The tragedy of Karen Carpenter and the trauma of weight loss

Monday, February 4th, 2013 marked the 30 year anniversary of the death of Karen Carpenter to anorexia nervosa.

Karen Carpenter had one of the most beautiful contralto voices that I have ever heard.  Hers was a heavy loss for music.  In addition to her stunning vocals, she was a rare female drummer who was awarded Best Rock Drummer in Playboy's 1975 annual magazine poll. (How prestigious was this poll?  Apparently, enough to piss off John Bonham of Led Zeppelin, landing in second.)

Her death sparked a national conversation about anorexia and bulimia and inspired several celebrities to go public with their eating disorders, including Jane Fonda and Princess Diana, helping millions of people realize that they are not alone.

(Karen Carpenter wiki.)

There are so many talented women artists out there, and they are some of my biggest inspirations.  And yet many female celebrities, held to a very thin standard, continue to perpetuate a harmful discourse about their size being more important than their careers.

(And here's the part where I dive into the dreaded garbage media.  And lose my mind.)

Jennifer Hudson, weight watchers spokesman, said: "Before Weight Watchers, my world was can't", even though she was already a major star with an Academy Award, Golden Globe, BAFTA Award, NAACP Image Award, Screen Actor's Guild Award, Grammy, and platinum album.  (In a similar vein: Janet Jackson reveals that Nutrisystem brought her success.)

On the Oz Show (I didn't realize that quack had his own show!), Dr. Oz reveals "America's most famous yo-yo dieter" (how about actress with a very long and distinguished career?!) Kirstie Alley, who reveals her dark secret for gaining weight: being in her 50s and wanting to spend time with her kids.  Her awful addiction to baking treats cause the women sitting in the audience to flash politely incredulous looks.  (Do you think the "look judgemental" sign is flashing right next to the one for "applause"?)

And a quick interjection - if you wonder how Oz makes his millions, I watched a 10 minute video on that website and saw no less than five commercials.

Rihanna in a recent interview with Complex magazine: she wants to steal another actress' identity who "just a had a baby and looks even better than I do".  Does better mean thinner?  Why would RiRi want to be thinner??  Hasn't she reached the celebrity gold standard of a perfect, media-sanctioned body?

I'm starting to notice a trend.  Could it be that there's a very strong correlation between weight loss and obsessive body dysmorphia?

credit Toothpaste for Dinner

Readers, I need your help.  Do these celebrity attitudes towards their weight at all resemble yours?  Do you feel that the process of losing weight is inherently traumatic, since your size is such an integral part of their identity?  Or is it important to feel like you have some degree of control over your body, in a way that symbolizes you have control over your life?  Was losing weight empowering for you or was it an impossible endeavor that made you crazy?

Please, tell me about your experiences with weight loss!  You can send me an e-mail or a facebook message, and of course you can leave your story in the comments if you're comfortable with that.

Thanks, guys, and stay phat.

GOOD news!

Amid the fiscal cliff and upcoming debt ceiling talks, Violence Against Women Act (RIP), continuing violence in Syria, human rights abuses in Russia, etc, etc, etc,

At least the little world of size acceptance has had some good news lately.

NYT: "Our Absurd Fear of Fat" by Paul Campos

"The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals."

And based on the same study:

NPR: "Research: A Little Extra Fat Might Help You Live Longer" by Allison Aubrey

A large aspect of this story is the (surprise!) vehement, angry backlash to the CDC/NIH's findings.

Also, Israel has passed a law banning models with a BMI lower than 18.5 from the runway, and requiring magazines to indicate when they have airbrushed a model to look like she has less than a BMI of 18.5.

I find it problematic that the word this article uses to describe these models is "anorexic".  (I chucked at the ABC headline that uses the phrase "BMI-Challenged".)  Still, I'm glad that they are diversifying women's bodies used in the fashion industry.  The article points to this statistic: "73% of teenage girls who abuse diet pills and 79% of teenage girls who self-purge frequently read women's fitness and health magazines." (Statistic via Rader Programs, an eating disorder clinical treatment program.)

