Wheezing Around the Block

One of the recent rants I moderated out of the comments included something* about how “wheezing around the block doesn’t count as exercise.”

Wheezing is a symptom of asthma, bronchitis, sinusitis, pneumonia, and other illness. Deciding that wheezing is only treated by weight loss is dangerous.

I do wheeze. I have asthma. Now that  it is properly treated I can exercise without wheezing. My treatment plan is greatly helped by insurance to cover the not-available-in-generic Advair & other meds. One of my asthma triggers is exercise itself. This means I need to medicate pre-exercise. I’m also affected by things like air pollution and pollen.

If you’re fat and wheezing while walking around the block, you may need to see a doctor about your wheezing. It’s not necessarily “just being fat.” Waiting til you’re thin? A, may not help, and B, you could die in the meantime.

The fat haters of the world would have you believe you only wheeze if you’re fat and should lose weight to cure it. The fat accepters think that if you’re sick, you should be treated for that without having to lose weight first. I’m on the fat accepting side.

*Paraphrased to remove profanity & improve readability.

Saturday Ramblings

1am is still Saturday if you haven’t gone to bed yet, right?

Note to self: The expensive twice-daily asthma med works best if the evening dose is 12 hours after the morning dose, not 18 or 20. You carry it with you. Set an alarm on your phone & use it. Don’t just turn it off.

Kath posted about a current fat acceptance tag on twitter, if you haven’t seen it already. Also the HAES blog has a piece on activist burnout.

I started watching the first season of Mad Men on Netflix.  Is it weird that I’m describing it as “a grown-up Bewitched”?

TSA Travels

I don’t fly very often. This is likely why it I didn’t go through a full-body security scanner until Friday and, again, today.  I don’t have strong opinions about the type of scanning used, although I do consider much of the airport security approach to be security theater. So I did the scanner instead of other measures.

image

Image from Wikipedia

These were the millimeter wave scanners. The opening is narrower than the machine. I turned sideways to get in. Otherwise I fit fine. Each time the machine flagged me for pat downs afterward on my thighs, just above my knees.  The second time also included pat downs of my tummy, back and bottom. I was always patted down by a woman – no waiting.

Other posts on flying:

Flying While Fat
Buying Plane Tickets (more seats than passengers)
A mid-flight conversation on flying while fat

Tell Me Again How It’s “For My Own Good”

Lara Frater wrote about this and I wanted to boost the signal.  The Rudd Center recently came out with a study (PDF link) showing that weight stigma affects the stress hormone cortisol.

Exposure to weight-stigmatizing stimuli was associated with greater cortisol reactivity among lean and overweight women. These findings highlight the potentially harmful physiological consequences of exposure to weight stigma.

It doesn’t require being fat to have this kind of reaction, by the way. Both the lean and overweight women “were equally likely to report that they would rather not see obese individuals depicted in a stigmatizing manner in the media.”

What’s cortisol? Some highlights from Wikipedia:

Cortisol, known more formally as hydrocortisone is a steroid hormone [...] released in response to stress and a low level of blood glucocorticoids. Its primary functions are to increase blood sugar through gluconeogenesis; suppress the immune system; and aid in fat, protein and carbohydrate  metabolism.  [...] Cortisol counteracts insulin, contributes to hyperglycemia-causing hepaticgluconeogenesis and inhibits the peripheral utilization of glucose (insulin resistance). [...] Cortisol can weaken the activity of the immune system.

Being fat (“excess weight”) is considered a cause of insulin resistance.  And it appears that weight stigma increases cortisol … which increases insulin resistance.  Which is the chicken? Which is the egg?

This isn’t necessarily new.  Weight stigma  has been tied to weight gain before.  What this study highlights is one mechanism.  There may be others.  We know that fat bias prevents fat people from getting jobs, from getting raises, and from getting proper healthcare treatment.   Fat people are also often paid less and harassed more than similar-qualified people who are thin.  None of this improves health.

So when I hear people saying that fat people just need more “tough talk” to lose weight “for their own good”? No, I don’t believe them.

Pursuing An Agenda

Earlier today, Melissa McEwan tweeted:

So, in response to the accusations that I have an agenda, yes -- yes I do. And that's what it is.

