Tag Archives: BMI

New Video and a New Plan

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CBSstill

There’s no question, I’ve been away for a while.  As this video demonstrates, I’m still spending plenty of time talking about Health At Every Size and loving the skin you’re in.  And now I am BACK baby, and I am super excited to tell you what my dear friend and business partner Ragen Chastain and I have been cooking up while I’ve been gone.  It’s called the Body Love Obstacle Course or BLOC.  We’ve been working on it for a while now, and I think you’re going to love it.  It’s designed to help you over around and through the body love obstacles that keep you from the life of your dreams.

And we’re super excited to be kicking it off with a brand spanking new FREE video. I think this might be the best video we’ve ever shot….

BLOC VIDEO

It’s about how the way we feel about our bodies affects every area of our lives, and about how we can use that fact to create our best careers, relationships, and life.

BLOC VIDEO

(There’s only one catch – you *might* have to renew your email subscription in order to see this video.)

Ragen and I had a blast shooting this one – even though we live less than an hour apart, we don’t get to see each as often as we’d like, so before we shot the video we rehearsed over
a delicious dumpling lunch, and got super psyched to shoot the video!  So we got to eat fabulous dumplings AND we get to share some of our most powerful ideas about overcoming body hatred, kicking butt and taking names.  Talk about a WIN/WIN situation.  I hope you’ll take a moment to hop on over to look at our first free BLOC video.  And looking forward to talking to you soon!

Love,

Jeanette DePatie

(AKA The Fat Chick)

P.S. This video will only be up for a few days…
go check it out right now:

 

Recent Tests Show Sending “Fat Letters” Home from School Earns a Failing Grade

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Forgive me for once again pointing out the blazingly obvious, but recent studies have not been able to find any actual benefits from sending “fat letters” home from school.  What is a “fat letter” you ask?  Many schools are now doing BMI testing on the entire student body.  When a student’s BMI is considered to be too high (using some relatively arbitrary measure) a letter is sent home from school to the student’s parent that goes something like this:

Hi.

Your kid is fat.  WE obviously don’t trust you to know your own kid is fat, because if you knew, you’d obviously have fixed it by now.  We also believe that you don’t know how to keep your kid healthy (because FAT) so here’s some arbitrary weight loss advice that hasn’t been shown to work long-term on anybody, but we’re sending it anyways (because FAT).  And obviously we know that you need help because your kid must be eating a whole cake and 4 liters of sugary soda every day and must need your assistance to run the remote as they watch TV because that is HOW kids get fat.

Also, clearly you aren’t showing the appropriate level of panic about this situation (because OMG Deathfat!) so here are some alarmist health statistics and nonsensical vague future health threats that indicate your kid won’t live as long as you (even though the statistics don’t bear this out because even though we’re in education EEK!  MATH!).  We don’t plan on doing anything to protect your kid from stigma because clearly if you were doing your job right there would be no stigma to protect against (and we don’t like the way your kid looks because OMG jiggly FAT!)

You’re welcome,

Signed Your Kid’s School

Wait, what?  You mean parents don’t love these letters?  You mean despite the fact there is nothing in medical science that indicates that there is a formula for long term weight loss, these kids don’t magically slim down like gazelles and become the most popular kids in the class after their parents receive the letter? Really?

Nope.  In THIS very recent study and this earlier study, no link was found between sending home fat letters and BMI, weight, health behaviors or health outcomes.  This doesn’t meant that the letters have no effect (for example we don’t know if it has an effect on self esteem or the price of broccoli in Boise.)  It simply means that after all the hoopla and distractions from study and public money spent, there is no discernable benefit.

Let me say this again.  State money is being spent on an educational program with no definable benefit.  Which begs the question, do fat people cost our country money or does the knee jerk requirement to “do something about the fatties” whether it does any good or not cost our country money.  Are we paying a premium to create a state-sanctioned forum for people to yell at parents of fat kids because we don’t like the way they look?  (We could create a thread on Reddit.com for a whole lot less money.  Look how much money I saved us!)

And let’s be clear.  This is not just a few dollars at a few schools.  According to the New York Times, nine states require that “fat letters” be sent home to parents.  And today, 25 states weigh public school students to monitor population data on obesity rates.

