our ideas about good mothers and good bodies.
May 13, 2023 3:01 PM Subscribe
Chapter 1: The Myth of the Childhood Obesity Epidemic (in full). And a delightful interview with Virginia Sole-Smith on her new book Fat Talk. Chapter 5 excerpt (on the diet culture of doctors) in TIME, and Chapter 9 excerpt (on fathers) in The Atlantic.
Very excited to read these - thank you.
posted by rrrrrrrrrt at 4:02 PM on May 13, 2023
posted by rrrrrrrrrt at 4:02 PM on May 13, 2023
Thanks for this!
Lately, I’ve been thinking about my first diets. The earliest I can remember was Diet Center at age 9. To be fair, I had put some on, plus my mother was doing it herself alongside me. I’m not mad about it, just sad, because it was the first of many bullshit self-inflicted fad diets or poorly organized eating disorders that left my metabolism in shreds.
And now when I really need to lose some weight to take pressure off joint problems, I don’t know what to fucking do. Punish myself with 1200 calories? Intermittent fasting and binging? Semaglutide? Medifast? Who can say! It all ends in the same place anyway: back where I started.
posted by Countess Elena at 5:28 PM on May 13, 2023 [7 favorites]
Lately, I’ve been thinking about my first diets. The earliest I can remember was Diet Center at age 9. To be fair, I had put some on, plus my mother was doing it herself alongside me. I’m not mad about it, just sad, because it was the first of many bullshit self-inflicted fad diets or poorly organized eating disorders that left my metabolism in shreds.
And now when I really need to lose some weight to take pressure off joint problems, I don’t know what to fucking do. Punish myself with 1200 calories? Intermittent fasting and binging? Semaglutide? Medifast? Who can say! It all ends in the same place anyway: back where I started.
posted by Countess Elena at 5:28 PM on May 13, 2023 [7 favorites]
Childhood obesity is a real medical problem that affects 1 in 5 children and adolescents. It has nothing at all to do with body size phobia or cosmetic preferences about body size. These articles contain a lot of medical misinformation, which is one of the worst types of misinformation.
posted by metatuesday at 5:36 PM on May 13, 2023 [28 favorites]
posted by metatuesday at 5:36 PM on May 13, 2023 [28 favorites]
I think it's best to read the linked post instead of imagining what it says and commenting about that. If you think there's misinformation it would be nice to cite an authoritative dissenting source, or at least specify what misinformation you think there is.
I don't see the linked post as arguing against obesity being medically harmful or claiming that absent stigma outcomes would be the same for obese and non-obese people. There is a hint of downplaying risks from obesity in a Chapter 2 that doesn't seem to be available but I get the sense that it's more about metabolic damage being the main source of adverse outcomes rather than the extra weight itself which as far as I'm aware is the consensus view.
Chapter 1 was pretty heavy, I was not aware there was that level of non-consensual and unhelpful medical treatment going on.
posted by hermanubis at 5:50 PM on May 13, 2023 [23 favorites]
I don't see the linked post as arguing against obesity being medically harmful or claiming that absent stigma outcomes would be the same for obese and non-obese people. There is a hint of downplaying risks from obesity in a Chapter 2 that doesn't seem to be available but I get the sense that it's more about metabolic damage being the main source of adverse outcomes rather than the extra weight itself which as far as I'm aware is the consensus view.
Chapter 1 was pretty heavy, I was not aware there was that level of non-consensual and unhelpful medical treatment going on.
posted by hermanubis at 5:50 PM on May 13, 2023 [23 favorites]
Well I'm glad someone is here to give voice to the underrepresented view that overweight people are unhealthy.
I was afraid we could for once have a discussion about how much damage our current culture does to people's health by focusing on weight as a metric. Thanks for helping us avoid that!
posted by Gygesringtone at 5:53 PM on May 13, 2023 [53 favorites]
I was afraid we could for once have a discussion about how much damage our current culture does to people's health by focusing on weight as a metric. Thanks for helping us avoid that!
posted by Gygesringtone at 5:53 PM on May 13, 2023 [53 favorites]
To take a less-snarky view:
The BMI (which is what the organization you linked to uses to define childhood obesity) is a pretty trash as a metric for adults, like even the guy who suggested using it to measure how healthy a person is weight wise admitted it was simply the easiest of 3 methods that were around at the time, and that none of them were all that good. It also comes from data that largely ignores populations that weren't white, so it's pretty much a useless measure for anyone but white folks. The various rankings for how overweight a person is shift around over time, and the current ones actually came about by WHO doing the opposite of the recommendation from the committee of Doctors they put into place to advise them on it.
Then we get into the fact that extending it to people whose body is constantly changing size and shape gives it extra amounts of trashiness, because kids are constantly changing size and shape as they grow, so like when you measure it will can you a very different view of the kids health, even if the only thing has changed is you've waited 4 months.
But hey, it keeps giving the medical community an excuse to be shitty towards overweight people, so...
posted by Gygesringtone at 6:06 PM on May 13, 2023 [28 favorites]
The BMI (which is what the organization you linked to uses to define childhood obesity) is a pretty trash as a metric for adults, like even the guy who suggested using it to measure how healthy a person is weight wise admitted it was simply the easiest of 3 methods that were around at the time, and that none of them were all that good. It also comes from data that largely ignores populations that weren't white, so it's pretty much a useless measure for anyone but white folks. The various rankings for how overweight a person is shift around over time, and the current ones actually came about by WHO doing the opposite of the recommendation from the committee of Doctors they put into place to advise them on it.
Then we get into the fact that extending it to people whose body is constantly changing size and shape gives it extra amounts of trashiness, because kids are constantly changing size and shape as they grow, so like when you measure it will can you a very different view of the kids health, even if the only thing has changed is you've waited 4 months.
But hey, it keeps giving the medical community an excuse to be shitty towards overweight people, so...
posted by Gygesringtone at 6:06 PM on May 13, 2023 [28 favorites]
???
You're coming into a conversation about how focusing on obesity as a marker of health is harmful; taking up a ton of air by making a little less then half of the comments since your entrance; and focusing on "well obese people ARE unhealthy". If you don't see how that is exactly the sort reducing someone's worth to their weight that you claim to be against I don't know how to help you. We are trying to have a conversation about other aspects of our lives, and you refuse to let that happen because you think it's too important to talk about how weight is a marker of health.
I mean, I'm not one to tell other people what they need to do, but maybe take a minute to think about why THIS is the important part of the article to you and why you have shown ZERO interest in discussing any other aspect. And maybe while you're doing that give overweight folks a space to exist outside of what you think is the important part of our lives.
posted by Gygesringtone at 8:22 PM on May 13, 2023 [12 favorites]
You're coming into a conversation about how focusing on obesity as a marker of health is harmful; taking up a ton of air by making a little less then half of the comments since your entrance; and focusing on "well obese people ARE unhealthy". If you don't see how that is exactly the sort reducing someone's worth to their weight that you claim to be against I don't know how to help you. We are trying to have a conversation about other aspects of our lives, and you refuse to let that happen because you think it's too important to talk about how weight is a marker of health.
I mean, I'm not one to tell other people what they need to do, but maybe take a minute to think about why THIS is the important part of the article to you and why you have shown ZERO interest in discussing any other aspect. And maybe while you're doing that give overweight folks a space to exist outside of what you think is the important part of our lives.
posted by Gygesringtone at 8:22 PM on May 13, 2023 [12 favorites]
Should Metafilter ideally be a fat positive space?
posted by Selena777 at 8:54 PM on May 13, 2023 [4 favorites]
posted by Selena777 at 8:54 PM on May 13, 2023 [4 favorites]
Epidemic is a term normally used to denote a widespread disease.
Is epidemic an appropriate term to use for a group of people weighing more over time? Only if you define higher weights to be as serious as a disease.
The author is questioning that assumption by looking at the data. If you want to refute her you need to be more specific.
posted by emjaybee at 9:15 PM on May 13, 2023 [6 favorites]
Is epidemic an appropriate term to use for a group of people weighing more over time? Only if you define higher weights to be as serious as a disease.
The author is questioning that assumption by looking at the data. If you want to refute her you need to be more specific.
posted by emjaybee at 9:15 PM on May 13, 2023 [6 favorites]
Should Metafilter ideally be a fat positive space?
Ideally.
Difficult to achieve, though, given the existence of the global fatness-revulsion epidemic. The one that's been fucking with my mental health and therefore my health in general since I was a tiny child.
Looking back on my own experience from the perspective the age of 61, I'm fully convinced that the single most helpful contribution that the medical profession and the community generally could possibly make to my chance of achieving a ripe old age as a fat man is stop clutching your fucking pearls about how fat I am.
I have no doubt that people who share my body type show some statistically significant associated morbidities, most of them mediated by an increased risk of heart disease. But stop and think for a minute. How much would your blood pressure elevate if you had to spend your every waking hour absorbing and/or deflecting and/or seeking refuge from a relentless barrage of reminders about what an unacceptable burden on society you are?
My own knees and ankles already complain to me constantly about what they're required to support. They don't need you making things worse. Nor do they need you to keep on reminding me that you think I'm incompetent to manage my own health.
The stereotype would have you believe that fat people are jolly. You know what that is? That's masking.
posted by flabdablet at 10:02 PM on May 13, 2023 [20 favorites]
Ideally.
Difficult to achieve, though, given the existence of the global fatness-revulsion epidemic. The one that's been fucking with my mental health and therefore my health in general since I was a tiny child.
Looking back on my own experience from the perspective the age of 61, I'm fully convinced that the single most helpful contribution that the medical profession and the community generally could possibly make to my chance of achieving a ripe old age as a fat man is stop clutching your fucking pearls about how fat I am.
I have no doubt that people who share my body type show some statistically significant associated morbidities, most of them mediated by an increased risk of heart disease. But stop and think for a minute. How much would your blood pressure elevate if you had to spend your every waking hour absorbing and/or deflecting and/or seeking refuge from a relentless barrage of reminders about what an unacceptable burden on society you are?
My own knees and ankles already complain to me constantly about what they're required to support. They don't need you making things worse. Nor do they need you to keep on reminding me that you think I'm incompetent to manage my own health.
The stereotype would have you believe that fat people are jolly. You know what that is? That's masking.
posted by flabdablet at 10:02 PM on May 13, 2023 [20 favorites]
Countess Elena, there are good systems for improving coordination, and that can buy you a lot of slack for being easy on your joints.
I like Feldenkrais method, and I've been getting good results from the qigong at energyarts.com.
posted by Nancy Lebovitz at 12:02 AM on May 14, 2023 [3 favorites]
I like Feldenkrais method, and I've been getting good results from the qigong at energyarts.com.
posted by Nancy Lebovitz at 12:02 AM on May 14, 2023 [3 favorites]
Mod note: Several deleted. Please allow people to discuss this article without disrupting and derailing with kneejerk commentary that misrepresents the linked material.
posted by taz (staff) at 12:18 AM on May 14, 2023 [8 favorites]
posted by taz (staff) at 12:18 AM on May 14, 2023 [8 favorites]
hey this is a pretty good read overall
posted by DoctorFedora at 2:07 AM on May 14, 2023 [2 favorites]
posted by DoctorFedora at 2:07 AM on May 14, 2023 [2 favorites]
The thing that writing by folks like Sole-Smith and many others really helped click for me around this whole debate is the fact that mainstream narratives around body size and morbidity (i.e. the whole "ob*sity" "epidemic" conversation) do absolutely nothing to help shift the trajectory of the thing they pathologise, while continuing to pathologise it significantly. The internet is full of people who seem horrified at the idea of fat acceptance, and see it as their moral duty to remind folks living in bigger bodies that those bodies are medical problems that need to be addressed urgently. Who seem to equate fat acceptance with giving up the constant fight of reminding larger folks that there's something wrong with their bodies and they have a moral and medical obligation to deal with that.
