I run because–t-shirts and food policing.

Today, while visiting my sister, I happened to look at an ad flyer for a local department store.  And guess which t-shirt was being advertised (just in time for back to school body hatred…)

CupcakeShirt1Look, I have no problem with people making their own choices.  Want to run?  Awesome, me too!  Want to eat cupcakes?  Yes, please.  I’ll have mine with extra sprinkles.  What burns my butt is the notion that we are not allowed to eat certain kinds of foods unless we do certain kinds of exercise.  What chaps my hide is the notion that we share a whopping dose of food policing and body shame as some sort of back to school special.  And by the way, this shirt was conspicuously absent from the section of the flyer advertising plus-sized clothing, junior or otherwise, because, duh.  Fat girls don’t get to eat cupcakes EVAR.

It always astonishes me that clothing buyers at these stores are so incredibly clueless that they still think this is okay–this after the controversy over the “girls can’t do math” t-shirt and the “asking Santa to bring me a new butt for Christmas pillow”.  Seriously?  Don’t these guys pay attention to social media, like ever?

This notion of fitness as punishment or penance or atonement for some sort of sinful eating is one of the reasons we have such a hard time sticking to exercise.  Rather than seeing fitness as something joyful we do because we love the way we look, we see exercise as something painful and awful we have to do because our bodies are in some way unacceptable or because we have to avoid even the slightest chance our bodies will become less acceptable in the future.  We don’t bother finding fitness that we love because we don’t feel we deserve it.  And then we are surprised when we choose not to stick with the icky, painful, punishing routine we pick for ourselves.

But in the end, this sort of body shame and food policing is unproductive, punishing and downright damaging.  It doesn’t help us feel better.  It doesn’t help us feel better about ourselves and it doesn’t help foster healthy behaviors of any kind.

So my advice is to go ahead and run for a different reason.  I’ve even immortalized it as a t-shirt.  Here ya go!

Bodyshirt2

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to speak at your school or company or organization?  Learn more HERE!

The 1% efficacy rate and weight loss as a prescription

Prescription

Talk to nearly any person over a size 12 and chances are, they have run into a doctor or medical professional who recommended that their health would improve if they would only lose weight.  Whether that person went to a podiatrist for help with their feet or a gyno for a pap smear or an optometrist to get an eye exam, chances are at least one of these medical professionals has stated that the solution for these health woes is that the patient simply lose weight.

Let’s take a look at that prescription for just a moment.  Just how likely is it that one of these people is going to lose any kind of significant weight (and keep it off for any period of time)?  A recent study, conducted by a team at King’s College suggests that this prescription is pretty unlikely to be successful.  For moderately fat people (BMI 30-35) the chances of returning to a “normal weight”  (heavy airquotes here) and staying there for a year is one in 124 for women and one in 210 for men.  For very fat people (BMI 40-45), the chances drop to 1 in 677 for women and 1 in 1290 for men.  The chances for losing only 5% of body fat were greater (one in 10 for women and one in 12 for men) however the majority of these folks gained the weight back within 5 years.

Keep in mind that there is no evidence that this very tiny percentage of people who had lost weight lived any longer or healthier than those who had not lost weight.  While there is some correlation of people who have always been thin and certain health benefits, there is virtually no statistical evidence that the microscopically small group of people who manage to maintain a significant amount of weight loss over the long term enjoy any health benefits at all over the people who don’t.

So, can we talk?  Can somebody tell me why, exactly, medical professionals are suggesting a “treatment goal” which in the very, very most optimistic scenarios can be achieved by 10 percent of those who try it and on the low end has a less than 1 in 1200 chance of being achieved?  And can anybody tell me why we recommend this strategy when there is virtually no evidence that in the rare case it will be achieved it will do any good?

Let’s talk about this in terms of a pill.  We tell the patient that they have somewhere between a 10%  and a .1% chance of even being able to ingest the pill.  And in the long term, so few people are able to keep this pill down long enough to test, that we don’t have really any convincing evidence that the pill does any good at all.  The side effects from even trying to take this pill range from frustration to eating disorders to weight gain, to poor nutrition to death.  So what on this God’s green earth is the point?

I think it’s time to recognize that weight loss is not a behavior–it’s a condition.  And that weight loss as a prescription is probably not worth the paper upon which it is printed.

Love,

Jeanette DePatie AKA The Fat Chick

P.S. Want me to come speak at your school, office, organization or group?  Learn more about my speaking at http://www.jeanettedepatie.com.

