Tag Archives: Health At Every Size

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

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:

 

Fitness is for ALL of Us

Ragen Chastain and I are so  very pleased to release our first video on our brand new YouTube Channel: Fitness for All of Us.  We’ve released our fight song to announce our intention to create a safe space where bodies of all shapes and sizes, ages and abilities can rejoice in joyful movement.  Here’s our first video:

For far too long, fitness has been a space relegated to those who have a certain body type or begrudgingly to those who are actively and seeking that body type.  Some have said that “Fit is the New Skinny!” without understanding that “fit” as defined by most is predominantly skinny.  It may include an extra pert rear and muscular legs.  It may include a six pack (or eight pack) and carefully-chiseled Michelle Obama biceps.  But the fit often referred to in the “fit is the new skinny” or even “strong is the new skinny” memes bounce right out of fitspiration with rock hard, totally toned, glistening, fitness model bodies.

But what about the rest of us?  Those of us who have bits that jiggle and flow?  Those of us with rolls and cellulite?  Those of us with big, bountiful bellies and big hips?  Those of us who are not exactly the slightly-upsized Barbie ideal of big boobs, tiny waist, swelling hips and tiny, pointed feet?  That is who this channel is for, it’s for ALL OF US who are interested in fitness in any capacity and at any level.

Because this is so much of what my work is and has always been about.  Fitness should be fun and encouraging and welcoming and physically and emotionally safe for all of us.  Fat and skinny, young and old, high powered athlete and folks who just want to walk their dogs.  Runners and walkers and boaters and swimmers and yogis and dancers and kickboxers and cyclers and multisport mavens.  Seasoned experts and frightened beginners.  Fitness should be for every BODY!

We should be able to get help when we ask for it and be left ALONE when we don’t.  We should be encouraged the same way as everyone else.  We should get a quiet thumbs up or even a shout of welcome for joining the posse for being part of the fitness community, not because somebody imagines that exercise is particularly difficult for us, or that we serve as some sort of weird inspiration for them and especially not because people imagine that we are forcing our bodies to comply to some ideal of shape, size, weight, or any other parameter.

Let us move.  Let us breathe.  Let us enjoy fitness on our own terms.  Above all, let us be.

Hope you like it!

Love, Jeanette DePatie (AKA The Fat Chick)

P.S.  Want to show us some special love?  Don’t forget to subscribe!

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.

Talking to Kids About their Bodies

I am sad to say that September is Childhood Obesity Awareness Month.  I cannot see the need for this particular marker.  I don’t know a single adult who isn’t aware that there are fat children in the world.  And the vast majority of them are wringing their hands and worrying about what we should do about it.  Schools are still sending kids home with BMI report cards despite significant evidence that this practice is not only not helpful but is often actively harmful.  And most doctors still tell parents to put kids on a diet when kids vary even slightly from the statistical norms.

Infographic.034-001

And it’s not as if kids are unaware of “the childhood obesity crisis”.  Hospitalizations for eating disorders are up 119 percent among children under 12 years of age.  80 percent of all 10-year-olds are afraid of being fat and 42 percent of all 1st through third grade girls want to be thinner.  Just who is it that remains unaware of a societal desire for kids to be thin?  The whole thing is so deeply depressing I didn’t know how I was going to write about it.  That is until I came across an article somebody posted to Fit Fatties yesterday about a dance teacher working to change the language she uses to talk to kids about their bodies.

Worried about how her words as a dance teacher were affecting the body image of the girls taking ballet lessons, dance teacher Amanda Trusty took several weeks off to work on the language she used in her classes.  Trusty noted that many of the traditional commands from dance class like “tuck in” or “suck in your belly” or “pull in the butt” were not only imprecise, but tended to confirm a societal notion that kids bodies should be smaller and tummies and tushes should disappear.

In her article Amanda says,

I realize now where all my insecurities started. They started in first position at age seven at the barre.

 

And now here I am, 20 years later, catching myself doing the same things to my own seven year old students.

