Tag Archives: weight stigma

More Evidence that Fat Stigma is Killing Us

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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)

Weight (Stigma) Affects School Children’s Grades

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chalkboard.001

My dear friend and colleague Angela Meadows recently penned this important article for The Conversation discussing the issues surrounding weight, school children and academic performance.  There have been  a number of studies over the years linking higher weights with lower performance in school–particularly among female pre-teens and teenagers.  Many of these studies have sought and eliminated co-variables in other health issues, potential depression and the onset of menses in women.  However, many of these early studies seemed to avoid what would seem the most obvious connection between school performance and weight–the impact of weight stigma on school children of all ages (especially girls).

Angela then shared with us the results of a new study from the Harvard School of Public Health specifically documenting the results of weight stigma on kids  in school.  For the most part, the study which followed over 3,000 kids for over 10 years found no significant difference in test scores for the kids who became fatter.  However, the study indicated that as the students weights went up, the teacher’s evaluation of the kids abilities went down.  (Primarily for reading in girls and math in boys).   And to a certain extent, as weights went up, the students evaluations of their own abilities went down.  Although, the studies didn’t specifically measure attitudes of weight bias in teachers, Angela pointed to other studies that do just that.

Angela goes on to discuss important research linking weight stigma to bullying by other children as well as studies that indicate that much of the lag in academic achievement by fatter kids can be explained by bullying from both fellow students and educators.

I have not been shy in the past in saying and saying and SAYING that stigma does not make people healthier, happier or thinner.  In fact weight stigma makes people less likely to seek medical treatment, leads to disordered eating and risky behaviors, leads to more stress, anxiety and illness and yes, leads to lower academic performance.  And since there is literally no scientifically proven way to help most people lose a lot of weight and keep it off, perhaps telling people to lose weight to avoid this stigma is ill advised.

We know that weight-based stigma is harmful for people of all ages, yet we continue to march in the war on obesity for the fatties’ own good.  We continue to fight body fat and ignore the plain fact that it is our societal attitude towards fat people that is causing much of the damage.  We continue to wring our hands and shout “What about the children?” as an excuse for maintaining this war on big bodies, without addressing the simple fact that the number one casualty of the “war on obesity” seems to be from “friendly fire” on the folks we are purporting to help.  At what point will we finally realize that stigmatizing children into a fruitless attempt to change their body size so that they can avoid weight stigma is at best, seriously messed up?

I hope that moment is coming and I hope it is coming soon.  Our kids have enough to deal with just trying to grow up in this world without being victimized by the very people who we engage to help them.  I hope that we can start some efforts to seriously help our educators and child caretakers recognize weight bias in themselves and work to push past it.  I hope that we can stop allowing our kids to be collateral damage from a war that it is nearly impossible for them to win.

Love,

Jeanette DePatie (AKA The Fat Chick)

More Victims Dying to be Thin

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DeadlyScale

I recently read about this story about student Ella Parry who died after accidentally overdosing on diet pills she bought from the Internet.  The pills were found to contain Dinitrophenal or DNP.  This highly toxic industrial chemical has been determined to be unfit for human consumption.  There is no known antidote to the toxin once it is ingested.  Ella, an otherwise healthy 21 year old woman bought 100 of the slimming pills online for the equivalent of about $100.  She did ingest more pills than the label suggested.  But very shortly after taking the pills, she started to feel quite ill.  Not long afterward, Ella drove herself to the local emergency room.  Her metabolism began to soar, and despite efforts by the doctors to bring her temperature down, Ella’s body “burned her up from the inside”.

Now there is no question that people fall victim to Internet scams all the time, and it’s easy to find illicit substances online.  But it leads me to wonder if Ella is simply a victim of an Internet scam, or if there’s more at play here.  How much pressure do young people get to be very, very thin?  How much have they heard that being thin is easy and anybody can do it if they try?  What happens when they find out it is not easy for them?  What lengths will they go to in order to achieve an “acceptable body”?  I can’t help feel that this is just another casualty of our culture’s obsession with thinness, and our culture’s utter inability to educate us about natural body diversity.  This leads to many potentially fatal problems including eating disorders.  And it leads to desperation that might cause an educated, intelligent young woman to buy pills off the Internet and consume them without even understanding what is in them or how dangerous they are.

