Tag Archives: HAES

Asking for help.

HELP

If I’ve learned anything this week it’s this.  Ask for help.  Ask for it sooner rather than later.  Do NOT spend time exhausting every other option on the planet first.  Just ask for help.

I think a lot of my identity is tied up with the notion that I am self sufficient.  I can handle anything.  Like I’m some sort of hybrid of Bear Grylls and Macgyver.  Just set me down with a laptop, a sharp object and a roll of duct tape and I can HANDLE it.  But this self view sometimes really gets in my way.

This week I’ve had two moments where I finally broke down (often sobbing) and asked for help about technical stuff I just didn’t understand.  And both times, the person I asked was able to help me.  And both times the helper asked me, “Why didn’t you come to me sooner?”  This is a really good question.  My stubbornness.  My need to be smart and independent and RIGHT cost me untold hours of frustration that could have been avoided.

And  I think this is part of the reason why Ragen and I have created the Body Love Obstacle Course.  I mean of course, many of us can get to a place of loving our bodies on our own.   In many ways Ragen and I did just that.  But why go it alone when you don’t have to?  Why suffer untold hours of frustration?  Why not ask for help a little sooner?

I’m proud to say we’ve released the second of our free BLOC videos here:

Click Here to check out the video!

I hope you’ll take a minute, click the button and take a look.  It’s all about being grateful for the body you have right now.  You might have to opt in.  But I hope you will.  Because we’ll all get by with a little less stubbornness and a little help from our friends.

 

Love,

Jeanette DePatie

AKA The Fat Chick

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New Video and a New Plan

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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:

 

Tuesday Reviewsday–Harriet Brown’s Body of Truth

For today’s Tuesday Reviewsday, I am pleased to discuss Harriet Brown’s recently released book “Body of Truth”.  Harriet Brown is already well known for her previous book, “Brave Girl Eating” about her experiences with her daughter who suffered from Anorexia.  “Body of Truth” uncovers Harriet’s epiphany regarding her own weight obsessed life within a society who complemented her daughter’s svelte figure even when they knew she was recovering from anorexia.

Like many of us, Harriet’s weight obsession and body hatred started early in life and lasted through most of middle age.  It wasn’t until she saw the devastating effects of anorexia that she even began to question society’s readiness to conflate thinness and health and began to question her seeming moral obligation to have thin thighs.  Harriet describes her own struggle in the midst of her Jewish family and describes the dichotomy of being in a culture that loves food and values hostesses who provide abundance at the dinner table while being terrified of fat.

Throughout the book, Harriet’s journalistic roots shine through clearly.  She provides a wealth of current information and facts to back up her assertion that we as a culture are a bit off the rails when it comes to body image and weight.  Much of the ground covered here will be familiar to those of us who have studied this area for some time.  There are the statistics about the failure of dieting.  There is an in-depth discussion of the “obesity paradox”.  And she covers Flegal’s research and the ensuing shameful medical backlash.  She follows the money and describes the intense conflicts of interest displayed by so many who serve on boards and are paid to do research to support the “war on obesity”.  However, there is much recent research covered in the book, and a significant portion of the anecdotal materials (for example on Professor Miller) are new and fresh.

Above all, I feel Harriet does a terrific job of weaving her personal narrative with a tight journalistic style that presents facts and evidence in a way that makes for a fast and enjoyable read.  I really  enjoyed the book and I think it may especially resonate with middle-aged readers who are just coming to HAES at this point in their lives.  I strongly recommend this powerful and enjoyable book.

Now, before I close, on to a bit of business.  Have you heard about our new Fit Fatties Virtual Events?  Have you signed up yet?  It’s super cool and you don’t want to miss it.  This time around the events feature a quintathlon option as well as Fit Fatties Flair.  Learn more HERE!

Also, this year I am seeking to earn a new fitness certification and so I am offering special discounts off of my regular speaking fees.  To learn more, send me an email describing your speaking request to jeanette at the fat chick dot com.  Learn more about my speaking HERE!

Love,

Jeanette DePatie (AKA The Fat Chick)

New Study Suggests Fat Correlated With Lower Risk For Dementia

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)

When Docs don’t listen…

I have to thank my colleague Michelle May, M.D., CSP for recently posting links to two articles that I had missed in the past.  Both were very interesting.  But what I found really fascinating was the way they worked together.