And of course it's impossible to unpick those 'health' concerns from rampant fat revulsion and fatphobia in our society. And it's impossible to unpick negative health outcomes for folks in larger bodies from medical fatphobia - we genuinely can't tell whether it's actually unhealthier to live in a larger body, or if it's only unhealthier because doctors treat you much worse to the point where you might avoid or delay seeking medical attention, both of which can definitely cause worse health outcomes. And there are no current methods of weight loss that are proven to work in the long term and don't lead to weight cycling and/or an increased risk of disordered eating, both of which also lead to worse health outcomes.
What I'm trying to say here is that it's obvious that the traditional narrative around health and weight does not work at all to tackle the problem it ostensibly exists to identify and solve. And it clearly does increase weight stigma and promotes behaviours that lead to things we do know increase health risks, like the metabolic effects of weight cycling and the even more wide-ranging negative health impacts of disordered eating at any weight.
So I'm totally open to a new way of framing this conversation and grateful for the work Sole-Smith and others are doing in this space, because I can see how it might lead to better discussions and potentially better outcomes. From my own experience, it's been better living in a body that's larger than society or bullshit measures like BMI say it should be while practicing intuitive eating and movement that feels good for me, vs living in the same size body stuck in never-ending waves of disordered eating and weight cycling. If the people who can't help themselves for two seconds without saying "but you're FAT don't you know that's BAD" were actually selling something that works without significant risk, I might consider buying it, but they're not, so I don't.
I'd like to live in a world where the "ob*sity" "epidemic" crowd don't get 90+% of the oxygen in any given room, and one where arguments were based on the actual science around human body weight (including the stuff that doesn't conclude it's your own fault for having no willpower), rather than basing their "health concerns" on the "logic" cycle of see a fat person > feel disgust > perceive that disgust as some kind of moral imperative to improve the fat person's health > shoot their mouth off about something they're not actually any better informed about than anybody else > have no actual impact beyond cruelty and harm because if shaming fat people actually worked, there's so much fat shaming in the world that there would no longer be any fat people. The continued existence of fat people in the face of fat shaming as a "tool" to counter "ob*sity" makes it pretty clear that the tool doesn't work.
The old conversation so obviously doesn't help at all that I actively welcome the new one. And I also thank folks like Sole-Smith and the many other amazing writers and content creators in this space for the idea that even if being fat is unhealthy, no one owes anyone else a particular performance of health from their body. Health is a great thing if you have it and you can sustain it but I don't believe it's a moral imperative to keep your body max healthy through desperate measures to reduce its size any more than it's immoral to develop cancer or any other condition. Bodily autonomy isn't truly autonomous if we don't get to choose what health-promoting measures we do and don't pursue - again, if we can even clearly define what is and isn't healthy in relation to the body, which I'm not confident we fully can with the current state of science.
posted by terretu at 2:14 AM on May 14, 2023 [36 favorites]
And of course it's impossible to unpick those 'health' concerns from rampant fat revulsion and fatphobia in our society. And it's impossible to unpick negative health outcomes for folks in larger bodies from medical fatphobia - we genuinely can't tell whether it's actually unhealthier to live in a larger body, or if it's only unhealthier because doctors treat you much worse to the point where you might avoid or delay seeking medical attention, both of which can definitely cause worse health outcomes. And there are no current methods of weight loss that are proven to work in the long term and don't lead to weight cycling and/or an increased risk of disordered eating, both of which also lead to worse health outcomes.
What I'm trying to say here is that it's obvious that the traditional narrative around health and weight does not work at all to tackle the problem it ostensibly exists to identify and solve. And it clearly does increase weight stigma and promotes behaviours that lead to things we do know increase health risks, like the metabolic effects of weight cycling and the even more wide-ranging negative health impacts of disordered eating at any weight.
So I'm totally open to a new way of framing this conversation and grateful for the work Sole-Smith and others are doing in this space, because I can see how it might lead to better discussions and potentially better outcomes. From my own experience, it's been better living in a body that's larger than society or bullshit measures like BMI say it should be while practicing intuitive eating and movement that feels good for me, vs living in the same size body stuck in never-ending waves of disordered eating and weight cycling. If the people who can't help themselves for two seconds without saying "but you're FAT don't you know that's BAD" were actually selling something that works without significant risk, I might consider buying it, but they're not, so I don't.
I'd like to live in a world where the "ob*sity" "epidemic" crowd don't get 90+% of the oxygen in any given room, and one where arguments were based on the actual science around human body weight (including the stuff that doesn't conclude it's your own fault for having no willpower), rather than basing their "health concerns" on the "logic" cycle of see a fat person > feel disgust > perceive that disgust as some kind of moral imperative to improve the fat person's health > shoot their mouth off about something they're not actually any better informed about than anybody else > have no actual impact beyond cruelty and harm because if shaming fat people actually worked, there's so much fat shaming in the world that there would no longer be any fat people. The continued existence of fat people in the face of fat shaming as a "tool" to counter "ob*sity" makes it pretty clear that the tool doesn't work.
The old conversation so obviously doesn't help at all that I actively welcome the new one. And I also thank folks like Sole-Smith and the many other amazing writers and content creators in this space for the idea that even if being fat is unhealthy, no one owes anyone else a particular performance of health from their body. Health is a great thing if you have it and you can sustain it but I don't believe it's a moral imperative to keep your body max healthy through desperate measures to reduce its size any more than it's immoral to develop cancer or any other condition. Bodily autonomy isn't truly autonomous if we don't get to choose what health-promoting measures we do and don't pursue - again, if we can even clearly define what is and isn't healthy in relation to the body, which I'm not confident we fully can with the current state of science.
posted by terretu at 2:14 AM on May 14, 2023 [36 favorites]
we genuinely can't tell whether it's actually unhealthier to live in a larger body, or if it's only unhealthier because doctors treat you much worse to the point where you might avoid or delay seeking medical attention
or because we internalize the omnipresent message that fat is both inherently disgusting and the obvious root of all ill health.
Fat people are constantly being told in all kinds of ways that if we're sick then we're sick because we're fat, and we're fat because we're too weak willed and lazy to look after ourselves, so if we're sick it's our own fault and it's up to us to choose either losing weight or staying sick. It should come as no surprise that so many of us come to believe it and that our health suffers as a result.
posted by flabdablet at 2:47 AM on May 14, 2023 [9 favorites]
or because we internalize the omnipresent message that fat is both inherently disgusting and the obvious root of all ill health.
Fat people are constantly being told in all kinds of ways that if we're sick then we're sick because we're fat, and we're fat because we're too weak willed and lazy to look after ourselves, so if we're sick it's our own fault and it's up to us to choose either losing weight or staying sick. It should come as no surprise that so many of us come to believe it and that our health suffers as a result.
posted by flabdablet at 2:47 AM on May 14, 2023 [9 favorites]
Then we get into the fact that extending it to people whose body is constantly changing size and shape gives it extra amounts of trashiness, because kids are constantly changing size and shape as they grow, so like when you measure it will can you a very different view of the kids health, even if the only thing has changed is you've waited 4 months.
So this is kind of a tangent to the main discussion, but I think the public largely doesn’t understand how BMI is used to assess weight status in children. The numbers that are used to define categories in adults are not used in kids - it’s the percentile or z-score for their age (85th percentile being where “overweight” starts), which change literally every day they age. The BMI of a “proportional” 5 year old would be EXTREMELY CONCERNING for low weight on a 17 year old.
That doesn’t mean it’s a valid tool, but it does adjust as children age and accounts for expected growth patterns (such as a BMI nadir around 4-6 years old).
As a pediatric dietitian I definitely have a lot of feelings about this. I basically refuse to do weight loss consults, but I can’t just ignore the order, so I’ll assess if there are actually unhealthy modifiable behaviors we can work on. Often there aren’t. Or there are, but there’s also a whole host of socioeconomic factors that outweigh eating a salad and an apple every day. But I’ve also seen extremely heavy six year olds with type two diabetes and hyperlipidemia who are eating half a dozen donuts and six hamburgers and zero fruits or vegetables daily. But still, it’s not the fat that’s the problem, but the food. No one ever consults me to see a slender kid who eats nutrient poor high calorie foods all day, because it’s assumed if they’re not fat they’re okay.
posted by obfuscation at 5:18 AM on May 14, 2023 [20 favorites]
So this is kind of a tangent to the main discussion, but I think the public largely doesn’t understand how BMI is used to assess weight status in children. The numbers that are used to define categories in adults are not used in kids - it’s the percentile or z-score for their age (85th percentile being where “overweight” starts), which change literally every day they age. The BMI of a “proportional” 5 year old would be EXTREMELY CONCERNING for low weight on a 17 year old.
That doesn’t mean it’s a valid tool, but it does adjust as children age and accounts for expected growth patterns (such as a BMI nadir around 4-6 years old).
As a pediatric dietitian I definitely have a lot of feelings about this. I basically refuse to do weight loss consults, but I can’t just ignore the order, so I’ll assess if there are actually unhealthy modifiable behaviors we can work on. Often there aren’t. Or there are, but there’s also a whole host of socioeconomic factors that outweigh eating a salad and an apple every day. But I’ve also seen extremely heavy six year olds with type two diabetes and hyperlipidemia who are eating half a dozen donuts and six hamburgers and zero fruits or vegetables daily. But still, it’s not the fat that’s the problem, but the food. No one ever consults me to see a slender kid who eats nutrient poor high calorie foods all day, because it’s assumed if they’re not fat they’re okay.
posted by obfuscation at 5:18 AM on May 14, 2023 [20 favorites]
But I’ve also seen extremely heavy six year olds with type two diabetes and hyperlipidemia who are eating half a dozen donuts and six hamburgers and zero fruits or vegetables daily. But still, it’s not the fat that’s the problem, but the food. No one ever consults me to see a slender kid who eats nutrient poor high calorie foods all day, because it’s assumed if they’re not fat they’re okay.
In my perfect world, we'd look at and treat health conditions and behaviors only, rather than making assumptions about someone's size. Being judgy, hurtful, or shaming don't "work" in the sense of creating healthy changes; they only "work" in the sense of making people feel bad.
posted by Dip Flash at 6:57 AM on May 14, 2023 [1 favorite]
In my perfect world, we'd look at and treat health conditions and behaviors only, rather than making assumptions about someone's size. Being judgy, hurtful, or shaming don't "work" in the sense of creating healthy changes; they only "work" in the sense of making people feel bad.
posted by Dip Flash at 6:57 AM on May 14, 2023 [1 favorite]
No one ever consults me to see a slender kid who eats nutrient poor high calorie foods all day
It's also generally held as an article of faith that no such kid could possibly exist, despite all of us having met them.