PADS Saturday–Kid Rocks Out to Cuba Pete at Local Swimming Pool

Not gonna lie, it’s been a tough week.  So I think it’s time for a PADS Saturday?  What’s a PADS Saturday you ask?  It’s a blog featuring a

Public

Act of

Dancing

Spontaneously

Frankly, I love this kid.  I love him even more than this guy (and that’s sayin’ something)

He is clearly talented and having a blast.  And a big thumbs up to the people in this kid’s life who allows him to feel supported and loved.  And that’s my message to you today–who do you know who needs to be supported and loved?  How can you help somebody out there to live their purpose, be their full and true selves and shake their groove thing?  What can we all do to help make the world a little better?  Because, I’m telling you, this week I’m feeling the need to make a better world.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to bring my speaking and bust a move with you at your school or business or school?  Click HERE to learn more and to BOOK ME!

Doctor Posts Joke Video Demonstrating Stigma That Kills People. Where’s the Hippocratic Oath When You Need It?

So apparently Dr. Terrible is getting a run for his money in my all time list of creeps.  Meet Dr. Irresponsible and Dr. Hatemonger.

So yesterday, a number of people told me about a video posted on Kevin MD that was horrible beyond the normal bonds of horrible.  (Sorry, no power on earth will compel me to link to that ish.  Some things deserve exactly zero clicks.)  And the first thought that came into my mind is, “This video is going to kill people.  Literally.  People are going to see this video and they are going to not go to the doctor and they are going to die.”

You see this video, created by Waqas Khan or (Who calls himself Dr. I Am Sorry) was one of the most nightmare cases of bigotry, prejudice and racism I have seen in a long time.  (Again, not willing to give clicks here.  Google it if you must.)  In this video (which is part of a series of videos of unrestrained bigotry by the way) we see Miss Fatty going to the doctor.  In this short video we get to see all of the following tropes played out:

  • Fat people are slow.
  • Fat people are pushy.
  • Fat people eat nothing but junk food.
  • Fat people are completely incapable of understanding what they are eating.
  • Fat people are lazy.
  • Fat people have done nothing to try to lose weight.
  • Fat people are stupid.
  • Fat women will never find a man.
  • Fat people believe that there is a magic pill that will make them thin.
  • Fat people are guaranteed to get diabetes.
  • Fat people understand nothing about their bodies or their health.
  • Fat people never exercise.
  • Fat people don’t do anything their doctors tell them to do.

Oh and by the way, did I mention that Ms. Fatty is African American?  So all those stereotypes, yup, you can apply them ALL to African American women while you’re at it.  And you can add:

  • African American Women are fat.
  • African American Women are bossy.

A lot of this is punctuated by soliloquies by Dr. I Am Sorry. (Or “Dr. You Should Be Sorry and I Predict Will Be Soon” as I call him) spouting anger and bile and vitriol and bigotry towards his imaginary non-compliant patients that make it clear he has nothing but disgust and hatred towards them.

Okay.  Now let’s get to the killing people part.

We know from several sources, including the Rudd Center for Food Policy and Obesity that weight stigma among American medical professionals is rampant.  In one study 24 percent of nurses reported being repulsed by obese patients and 12 percent preferred not to touch fat patients.  In another study, 48 percent of nurses reported being uncomfortable treating fat patients and 31 percent reported a preference for not having to care for obese patients at all.  Yet another study involving doctors found that two-thirds reported that their obese patients lacked self-control, and 39% stated that their obese patients were lazy.

Prejudice towards obese people in medical settings is well documented and you can bet that patients are aware of it.  Naturally for some fat people, this awareness makes them more fearful about going to the doctor.  In some cases it makes them delay going to the doctor or avoid going to the doctor altogether.  In one study, over 12 percent of women said they canceled or delayed doctor appointments due to concerns about how they would be treated regarding their weight.  In this same study, embarrassment over weight and concerns about how the doctor and staff would treat them was cited as the number one reason among women for cancelling or delaying appointments.  It is also well documented that when people delay or stop going to the doctor, they get sicker and they die sooner.

So we have a situation where:

  1. Doctors, nurses and medical students have a demonstrated bias against fat people.
  2. Fat people are aware of this bias.
  3. The awareness of this bias causes fat people to delay or avoid going to the doctor.
  4. The number one prescription of doctors for people is weight loss even though there is no medically proven (outside of amputation) method to achieve this for most patients–at least not long term, and the weight loss “cure” suggested by doctors is more likely to leave patients sicker, sadder and fatter than before.

And the solution suggested by these two “doctors”  is to create (Dr. Waqas Khan) and publicize (Dr. Kevin) a video that shows a fat African American woman actively demonstrating every stereotypical view that medical professionals typically hold about African American women and fat women while simultaneously demonstrating the medical profession’s hatred and disgust towards these very patients?  How is this not convincing even more people of size not to go to the doctor?  How is this not eventually killing people who have decided not to go to the doctor?  How is Hippocrates not jumping out of his grave to take away their medical licenses?

