Tag Archives: mortality

More Evidence that Fat Stigma is Killing Us

Today, I got an email pointing me towards some new research on fat stigma.  There has been an ever increasing pile of evidence indicating that weight stigma is making us miserable and sick.  We know that weight stigma makes us fatter,  increases inflammation, increases disease burden and decreases quality of life, increases the chances that we will engage in risky behaviors and may contribute significantly to diseases like diabetes and heart disease. We know that weight-based discrimination increases blood pressure and reduces our ability to think clearly. Now we have further proof that weight stigma is shortening our lives.

It has always been supremely frustrating to me that concern trolls are so ready to tell us that they beat us up about our weight because they are concerned for our health.  But as a person who has been on the end of concern trolling, I can tell  you that it doesn’t feel anything at all like genuine concern.  It feels like people relishing the fact they have an excuse to be a bully.  It feels like having a license that allows some people to spew hate under the micron-thick veneer of caring.  It feels like complete B.S.

And this new study indicates that the results of this hate can be profound and life-threatening.  The study states:

The ultimate cumulative effect of these hostile social interactions may be lower life expectancy. The present research examined whether the harmful effect of weight discrimination reached beyond morbidity to mortality and whether common comorbidities and health-risk behaviors accounted for this association. We also compared weight discrimination with other forms of discrimination (e.g., age, race, sex) to examine whether they share weight discrimination’s association with mortality risk. Finally, we examined whether the association between discrimination and mortality varied by sex, ethnicity, age, or body mass index (BMI). We tested these associations using data from two large longitudinal studies, the Health and Retirement Study (HRS) and Midlife in the United States (MIDUS).

After reviewing the data from both the HRS and the MIDUS, the study group came to some rather startling conclusions.  It appears that weight stigma can increase risk of mortality by a significant amount:

Weight discrimination was associated with an increase in mortality risk of nearly 60% in both HRS participants (hazard ratio = 1.57, 95% confidence interval = [1.34, 1.84]) and MIDUS participants (hazard ratio = 1.59, 95% confidence interval = [1.09, 2.31]). This increased risk was not accounted for by common physical and psychological risk factors. The association between mortality and weight discrimination was generally stronger than that between mortality and other attributions for discrimination. In addition to its association with poor health outcomes, weight discrimination may shorten life expectancy.

If people are truly worried about the health of fat people, they are going to have to give up on concern trolling.  Outside of the fact that you can’t hate someone for their own good (thank you Marilyn Wann), there is hard statistical evidence that it just may be your hate that is making fat people sick and giving them a shorter life.  Not to mention the horrible effect you have on their quality of life.  The study goes so far as to suggest that the harm of weight discrimination may be more harmful than any other effects of being overweight:

The present findings indicate that the harmful effect of unfair treatment that is attributable to body weight is not limited to psychological distress and morbidity: It also extends to risk of mortality. This association was apparent in two independent samples that covered different periods of the life span, and the association persisted after we accounted for behavioral and clinical risk factors. The effect of weight discrimination on mortality was generally stronger than that of other forms of discrimination but was comparable with that of other established risk factors, such as smoking history and disease burden. Moreover, the association between weight discrimination and mortality risk was in sharp contrast to the protective relation between some of the BMI categories and mortality risk. These findings suggest the possibility that the stigma associated with being overweight is more harmful than actually being overweight.

This type of research can have a profound effect on the lives of fat people around the world.  But just because it can doesn’t mean in necessarily will.  The media doesn’t jump to report these stories.  For many reasons, these articles aren’t popular with media outlets and are especially unpopular with advertisers.  If we want these studies to have an impact, we have to make sure that people in the world at large know about them.  We need activists.

That’s why I’m so excited that the Fat Activism Conference is starting tomorrow.  It’s not too late to get your tickets.  We have dozens of amazing speakers lined up ready to share ways that you can be an activist and an advocate for people of all sizes.  We’ve got speakers talking about activism and medicine and activism and art and activism and sex and many other topics.  I hope you’ll consider joining us for the conference.  This study indicates that activism against weight stigma may do more than just make us feel better and feel better about ourselves.  It just might help to save our lives.

Love,

Jeanette DePatie (AKA The Fat Chick)

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Another study indicates fitness more important than fatness for longevity

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.

What is a “healthy weight”?

I have to admit I was taken aback when I was named one of “Healthy Weight Week’s Top-35 Healthy Weight Blogs”.  I am actually aware of “Healthy Weight Week” from many years back.  I know that Francie Berg started “Healthy Weight Week” 25 years ago in an effort to change the dialog from weight (a number on a scale) to health (decidedly not a number on a scale).  This is part of Francie’s program which includes the annual “Slim Chance Awards” which chronicles some of the dumbest, most dangerous and least likely weight loss schemes of the year.

While I am firmly behind the notion of moving away from the number on the scale as an indicator of health, and I am deeply gleeful at the notion of poking fun at some of the most ridiculous diet schemes of the year (and the epic race to the bottom that THAT entails), I have to admit a fair amount of discomfort about putting the words “healthy” and “weight” together in any given sentence.  While I think the spirit of the week is a really great thing, the name of the event still seems to imply that there is a particular “healthy weight” for each person to be.  And I think that this notion is both simplistic and dangerous.

