That Questionable “Fit and Fat” Study

fat people have the right to existA blog reader asked me to take a look at this study.  It’s another one of those studies that headlines claim prove that you can’t be fat and “fit” (we’ve been here before and it was crap then as well.)  Let’s talk about this:

First, they are making an extremely basic correlation vs causation mistake – the fact that two things happen at the same time doesn’t indicate that one causes the other.  (Short example – they are suggesting that if people with fatter bodies have higher rates of cardiac incidents than thinner people, then making fat people look like thin people will give them the same health outcomes. That’s not good science. For comparison: men with male pattern baldness have higher rates of cardiac incidents than men without male pattern baldness.  Imagine if, upon finding out that information, researchers did as these researchers have done and suggested that in order to reduce the cardiac incidents, we need those bald men to grow hair – then the government started a “war on baldness,” studies calculated the cost of “baldness” on society etc. In this case while there is a correlation, there is no causation – both the baldness and the cardiac incidents are caused by a third factor, but if researchers had treated baldness like they treat body size we wouldn’t know that.)

One of the measures of “unhealthiness” that they are using is “increased waist circumference,” so they are studying whether it’s unhealthy to live in a larger body and they are using having a larger body as a measure of  “unhealthiness.” You can do that I guess, but you probably shouldn’t call it credible research.

They don’t control for the negative health effects of dieting and/or weight cycling (aka yo-yo dieting) which the larger bodied participants can be much more likely to have engaged in. Let’s not forget that in a diet culture, whenever anyone studies the effects of having a larger body, they are also studying the effects of dieting since that’s what is encouraged for fat people in our culture.

They don’t control for the negative health effects of living in a society where larger people are shamed, stigmatized, bullied, and oppressed in a number of ways including a lack of evidence based healthcare (because of systemic fat bias as well as doctor’s individual bias and the tendency to prescribe diets to fat people when they would have given a thin patient an evidence-based intervention), being hired less and paid less than thin people and, as Peter Muennig from Columbia found in his research, just living in a society where one is stigmatized is correlated with many of the same health issues that this study used to judge “unhealthiness.”

One of the quotes in the article my reader sent says that “information on physical activity, smoking, diet and social status could be adjusted for.” Looking at the study while they claim to have “adjusted the data” it does not appear that they actually had this information from the study participants. This is important because studies that do include behaviors (including Wei et. al; Matheson et. al; and The Cooper Institute Longitudinal Studies) have found that behaviors are a much better predictor of long term health than is body size, so studies that don’t include participant’s actual behaviors aren’t really relevant and are either poorly designed, or specifically designed to get exactly the results that this study did. (For an exhaustive list of evidence around this, check this out.)

The conclusion that if fat people are in more danger of cardiac incidents then it’s “not ok to be fat” or that one should attempt weight loss is problematic on a number of levels. First, they are acting as if body size is something that we can control, but provide absolutely no evidence for that. (Hint: it’s because there is none. The research shows that the most common outcome of weight loss attempts is weight gain, and there isn’t a single study where more than a tiny fraction of people achieve long term weight loss and even among those the weight loss is often just a few pounds.)

Again, saying that if fat people have more cardiac incidents than thin people then we should try to make them thin, is like suggesting that if men have more cardiac incidents than women we should recommend that they go through sex reassignment surgery (note that this is not be the same thing as correctly recommending gender confirmation surgery that a trans person might choose.)

People are at higher risk for health incidents based on everything from genetics, to race, to height and more, so suggesting that we try to make some people look like other people to make them healthier is seriously questionable. (Speaking of race, I think we should stop funding studies that under sample and/or ignore People of Color.  For far too long studies like this have been allowed to act as if white people are the only people worthy of study, and that’s bullshit.)

I also noticed that many of the doctors quoted in this article and others seem absolutely giddy that fat people might die sooner. I think that this is part of a (fatphobic) process by which scientists, healthcare professionals, and public health professionals are shirking their responsibilities to tackle the difficult things that would actually improve health – access to non-biased physical and mental healthcare for everyone, a good wage for everyone, enough vacation and down time for everyone, a world without oppression and more (these are often referred to as Social Determinants of Health.) Instead, these “professionals” shift the conversation to suggest that the “problem” is that fat people exist, and then they claim that fat people could be thin if we wanted, so they conclude that all the world needs to be healthier is just a little more fat-shaming and weight loss culture, which isn’t just lazy, it’s dangerous and wrong. We have to start calling them on this behavior.