Story: Plus Model Mag: "Israel Law Against Anorexic Models Goes Into Effect" (Picture at top mildly NSFW)

Finally, there's this Huffington Post article from today, pointing out the HAES - related fail in the UK Royal College of Physicians report on obesity, including their dubious suggestions to help people lose weight, their misleading spin on how obesity impacts medical costs, pictures of headless fatties, and Meadow's assessment of why the report's entire concern is misguided.  The worst part is the first few comments I read (I know!  I know!  I gotta stop) - defensive people who are concerned with the "why" of obesity - who clearly didn't take in anything from the article.  It's definitely worth a read!

Huffington Post: "Same Year, Same Old Nonsense About Obesity" by Angela Meadows

Now, back to all the important, depressing news in the entire world.

To view other studies that I have published, check out this post.

Just want to clear something up really quick

credit examiner.com

"I can't get behind fat acceptance because I have known fat people who have been sick/have died because they were fat." -Everyone

If you want the perfect response to that misguided person (all 23498072348970324 of them), look no further.  I found it in the comments section of this Jezebel article.  Jezebel, which has criticized the Biggest Loser in the past, broke the news that this awful show will now feature 13-16 year old contestants.  Jezebel is a feminist site that runs FA articles, but,as you might expect, I saw a lot of "but fat is bad for you so I can't support fat acceptance" retorts.  And then I saw this:

"If people think the objection to Biggest Loser is because Fat Acceptance is against health, then you have no clue what Fat Acceptance is about. The problem is that the Biggest Loser promotes an unrealistic and unsustainable lifestyle with a superficial definition of health. Contestants exercise an average of 6 hours a day and engage in severe caloric restriction to get the results that they do. Actual health experts recommend a more modest lifestyle change (150 minutes of moderate exercise or 75 minutes vigorous, plus strength training) and a focus on improving the quality of your diet, rather than engaging in caloric restriction.

Fat Acceptance is not about shunning health. It's about reminding people that we all have the autonomy to make choices about our own health, whether we choose to smoke, drink, have unprotected sex, climb mountains or eat Twinkies. For health, FA recommends Health at Every Size, which basically says that if you make healthy changes, you may improve your metabolic indicators (blood pressure, sugar and lipids), but you may not be thinner for it. But medical research backs that up, as researchers now tout a weight loss of 5-10% of your starting weight as "clinically significant" in terms of the effects on metabolic health. But a 300 pound person losing 15 to 30 pounds is not good television. Forcing inhumane caloric deficits produces 100+ pound weight losses, but has been proven to be unsustainable for the vast majority of people.

So taking this already skewed and unhealthy message and applying it to children is even more dangerous. And for all those saying "SAVE THE FAT KIDS," it's worth noting that just 12 in 100,000 kids have type 2 diabetes, while 2,700 in 100,000 kids have an eating disorder. Encouraging Biggest Loser-esque lifestyle changes will not help the former statistic, it will only worsen the latter.

For an overview of some of the worst violations the Biggest Loser has committed, you can read this post I wrote about Michelle Obama unfortunately endorsing the show:[fiercefatties.com]"

credit to the awesome Shannon at Fierce Fatties.

"But it's SCIENCE": STUDIEZ.

By now, we're all on board that we shouldn't be mean to fat people, right?

(By the way, I love how this blog has played out like a cumulative course in FA 101.  I wish I could bring in guest lecturers, just like a real course!  Or that I was actually qualified to disseminate any of this information.  But thanks for reading.  -The Phat Ally)

Okay, there's this one retort that you, my disbelieving loved one, have.

That being fat is bad for you.  It's SCIENCE!

Okay, this mentality may be a result of years of conditioning or brain washing or whatever you want to call it, but it actually can be credited with almost all our fat hatred: from well-intentioned, condescending "interventions" towards friends to whispering-behind-our-hands, this-gossip-is-justified-because-that-fat-person-has-brought-it-upon-themselves type reactions.

One thing I have definitively learned: the multi-billion dollar industry exists for the purpose of maximizing profit at the expense of the mental health of millions of people, especially women.  So be careful when you read studies.  Are they trying to sell you a diet, with a side of low self-esteem?

Enough talk.  I always talk too much.  This time, I'll let more qualified people do the talking.  With studies that I feel are rigorous and refreshingly free of the weight bias that colors so many other studies.

