You Don’t Know What You Think You Know

I’ve gotten some emails from people  – not trolls – but totally brand spanking new to the subject who are just dead sure they understand everything they need to know about fat: we’re in an obesity crisis, and fat is just calories in/calories out.

So for all of you folks, I am going to kick you off with two articles – which aren’t from fat positive sources at all – just to problematize everything you think you know about fat.

Scientific American –  Obesity: An Overblown Epidemic?

War on Obesity Not the Obese

How Hard Must I “Try” Before You Stop Hating Me?

It’s very weird.  In online environments where I indentify as a fat chick with a BMI of 37, I get so much more hostility directed at me than I do in the “real world.”  To be honest, IRL I get very little weight-related harassment, despite my ginormous marked-for-instant-death BMI.  If people guess my weight, they guess waaaay lower than the 212 pounds I actually am.  I’ve actually had people say to me, “But you’re not obese.”  Rather than revel in this pseudo-thin privilege, however, I take the time to correct them.  Typically I then get some kind of shrugging response along the lines of, “Well, I guess you’re different, then.” Read the rest of this entry »

More Evidence…

…that there’s no evidence behind the War on Fat Kids.  According to a review of weight monitoring in children published in Health Technology Assessment:  

No sound evidence supports weight monitoring to identify and treat obese children, according to a review of worldwide research published this month in the United Kingdom.The relative benefits and harms of monitoring have not been determined, and the effectiveness of current treatments is doubtful,” say review authors led by Marie Westwood, Ph.D., of the University of York.

Also the press release points out another admission – this time by the American Academy of Pediatricians – that there was no evidence behind the AMA’s recently released weight loss protocol for kids. (Which, to review, instructs doctors to use increasingly aggressive weight-loss “interventions” for 15% of children, including dieting, “behavioral modification” and “consideration of” very low calorie diets, medications and surgery):

The American Academy of Pediatricians, members of which served on the expert committee, acknowledges the lack of evidence on prevention and early identification of obesity in children. Their policy statement adds, “The enormity of the epidemic, however, necessitates this call to action for pediatricians using the best information available.”

Let’s set aside that it’s completely disingenuous to imply that “the best information available” suggests that either “prevention” or enforcing weight loss on children works (just the opposite, actually). What’s phenomenal is that in one fell swoop both the rules of evidence and the principle of “do no harm” have been tossed aside.

And how do they justify this suspension of the normal checks and balances? “The enormity of the epidemic necessitates” it. What they’re really saying is: “the sheer size of the population who will be affected by our recommendations means we don’t need any evidence.”

Come again? With any other “condition” the size of the affected population is precisely what restrains public health officials from making recommendations without solid evidence. If millions of patients (especially children) will be affected – that’s when they are ordinarily compulsive about evidence – because the potential for harm if you’re wrong is staggering.

I have never heard of – nor can I really imagine – another situation where the size of the target population alone was the only reason given for not using caution and not waiting for evidence.

It is a mind-blowing abandonment of both restraint and logic.

Big Girl (You Are Beautiful)

…then this came along and cheered me right up: 

(via Every Woman Has an Eating Disorder)

The Trouble With Normal Weight, part 2

Stef very helpfully pointed out in her comment on The Trouble With Normal Weight:

Eric Oliver in Fat Politics has a couple of pages about the historical developmental of the concept that “average” is the same as “ideal”. He discusses a Belgian astronomer named Adolphe Quetelet who, in the 1830s, invented the notion of BMI by studying the height and weight of members of the French and Scottish armies…

This is what I get for buying, but not reading Fat Politics. When I read that comment I glanced up at my bookshelf, where the book stared back at me reproachfully.

It turns out Quetelet is the very same statistician that Michael Warner credits with instigating the conflation of the “statistical average” with “health” in medicine starting in the 19th Century. Warner’s concerned with the pernicious effect this had on the construction of homosexuality, and I didn’t put together that he was the same statistician who created the BMI until I read Stef’s comment.

quetelet2.jpgI looked up the Quetelet section in Fat Politics, and it puts the pieces together. If you haven’t bought it (or – ahem – read it), you should. Anyway, I know what I’m going to be reading for the next few days.

Oliver explains:

Among his many accomplishments, Quetelet first derived the concept of the ‘average man.’ Because most people congregated around average points in their physical characteristics, Quetelet believed that deviants, criminals or troublemakers could be identified by their physical abnormalities….The farther someone was from the average weight, the more they violated other social norms, and the more they could be monitored, institutionalized, or controlled.

