Hm, maybe I should post more often

The 2nd-most-recent post on the blog is from February and mentions that I’d gotten my silver Translator badge that week.  I got my gold Translator badge* last week.  Maybe I should post more?

Harriet Brown has been writing more about weight and health of late.  The most recent, in Slate, is worth reading (though the comments are NOT supportive and can be easily skipped).

Harriet also tackled 4 lies at Psychology Today:

  1. Americans keep getting fatter and fatter – nearly half with will be obese by 2030
  2. Being fat takes years off your life
  3. Being fat makes you sick
  4. Diets make you thinner – and healthier

Meanwhile, at Everyday Feminism, Liz Boltz Ranfeld asks what would happen if fat people were allowed to be happy?

My native Seattle is getting more inequal; the rich’s income is going up more than in other US cities. The median income is up to $100K here now too. I think it’s good that franchises didn’t win their injunction against raising the minimum wage.

Oh, and the Sounders season started :)

Major League Soccer (Football to the rest of the world) has scarves. It's a Football thing.

Major League Soccer (Football to the rest of the world) has scarves. It’s a Football thing. This is my 2015 season ticket and Alliance member scarf. 

*I realize that last may make no sense if you don’t know about Ingress, but in sum, I did a lot of game-playing to go from silver to gold.

Why Isn’t Obesity Research Better Known?

CBC has an article on the part of obesity research that doesn’t always get talked about.

Tim Caulfield says his fellow obesity academics tend to tiptoe around the truth. “You go to these meetings and you talk to researchers, you get a sense there is almost a political correctness around it, that we don’t want this message to get out there,” he said.

“You’ll be in a room with very knowledgeable individuals, and everyone in the room will know what the data says and still the message doesn’t seem to get out.”

In part, that’s because it’s such a harsh message. “You have to be careful about the stigmatizing nature of that kind of image,” Caulfield says. “That’s one of the reasons why this myth of weight loss lives on.”

Stigmatizing.  How is it stigmatizing to know that being fat isn’t something that can be easily changed by anyone?  One theory: accepting that most fat people cannot permanently become thin implies that fat people aren’t fat “for now”. They may be fat forever.  For the fat people who are rationalizing “I’m fat but I’m losing weight,” the idea that they may not be able to fulfill their fantasy can unfortunately cause another round of self-hate.  Realizing that thinness may not be as controllable as they thought could be scary. But — my understanding is that most obesity researchers are thin. So let’s try another theory.

Researchers may not be fat, but they know fat people, and are probably influenced by implicit and explicit biases.  Adding awareness that fat people will probably stay fat — even the fat people you like, that might become friends?   That’s scary.  It implies that fat people may not actually be sabotaging their weight loss, may not be at fault for weight regain.  Why, fat people may not actually be deserving of hatred.  What, then, of your attitudes toward fat people?  What kind of person are you?

Or, y’know, it might be that researchers are just concerned that if they stop promoting weight loss they they’ll lose their jobs and funding.  In the book Health At Every Size: The Surprising Truth About Your WeightLinda Bacon discussed the funding for her HAES vs weight loss study.

[…S]tatistics clearly show that when industry funds research, the published results are much more likely to show beneficial effects than research conducted without industry funding.

[…] I follow a strict policy of never accepting research money from private industry. Not that private industry would have been interested in funding this research anyway—I mean, there’s no profit to be made if we show people getting healthier with lifestyle change, without worrying about weight loss, or if we show that weight isn’t the be-all and end-all when it comes to health.

Consequently, I’m limited to public funding […] Given that Congress shares the general perception that Americans need to lose weight, that’s where much of the nutrition money goes these days. Plus, many (all?) researchers who sit on the panels that review the grant requests are on industry’s payroll themselves. In fact, some in my field jokingly refer to a group of researchers from the Universities of Colorado and Pittsburgh and Columbia University as the “obesity mafia,” given their control over National Institutes of Health funding.

With my HAES study, I managed to wrangle a relatively small grant out of the NIH […] I’d like to believe we got the grant because of the outstanding proposal. But I’m not that naïve. The reality, I think, is that I took my name off the proposal as the primary investigator and substituted Dr. Stern’s, who is better connected to the mafiosi.