Yet the results section of Gee’s study states:

BMI screening and parental notification during late adolescence, given prior screening and notification in early adolescence, was not significantly related to BMI-for-age z-scores, the probability of being in a lower weight classification or exercise and dietary intake behaviors.

So what “grade” do you give this exercise?  After careful consideration, I’d have to give this project an “F”.

Love, Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to come speak at your school?  Check out my info here!

The 1% efficacy rate and weight loss as a prescription

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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.

New Study Suggests Fat Correlated With Lower Risk For Dementia

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FatBrain

Nearly 60 percent of the brain is composed of fatty acids.

Previously we heard that obesity increased your risk of dementia.  Now a new study contradicts these former findings and suggests that increased body size is correlated with a decreased risk for dementia.  I say correlated with, because no causal link has yet been found.  And we don’t want to go the way of those finger pointers who say that being fat “causes” sickness by saying being fat “prevents” sickness.  We simply don’t know that much yet.

However, this new study does seem to indicate that there is a strong correlation between low body weight and dementia in middle aged people.  The study reviewed statistics for nearly 2 Million people from the United Kingdom Clinical Practice Research Datalink (CPRD).  The CPRD data included people over 40 who had their BMI measured between 1992 and 2007.  (The median age for those measured was 55.)

The study found that compared to those of a “healthy weight” (heavy airquotes here) those who were underweight (BMI less than 20) had a 34% higher risk for dementia.  As people got fatter, their risk for dementia decreased–with the fattest people (BMI over 40) experiencing a 29 percent lower risk of dementia than those with “healthy weight”.

Cue the inevitable articles about the “obesity paradox”.  This is the title given to the fact that fat people are at lower risk for certain conditions than skinny people, despite the medical establishment’s insistence that this shouldn’t be the case.  This is the label given to the fact that overall, “overweight” people live longer than “healthy weight” people.  It really makes me wonder when they are finally going to do away with the “healthy weight” label, since in many cases, other weights are healthier than the healthy weight level.  And it also makes me wonder when they are going to stop calling something a paradox, when it clearly isn’t one.  Some weight ranges come with higher risks in some areas and lower risks in other areas.  And maybe we will come to realize that there isn’t one healthy weight, but rather a range of risks that slide around in various places on the BMI chart.

As reported by the BBC (LINK WARNING, HEADLESS FATTY PHOTOS GALORE) Alzheimer’s Society’s Dr Doug Brown said: “People should make positive lifestyle choices to keep their brains healthy by taking regular exercise, not smoking and following a healthy balanced diet.”  This seems sound HAES oriented advice to me.  Naturally, despite the fact that this study is much larger and more detailed than previous studies that claimed that obesity increased the risk for dementia, there’s a lot of head scratching and backpedaling going on.  The article is careful to point out that there is no clear causal link yet evident (hence the opening of this blog post).  If you have the sanity points to spare, you can click on that BBC link earlier in this paragraph to read things like, “Sure you’ll be less likely to get dementia if you live long enough.”  and “This is no excuse to sit on the couch and eat an extra piece of cake.”  Because somehow, no matter what the evidence shows, some medical professionals just have to get their jab in at the fatties.

I am just hopelessly naive enough to imagine a day when the “healthy weight” category is called something else.  I imagine that over time we will find more and more evidence that being fat has risks, being skinny has risks and being midsized has risks.  After all, being alive has risks, for people of all sizes.  Maybe we can finally focus on living the best, most productive, most joyful and healthiest life in the bodies we have right now.

Food for thought.

Love,

Jeanette DePatie (AKA The Fat Chick)

Paris Cracks Down on Super Skinny Models

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French MPs have voted to make it illegal to put models who are too thin on the catwalk.  Modeling agencies who put models on the catwalk who are deemed too thin face significant fines (up to $75,000) and even more astonishingly up to six months in prison.

The MPs are engaging in this crackdown in an attempt to help curb anorexia and other eating disorders in France.  The fashion industry, especially in Paris, has a very important cultural effect on young women.  And there is no question that the average Paris fashion model is startlingly thin.  According to the WHO, a BMI under 18.5 is considered underweight.  18 is considered malnourished and 17 is considered severely malnourished.  The average fashion model is 5ft. 9in. and weighs in at just over 110 pounds.  This makes the average BMI in the fashion industry a 16.  The French MPs have thus far failed to determine what BMI will be considered too low for the fashion industry.

