A Study Worth Reading

Huge thanks to Twitter follower @shellymc for introducing me to this great study!

The goal of the study was to see if BMI, waist circumference, and abdominal adiposity (how much fat you carry in your mid-section) were good predictors of cardiovascular disease.

They looked at information for people who did and did not develop cardiovascular disease to see if one or a combination of those measurements could have reliably predicted their disease outcome.

What did they find?

In their words:  BMI, waist circumference, and waist-to-hip ratio, whether assessed singly or in combination, do not importantly improve cardiovascular disease risk prediction in people in developed countries when additional information is available for systolic blood pressure, history of diabetes, and lipids.

In my words:  They found that just looking at body size and shape was not worth doing if you could use actual measures of health.  Which we can.

But I think the real question is – when did we become so medically lazy that we require a study to tell us that?  And when are doctors going to stand up and say that they got into their profession to practice medicine, not guessing and body shaming? (Edit:  Some readers have taken this paragraph to mean that I don’t think that the study was necessary. To be clear, I’m all for the science, what I’m trying to point out is that we’ve abandoned actual medicine in lieu of staring at people fully clothed and making guesses about their health and we shouldn’t require a study to tell us that’s stupid and lazy.)

I would be remiss if I didn’t point out that this is what happens when studies are not funded by the weight loss industry.

I’ve said it before I’ll say it again, body size is NOT a diagnosis. This study points to what should be face-palmingly obvious:  The only thing that you can tell from someone’s size is what size they are.  If you’re looking at someone’s size and drawing conclusions other than what size they are then congratulations – you’ve discovered your prejudices and preconceived notions and what a great chance for you to choose to work on those!  Especially if you happen to be entrusted with that person’s health and well-being.

Published in: on July 31, 2011 at 9:14 am  Comments (24)  

Not the Me I See on TV

I’ve had a number of people ask me to comment on this NPR article.  [Trigger Warning: contains diet talk, body shaming, disordered eating discussion etc.)  It’s called “One Woman’s Story” and if that’s all it was I would have no problem with it.  Kara Curtis is entitled to her life experience.  She is allowed to conflate weight with health, weight with fitness, to be ashamed of her body, and to pour “all her energy and untold resources” into being thin. It’s Kara’s life and Kara’s body and Kara gets to choose whatever experience she wants.  It couldn’t have been easy to tell her story like that, she never tried to extrapolate her experiences to others, and I wish her all the best.

To me the problem isn’t this “one woman’s story”, the problem is that it’s basically the only story that we ever see told about fat women, especially from a news outlet.  When I see people like me portrayed on TV, in the movies, in magazines, and on the news with very few exceptions they are self-loathing, desperate to lose weight, unfit, unable to find love (or not even seen as sexual beings), the constant butt of jokes etc. I was once recruited for a reality show that was going to tell the stories of happy fat people.  But the show didn’t get picked up because “nobody cares about fat happy people, and lots of people don’t believe in them”. People don’t believe in me?  Am I a leprechaun? What the…

If NPR ran with something called “Two Women’s Stories” and one of the stories was of a woman who rejected the diet culture and lived a happy, healthy life with Health at Every Size that would seem more like balanced reporting.  Maybe they intend to offer a balanced perspective:  in their More About the Series box they say that they will talk about a “size acceptance” movement (quotation marks are theirs and don’t give me a lot of faith in how balanced this portrayal is going to be).  But that only comes after they say a lot of very questionable things about obesity as if they are given facts.  I hope that NPR isn’t joining the media frenzy OMGDEATHFATISCOMINGFORUS panic and contributing to a culture of body shaming and bullying as a cheap way to get readers and listeners, and I’ll wait to see how I feel about it until after the series is over.

It’s for this and many other reasons that I’m really excited to be in an upcoming documentary about weight and health. (See how I segued into shameless self-promotion? I’ve got skills!)  Darryl Roberts, creator of the incredible documentary America the Beautiful which you can find on Netflix, is wrapping his newest movie and it’s about the conflation of weight and health and BMI and health in the US and I have a part in it! I’m super excited to be able to show a side of fat women that’s rarely seen in the media.  I saw a pre-screening and the movie is amazing and I still kind of can’t believe that I get to be part of it.  If you are going to be at the ASDAH conference in August the movie will be screening there and I’ll be part of a Q&A afterward. I’m so excited!

Enough about me.  The point is that we do not have to buy what the media is selling us.  We do not have to be who we see on TV.  We can be happy, healthy, strong, fat, demanding of respect and certain that we are worthy of love.  The more of us who claim that identity, and the more people who know us and see us living that life, the harder it is for the media to make people believe the negative caricature of us that they like to portray.