(emphasis added by me)

Others have also speculated that obesity researchers are afraid of losing funding.  To quote Melissa McEwan,  “Boy, it’d sure be sad if they lost funding. Almost as sad as if I lose my life [because] a deadly ailment is misdiagnosed as fat.”  The emphasis on thinness as a measure of health and the societal biases against fat people conspire to prevent fat people from getting proper healthcare.

And that, of course, brings the biggest reason this could be stigmatizing: If the “everyone can be thin” drumbeat is a lie, researchers are complicit in this lie.  You’re not just kowtowing to Weight Watchers, Congress or the NIH when you continue to encourage “just eat less and move more” — you’re a fraud.  That might, indeed, be stigmatizing.

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.

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.

OBESITY NIGHTMARE….

…or rather, a site is starting to show fat people’s reaction to America’s (drumroll…fanfare…lights…)

Obesity Nightmare 

It started with a Tumblr post, and has continued with photos from Brian (at Red No 3) and Turn It Over.

Why?

Because we do not exist to be the government’s or the healthcare industry’s nightmare.

We are people.

We are living our lives.

You want to know what we think of the “obesity nightmare”? Here is our response.

Our lives? Are our lives.  

Not yours.

I realize this may be a challenge to you.

We are not nightmares,

unless your nightmare is

people who aren’t afraid of being fat.

Seriously: Think about this.  If me living my employed, home-owning, happily married life without your intervention is your nightmare … why?

On the other hand, if your nightmare is fat people demanding to be treated as people without losing weight, then yes, I am your nightmare.

Want to join in?  Submissions are welcome. :)

Americans Are Fatter Than They Think!

I tweeted this, but I’m just not sure how to fully express the snark this deserves, so I thought y’all might want to give it a try.

See, a study has discovered that…drumroll…BMI can be inaccurate!!!!  Really!!!  You might be fat and not know it!!!  (eeek!)  And since most people who are “overweight or obese” aren’t actually very fat, increasing the number of people who think they need to lose weight can increase customers for the weight cycling industry.

….

I keep thinking I’m missing something here.  Got anything else?

A few common fallacies

From a poster going around Tumblr.  Some of the examples have been edited a bit to suit myself.

A fallacy is any defect in reasoning which destroys an argument’s validity.

1) Ad Hominem. Latin term meaning “against the man.” It is discrediting the opponent instead of his or her argument.

For example: “You’re fat, therefore you cannot be correct.”

2) Faulty Cause and Effect. The belief that if event B occurs just after event A, then A causes B.

For example: “Whenever I wash my car, it rains the next day. Therefore, washing my car alters weather patterns.”

3) Either-Or. Suggesting that there are only two possibilities for any given situation, rather than more.

For example: “Either you lose weight, or you are self-destructive.”

4) Guilt By Association. “Attempting to discredit an idea, person, or believe by associating it with an undesirable person or group.

For example: “I can’t believe you are a Christian! Hitler was a Christian!”

5) Loaded Question. A loaded question is a question phrased so that it forces an answer based on a false or controversial premise.

For example: “Why do fats hate thin people so much?”

Junk Food In Schools Doesn’t Correlate To Fat

Remember how banning junk food in schools was supposed to make fat kids thin?  Guess what?  No,  it doesn’t.  At least not according to “Competitive Food Sales in Schools and Childhood Obesity: A Longitudinal Study” in Sociology of Education (January 2012).

But of course we should’ve thought it would, right?  It’s not like “Snack food intake does not predict weight change among children and adolescents” was published in International Journal of Obesity in August 2004, right? And there wasn’t any studies about “energy-dense snack food” not being correlated with weight gain in adolescents either…right?  Wrong.

Once again, America is continuing to do the same thing (that didn’t work) to try to prevent fat kids.  And yet, fat kids exist.  Time to ban fat marriage?

Weight Cycling Industry

From Deb Burgard comes this amazing post on weight cycling:

Why do we call it the “weight loss industry” when what we really get for our time, sacrifice, and money is weight cycling? 19 times out of 20, what we are really purchasing is the experience of weight loss and regain.