I hope to keep adding to this list.  Also, links may appear either blue or grey.  I wish I knew how to standardize that, sorry!

On Advocating for a Health at Every Size (HAES) public

health model:

"Healthy Lifestyle Habits and Mortality in Overweight and Obese Individuals"
Source: Medical University of South Carolina, Department of Family Medicine 

"Healthy lifestyle habits are associated with a significant decrease in mortality regardless of baseline body mass index."

"They all work...when you stick to them": a qualitative investigation of dieting, weight loss, and physical exercise, in obese individuals:

Source: National Institute of Health

"Public health approaches to obesity must engage and consult with those currently living with obesity, if patterns of social change are to occur."

"Health at Every Size: New Hope for Obese Americans?"

Source: US Dep of Agriculture

"'For obese folks who can’t find a healthful weight-loss regimen that gives them lasting results, this alternative to conventional dieting may offer greater and more sustainable improvements to several key indicators of their health.'"

"Size acceptance and intuitive eating improve health for obese, female chronic dieters"

Source: UC Davis

"Encouraging size acceptance, reduction in dieting behavior, and heightened awareness and response to body signals resulted in improved health risk indicators for obese women."

"Weight loss for the obese: panacea or pound-foolish?"

Source: National Association for Physical Education in Higher Education

"Because traditional weight loss programs have poor long-term efficacy, a nonweight-centered paradigm might be more effective for improving the health of individuals considered overweight or obese."

"Dietary Therapy for Obesity: An Emperor With No Clothes"

Source: University of Iowa

"As he has ably pointed out in his accompanying article, there are numerous biological, behavioral, and environmental paths to overweight. It is not surprising that the more or less “one size fits all” approaches that have been taken in past behavioral interventions have been less than impressive."

On weight cycling being worse for you than maintaining a constant weight:

"In Obesity Paradox, 'Thinner' May Mean 'Sicker'"

Source: The New York Times

"In study after study, overweight and moderately obese patients with certain chronic diseases often live longer and fare better than normal weight patients with the same ailments."

"The effect of weight cycling on blood lipids and blood pressure in Multiple Risk Factor Intervention Trial Special Intervention Group"
Source: International Journal of Obesity

"RESULTS: Men who weight cycled did not have the predicted smaller improvements in total cholesterol, HDL, the ratio of total cholesterol to HDL, or diastolic blood pressure, compared with noncyclers."

"Genes take charge, and diets fall by the wayside"
Source: The New York Times

"'It is entirely possible that weight reduction, instead of resulting in a normal state for obese patients, results in an abnormal state resembling that of starved nonobese individuals.'"

"Confronting the failure of behavioral and and dietary treatments of obesity"
Source: PsycNET

"The stigmatization of obesity, the overstatement of health risks, and the pervasive influence of the lucrative diet industry have maintained public demand for dietary treatment. However, much evidence suggests that maintenance of high but stable weight is safer than weight fluctuation. "

Pathways from weight fluctuations to metabolic diseases: focus on maladaptive thermogenesis during catch-up fat
Source: International Journal of Obesity

"In particular, Debray et al noted that the early increase in the weight of prisoners transferred from German concentration camps to a Paris hospital in a condition of severe starvation was largely due to the accumulation of fat rather than to the rebuilding of muscles...These findings led Keys et al to describe such preferential fat accumulation and fat overshooting as ‘post-starvation obesity’."

Dieters Put on Weight in the Long Run: Study
Source: Reuters

"'The majority of people -- up to two thirds -- regained all the weight they had lost, plus more.  We concluded most of them would have been better off not going on the diet at all.  Their weight would be pretty much the same, and their bodies would not suffer the war and tear from losing weight and gaining it all back,' said Mann."

"Does Exercise Really Keep Us Healthy?"
Source: The New York Times

"But before you turn to a fitness program as the solution to your particular health or weight concern, consider what science has found...Exercise alone has not been shown to bring sustained weight loss."


NYT: "Our Absurd Fear of Fat" by Paul Campos

"The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals."