The first article she posted was in the BMJ (formerly the British Medical Journal).  It was an editorial article written by Emma Lewis entitled “Why there’s not point in telling me to lose weight”.  In this poignant piece, Emma talks about how no matter what she goes to the doctor for, she’s told she needs to lose weight.  She talks about the fact that her health markers are good and how she exercises regularly and strenuously.  She talks about the fact that doctors often tell her to start exercising, without even asking if she is exercising already.

Emma also talks about how her doctor’s “one-size-fits-all-fatties” approach to wellness makes her feel alienated, unheard, and shamed.  And she talks about how it keeps her away from doctors–how she hasn’t been to see her GP in a while, how she’s not doing routine diagnostic stuff.

This article is in a section of the BMJ called “Practice: What Your Patient is Thinking”.  I applaud BMJ for running this piece.  But I have to fight despair when I read the comments.

The comments are not uniformly bad.  There are a few doctors that get it.  But lordy, lordy, LORD there are quite a few that don’t.  I’ll summarize some of it so you don’t have to waste the sanity points reading the comments yourself.  But most of them go something like this:

1.  The Super Snarker:  Well if the fatties don’t WANT to change, then she’s right–there’s no point telling them to lose weight.

2.  The Concern-Trolling Hand Wringer:  But it would be irresponsible for me as a DOCTOR to not bring it up.  Maybe they don’t know they are fat.  Maybe they don’t think fat is bad.

3.  The Food Policer: Well yeah, she exercises.  But exercise doesn’t make people lose weight.  She just has too much hunger.

4.  The Math Guy:  Well of course she can lose weight.  Energy in vs. energy out!  Look it worked in concentration camps and lands with famine so it’s just math.

5.  The Apocalypser:  Obesity is bad.  Everybody Panic!  Cuz’ FAT!

Like I said, there are some that point out that Emma has a point.  There are some that get the fact that she feels unheard and disrespected and that this is a problem.  But virtually everybody who commented seems to believe that Emma’s main problem with weight loss is a problem of will.  If she wanted to, she could be skinny.

Except the evidence is not in favor of this hypothesis.

We simply don’t know any way of helping any but a very small percentage of people to lose a significant amount of weight and keep it off.  We just don’t.  And for any weight loss intervention we undertake, a very small percentage of people lose some weight and keep it off, the vast majority of the people gain all the weight back and a significant percentage of those people end up bigger than when they started.  And a whole lot of people end up facing serious negative financial, social, medical and psychological side effects from the whole process.

And we simply don’t have enough evidence from the very small percentage of people who lost the weight and kept it off to determine, if even that tiny percentage of people end up healthier because they lost weight.  We know that most people who exercise and eat better experience health benefits regardless of whether or not they lose weight.  But we don’t know if fat people who become skinnier are healthier in the long run.

So all five of the commenter types above are missing a few very important points:

1.  There is no intervention that you can offer Emma that offers her any kind of reasonable chance for significant, long-term weight loss.  In fact, statistically, just about any kind of intervention you offer is statistically more likely to make Emma bigger in the long run than to make her smaller.

2.  Any intervention that you offer Emma is likely to have negative side effects.  These negative side effects include physical, social, financial, emotional, relational, and physical problems.

3.  You can offer no reliable evidence that, should Emma be one of the very few people to achieve long-term, significant weight loss, she will experience health benefits from the weight loss that she would not achieve from far less invasive wellness efforts with far fewer side effects.

Cue the second blog  post shared by Michelle May.

This post called “Let’s Talk About Intentional Weight Loss and Evidence-Based Medicine” is found in the blog entitled Worse for the Fishes by Anna G. Mirer, M.P.H.  In this wonderful post, she talks about all of those wonderful interventions available to the five classes of point-missing commenters above.  She talks about how they don’t work.  She talks about how they cause more problems than they solve.  She talks about how there’s no real evidence that they help anybody.  And she provides lots of links to back this up.

I’m sure that this will all be refuted by another special kind of commenter:

The Research Refuter: Despite the fact that there is massive amounts of evidence supporting what you say–amounting to hundreds of peer-reviewed studies in reputable journals, I don’t like your evidence.  Therefore I will accuse you of cherry-picking your articles.

Again, I have to thank Michelle for bringing these two articles together in my world at the same time.  It so perfectly illustrates how we as a society are perceiving the wrong things as the problem and thus suggesting the wrong solution.

