The-F-Word.org

I tore out this snippet I found in one of those “health” magazines at my doctor’s office. You know the kind… the ones that purport to be about health and yet the first half of the magazine is devoted to “losing weight” and “looking better.” Yeah, well, it was either that or read Nicole Ritchie’s gushing about her new baby.

Gym-goers who look out of shape aren’t the best role models, but they might actually inspire you more than people with buff bodies. University of California, San Diego, researchers found that women who exercised next to plump peers worked out two minutes longer than they did when working out next to fitness freaks. Lead researcher James A. Kulik, PhD, thinks the women wanted to show off next to (or avoid becoming like) someone less fit, but they felt demoralized when next to a woman who was more toned.

What strikes me most about this snippet is that because the “non-plump” gym-goers are compelled to exercise more, the tone of the brief seems to condone and even promote the behavior, regardless of the destructive motivations driving it (it was included on a page with other weight-loss advice and tips). Both hypotheses — the woman who wants to “show off” in front of a fatter woman or the woman who uses her “plump peer” as the yardstick by which she measures her own self-worth — indicates a degree of self-insecurity and self-anxiety, feelings that an extra two minutes on the stairclimber won’t ever whittle away.

I looked up the study and found it ironically enough to be published in the July, 2007 edition of the International Journal of Eating Disorders - abstract here. Some additional context: The study included female undergraduate students (who may be more susceptible to this kind of behavior) and sought to measure the the effects of peer comparisons in a naturalistic setting or on objective behavior one body-image perceptions. The results?

Exposure to a fit peer had undermining effects on women’s body satisfaction and exercise duration, whereas an unfit peer produced no compensating greater body satisfaction but did elicit longer exercise duration relative to controls.

The thrust of the study measured body dissatisfaction, and so it’s inclusion in an eating disorders journal isn’t strange. What is curious is the “health” magazine’s positive slant on it as evidenced by its very title, “Fitness Freaks bad for your figure.” Maybe a more appropriate title would have instead been “Low self-esteem bad for your mind.” Instead of recognizing the negativity revealed in the study published in an eating disorders journal, the magazine chose to appropriate aspects of it to further promote “health” and weight-loss. Once again, what would be considered disordered and even mentally ill for thin people is liberally disseminated as healthy advice for fat people. Who needs pro-ana sites when mainstream media normalizes disordered eating and behaviors?

My gym membership now is through our company’s on-site gym and I’m usually the only one working out in the late evening hours. My last gym membership where I worked out with other people was during the heydays of my eating disorder, when I habitually compared myself against every other woman anyway, so, my perspective may be a bit skewed. I do acutely remember one particular instance, though, from a few years ago, partly because I journaled about it. I usually ended my workouts with my own hillbilly version of yoga in a darkened, unused aerobics room. I was stretching on the bar when another, thinner girl about my age came in and started stretching also. I don’t think she was paying me the slightest bit of attention, but I soon began mimicking her movements and deliberately stretching farther than she and longer in a physical and mental game of endurance. She soon left and I “won.”

Have your workouts ever been subject to influence by the woman working out next to you? Do you feel like others pay any attention to what it is you’re doing at the gym?

When I began making a concerted effort to deal with my gym phobia two months ago and become more active, my litmus was not weight loss or even inches lost. No, my goal was far less common: To run up the three and a half flights of stairs to my graduate class without huffing like a diesel truck.

Two months and hundreds of stairclimbing, cycling and walking miles later, I haven’t lost a single solitary pound, but I’m able to glide up the stairs effortlessly without getting winded. I kind of felt like Rocky after climbing the steps to the Philadelphia Art Museum.

An MSNBC story today addresses America’s “couch potato crisis,” but like most stories on fitness, it mindlessly conflates a lack thereof with obesity. Although the article notes that the average 2005 life expectancy is 78, up from 47 in 1900 and 68 in 1950, it continues to echo the as yet unsubstantiated claim that this generation may be the first to live shorter lives than their parents.

Read the rest of this entry »

Sanjay Gupta is presented by media outlets as the wonder doctor of all fields, the Doogie Howser neurosurgeon extraordinaire who can just as effortlessly deliver a baby as he can diagnose rare genetic diseases. Gupta is quite accomplished and boasts an impressive array of credentials and qualifications, but considering his career as the medical talking head of CNN, he probably doesn’t spend much time with patients or in practicing medicine.

So, it doesn’t strike me as odd that he’s at a loss as to why people don’t exercise. He addressed the issue recently in a column for Time magazine. It’s a good thing A. Chris Gagilan helped the good doctor out with some basic reporting, because I think the answer to Gupta’s question is right here:

Research by psychologist Roy Baumeister at Florida State University, for example, suggests that self-control is like a psychological muscle — one that can simply become exhausted.. If that routine involves a diet, things can get even more complicated, as the effort you make to resist having a Snickers in the afternoon depletes your resolve to work out in the evening. “The more you use the self-control muscle,” Herbert says, “the more tired it gets.”

