point is not good for you, but also that maintaining a weight much higher than your body’s natural set-point range is also not good for you.

The thing is, despite what the BMI dorks seem to think, set-points, or body weights, or body compositions, naturally come in a wide variety. I like to think of this as one way our species protects itself against extinction by one poorly-timed famine, epidemic, or ice-age. If all our bodies operated identically, the human race could easily be wiped out in one fell swoop, because we’d all react in exactly the same way to dramatic environmental changes.

So there is variety in size. There is variety in nutrient requirements as well…not only for kcalories, and macronutrients like fat, protein, and carbohydrates, but also for vitamins and minerals. Now I know those RDAs and the popular multivitamin supplements and the Food Guide Pyramid and everything seem to suggest that we all have the same requirements, dependent on things like age and sex, but it’s not so. Those things are basically educated guesses on how we can catch most of the population, within its wide range of requirements, so that nutrient deficiencies are no longer widespread. There was a time when things like scurvy and rickets were near-epidemic, so the usefulness of these tools can’t be overstated. But they do not represent some magical, unequivocal number that super-smart scientists have determined to be the perfect amount of X nutrient for everyone in the whole world.

If you doubt this, I would like to turn your attention to the development of the DRIs, which are, basically, a more complex and comprehensive form of the RDAs. There were huge debates, for example, over the recommended intake of calcium. Calcium! A nutrient we all take for granted as being a set-in-stone, God-given prescription for strong teeth and bones! Well, the goddamn scientists argued so much over the RDA for calcium that they never came to consensus. So, yes, you read that right, there is no RDA for calcium at this time. Instead, they came up with a rough guesstimate (the AI), from which specific recommendations cannot be extrapolated.

Okay. Phew. Sorry for the Nutrition 101 lecture. I just wanted to illustrate my point that, if we can’t even come up with solid numbers for the entire population on something as basic as calcium, why do we assume that ideal weight can be so easily established?

It can’t. Just as it is not logistically feasible to thoroughly test and document the nutrient requirements of each individual across the entire population, it is logistically infeasible, and as yet IMPOSSIBLE (since we are nowhere near understanding all of the complex mechanisms that influence body weight), to determine every single person’s healthiest weight. For practitioners of the HAES model, the definition of ideal weight is this: the weight you maintain when you are eating nutritiously and getting adequate physical activity. Not some arbitrary, shame-inducing number on a goddamn table picked out by a bigot like Walter Willett. Sorry, but for all you BMI-lovers out there — them’s the fucking breaks.

So, back to this woman. Is it possible that she maintained a weight that was above her own healthiest weight? YES. Does this mean that anyone else maintaining the same weight and body composition at similar height, age, and gender is also above their healthiest weight? NO.

Health at every size, as I have said approximately 7,386 times on this journal, does not mean that one individual can be healthy at every size. Cause you can’t. You’ve got a basic range, and the range may shift a bit during different stages of life, but you cannot run up and down the huge spectrum of possible body weights, like a pianist running his hands over the keys from lowest to highest, and expect to be perfectly healthy at each step.

It is perfectly possible that, by an individual definition, this woman was ‘overweight.’ The problem, though, with focusing on weight, even if it does prove to be causing health problems for a person (and this is rarely, if ever, proven), is that not only is there no way of predetermining an individual’s ideal weight, there ain’t much we can do about the weight anyway. Weight-loss treatments, from drugs to diets, are dismal failures. GI surgeries are risky and do not have a lot of long-term research to back them up (I won’t even mention the anal incontinence, or possible vitamin deficiences that can cause irreversible neurological damage. Oh wait, I just did. Sorry.) Even people trying to gain weight have some difficulty.

So it’s a bit of a bind, isn’t it? And even if someone buys fully into the political aspects of fat liberation (there, I said it, fat liberation), the health argument is just sitting there, waiting for them to have a bad day, or to get tired of being fat (which is a very real possibility in this culture), or to get sick in a way that a doctor would readily attribute to ‘obesity.’ Under these circumstances, it is very easy to see why even an ardent supporter of the politics of fat liberation might go and do a thing like have weight-loss surgery, or start a reducing diet, or take the newest FDA-approved fat-person extermination pill — I mean, ‘obesity treatment’ — and maybe start to side, just a little, with the attendant propaganda. Because cognitive dissonance is a bitch.