Weight loss studies tend to be biased:

"A meta-analysis of the past 25 years of weight loss research using diet, exercise or diet plus exercise intervention."
Source: US National Library of Medicine, National Institute of Health

"Weight loss research over the past 25 y has been very narrowly focused on a middle age population that is only moderately obese, while the interventions lasted for only short periods of time."

"Medicare's Search for Effective Obesity Treatments: Dieting is Not the Answer" (PDF)
Source: UCLA

"It is clear that dieting does not lead to sustained weight loss in the majority of individuals, and additional studies of the effects of dieting on weight are not needed...We recommend that researchers conduct long-term randomized studies on the effects of dieting on health outcomes, with a specific focus on whether the short-term health benefits of weight loss persist after the weight is regained...These studies must make every effort to minimize the biases that led to overly optimistic reports of the success of diets."


I will close with a quote from Michelle Allison, the incredible Fat Nutritionist:

"I am comfortable with the fact that, yes, there is a clear association between higher levels of weight and ill health...I am comfortable with the fact that, yes, behaviour contributes to weight...I am comfortable with the fact that, yes, many people do not find fat people sexually or aesthetically attractively...None of these facts shakes my conviction that It Is Not Okay to Engage In Appearance-Based Discrimination, to deny rights or enforce unfavourable social policies on people because of their appearance. 


"These facts also do not preclude the peculiar theory to which I subscribe, that people can be healthy and happy at a variety of weights by focusing on self-care instead of weight loss, and that, in my opinion, this is a preferable policy to the destructive and ineffective "War on Obesity" we have waged for the last decade."

Post in context.

The BMI post

Hey!  Long time no write.  I've been working, cooking, and receiving a slew of impersonal mass apologies just in time for Yom Kippur.  Although, some one made the good point in my hippy-dippy non-denominational synagogue today that it's not necessarily a bad thing to "exercise your apology muscle" and remind yourself that you have a huge capacity to forgive.  And I think I understand forgiveness for misdeeds better than atonement for sins.  Jewish thought for the day.

Also - since I'm fasting - I'm more attuned to the idea of fat people being chided whenever they are spotted eating.  This morning, I was sitting next to a man who half-jokingly was telling us about how he will weigh himself for Weight Watcher's tonight before break fast.

He can joke, but there is a very real trend of a high incidence of eating disorders among fat people.  Eating disorders are not a new phenomenon in this culture.  There are many different types of mainstream medical professionals who work with eating disordered patients.  And yet all too many of these people have encouraged overweight patients to starve and purge themselves.

Because apparently, you can only have an eating disorder if you have a "normal" BMI.

It's hard to rally laypeople's attitudes around medical science.  But it sickens me, the number of licensed medical professionals that are complicit in favoring the BMI - a quick 19th century formula to determine the average weight proportional to height (according to this 2009 NPR report, in order to determine the allocation of resources to the population) over the urgent psychological/health care that these people really need.

And the BMI's own website is upfront about some of the its shortcomings, but in this society, where invoking the BMI has become a shorthand for determining the be-all end-all of a person's health, I thought it would be useful to talk about some widespread BMI misconceptions.  Namely,

The people with "obese" BMIs look like the headless fatties.

Blogger and fat activist Kate Harding founded the BMI project.  You can read her concise guest post on Shakesville.  To sum it up:




According to BMI, this woman is overweight.  She wears a size 4.

And compare these two women:



(Joy, 5'8", 224 lbs.), "obese with high risk of associated disease", and



(Fillyjonk, 5'7", 225 lbs., one inch shorter and one pound heavier), "obese with very high risk of associated disease".

Also, since BMI does not distinguish between relative bone, fat, and muscle density, then, according to the NPR report, "a person with strong, bones, good muscle tone, and low fat will have a high BMI."  I know I already made this point in my post about Cheryl Haworth, but these olympic athletes clearly have widely varying BMIs:

courtesy roundshape.wordpress.com

Okay, in the meantime, I enthusiastically refer you once more to the NPR report, remind you that our societ's blind hatred of fat often causes us to accept oversimplified explanations to justify that hatred, and advise you to be wary in the future when you hear about the BMI referenced as a health ideal.  Especially if a person who does not have an average BMI is creaking under the pressure of society and killing themselves with disordered eating habits to get there.