This is why the war on obesity is not just a war against fat bodies, but about all bodies.  Because fear of not having the perfect body, fear that a body could become fat one day, leads people of all sizes to make poor choices with sometimes devastating consequences in order to fit into their skinny jeans.  This is why I will continue to fight for body diversity and for better education about the real facts about bodies and weight.

If you’re interested in joining this fight, perhaps you would consider participating with us in the upcoming Fat Activism Conference.  We’ve got a call for participation HERE.  It’s a very simple form that you could fill out in just a few minutes.

And I’d like to remind you, that if you are interested in joining us in our upcoming Fit Fatties Virtual Event, there are just a few short days left to sign up.  You can learn more HERE.

Love, Jeanette DePatie (AKA The Fat Chick)

P.S. Want to hear me speak about body diversity?  Learn more HERE.

New study says weight stigma signficantly reduces Quality of Life–and water is wet.

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Don’t get me wrong.  I am deeply glad that they are studying the negative effects of weight stigma.  But I am wondering when this will finally be considered obvious.  I am waiting for the moment when somebody says, “shaming fat people is bad” and the primary response is, “well, duh”.

I recently read this study which was released as an online precursor to publication in Obesity magazine.  The study seeks to understand the affect that weight stigma and discrimination on conditions like depression and overall quality of life.  As the study states:

Weight stigma is often cited as a potential mechanism leading from obesity to poorer psychological well-being [4, 5, 7, 9]. Prejudice against individuals with obesity is pervasive and rarely challenged in Western society [10]. As a result, many individuals with obesity, and particularly those with severe obesity, report being discriminated against because of their weight in their everyday lives [11, 12]. Given that weight stigma and discrimination have both been shown to have a negative impact on psychological health outcomes, including well-being [10], depression [13, 14], self-esteem and self-acceptance [13, 15], and body image dissatisfaction [13, 16], this might explain why people with obesity suffer psychologically.

You would think that this had been studied in depth before.  However, according to the introduction of the study, this hasn’t previously been explored in a lot of depth.  According to the study:

Only one study to our knowledge has tested the mediating effect of weight-related discrimination, showing a significant reduction in the association between obesity and self-acceptance after adjusting for perceived weight discrimination [15]. None have examined the role of discrimination in relation to more global indices of psychological well-being, such as quality of life or depression. The aim of the present study was therefore to investigate the extent to which perceived weight discrimination mediates associations between obesity and three markers of well-being: quality of life, life satisfaction, and depressive symptoms.

In other words, many studies have suggested that fat people experience a lesser Quality of Life (QOL) than thin people.  However, this study seeks to determine whether that reduction in Quality of Life is simply because of person’s body size or whether it is caused by the world’s reaction to their body size.  I won’t keep you hanging too long.  The study determines that 40% of the person’s reduction in QOL is from perceived discrimination.

We used mediation models with bootstrapping to test the proposition that associations between obesity and well-being are mediated by weight discrimination and found that approximately 40% of the total effect of obesity on psychological well-being could be explained by perceptions of weight discrimination.

This is I think an important distinction.  So much in the “War on Obesity” suggests that the solution is for all fat people to simply lose weight.  The study suggests that the reason fat people are depressed might be–in large part–the “War on Obesity”.  As Ragen Chastain frequently states in her blog, Dances with Fat, “The way to deal with oppression is not to remove people from the oppressed group.  The way to deal with oppression is to fight the oppression.”  And I have to wonder to what extent this 40 percent takes into account the internalized oppression experienced by people of size.