More important than any statistical analysis is that health is a complicated, multifaced concept. Health is not an obligation, a barometer of worthiness, entirely within our control, or guaranteed under any circumstances. Nobody owes anybody else “health” or “healthy behaviors” by any definition. Fat people have the right to exist in fat bodies without shame, stigma, bullying, or oppression and it doesn’t matter why we are fat, what being fat “means” for our health, if we could become thin, or if doing so would make us “healthier” by some definitions. The right to life, liberty, and the pursuit of happiness are not size (or health) dependent.

The conclusions being drawn here (that if fat people have higher rates of cardiac incidents then fat people should be eradicated – yes, eradicated is the right word) are sizeist and healthist and add to the stigma that negatively effects fat people’s health, includingthe suggestion of dangerous so-called “weight loss interventions” that include things like drugs, stomach amputation surgeries, and balloon swallowing, that end up killing fat people. So the most important takeaway needs to be that, regardless of what any study finds, it’s ok to be fat no matter what.

Want to create a world where researchers don’t call for the eradication of fat people? Join us for the Fat Activism Conference!

Click Here to Register for the Fat Activism Conference

The Fat Activism Conference is all online, so you can listen by phone or on your computer wherever you are.  Plus you get recordings and transcripts of each talk so you can listen and read live and/or on your own schedule. The conference is happening October 6-8, 2017!

If you enjoy this blog, consider becoming a member or making a contribution.

Like this blog?  Here’s more cool stuff:

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

If you are uncomfortable with my selling things on this site, you are invited to check out this post.

 

Published in: on September 7, 2017 at 3:18 pm  Comments (24)  

Now An Actual Rain Cloud

Content warning – oops, this was meant to be posted over on my IronFat.com blog. I’m not sure how it ended up here, but I’ll just post it in both places.  Sorry for the repeat for those who are subscribed to both!  Trigger warning for discussion of exercise, no specific times or distances are mentioned.

I’ve been enjoying open water swimming recently and this weekend I headed to the ocean to try out my new Aquatard from Swimsuits for All  (full disclosure, they gave me a suit a while back to try out,  I liked it so much I paid my own money for this suit, I don’t get compensated for linking to it, I just thought people might like to know where they could get one.)  I bought it because I haven’t been able to find a tri suit in my size and this is one of the things I’m considering using as one. It was around 5:30pm and the beach wasn’t as crowded as I thought it would be, which was nice.  Julianne and her visiting family decided to play in the water while I did my swim.

I took off and felt really strong though it was tough going for the first half – the water was a bit choppy, and there were a ton of boats outside the swim area which made it even choppier in an totally unpredictable way.  It’s still a weird sensation to me to be swimming while little waves hit me in the head every few seconds, and I understand that this is nothing compared to people who swim in real waves.

Unfortunately there were lots of stand up paddle boarders and kayakers in the swim area.  Despite my efforts to avoid them one of them bumped up against me trying to get over the rope that divides the swim section.  I pointed out where the launch area where she wouldn’t have to deal with the rope for the way back, but she was struggling and I was afraid it would take her the entire time that she had rented the kayak for to get over there so I held the rope down so she could join her friend (whose sole contribution to the situation had been to float on the other side in his kayak and scream “PADDLE!”) and wished her well.

As I turned around and headed back I’m pretty sure the tide was coming in because the ocean was trying to push me back onto the beach. My sighting left much to be desired – I knew I was drifting but then I heard a conversation on one of my breaths and thought “What are people doing out here?” Turns out they were hanging out in the shallows and I should maybe take another less in sighting.

Maybe writing about my perceived personal rain cloud was tempting the whatever from high atop the thing, because I suddenly felt an odd sensation – I picked my head up and realized that it had started to rain – sprinkle, really but this is Southern California so people were freaking out and engaging in a mass exodus.  This become more comical a couple of minutes later when it started POURING down rain and people began to run from the beach like they might melt (and to be fair there’s no way to know if you will since there’s never rain here.)