Which is what the moral panic of the obesity epidemic, is all about, isn’t it? It’s why so much of the focus is on controlling behavior of fat people. And too little is on whether that  “control” actually makes anyone healthier. Read the rest of this entry »

The Trouble With Normal Weight

I’m reading Michael Warner’s  “The Trouble With Normal,”  about homosexuality and…well…the trouble with the idea of “normal.” I had to share this passage…which was so relevant to the relationship of fat to the “normal”:

As [19th Century] doctors began using…statistical methods [to determine the statistical norm], they usually thought they were discovering natural laws…normal came to mean right, proper, healthy. What most people are, the new wisdom went, is what people should be….

He points out how these “norms” are invariably dependent on just who is chosen as “normative” (e.g. White Europeans? People in which environment? Which age group? Which era?), and something that should be fairly obvious, health itself is impossible without variety and variability in the population in order to allow for change and adaptability. “Health requires variation. Not a pregiven norm.”

He continues:

…From the late nineteenth century onward, people had to work very hard to resist this medical fallacy, which was rooted in the confusion between statistical regularities and natural laws. The lesson in this struggle should have been one of skepticism toward all norms of health that express social norms, preferences for certain ways of living, or tastes of the majority.

This so resonates with “the trouble with normal weight.” Fat-phobia is not just about a taste for certain body-shapes. It’s also about a taste for a certain way of living. And the fear that people who don’t have the right body shape, aren’t living the right way. It’s almost impossible to listen to discussions about the “obesity epidemic” without hearing it morph into a detailed dissection of what it means to live “right”, and the need to “educate” or otherwise coerce the fat (especially the poor and minorities) to change their imagined “poor lifestyle” into something more presentable.

And of course, the most aggressive and ill-considered fallacy on which most people premise their pronouncements about weight, is, of course, that everyone is “meant” to be a single weight – that variations from the “normal” aren’t about natural human variability – they’re “abnormal,” and therefore “unhealthy” and therefore “disease.”

bell_curve.jpg

And since those same people also tend to believe that fat isn’t heritable and is purely a reflection of “lifestyle,” then the distance from which you travel from the “normal” is a reflection of your distance, not only from “health” but from “good behavior.”

By the way, I’m not discounting any correlations of fat with health effects. Every human variation has its own “risks” – as a woman I know I’m at risk for breast cancer, ovarian cancer, and osteoporosis.  Men have other risks. Short people have certain risks, and tall people others. Straight men have different risks from gay men who have different risks from lesbians. Every ethnicity has its own risks too. And as I enter middle age I find myself confronting an array of risks I didn’t have when I was young. Am I now officially “unhealthy?”

And just as importantly, whatever health correlations there are for weight vary immensely depending on who you’re talking about, their age, their gender, their ethnicity, their illnesses, and any number of other variables. 

So that in general the  label of “unhealth” to fat is so vastly overgeneralized, oversimplified and hyperbolically stated that it serves little value in improving health. It only serves to rationalize hate and discrimination, to foster panic-driven (and not evidence-driven) public policy, and to undergird the (il)logic of a universal prescription for weight loss without consideration for benefits, dangers, (in)efficacy….or simple humility in the face of how much is not yet known.

How does the idea of fat as simple “unhealth”  jibe with two studies this week that showed that the fat have a lower risk of suicide, and that fat people with heart disease fare better than others? They make it jibe by calling it “The Obesity Paradox.” Yes, it must be a paradox because we’ve already labelled fat as unhealthy.

But why are we so quick to impose the label of “unhealth” on any and all variations from “normal weight?” For the most part it’s simply because we’re always quick to assume that anything straying from the statistical average -“the normal” – is by definition deviance and disease.

Open Fat Thread

If anybody feels the urge, use this space for shameless self-promotion, interesting links you’ve found, fat rants, fat raves, questions, complaints, Deep Thoughts, grocery lists, or just to say “hi Mom!” (Not that your Mom is reading this, but you never know.)  

In the meantime, if you haven’t run across them already:

  • The brilliant Kate Harding (of Shapely Prose), is now a contributor at Shakesville. I was grinning all day when I heard this. Check out her rapidly growing body of work
  • Bored with scrolling through pages of tedious and repetitive fat hatred in your threads?  Wish you had a nickel for every time you’ve been lectured on thermodynamics by someone who can’t spell the word? Red No. 3 has your answer: Fat Hate Bingo.
    .
  • So you think you should boycott So You Think You Can Dance? You’re right, and Rachel of the The f-word tells us why.
    .
  • BABble found an oh-so-timely article on the dangers of food-restriction in kids. In the mainstream press even.