I hope that this, along with so many other studies regarding the harm caused by weight stigma will finally convince some of the folks in the Obesity War to consider the harm they are causing–the millions of lives ruined by “friendly fire” in this war that makes people sadder and sicker rather than healthier or happier.  And  I hope that those proponents of “tough love” and “the ends justify the means” will reconsider their stance.  Because in the case of weight stigma, love is indeed very tough to come by.  And when the ends are actually worse that the starts, it’s time to carefully consider some new means.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S.  Want to hear me speak about weight stigma at your school or organization?  Learn more about me here.

Hippocratic Hypocrisy?

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An article recently released in Lancet magazine calls out some prominent researchers who presented at the Association for the Study for Obesity conference on September 16-17, 2014 in Birmingham, UK.  Apparently they served up their research papers on how to “help people with obesity” with a hefty side dose of sarcasm, stigmatizing comments and downright nastiness towards people of size.  I can’t say I’m surprised, but I am glad that they are getting called out on some of their nonsense.

The article stopped short of naming names, which I found disappointing.  But I am glad that somebody is taking the time to point out in print that there’s not a lot of do no harm and an awful lot of hypocrisy going on at these conferences.  For one thing, these “obesity researchers” know better.  If they have done any homework at all, they know that stigmatizing overweight and obese people does not lead to better health outcomes.  In fact, it causes overweight and obese people a lot of stress, leads to poorer health and actually tends to increase weight–the very thing they are making fun of fat people for in the first place.

Want to know what I’m talking about?  TRIGGER WARNING–I’m going to share some serious fat shaming stuff here.  If you don’t want to read some really icky stuff that people said, skip down until after the video, okay?  As one researcher criticized a media source that suggested exercise isn’t particularly good for health exclaimed, “Exercise is rubbish?  That is precisely the message obese people want to hear.”  This exploits the stereotype that fat people hate to exercise and are lazy.  I think many of the thousands of people in our Fit Fatties Forum, you know the ones who are training for marathons and triathlons and Ironman competitions, the ones that did TWO 5Ks over the Thanksgiving break just because, I think they might take issue with this stereotype.  And if we want people to exercise more, I think a very brief search of the literature would indicate that shaming folks is not an effective tool to increase exercise adherence.

Then out of the mouth of another researcher who has published researcher on weight stigma and it’s effect on fat people, we got this little gem.  She said if people lost weight, “They would have a lot of sex, which is probably good as they won’t have had it for a while.”  Hmm. I wonder where in the body of research on fat people it suggests that fat people don’t have much sex?   A pretty brief search indicates that some studies show that larger people, are often more attractive to the opposite sex, have more sex and have the big O more often than their thinner counterparts.  But yes, the way to help people live a better life is to convince them that they are utterly sexless and unworthy of sex as they are.  NOT!

Finally, we have the researcher who was receiving one of the “best practice awards”.  She stated that the work they had done in reducing the weight of some of their patients, “provided more space for commuters on the London tube.”  Insert rimshot here.

END TRIGGER WARNING.

Look, when we talk about “best practices” for researchers, we are looking for people who not only seek to eradicate bias from their work, but also have enough self awareness to recognize their own bias.  I ask you, when researchers who are RECEIVING AN AWARD FOR BEST PRACTICES feel it’s okay to round out their acceptance talk with a cheap joke at the expense of the subjects they are reportedly trying to help, I call foul!  When you have somebody who has published research on weight stigma, demonstrating some malicious and completely unfounded stereotypes about fat people at a professional conference, I think we really ought to step back and take a look.  This not only calls into question the researchers who presented these horrible slurs, but also the committee that selected them to speak and the organization who decided to give one of them an AWARD for best practices in research.

This is something that I find deeply frightening.  The notion that the people who claim to dedicate their lives to “helping” us, hold us fat people in such deep-seated and largely unquestioned contempt.  The truth is that we all hold bias in some form or another against some group or another.  But it is only when we choose to or are forced to confront it that we can move forward without damaging those we claim to wish to help.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want to book me to come and speak about Weight Stigma?  Click HERE to learn more.

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Jillian Michaels Co-opts Body Love Messaging (This is why we can’t have nice things…)

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Body love courtesy of Jillian Michaels.

