Tag Archives: research

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)

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Scientists Say they may have Underestimated Fat Hatred. I say, “Yup!”

Wow, what a week.  On the one hand I got a nice mention in Women’s Health magazine.  On the other hand, a rabid group of haters found my YouTube channel and I’ve spent the week combing through literally thousands of very hateful and unbelievably stupid comments to see if I could post any of them on the site.  The answer is, “nope”.  But I do need to shout out and say “Thank You Haters” for bumping up my views even if they are to leave me comments about my sexual preferences, my intelligence and my smell that will never see the light of day.

And right smack in the middle of this crazy week, I came across this press release about a recent study that indicates that fat stigma may be a lot more prevalent than they originally thought.  It turns out that a lot of the previous studies that attempted to measure weight stigma relied on people remembering episodes of fat hatred from as far back as 30 years ago.  Not surprisingly, people recounted some very severe stories of weight stigma, but reported that weight stigma didn’t really happen that often.  A new study from Western New England University used a different approach to measuring weight stigma.  They are the first to use a daily diary approach to measure incidents of weight stigma among fat women.  It’s probably not that hard to imagine that the Western New England University study found that weight stigma was more common than originally thought.  And I mean a lot more common.  50 “overweight” and “obese”* women were studied.  Over the period of 1 week, the women reported 1,077 stigmatizing events.  That averages out to 3.08 events per person per day.

What’s more, Jason Seacat, Ph.D., associate professor of psychology at Western New England University in Springfield, Massachusetts and the study’s lead author says that the source of this stigma might surprise you.  “A surprisingly high number of stigma events came from close family members or friends,” Seacat says, citing experiences like a woman whose boyfriend’s mother withheld food and called her lazy.  He goes on to say:

“We have probably underestimated the size of the weight stigma problem,” he says. “People are encountering more barriers on a daily basis than is reported in the literature. Standing in line and overhearing someone comment on your size, having to ask for a lap band extension on an airplane, going into a clothing store and not finding something in your size… Those are all stigmatizing events, but we as a general public might not realize the effects those events can have on people.”

I have to admit, that it’s mighty tempting for those of us that are perpetrating the crime of living in the world while fat to respond to all of this by saying, “Duh!”  When you are filtering your 37th email in one day calling you a fat c**t, you might be tempted to call Mr. Secat Captain Obvious.  Even so, I’m glad we are doing more to measure this problem in a more meaningful way.

Because I’m sick and tired of hearing about how we are being oversensitive.  I’m really done with hearing people tell me that fat folks are not really oppressed–that asking for basic human rights while fat is some sort of crime against decency and humanity, and that we should just stop eating and stop whining and consent to be miserable.  And all of this denial of fat oppression is happening at the same time that fat grad students are told “not to bother” applying for a doctoral program, and that fat people can’t be researchers or scientists because they just might more than their share of the departmental pizza.

So, yes.  I’m very grateful that this research is being done.  Just don’t expect me to be surprised by these results.

Love,

Jeanette DePatie (AKA The Fat Chick)

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*This is what the study called them.  I’d just call them fat.

Professor Terrible Learns about Consequences

Millerslide2.001-001I was oh so VERY happy today to read that the University of New Mexico has decided to Censure Professor Terrible, (AKA Professor Geoffrey Miller) about his now infamous tweet.  For those of you who have been on a media fast or have been living under a rock, Geoffrey Miller Tweeted:

professorterribleAs I predicted, a media “sharknado” of epic proportions ensued.  Geoffrey issued a few half-hearted apologies and then, when that didn’t work, he claimed the tweet was part of a “social experiment” in some “research” he was conducting.

Except, um, no.  Both universities where Geoffrey teaches, UNM and New York University determined that this tweet does not meet the requirements for university “research” which among other things, would have required pre-approval by an institutional review board.

So, after several months of review, the University of New Mexico has decided to officially censure Professor Terrible and have demanded that Miller:

  • Not serve on any committee involving the admission of graduate students to the psychology department for the duration of his time as a faculty member at the university.
  • Work with the faculty co-advisers of the psychology department’s diversity organization to develop a plan for sensitivity training on obesity (for himself to undergo, said a university spokeswoman). The plan must be approved by a co-adviser or by the chair of the department.
  • Be assigned a faculty mentor for three years with whom he will meet on a regular basis to discuss potential problems.
  • Have his work monitored by the chair of the department.
  • Apologize to the department and his colleagues for his behavior.

All of which seems completely reasonable and on the right track to me.  Now if you read the comments section (which you should probably never, ever do by the way) in the publications where this is being reported, you’ll see a lot of people jumping up and down and screaming that academics have gotten out of hand and that political correctness has taken over the country.  You’ll also read a lot of comments screaming about First Amendment rights and censorship.

To which (after breathing in a paper bag to calm myself down) I offer this response.  Even though censure sounds like censor, they are not the same thing.  The University of New Mexico found that Miller’s tweet violated three different UNM Faculty Handbook policies.  Presuming Miller read the handbook when he became a professor at UNM, he knew what he was and was not allowed to say in a public forum.  He chose to ignore those rules.  The fact that the University subsequently chose to discipline him for violating those rules is perfectly reasonable and appropriate.  It is not censorship.

His behavior brought shame upon his employer, caused students to call into question whether they had been discriminated against based on appearance, and called into question whether the admissions process at this university was fair.  I’m not sure whether or not this opened the University up to a lawsuit, but I’m fairly sure that legal dollars were spent assessing a potential threat.