To me the solution is simple:

1.  Everybody benefits from eating well and exercising, along with managing stress, sleeping well, and having strong social relationships.

2.  So medical  professionals just ask if people need any support with eating well, exercising, managing stress, sleeping well and having strong social relationships.

3.  If people say no, then stop.  If people ask for help on any of those specific behaviors, offer help with those behaviors.

The End.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to come and talk to your group about evidence-based medicine and wellness?  Send me an email at jeanette at the fat chick dot com.

P.S.S. You can learn more HERE.

Powerful new Resource Helps Medical Professionals Understand HAES.

I am very excited to tell you about an epic new article that has appeared in the Journal of Obesity.  This article called, “The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss” reviews much of the available literature on doctors and weight loss and comes to a very firm conclusion: our medical obsession with weight loss is not making us any healthier.  The article defines the difference between the Weight Inclusive and Weight Normative approaches this way:

In this paper, we review evidence that challenges the weight-normative approach for health promotion and offer evidence to support a weight-inclusive approach for health promotion. Instead of imagining that well-being is only possible at a specific weight, a weight-inclusive approach considers empirically supported practices that enhance people’s health in patient care and public health settings regardless of where they fall on the weight spectrum [1, 2, 22]. These approaches differ in the emphasis each one places on weight. While health care professionals using either approach may share some commonalities (e.g., recommending similar self-care practices), they contrast in the relative importance they place on body weight in the context of health and medical treatment, their perceptions of the malleability of weight, and how they respond to patients based on their weight.

The article is very long and rich and cites hundreds of sources.  But I thought I’d pull out

10 things you can learn about weight-focused healthcare in this article:

1.  Recommending weight loss is actually a less conservative approach than recommending HAES because there are negative consequences associated with weight loss attempts.  Thus prescribing weight loss can go against the edict to “first do no harm”.

2.  The data do not support the notion that higher BMI causes poor health outcomes.

3.  Prescribing weight loss supports the notion that permanent weight loss is largely under a person’s control, and that fat people cost society more money.  Neither of these notions are supported by the data.

4.  Weight bias not only exists, but is common in clinical environments.  This is a part of the general increase in weight stigma in the wider world, and weight stigma is dangerous to your health.

5.  Not only does weight loss not work on a permanent basis, but weight cycling (the common result of repeated weight loss attempts) is dangerous for your body.

6.  Obsession with weight loss has led to an increase in eating disorders.

7.  But there is another way.  The  weight inclusive approach focuses on weight as a simple data point in a much larger view on health and focuses on positive behaviors.

8.  The basic principles of the weight inclusive approach are these:

1)Do no harm.

(2)Appreciate that bodies naturally come in a variety of shapes and sizes, and ensure optimal health and well-being is provided to everyone, regardless of their weight.

(3)Given that health is multidimensional, maintain a holistic focus (i.e., examine a number of behavioral and modifiable health indices rather than a predominant focus on weight/weight loss).

(4)Encourage a process-focus (rather than end-goals) for day-to-day quality of life. For example, people can notice what makes their bodies rested and energetic today and incorporate that into future behavior, but also notice if it changes; they realize that well-being is dynamic rather than fixed. They keep adjusting what they know about their changing bodies.

(5)Critically evaluate the empirical evidence for weight loss treatments and incorporate sustainable, empirically supported practices into prevention and treatment efforts, calling for more research where the evidence is weak or absent.

(6)Create healthful, individualized practices and environments that are sustainable (e.g., regular pleasurable exercise, regular intake of foods high in nutrients, adequate sleep and rest, adequate hydration). Where possible, work with families, schools, and communities to provide safe physical activity resources and ways to improve access to nutrient-dense foods.

(7)Where possible, work to increase health access, autonomy, and social justice for all individuals along the entire weight spectrum. Trust that people move toward greater health when given access to stigma-free health care and opportunities (e.g., gyms with equipment for people of all sizes; trainers who focus on increments in strength, flexibility, V02 Max, and pleasure rather than weight and weight loss).

9.  Along with the data that shows the weight normalization (weight-loss focused) approach is ineffective and harmful, is significant data showing the weight inclusive (HAES-oriented) approach is more successful, and that it does not share the negative side effects of the weight normalization approach.

10.  With these thoughts in mind, it makes sense to move to a weight inclusive approach in both personal and public health and actively work to reduce stigma both within and outside of the world of medicine.