Ding Dong, Rimonabant Is Dead

For now, anyway, per the Associated Press.  Reason given: In clinical trials of rimonabant (trade names: Acomplia and Zimulti) it was found that 88 percent of those reporting psychiatric problems (including suicidal feelings) while on the drug had no prior history of depression, strongly suggesting causality.

The unanimous finding by the expert panel’s 14 voting members made it unlikely the Food and Drug Administration will approve the drug. The agency usually follows its panel’s advice, but it isn’t required to do so.

“There is a reasonable suspicion we better learn some more and watch this affair more closely before we launch into massive use of this drug,” said panelist Dr. Jules Hirsch, of The Rockfeller University.

 I knew there was a reason I dug Dr. Hirsch.

So at least we can rest easy that they’re not going to stuff all us fatties with a pill that removes all our pleasure in eating. Or sex. Or life.

The search for the magic words that will destroy all fat folks’ pleasure in living, however, continues apace. Wheee.

The Children’s Crusade

If you’ve been reading Junkfood Science you’re probably aware of the new AMA guidelines on preventing childhood obesity, which is the battle plan for the War on Obesity Version 2.0  – the Children’s Crusade. 

The War on Obesity 2.0 is a “preventive” war on fat children childhood obesity. At heart it’s anti-obesity crusaders’ answer to Bush’s “surge strategy” in Iraq, a never-admit-you’re-wrong response to the failure of the the War on Obesity Version 1.0: The Weight Loss Campaign.

In case it slipped your mind, for decades fat people have been harrassed to lose weight and have spent up to 50 billion dollars a year trying to – only to lead to an average increase in weight by 5 to 10 lbs in the population. And only now, after the evidence that weight loss doesn’t work long-term could stretch from here to the moon and back, are anti-obesity crusaders copping to the failure of the War on Obesity 1.0.

Well quietly copping to it – the admission is usually drowned out by their very noisy opening salvos of the War on Fat Kids. I have no doubt it will take these same people another thirty years before they ever admit there’s anything boneheaded about the War on Fat Kids – and they’ll spend all that time insisting the “expert guidelines” must work because, after all, they’re “expert guidelines.”

But to get down to brass tacks, as Sandy points out, doctors are now supposed to police all aspects of fat children’s lives (the fattest 15%) and implement a three-stage plan of increasing punishment intervention when if the prevention strategies – which have never been shown to work – don’t work. 

“Interventions” range from reducing children’s access to tv and computers to <1 hr a day (so much for computer literacy); to not allowing them to drink any sweetened drinks (e.g. juice); to having parents supervise their eating and exercise, and so on. When those “interventions” don’t work, referral to kiddie weight loss centers for “consideration of:” very low calorie diets, meal replacements (i.e Slim-Fast), “behavioral modification,” medications and surgery.

792670_teddy_and_rabbit.jpgBear in mind we’re talking about kids as young as two years old. Yes, even toddlers don’t get a pass on the most extreme weight loss measures.

The way the recommendations are “staged” make them sound, at first glance, almost reasonable – because the first “stages” are things we might all get behind, like making sure kids get exercise and eat well. But the key is if the child does everything he’s supposed to but stubbornly refuses to be thin, then it’s on to very low calorie diets, medications and surgery. 

So even though we’re always told that fat is just a matter of “good nutrition and exercise,” good nutrition and exercise are apparently not good enough. Even if all the things that are supposed to “prevent” fat don’t prevent fat, then extreme measures must be taken to make prevention “work.”  Which means, in the end, that “prevention” just amounts to forcing on kids the same weight loss strategies that don’t work on adults.

And, in case you’re skeptical about these “interventions” being based on zero evidence. Here’s a summary of the “insights” from the conference that spawned them (reproduced in toto, just so you can see how absolutely pulled out of the vapor all of this is):

  • The magnitude of the obesity epidemic is too great to wait for evidence-based guidelines before increasing efforts focused on prevention and intervention.
  • There should be an increased focus on what has worked in the past for other public health threats such as tobacco.
  • Much more research is needed to determine what clinical and community based interventions are helpful in decreasing childhood obesity.
  • The Robert Wood Johnson Foundation, the NICHQ, the CDC, the MCHB of HRSA, and the AMA provide the basis for a national network of organizations that can accelerate the necessary research and interventions related to the prevention, diagnosis and treatment of childhood obesity, so that best practices are determined and disseminated at a rate surpassing the normal diffusion of knowledge and practice into the health care community.