And I’d like to point out, that Dr. Miller got a relatively light sentence.  He didn’t lose his job.  They didn’t dock his pay.  They simply have to make sure that it’s clear that Miller’s prejudice can’t be connected with the University’s admissions process.

I would argue that the many, many graduate students who are denied access to higher education because of the way they look are paying a much higher cost than Professor Terrible.  Recent research has offered further evidence of this discrimination and the lasting economic effects experienced by those who are subject to this discrimination.  These students do not get “censured” they simply don’t get accepted to University–and I consider that a much more serious consequence than the slap on the wrist “poor Geoffrey” has to endure.

I suppose in a way, I need to thank “poor, downtrodden, Professor Terrible”.  He brought this issue to light in a very public way, he caused a university to further examine their own bias around size and weight, and got a lot of people to open their minds to the effect that weight stigma has on higher education–well at least those people who are not writing in the comment section.  Well except for you of course.  I am confident that you can write stuff in the comment section below that is insightful and intelligent, because you are the best readers ever.

Love,

The Fat Chick

 

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For the 100th Time, Shaming People Doesn’t Help!

chalkboard.001This week I ran across even more research that indicates that shaming fat people does not turn them into thin people.  This is hardly the first time this sort of research has surfaced.  I’ve talked about this many, many, many times.  But somehow, it seems nearly impossible to get public policy people and health people to get it through their heads.  They still advocate BMI report cards and singling kids out for special “health interventions” and still do not think they need to add “body size” to any of their legislation about bullying.  And meanwhile, bullying against fat kids is getting worse.

Maybe we should make them all stay after class and write 100 times on the blackboard, “Shaming people does not make them happy, healthy or thin.”  It doesn’t save our country money.  It doesn’t save our children.  Shaming people about their weight does not do anything positive at all.  Shaming or bullying people about their weight:

  1. Makes them more likely to engage in unhealthy behavior.
  2. Makes them less likely to seek medical help.
  3. Makes them miss more school and get lower grades.
  4. Makes them sicker.
  5. Makes them heavier and puts them at greater risk for eating disorders.

Despite a mountain of evidence that dieting and shaming don’t work, and a mountain of evidence that dieting and shaming cause harm, we still have public policy and health experts suggesting that we help kids by shaming them and teaching them to diet.  I think we just might have to give them all a piece of chalk and make them stay after school.

Love,

The Fat Chick

P.S. Want to learn about a body positive approach to health and wellness?  How about checking out my book or my DVD?

Finding Help: Buyer Beware

When it comes to fitness, if it hurts, DON’T DO IT!

So far this week we’ve been talking about helping others. And I’m a BIG fan of that. Today we’re going to talk about finding help for yourself.  And I’m a BIG fan of that too.  But in finding help, you DO need to be careful.

Settle in my little chickies, and I’ll tell you a little story–an instructive parable as it were.  At one point in my life, when I was deeply worried about being thin, I panicked and I hired a personal trainer. Now believe me, I think having a personal trainer can be an awesome investment. But in this case, I was ruled by panic. Did I check to see if this guy was certified? Nope. Did I ask to talk to other students of his? Uh uh. Did I even do an online search to see if this guy was a maniac? That would be negative. I saw the guys phone number on the gym bulletin board, I called him and I started working with him.

I should also mention that at the time I could barely afford to buy food or medicine. But that didn’t matter because this guy was gonna do it. He was gonna make me skinny and from there on out my life would be PERFECT.

I should have known from the very first workout that this guy was not for me. The FIRST thing he did, before he did an intake questionnaire or asked me about my fitness level or fitness goals or potential health problems was to plunk me on a treadmill, crank up the speed, crank up the incline and to tell me to stay on there for 20 minutes. And by goodness I DID stay on there for 20 minutes.  Sweating, wheezing, heart pounding, and feeling sick, I staggered over to where he was reading a muscle magazine.  “Wow,” he said.  “I wasn’t really expecting you to do the whole 20 minutes.  Now we can get down to some real work.”

Now my little chicklettes, that scenario is what we in the business call a “clue”.  The guy basically threw me into a “maximal” testing situation where he intended to test me to failure, but he didn’t check my history first, he didn’t monitor me and, here’s something important, he DIDN’T BOTHER TO TELL ME that’s what we were doing.  Dangerous? Yup. Epic stupidity?  Yah, you betcha!  But he later confessed he didn’t tell me because he could tell by looking at me that I was “soft” and he didn’t want me to “wimp out”.

But did I yell at him? Did I quit giving him money? No I did not.  I kept training with him because he was thin and muscular and I was fat.  I trained with him for months.  Unable to walk after our exercise sessions, frequently vomiting in the locker room after workouts and feeling sick and miserable, I worked with him until I got injured and couldn’t work out any more.  And I guess you can tell at this point, I’m still pretty darn angry about it.

Look, if I had tuned in with my instincts, which were SCREAMING by the way, that I should RUN (well at least stagger) away from this guy, I could have avoided a whole lot of heartache and saved money to buy something awesome, like shoes.  But I allowed my feelings of insecurity and false hopes to lure me into getting myself hurt.

So my little chicklettes, the lesson is this.  Please do seek help.  We all need help from time to time.  No woman is an island.  But please seek help that is competent, qualified, and compassionate.  Do your research first.  Shop around.  Ask questions.  Ask for references.  Ask for qualifications.  Any trainer, doctor, therapist or coach who doesn’t want to give this sort of information to you is not worth considering.  And if your instincts tell you that this isn’t the right person for  you or that you don’t feel safe, leave.  Take your toys and GO HOME.

Because my sweet little chickadees, when it comes to helpers as with everything in life, you deserve only the best.

Love,

The Fat Chick