Imagine if we called it the “weight cycling industry,” and “weight cycling programs.”  Would you participate in Weight Cyclers at work?  Buy food from NutriCycle?  Hire a trainer from the Biggest Weight Cycler?  […]

Because that is what we are doing, folks.   Better face the facts:  Of 100 people trying to lose weight, the vast majority of people will regain weight. Some significant group – perhaps a third – will gain more weight than they lost.  Some tiny number (7? 5? 3?)  will maintain their weight loss, and of that group, some number from 0-4 of them will be flirting with, developing, or fortifying an eating disorder.

People ask me why I don’t diet anymore.  I don’t lose weight “for good” — my weight goes down in the short term  and up in the long term, ending up weighing more than when I started.   So yeah, “weight cycling” is more descriptive than “weight loss”.

And yet, people ask, “what about health“?  As Deb points out in the same post:

It is the practices that people adopt in the pursuit of weight loss that are the problem, because for the 95 out of 100 people who regain weight during a diet, when the practices are not sustainable they lead to more physical and psychological illness.

The Health at Every Size® model is weight neutral.  People using this approach are not pro- or anti-weight loss, but they are mindful that the pursuit of weight loss is usually harmful, unlike the cultivation of sustainable practices that feel life-affirming and support your health.   In keeping with the “truth in advertising” theme, the Health at Every Size model does not insist that everyone is healthy at every size, or that anyone anytime is necessarily the size that optimizes their health.  “Health” in this context means that whatever size you are, there are practices that will support your health.

As I’ve written before, I don’t consider myself perfectly fit.  But I refuse to frame exercise or healthy eating or getting enough sleep as “something I’m doing for weight loss”.  What matters is the effect is has on me.  Getting enough sleep makes me feel good.  Lifting weights makes me feel strong.  Walking increases my endurance.  That’s why I’m doing it.

For All The Parents Out There…

Think about how you will react if your child is fat.  Over time, if you’re making it clear that you don’t want a fat son or daughter, well, your son or daughter may not be able to stop being fat.  But your son or daughter can eventually choose to stop being your son or daughter.  Imagine your adult child building a life with people who aren’t nagging about weight loss, or who can enjoy doing something physical without making it about weight loss, or who can eat a meal without it being about weight loss.  Calling home?  Not required.  Spending time together?  Optional.  Listening to lame weight jokes?  Optional.

There are certainly other issues that can cause this sort of distrust.  It didn’t help that my parents’ reaction to my dating a woman was insist I not tell any other family members and then studiously not  want to talk about her much less meet her.  It didn’t help that my father drank large amounts of beer daily for the first 20 or 21 years of their marriage.   A lot of things didn’t help.   But it’s generally expected that drinking or rejecting a child’s sexuality is going to be harmful to the relationship.  Giving kids shit for being fat is practically a requirement of “good parenting” these days.

My dad periodically asks why he can’t move in with my husband and I.   Frankly?  I don’t want to provide day-to-day care for him.  I distanced myself for my emotional safety.   I wouldn’t want him as a roommate, much less as a semi-disabled adult I’m caring for.  My emotions are tangled on this, but my want is for him to live happily ever after … without needing me.

US Obesity Rates Level Off Again?

Oh, not again.  Still.  They’ve been level for years, but this time the Journal of the American Medical Association noticed. There’s discussion as to why, such as “people are getting healthier”.  Given how dieters often gain weight in the long term, I thought this perspective a bit more realistic:

Dr. Ludwig said the plateau might just suggest that “we’ve reached a biological limit” to how obese people could get. When people eat more, he said, at first they gain weight; then a growing share of the calories go “into maintaining and moving around that excess tissue,” he continued, so that “a population doesn’t keep getting heavier and heavier indefinitely.”

That’s not what my mother told me.  She was convinced that if I wasn’t actively dieting I would continue to gain weight for the rest of my life.  Yet when I finally quit dieting my weight … leveled off.  Huh.

Furthermore, Dr. Ludwig said, “it could be that most of the people who are genetically susceptible, or susceptible for psychological or behavioral reasons, have already become obese.”

Gee, y’think?

Twitter Party

There’s a bunch of fat folks tweeting about “things fat people are told” – in twitterspeak, #thingsfatpeoplearetold. (The # before makes it searchable.)   Some examples:

You have muscle?