I urge you to take some time to work your way through this epic piece of work.  And I urge you to print a copy and bookmark this for sharing at a later date.  Maybe you could take this along to your next doctor appointment.  Maybe you have a friend that is struggling with health care that can use the data to his advantage.  In any case, I’m very, very excited about this and couldn’t wait to share it with you.

Love,

Jeanette DePatie (AKA The Fat Chick)

Study Proves “Not all Fat People are Unhappy”–Follow up to indicate Papal Affiliation With Catholicism

PopeCatholicSo I got a notice in my inbox this week that a study has been announced that indicates “Not All Fat People are Unhappy.”  And honestly, my first thought was, “Duh.”  I mean it seems quite obvious to me that not all Fat people are miserable, much as it seems obvious that the Pope is Catholic.  But apparently the notion that not all fat people are sick, miserable, about to die and ready to throw in the towel is something we need to prove again and again.

But you know, before I cast to many aspersions on the study, I think maybe we really just need to look at the headline drawn from the study results.  Because there are actually quite a few interesting things indicated by this piece of research.  Let’s look at a few:

1.  Your happiness seems to have a lot more to do with homogeneity than body size.  If you are a fat person who lives in a town with lots of other fat people, you tend to be more happy than if you live somewhere with no other fatties.

2.  The study creators speculate that being fat does not in itself make people unhappy.  In the accompanying press release, study co-author Philip M. Pendergast states:

“In that light, obesity in and of itself, does not appear to be the main reason obese individuals tend to be less satisfied with their lives than their non-obese peers. Instead, it appears to be society’s response to or stigmatization of those that are different from what is seen as ‘normal’ that drives this relationship.”

3.  Women tend to pay a higher emotional price for being fat than men do.  The study creators speculate that this is because women face more social stigma based on body size then men do.  In the press release Pendergast also says,

“Think about the advertising we see on television or in magazines—we are bombarded by images of thin women, and we are told that is the ideal,”

So here is yet another study that seems to indicate that how we feel about our size may have a lot more to do with our actual health and wellness outcomes than what we weigh.  It follows on the heels of many other studies we’ve talked about on this blog regarding stigma and health outcomes like this one or this one.  And all of these studies lead me to ask one very important question.

Even if we knew how to make people permanently thin (which we do not) should we ask them to change their body size to fit in?  If being different leads to social stigma, and social stigma leads to poor health outcomes, should we encourage everybody to be the same for the sake of their health?

Even if we knew how to make people all be the same size (which we categorically do not) it seems to me that the answer is to deal with stigma rather than to make a completely homogeneous society to reduce stress on everyone involved.  What if we actively worked to fight stigma based on body size?  What if we actively worked to help people accept their own differences?  What if we could feel better about our bodies?  Might we be singing a song like this magnificent lady right here?

I mean just check these fabulous lyrics:

I looked in the mirror
What did I see a brand new image
Of the same old me ohhhh
But now I wonder why should I be surprised
I like the things about me that I once despised

There was a time
When I wished my hair was fine
And I can remember when
I wished my lips were thin

Makes no difference now y’all
How you may feel
I’ve done reached the point
Where I wanna be real
I’m tired of living living in disguise
I like the things about me that I once despised

Let’s face it, Mavis Staples has got it going ON!  But she leads me back to my original question.  Why can’t we take some of this time, money and energy that we are currently spending on stigma-inducing ineffective advertising that convinces people that they not only must be thin, but may easily obtain this state of grace by eating yogurt, and spend it on something that might actually help people feel better?  It will help them feel better emotionally, and it will help them feel better physically.  Why can’t we take some of the time, energy and money we are spending driving wedges into our society, by creating classes of otherness which we can blame for all our problems from the high cost of airplane tickets to soaring healthcare prices and spend it on something that teaches us to celebrate our differences.  It will bring us together.  It will help us live and breathe as a community rather than a simple pile of competitors in a winner-take-all, Victoria’s Secret model competition.  When will we reach the obvious conclusions?  Bears poo in the woods, stigma doesn’t help people, and yes, the Pope is indeed Catholic.

Call me captain obvious if you like.  I’ve stopped spending on diets and weight loss schemes and self hatred because I like the things about me that I once despised.

Love, Jeanette DePatie (AKA The Fat Chick)

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