If I notice that I'm eating similar types and quantities of food as somebody else who is similarly tall and similarly old and similarly active, and I'm stacking on the weight and they're not, and I make the mistake of remarking on that, then that's instantly taken as evidence that I am (a) lying (b) delusional (c) making excuses (d) (e) (f) (g) (h) assorted etceteras that you'd expect from the fat kid. It couldn't possibly be just true, because physics, so there!
People go out of their way to ignore the eating habits of slender people with large appetites. We fat ones cop relentless scrutiny and criticism as kids, and end up adopting reputationally unhelpful habits like hiding the evidence of what we've been eating just so others will shut the fuck up about it. And it is unhelpful, because all it takes is getting busted once to cop a doubled and redoubled serve of scrutiny and opprobrium forever.
A lean person eating fish and chips is just eating fish and chips. A fat person eating fish and chips is objectively a pig. Or so I've been kindly informed, in any number of ways, for as long as I've been alive.
posted by flabdablet at 7:07 AM on May 14, 2023 [20 favorites]
It's also generally held as an article of faith that no such kid could possibly exist, despite all of us having met them.
If I notice that I'm eating similar types and quantities of food as somebody else who is similarly tall and similarly old and similarly active, and I'm stacking on the weight and they're not, and I make the mistake of remarking on that, then that's instantly taken as evidence that I am (a) lying (b) delusional (c) making excuses (d) (e) (f) (g) (h) assorted etceteras that you'd expect from the fat kid. It couldn't possibly be just true, because physics, so there!
People go out of their way to ignore the eating habits of slender people with large appetites. We fat ones cop relentless scrutiny and criticism as kids, and end up adopting reputationally unhelpful habits like hiding the evidence of what we've been eating just so others will shut the fuck up about it. And it is unhelpful, because all it takes is getting busted once to cop a doubled and redoubled serve of scrutiny and opprobrium forever.
A lean person eating fish and chips is just eating fish and chips. A fat person eating fish and chips is objectively a pig. Or so I've been kindly informed, in any number of ways, for as long as I've been alive.
posted by flabdablet at 7:07 AM on May 14, 2023 [20 favorites]
we genuinely can't tell whether it's actually unhealthier to live in a larger body, or if it's only unhealthier because doctors treat you much worse to the point where you might avoid or delay seeking medical attention
.... And even if it's unhealthier to live in a larger body, we also genuinely have no idea whether that's a symptom or a cause. That is: okay, say fat bodies are demonstrably unhealthier than skinny ones, because there are several metabolic disorders that cause adipose tissue aggregation or insulin insensitivity or a number of other things that create a fat phenotype.
Take something like sleep apnea. Sure, it's worse in fat people, but sleep deprivation also causes weight gain, so how do we know that the observed correlation between weight and sleep apnea severity is driven by the weight itself rather than the number of sleep interruptions? Maybe it's that people with more severe sleep apnea pack on weight because the sleep disruption changes their body's metabolism; I can think of at least three mechanisms that might create that effect and I haven't worked on metabolism for two years.
If fatness is a symptom but not a cause, then trying to treat people with that symptom by making the symptom go away is, how shall we say this, bad fucking medicine. It's as if we treated everyone with persistent coughs by telling them to stop coughing. We know that coughs are a symptom of decreased health, but coughing is also a behavior so it must be under patient control. Right? At best we can dole out some dextromethorpham to help you manage that, at least if the cough drops and breathing exercises don't work and we believe you've been compliant. When you can present in the doctor's office without engaging in that nasty habit, then we can do further digging to see what really might be wrong.
It's so irritating.
posted by sciatrix at 7:22 AM on May 14, 2023 [27 favorites]
.... And even if it's unhealthier to live in a larger body, we also genuinely have no idea whether that's a symptom or a cause. That is: okay, say fat bodies are demonstrably unhealthier than skinny ones, because there are several metabolic disorders that cause adipose tissue aggregation or insulin insensitivity or a number of other things that create a fat phenotype.
Take something like sleep apnea. Sure, it's worse in fat people, but sleep deprivation also causes weight gain, so how do we know that the observed correlation between weight and sleep apnea severity is driven by the weight itself rather than the number of sleep interruptions? Maybe it's that people with more severe sleep apnea pack on weight because the sleep disruption changes their body's metabolism; I can think of at least three mechanisms that might create that effect and I haven't worked on metabolism for two years.
If fatness is a symptom but not a cause, then trying to treat people with that symptom by making the symptom go away is, how shall we say this, bad fucking medicine. It's as if we treated everyone with persistent coughs by telling them to stop coughing. We know that coughs are a symptom of decreased health, but coughing is also a behavior so it must be under patient control. Right? At best we can dole out some dextromethorpham to help you manage that, at least if the cough drops and breathing exercises don't work and we believe you've been compliant. When you can present in the doctor's office without engaging in that nasty habit, then we can do further digging to see what really might be wrong.
It's so irritating.
posted by sciatrix at 7:22 AM on May 14, 2023 [27 favorites]
People go out of their way to ignore the eating habits of slender people with large appetites.
I resemble this remark! And your point is true. I eat a lot even when I'm being inactive, and when I'm doing physical exertion that goes way up. Occasionally people will make joking comments like "where do you put all that?" and so on, and all the time people make comments about metabolisms, but the closest to judgy is the very occasional person who expresses revulsion about seeing someone eating a large amount of food.
Friends who are larger and who eat perfectly normally are always getting unsolicited diet comments and input.
posted by Dip Flash at 7:36 AM on May 14, 2023 [4 favorites]
I resemble this remark! And your point is true. I eat a lot even when I'm being inactive, and when I'm doing physical exertion that goes way up. Occasionally people will make joking comments like "where do you put all that?" and so on, and all the time people make comments about metabolisms, but the closest to judgy is the very occasional person who expresses revulsion about seeing someone eating a large amount of food.
Friends who are larger and who eat perfectly normally are always getting unsolicited diet comments and input.
posted by Dip Flash at 7:36 AM on May 14, 2023 [4 favorites]
It's also generally held as an article of faith that no such kid could possibly exist, despite all of us having met them.
They're called teenage boys, and people will joke about this just by saying those words and rolling their eyes. Of course teen boys aren't the only people who can eat a lot without gaining weight, but the point is that others accept that. Then they turn around and act as if every body is a machine that runs on the same CICO equation or that it can switch to the backup fuel tanks in your hips with just a little effort. I can't count the times that, even through my twenties, I would tell myself: look, it's very simple, the body will burn fat if I just don't eat so just stop eating! This never lasted long, only long enough to make me feel morally defective.
posted by Countess Elena at 7:45 AM on May 14, 2023 [8 favorites]
They're called teenage boys, and people will joke about this just by saying those words and rolling their eyes. Of course teen boys aren't the only people who can eat a lot without gaining weight, but the point is that others accept that. Then they turn around and act as if every body is a machine that runs on the same CICO equation or that it can switch to the backup fuel tanks in your hips with just a little effort. I can't count the times that, even through my twenties, I would tell myself: look, it's very simple, the body will burn fat if I just don't eat so just stop eating! This never lasted long, only long enough to make me feel morally defective.
posted by Countess Elena at 7:45 AM on May 14, 2023 [8 favorites]
And even if it's unhealthier to live in a larger body, we also genuinely have no idea whether that's a symptom or a cause.
I wish I could remember where I found this, but I saw a quote recently from someone who was either a doctor or a dietitian along the lines of "during my training we were constantly reminded that correlation does not imply causation, except when it came to assumptions around health and fat bodies, at which point we were basically told that correlation does indeed imply causation".
If correlation only implies causation when it comes to ideas like fat bodies automatically being unhealthy bodies, that's fatphobia rather than science.
posted by terretu at 7:58 AM on May 14, 2023 [21 favorites]
I wish I could remember where I found this, but I saw a quote recently from someone who was either a doctor or a dietitian along the lines of "during my training we were constantly reminded that correlation does not imply causation, except when it came to assumptions around health and fat bodies, at which point we were basically told that correlation does indeed imply causation".
If correlation only implies causation when it comes to ideas like fat bodies automatically being unhealthy bodies, that's fatphobia rather than science.
posted by terretu at 7:58 AM on May 14, 2023 [21 favorites]
That is an extremely good quote, terretu.
posted by obfuscation at 8:02 AM on May 14, 2023 [1 favorite]
posted by obfuscation at 8:02 AM on May 14, 2023 [1 favorite]
They're called teenage boys, and people will joke about this just by saying those words and rolling their eyes.
I mean, I agree with the rest of your comment, but as a former fat teenage boy, who knew several average weight teenage girls who ate way more than me, I'd ask that you stop and examine if this bit is REALLY true, or just a weird cultural artifact.
Like, I know that teenagers eat a lot because they're growing, mentally and physically, and that's expensive calorically. I've got one kid going through that right now and another ramping up to start pretty quickly. But the idea that all teenage boys can eat without being fat just runs really counter to my personal experience, and the idea that it's teenage boys that can do that seems like part and parcel to the general policing of female bodies that happens.
Anyway, I've been slowly reading the transcript linked and the supplementary material because I was, as I mentioned, an overweight kid. And this kind of hits hard for me. The thing is I wasn't constantly overweight, sometimes I'd shoot up and be REALLY TALL and 'normal' sized, and sometimes I'd slow down and be average and fat, and sometimes I'd be just tall and big. But, my Mom was constantly dieting, and while her struggles with anti-fat bias and misogyny aren't really mine to tell, I will say that my entire youth I was shown the message that if I was overweight it was because my relationship with food was messed up. And like, as a kid who was all over the place size and shape wise, but was pretty consistent with what I was eating... that got complicated really fast. I'm still dealing with a lot of the fall out from that.
This paragraph in particular struck me really hard:
posted by Gygesringtone at 8:24 AM on May 14, 2023 [6 favorites]
I mean, I agree with the rest of your comment, but as a former fat teenage boy, who knew several average weight teenage girls who ate way more than me, I'd ask that you stop and examine if this bit is REALLY true, or just a weird cultural artifact.
Like, I know that teenagers eat a lot because they're growing, mentally and physically, and that's expensive calorically. I've got one kid going through that right now and another ramping up to start pretty quickly. But the idea that all teenage boys can eat without being fat just runs really counter to my personal experience, and the idea that it's teenage boys that can do that seems like part and parcel to the general policing of female bodies that happens.
Anyway, I've been slowly reading the transcript linked and the supplementary material because I was, as I mentioned, an overweight kid. And this kind of hits hard for me. The thing is I wasn't constantly overweight, sometimes I'd shoot up and be REALLY TALL and 'normal' sized, and sometimes I'd slow down and be average and fat, and sometimes I'd be just tall and big. But, my Mom was constantly dieting, and while her struggles with anti-fat bias and misogyny aren't really mine to tell, I will say that my entire youth I was shown the message that if I was overweight it was because my relationship with food was messed up. And like, as a kid who was all over the place size and shape wise, but was pretty consistent with what I was eating... that got complicated really fast. I'm still dealing with a lot of the fall out from that.