If you feel like commenting today I’m curious to know :  Who are your favorite fat role models?

Published in: on July 29, 2011 at 6:42 am  Comments (53)  

What Is a Fat Activist?

If you were following the comments on Wednesday’s post, then you probably saw this one coming. If you weren’t, the basic background is that a reader suggested that I post a food log.  I said:

No.  I don’t try to prove things to people any more.  I understand that you are well intentioned and where you’re coming from with this, but I’m not going to do it. I’ll post my food log and then I’ll have to deal with 1,000 comments and e-mails where people call me a liar, or tell me what I SHOULD be eating to lose weight, or offer to let me try their weight loss plan for free etc.  I don’t feel like dealing with it and I don’t owe anyone an explanation.

A reader named Barbara made the following comments:

Ragen is an Activist. And unfortunately being an activist has to come with a certain amount of disclosure. You can’t say ” take my word for it”…You can’t say ” I am a fit, healthy, proud fat person who has nothing to hide, and wants to share with the world that you can be fat and healthy” And then say ” No body will believe me if I put the information out there, so I’m not going to” You either believe that you are helping the cause, or you believe there is no changing peoples minds and you are wasting your time.

Barbara is well-intentioned, but from my perspective she is way too into telling me what I can and can’t do.  You are welcome to read my response to that comment on that post but today I want to talk about one phrase in particular:

“an activist has to…”

Personally I don’t feel that those words should be put together in that order, ever. There was room for Malcolm X and Martin Luther King, Jr.,  Harvey Milk and Larry Kramer, Gloria Steinem and Betty Ford.  I am IN NO WAY comparing myself to any of these people but they are all heroes of mine in one way or another and they had very different styles of activism so I feel comfortable that there is room for fat activists who post food logs, and for those of us who do not.

In fact, I think that this is particularly true for fat activists. When we live in a world that constantly pummels us with messages that we are not healthy, not attractive, and not worthy of love, just getting out of bed in the morning and not hating ourselves is a revolutionary act.  When so many fat people think that they deserve to be shamed and stigmatized, standing up for our basic rights to be treated with respect and dignity constitutes activism.

If it seems like I’m picking on Barbara, I’m not.  I believe that she had the best of intentions and I wanted to talk about this because her comments are just representative of things I hear all the time from lots of people – what I’m obligated to do and who I’m obligated to be so that I can meet their definition of an activist. For me, activism is about what we want to be and how we want to be it, not about trying to fit our picture into someone else’s frame.

You be the boss of your fat activist underpants, and I’ll be the boss of mine. I think that we could use a whole lot more fat activism of all kinds and a whole lot less people telling us how we have to do it.

Published in: on July 24, 2011 at 8:53 am  Comments (47)  

Healthy Respect

Obesity epidemic, painfully thin, too fat. They are just descriptions with a judgment attached.  It’s just like any other assumption that you make by looking at someone (ditzy blonde, dumb jock)  Judgments about body size aren’t where the true conversation is at. Here’s why:

First, let’s agree that health is not a moral, societal or personal obligation.  People are allowed to smoke, drink, cross the street without looking both ways, bungee jump, paraglide, jump their motorcycle over a series of busses, compete in skeleton and luge, lead incredibly stressful lives, not get enough sleep, cliff dive, eat a diet of fast food, and be sedentary.  People are allowed to prioritize things other than their health.  If you’re about to make an argument that includes the phrase “my tax dollars”, head over here.

Now, consider that health is multi-dimensional and includes genetics, access to healthcare (including money, distance, time, hours of operation, and the ability to get a doctor who will give you appropriate care etc.), stress, environment, and behaviors (which also includes the ability to acquire, store and afford the kinds of foods that you want, as well as access to safe movement options that you enjoy).

Once I wrapped my head around all of that, and made the decision that health was a priority for me, I looked at my options for health:

a.  practice healthy habits

b.  try to increase my access to health care

c.  Try to reduce my stress

d.  Try to improve my environment

e.  Try to make my body smaller

You get to decide for you, but in my case I went with “all but e.”

Once I really looked at health it became crystal clear the the old adage is, at least in this case, true: Size doesn’t matter.  There are people who practice healthy habits who are fat. There are people who eat poorly and are sedentary and thin.  In my experience weight loss and thinness are simply a possible, but definitely not guaranteed, often short-term, side effect of healthy habits. Due to the multi-dimensional nature of health, healthy habits are not guaranteed to produce health, but I think that they have a much better chance of leading to health then doing the unhealthy things  that the diet industry recommends to make my body smaller.