But have you really, really TRIED to lose weight?

You’re too fat to do yoga properly, so don’t think you’re REALLY doing yoga.

Your allergies (that you’ve had all your life) would go away if you lost weight.

To read more, check out the #thingsfatpeoplearetold search results page.

Many Obese People DO Look Great The Way They Are

It’s hard to read this and not just shake my head.

[M]any clinically obese men and women think they’re already at a healthy weight.

In a study of 2,056 obese people in Dallas County (all participants had a body mass index, or BMI, of 30 or higher), researchers asked each participant to look at nine illustrations of bodies, from very thin to very obese. The volunteers were asked to pick their ideal shape along with the one that most closely resembled their own body. About 165 people, or 8% of the group, chose ideal body shapes that were the same or bigger than their own, suggesting a misunderstanding of healthy weight.

Eight percent.   8% of respondents preferred bodies their size or larger and you’re concerned that’s too high?   Eight percent?

Not to mention that a BMI of 30 isn’t all that large.  Don’t be fooled by the article’s illustration.  Here’s a picture of a woman with a BMI of 30.  The man in this photo has a BMI of 30.  Do you think a magazine or newspaper would use one of these photos when illustrating the “obesity epidemic”?  Of course not.  But they’re photos of people who have a BMI of 30 and therefore are considered “clinically obese”.

I can certainly understand someone could see one of these photos as a desirable body.  Especially if many of the photos are of men like athlete and actor Dwayne Johnson (“The Rock”), who is also officially “obese”.

But Time doesn’t bother with actually thinking about this, or the fact that permanent weight loss is nearly impossible, or that self-acceptance can be part of a healthy life at any size, or even that aesthetics vary.  Instead they slap on a misleading illustration and crank up the panic.  Joy.

Fat Bingo: Fat and Fit Article

Using the article “Fat but fit? Big gray area confounds scientists“.

“Is it possible to be fat and fit? Perhaps, researchers say, but losing weight may make you even better off.”

Message: Don’t get your hopes up, fatty, exercise and a healthy diet are only worthwhile if you lose weight—if your weight is stable you might as well skip the gym.

“No excuse to pack on pounds”

Message: Fat people really want to be MORE fat and are looking for excuses to gain weight.  Always.

“Obesity is a major public health issue”

Message: Fat people are a drain on society.

“Is it really protective to be metabolically healthy?”

Message: Health markers like cholesterol or blood pressure or insulin sensitivity can be valuable in helping thin people avoid problems, but are only valuable in fat people if they reinforce that weight loss is needed.

Then there’s a bit about a 2008 study I’d like to track down, where 20 metabolically healthy obese women and 24 metabolically at-risk women went on a six-month diet to lose weight and some of the metabolically healthy women ended up decreasing their insulin sensitivity.  Then the author contrasts this with a more recent study that used diet and exercise — you remember exercise, that thing which often improves insulin sensitivity? — and found that insulin sensitivity didn’t decrease while losing weight in the study that used exercise.

Yes, this does appear to be comparing apples with oranges and saying, hey, apples are really orange!  Or something.   Head, meet desk.  And nothing about how weight was affected long-term, of course, because long-term studies are more expensive and tend not to show much weight loss and are therefore depressing or something.

Then, finally, at the bottom of the article:

[G]iven that most people fail to maintain weight loss (and findings that yo-yo weight loss and gain may be psychologically and physically harmful), the best message for the metabolically healthy subset is unclear.

“Most people fail to maintain weight loss” but this may only trouble the “metabolically healthy” fat people?   Bwah?  Hello?

“Whether we should be actively promoting weight loss knowing that over 90 percent of these individuals are going to fail is a question that I don’t think anyone can answer at this point,” [Jennifer Kuk, a professor at York University in Toronto] said.

Here’s an answer for you:  NO.   No, don’t promote weight loss.  No, don’t push weight loss.   Permanent, sustainable weight loss is not possible for most people, and for many, dieting is tied to long-term WEIGHT GAIN.

The frustrating thing about this article?  There’s good facts there about how fat people who are metabolically fit tend to be more active.  There’s a closing quote about how exercise can increase your fitness, whether it causes weight loss or not.  This could have been an article on how exercise can be good for you and that it’s not about weight loss.