The lower house of Parliament also voted recently to mark all photos of models that have been retouched to change body size or shape and to make promotion of anorexia on the Internet.  One supposes that it is fairly easy to legislate the first of these ideas, but I admit, I’m not sure how they will enforce the latter.

While we all know that BMI is an unreliable indicator of health, nevertheless extremely low weights (along with extremely high weights) are associated with health risks.  In particular, extremely low weights are sometimes indicative of Anorexia–a serious eating disorder which has proven the most deadly of all forms of mental illness.  While one could imagine that some of these women are simply naturally very thin, it is unlikely that all or even most of them have a natural BMI that low.  And first hand accounts from many models who speak of living on diet coke and cotton balls, and who pass out at photo shoots from lack of nutrition, lead us to believe that achieving a weight this low for many models requires extreme measures.

Naturally the fashion industry is fighting back.  They state that just because their models are thin, does not mean they are anorexic.  And there is a certain amount of truth to that.  If we are going to argue for body diversity, we must accept that some people are naturally very thin, just as some people are naturally very fat. And if we ban very thin models, shouldn’t we ban very fat ones too?

Personally, I think it’s important to recognize that the Paris fashion industry is not representing body diversity on the catwalk.  The average Paris fashion model’s body size is far, FAR below the national average for BMI.  And there is virtually no representation of even averaged sized women on the catwalk.  By focusing the fashion shows on body sizes that are way below average, the modeling industry creates a “new normal”.  As people come to see a body type that is not healthy or normal for the vast majority of the population as the right and most desired one.

So what say you?  Do you think these proposed French measures go too far?  Or not far enough?  I’d love to hear from you in the comments below.

Another study indicates fitness more important than fatness for longevity

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Functional fitness kitty adds activities for daily living (ADLs).

Recently on one of the lists I was introduced to another study which suggests that one of the most important things we can do to have a longer life is to exercise–at least a little bit.  The study report begins by pointing out that in the past there has been an assumption that exercise helps people live longer indirectly because it helps them lose weight or change their body size.  However the paper goes on to state that recent evidence suggests that physical activity (including recreational activity and activity accumulated during work hours) seems to help people live longer regardless of whether or not there is a change in BMI or body size:

Whereas it could be hypothesized that PA exerts its influence on mortality indirectly through reducing adiposity, recent data from the European Prospective Investigation into Cancer and Nutrition (EPIC) suggest that PA is unrelated to change in body weight and inversely, albeit weakly, associated with change in WC (12). Thus, PA may interact differentially with BMI and WCin relation to all-cause mortality.

So the study went on to test this question.  Is it the change in body size or the activity itself that affects longevity?  And the answer seemed to be pretty clear that physical activity helps people live longer whether or not their was weight loss or a change in body size.  And furthermore, the test indicates that the biggest differences in longevity seem to be between the completely sedentary and the moderately inactive groups.  In other words, they hypothesized that the place where there is the greatest impact in longevity is moving people from the group that doesn’t do any exercise at all to the group that does a little bit of exercise.  More exercise helps a bit more.  But moving out of the completely sedentary group seems to have the most impact.

The greatest reductions in mortality risk were observed between the 2 lowest activity groups across levels of general and abdominal adiposity, which suggests that efforts to encourage even small increases in activity in inactive individuals may be beneficial topublic health.
Am J Clin Nutr doi: 10.3945/ajcn.114.100065.

So what does this mean to us?  First of all, let me plainly state that nobody is  under any obligation to prioritize their health or engage in any activity if they don’t want to.  Your body is your own and you get to decide how you want to live.  But if you are somebody who is interested in living longer, perhaps one of the best things you can do (outside of being rich and born to parents with great genes) is to do at least a little bit of exercise.

So what does this mean to public health?  To me it suggests that if we really want people to live longer, we need to focus on helping them get more active.  Outside of the fact that most weight loss attempts fail, and about 1/3 of the time lead to people getting larger, outside of the fact that many of the more radical weight loss schemes (like surgery) can lead to life-altering side effects, is the simple fact that getting people to exercise even a little bit seems to have a more dramatic effect.  And getting people to exercise–provided they can do it in a safe environment–seems to be a lot less risky.