In an epic moment of facepalm, my facebook feed threw up this little fact:  Jillian Michaels has published her “Top 3 Guidelines for Improving Body Image” at EverydayHealth.com.  (No, I’m not gonna link to that ish.  Nope.)  This seems in line with her recent move to distance herself from Biggest Loser after she made untold millions from screaming at fatties on the show.

Now the irony of Jillian Michaels would be really funny if it weren’t so very sad.  This woman styled her entire career on being the queen of mean.  She came into our living room every week screaming at the fatties–about how ugly we were and how we were killing ourselves.  And some might suggest that Jillian Michaels might be making a genuine change or shift in attitude.  And I might even consider believing her if she started pulling products like her “6-week Six Pack” or her “Banish Fat, Boost Metabolism” or her “No More Problem Zones” off the shelves.  Nope, no, nopety nope.  You don’t get to give advice like “Be realistic about your body type.” when you are actively marketing a product called “1 Week Shred”.  And you don’t get to advise people to “Stop negative self talk.” while marketing a product called “No More Problem Zones.”

And if that didn’t tickle my sarcasm zones quite enough, this little gem is posted on EveryDayHealth.com with the tagline, “Always choose well.”  Seriously?  You put the queen of scream in charge of body image on your site?  For REALZ?  Is that choosing well?  Look, I’m sorry guys.  Just because Jillian is wearing a nice soft stripy sweater, and you’ve got her on a white set with a soft filter, it doesn’t make her nice.  And it certainly doesn’t make her qualified to talk to women about body image.

But can we talk here?  This is really a bigger issue than the Biggest of the Biggest Loser Meanies trying to change her image.  The real issue is the co-opting of important messaging in the body acceptance movement by people who just see it as the latest way to add market share to their products.  And I think as we go forward, and we start to gain traction, this is likely to become a bigger and bigger issue.

Let me take a moment and disclose some facts about me.  First, I acknowledge that even as “The Fat Chick”, I have an awful lot of privilege.  I’m white, middle class, and heterosexual.  That makes a lot of things in this society a lot easier for me.  Also, in terms of my size, I’m what you might call a mid-size fatty.  I’m certainly “plus-sized”.  But my size and my shape make certain things a lot easier for me than for many other fat people.  I face discrimination, but nowhere near as much or as intensely as many of my brothers and sisters in the movement.  I don’t receive these privileges as a result of anything virtuous I’ve done.  I was born with them.  And thus, while I can sympathize with people of all sizes, I can’t say that my experience is the same as all other fat people.  It just isn’t true.

I also have to admit that, having been in this space for many years, some messages are easier to sell.  Some messages are more palatable for the general public and as such, are more fun to say.  I get a lot more rewards for telling people to love themselves than I get for saying that society is brutalizing entire segments of the population, and that it is not okay and it has to stop.  A lot of people look at my midsized status and nudge me and say, “Well you’re okay, you’re not THAT fat.”  To which I usually respond, “ALL bodies are good bodies.  And people thinner than me are okay and people fatter than me are okay.  You don’t get to decide what sized body is acceptable for the general population.”  I say usually.  Because sometimes I just don’t have the spoons to deal with it and I just walk away.  I am not a persona.  I am not perfect.  I’m just a person.

But I think it’s important going forward to acknowledge that it’s not really okay to co-opt body diversity, size acceptance and body love language just to soften a campaign of ongoing body hatred.  It’s not really okay to call yourself an activist against weight bias or weight stigma if you still adhere to the “fat but not that fat” ideal.  It’s pretty easy to accept that nobody looks like a supermodel.  “Not a supermodel” is a pretty safe position to take.  Only a few of us in the world look like that, and even those few are Photoshopped beyond recognition.  But true work against weight bias and weight stigma includes recognizing that weight stigma and weight bias are institutionalized, rampant and ubiquitous.  It includes recognizing that even if most of us hate our bodies, that stigma and bias are likely to be different at size 12, size 22, and size 32.  And that weight stigma is not allowed once you are beyond a certain size.  Body acceptance is not just loving your body, unless you are, you know, really fat.  Body acceptance is for EVERY BODY.  And this work demands that you accept that you can’t simply solve the problems of weight stigma and weight bias with a poster and a little boost to your self confidence.  Working on your own feelings and confidence are important first steps to coping with weight stigma and weight bias in your own life.  But they are only first steps.  If you really want to fight these problems, you have to move on to finding these oppressions out in the world and making things better–no matter how uncomfortable or unpalatable these messages might be.