Somewhat inexplicably, some cannot accept that this is the plan at which I arrived after extensive research and they speak to me about it in a way that is completely disrespectful which I find unacceptable.

I suggest a three step plan:

1.  Stop trying to figure out anything about someone’s size except what size they are

2. Make choices for yourself

3.  Respect other people’s choices, even if they aren’t the choices that you would make

Voila – Healthy Respect!

Published in: on July 22, 2011 at 9:08 am  Comments (14)  

Correlation is Killing Us

I received an e-mail from reader Melissa who asked some good questions really respectfully, so I thought that I would answer them publicly.  To be clear, when I talk about trolls and such, I’m not talking about Melissa, it just happens that her questions frame a larger debate that I and lots of other fat people deal with:

If study after study shows us a correlation between obesity and the so-called diseases of civilization, aren’t you curious about the potential causal link there? Some of the study authors may be doing bad science, oh yes indeedy, and I’m not implying that the way the media goes about reporting on these things or pushing the “beauty ideal” is the way to go. And I’m certainly not arguing with you that you can’t be fit—all evidence suggests to me that you are. Do you believe that obesity’s correlation with disease is unrelated to the obesity itself and may be a result of other choices that some obese folks make (such as not remaining as fit as you)?

First, there is a reason that “Correlation does not imply causation” is such an important fact. It is the most basic tenet of research. The problem with correlational research is that it only proves that things happen at the same time, it does nothing to prove that one thing causes the other, and if you can’t prove the cause then you don’t know the cure.

  • The body size and the health issue could both be caused by a third factor
  • They could be unrelated and so losing weight would just mean that they would just have the same problem in a smaller body.
  • The health problem could be causing the body size and so weight loss would either do nothing or could even exacerbate the problem.
  • They could caused by two different things and then neither issue is treated properly.
  • They could both be side affects of a behavior, but the behavior change my help the health problem but not change the size of a person’s body – unfortunately that person may be labeled a “failure” because, even though they reversed their health problem, they “failed’ to reverse their weight.

These are just a few possible scenarios.  I’m not saying a causal link is impossible, I’m saying that it’s not proven and that nobody seems to be too worried about finding out because they are too busy yelling “IT’S YOUR FAULT FATTY EAT LESS AND EXERCISE MORE!!’  Look at the comments these two posts on health and you’ll see story after story of people who received poor medical care because their doctor thought that weight loss was a cure-all.  Hell yes I’m going speak out against this practice and point out every chance I get that there is NOT a proven causal link because lots of people, including medical doctors, think that there is and that lack of simple knowledge can kill people.

The media does an abhorrent job of researching stories about weight and health before they spread them far and wide and so a study wherein 3% of children lost weight on a diet gets the headline “Say Goodbye to Obesity”.  The CDC retracted their statement that 400,000 deaths per year were caused by “obesity related disease”. The retraction stated that only 110,000 deaths could be connected and admitted that “the link was probably weak” but I’ve seen three stories this week that said that according to the CDC 400,000 deaths a year are caused by obesity – which not only ignores the retraction, but also the fact that nobody ever claimed causality except the media.

I’ve never said that I know the answers to these things, I’ve just pointed out that there is evidence that runs counter to the mainstream, and that people are running around acting like they know the answers when they don’t.  And if the media’s numbers are to be believed, it’s putting the health of over a third of Americans (who are “obese”) at risk due to improper medical care.

There are thin people who have diseases correlated with “obesity” and “obese” people who don’t.  I think that we need to stop looking at weight and start looking at health.  We have the ability to evaluate health with everything from blood pressure cuffs to blood panels to VO2 Max scores, so there’s just no reason to look at someone and make guesses about their health based on their size. It’s just cheap, lazy medicine.  Also, when we continually repeat that weight is the “reason” for health issues, it gives thin people a false sense of security that they are healthy as long as their bodies remain small.

I believe that health is a combination of genetics, access, environment, stress, and behaviors. I also think that people’s prioritization of their health and the path, if any, that they choose to get there is nobody else’s business.   Telling people to lose weight to be healthy is telling them to do something that nobody can prove is possible for a reason that nobody can prove is valid and I have a problem with that.  I don’t think that health is a moral, societal, or personal obligation but I do think that if someone is interested in greater health, the best chance that they have is to practice healthy habits. (Actually, statistically the best chance is to be born to wealthy parents with good genes in a city where they have access to robust healthcare but I assume if they’re reading the blog then that opportunity has either come to fruition or passed them by.)