Scrolling back, I saw Melissa’s prior tweet was regarding Dylan Farrow: “I am speaking about this because it is wrong; I am speaking in solidarity with Dylan Farrow; I am speaking in defense of my own survival.”

This blew me away.

In retrospect it seems silly — of course people often have their own agendas on the internet! — but we often want to stay neutral and avoid “taking sides.”   Especially in matters of activism, we want to be one of the good guys, to avoid self-interest.  It’s not that I’m getting something out of this, it’s that it’s the right thing to do.

Self-interest is not necessarily wrong.  Yet people often try to put it aside, to derive credibility from their neutrality.  I’m one of them.

I’ve been accused of ignoring research that shows an increased risk of death among people with my BMI.  I don’t ignore it. I just don’t see how it changes the research showing that diets don’t result in long-term weight loss for the overwhelming majority of people.  Or that in the long term, weight loss efforts often result in regain (or net gain), loss of self-esteem, and are ultimately a waste of time.

Yes, I have an agenda in my choice to live life at my current weight instead of trying, yet again, to win the weight-loss lottery.  Yes, when I discuss weight-loss scams, it’s because I consider selling such frauds to be unethical, unhealthy, and wrong.  Yes, rejecting the decade-plus I spent dieting has done wonders for my mental and physical health.

So yes, if you’ve wondered what my agenda is in writing about weight — there it is.

Things I’m reading

Kath as a post at Fat Heffalump on the feedback from her recent interview by Jasmin Lill on news.com.au, Brisbane blogger speaks out against online bullies. Go Kath!

Closet Puritan has a thoughtful response to some of the conflation between “Fat people are more common in communities with a Walmart” and “Eating more processed food from Walmart makes people fat”.

This Adipose Rex has some musings on Christianity and the body:

This Advent I am thinking about how if my body is a temple of the Holy Spirit, then this flesh itself is sacred — this same substance worn by the God of the universe, and shaped into God’s image. If I really believe in the words I recite every week, the resurrection of the body, then this is not some temporary meat-costume I will abandon so my soul can flit off to an immaterial heaven, but the too too solid flesh that will dance in the hereafter.

This reminds me of The Unapologetic Fat Girl’s Guide to Exercise and Other Incendiary Acts by Hanne Blank, which I’ve been reading. From the introduction:

Exercise—by which I mean regular physical movement that puts your body through its paces—is crucially important because it is something that makes it possible for you and your body to coexist in better and more integrated ways. It builds a bridge across the mind-body split. [...E]xercise gives your body to you. [...] Most of all, it teaches you that your body is not just a sort of jar made out of meat that you lug around because it’s what you keep your brain in, but an equal and in fact quite opinionated partner in the joint production that is you.

And over on the HAES blog, there’s an interesting discussion on healthism & privilege.

Quote of the day: Easier to get fit than thin

Not that everyone has to want to be fit or can be fit, but for those who exercise and don’t lose weight, this might be helpful.

[Deb Burgard, Ph.D. points out that] fat people who repeatedly try to lose weight are more likely to yo-yo diet, or weight-cycle, than they are to maintain weight loss permanently. And because weight-cycling has been linked to cardiac disease and other problems, overweight people who are metabolically healthy could increase their risks of the very diseases they tried to avoid in the first place if they lose weight and gain it back again.

The takeaway for fat people? Keep on trucking when it comes to increasing your physical activity, and don’t get discouraged by headlines that seem to make weight the single determining factor in living a long, healthy life.

“It’s much easier to get a fat person fit than it is to get a fat person thin,” concluded Gaesser. And that’s a good thing, because fitness may be much more rewarding than thinness alone.

— From a Huffington Post discussion of a new “But fat people are so unhealthy” study.

Labor Day

I created this blog 5 years ago.  Thanks for reading :)

Today is also Labor Day in the US.  I work in a field that is very un-unionized and I know unions aren’t perfect, but I was raised by union members and I support organized labor.  Growing up I didn’t see much like my family in the media — fathers who take steel-toed boots and overalls to work, to wear at work?  Who don’t own a suit?  Then I discovered this song.