It’s time for doctors to realize that holding a lot of unsubstantiated and biased views about people of size is lazy, unethical, dangerous and deadly.  And it is way past time for doctors to realize that posting a pile of hate that pours lighter fluid on an already painful and problematic situation for a little click bait is beyond irresponsible–it can be fatal.

In short, shame on you doctors.  Shame. On. YOU.

Sincerely Yours,

Jeanette DePatie (AKA The Fat Chick)

How Long Do We Have to Hate Our Bodies?

It’s not new, but it recently surfaced in my Facebook feed–an article on CNN.com called What the Dying Really Regret.  In this article Kerry Egan, a hospice chaplain who has spent a lot of time consoling those with little time left on this earth, states:

There are many regrets and unfulfilled wishes that patients have shared with me in the months before they die. But the stories about the time they waste hating their bodies, abusing it or letting it be abused — the years people spend not appreciating their body until they are close to leaving it — are some of the saddest.

In this article, the chaplain talks about how, even as they are in hospice, nearing the end of their lives people have not learned to make peace with their bodies.  And how many people, close to losing or actively losing many of the wonderful things about their bodies regret that they never truly appreciated their bodies until they were nearly gone.  She talks about the sadness of it and the waste of it.

I have absolutely no doubt that this is true.  I’ve talked to quite a few women in their seventh and even eight decade that have never learned to make peace with their hips or their thighs or their bellies–hips that have shaken to music of many eras, bellies that have borne babies and thighs that have propelled them inevitably forward to a ripe old age.  And I see the part of them that has been carefully educated to be smaller, to be less than, to show no excess warring with the part of them that wants to stop worrying about it all and just eat the damn cookie.  And it makes me sad.

I say carefully educated, because this body hatred–this need to make ourselves smaller and less than–is something we learn.  In her brilliant piece, Egan states:

…unlike the foolish or best-intentioned mishaps, the terrible accidents, the slip-ups that irrevocably change a life, this regret is not a tragic mistake. It’s intentional. It’s something other people teach them to feel about their bodies; it’s something other people want them to believe.

But in this sad story, there is some good news.  Behavior that can be learned can be unlearned.  We can choose to love our bodies before it is too late.  We can choose not to spend years or decades or a lifetime not hating something so precious, so finite, so personal and so wondrous.  We can chose not to squander our lives and resources on something so unproductive.  We can choose to spend that time, loving ourselves, making ourselves bigger, making our lives better and making things better for everyone around us.

When people ask me why I do what I do, I tell them that this, this is why I do what I do.  Because we are all so precious and life is so precious we simply can’t waste any more of it agonizing about cellulite.  We need to be dancing with our children and our spouses.  We need to be writing our poems and righting the world’s wrongs.  We need to be teaching our children and our parents and everybody how to share this wonderful world before we lose our wonderful world.  And if I, in some tiny, tiny way can help a person get to that place–to the writing and righting a little bit sooner–even by one single day, then I am doing something worthwhile.  Because while one single day may not seem like much to me now, it can seem like forever to someone facing the end of their days.

Love,

Jeanette DePatie (AKA The Fat Chick)

Facebook Envy: Feeling Bad About our Pretend Digital Lives

photo-4

Really struggling to lift that styrofoam…

If you scrolled quickly past the above picture in Facebook, you might be convinced that I’m lifting some pretty hefty weights.  You might feel intimidated by yet another picture of a person seemingly able to do all the things. You might feel in some way inferior because you don’t have a picture in your Facebook feed showing you lifting a righteous amount of weights over your head in triumph.

But if you look closer, you might notice that what I’m actually lifting is made of PVC pipe and painted Styrofoam.  It’s a photo prop from a company called Maxx Bench that I ran across at the IDEA conference yesterday.  If you look at the picture below, you can see that I’m actually lifting the “weight” with ease.  (Not surprising as I estimate that the whole thing weighed less than 3 pounds.)

photo

On the one hand this exercise was a lot of fun.  I mean how often do you get to do that?  I felt pretty fierce.  And I’m glad to promote a really cool new product called MAXX Bench that takes the danger and fear out of the bench press.  But it also got me thinking.  How often do we scroll through somebody’s feed and think, “Wow that person’s life is really cool!  I wish my life was that cool.”  And I wondered if my totally pretend picture might inspire that same reaction in somebody else.  I know it happens to me.  I see somebody’s feed and I think that they are so much cooler than me and that I could never possibly reach their level  of awesomeness and bad assery.  In fact this feeling happens often enough to launch scientific studies and create a new phrase “Facebook envy”.  But our digital lives are really a construct.  Even if we aren’t digitally manipulating the pictures or pulling off complete hoaxes (like my bit of “weight lifting” fun above) we are editing.  We are choosing which bits of ourselves to share online.  And although some of us tend to share some deep and not entirely flattering bits about ourselves from time to time, it’s pretty clear that most of us, most of the time, tend to share the cool stuff.