I do not see how blaming everything on a ratio of weight and height and telling people that the solution to their problems is to give their body less food than it needs to survive so that it eats itself thereby becoming smaller and changing their height/weight ratio (despite a marked lack of evidence that that is even possible over the long-term, or that it will solve their problem if it does) is a better idea than telling people that if they want to be healthy they should practice healthy habits and then actually evaluating their health to check their progress.

Lastly  I wanted to note that it might be helpful for ammunition against your detractors if you kept a food log for a couple of weeks and posted it. This, it seems to me, would be as great a testimonial for who you are and how you live as the lovely exercise photos. They may not all believe you’re telling the truth, but some might, and it’s possible that some will then question the old “calories in, calories out” canard. I think that’s a worthy goal. :)

No.  I don’t try to prove things to people any more.  I understand that you are well intentioned and where you’re coming from with this, but I’m not going to do it. I’ll post my food log and then I’ll have to deal with 1,000 comments and e-mails where people call me a liar, or tell me what I SHOULD be eating to lose weight, or offer to let me try their weight loss plan for free etc.  I don’t feel like dealing with it and I don’t owe anyone an explanation.

This blog is not meant to be an exercise in persuasive writing and it’s not my job to prove anything to anyone, least of all my detractors.  (To be honest, it wasn’t that long ago that 6 people, including my mom, formed the entire readership of this blog, so the fact that it’s popular enough to have detractors makes me kind of  happy.  Although, of course, not as happy as the fact that I have fans – I can’t even type that without smiling).  I try my best to provide my well-researched, thoughtful, and level-headed (most of the time!) point of view that is outside of what the diet industry spends billions of dollars a year promoting.  I doubt I have a single reader who agrees with everything I’ve ever said.  Some people like my blogs about self-esteem and body size but disagree with what I say about science and statistics.  Some people love my science and stats blogs but say that the self-esteem and body size ones are “fluff”.  Some people get upset that I write blogs responding to criticism.  All of that’s fine.

In blogging as in life, I think that the absolute worst thing that I could do is try to become what I think other people want me to be.  Not only does it not typically work, but it would leave me in a place of being inauthentic which is way worse than being disliked or called a liar.  So my detractors can detract away while my fans – like Melissa – can read this blog and others like it, ask questions, and have intelligent and interesting discourse. Yay us!

Like my blog? Here’s more of my stuff!

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

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Interviews with Amazing Activists!!  Help Activists tell our movement’s history in their own words.  Support In Our Own Words:  A Fat Activist History Project!

If my selling things on the blog makes you uncomfortable, you might want to check out this post.  Thanks for reading! ~Ragen


Published in: on July 20, 2011 at 8:02 am  Comments (74)  

My Joints, My Fat, and Me

Ragen Chastain 5’4, 284lbs. Trained by Kate Wodash. Fun fact – that thing that my right foot is on slides. I’m not only having to balance but also having to keep it from sliding too far in either direction.

One of the things that I often see stated as irrefutably “caused” by obesity is joint problems.  This sometimes goes with the oft-repeated claim that the human body “wasn’t meant to carry [insert completely arbitrary number of] pounds”.  It also goes hand in hand with the VFHT (Vague Future Health Threat) in this case taking advantage of the fact that bodies break down over time to say that if my joints do that, it will be because of my fat and not for the reason that thin people’s joints break down.

There have been a few times in my life, at various weights, when I’ve had knee pain.  When I was thinner doctors looked at things like muscle imbalances and tightness, gait, and sure enough that was the (solvable) problem.

When I had knee problems a few years ago the only explanation offered to me by doctors was that I needed to lose weight.  Because I had the luxury of knowing how they treat these issues with smaller people, I asked the doctor if people who weren’t fat had knee problems.  After some pushing he admitted that they do.  So I said that I wanted to be treated like they treat thin people.  I was told that there was no point in treating any muscle issues until I lost weight.  What with the who now?  So I left the doctor’s office and I started working with a massage therapist and when we cleared up the tightness in my quads the knee pain disappeared.  Losing weight would have done NOTHING to help the actual issue – I would have had knee pain in a smaller body.  Later I started working with Kate Wodash at The Mindful Body Center in Austin and I learned to correct my movement patterns to avoid the muscle issues that caused the knee pain.  Yesterday I did 75 full squat jumps (where you do a full squat, hand flat on the floor and jump up explosively, then repeat). Knees feel great.  Still 5’4, almost 300 pounds.  Still have more fat and also more lean body mass than most people.