Instead, it’s a near-Bingo.

Sleep-Deprived Teens May Pay A Hefty Price

That’s the title of this piece on Yahoo! news about teens who sleep less eating more fats.  (Eating more fat = the “hefty price”.  Geddit?  Amazing how reporters think nobody’s ever made a fat joke before them.)

In the study, adolescents who slept fewer than eight hours on a weeknight consumed more of their daily calories from fat and fewer calories from carbohydrates than teens who slept eight hours or more. […]

However, the researchers note that their study only shows an association and cannot say for certain whether sleep loss did in fact cause the teens to eat more fatty foods.

The correlation between sleep dep and weight gain has been noted before.  (So’s the correlation between weight gain and stress.  And sleep deprivation is also linked to stress.)   Whether it’s the 2.2% increase in fat intake doing it or not is unclear.

But what had me rolling my eyes was the speculation on why this might be.   Sleep deprivation’s effects on hormones?  Being up longer might provide more time to eat?  The time of day that one is eating might have an effect? Seeking a boost in “reward-seeking behavior”?   I wonder if the researchers ever were sleep-deprived as teens.  I certainly was; I remember the fatigue, falling asleep in class, feeling like I’d never be rested.  I also remember that food would give me energy.  Energy to finish my homework, energy to get through gym class, energy to walk home from school, energy for my after-school cleaning-woman job.  Caffeine was my friend too, but it worked much better with food.

When I was on a diet, of course, I was even more tired—and thus craved food even more.  I’d skip breakfast, have a salad for lunch, and wonder why I was so exhausted at dinnertime.  By college I’d routinely stop for a snack on the way home from work.  Two-packs of Hostess cupcakes; a Twix bar; a single-serving bag of Bugles;  I loved them all, even as I was ashamed of what I then considered binges. (Now that I’ve learned more about eating disorders, I realize that while I might have been “cheating” on my diet, those weren’t binges.)

It’s frustrating, though, that the article doesn’t mention other effects of sleep deprivation: cognitive impairment, increased risk of occupational or automobile accidents, high blood pressure, impaired immune systems — all of which are much more serious to me than being fat.  Or that many teens naturally have a later “sleep phase” than younger kids or adults, which makes it harder for them to get to sleep earlier.   Maybe those weren’t in the press release.

Deciphering studies: Absolute vs Relative Risks

I thought this example Lisa Martinez made in the comments at the Well blog was one of the clearer examples I’ve seen for absolute vs relative risks.

100 women took ABC pill and 100 women took a placebo, which is not an actual medication. Of the 100 women who took ABC pill, 2 developed cancer and of the 100 women in the placebo group, 4 got cancer. It is reported that this clinical trial showed a 50% reduction in cancer and another report states that the same clinical trial showed a 2% decrease in cancer. Both percentages are accurate and that is because the data are being reported in two different ways.

The 50% reduction was reported using relative risk reduction. The 2% decrease was reported using absolute risk reduction. It is extremely important that you understand the difference between the two when making decisions about your care. So when presented with options for chemotherapy or any treatment, make sure you ask your healthcare provider to give you the relative and the absolute risk reduction percentages.

Many publicists and news articles on the risks of weight use relative risks not absolute. As you can see, this can be a BIG difference!

I’m squishy, but I’m NOT obese

You may have seen today’s Pickles.


Transcript:
Panel 1: Nelson asks Earl: Grampa, are you obese?
Panel 2: Earl: Obese? No, I’m NOT obese.
Panel 3: Nelson: [pokes tummy, with a “squish” noise]
Panel 4:  Earl: I’m squishy, but I’m NOT obese.

This illustrates much of the “obesity” discussion. Earl knows he’s fat.  Earl assumes he’s overweight, not obese.  He forgets that the definition of “obesity” was changed to include people at lower weights.  He sees news stories about “obesity” that are illustrated with photos of very fat people like myself, and assumes that I’m a typically-sized fatty.

Sorry Earl.  The truth is I’m not typical.  Check out the Illustrated BMI project: if Chris and Angelos are nearly “obese”, Earl probably is too.