For so many reasons, I think it’s time to move outside of the weight loss rhetoric about the war on obesity and just move into an environment focused on making it physically, emotionally and financially safe, comfortable and accessible for all folks to integrate physical activity into their lives.  That is, if we are ready to stop worrying about making money upon broken dreams and start helping people actually have better lives.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. I’m setting my spring speaking schedule.  Want to book me to speak to your group or school?  Send an email to jeanette@thefatchick.com.  I can work to fit most programs and budgets.  You can read more HERE.

Is Godzilla Yo-Yo Dieting?

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Japanese fans are up in arms about the new Americanized Godzilla’s hefty size–citing poor diet as cause for the unwelcome change.

The trailers for the newest Godzilla film have hit American shores and has spawned some significant controversy.  It appears that Godzilla has come “under fire” not for his acting (which has been notably wooden in the past) but for his BMI.  No we are not talking about the Bad Monster Index–where Godzilla holds the undisputed title of King of the Monsters.  We are talking about the Body Mass Index.  Many are currently arguing that Godzilla is just sporting too much weight on his 350-foot high frame.  Using the current BMI, Godzilla could weigh about 750,000 pounds before he hit the dreaded “Obese” category.  Godzilla has not been forthcoming about his weight, but many Japanese fans have calculated that the hapless lizard may have stomped out of the “ideal weight” category.

“He’s so fat I laughed,” was one particularly cutting remark found on Japanese forum 2chan.  Others have referred to him as “metabozilla”, “marshmallow Godzilla” and even “pudgy and cute”.  Some have speculated that Godzilla’s size is due in part to his American diet and sedentary lifestyle.  “That’s what happens when all you do is eat Snickers bars,” said one commenter.

Much of this has led to speculation about Godzilla’s diet.  He has never been shown on screen eating (although he has ingested a nuclear reactor and seemed to absorb energy from that).  He has been seen in comic books eating raw seafood.  Most people guess that he lives largely on radiation and sushi.

It seems pretty likely that Godzilla has to eat quite a bit to sustain is 350 foot high body.  An African elephant weighs in at about 7,000 pounds and needs to eat about 500 lbs. of plant matter per day to sustain itself.  Using that same ratio, Godzilla would need to eat about 50,000 pounds of plant per day.  Now the King of Monsters might be able to absorb some of his energy via nuclear radiation.  And naturally protein sources like fish are more dense in calories than say, trees.  But I ask you, do we really want a creature that needs to eat 10,000 pounds or more of food per day to turn to a protein diet?    So far as we know, Godzilla does not eat people, yet.  But I don’t know if I want to encourage him.

But Godzilla hasn’t always been svelte.  A quick look at his film debut publicity photos in 1954 show a relatively “fluffy” monster with more of a pear-shaped figure.

There is no question that Godzilla has gotten bigger over the years.  Traditionally, the giant lizard has grown larger in proportion to the buildings he stomps around.  The Godzilla of 1954 was a mere 50 meters tall.  The newest Godzilla is over 100 meters tall and noticeably beefier:

But if you look carefully at the creature’s shape, you might notice something very interesting and somewhat familiar.  It’s even clearer if you look at this picture here:

Clearly the great monster’s shape has cycled too.  He appeared to have shed some pounds in the the MusoGogi period (1964) beefed up considerably in the BioGogi period (1989-91) gone through some sort of radical weight loss program in the Shodaijira period (1998) and bulked back up for his current appearances.  Seem familiar to you?  Seemed that way to me too.  In fact, I think Godzilla is experiencing the most common outcome of trying to stay slim.  I think the King of Monsters is weight cycling–probably from yo-yo dieting.

Now there is no way to know for sure.  As my good friend Ragen Chastain says, the only thing you can know about a fat  person (or monster) by looking at them is your own prejudices about fat people (or giant lizards).  But if our good friend Godzilla is experiencing weight cycling, he would certainly be experiencing the same thing that most people who try to lose weight experience.  Most people are able to keep some weight off for a while, but the vast majority of folks (90 percent or more) regain the weight they’ve lost and often a little more.