This paragraph in particular struck me really hard:
But when we talk about the impossibility of raising a happy, fat child, we’re ignoring the why: It’s not their bodies causing these kids to have higher rates of anxiety, depression, and disordered eating behaviors. Even when high weight does play a role in health issues, as we’ll explore in Chapter 2, it’s often a corresponding symptom, a constellation point in a larger galaxy of concerns. The real danger to a child in a larger body is how we treat them for having that body. Fat kids are harmed by the world, including, too often, their own families.I grew up relatively unscathed by a most of it, but it was a really close call, and other people in my situation would have been a lot worse off at the end, I'm just lucky that I have the temperament I do. I know I wasn't as happy growing up as I could have been, and I know that I'm very careful what I say around my kids to not inflict my own hangups on them. To this day, I still occasionally remember something that was said to me, or things I did on my own to try and "be healthy" and think "boy that was really messed up".
posted by Gygesringtone at 8:24 AM on May 14, 2023 [6 favorites]
Also I just want to say I was guilty of the Teenage Boy thing myself until I saw how differently some family members treated my son going back for 3rds than my daughter at the same age a handful years later. I'm sure there is a ton of other things in my own thinking\speech like that lurking around in my own brain. Breaking free of a cultural narrative is really hard work. Especially when it's one that's we've been telling ourselves.
posted by Gygesringtone at 8:37 AM on May 14, 2023 [5 favorites]
posted by Gygesringtone at 8:37 AM on May 14, 2023 [5 favorites]
Should Metafilter ideally be a fat positive space?
If we want the full and equal participation of metafilter's fat members, then yes. Based on how I find most weight, nutrition, diet, threads on mf go I'm not convinced a great deal of the community wouldn't actually rather the fat people stopped showing up with in these discussions. I'm also convinced the same many have no idea how biased they are being and would go the grave swearing it's about the health and the science and saving children or something (there is always a moral component to fatphobia that means fat adults cannot/should not advocate for their better treatment, it is morally wrong from them to do so).
the idea that it's teenage boys that can do that seems like part and parcel to the general policing of female bodies that happens.
So I spent the last four years teaching at a very fatphobic, "progressive" hippie boarding school. The kids complained about being hungry all the time. The adults were terrified of the kids having too many calories or eating "unhealthy" foods, or, honestly, resting bc free time not spent active was "unhealthy". Food preferences were considered basically a joke (despite a rather self-selecting population of neurodivergent students ending up there). No one ever brought up the eating behaviors of a male student, ever, during meetings about student well-being. There'd be discussion about how we should make sure to basically police one of the two overweight (and only Black) female student bc she must surely have bad food hidden in her dorm room so we should watch her and 'encourage' her to make healthy choices. Not a word paid to the majority of the girls dorm being constantly exhausted, cold, spaced out, and coming to required meals to only push some white rice around and eat nothing, every day. No discussion of them. No discussion of the boys who also ate poorly, worked out excessively etc. I mean it was a truly messed up place for food. I knew better than anyone.
Because... I went there as a student and it was exactly the same in the early aughts. Except now there is even MORE moralizing wellness makeup on the clown's face, and social media pressure is hounding the kids relentlessly. Disordered eating is worse than it's ever been for young people. My heart truly breaks for this generation.
posted by wellifyouinsist at 8:51 AM on May 14, 2023 [10 favorites]
If we want the full and equal participation of metafilter's fat members, then yes. Based on how I find most weight, nutrition, diet, threads on mf go I'm not convinced a great deal of the community wouldn't actually rather the fat people stopped showing up with in these discussions. I'm also convinced the same many have no idea how biased they are being and would go the grave swearing it's about the health and the science and saving children or something (there is always a moral component to fatphobia that means fat adults cannot/should not advocate for their better treatment, it is morally wrong from them to do so).
the idea that it's teenage boys that can do that seems like part and parcel to the general policing of female bodies that happens.
So I spent the last four years teaching at a very fatphobic, "progressive" hippie boarding school. The kids complained about being hungry all the time. The adults were terrified of the kids having too many calories or eating "unhealthy" foods, or, honestly, resting bc free time not spent active was "unhealthy". Food preferences were considered basically a joke (despite a rather self-selecting population of neurodivergent students ending up there). No one ever brought up the eating behaviors of a male student, ever, during meetings about student well-being. There'd be discussion about how we should make sure to basically police one of the two overweight (and only Black) female student bc she must surely have bad food hidden in her dorm room so we should watch her and 'encourage' her to make healthy choices. Not a word paid to the majority of the girls dorm being constantly exhausted, cold, spaced out, and coming to required meals to only push some white rice around and eat nothing, every day. No discussion of them. No discussion of the boys who also ate poorly, worked out excessively etc. I mean it was a truly messed up place for food. I knew better than anyone.
Because... I went there as a student and it was exactly the same in the early aughts. Except now there is even MORE moralizing wellness makeup on the clown's face, and social media pressure is hounding the kids relentlessly. Disordered eating is worse than it's ever been for young people. My heart truly breaks for this generation.
posted by wellifyouinsist at 8:51 AM on May 14, 2023 [10 favorites]
I read some of the arguments about BMI and I think it's important to point out what it is useful for and what it's not.
BMI is a ratio of height to weight, basically. While it's true that the raw number can be misleading, there are uses for it. On the large scale, it can show trends over time in populations. It can also show differences in body composition tendencies for different cultures and ethnicities. On the individual level, it's fair to say that the number itself says only a little about your overall health. However, over time, it can reveal trends and that information is useful.
On of the reasons weight and/or BMI are discussed so much is because it is one of the few object measures of fitness a typical person can use in their daily life to improve their health and longevity. Yes it's true that you can weigh a lot and still be healthy. However, if a person has experienced a recent weight gain, that can be a sign that they should look at other factors in their life. (Did their diet or daily lifestyle change?) For 90%+ people, weight is a good metric for measuring the one thing they can control in their health: their diet. Yes, BMI can be less useful if a person's body composition is different. However, there is not sufficient evidence to show that, for the vast majority of people, increased muscle mass has led them to misunderstand their BMI. We do not have a muscle epidemic in the Western world.
posted by Stabilator at 9:03 AM on May 14, 2023 [2 favorites]
BMI is a ratio of height to weight, basically. While it's true that the raw number can be misleading, there are uses for it. On the large scale, it can show trends over time in populations. It can also show differences in body composition tendencies for different cultures and ethnicities. On the individual level, it's fair to say that the number itself says only a little about your overall health. However, over time, it can reveal trends and that information is useful.
On of the reasons weight and/or BMI are discussed so much is because it is one of the few object measures of fitness a typical person can use in their daily life to improve their health and longevity. Yes it's true that you can weigh a lot and still be healthy. However, if a person has experienced a recent weight gain, that can be a sign that they should look at other factors in their life. (Did their diet or daily lifestyle change?) For 90%+ people, weight is a good metric for measuring the one thing they can control in their health: their diet. Yes, BMI can be less useful if a person's body composition is different. However, there is not sufficient evidence to show that, for the vast majority of people, increased muscle mass has led them to misunderstand their BMI. We do not have a muscle epidemic in the Western world.
posted by Stabilator at 9:03 AM on May 14, 2023 [2 favorites]
To those who say that BMI is only a correlation, it is worth reading the SOS study, which found that reducing weight reduced mortality and a host of other adverse weight-related outcomes over the course of 10 to 20 years of follow-up.
I am surprised that the body shaming issue and the health issue of obesity are so difficult to discuss separately, but they are indeed separate issues. Pointing out that obesity is associated with long-term health consequences is not body shaming. In people with metabolically healthy obesity, transition to metabolically unhealthy obesity occurred about 8 times more often than among non-obese patients.
That said, it may be possible to have a true healthy obesity. Sumo wrestlers, for example, have subcutaneous fat, and almost no visceral fat. They do not have impaired glucose tolerance. It is also possible to be nonobese and have a lot of visceral fat (the so called thin outside fat inside or TOFI phenomenon).
Twin studies show a strong effect of heredity on the risk of obesity, but that does not explain the increase in obesity in Western culture over the post-WWII period.
A lot of scholarship has been dedicated to studying obesity as it affects population health and discarding all of that is counterproductive. People researching and treating people have the common goal of finding ways to help people live longer and healthier lives. And part of that is addressing the societal biases that exist around obesity and combatting those biases.
posted by metatuesday at 9:09 AM on May 14, 2023 [12 favorites]
I am surprised that the body shaming issue and the health issue of obesity are so difficult to discuss separately, but they are indeed separate issues. Pointing out that obesity is associated with long-term health consequences is not body shaming. In people with metabolically healthy obesity, transition to metabolically unhealthy obesity occurred about 8 times more often than among non-obese patients.
That said, it may be possible to have a true healthy obesity. Sumo wrestlers, for example, have subcutaneous fat, and almost no visceral fat. They do not have impaired glucose tolerance. It is also possible to be nonobese and have a lot of visceral fat (the so called thin outside fat inside or TOFI phenomenon).
Twin studies show a strong effect of heredity on the risk of obesity, but that does not explain the increase in obesity in Western culture over the post-WWII period.
A lot of scholarship has been dedicated to studying obesity as it affects population health and discarding all of that is counterproductive. People researching and treating people have the common goal of finding ways to help people live longer and healthier lives. And part of that is addressing the societal biases that exist around obesity and combatting those biases.
posted by metatuesday at 9:09 AM on May 14, 2023 [12 favorites]
Can we for once, please, talk about overweight people's lived experiences without having to debate the BMI?
I'm asking as one human being to another, let me tell my story. I'm asking as a person here to engage with other people, let them tell their stories.
Please.
posted by Gygesringtone at 9:59 AM on May 14, 2023 [10 favorites]
I'm asking as one human being to another, let me tell my story. I'm asking as a person here to engage with other people, let them tell their stories.
Please.
posted by Gygesringtone at 9:59 AM on May 14, 2023 [10 favorites]
As long as we are talking about lived experience, I would like to share my own. I grew up in a family of Eastern European immigrants to the United States who would constantly talk about weight and would force-feed, having experienced abject poverty and the privations of war. I was diagnosed with childhood obesity and overcame it by becoming a competitive long-distance runner. My pediatrician said, “You are living proof that childhood obesity can be addressed with lifestyle change.” Unfortunately, my experience is not typical.
BMI is one metric and it is imperfect, but the very word “overweight” is a mathematical definition based on BMI, so any discussion of this issue implies the discussion of the relative merits and drawbacks of this measure
Having lived with and struggled with weight, engaged with people struggling with weight, and studied weight bias, this is a subject I fee qualified to discuss.
Deleting my constructive, factual, and respectful comments reflects poorly on this community.
Weight bias and the medical consequences of obesity are frequently conflated, but they are separate issues. Although some may want to talk about obesity if it were a bias issue alone, that is not the full story.
posted by metatuesday at 10:42 AM on May 14, 2023 [6 favorites]
BMI is one metric and it is imperfect, but the very word “overweight” is a mathematical definition based on BMI, so any discussion of this issue implies the discussion of the relative merits and drawbacks of this measure
Having lived with and struggled with weight, engaged with people struggling with weight, and studied weight bias, this is a subject I fee qualified to discuss.
Deleting my constructive, factual, and respectful comments reflects poorly on this community.