In general I think that a diagnosis of “fat” is just lazy medicine.  Anytime someone tells you that weight loss is the “solution” to your problem, I would suggest that you ask if thin people have the problem that you do.  If they do, then ask how they are treated.  Every weight loss method ever tested scientifically has a success rate of 5% or less, so prescribing weight loss as if it’s a solution that works isn’t just lazy, it’s also medically unethical without a disclaimer explaining that it’s unsuccessful 95% of the time and also that they have no idea whether or not it will solve the issue, because they have no idea if it caused the issue. So if you are dealing with joint pain, and even if you are choosing to attempt weight loss as a solution, I highly suggest looking into other options that might make you feel better on the way.  It may be that you need to strengthen the supporting muscles, or that your movement patterns have lead to imbalance and so you need to stretch the supporting muscles.  Maybe a bit of both.  Regardless, when joint pain is the problem, weight loss is not the only solution.

Related to this is a video that I’ve been meaning to share here for a while.  Revtristy does Olympic Style Weight Lifting and put together a video called “Strong Fat Lady” that is amazing:

Published in: on July 18, 2011 at 7:15 am  Comments (59)  

Fatties and Healthcare

I was recently fortunate enough to be a guest blogger on Sociological Images.  I blogged about the Fit/ Fat debate.  One of the commenters is a health care  provider who mentioned the issues that fat people create for health care workers. He/she was very respectful and kept the discussion to the facts.  Specifically mentioning that we are more difficult to turn/lift/carry, people who have more skin folds are harder to keep clean, it can be difficult to adequately feed us in a tube feeding situation because our bodies can require more calories and be Insulin resistant.

I’m not disputing these issues, but I am asking some questions:

1.  If the numbers are true and 30% of the population is actually obese, that means that the health care system is unable to provide adequate care to a full third of the population.  How is that ok?  Why are people not working on solutions? It’s not like this is a new issue – how did the people responsible for our health care not see this coming and get ahead of the issue?

2. How do they provide healthcare for NFL Linebackers? Those guys get hurt all the time and they are huge. Who takes care of Shaquille O’Neal – that dude is 7’1 and 325 pounds and he was injured a lot.

3. Fat bodies aren’t the only ones that cause issues for health care providers.  Elderly bodies, those frail from disease or malnutrition, people with certain disabilities, people with alzheimers/dementia, young children, people who lack sufficient muscle mass, people with severe osteoporosis etc. all pose difficulties for health care providers.  I work with people who are dealing with under-eating disorders and their bodies create tons of difficulties for their health care providers – they are frail, their stats are all over the place, their bodies won’t tolerate food, etc.

The difference between these other situations and obese people seems to me to be that obese people are told that we should “do something about it” or, more correctly, that we should have “done something about it” before we got sick and so we “deserve” our sub-par health care, or at any rate we don’t deserve to have people working on solutions that would allow us to get the best possible care and allow health care workers to provide care for us without putting themselves at risk.

However, the idea that the solution is just for all of us to become thin is problematic at best. Scientifically no study of intentional weight loss has ever shown a long term success rate above 5% so there is some question as to whether long-term weight loss is possible for the majority of people. Even if it is, that doesn’t help people care for the person who comes in right now with a health problem and a large body.

What I am suggesting is that the problem is neither large people nor health care providers.  The actual problem is that the health care providers don’t have what they need to give large people adequate care without putting themselves and/or us at risk for injury/health issues, and that’s not a good situation for anyone.

So I think that instead of pointing the finger at each other, fat people and health care providers should form a team against the problem. For example in some large people turning them face down causes breathing problems because their fat compresses against their diaphragm. They have massage tables with cutouts so that pregnant bellies don’t get squished, why can’t they do the same thing for fat people?  It seems like these problems are solvable if we just put some effort into solving them.

Published in: on July 17, 2011 at 11:13 am  Comments (33)  

Should Parents of Obese Kids Lose Custody?

In an opinion piece in the Journal of the American Medical Association, a couple of  doctors suggested that kids who were extremely obese with health problems should in some cases be subject to intermediate interventions by child protective services and, in extreme cases put in temporary protective custody. This is one of those things that causes a knee jerk reaction from both sides so I want to try to cover this as calmly and rationally as possible.

I first saw this article about it on Yahoo (thanks to readers Karen, Barbara, Jennifer and anyone else I’m forgetting for bringing it to my attention!)  I was concerned that I wasn’t getting the full story from Yahoo so I went to the horse’s mouth at JAMA and paid $30 to read the piece (the things I do for you guys!).  In this case I’m really glad that I read it.