This disconnect is all the greater for the celebrities we admire.  Many of them have handlers and PR specialists and people who airbrush all their photos and painstakingly edit every frame of their appearance in a particular film.  I am not blaming these folks.  Their careers in many cases depend on giving the illusion of being consistently and constantly flawless.  And the game has gotten so sophisticated that one might fear simply going to Starbucks without a team of makeup artists, photographers, digital ret-ouchers, and extra, extra strong turbo Spanx.  We are all caught in a deadly game of visual perfection one-upsmanship.  We make friends and fall in love based on our ability to create a compelling avatar–a perfect profile.

But I think where we really get messed up, is when we begin to believe that this stuff is real–that this is a level to which we should realistically aspire.  Because most of it is giant steaming piles of male cow poo.  We aren’t seeing what these folks look like when they roll out of bed in the morning.  We aren’t seeing blemishes or smelling morning breath or seeing PMS bloat from the celebrities or even from the Facebook feeds of mere mortals.  We’re mostly seeing the carefully selected cool bits.

So maybe the next time you start wondering if your life could possibly be as cool as that person you see on Facebook, you should really be wondering if anybody’s  life could possibly be that cool.  Maybe it’s time to stop comparing yourself to stuff that is carefully edited and not so much really real.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want to share your real stories as a plus-sized exerciser?  We’ve extended the date for the call for submissions for our new anthology “Throwing our Weight Around–Real Stories of Fat People in the Fitness World”.  You can contribute a scholarly article or a poem or a personal story or whatever!  Click HERE for the CFP. oxoxoxo

Diminishing Distress Dials Down Diabetes

First do no harm. Diabetes scare tactics just might kill you.

I recently ran across this article on Diabetes Hub which describes two important studies which correlate distress with poorer outcomes for people coping with diabetes.  The first of these studies involved a randomized trial of 150 women with uncontrolled diabetes.  What the study found is that those women in the study who were able to reduce their level of disease-related distress had significantly improved glycemic control.

Typical sources of disease related distress included fear of getting sicker and feelings of isolation or overwhelm in relation to disease management and treatment.  The EMPOWER study tested various forms of treatment interventions and found that regardless of treatment methodology, those people who were able to lower their distress were more compliant with treatment protocols:

HbA1c dropped much more substantially in those in whom distress was lowered, compared to those with whom distress was unchanged or increased,” Dr. Cummings said. “Medication adherence, self-care behaviors, and diabetes empowerment and self-efficacy were all substantially improved in the group with lower levels of distress at the end of the trial.

The doctors admit that they don’t quite know why lowering distress has such a significant effect on glycemic control among people with diabetes.  However it seems that working to lower distress among people with the disease is an important treatment goal.  According to Dr. Cummings:

We’re surprised at the number of these women caring for children, grandchildren, and other members of their families, often while working, and yet not finding time to care for themselves. It is clearly an important cultural phenomenon that we need to understand better.

The article went on to discuss data gathered from another important study: the national Reasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study.  Dr. Cummings noted that in this study which included 4,000 black and white adults 45 years and older with diabetes and nearly 18,000 adults without diabetes, those subjects with diabetes were more likely to suffer from depression or distress (26.7% vs. 23.2%, P < .001) or both (10.1% vs. 6.2%, P < .001), compared with those without diabetes.  Those people who had diabetes and also symptoms of distress or depression had higher risks for stroke and CV death than people with diabetes without depression or distress.

What all of this seems to make clear to me is the deep need for compassionate, blame-free, stigma-free, evidence-based health care for people coping with diabetes.  The notion of scaring people straight or using dire warnings to fuel completely unrealistic weight loss goals may be more than counterproductive–they might prove especially medically dangerous for this population.  Many forums for people with diabetes are filled with horror stories about how members were stigmatized, told their conditions were their fault and told that if they didn’t get thin, they wouldn’t live to see their children or grandchildren grow up.

But maybe what really needs to grow up is our approach to helping people with diabetes live better, longer and happier lives.  Maybe we need to spend a little less time pointing fingers and a little more time holding hands as we help people make small, incremental, manageable and realistic changes in their lives.  It’s just possible that fear tactics are doing more to harm people with diabetes than to help them.

That’s one of the reasons I’m so excited to be giving a presentation at the upcoming Take Control Of Your Diabetes Conference on September 26 in San Diego, CA  The event focuses on helping people with diabetes take positive, small and sustainable steps to better health.