And for those of you who want to feel better about your  body, here are three pieces of advice:

1.  Don’t listen to Jillian Michaels.

2.  Don’t listen to Jillian Michaels.

3.  Don’t listen to Jillian Michaels.

Love,

Jeanette DePatie (AKA The Fat Chick)

P.S. Want to hire me to speak about size acceptance, weight bias and weight stigma? CLICK HERE.

Want to join me in making the world a safer place for bodies of ALL sizes?  Click here and join me!

Dear Abby, Let The Fat Chick Give you a Little Advice

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Abby

So I don’t know if you’ve been following the kerfluffle regarding Dear Abby’s terrible advice regarding a fat woman and her mother’s reaction to the crime of wearing a bathing suit while fat.  The whole thing started in August when a woman wrote to Dear Abby saying:

DEAR ABBY: I’m a 24-year-old plus-sized woman (60 or 70 pounds overweight), but very comfortable in my own skin. When swimming in public, I wear a one-piece bathing suit because it doesn’t attract a lot of attention. When I’m home, I have a bikini top and shorts I prefer to wear. This is because I don’t like being covered up like it was in the 1950s, and I feel good when my curves are properly accentuated.
When I go back to see my family and swim, I wear a bikini top and black shorts. Recently, my mother said, “When the family comes over, you can’t wear that. It makes people uncomfortable.” I was shocked, and we had a huge argument. Most of my cousins are fine with my attire, as are my aunts. Only Mom has a problem with it. I asked if she’d feel the same about a large man swimming without a T-shirt. She said it’s different for women. Am I wrong for wanting to be comfortable in my childhood home? Mom should be proud to have a daughter who accepts herself as she is. Who is wrong here? — OFFENDED DAUGHTER IN CHICAGO

And here’s Abby’s assumption-ridden (and apparently clairvoyant) response:

DEAR OFFENDED DAUGHTER: You are not wrong for wanting to be comfortable. But please remember that when you visit someone else’s home, that person’s wishes take precedence — even if it used to be your childhood home. While you say you are comfortable in your own skin, it would be interesting to know what your physician thinks about your obesity. I suspect that your mother would be prouder of you if you were less complacent and more willing to do something about your weight problem.

Oh. My. God.  This response has problems on so many levels.  On the one hand, okay.  When you are visiting someone else’s house, it is a good idea to keep their wishes and their “rules” in mind.  It is their house.  But then, after that we slide off a deeeeep dark cliff into nonsense land.  Why would it be interesting to know what her physician feels about her obesity.  I suspect it’s not interesting at all but rather a sort of boring restatement of the “fat bad, skinny good” trope played out in doctor’s offices everywhere.  The only way this would be interesting is if this doctor were one of the few medical professionals aware of the significant evidence showing:

1.  Weight is not in and of itself a health risk.

2.  Focusing on healthy behavior is more effective than focusing on weight loss for long term health.

3.  Stigmatizing people based on their weight is likely to make them sadder, sicker and fatter.

But that’s not what Abby meant at ALL.  Abby thought, “Hmmm, I’m not a doctor, but if I vaguebook that hazy potential future health threat thing that doctor’s often do towards fat people, maybe I can get away with sounding sort of medical.”

And then we get to the real kicker line of the whole “advice” thing.  Abby says: “I suspect that your mother would be prouder of you if you were less complacent and more willing to do something about your weight problem.”  And I suspect that you, dear Abby are an @ss.  Here’s how I know.  First of all, you are basing this next bit on on assumptions and everybody knows that an assumption makes an @ss out of u and me.