Through the mansions of fear, through the mansions of pain
I see my daddy walking through them factory gates in the rain
Factory takes his hearing, factory gives him life
The working, the working, just the working life

— “Factory” by Bruce Springsteen; lyrics are here.

This Shouldn’t Give Me A Headache

But it’s trying.

Dear,

My name is Lisa. I have been following your blog  from quite some time now and thoroughly enjoy every post of yours.

Well, after reading through your blog, I think you would be interested in having a look at our recently launched infographic America’s Battle With Obesity([link to typical FEAR The Obesity Epidemic Because We Said So FEAR Booga Booga removed - Ed]). If you find it helpful, then please consider it for sharing with your readers.

Thanks, and I hope to hear from you soon!
Best Wishes,
Lisa

My reply:

Dear Lisa,

I really don’t see how anyone who’s read my blog would think that graphic would be of any interest to the my readers.

Regards.

- LFP

In other goings-on, NPR reports “Hating On Fat People Just Makes Them Fatter”.   Of course they still do, as this eloquent tumblr post from The Mighty If points out.

Marianne Kirby wrote about working in plus-size retail in college, and how huge being able to buy clothing can be.  This is even harder for supersize or extended-size people.  I usually shop online because my brick-and-mortar store options are so limited.

[S]o many fat people lacked any experience of being treated with dignity and respect in a retail setting. It wasn’t just me. And if it wasn’t just me, then maybe I didn’t deserve to be mocked and harassed and made fun off. Maybe I didn’t deserve to be treated badly just because of my body.

And neither did anyone else.

And yet the lack of respect for fat people is constant.

Opting Out Of The Illusion Of Immortality

Deb Burgard has a terrific post on the latest “being fat makes you die, damnit” study

Masters’ central argument seems to be that even though the repeated findings for decades of rigorous research (reviewed by Flegal, 2013) has found that BMI and mortality are only weakly correlated, and that higher BMI may actually correlate with longevity in old age, this set of findings must be wrong, because 1) fat elderly people are more likely to be unable to participate in the surveys due to being “institutionalized” more than thin elderly people (no citation), and 2) there are apparently going to be major differences in longevity between people who were fat in their 60′s in 1995 and people who will be fat in their 60′s in 2030 because of the latter group’s “longer exposure to the obesogenic environment.” I guess that is an interesting thought experiment, but if you look at current trends it would seem that fat people are more likely to be healthier in the future if we continue to improve access to healthcare and continue the progress in managing hypertension and diabetes.

Catastrophizing isn’t exactly new in writing about fat, but it does get attention, if only because it gives the fear-of-fat industry something new to write about. Deb responds to this in an inspiring way:

My body […] is not a cautionary tale, a ticking timebomb, or a battleground for corporate adversaries trying to make money on marketing to fat people (weight cycling industry! workplace wellness programs! Big Pharma!) or trying to save money by hoping fat people die  (health insurers! HMOs! Cost-of-obesity policy wonks!).

My death will not be a point for one side or the other.  I am opting out of the illusion of immortality[…]. I am going to live as well and as long as I can, and then I have to get off the bus. It is not different for any of us, and the best use of my time is to make this world a place that gives every one of us the maximum chance at happiness and well-being.

I’ve buried both of my parents. At the risk of sounding trite, it brought home the very real fact that people don’t live forever. Turning that into marketing just feels wrong.

Things to Read

Some links I thought worth sharing:

Lara Frater on the word “fat”.

Grief moves at its own pace, despite the “rush to normal” common in our society.

You know how kids will bulk up a little before a growth spurt?  That’s now a strange thing to be studied, not a normal thing.

Swimming laps & self-acceptance.

On the US government, but likely applies to others: Fewer secrets would also be smarter secrets.

Anyone have others to share?

Medical Equipment Size Limits

This article focuses on the weight limits of air ambulances, but it’s depressing anyway. The overall message of the piece is to lose weight (which we all know works so well! And immediately!)

Now, yes, most fat people aren’t very fat; most cutoffs are 300 or 350lbs; air ambulances appear to have lower-than-typical requirements.