This is the where Health At Every Size becomes not only a useful tangent to fat liberation, but an essential component.

Listen: there is an alternative. We need not be extremists on either end of the spectrum of fattitude — one being the end that says “I am healthy no matter what” and the other being the end that says “I’ll take the Roux-en-Y with a side order of Meridia” — because, all-too-often in my experience, two extreme ends of any spectrum eventually meet in the same, frighteningly psychotic person. Like radio shock-jocks who go from an ultra-liberal upbringing to ultra-conservative vitriol in the brief time it takes to experience one adolescent disillusionment. Like the woman who writes about being “involved in the fat acceptance movement as a way to stay in an illusion that one can be extremely fat and healthy.”

Thing is, there are extremely fat and healthy people out there. That’s how the fucking bell curve works. No, you cannot be healthy at every size. But we can. Here’s how:

You eat well. This is not a moralistic determination, nor is it the same from person to person. There are general suggestions that most people can safely follow, but the most important is to learn to listen to your gut. Try to resuscitate the cues that a lifetime of dieting and an eating-disordered culture have probably killed. If you can’t do it on your own — and many can’t; it’s hard — get someone to help you. Size-friendly therapists and dietitians exist, and many of them believe in an empowering philosophy of health promotion, which in English means: you get to make your own choices. You get to figure out what is best for you. Because even scientists can’t tell you how much goddamn calcium you need.

You move well. This is also hard to figure out, and I’m currently doing battle with it myself. Kell has some good ideas. Like we all have an appetite for food, I think we all have an appetite for movement. Think back to the way you might’ve played as a kid, the times you got restless from sitting still for too long. Try to remember a time when being sweaty and out of breath meant you were having a fucking awesome time (if you’re lucky enough to have such memories.) Think back on those times, and try to come up with creative ways to have fun now. REAL fun, like the kind of fun you had when all you needed was a hot day and a sprinkler in the yard, or a jump-rope, or a piece of chalk and a stretch of concrete. When did adult movement become so boring and medicinal? Who says you need to have ‘proper footwear’ or a gym membership or all sorts of ugly spandex clothing in order to get a little hot and sweaty? If you’re into that kind of thing, cool; you have that many more options than the rest of us who hate all that shit. And if you hate it, take heart: so do I. But I won’t be disingenuous and pretend that physical activity has no bearing on our well-being. Neither will I deny that it’s more than possible to go out and find ourselves a bit of fun.

Third, you learn to deal with your body. Whatever size it’s at, whatever health conditions you might be facing, whatever colour it is, however big your butt is, or small your tits are, or anything. You take what God fucking gave you, and you make the best of it. You do the treatment for any health problems by focusing directly on the problem itself, not by buying into the cultural fantasy that, if you lose weight, you’ll magically lose any physical and/or mental illnesses along with it.

By doing this, your body is going to change in whatever way is best for it to change. You don’t get to control that. It might mean gaining weight, in the form of fat or muscle, and feeling self-conscious. But we have tools to deal with that, because that is what this whole movement is about: creating a society where people of all sizes can feel reasonably welcome.

It might mean losing weight, and you might feel guilty, like you’re betraying your fat liberation buddies. But you’re not betraying anyone. A real betrayal would be to go and swallow shit like “I wanted to believe I could be as healthy as a person whose weight didn’t literally drag them down. This was my greatest lie – a lie that allowed me to get more and more fat, until I’ve now reach the point of do or die.” Betrayal would be to believe that, in order to be healthy, you must first focus on changing your body to a socially-enforced ideal…in order, presumably, to become ‘deserving’ of proper health- and self-care. Betrayal would also be to totally deny the fact that eating and moving well will have a positive impact on your health, and that, if you want to, you deserve those things as much as anyone else.

Most likely, no matter how your weight changes, your basic health indicators are going to improve. Your blood pressure is probably going to improve, as well as your blood cholesterol, and your ability to use insulin and regulate your own blood sugar. These are much more accurate proxies for health than body size could ever be. And if things get worse, it’s a sure sign that something else is going on and you need to see a doctor. But for most people, you can bank on the fact that eating and moving well and treating your body with respect is only going to make things better, whether or not you get bigger or smaller in the process.