So this leads us to the question of what should be done about Tokyo’s most famous building-stomper.  I think if we are seriously going to spill digital ink regarding the size of a fictitious reptile who bangs buses together for fun, we should use this as a truly teachable moment.  Let’s talk about what really works in making creatures of all shapes and sizes happier and healthier.  I think the first thing we should do, is to stop trying to shame the poor creature.  There is ample evidence after all, that shame doesn’t help anybody lose weight.  I’m sure the producers at The Biggest Loser are planning epic monster battles between Godzilla and their “Monster Trainers” as we speak.  And even though the King of Monsters’ agent is probably taking calls right now from diet companies seeking his endorsement for the new “Monster Weight Loss Formula”, we should probably discourage him from falling into his old habits of dieting and weight cycling.

I recommend the same thing for Godzilla that I recommend for everybody else.  He should eat a varied diet including foods that he loves (but not including people).  He should engage in joyful and pleasurable physical activities (not too close to major cities).  In fact, I think he should try my DVD.  He should sleep well.   And he should manage his stress (again, hopefully not too close to major metropolitan areas).   At 60 years old, Godzilla is showing no signs of slowing.  If he follows these simple recommendations, he’s likely to stay happy and healthy for many years to come.  Which is good.  Because I freakin’ LOVE this guy.

Love,

Jeanette DePatie (AKA The Fat Chick)

CEO: Every BODY Can Exercise.com

 

Why BMI stands for “Blatantly Meaningless Information”

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Yup, higher shoe size means higher BMI. Maybe we should re-institute foot binding for better health?

The LA Times has published another awesome article, this time taking aim at BMI.  The article headline states “For nearly 1 in 5 Americans, BMI may tell the wrong story”.  Although one of the main studies actually places the misdiagnosis statistic closer to 2 in 5 Americans, I have to give the LA Times credit for posting this story which goes on to detail something that many of us in the HAES (R) universe already know: BMI is not a good predictor of individual health.  In short:

Having a high BMI does not mean you have poor metabolic health.  Having a low BMI does not mean you have good metabolic health.

So why is this important?  Well for a lot of reasons.  First off, if your doctor is using BMI to determine whether or not you should get further screenings or tests, he or she is using an extremely unreliable metric to make this determination.  This means as a fat person you may be exposed to a lot of tests you really don’t need.  This means as a thin person, your doctor may miss some stuff that is really important or even life-threatening.  I often wonder if a significant proportion of the medical costs associated with fat people are because we have so many more tests done.  Or even if higher percentages of certain diagnoses among fat people are in part because we look so much harder for these diagnoses among fat people.

Another reason that BMI bias is such a big problem is that the workplace wellness gurus are using it to coerce or even force us into interventions that may be entirely inappropriate for us.  For example, I’ve been talking a lot about this Michigan “walking program” for fatties.  BMI was used as the sole determinant as to who had to participate.  Those with higher BMIs were told they either had to wear a pedometer that reported their steps to the “home office” or they had to go to Weight Watchers.  There was no initial fitness assessment done.  There was no assessment of eating behaviors.  The program simply assumes that people with higher BMIs don’t engage in fitness and eat very poorly.  It’s entirely possible that people in the program had to reduce other, more strenuous and more enjoyable exercise programs in order to comply with the stupid walking rules.  It’s entirely possible that people in the program with well-balanced healthy eating habits were encouraged towards more disordered eating habits after their new stint with Weight Watchers.  It’s almost certain that people with low BMIs who are also sedentary and eat nothing but junk food were patted on the head and told to “keep up the good work”.

But we’ll never know because they never tested this stuff.

You know what?  When company money and government money and my money gets spent on stupid health programs that are just as likely to make people less healthy than before, and nobody bothers to test the hypotheses because “fatties” I get pretty annoyed.  In fact I’m crossing right over the line towards enraged.

It’s not like this research is all new.  It’s not like the problems inherent in the BMI as a measurement of individual health haven’t been known for decades.  But as long as entire industries are set on putting their fingers in their ears and chanting, “La, la, la, I can’t HEAR you!” I’m just gonna have to keep on saying the same things over and over and over.  As long as people walk around with misdiagnosed brain injuries because doctors simply think they need to lose weight, as long as thin people miss out on important medical screenings because they are assumed well, and as long as some insurance programs think it’s okay to strap a piece of hardware to my a@@ to track whether I’m moving enough just because of my dress size, I’m gonna keep on talking.

You hear that universe?  I’ll keep shaking my chubby fist and you and shouting that your BS. Measuring. Instrument. is not a valid way to understand anything about who I am.