It’s not nearly as bad as I expected.  The author’s main focus seems to be suggesting intervention by the state as a better solution than the dangerous bariatric surgeries that are currently being recommended.  They are also in favor of trying everything possible prior to removal from the home:

Child protective services typically provide intermediate options such as in-home social supports, parenting training, counseling, and financial assistance, that may address underlying problems without resorting to removal. These less burdensome forms of legal intervention may be sufficient and therefore preferable in many cases. In some instances, support services may be insufficient to prevent severe harm, leaving foster care or bariatric surgery as the only alternatives. Although removal of the child from the home can cause families great emotional pain, this option lacks the physical risks of bariatric surgery. Moreover, family reunification can occur when conditions warrant, whereas the most common bariatric procedure (Roux-en-Y anastomosis [gastric bypass]) is generally irreversible.

That actually sounds reasonably logical and I am happy to see a doctor speak out against weight loss surgery, but that’s not to say that I don’t have concerns.  I absolutely do:

It’s tricky to use body size as a diagnosis: 

  • What about families where there are more than one child who eat the same diet but only one meets the definition of “extreme obesity”? Do they do interventions with all the children?
  • What about parents who raise kids who eat lots of fast food and are sedentary but don’t become fat? Do those kids not get attention for their health issues?

We don’t actually know that much  about childhood obesity:

Despite the fact that everyone and their overbearing mother thinks that they know exactly why we have a childhood obesity crisis, the truth is that nobody is sure.  There is even some argument as to whether a crisis even exists. We don’t know if there are things in the environment that trigger some kids to gain a lot of weight, we don’t know if it’s that we have a fast food culture etc.  Nothing is proven here so no matter how vehemently someone says that they know, they don’t.  That makes it hard to find fault and place blame.

We don’t have a proven solution:

  • Every weight loss method tested shows a less than 5% success rate over a five year period.  This is particularly bothersome in situations where children are placed in foster care, lose the weight and then return to their family with a 95% chance that they’ll regain the weight and their parents will be labeled as repeat offenders.
  • If they go to foster care and do not lose weight or gain weight, are the foster parents then at risk for being accused of neglect? What happens next?

Determining Fault

  • The system already deals with “failure to thrive” cases in which parents are suspected of starving their children.  Even those cases are problematic because sometimes there is a health issue with the child (celiac’s disease for example or food allergies) that are causing the issue.
  • Unless the parents are force-feeding these kids, there are issues determining causality and fault.

Slippery Slope:

  • Where are we going with this?  Who is next?
  • What about smokers who raise kids?  Secondhand smoke contains more than 250 chemicals known to be toxic or carcinogenic (cancer-causing), including formaldehyde, benzene, vinyl chloride, arsenic, ammonia, and hydrogen cyanide. Children who are exposed to secondhand smoke are inhaling many of the same cancer-causing substances and poisons as smokers. Do we remove the ones who develop asthma? The ones with elevated blood pressure? Those born pre-term or with low birthweight?
  • What about parents who choose not to vaccinate.  If the kids get diseases after the parents refuse to vaccinate them,  should they be removed?

This is a tricky and knotty issue. It deals with everything from parental rights to kid’s autonomy.  Children who are under-nourished have long been subject to the type of interventions that are mentioned above despite many similar issues. I honestly don’t know the solution for these individual cases and it’s possible that, just like in under-nourishment situations,  in some cases intervention probably is warranted but I certainly don’t want to have to decide which ones.

More importantly, CPS intervention and Gastric Bypass are not the only two options. What I think we really need to get out of this is how important it is for people to have information and access to the building blocks of health.   Information about healthy eating and movement in combination with access to affordable foods and safe, affordable movement options that kids enjoy, affordable accessible preventative health care (not just reactive sick care).  PE in every school and options that encourage a lifetime love of movement, rather than a lifetime of bitterness about PE. Dodgeball should go the way of the dinosaur.  What if schools could offer more than just sports:  dance, walking/hiking, Kinect style video games that incorporate movement etc?   And not just during a PE hour but before and after school and during lunch and free periods, even on weekends? What if they offered busses and share-a-ride systems to the local YMCA or to the schools after-hours PE program? Wondering where you’ll get the money?

We’ve talked about this before but every year we give the diet industry $58 Billion dollars. Can you imagine what we could do if we could take that money out of their back pocket and use it to create access to food and movement for people in under-served areas? If we could get Michelle Obama to be for healthy kids instead of against obese ones? If we stopped body shaming and bullying fat kids allowing them to have the mental health that can only exist when they don’t live in a constant state of stigmatization would they be more likely to make healthy choices?  I think so.

As usual I think our focus on weight is wasting time, money and effort and pushing us in the exact wrong direction. I would wager my life savings that if we would focus on health, spend our time thinking of ways to create access to health, invest our money creating access to health, we would actually have more health.

Published in: on July 14, 2011 at 9:11 am  Comments (31)  

Dancing with my Ass On

Dancing with my awesome coach Rowdy Dufrene

(Sorry to those on the subscription list who got this early due to my premature pushing of the publish button!)

