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Showing posts with label public health. Show all posts
Showing posts with label public health. Show all posts

Sunday, November 11, 2012

"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."
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.'"

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."

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:

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."


Tuesday, October 30, 2012

gay, smoking, fat

Whew, happy hurricane aftermath.  Is everyone okay?  I'm happy to report that I did not lose power, and in fact spent my Monday watching almost the entire second season of this glorious show:



RuPaul's Drag Race!  The most perfect application of the reality tv format that this world has ever seen.  And besides all the (staged) backstage fights, absurd challenges, and just incredible camp, I love that Logo, the (queer) channel that hosts the show, features moments of the queens talking about their experiences being gay and how doing drag has helped them after rough childhoods.

While I had that thought stewing in the back of my brain, I spent a lot of time today browsing Dave Eggers and Jordan Kurland's site, 90 Days, 90 Reasons, where 90 different writers and performing artists have written short essays on why they are voting for Barack Obama.  I came across Lemony Snicket's essay, which features jaw-dropping quotes from GOP politicians, including this one:

I feel homosexuality is an aberrant, unnatural, and sinful lifestyle, and we now know it can pose a dangerous public health risk.

We can credit Mike Huckabee with this quote.  He said it in 1992, an important year in the AIDS epidemic, when many, less extreme people shared this same belief.  It made me think about changing public perceptions of fatness: on one end of the spectrum we have fat advocates who equate fat hatred with the passe belief that homosexuality was an immoral choice/ communicable disease; and on the other, fatness is like smoking; a bad choice for your health that we should shame and legislate around as much as possible.

Ah, obesity, the next great public health disaster.  Are fat people just "born that way"?  Or are they a product of some giant obesity lobby?  By the way, there is no such thing.

If you read Huckabee's quote out loud and change the word "homosexuality" to "obesity", does it feel natural for you to say?

The most problematic part of this comparison, and Mike Huckabee's wording, is that the idea of fatness is that it's "sinful" - morally reprehensible.  (Uh, it's not.  Prepare for a post on that soon.)  And that it's contagious.  (That is also untrue.)

So yes, as you can imagine, I fall into the camp that wants to push the stigmatization of fat people where it belongs, in the past, with the unfair stigmatization of homosexuality.  Which I believe is not incompatible with a productive dialogue about health that includes every one, regardless of sex, size, or income level.

Okay.  Looking on the other end of the spectrum, we have condescending reactionaries who write garbage articles like this one and think they are so clever.  The beginning of the article actually sounds like a satire, or a critique of the many ways in which we already shame fat people, but by golly the man is serious.  It stresses me out to think that this writer represents the epitome of what we're up against; a complete ignorance of what fatness is/means, an unwillingness to accept that shame is not an effective motivator and a handful of crude fat jokes.

We've already tried shame.  It doesn't work.