Weight bias and the medical consequences of obesity are frequently conflated, but they are separate issues. Although some may want to talk about obesity if it were a bias issue alone, that is not the full story.
posted by metatuesday at 10:42 AM on May 14, 2023 [6 favorites]
If correlation only implies causation when it comes to ideas like fat bodies automatically being unhealthy bodies, that's fatphobia rather than science
It's absolutely not true to say that the evidence for fat being unhealthy just comes from correlations. Yes, the correlations exist and are strong. But we also know the mechanisms by which fat causes ill health. And there are a vast number of experimental studies in animals ranging from fruit flies to fish to mammals where you overfeed them and cause illness in them.
If someone said it was uncertain whether asbestos dust causes cancer, that maybe it's just an accidental correlation in humans, and the animal experiments where you expose them to asbestos and they get cancer should be ignored because they're just animals, you wouldn't take them seriously at all. I don't see why the equivalent statement for fatness gets so much credence on Metafilter.
posted by TheophileEscargot at 10:45 AM on May 14, 2023 [6 favorites]
It's absolutely not true to say that the evidence for fat being unhealthy just comes from correlations. Yes, the correlations exist and are strong. But we also know the mechanisms by which fat causes ill health. And there are a vast number of experimental studies in animals ranging from fruit flies to fish to mammals where you overfeed them and cause illness in them.
If someone said it was uncertain whether asbestos dust causes cancer, that maybe it's just an accidental correlation in humans, and the animal experiments where you expose them to asbestos and they get cancer should be ignored because they're just animals, you wouldn't take them seriously at all. I don't see why the equivalent statement for fatness gets so much credence on Metafilter.
posted by TheophileEscargot at 10:45 AM on May 14, 2023 [6 favorites]
Pointing out that obesity is associated with long-term health consequences is not body shaming.
I've had that very thing pointed out to me ad nauseam by well-meaning thinsplainers for my entire life. And having fully internalized it well before my critical thinking ability grew in: every single time one of you does that, I experience shame.
So it is exactly body shaming, and I'll thank you to keep it to yourself for the rest of this thread. Preferably forever if there are fat people in range.
posted by flabdablet at 11:00 AM on May 14, 2023 [19 favorites]
I've had that very thing pointed out to me ad nauseam by well-meaning thinsplainers for my entire life. And having fully internalized it well before my critical thinking ability grew in: every single time one of you does that, I experience shame.
So it is exactly body shaming, and I'll thank you to keep it to yourself for the rest of this thread. Preferably forever if there are fat people in range.
posted by flabdablet at 11:00 AM on May 14, 2023 [19 favorites]
If I understand getting fat correctly, it's what bodies do when they are anticipating a calorie deficit. Cis-girls approaching puberty put on weight. They can't actually hit puberty until they have a threshold percentage of fat. The fat helps regulate the hormones and provides a stockpile for if they get pregnant and/or nurse a baby. They have the calorie resources to do it, even if they don't get access to the additional calories that being pregnant and nursing requires.
Bears gain weight in the autumn before they hibernate. They spend the winter months living on the fat stores. Other animals, including humans gain weight and store fat in their bodies during periods of stress, particularly if they are being harassed by others and have low status. The fat they are storing is presumably a stockpile for if the others start blocking them access to food sources. It's a reaction to feeling like you are going into competitions you are going to lose. I understand that you can gain weight without taking in extra calories. If you stress an individual they start storing more of the calories they already take in, instead of either excreting them or burning them up in activity. I've read about rats on a diet that was too low in nutrients to sustain them long term gaining weight before they died from dietary deficiencies, not just minerals and vitamins, but also calories.
I'm pretty sure it's also made more complicated by our metabolisms and how we digest and absorb food, which in turn is partially dependent on our digestive biota. If you eat lots of beans and lentils in your life chances are high you have a large population of the bacteria that helps you digest those things and maximize the absorption of the nutrients, whereas if you never ever eat beans, suddenly doing so in large quantities will result in bloat and discomfort while your digestive system struggles to deal with and actually make use of what you ate. The same is true for other food like meat, refined sugar, milk and raw vegetables.
So does the aversion for fatness and the rise in the number of fat people chart with capitalist competition? Has anyone ever measured changes in fatness by population and compared it with changes in status and life expectations?
For example one of the worst things any person can do for their status and income is to get pregnant. It significantly curtails their job prospects and career, and their status in their immediate social circle. And despite burning extra calories to nourish their infants, nowadays pregnant and nursing mothers frequently gain weight anyway. Does that chart with the loss of status that so many of them incur?
posted by Jane the Brown at 11:01 AM on May 14, 2023 [3 favorites]
Bears gain weight in the autumn before they hibernate. They spend the winter months living on the fat stores. Other animals, including humans gain weight and store fat in their bodies during periods of stress, particularly if they are being harassed by others and have low status. The fat they are storing is presumably a stockpile for if the others start blocking them access to food sources. It's a reaction to feeling like you are going into competitions you are going to lose. I understand that you can gain weight without taking in extra calories. If you stress an individual they start storing more of the calories they already take in, instead of either excreting them or burning them up in activity. I've read about rats on a diet that was too low in nutrients to sustain them long term gaining weight before they died from dietary deficiencies, not just minerals and vitamins, but also calories.
I'm pretty sure it's also made more complicated by our metabolisms and how we digest and absorb food, which in turn is partially dependent on our digestive biota. If you eat lots of beans and lentils in your life chances are high you have a large population of the bacteria that helps you digest those things and maximize the absorption of the nutrients, whereas if you never ever eat beans, suddenly doing so in large quantities will result in bloat and discomfort while your digestive system struggles to deal with and actually make use of what you ate. The same is true for other food like meat, refined sugar, milk and raw vegetables.
So does the aversion for fatness and the rise in the number of fat people chart with capitalist competition? Has anyone ever measured changes in fatness by population and compared it with changes in status and life expectations?
For example one of the worst things any person can do for their status and income is to get pregnant. It significantly curtails their job prospects and career, and their status in their immediate social circle. And despite burning extra calories to nourish their infants, nowadays pregnant and nursing mothers frequently gain weight anyway. Does that chart with the loss of status that so many of them incur?
posted by Jane the Brown at 11:01 AM on May 14, 2023 [3 favorites]
The rest of the discussion? Meaningless. Not unless we stop and make sure that every fat person in here who said long complex and personally meaningful things shuts up and agrees that obesity BAD. /s
I get it. Our pleas for how this focus on 'disease', this oversimplification, that pathologization is unhelpful, counter-productive, CAUSES MORE HARM AND SUFFERING. PERIOD. All of that's meaningless to you vultures. MEANINGLESS, unless we say first and foremost we are bad unhealthy and immoral people, who should be ashamed. OBESITY BAD BMI RIGHT okay good, now we may talk about medical abuse. Only first if we preface can our opinions without how shamed we are of ourselves and how of course, being fat is a bad bad thing and you're not fat you're OBESE and it's the MOST important thing about you. Can I only speak to this if I 'struggle' with my weight? Because a long time ago I decided to stop STRUGGLING with my weight and just decided to BE A FAT PERSON. I'm fat. I will always be fat, no matter what I eat or do, just like THE FUCKING SCIENCE actually says (that diets don't work), so can we MOVE FORWARD AND REDUCE HARM.
We are begging you to stop harming us. For many complex reasons that the several chapters lay out explaining why and how it's harmful and more nuanced. But damn if it's impossible for these people. Will you move on? Get more in depth and empathetic with the conversation? Anything at all? No, of course not.
posted by wellifyouinsist at 11:07 AM on May 14, 2023 [23 favorites]
I get it. Our pleas for how this focus on 'disease', this oversimplification, that pathologization is unhelpful, counter-productive, CAUSES MORE HARM AND SUFFERING. PERIOD. All of that's meaningless to you vultures. MEANINGLESS, unless we say first and foremost we are bad unhealthy and immoral people, who should be ashamed. OBESITY BAD BMI RIGHT okay good, now we may talk about medical abuse. Only first if we preface can our opinions without how shamed we are of ourselves and how of course, being fat is a bad bad thing and you're not fat you're OBESE and it's the MOST important thing about you. Can I only speak to this if I 'struggle' with my weight? Because a long time ago I decided to stop STRUGGLING with my weight and just decided to BE A FAT PERSON. I'm fat. I will always be fat, no matter what I eat or do, just like THE FUCKING SCIENCE actually says (that diets don't work), so can we MOVE FORWARD AND REDUCE HARM.
We are begging you to stop harming us. For many complex reasons that the several chapters lay out explaining why and how it's harmful and more nuanced. But damn if it's impossible for these people. Will you move on? Get more in depth and empathetic with the conversation? Anything at all? No, of course not.
posted by wellifyouinsist at 11:07 AM on May 14, 2023 [23 favorites]
Bit of a fragile breed, your common or garden thinspert. They can't wait to tell you, but they bitterly resent being told.
posted by flabdablet at 11:21 AM on May 14, 2023 [4 favorites]
posted by flabdablet at 11:21 AM on May 14, 2023 [4 favorites]
I grew up in a family of Eastern European immigrants to the United States who would constantly talk about weight and would force-feed, having experienced abject poverty and the privations of war. I was diagnosed with childhood obesity and overcame it by becoming a competitive long-distance runner. My pediatrician said, “You are living proof that childhood obesity can be addressed with lifestyle change.” Unfortunately, my experience is not typical.
See now, this story, this is a contribution to the dialogue. Way more than repeating "truths" that I can almost guarantee every one of us has been told by our doctors. What you went through sounds like a truly terrible experience, much worse than my own, and I have a much better understanding of where you are coming from.
Having people obsess over what food they do or don't eat is harmful to kids. Like, I know people who grew up in households obsessed with how "natural" the foods they ate were, and I grew up having every helping of food discretely (they thought) analyzed to make sure it was a "healthy choice" and not going to contribute to my "weight problem". There's a lot of commonality between our experiences. I bet I can also find a lot in common with you, because we both experienced opposite sides of our eating being controlled to soothe adult fears.
And in the end, that's what the article is talking about, how harmful it is for adults to use kids as a proxy for our own issues and fears. Even if we wrap the issues up in "concern for the kid's health".
posted by Gygesringtone at 11:50 AM on May 14, 2023 [5 favorites]
See now, this story, this is a contribution to the dialogue. Way more than repeating "truths" that I can almost guarantee every one of us has been told by our doctors. What you went through sounds like a truly terrible experience, much worse than my own, and I have a much better understanding of where you are coming from.
Having people obsess over what food they do or don't eat is harmful to kids. Like, I know people who grew up in households obsessed with how "natural" the foods they ate were, and I grew up having every helping of food discretely (they thought) analyzed to make sure it was a "healthy choice" and not going to contribute to my "weight problem". There's a lot of commonality between our experiences. I bet I can also find a lot in common with you, because we both experienced opposite sides of our eating being controlled to soothe adult fears.
And in the end, that's what the article is talking about, how harmful it is for adults to use kids as a proxy for our own issues and fears. Even if we wrap the issues up in "concern for the kid's health".
posted by Gygesringtone at 11:50 AM on May 14, 2023 [5 favorites]
Gygesringtone: I apologize; I should have been more careful. I guess I haven't actually unpacked a lot of my own assumptions and received wisdom about the way men's bodies respond to dieting and food intake.
So does the aversion for fatness and the rise in the number of fat people chart with capitalist competition?