First of all, who says this woman is complacent?  She says she is comfortable in her own skin.  It does not say whether or not she is trying or has tried to lose weight.  It does not say whether or not she exercises or eats well.  It does not say whether or not she actively works to be healthy or not.  It says she doesn’t hate herself for the way she looks.  Well here’s a news flash dear Abby.  Hating yourself is bad for your health.  Period.  Being comfortable in your own skin helps you do the things that give you a more healthy and productive life.  And living your life caught in a cycle of weight cycling to make your Mom proud of you does not even bear discussion.

But wait, it gets “better”.

Not surprisingly, thousands of people wrote Abby letters telling her that she was insensitive, inappropriate and off base.  This presented Abby an opportunity for a “growth experience”.  She could accept that if thousands of people told her she was being an insensitive jerk, perhaps she could reflect carefully on what she wrote.  Maybe she could learn from this experience.  Maybe she could do a little research about the unsubstantiated assertions she made about fat and health.  Maybe she could seek to make amends to the people she hurt with her ham-fisted response.

Did she do this?

Nope.

Abby responded with an even less informed, more hateful response.  And clearly she felt proud of it.  She presented just one of the thousands of letters that called her out and then responded thus:

DEAR LINDA: Thousands of readers in newspapers and online wrote to tell me how angry they were about my response to that letter, accusing me of “fat-shaming.” If anyone was hurt by my reply, I sincerely apologize, because my remarks were not meant to be rude or disrespectful. When I called the young woman after that column ran to apologize if I had hurt her feelings and read her my response to her letter, she told me she was not offended.

When I answer questions, it is my responsibility to be honest and direct. As anyone who has read my column knows, I am not always politically correct. When I saw her statement that she was 60 to 70 pounds overweight — which is obese — and “comfortable in her own skin,” my reaction was alarm. If she doesn’t become proactive now, by the time she’s 35 she could be far heavier.

Everyone knows the many health complications associated with obesity, so I won’t list them. And while not everyone develops complications, in general, the greater a person’s weight, the greater the likelihood of developing them. While losing weight may be challenging, as I know from personal experience, it’s important to make beneficial lifestyle changes to promote healthy weight, just as it is important to have healthy self-esteem.

That young woman needs to have a frank talk with her doctor about what’s causing her to be so heavy. I told her that when I talked to her. I also suggested it might be helpful to consult a nutritionist.

As to my comment about her mother, I strongly suspect what I said is true, and I’ll stand by it until I hear from the woman telling me different.

Oh. My. GOD.

I could honestly write fourteen blog posts about how terrible Abby’s response to the response to her response is, but I have to get my fat butt over to teach an exercise class now.  So let me just move on to offer our dear Abby just a little advice about taking criticism.

1.  If thousands of people take the time to write you a letter to say they are offended, chances are, you said something pretty darn offensive.  This is an excellent time for you to start listening.  In order to do that you will need to STOP TALKING.

2.  If thousands of people take the time to write you a letter to say they are offended, it’s a little silly to say “if anyone was hurt by my reply”.  Yes they were.  And they took the time to tell you so.  If you’re not sure about whether or not they were hurt, some cognitive impairment may be at work here so you should probably STOP TALKING.

3.  Saying you sincerely apologize because you didn’t mean for your remarks to be rude or disrespectful and then continuing for SEVERAL PARAGRAPHS to be even MORE RUDE AND DISRESPECTFUL just makes you look hypocritical and foolish.  If you want to apologize, say I’m sorry.  Say you’ll try to do better and then STOP TALKING.

4.  Saying that somebody who is fat and comfortable now is only going to be fatter down the road is just stupid.  You don’t know that.  You are not psychic.  So this means you should STOP TALKING.

5.  Saying everybody knows the health problems associated with obesity so you won’t list them is lazy.  Literally hundreds of studies contradict the notion that health problems are caused by obesity and a lot of those studies indicate that the real problem is the sort of B.S. stigma you are perpetrating here.  So maybe, as I said before, you should STOP TALKING.