Love,

The Fat Chick

 

 

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Proof Please

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Web_Proof

So very often these days we hear that the world has deemed to help the portly because they so desperately need help and the world is being nice–and stuff.  Millions upon millions are invested in trying to prove that fat people are unhealthy, and if they would just eat a little less and move a little more, all their problems would be solved, everybody in the world would be healthy, and good, quality health insurance would cost everybody $1.  The fact that despite the millions of dollars spent, nobody has been able to prove these or demonstrate any way to make this magical weight loss happen on all but a fleeting and temporary basis doesn’t seem to deter anybody from testing this hypothesis again and again.

And even when the proof is not available, or indeed the available evidence says that your “weight intervention” causes negative effects and makes people fatter current policy seems to involve simply ignoring those pesky little facts.

Take the current practice of weighing and measuring kids at school and then sending home “BMI report cards”.  Despite showing again, and again and again that shame doesn’t make kids thinner or healthier, showing that shame causes kids to engage in more unhealthy behavior, that shame makes kids fatter, we still do this.  Why?  The National Eating Disorder Information Center issued the following statement regarding BMI testing in schools:

What the American Academy of Pediatrics (AAP) seems to be ignoring in its advocacy of weighing and measuring the height of schoolchildren is the risk it carries not just to increase body-based bullying from student’s teachers and peers, but the risk to children’s developing self-stigma and poor body image.

Body-based bullying continues to be the most common cause of bullying in youth. 29% of girls and 15% of boys are already teased about their weight at home. By grade seven, up to 30% of girls and 25% of boys are teased by other students. Poor body image has been found to stop youth from engaging in social, academic and physical opportunities. It limits willingness to express an opinion. In perpetuating focus on body shapes and sizes rather than on encouraging health providing attitudes and behaviours in children regardless of size, what are our schools (and public health) teaching?

However, it seems that plans to do BMI testing and BMI report cards in schools is continuing throughout North America.

This also reminds me of another recent situation I had recently reported.  Blue Care of Michigan is still touting the positive results of their “enforced march” walking program for fatties despite the fact that there is no evidence at all that those who participated either lost weight, or had any positive health outcomes associated with the program.  They apparently did nothing to track the original fitness level of the plus-sized participants and had no idea whether or not these folks were already active.  They just told these people that unless they wanted to pay an additional $2,000/year they had to participate.  They also forced those who participated to either be a member of Weight Watchers or wear a monitor which counted their steps during the day.  Just like a prisoner, they were forced to wear a physical implement on their bodies that told their insurance overlords what they were doing throughout the day.  Just because their BMI is over 30.  They declared this project a success even though nearly 1/3 of the 12 percent of participants who bothered to respond to the survey said they hated the program and found it coercive.  For more information, you may wish to read this article from my friend and colleague Jon Robison.

Throughout all this rhetoric about making fat people into “healthy thin people”.  Throughout all this spending on proving that fat people can become thin people on more than a very temporary basis and that making fat people into thin people will make them healthy there is one thing continually missing and that thing is proof.

When the available evidence points to the opposite of the fat people can become thin people, or fat people can’t be healthy people or fat kids just have ignorant parents rhetoric, the powers that be either request more money to re-test the hypothesis or simply ignore the inconvenient facts.

You may have heard of iatrogenic effects in medicine.  Dictionary.com defines them as: (of an illness or symptoms) induced in a patient as the result of a physician’s words or actions, esp as a consequence of taking a drug prescribed by the physician.

And good old Dictionary.com also defines iatrogenic as relates to social welfare: “(of a problem) induced by the means of treating a problem but ascribed to the continuing natural development of the problem being treated”.

Some experts have suggested that the “obesity crisis” is a textbook example of iatrogenic effects in both medicine and social welfare.  But I wonder if the “obesity crisis” isn’t responsible for iatrogenic effects in the economy as well.  If the response to the mounting pile of evidence that “diets don’t work” and “shame doesn’t work” and “fat people can be healthy” is always, “let’s pay for more tests” or “let’s do the weight loss junk but try harder this time” the obesity crisis will continue to be very, very expensive.