On another breath I heard a stand up paddle boarders scream “Oh my god I’m getting soaked”  that would be something that I would assume was well within the realm of possibilities were I balancing on a piece of plastic in the middle of the ocean, but I imagine people who have some skill can expect that they will stay dry the whole time.

And lest you think that I’m immune to questionable behavior in the face of precipitation, I started to ask myself questions like “Does rain bring toothy sea creatures to the surface?” And “am I going to be hit by lightening?” It definitely put the proverbial spring in my metaphorical step and I finished the swim in a respectable time.

As we drove away Southern Californians were being Southern Californians in a way that made me smile – people beeping every few seconds and turning on the hazard lights to make sure that… I’m not sure actually but it’s adorable though Julianne’s relatives who were visiting from Montana were less than impressed with our inability to handle…really any weather at all.

The new suit passed the test, sort of.  I don’t love swimming in the aquatard, it’s a bit of the vague discomfort of a wetsuit without the speed and buoyancy benefits, but it may well work if I had to bike and then run after this.  And I think has more drag than a regular suit which, if it’s true, makes it a helpful training tool.

Workout selfie and post workout “look at this rain!” picture

Published in: on September 5, 2017 at 10:47 am  Comments (4)  

Rx to Swallow Balloons is Killing Fat People

not making us disappearA few months ago I wrote a blog post called “They Want Fat People to Swallow Balloons Now.” In the post, I talked about a fairly new “weight loss” method in which doctors place balloons into people’s stomachs and then fill them with saline. I pointed out that, according to their own literature, in addition to dangerous and miserable side effects, there are at least a couple of ways that it can kill you:

• Death due to complications related to gastric or esophageal perforation is possible.

• Death due to complications related to intestinal obstruction is possible.

While it didn’t really take a psychic to figure out what was going to happen, I still hoped that I was wrong on this one. Heartbreakingly, I was not.

The FDA reports that five people died within a month of having the procedure, and three of the victims died within just three days. According to a safety alert from the FDA, they also received reports of two additional deaths — one from gastric perforation, the other from esophageal perforation.

According to their statement:

“The FDA continues to work with Apollo Endo-Surgery and ReShape Medical Inc. to better understand the issue of unanticipated death, and to monitor the potential complications of acute pancreatitis and spontaneous over-inflation. Additionally, as part of the ongoing, FDA-mandated post-approval studies for these devices, we will obtain more information to help assess the continued safety and effectiveness of these approved medical devices.”

Note that they aren’t going to ban the practice (thus ending the unanticipated deaths), but rather they hope to better understand the unanticipated deaths. I would point out that, based on the manufacturer’s own warning labels, they knew the risk of these deaths before they happened. Even if we are OK with them feigning ignorance on that, at this point future deaths should be considered “anticipated” — more causalities in the “War on Obesity” which wants us thin or dead and doesn’t seem to care which.

Read the rest of this piece here!

Want to create a world where doctors treat us rather than trying to make us disappear? Join us for the Fat Activism Conference.

Click Here to Register for the Fat Activism Conference

The Fat Activism Conference is all online, so you can listen by phone or on your computer wherever you are.  Plus you get recordings and transcripts of each talk so you can listen and read live and/or on your own schedule. The conference is happening October 6-8, 2017!

If you enjoy this blog, consider becoming a member or making a contribution.

Like this blog?  Here’s more cool stuff:

Become a Member! For ten bucks a month you can support fat activism and get deals from size positive businesses as a thank you.  Click here for details

Book and Dance Class Sale!  I’m on a journey to complete an IRONMAN triathlon, and I’m having a sale on all my books, DVDs, and digital downloads to help pay for it. You get books and dance classes, I get spandex clothes and bike parts. Everybody wins! If you want, you can check it out here!

Book Me!  I’d love to speak to your organization. You can get more information here or just e-mail me at ragen at danceswithfat dot org!

If you are uncomfortable with my selling things on this site, you are invited to check out this post.

Published in: on September 2, 2017 at 5:11 am  Comments (11)