But what can you do? Some ideas:

  1. Ask your local hospital about their equipment. 
  2. Ask you local doctor about their equipment.
  3. Ask local fat friends about their experiences.
  4. Research what is available and ask for it to be considered when new purchases are made.
  5. If there is an organization that fundraises for your local hospital, consider joining. 

I wouldn’t expect any of these to have an immediate effect, and some are long-term commitments.  These are also biased toward people who have the  time, money, education, and (possibly) public speaking skills to succeed.

Finally, you can move to an area with more choices.  This is definitely a long-term choice, and one that may also be impossible. But it may work for some.

Other thoughts?

Genetics Affect Weight

This New York Times article by Gina Kolata isn’t totally news to me. At least not this summary of a study published in a 1990 issue of The New England Journal of Medicine (bolding added):

The work fascinates Claude Bouchard, a genetics researcher at the Pennington Biomedical Research Center in Baton Rouge, La., because it might offer insight into an intriguing finding: there are genetic controls not just of how much people want to eat but also how much of what they eat turns into fat or is burned off and not used by the body. Although the common mantra is that a calorie is a calorie and 3,500 extra calories eaten equals a pound of fat on the body, that is not what happens in real life, he found.

For example, in one of his studies, Dr. Bouchard enlisted 12 pairs of lean identical twins to live in an enclosed area for 120 days so their food and exercise could be monitored while they ate 1,000 calories a day more than needed to maintain their weight. The twins in each pair gained about the same amount of weight, but the amount gained varied threefold among the pairs. Those who gained the most put on as much as 29 pounds while those who gained the least put on 9 ½ pounds.

“It is not a freak finding,” Dr. Bouchard said, adding that about 20 studies found the same threefold range in weight gain in response to excess calories.  

 …and, in fact, this isn’t news to anyone who’s read Health At Every Size by Linda Bacon, PhD.  What is new is more information about a particular gene that appears to be involved.

The mice were eating their usual chow and exercising normally, but they were getting fat anyway. The reason: researchers had deleted a gene that acts in the brain and controls how quickly calories are burned. Even though they were consuming exactly the same number of calories as lean mice, they were gaining weight. [...]

[This] may help explain why some people put on weight easily while others eat all they want and seem never to gain an ounce. It may also offer clues to a puzzle in the field of obesity: Why do studies find that people gain different amounts of weight while overeating by the same amount? [...]

[Reasearchers] are now trying to determine whether additional mutations in the gene they discovered — ones that hinder its function but do not completely disable it — might explain why some people gain weight.

This research may lead to a better understanding of why some people are naturally very large and others aren’t.  It may also be useful in helping to spread some pesky, little-known facts:

  • Body weight is strongly inherited.
  • Some fat people eat the same amount food, or less food, as some thin people.
  • In studies where people deliberately eat more than they do normally, different people gain weight at different rates.
  • Twins in those studies, who overeat by the same amount, have almost identical weight gains.
  • An addition or subtraction of 3500 calories does not automatically mean gaining or losing a pound.

If this is new information for you or you just want one link to reference when needed, it’s on the NY Times site.

Saving Our Parents

As adults, we try to develop the character traits that would have rescued our parents.
— Alain de Botton
I still have problems, of course.  I just have different ones.

Why are so many people thin?

Closetpuritan made my jaw drop:

[O]nly 3.5 percent of Americans between the ages of 18 and 59 get 150 minutes a week of moderate activity, yet about 1/3 of American adults have a BMI of < 25. Even if you assume that all of that 3.5 percent is “normal weight” and “underweight” people [protip: don't!] the vast majority of thin people do not get the recommended minimum amount of exercise–let alone hardcore-fitness-nut amounts of exercise.

I’ve been told all my life that I’m fat because I don’t exercise “enough”  But if  only 3.5% of American adults exercise “enough” to maintain health, maybe we fatties are exercising too much?  Or, y’know, maybe setpoint is real and weight is largely inherited?

Why I Think Declaring Obesity A Disease is Harmful

It’s inaccurate:

It distracts from the real issues:

It’s a win for the weight cycling industry

Unfortunately, what’s good for the weight cycling industry isn’t necessarily good for patients: 

There is a Change.org petition on this – I’ve signed, have you?