Because, you know what?  There is no magic number.  There is not a spot on the dial of the scale that, once attained, will make you immortal or even impervious to health problems or pain or sickness.  Even if you reach that number using Health At Every Size(R) techniques or intuitive eating or super fun physical activity plans.  Even if  you attain this place by deep meditation and perfect self-love (as if that even exists) and flowers and love and light.  There is no number on the scale that will make you perfectly happy or well-adjusted or even sane.  It’s just a number on the scale.  There is no perfect weight.

And there is no perfect health.  Nobody is in “perfect health”.  We’re all crumbling away–sometimes gradually and sometimes precipitously–towards our eventual demise.  I’m sorry to be a little bit morbid.  But I think that this notion of “perfect health” is something we need to put to bed right now.  I mean right this very minute.

There are many ways to define health.  Just as there are many ways to define Health At Every Size (R).  But I favor a definition that sees health as a continuum rather than a condition.  I think moving away from health is moving in a direction where we are less able to take advantage of our current physical condition to enjoy the things we love the most.  Moving towards health is living in a way that allows us to take greater advantage of our current physical condition and squeeze more of the things we love the most out of the remainder of our lives.  It doesn’t sound super sexy.  I sincerely doubt it will sell a lot of tennis shoes or create a great bumper sticker.  However, I think this definition of health allows everybody a spot at the table.  It doesn’t separate the haves from the have-nots.  It defines health in a way that can you can keep with you for your entire life.

This is particularly important in my work as a fitness instructor.  I work with many people who are coping with many levels of physical challenges.  From joint difficulties, to disease, to chronic pain conditions to plain old aging, many of my students and readers find it difficult to identify themselves as “healthy” as it is commonly understood.  And for many of my students, the notion of “perfect health” seems so remote that it might as well be another planet.  And this distance from the notion of “perfectly healthy” can be extremely demoralizing.  “How can I even start?” or “Why bother?” they ask.

And that’s why I choose to talk about health in terms of a continuum.  I tell them, “If we can do five minutes together today, we are going to ROCK those five minutes.  We are going to count it as a success and then we are going to do a booty dance of victory to celebrate!”  Because even though five minutes of exercise can’t move them to a “perfect weight” or “perfect health”,  it can move them towards a life that contains a little more energy and allows them to fit in a little more awesome.  Even as their teacher I am neither a perfect weight nor am I in perfect health.  However, my life contains a significant amount of awesome that I am happy to share.  And to me, helping your life contain even just a little more awesome is a worthy goal.

So, I am deeply honored and deeply grateful that I have been selected as one of the unfortunately-named but super-well-intentioned “Top 35 Healthy-Weight blogs”, because it gives me the opportunity to share my thoughts on this very important topic with you.  And I thank you, as always, for listening.

Love, Jeanette (AKA The Fat Chick)

P.S. If you’re interested in a fitness challenge tailored to your specific body and capabilities, I’d like to invite you to consider the Fit Fatties Virtual Events and Decathlon.  We’ve got all kinds of events both traditional (1 Mile Walk/Run/Roll, triathlon, 10 mile bike ride) and extremely non-traditional (romp with your kids or your dogs, engage in cheesy dance moves, shovel snow out of your driveway, tromp around a museum).  Join in the fun!

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Death and Taxes

deathandtaxesWell we’ve survived another U.S. “tax day”, so I thought I’d share a little post about inevitability.  Most of us have heard this quote, “In this world, nothing is certain but death and taxes.”  And while most of us understand the notion that taxes are inevitable (well at least unless you are a multi-billion dollar corporation) we have a little harder time with the whole death thing.  We know on an intellectual level that everybody, including us, will die.  Yet on an emotional level, many of us believe that if we eat enough fiber, do enough exercise, and stay thin, we won’t die.

Now don’t get me wrong.  It’s perfectly reasonable to want to make choices that can potentially extend our lives or improve the quality of our lives.  That makes sense.  But I’ve often wondered at the emotional response to my acceptance of my own size.  I understand that not everybody agrees with me.  Some people think I should do anything and everything that just conceivably might help me at least for a short time to lose weight.  But it’s the emotional involvement with this disagreement, the hatred and anger and spitting vitriol that comes with it, that sometimes throws me for a loop.

I recall sitting in a crappy and inadequate paper gown in a medical center where a doctor was nearly frantic in telling me that since I was fat, I was going to die.  He wasn’t offering me any statistics or research indicating increased risk for mortality or morbidity.  He was simply doing that finger wagging, nagging, since you’re fat, you’re going to die speech.  And I replied, “well you know, I don’t have an M.D. after my name, but I’m pretty sure we’re all going to die.”  Which gave me at least 10 seconds of respite before he started in on me again.