My friend to her friend (who I don’t know):  That’s Ragen, she’s a bad-ass dancer.  She has won National competitions!

Friend’s friend:  Keep at it, you’ll lose the weight.

Me:  What the fuck???? (Actually I said that in my head but it must have come across in my facial expression because she quickly developed an acute case of verbal diarrea…)

FF:  I mean, when those people go on Dancing with the Stars they lose weight and there’s that Dance Your Ass Off Show and all  of those people lost weight…

On Dancing with the Stars there is great emphasis placed on the star’s weight loss.   If Kirstie Alley would have won Dancing with the Stars but not lost any weight what kind of press do you think she would have received?

Dance Your Ass Off is a reality show and fat people go on the show and they learn to dance and are put on extreme diets and the only way to win is both dance well and lose weight.

The creator of Dance Your Ass off is actress/comedienne Lisa Ann Walters.  I was a huge fan of her from her work on Shall We Dance where she played a fat eccentric who was a great dancer.  So it actually broke my heart a little that she had jumped on the fat=fit train.  Then, when I posted about the world the diet culture built, she commented on the blog:

This link came to my Dance Your Ass Off FB page and I, like you, am appalled – but, sadly, not surprised at the flourishing “size-ism” that is our last, completely acceptable prejudice. I am encouraged by voices like yours that fight. I created DYAO for that reason. I did, in fact, write a book about women and self-esteem to help combat negative body-image issues!It’s funny and very empowering – I hope you get a chance to take a look, you are very inspiring. Best, LAW

After much soul searching, I replied with this:

First, I am such a fan of you and especially your performance in Shall We Dance. While I am honored that you would consider me inspiring and the book looks fantastic, you are breaking my heart because I believe you that you think that Dance Your Ass Off helps to fight fat hatred. However I, who am a fat National Champion Dancer, am certain that your show and others like it are partially responsible for creating a culture where a stranger feels comfortable telling me they want to punch me until I die because I’m fat. You are an amazing actress and comedienne with a platform much bigger than mine and if I could truly inspire you, I would inspire you to encourage a focus on actual healthy habits rather than a focus on thinness that only adds to the stigma against fat people and doesn’t actually increase anyone’s health. Your show sends the loud and clear message that talent is not enough and health is not enough – you must be thin to win. I wrote this post http://danceswithfat.wordpress.com/2010/05/28/the-real-biggest-loser last year specifically to discuss the dangers of shows like yours, I hope you’ll read it, think it over, and then do whatever you think is right.

Thank you for the comment and very best of luck to you,

~Ragen

The whole dancing/weight loss thing creates an annoying problem for me.  The conversation that I opened with is not rare.  Most people would be shocked at how many times someone appends a compliment of my dancing with “how much weight have you lost?”.  I understand that some people think that these go hand in hand but to me they are so different that it’s like someone telling an artist “Wow, that’s a beautiful painting.  Had you considered a boob job?”  Non sequitur and inappropriate all at the same time.

Let’s talk about what you know in this situation.  You have watched me dance, and you thought that I was talented.  You complimented me.  Excellent logical thought process.  And thank you for the compliment.

You watched me dance, you thought that I was talented, you see that I’m fat. You asked me how much weight I’ve lost. Hit the brakes and back up the logic train, we had a passenger fall off.

I haven’t lost any weight.  I am not trying to be thin.This is not the kind of thing to guess about.  Now I’m irritated and the person who made the comment is embarrassed.  This could all be avoided by focusing on what’s in front of us.  You don’t know anything about my weight, or my health or my intentions for either by watching me dance.  You do know whether or not you think I’m a good dancer so let’s keep our eye on the ball here and stick with what we know.

Published in: on July 13, 2011 at 3:49 am  Comments (28)  

That Fit and Fat Thing

Surprisingly often, people incorrectly assume (often out loud or in comments)  that I “can’t climb a flight of stairs without being winded” because I’m fat. But, in the same breath, say that the only reason that I can leg press 1,000 pounds or do a standing heel stretch is because I’m fat. Huh?

Of course, this doesn’t make any sense – my strength, stamina and flexibility are the result of a combination of my genetics; my access to movement options, information and professional assistance; and my extremely hard work on strength, stamina and flexibility.

These statements are typically made by people being idiots and trying to diminish my accomplishments so that they can hold onto their stereotypes and sense of superiority at all costs.  I don’t care so much about it when comes at me but I do worry that other people, who may have not had the opportunities to understand health that I have, will believe the oft-repeated  false assertion that the only way to gain strength, stamina and flexibility is to lose weight.