So, it’s pretty much exactly what the critics have been saying. This war on obesity is a panic. It’s the panic that’s driving it, and not evidence. There’s no more evidence that fat can be “prevented” than there ever was that it can be “cured.” And nobody has any idea what the long-term effects of any of these recommendations are. Nevertheless the complete lack of evidence has convinced the AMA to implement a police-state policy with regards to fat children and their families.

And just as important is their admission that the War on Obesity is predicated on the assumption that fat is like smoking – an assumption that each day is shown to be more obviously wrong. Smoking is medically, physiologically and socially a completely different issue from fat.  Fat is in large part genetic and a reflection of natural human variability; it’s controlled by an extremely complex and powerful physiology that homeostatically regulates it; it’s relationship with health is highly variable, and there’s never been any evidence that it can be successfully “cured” or “prevented.”

Tobacco is none of these things, and the more the “War on Obesity” fails to live up to the “War on Tobacco” the more these policy morons try to hammer the square peg ever harder into the round hole. And the more draconian their “solutions” become.  And by the way, if you look at who’s composing these guidelines, there’s no evidence that many (any?) of them are experts in fat or obesity – for the most part they’re preventative medicine or public health policy wonks still nostalgic for the clear line between good and evil that characterized the Tobacco Wars, and who simply can’t wrestle themselves out of the tobbacco model to see fat for what it is.

Lest you think that these are just “guidelines” that parents can filter for appropriateness or idiocy, think about a recent proposal to the British Medical Association to have fat kids taken away from parents who fail to “follow doctor’s recommendations.” The days when all we were worried about was putting BMI on children’s report cards are already behind us, and we may come to see such humiliations as a “more enlightened time.”

Welcome Meows(z)er!

Many of you know Meowzer as that kickass commenter you wish had her own fat blog, because of her flawless instincts which cut straight to the heart of the matter – with wit, precision and passion. She’s an amazing writer, so I was bowled over with glee when she agreed to write for fat fu now and then.  

Below you’ll find her post on Fat Girl Speaks and how it sparked the Meowser revolution.  A revolution I, for one, am seriously looking forward to hearing more about.

Unfortunately Meowzer lost her “z” in the WordPress registration process and henceforth she’ll be Meowser. For now we’ll overlook the impudence of the Meowzer pretender who stole her rightful name.

Fat Girl Speaks — Woohoo!

I just returned home from Fat Girl Speaks in Portland, Oregon, the first show FGS has put on since 2004 (and the third one ever). The theme this year was “Every Day is a Revolution,” and although you could ultra-technically say they were preaching to the way-converted in me, the event — consisting of a bang-up fat-chick fashion show followed by a whole mess of voluptuously gifted (in every sense) performers — definitely caused a revolution in my own personal soul.

You see, I am a closeted…musician. I used to perform fairly regularly in coffeehouses in my 20s, but ever since I gained about a kajillion pounds about a decade ago from medication, I have appeared on stage only once — in the variety show Dangerous Curves in Seattle in 2004, wherein I sang my song about the Venus of Willendorf as part of the folk trio “The Willies.” (Yes, I know there is another band by that name; this was a one-off performance for charity only.) Let me tell you, as a fat performer, the idea that you can go onstage and know that you will be accepted for who you are by every single person in that room is a rare thrill indeed.

I have written more songs since then, but sadly, despite that one-shot deal I have been a horribly inhibited writer and performer and musician; despite playing multiple instruments and having a voice that has been complimented often (and even called “sexy” by some), I am often haunted by the idea that my talent “doesn’t count,” that I need to be ten times as great as younger, thinner, “cuter” women to get half the respect. And since I’m simply not 20 times as good as anyone else (how do you measure those things, anyway?), quite often I have squished my creative ideas like cockroaches under a giant Chuck Taylor for no very good rational reason at all.