This is always what I have understood, seeing as beauty ideals have become more and more slender with the increasing industrialization and mechanization of the world. (Take a look at illustrations of the great beauties and rakes of the 17th and 18th century. Double chins everywhere.) But Sole-Smith has also been arguing that racism has a lot to do with it.
This clip about black grandmas is funny, and it made me smile because it reminded me so much of women I grew up around, but in this context it's of interest. "That chart ain't for our bodies, anyway!"
posted by Countess Elena at 11:54 AM on May 14, 2023 [4 favorites]
So does the aversion for fatness and the rise in the number of fat people chart with capitalist competition?
This is always what I have understood, seeing as beauty ideals have become more and more slender with the increasing industrialization and mechanization of the world. (Take a look at illustrations of the great beauties and rakes of the 17th and 18th century. Double chins everywhere.) But Sole-Smith has also been arguing that racism has a lot to do with it.
This clip about black grandmas is funny, and it made me smile because it reminded me so much of women I grew up around, but in this context it's of interest. "That chart ain't for our bodies, anyway!"
posted by Countess Elena at 11:54 AM on May 14, 2023 [4 favorites]
Like, I know that teenagers eat a lot because they're growing, mentally and physically, and that's expensive calorically. I've got one kid going through that right now and another ramping up to start pretty quickly. But the idea that all teenage boys can eat without being fat just runs really counter to my personal experience, and the idea that it's teenage boys that can do that seems like part and parcel to the general policing of female bodies that happens.
Or, for that matter, that once you stop your growth spurt, you can go very quickly from being a skinny teenage boy to an unskinny young man in nothing flat, which is precisely what happened to me.
posted by Halloween Jack at 12:19 PM on May 14, 2023
Or, for that matter, that once you stop your growth spurt, you can go very quickly from being a skinny teenage boy to an unskinny young man in nothing flat, which is precisely what happened to me.
posted by Halloween Jack at 12:19 PM on May 14, 2023
My only problem with these links is that they all have links to more pieces I want to read and names of books that sound interesting and other writers mentioned that I would like to seek out...
Anyway, in the words of Ms Sole-Smith herself, "Listening to fat people and believing what we say about our bodies will very likely mean you have to question a lot of your assumptions about weight and health, diet, and exercise, and what it means to be a good person, with a good body."
Starting with that instead of expressing concern that people here or somewhere aren't taking obesity seriously would make this conversation worthwhile.
posted by Emmy Rae at 12:28 PM on May 14, 2023 [7 favorites]
Anyway, in the words of Ms Sole-Smith herself, "Listening to fat people and believing what we say about our bodies will very likely mean you have to question a lot of your assumptions about weight and health, diet, and exercise, and what it means to be a good person, with a good body."
Starting with that instead of expressing concern that people here or somewhere aren't taking obesity seriously would make this conversation worthwhile.
posted by Emmy Rae at 12:28 PM on May 14, 2023 [7 favorites]
"It significantly curtails their job prospects and career, and their status in their immediate social circle."
You're saying that family and friends look down their nose at pregnant women, Jane The Brown? Where do you get that idea?
posted by Selena777 at 12:33 PM on May 14, 2023 [1 favorite]
You're saying that family and friends look down their nose at pregnant women, Jane The Brown? Where do you get that idea?
posted by Selena777 at 12:33 PM on May 14, 2023 [1 favorite]
Other animals, including humans gain weight and store fat in their bodies during periods of stress, particularly if they are being harassed by others and have low status.
This very interesting idea is completely new to me. I would appreciate references.
posted by ALeaflikeStructure at 12:36 PM on May 14, 2023
This very interesting idea is completely new to me. I would appreciate references.
posted by ALeaflikeStructure at 12:36 PM on May 14, 2023
I am in between things this weekend and therefore in and out, but let me point out that stress induced adiposity gain is a common enough phenomenon that it's actually a reasonably common mouse obesity model.
Fun fact: the hormones we call "stress hormones" (aka glucocorticoids) are exactly the same ones that are intimately tangled in energy balance and maintaining appropriate blood sugar levels. That's where the gluco in glucocorticoid comes from.
posted by sciatrix at 12:43 PM on May 14, 2023 [14 favorites]
Fun fact: the hormones we call "stress hormones" (aka glucocorticoids) are exactly the same ones that are intimately tangled in energy balance and maintaining appropriate blood sugar levels. That's where the gluco in glucocorticoid comes from.
posted by sciatrix at 12:43 PM on May 14, 2023 [14 favorites]
1) It does not matter if fat is healthy or not, because weight loss from diet and exercise has never been shown to work for even half of participants 5 years out. When the most-recommended treatment is ineffective, and the weight-cycling from repeated dieting attempts leads to worse health outcomes than a stable fatter weight (they do), it’s on doctors and researchers to find cost-effective long-term interventions that work for most people and don’t have widespread, disabling side effects. You think fat is dangerous and care about fat people’s health? Fund research into new medical therapies, and get off our backs. Stress kills too. And medical fatphobia.
2) A lot of chemicals, including DDT (widely used in the 60s), are intergenerational obesogens to the point where you could be fatter because your great-grandma was exposed.
posted by vim876 at 4:02 PM on May 14, 2023 [16 favorites]
2) A lot of chemicals, including DDT (widely used in the 60s), are intergenerational obesogens to the point where you could be fatter because your great-grandma was exposed.
posted by vim876 at 4:02 PM on May 14, 2023 [16 favorites]
Selena777, Pregnant women are definitely sidelined - they're not individuals anymore but gestating vehicles. And pregnant women's weight gain is policed, as is what they eat and drink, how much they move - it's heightened scrutiny "for the baby", but also because this is where socially, they are the most dependent on everyone else. And don't get me started on post-partum pregnancy weight loss which is terrifyingly intense.
I really appreciate this discussion and people speaking up to push back politely and to share their own experiences.
posted by dorothyisunderwood at 6:32 PM on May 14, 2023 [4 favorites]
I really appreciate this discussion and people speaking up to push back politely and to share their own experiences.
posted by dorothyisunderwood at 6:32 PM on May 14, 2023 [4 favorites]
1) It does not matter if fat is healthy or not, because weight loss from diet and exercise has never been shown to work for even half of participants 5 years out.
This is another thing that just isn't true.
This is another thing that just isn't true.
...increased frequency of weight loss attempts of five pounds or more in middle-aged adults was associated with lower future mortality risk. As compared with individuals who never intentionally lost at least five pounds, individuals who had 11+ attempts over 20 years had a 12% lower risk of death. Notably, this inverse association was observed even among those who gained weight over the 20-year period, suggesting some benefit to frequent attempts at weight loss even if weight is eventually gained over time.posted by TheophileEscargot at 8:47 PM on May 14, 2023
I don’t know, I somehow don’t think you can really apply a study of AARP members to discussions about childhood obesity.
posted by Gygesringtone at 9:34 PM on May 14, 2023
posted by Gygesringtone at 9:34 PM on May 14, 2023
I don’t know, I somehow don’t think you can really apply a study of AARP members to discussions about childhood obesity.
Here ya go
Here ya go
Type 2 diabetes is increasingly prevalent in adolescents and young adults who have had obesity during childhood. When it is diagnosed in young individuals, the morbidity and mortality rate is higher than when it occurs later in life, and more dangerous than type 1 diabetes. Childhood obesity also increases the risk for several autoimmune diseases such as multiple sclerosis, Crohn's disease, arthritis, and type 1 diabetes and it is well established that childhood obesity also increases the risk for cardiovascular disease. Consequently, childhood obesity increases the risk for premature mortality, and the mortality rate is three times higher already before 30 years of age compared with the normal population. The risks associated with childhood obesity are modified by weight loss. However, the risk reduction is affected by the age at which weight loss occurs. In general, early weight loss-that is, before puberty-is more beneficial, but there are marked disease-specific differences...posted by TheophileEscargot at 9:58 PM on May 14, 2023 [1 favorite]
Weight loss in childhood seems to be even more beneficial for long-term cardiovascular health than weight loss in adulthood. A weight loss of 0.2 BMI Z-score units (corresponds to approximately 5–6 kg weight loss for an adult) is associated with reduced cardiometabolic risk markers. Hypertension is effectively reduced provided that marked weight loss is achieved. Moreover, obesity in childhood that does not remain till adulthood does not seem to be associated with increased long-term morbidity compared with children who have had normal weight during childhood.
That article doesn't really say there's a definitive effective weight loss treatment either:
The efficacy of childhood obesity treatment is still rather limited [60, 219]. A reduction in calorie intake is always the goal, but this is difficult to achieve in our society. Intensive lifestyle support with frequent visits every other week is required to obtain a consistent effect [220], but this is rarely an option for families or health care systems.
The authors also point out that you have to be careful interpreting the review:
However, it has to be emphasized that the associations between weight loss and long-term comorbidities have to be handled cautiously. There are decades between the weight loss and some of the comorbidities studied, and the obesity treatment offered 20–40 years ago was of limited efficiency and often nonexistent. During such conditions, genetic and social factors contributed considerably to weight loss, factors that may also affect later comorbidity risks. Thus, the associations between specific diseases and the timing of weight loss have to be confirmed in studies performed when effective weight-loss treatment methods are available.
So even if we want to talk about the impact of weight loss, rather than how achievable and sustainable it is, we still need to be careful about causation and correlation.
posted by ghost phoneme at 6:31 AM on May 15, 2023 [7 favorites]
The efficacy of childhood obesity treatment is still rather limited [60, 219]. A reduction in calorie intake is always the goal, but this is difficult to achieve in our society. Intensive lifestyle support with frequent visits every other week is required to obtain a consistent effect [220], but this is rarely an option for families or health care systems.
The authors also point out that you have to be careful interpreting the review:
However, it has to be emphasized that the associations between weight loss and long-term comorbidities have to be handled cautiously. There are decades between the weight loss and some of the comorbidities studied, and the obesity treatment offered 20–40 years ago was of limited efficiency and often nonexistent. During such conditions, genetic and social factors contributed considerably to weight loss, factors that may also affect later comorbidity risks. Thus, the associations between specific diseases and the timing of weight loss have to be confirmed in studies performed when effective weight-loss treatment methods are available.
So even if we want to talk about the impact of weight loss, rather than how achievable and sustainable it is, we still need to be careful about causation and correlation.
posted by ghost phoneme at 6:31 AM on May 15, 2023 [7 favorites]
There are decades between the weight loss and some of the comorbidities studied, and the obesity treatment offered 20–40 years ago was of limited efficiency and often nonexistent.
When was this study written? 20 years ago was 2003, and my mom has been yo-yo dieting for the past 40, and basically nothing has changed since then. I guess the main change is the caffiene diet pills are more fringe now, and weight loss via smoking is less encouraged.
posted by The_Vegetables at 7:59 AM on May 15, 2023 [3 favorites]
When was this study written? 20 years ago was 2003, and my mom has been yo-yo dieting for the past 40, and basically nothing has changed since then. I guess the main change is the caffiene diet pills are more fringe now, and weight loss via smoking is less encouraged.
posted by The_Vegetables at 7:59 AM on May 15, 2023 [3 favorites]
Also unfortunately, a lot of the SlimeMold/Time Mold stuff has been mostly debunked, or they quoted the study in a questionable manner, or jumped to seriously wrong conclusions and have not responded to criticisms, specifically around animal weight gain (not true) and CICO increases are far more than enough to account for all the weight gain, no special chemicals needed. Which sucks.
posted by The_Vegetables at 8:16 AM on May 15, 2023
posted by The_Vegetables at 8:16 AM on May 15, 2023
"... this inverse association was observed even among those who gained weight over the 20-year period, suggesting some benefit to frequent attempts at weight loss even if weight is eventually gained over time."