We talk a lot on this blog about how intentional weight loss fails 95% of the time.  Today I want to talk about the areas where movement succeeds:

“Groundbreaking work on fitness and weight has been done by [epidemiologist Steven] Blair and colleagues at the Cooper Institute. They have shown that the advantages of being fit are striking and that people can be fit even if they are fat … and thus have lowered risk of disease. A remarkable finding is that heavy people who are fit have lower risk than thin people who are unfit.”
-Dr. Kelly Brownell, Director of the Yale Center for Eating and Weight Disorders, 2003

“We’ve studied this from many perspectives in women and in men and we get the same answer: It’s not the obesity—it’s the fitness.”
-Steven Blair, P.E.D., Cooper Institute for Aerobics Research, 2004

“Active obese individuals actually have lower morbidity and mortality than normal weight individuals who are sedentary … the health risks of obesity are largely controlled if a person is physically active and physically fit.”
-The President’s Council on Physical Fitness and Sports, 2000

“This prospective follow-up study among middle-aged and elderly men and women indicates that obesity (as assessed by increased BMI) is not related to an increased risk of all-cause and CVD mortality, but low-level LTPA [leisure time physical activity] and a low level of perceived physical fitness and functional capability are … In conclusion, in contrast with our initial hypothesis, obesity was not found to be an independent predictor of mortality among middle-aged and elderly men and women. However, low-level LTPA seemed to predict and a low level of perceived physical fitness and functional capability predicted an increased risk of all-cause and CVD mortality among both men and women.”
-International Journal of Obesity Related Metabolic Disorders, 2000

See the rest of this list of quotes here. (Warning, the list of quotes is good but this site may be triggering for some).

Why do we not hear about the vast benefits of exercise?  Maybe because it’s not proven to lead to weight loss.   In fact, while the diet industry spends billions of dollars on marketing and funding “scientific” studies to mislead the public into believing that its solution works, there’s nobody pouring billions of dollars into the message that movement is likely to make you healthier even though it probably won’t make you thinner.

When studies came out saying that exercise did not lead to weight loss, a litany of “news” sources published reports that overlooked the benefits of exercise entirely and told people that they might be better off NOT exercising since it didn’t help lose weight.  What with the who now?  The most egregious to me was  a Time Magazine article which lost any modicum of credibility as far as I’m concerned by writing: “after you work out hard enough to convert, say, 10 lb. of fat to muscle — a major achievement…”  A major achievement indeed since it’s physically frickin impossible.   I get that this is stated a lot and that many people believe it, but how does someone who wants us to trust him as a reporter make this mistake?

The ways in which this article gets science wrong are so numerous that they would require an entire blog post so I’ll just leave it for now with the thought that the reports all mention that study participants didn’t lose weight, but they fail to discuss what health benefits participants may have received.  Based on all the research available, we would expect to see improvements in one or more of the following:  blood glucose, blood pressure, triglycerides, insulin use by the body, cholesterol , strength, stamina, flexibility, and self-esteem. But I mean, if it’s not going to make my body smaller then why would I do it?  (sarcasm meter is a 10 out of 10 here)

Back to the point of my first paragraph.  Plenty of people who develop heroin habits lose weight but they don’t experience increases in their strength, stamina or flexibility as a result. I am ginormous but I have the strength, stamina and flexibility of a professional athlete.   I think that if you want to be healthier, it couldn’t hurt and might help to find some form of movement that you enjoy and do a little more of that than you are currently doing.  Garden, dance around your living room, take a walk, whatever. If you are going to work with a fitness professional, I highly recommend finding one who works from a Health at Every Size approach and who is not grossly incompetent.

Listen to your body.  If you are somebody who thinks of you and your body as two separate things,  then  consider the radical idea that your body is a friend and supporter rather than a limitation to be overcome through mental toughness.  Celebrate EVERY victory – did you switch from 10 to 12.5 pound weights? Were you able to lift your grand kid for the first time?  Booty shaking happy dance time!

If you’re struggling with this, or even just with the word exercise which, because of the way it’s used in our society can be really  triggering, you might check out this post for more specifics.

And finally, just to make sure that we understand each other: I am not trying to tell anyone how to live or what they “should” do.  My goal is, as always, to provide options and information while being very clear that:
  • Health and fitness are multi-dimensional and include things that are in our control and things that are out of our control
  • Health and fitness are not moral or social obligations
  • Your mileage may vary – bodies are different so what works for me, or anyone else, may not work for you
  • Everyone deserves to be treated with respect
Published in: on July 11, 2011 at 8:44 am  Comments (28)