But after seeing the fabulous Joy Nash reenact her “Fat Rant” video live, and FGS founder Stacy Bias do an amazing set of rockin’ numbers fronting Fatty and the Hamslappers (culminating in the showstopping “Bearded Clam”), and bellydancers Samina and Miasia bring down the house with their terpsichorean brilliance, and Jana Phoenix and Nedra Johnson applying their gorgeous blues voices to their gorgeous blues tunes, and way way way too much else to do justice to in a mere few paragraphs…my mind started moving away from, “Gee, it’s too bad the rest of the world isn’t as size-accepting as this room,” to, “Well, why the fucking hell isn’t it? And am I really going to sit around waiting until it is before I turn the damned microphone on? Or even buy one in the first place?”

Screw it. I am crashing rapidly towards 44 and the numbers are never going to go backwards. The numbers on the scale are unlikely to do so either any time soon, at least not in any permanent, meaningful sense. I have spent way too long hiding my big fat light under the biggest bushel I can find. It’s depressing me. It’s killing me. It must stop now. It is time for the Meowser Revolution, it is time I quit feeling sorry for myself because I wasn’t given the “physical gifts” of anyone from Joni Mitchell to Jessica Valenti, and work with what I bloody well do have. The world might not “need” my music as such, but it definitely does need me to be a lot less grumpy, victimized, stymied and frustrated.

Thank you, Stacy Bias, and everyone else involved in this show, on stage and off. You might just have saved a life.

For Fat Science Geeks

(Both fat “science geeks” and “fat science” geeks. Or even fat fat science geeks like me.)

I found a fascinating lecture on the science of fat and weight regulation by Jeffrey Friedman and Steve O’Rahilly (two big-shot obesity researchers) debating at the Imperial College of London.

Link to Video. (Realplayer)  (Original Website).

It’s an hour and twenty minutes long and at times highly technical, but also dense with information and (I found) entertaining. I recommend anyone with the inclination and the science fu to follow it have a listen. (See my warning first, though).

It’s mainly an overview of some of the research that Gina Kolata was referring to in her book “Rethinking Thin.” (For something more accessible, here’s another in-depth interview with Gina Kolata on NPR’s On Point.)

Being a bit of a science geek is actually how I came to fat acceptance, which I know is odd since most of us have learned to think of obesity researchers as, um, not so much this:

einstein.jpg

….but a little more like this:

strangelove.jpg

. 

But life is strange. And so is the science of fat. Because at the same time that “obesity research” has gifted the world with obesity hysteria and possibly the worst era in the history of human civilization to be fat, it’s also uncovered overwhelming evidence that fat is largely genetic and a reflection of normal human variability; and has elegantly described the architecture of an elaborate physiological system that that closely regulates weight in both the fat and the thin.

So, no, fat isn’t a reflection of your character. Yes, you’re probably supposed to be basically that weight. And no, diets don’t work…and now we know why.

Caveat Auditor

Here’s the caveat auditor – let the listener beware. This lecture isn’t fat positive in the least. And like all “obesity researchers” these two have both their fat advocacy moments (mocking diet ads and legislation that referred to fat as “gluttony” or “sloth”; showing how the “obesity epidemic” is just a slight shift in the bell curve) and they have their Strangelove moments (e.g. trying to “treat obesity” with a liter of leptin a day, and describing fat prejudice as a “consequence” of fat and all the more reason to find a “cure”).

Because although they construct fat as largely a reflection of normal human Read the rest of this entry »

Notes from the Fatosphere

It’s hard to keep up with everything that’s going on in the fatosphere, so I decided to make an aggregate feed for myself to make things easier. And then I figured – why not add that aggregate feed to fat fu?

So in the right column of Fat Fu you’ll now see Notes from the Fatosphere – which will show you the 10 most recent posts in my aggregate feed. I haven’t finished setting up the aggregate, so there are a bunch of feeds still missing. And also I’ll be adding a second feed for fat fashion, so fashion blogs haven’t been included in this feed.

RSS Feed Link

If you want your feed added to either list, or want it taken off – drop me an email: fatfu9@yahoo.com

Update: If anyone wants to add this feed directly to their site – feel free. But make sure to use the Feedburner Feed. WordPress is buggy and can’t read Yahoo Pipes feeds directly. 

Second Update: Anyone who has a blog that is not primarily fat-related, but wants their fat-related posts included in the Notes feed, I can filter most feeds by tag or category, so we can set it up to pull out just those posts you think should be in the Notes. Drop me an email to let me know.

And the third update: The Feed seems to be having issues with not updating some blog feeds – I’m going to be sorting it out this evening.