Huh. Wow. It almost sounds as if a person's weight doesn't have much impact either way and that it's eating vegetables and exercising that gives people longer lives enjoyed in better health. (Given that when people attempt to lose weight, they eat vegetables and exercise.)
If that is the science, it would make sense to begin now to drown out your automatic "hurfdurfbuttereater" inner monologue that starts up whenever you see a fat person with "I cannot and do not know what the contents of that person's colon are based on their adipose tissue. I do not know anything at all whatsoever about that person's health."
posted by Don Pepino at 8:36 AM on May 15, 2023 [11 favorites]
Huh. Wow. It almost sounds as if a person's weight doesn't have much impact either way and that it's eating vegetables and exercising that gives people longer lives enjoyed in better health. (Given that when people attempt to lose weight, they eat vegetables and exercise.)
If that is the science, it would make sense to begin now to drown out your automatic "hurfdurfbuttereater" inner monologue that starts up whenever you see a fat person with "I cannot and do not know what the contents of that person's colon are based on their adipose tissue. I do not know anything at all whatsoever about that person's health."
posted by Don Pepino at 8:36 AM on May 15, 2023 [11 favorites]
Chapter 1 makes the point that, (1) over the decades, humans have become fatter. But, also over the decades, (2) humans have become taller. And, over the decades, (3) humans are living longer. Points 2 and 3 are always considered positives, but point 1 is always a negative. Why? If we're fatter and still living longer, why is being fat so negative?
I'm fat. Recently, I've tried semaglutide (in Wegovy, not Ozempic, but it's the same). I lost 20 pounds, but I have felt pretty miserable the whole time (and I'm still fat!). It's got crappy side effects and I'm going off of it this week because having a life with my family is more important to me than losing weight.
But one thing I noticed--one one thing other people I've talked to on social media noticed--it that food noise disappears. Someone wondered if this was what "normal" people felt like, those people who claimed that you could just stop eating through willpower. Maybe those people respond better to ghrelin and leptin than some fat people do. Maybe they just throw out "eat less and exercise more" because they don't know what it feels like to feel hungry and think about food all the time. What I ate at my last meal, what I'll eat at my next, what will I eat tomorrow? It sucks to feel that way all the time. And, if the semaglutide subreddits are anything to go by, some people feel that way all the time.
I'm tired of it all. I just want to live--happily--in my body, no matter what size it is.
posted by ceejaytee at 10:45 AM on May 15, 2023 [14 favorites]
I'm fat. Recently, I've tried semaglutide (in Wegovy, not Ozempic, but it's the same). I lost 20 pounds, but I have felt pretty miserable the whole time (and I'm still fat!). It's got crappy side effects and I'm going off of it this week because having a life with my family is more important to me than losing weight.
But one thing I noticed--one one thing other people I've talked to on social media noticed--it that food noise disappears. Someone wondered if this was what "normal" people felt like, those people who claimed that you could just stop eating through willpower. Maybe those people respond better to ghrelin and leptin than some fat people do. Maybe they just throw out "eat less and exercise more" because they don't know what it feels like to feel hungry and think about food all the time. What I ate at my last meal, what I'll eat at my next, what will I eat tomorrow? It sucks to feel that way all the time. And, if the semaglutide subreddits are anything to go by, some people feel that way all the time.
I'm tired of it all. I just want to live--happily--in my body, no matter what size it is.
posted by ceejaytee at 10:45 AM on May 15, 2023 [14 favorites]
When was this study written? 20 years ago was 2003, and my mom has been yo-yo dieting for the past 40, and basically nothing has changed since then.
It's a review article from 2022. They didn't include parameters of what they considered including in this review, so drawing any hard or fast findings from this probably isn't advisable. To be fair, this isn't put forth as a systematic review.
But I think your experience is probably broadly applicable: the table of "treatment options" had a lot of "limited effect" and "low adherence" entries.
Just read the chapter 5 excerpt and the doctor mentioned she doesn't do routine weighings anymore. I wonder if that's catching on: I had a doctor's visit the other day where I didn't have to get on a scale. It was for a bump on my lip that wasn't going away, so weight wasn't really going to be relevant to the visit and I'd been in for my annual a few months ago. I don't remember the last time I didn't have to hop on a scale.
The MA did ask what my weight was, but my blood pressure was high--as it always is at the doctor's office, regardless of where I am on the BMI scale. So maybe that's why? Or maybe it's a screening. Any dramatic weight change, up or down, should probably get checked out: Sudden dramatic weight loss has been the first sign of a big problem (definitely not the good thing it was sometimes initially treated as) for a few different friends/relatives.
posted by ghost phoneme at 1:56 PM on May 15, 2023 [1 favorite]
It's a review article from 2022. They didn't include parameters of what they considered including in this review, so drawing any hard or fast findings from this probably isn't advisable. To be fair, this isn't put forth as a systematic review.
But I think your experience is probably broadly applicable: the table of "treatment options" had a lot of "limited effect" and "low adherence" entries.
Just read the chapter 5 excerpt and the doctor mentioned she doesn't do routine weighings anymore. I wonder if that's catching on: I had a doctor's visit the other day where I didn't have to get on a scale. It was for a bump on my lip that wasn't going away, so weight wasn't really going to be relevant to the visit and I'd been in for my annual a few months ago. I don't remember the last time I didn't have to hop on a scale.
The MA did ask what my weight was, but my blood pressure was high--as it always is at the doctor's office, regardless of where I am on the BMI scale. So maybe that's why? Or maybe it's a screening. Any dramatic weight change, up or down, should probably get checked out: Sudden dramatic weight loss has been the first sign of a big problem (definitely not the good thing it was sometimes initially treated as) for a few different friends/relatives.
posted by ghost phoneme at 1:56 PM on May 15, 2023 [1 favorite]
Story 1:
It's hard to overstate the doctor diet culture. My MIL has in the last 5 years gone from "dialysis might be soon" and "can't walk 6 houses down the street" to much-improved kidney function, much better numbers, and she walks 3-4 km a day. She also has lost over 125 lbs. She went from a lot of insulin to very little. (Basically none really.)
In her case, I would say that the first priority was getting the right medical care - not losing the weight. She needed different medication than she was getting, to get physio for pain she had while walking that was not weight-related, and so on. Once she was feeling better, then she did start losing weight.
Here's the heartbreaking thing though...the family doctor that referred her to the right specialists and changes up her meds and really got her on her feet...is now obsessed with the last 20 lbs to get her to 'goal' weight.
It's somewhat bizarre because my mother-in-law has already demonstrably had good health outcomes (and again, I do believe the weight loss was not the primary cause, although it is significant).
But now she doesn't want to go to the very doctor that achieved those results, because every appointment is about that last 20 lbs. And she's tired of it and it stresses her out. It absolutely boggles my mind. Because my MIL is doing way way better than ever predicted and at over 75, she's fine.
That is just one example but that is the absolute toxicity of diet culture. \
* Her blood sugar always goes up under stress, and generally not that much due to carbs. It's like we don't understand anything.
Story 2:
When I was pregnant with my eldest son I couldn't gain weight and he wasn't growing enough. So I was put on a 4500 calories/day diet. It was horrid. I was crying at 7 pm because I didn't want to eat before lying down due to my organs being compressed as they are in pregnancy, and trying to drink milkshakes packed with protein powder, and tapioca, etc.
I was in the grocery store miserably buying ice cream, whole milk, and pasteurized brie when a woman came up and critiqued my cart and suggested I look at her cart. Well, kale-and-chickpea-salad lady, my obstetrician advised me against kale as it would fill me up without giving me any calories for my baby, thanks.
That was not even close to the only time people felt they had to police my eating while pregnant.
Story 3:
I've told this before but one of my friends was obese and she had back pain, which her doctor insisted for a long, long time was due to her weight. She finally switched doctors and nope, it was a disk problem. I, not skinny but not really overweight, had a collapsed disk around the same time. I saw my doctor once, got x-rays, got opiate pain medication and physical therapy. Same exact issue. Different belly fat.
posted by warriorqueen at 2:49 PM on May 15, 2023 [19 favorites]
It's hard to overstate the doctor diet culture. My MIL has in the last 5 years gone from "dialysis might be soon" and "can't walk 6 houses down the street" to much-improved kidney function, much better numbers, and she walks 3-4 km a day. She also has lost over 125 lbs. She went from a lot of insulin to very little. (Basically none really.)
In her case, I would say that the first priority was getting the right medical care - not losing the weight. She needed different medication than she was getting, to get physio for pain she had while walking that was not weight-related, and so on. Once she was feeling better, then she did start losing weight.
Here's the heartbreaking thing though...the family doctor that referred her to the right specialists and changes up her meds and really got her on her feet...is now obsessed with the last 20 lbs to get her to 'goal' weight.
It's somewhat bizarre because my mother-in-law has already demonstrably had good health outcomes (and again, I do believe the weight loss was not the primary cause, although it is significant).
But now she doesn't want to go to the very doctor that achieved those results, because every appointment is about that last 20 lbs. And she's tired of it and it stresses her out. It absolutely boggles my mind. Because my MIL is doing way way better than ever predicted and at over 75, she's fine.
That is just one example but that is the absolute toxicity of diet culture. \
* Her blood sugar always goes up under stress, and generally not that much due to carbs. It's like we don't understand anything.
Story 2:
When I was pregnant with my eldest son I couldn't gain weight and he wasn't growing enough. So I was put on a 4500 calories/day diet. It was horrid. I was crying at 7 pm because I didn't want to eat before lying down due to my organs being compressed as they are in pregnancy, and trying to drink milkshakes packed with protein powder, and tapioca, etc.
I was in the grocery store miserably buying ice cream, whole milk, and pasteurized brie when a woman came up and critiqued my cart and suggested I look at her cart. Well, kale-and-chickpea-salad lady, my obstetrician advised me against kale as it would fill me up without giving me any calories for my baby, thanks.
That was not even close to the only time people felt they had to police my eating while pregnant.
Story 3:
I've told this before but one of my friends was obese and she had back pain, which her doctor insisted for a long, long time was due to her weight. She finally switched doctors and nope, it was a disk problem. I, not skinny but not really overweight, had a collapsed disk around the same time. I saw my doctor once, got x-rays, got opiate pain medication and physical therapy. Same exact issue. Different belly fat.
posted by warriorqueen at 2:49 PM on May 15, 2023 [19 favorites]
From the Chapter 8 excerpt in the FPP:
It’s a painful memory. As is her own memory of being 8 years old and reveling in eating an entire plate of french fries in a restaurant — only to be reprimanded by both of her parents.
HOLY FLASHBACKS, Batman.
All through my little-kid childhood you got to sort of level up your food orders as you "proved" you were big enough. I very, very clearly remember the day, shortly after I had graduated into being able to order whatever I wanted (probably 9 or 10 years old), scarfing down a Big Mac with abandon and my mother scolding me that it was nothing to be proud of for a girl to eat so much.