If you want to talk to me about increased risks for morbidity and mortality that may or many not be attributable to being fat, well okay.  I’m armed.  I’ve got data.  Let’s rumble.  But if you want to argue that all fat people are going to die, guess what.  You’re right!  All people, everywhere are going to die.  Even if they eat whole grains, and their chi is perfectly aligned and they run a marathon every day-even if they are thin, they are still going to die.

I think this is at least a small part of what freaks people out so much about my decision not to actively pursue weight loss.  Because at least in a small way, I’m not buying into their emotional fantasy, that if they do all the right things, they just won’t die.  Here’s the thing. I’ve lost many who are close to me.  And some of these folks did everything “right”.  They ate well, they slept eight hours per day, they managed their stress, they went to the doctor and they simply got sick and died–sometimes quite young.

Am I suggesting that we should just ignore our health? Absolutely not!  I am suggesting that there is no day in our life that is guaranteed.  And I for one refuse to spend so much of my life trying to change one potential (and questionable) risk factor for mortality that I don’t have time to really live.  If my days are limited on this earth, and they are limited, I want to do what makes me feel good and allows me to experience wonder and contentment and joy.  Sometimes that’s taking the dog for a walk.  Sometimes it’s eating ice cream.  Because I’m grown up enough to understand that both walking the dog and eating ice cream are wonderful.  And even giving up ice cream won’t allow me to live forever.

Love,

The Fat Chick

P.S. If you’d like to hear more about that story in the doctor’s office, you might want to check out this episode of the Right Now Show.  And I’m pleased to let you know that the deadline for the RESOLVED project has been extended.  So it’s not too late to create and share your video about your experiences with health care.

And if you’re interested in learning a little more about the joy of exercise, don’t forget to check out my book and DVD!

Weight Loss Surgery, Colon Cancer and Some Other Considerations

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Recently I read about a new study that links increased risk for colon cancer with weight loss surgery.  I thought it was important to share this information with you, because it seems to me that information about the possible negative side effects of weight loss surgery is so often buried in the general media.  And I think the positive effects of weight loss surgery are often blown out of proportion in the media as well.

That’s not to say that I have any interest in telling you what to do with your body.  It’s YOURS.  You should do whatever you think is best.  However, with over 100,000 weight loss surgeries performed in the US annually, I know that weight loss surgery is big business, and therefore, there are large financial incentives for certain companies to suppress information about the potential unfortunate side effects from these surgeries.  So I’d like to provide a few links to some of information about weight loss surgery that is not supported by those who profit from it.  And hopefully I can help “balance the scales” a little bit.

To be clear, one of the potential side effects of this surgery is death.  To be sure, there is a risk of death from any surgery.  But there is growing concern that the risks of weight loss surgery are often underplayed and that the evidence often cited concerning the potential upside to weight loss surgery (including savings in medical costs and lives) is deeply flawed.  It is also really important to understand that weight loss surgery is not a miracle cure, and it isn’t always the patient’s fault when things go wrong.  It seems that weight loss surgery is often treated like other weight loss techniques in that success is usually attributed to the surgery and failure is usually blamed on the patient.  Thus many who have negative experiences with weight loss surgery are often shamed and ridiculed and even asked to leave public forums where they might share their stories.  That’s why I think it’s important to share this link to a site dedicated to those who wish to share their stories about complications arising from weight loss surgery.  I think people who are considering weight loss surgery are provided with plenty of links to people often still experiencing the “honeymoon glow” of the initial weight loss.  But I think if you are considering this important life-changing step, you should also have access to a few of the heartbreaking stories of those who have not had such a wonderful experience.

To reiterate.  I am not telling you that you should or should not have weight loss surgery.  It is your body and your decision.  Clearly some people feel that the surgery has had a positive effect in their life and there are plenty of places where you can read about that.  I know people who have had the surgery and are glad they did.  But I have also known and cared for people who have died from these procedures.  I know people who have had these procedures and didn’t feel they were told the truth about what to expect.  I know people who felt that the potential downside was significantly underplayed and wish that they were given more balanced information before they had the surgery.  I simply wish to provide a few links that will hopefully help provide that balance.

Love,

The Fat Chick

Another year older…

Okay, sorry kids.  The blog post is late today.  But I have an excuse.  You see I’m another year older.  Well technically, I’m only one day older than yesterday.  But I just celebrated the dreaded B-day with all the accompanying happy wishes on Facebook and desolate dread surrounding my own mortality.

Don’t get me wrong.  Birthdays can be awesome.  But they are also a reminder that another year has passed that I will never get back again.  And I like to think it’s a kick my pants reminding me to go out there and DO what I was put on this earth to do.  Because darlin’, ain’t none of us gonna last forever.  We only get one go around.

One thing I was put on earth to do, is eat birthday cake.  I will do that.  Cake will happen.  Morbid thoughts will lessen.  My mood will brighten.

But the other thing I was put on earth to do is to encourage YOU my dear Chicklettes to get on out there and grab the brass ring.  Go out there and have a second helping of awesome because you only have one life and you should enjoy it to the very dregs.  Don’t let anything hold you back or anyone get in your way.  Oh and eat cake.  Cake is important.

Love,

The Fat Chick