 

Oh, but I refuse. Nuh-uh. No way. I’m a body love advocate. How can I tell my ballerinas to suck it in and tuck it under, knowing how much that shaped my childhood?

So Amanda consciously and thoughtfully worked to change the language with her students.  The new language was not only more imaginative and precise, but also managed to remove body judgement from the equation.  Now rather than telling them to tuck the butt under, she asks the students to imagine they have beautiful tail feathers.  And she asks the students to send their tail feathers down rather than out.  Instead of asking kids to lift their chins, she tells them to imagine they are wearing a beautiful necklace and she asks them to display the necklace to everyone else.

Kids are perfectly well aware that many, many grownups are freaked out beyond all reason that their bodies are not thin enough.  We don’t need a month dedicated to getting adults more freaked out about childhood obesity.  And we don’t need a month dedicated to convincing fat kids that they should not exist, that there is a worldwide movement to eradicate them from the planet.  What we need is a month dedicated to thinking about how we talk to kids about their bodies.  We all need to take a time out like Amanda did, to figure out ways to communicate health and wellness to kids in a way that isn’t damaging to their body image and doesn’t send them charging down the road towards a life of eating disorders.  Now that’s a month I could get behind.

 

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S.  Want to hear me speak with YOUR group about how to teach fitness to kids in a way that isn’t damaging to them?  Book me to speak!

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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)

BACK (sorta)


 

Hello my dear readers.  As you may have noticed, I’ve been gone for a while.  Fortunately I had the opportunity to meet and speak with over 400 schoolteachers this past week and share the word about shame-free fitness and Health At Every Size for children.  It was wonderful, engaging and fun.  It was also a set of 7 grueling days with a very intense schedule.  Nevertheless I planned to continue blogging while away.

Alas, the universe had a different plan.  Shortly after I started at the conference, I reached for a piece of paper in my bag and something in the region of my lower back and right hip went completely out of whack.  My friends at the conference insist that it makes a better story that I hurt myself busting a move, that the limbo initiated my lumbago or SOMETHING.  But the truth is, I was sitting in a chair reaching for something in my bag, and I had that MOMENT.  There’s a moment when time stops and that surprising pain comes and all you can think is “WHOOOOOOAAAAA, that can’t be good!”.

I managed to fulfill all my obligations at the conference and even have some fun.  But sitting aggravated my pain the most and I simply couldn’t bring myself to blog last week.  Sorry about that.  But I thought I would take this moment to share a few thoughts with you about my back experience.

1.  Sometimes poop occurs.  It just does.  I could make myself crazy wondering if it was tension or a posture problem or lack of sleep or the size of my hips or the tilt of the universe that caused that pain.  But at the moment that the pain occurs I need not to focus on that.  I just need to deal with it.

2.  Dealing with it means that sometimes your plans have to change.  When pain or a serious setback happens, it’s time to reorganize priorities.  Some stuff will not get done.  You can either triage and choose which things you can do, or you can try to do everything and end up able to do nothing.  You wanna know how I know?  Experience.  So many times, I’ve been in denial about the fact that I can’t do everything.  So many times I’ve ended up at that point, in pain, completely spent, where I can’t do anything.  I really don’t want to do that any more.

3.  Pain is a sign that something is out of whack.  It could be posture.  It could be schedule.  It could simply mean something in my body isn’t working properly.  As I am healing this week, I will start, very gently to figure out what is out of whack.  I’ll see my doctor and start reviewing things in my life to see if I can figure it out.  But I may have to accept that the discovery process may be long and challenging.  And I may have to accept that I can never figure out exactly what caused this episode.

The good news is that hundreds of school teachers, councilors, administrators, and other employees were exposed to the notion of shame-free exercise and the Health At Every Size(TM) approach to wellness–many for the first time.  So I’m going to take an aspirin and take my leave glad for a job well (if shakily) done.

Love, Jeanette DePatie, AKA The Fat Chick

P.S.  Don’t forget about the Fat Activism Conference coming up soon. Click here to register for the Fat Activism Conference!

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