Thirty five years later I still have not managed to unpick the four hundred toxic bullshits woven together into that sentence. And I was a skinny kid, by any metric but hers. I can only imagine how much worse it would have been if I wasn't, if that horrifying trash fire message had been coming from every adult, everywhere, all the time.
posted by We put our faith in Blast Hardcheese at 3:16 PM on May 15, 2023 [7 favorites]
It’s a painful memory. As is her own memory of being 8 years old and reveling in eating an entire plate of french fries in a restaurant — only to be reprimanded by both of her parents.
HOLY FLASHBACKS, Batman.
All through my little-kid childhood you got to sort of level up your food orders as you "proved" you were big enough. I very, very clearly remember the day, shortly after I had graduated into being able to order whatever I wanted (probably 9 or 10 years old), scarfing down a Big Mac with abandon and my mother scolding me that it was nothing to be proud of for a girl to eat so much.
Thirty five years later I still have not managed to unpick the four hundred toxic bullshits woven together into that sentence. And I was a skinny kid, by any metric but hers. I can only imagine how much worse it would have been if I wasn't, if that horrifying trash fire message had been coming from every adult, everywhere, all the time.
posted by We put our faith in Blast Hardcheese at 3:16 PM on May 15, 2023 [7 favorites]
Oh also -
Story 4:
My son, the one that wouldn't grow, is now over 6 ft and built like his dad - Viking shoulders. But he did do that thing where he grew really fast, plus pandemic, and then his growth stopped and now he's overweight. I have no idea what my role should be, like should I even care, and I have sooooo many toxic eating messages that I get really almost like, blocked trying to figure it out. (Also food in my house is very complicated because of all this stuff.)
Anyways, I consulted his doctor when I had a chance (not in front of him) and his doctor said "it's not yours to manage, mum, back off" to me, and so I have. That was great advice.
And a few weeks ago my son decided on his own to talk to this doctor (same group as the other, but a different one) about...I don't know what, but he did mention weight was one thing, and came home with what seems like a good approach - which is don't worry, eat right 80% of the time, get exercise. I continue to stay out of it and just have food around.
Thanks for these links, I'll be getting the book.
posted by warriorqueen at 3:30 PM on May 15, 2023 [10 favorites]
Story 4:
My son, the one that wouldn't grow, is now over 6 ft and built like his dad - Viking shoulders. But he did do that thing where he grew really fast, plus pandemic, and then his growth stopped and now he's overweight. I have no idea what my role should be, like should I even care, and I have sooooo many toxic eating messages that I get really almost like, blocked trying to figure it out. (Also food in my house is very complicated because of all this stuff.)
Anyways, I consulted his doctor when I had a chance (not in front of him) and his doctor said "it's not yours to manage, mum, back off" to me, and so I have. That was great advice.
And a few weeks ago my son decided on his own to talk to this doctor (same group as the other, but a different one) about...I don't know what, but he did mention weight was one thing, and came home with what seems like a good approach - which is don't worry, eat right 80% of the time, get exercise. I continue to stay out of it and just have food around.
Thanks for these links, I'll be getting the book.
posted by warriorqueen at 3:30 PM on May 15, 2023 [10 favorites]
metatuesday, your physician was not correct; I'm very glad you were able to become a distance runner, if you enjoy running. It's great for a lot of people. But every case is different -- bodies react differently, and circumstances differ. You pointed out that many are not so fortunate, but you didn't expand.
I would say that, first, most girls do not have the live option of becoming distance runners. It's not part of their experience of girlhood, or femininity, and many parents would simply not allow it. (And, it can lead to real health problems in adolescence for those raised as women.)
Many people don't have access to the kind of coaching that makes for healthy training -- how many runners on MeFi have told stories about why they had to stop running, because of health or injury problems? it's not available to everyone.
People can't afford the shoes, or they don't live in areas where running is safe, or pleasant. I currently live in Boston, home of The Marathon -- many neighborhoods here are just impossible to run in due to traffic, pollution, and the state of the road/pavement.
I have friends who struggle with weight and they report that running while "ob*se" is not possible for them -- their backs, their knees, what have you.
So I don't know how it worked for you, or why, or what stars aligned made it possible for you to do extreme sports and thus lose weight, but most of us cannot do it. I'm glad for you, and I hope you are happy and also love food.
The bottom line is this: nobody gets healthy because someone else makes them feel bad about their body. Metabolism is tricky, and doctors still don't know what they are doing when it comes to weight. They tell you to lose weight, they think if you aren't losing weight you must be "cheating", but they don't know.
Everyone has to eat. They have to. And living in a fat-hating society is exhausting as hell, and it's not making anyone healthier.
posted by allthinky at 6:23 PM on May 16, 2023 [6 favorites]
I would say that, first, most girls do not have the live option of becoming distance runners. It's not part of their experience of girlhood, or femininity, and many parents would simply not allow it. (And, it can lead to real health problems in adolescence for those raised as women.)
Many people don't have access to the kind of coaching that makes for healthy training -- how many runners on MeFi have told stories about why they had to stop running, because of health or injury problems? it's not available to everyone.
People can't afford the shoes, or they don't live in areas where running is safe, or pleasant. I currently live in Boston, home of The Marathon -- many neighborhoods here are just impossible to run in due to traffic, pollution, and the state of the road/pavement.
I have friends who struggle with weight and they report that running while "ob*se" is not possible for them -- their backs, their knees, what have you.
So I don't know how it worked for you, or why, or what stars aligned made it possible for you to do extreme sports and thus lose weight, but most of us cannot do it. I'm glad for you, and I hope you are happy and also love food.
The bottom line is this: nobody gets healthy because someone else makes them feel bad about their body. Metabolism is tricky, and doctors still don't know what they are doing when it comes to weight. They tell you to lose weight, they think if you aren't losing weight you must be "cheating", but they don't know.
Everyone has to eat. They have to. And living in a fat-hating society is exhausting as hell, and it's not making anyone healthier.
posted by allthinky at 6:23 PM on May 16, 2023 [6 favorites]
I totally agree that my experience was not typical. It was sort of an “exception that proves the rule” type of inference my pediatrician made. I do not mean to imply that everyone in any circumstances could have done something similar.
It seems difficult to talk about the science of metabolism without making some people feel bad about themselves, and that is never my intention. In fact, the opposite is the case. Did you know that Michigan is the only state where there is legislation protecting employment discrimination based on body size? I think we need more legislation like that nationwide.
People are built differently, and genetics are an important factor, as shown by twin studies. And, as stated before, it is possible to be any body size and be metabolically healthy or metabolically unhealthy.
All of that said, we are facing some issues in Western society that make optimal metabolic health very difficult to achieve. Those factors are systemic and not the fault of people living in those societies, and are not addressable without policy change. We need walkable communities instead of urban sprawl, changes to regulations around the way foods are processed and flavored (there are food scientists who work only on making food flavorings that increase consumption), changes to what is allowed in advertising of foods, amelioration of food deserts, and changes to our schools, our workplaces, alongside many other factors. Those external influences that need policy solutions have been so often blamed on the people as a personal failure when they are not personal failures at all, but systemic issues.
posted by metatuesday at 7:56 AM on May 17, 2023
It seems difficult to talk about the science of metabolism without making some people feel bad about themselves, and that is never my intention. In fact, the opposite is the case. Did you know that Michigan is the only state where there is legislation protecting employment discrimination based on body size? I think we need more legislation like that nationwide.
People are built differently, and genetics are an important factor, as shown by twin studies. And, as stated before, it is possible to be any body size and be metabolically healthy or metabolically unhealthy.
All of that said, we are facing some issues in Western society that make optimal metabolic health very difficult to achieve. Those factors are systemic and not the fault of people living in those societies, and are not addressable without policy change. We need walkable communities instead of urban sprawl, changes to regulations around the way foods are processed and flavored (there are food scientists who work only on making food flavorings that increase consumption), changes to what is allowed in advertising of foods, amelioration of food deserts, and changes to our schools, our workplaces, alongside many other factors. Those external influences that need policy solutions have been so often blamed on the people as a personal failure when they are not personal failures at all, but systemic issues.
posted by metatuesday at 7:56 AM on May 17, 2023
"It significantly curtails their job prospects and career, and their status in their immediate social circle."
You're saying that family and friends look down their nose at pregnant women, Jane The Brown? Where do you get that idea?
posted by Selena
Oh everybody in the family gushes over the baby, but you don't get invited out Friday night after having to cancel once because of needing a sitter. And the number of guys in your dating pool contracts enormously. And you tend to be passed over for promotion. And they treat you differently at the grocery store - your shopping cart gets cut off. People crowd you more in public.
You also can't shoulder people aside the way you used to once you have a baby with you. Getting on the bus or to the front of the line is a lot harder. Older people don't consider you sweet anymore, they consider the baby sweet. You start getting judged on your parenting.
Status drops in a lot of ways.
posted by Jane the Brown at 10:15 AM on May 17, 2023
You're saying that family and friends look down their nose at pregnant women, Jane The Brown? Where do you get that idea?
posted by Selena
Oh everybody in the family gushes over the baby, but you don't get invited out Friday night after having to cancel once because of needing a sitter. And the number of guys in your dating pool contracts enormously. And you tend to be passed over for promotion. And they treat you differently at the grocery store - your shopping cart gets cut off. People crowd you more in public.
You also can't shoulder people aside the way you used to once you have a baby with you. Getting on the bus or to the front of the line is a lot harder. Older people don't consider you sweet anymore, they consider the baby sweet. You start getting judged on your parenting.
Status drops in a lot of ways.
posted by Jane the Brown at 10:15 AM on May 17, 2023
Once upon a time in the early '00s in the Midwest of the United States, I was out grocery shopping when a woman, who had been reading the labels on bags of rice, casually commented to me, "Will you look at that; this one has less fat," and put the (clearly superior) white rice in her cart and the brown rice back on the shelf. I was too busy boggling to reply.
posted by heatherlogan at 7:56 PM on May 17, 2023 [1 favorite]
posted by heatherlogan at 7:56 PM on May 17, 2023 [1 favorite]
“The Rebranding of Fatness”—Foreign Man in a Foreign Land, 15 May 2023
posted by ob1quixote at 9:14 AM on May 18, 2023
posted by ob1quixote at 9:14 AM on May 18, 2023
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Excerpt from Chapter 11 (on anti-fatness in youth sports!) on Literary Hub.
At every competition, Meghan’s team of just over one hundred dancers, some tall, some short, some thin, some fat, line up next to teams where virtually every girl is five foot seven and weighs 100 pounds. “I feel like the impression of my team at dance competitions is that my studio takes it less seriously,” says Meghan. “Which is kind of true if [body size] is your scale. Nobody on my team would make it onto their team.”
Excerpt from Chapter 8 on moms trying to raise “normal” eaters after a lifetime of diet culture.
we still haven’t found a way to talk about the fact that mothers do influence our children on food and weight without blaming and stigmatizing us for that influence. The early researchers who analyzed Peter’s mother and other mothers of the first generations of people diagnosed with our modern definition of anorexia completely ignored the ways in which those mothers were victims of the same pressures they were accused of inflicting on their children.
posted by spamandkimchi at 3:36 PM on May 13, 2023 [4 favorites]