Listen: as surely as we are oppressed by systematic external discrimination, we collude in our own oppression by not demanding the care we deserve from health professionals, and by not caring for ourselves in the way we deserve. And don’t you believe for a MINUTE that you have to submit to ‘their’ idea of health and self-care, or the health meritocracy. First and foremost, all of this is a choice. It is optional. But in order for that choice to even exist, we have to have access to good information, and we have to really believe that we deserve to be cared for. I have a sneaking suspicion that an internalized sense of inferiority drives a lot of our rebellion against ideas of self-care and health at every size. And I totally understand. I get panicky, too, when I entertain ideas of ‘making healthy choices’ and what-not because, more often than not in our deranged, pathological society, ‘making healthy choices’ is code for ’submitting to coercion.’ I know. I know. But we can’t let the difficulty of the fight let us stop fighting it.

There are size-friendly health professionals out there. There are dietitians and therapists and doctors in a number of specialties who are on our side. We definitely need more of them, and that’s another thing we’re working on, but we should be taking advantage of the ones we’ve got. (Check out Stef’s Fat Friendly Health Professionals page.) We also need better resources for general information on health and nutrition — in print, on the internet, on TV — stuff that comes from a size-positive perspective (hell, even a size-neutral perspective would be an improvement over what we’ve got now.)

Pattie pointed out that a lot of the HAES terminology is being co-opted by forces that are anything but size-friendly. This scares me, and I think one of the reasons they’ve been able to do this is that HAES has not yet come into its own. One of the things we’ve got to fight for is to make HAES work, and work in the way we want it to. We can’t let it revert into yet another health-fascist approach that’ll only find creative new ways to blame and marginalize people in the name of health.

Pattie also talked about how “the personal is political.” With the way things currently are, what could be more political than for people to stand up, demand quality health-care, and to make truly free and informed choices about their health, regardless of what size they are? In a true HAES framework, this would never result in dividing us into ‘good people’ and ‘bad people.’ It would simply give people of all sizes the information and support they need to make real choices — something we don’t currently have, since most of our resources are hopelessly tainted by their association with “Brand Thin” — and its mandate would be to then respect those choices, whether they might be classified by the majority as ‘healthy’ or not.

If we’re fighting a war here (I’ll indulge in some militaristic language, since everyone else seems so eager to compare fat people to terrorists and to declare ‘war on obesity’), we need our troops to be as strong as possible. And that doesn’t mean conforming to some arbitrarily defined, absolutist notion of what ‘health’ is. To me, health is a matter of making autonomous choices, and having the resources necessary to inform those choices. Though we may all disagree on which behaviours are healthy or not, I think we can all agree that losing once-fervent supporters to the health meritocracy does not strengthen our numbers. Having an alternative that emphasizes good information, respectful practitioners, and a culture of individual sovereignty will.

The word ‘diet’ has become terribly perverted from its original, life-affirming definition. In the original sense, diet meant: “food and drink regularly provided or consumed; habitual nourishment.” (www.webster.com.) In the last century or so, it has taken on a second, uglier definition: a particular way of eating, especially to achieve weight loss (or, euphemistically, to achieve health, which 95% of the time includes losing weight.) THAT is the kind of diet I’m talking about.

Let me fill you in on a couple things. First of all, a diet in the secondary sense is always temporary. Even if you call it “a whole new way of eating” or a “lifestyle change.” If you’re really and truly making a lifestyle change, it’s probably going to be so gradual that you can’t refer to it collectively. It’s going to fit in seamlessly with your life so that it doesn’t NEED a name all its own. This is the point.

Anyone who says they are embarking on a “lifestyle change” is going on a diet, plain and simple. Sometimes they will insist that the “maintenance” period (which comes after the weight loss) PROVES that what they are doing is for life. Actually, it proves the opposite. If you go from ‘actively losing’ to ‘maintaining’ you have been on a diet. Maintaining itself is a type of diet, though typically not as restrictive as the original weight loss diet. And the funniest part about maintenance? Ask anyone who’s done it: maintenance is hard…even harder than weight loss.

Why is that? Well, one, because the thrill of seeing your body change is gone. The excitement and novelty have worn off by the time you’ve reached maintenance. Now you’re down to the dirty work of trying to convince your body to behave a