But I think the treatment for the economic effects of the hysteria surrounding the “obesity crisis” may be as simple as this.  Demand proof.  If your insurance company wants to put you on a walking program without doing an intake of any kind or presenting any data regarding the efficacy of the program, demand proof.  If your kid’s school wants to measure their BMI along with everybody else’s and send home a BMI report card, demand proof that this makes kids happier or healthier.  It’s not easy.  It’s not fun.  But the rights of fat people to enjoy life, liberty and the pursuit of happiness demands that we, the fierce fat folks, demand proof.

Love,

The Fat Chick

 

 

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New Zealand Tells South African Chef, “You’re Too Fat to Live Here!”

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I know I am not the first and I certainly hope I’m not to write about this story.  Because you know what?  This scares me right out of my sparkly, yet sensible shoes.  Last week, New Zealand immigration officials told South African chef Albert Buitenhuis that due to his weight of 286 pounds he has an “unacceptable standard of health” and faces expulsion from the country.  Despite the fact that Buitenhuis has actually lost weight since he was originally admitted to the country in 2007, he has lost his work visa because he failed to lose weight.

He needed to stop working immediately.  And because Albert was the primary applicant on the original work visa, his wife needed to stop working as well.

An immigration spokesperson has stated that Mr Buitenhuis’s application had been rejected because his obesity put him at “significant risk” of complications including diabetes, hypertension and heart disease.  The spokesman reportedly said:

“Unless it is in the extreme, obesity will not in itself cause an applicant to fail health screening requirements, but INZ’s medical assessors have to consider to what extent there might be indications of future high-cost and high-need demand for health services,”

It should be noted that Albert may also need a knee replacement which could cost the health system over $20,000.  However, it has also been reported that the fact that Mr. Buitenhuis’ BMI was over 35, originally triggered the rejection of his work visa renewal.

This story has hit international news outlets including the Daily Mail and the BBC.  So I am hopeful this won’t just slip into obscurity in the next day or two, and I am eager to hear how Albert’s appeal process proceeds.  Because I have to admit, I find this story terrifying and frustrating in the extreme.

Here are just a few points:

1.  Immigration officials arbitrarily choose to apply or not apply BMI statistics in regards to work visa renewal.  If the irrational or irregular application of body size regulations are enough to leave people traveling on a jet plane in the lurch, think of the effect it can have on people moving their entire lives from one country to another.  And as we’ve seen in regards to flying on airplanes, if fat people are unable to ascertain exactly how these regulations will apply to them they are more likely to avoid the situation altogether.

2.  It appears that the rules changed after Albert moved to New Zealand.  Albert and his wife set down roots, made friends, built a career and a life, and then the rug got pulled out from under them.  This should be a chilling tale for everyone interested in ever immigrating anywhere.

3.  It appears the New Zealand Immigration ministry are using BMI and health interchangeably.  There is ample evidence that as a health metric BMI is extremely problematic and unreliable.  There is significant evidence that people who have a BMI in the “ideal range” actually live shorter lives than those in the “overweight” range.  Furthermore, I have heard no indication that New Zealand’s Immigration ministry are using other, far more reliable health metrics in determining visa renewal status.  Are they taking into account issues like: stress level, sedentary lifestyle, tobacco use, levels of discrimination, lack of sleep, working third shift or driving a motorcycle, being older, or being male?  There’s also evidence that bald men are more likely to have heart disease and taller women are more likely to get cancer.  Why are they taking this one extremely unreliable metric (BMI) out of context and using it to determine immigration status?

4.  Is BMI used because it is a “cheap shot” both figuratively and literally?  Despite the many, many questions about the effectiveness of BMI as a health metric, there is no question that it is extremely easy to measure and verify.  And I wonder whether discrimination based on body size is cheap politically as well?  Immigration necessarily needs to limit the number of people who can enter and stay in a country.  And they need to make sure the limitations that are used are politically tenable.  Are fat people singled out and discriminated against simply because politically, they are easy targets?

I admit that I can’t claim to know everything that is going on in this case.  I will be watching with interest to see how it plays out.  But, in any case, I think this is further proof that we need to be ever vigilant of new ways that discrimination is heaped upon people of size.

Love,

The Fat Chick

UPDATE: Don’t miss this amazing post by Angela Meadows in Huff Po!  And don’t forget to like the story and comment if you have the sanity points to spare!

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Buy my book: The Fat Chick Works Out! (Fitness that is Fun and Feasible for Folks of All Ages, Shapes Sizes and Abilities)–available in softcover and e-book versions

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