6.  When you insult an entire group of people to the point that thousands of them take the time to write you letters, and then you call one person in that group for absolution.  Even if that person says they are not offended, you are not absolved of your infraction.  You are guilty and that means you should STOP TALKING.

I could go on and on.  But I think I will take my own advice now and listen to what you all have to say.  So I’ll STOP TALKING.

Love, Jeanette DePatie (AKA The Fat Chick)

P.S. If you’d love for me to KEEP TALKING to your group or organization, click HERE to book me.

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Powerful new Resource Helps Medical Professionals Understand HAES.

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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)

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

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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.

Protecting your Heart from new Weight Loss Drugs

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Well it’s that time of year again.  The time of year that we talk about cupids and Valentines and love and stuff.  And, as a good friend of mine on facebook pointed out, we’ve also reached the golden moment where post-Valentine’s day chocolate is 50% off.  It’s the time of year when we think about our hearts.

So in this spirit, I thought I’d write about a new controversy brewing over two new weight loss drugs/combinations that have recently been approved by the FDA.  In 2012, the Food and Drug Administration approved two new sets of magic beans, I mean “weight loss drugs” lolorcaserin hydrochloride (brand name Belviq, manufactured by Eisai Inc.) and phentermine-topiramate (brand name Qsymia, manufactured by Vivus, Inc.).

People have been pretty excited about these coming out, especially since a number of other “weight-loss” drugs have been taken off the market due to concerns over cardiac side-effects.  Now one might think, in light of the fact that we put thousands of people at risk with the previous round of “weight loss” drugs, that the FDA might be extra careful not to release a new round of weight loss drugs with the same problems.

Not so fast, say a pair of doctors in an editorial recently published in the February 10, edition of JAMA.  In this article, Steven Woloshin, MD, and Lisa M. Schwartz, MD, point out that these drugs were approved by the FDA despite an alarming number of side effects.   In the abstract for the piece the doctors state:

The drugs have been associated with serious harms: Both drugs’ labels include warnings about memory, attention, or language problems and depression; for lorcaserin, the label also warns of valvular heart disease and euphoria; and for phentermine-topiramate, the label warns of metabolic acidosis, increased heart rate, anxiety, insomnia, and elevated creatinine levels. Neither medication is marketed in Europe because of safety concerns.

And as I read these words, all I can think is, “Here we go again!”  The drugs were approved under the condition that the drug manufacturers would conduct studies looking into the drugs’ heart risks.   According to the FDA, waiting until such studies were completed to approve the drugs would “delay effective therapy” for obesity.  The post marketing trials that were required to begin 16 months ago, do not appear to have begun.  And even once those trials begin, those studies are not scheduled to be finished for another four or five years.  And in the meantime we’re prescribing drugs known to potentially cause memory, language, attention, mood and serious vascular and inflammatory problems because some trials have shown short-term weight loss improvements of 3 to 7 percent over placebo.  There are no studies indicating long-term weight loss improvements in those who take these medications.  Nor, as Doctors Woloshin and Schwartz point out, is there any proof that these medications prevent disease or help us live any longer.

In the meantime we play with people’s hearts both literally and figuratively.  In a culture and a society where many of us are taught that being overweight is the worst possible situation, doctors are peddling hope in the form of these pills.  And rather than rule out potential cardiac and other serious heart attacks before the drugs are prescribed, doctors prescribe these pills to hundreds of people and “expose a lot of people to it while sorting it out,” said Woloshin.

So we can hope that the “post marketing studies” will actually begin and show no serious, long-term side effects like the permanent heart-valve damage we’ve seen from similar drugs in the past.  We can hope that we won’t market these drugs as the next great hope for people hoping to escape the pain of weight stigma in our society just to have to pull them off the market a short time later.

But I fear this is yet another page in the weight-loss-fantasy playbook likely to leave a string of broken hearts.

Love, Jeanette (AKA The Fat Chick)