In short: Physical activity should be something you want to do, not something you have to do.

Read the rest of this entry »

I always read advice columnists whenever I’m procrastinating at writing papers, and I came across this rather interesting letter to Dear Abby.

Despite a family history of high blood pressure, Dawn Edwards, a self-described “healthy, vibrant mother of one” and “active health-conscious vegetarian,” thought she was at her physical peak. So when she experienced nausea and lower back pain, she assumed she might be pregnant. Instead, she was shocked to learn she was in kidney failure. After 10 years of dialysis, Edwards received a transplant and now works to promote kidney disease awareness and education. Writes Edwards:

Many people don’t realize that high blood pressure and diabetes are the two leading causes of kidney disease. More than 26 million Americans have chronic kidney disease, and millions more are at risk. Screening for kidney function is not part of a routine physical examination, and kidney disease generally shows no symptoms — so if you have a family history of high blood pressure or diabetes, you are at risk.

Edwards’ letter doesn’t reveal her weight, but it is to be assumed by the descriptive characterization of her health, she is at least relatively thin. Of course, Edwards could be a proponent of Health at Every Size, in which it’s recognized that you can be healthy and active at any weight, but for the sake of this argument, let’s assume Edwards is among the majority of people who have been sold the special-interests-funded medical mantra that fat is unhealthy.

Which leads me to this: High blood pressure and especially the dread diabetes are two of the most common health-related disorders doctors and researchers like to use to fan the flames of obesity fear mongering. While there very may well exist a correlation, one’s family history and genetic predisposition remain the highest predictors for the great majority of illnesses and diseases commonly attributed up to obesity. By suffocating these disorders beneath a warm blanket of obesity, thin people like Edwards are led to develop a false sense of security in that because their BMI falls within that arbitrary and narrow range deemed “healthy,” their risk for developing such health-related problems is slight to none.

Take type 2 diabetes, for example, the most popular medical whipping boy of the anti-obesity establishment. To develop diabetes, you must first inherit the predisposition to diabetes and of the two types of diabetes, it is type 2 diabetes - the type most often blamed on obesity - that has the stronger genetic basis. In fact, family history is such an overwhelming and dominant factor in whether one develops diabetes that a recent study called for the formal addition of family history in public health strategies aimed at detecting and preventing the disease.

When a thin person develops diabetes or kidney failure, it’s most often attributed to a strong family history or to some freak anomaly of nature. Yet when a fat person with the same family history develops the same disorder, it’s automatically blamed on their fatness. Even more dangerous are those scary cases in which a person has a genuine disorder entirely unrelated to weight, but are dismissed by doctors who can’t see past weight to treat the real problem.

Environment is a trigger in many disorders, sure, but even people with extremely healthy lifestyles are destined to develop health problems if there exists a strong family history - just ask Kazz or Mike Benson. And I don’t dispute the role that nutrition or lack thereof plays in the development of some disorders, like diabetes. What I do dispute are the ungrounded assumptions that as a group, fat people eat poorly and engage in behaviors that are more likely to contribute to disorders like diabetes. In fact, studies have shown that fat people eat no differently than thin people, and in the case of diabetes, some studies claim that one’s diet is inconsequential in the development of the disease. I also question studies that purport the health hazards of obesity as an independent variable, especially when the data - which is often funded by groups with a financial vested interest in seeing a particular outcome - is questioned, refuted, reasserted and then disproven time and time again in what is known as the obesity paradox.

Poor nutrition and a sedentary lifestyle do cause health problems - in people of all sizes. So, too, does one’s genetic predisposition and family history play a strong, if not the strongest, role. By exaggerating and over-inflating the tenuous and often hypothetical influence of obesity in the development of illness and disease, the medical establishment is only hurting the very people they strive to help.

As if unwrapping a digital scale instead of say, an iPod for Christmas isn’t disappointing and blatantly offensive enough, now Forbes magazine suggests spouses (and significant others) give their partners the gift of a “longer, healthier life” this Valentine’s Day.

And, of course, as readers here are well aware - *cue eye rolling* - good health is entirely synonymous with weight-loss.

What’s next? Weight-loss surgery for your birthday? Sheesh…

According to the Forbes article:

For years research has shown that married people, aside from weight problems, tend to be healthier than those who are divorced, widowed, never married or cohabitating…

Hmmm.. didn’t a recent study just show that married adults, particularly men, weigh more and have higher rates of obesity than do single adults? Yes, I do believe the study also claimed that people who have never been married are the least likely to be obese.

So, the fact that a 2006 paper tracking mortality over an eight-year period found that people who never married - you know, the folks least likely to be obese - were 58 percent likelier to die during that time than married folks is totally a coincidence.

The article continues with more sage medical advice:

Want your spouse to lose weight? Try focusing on your own waistline, the study suggests. And other recent research has shown that being a good role model can help make your spouse healthier, too.

Tracy Falba, a visiting professor at Duke University, co-authored a 2007 study published in the journal Health Services Research that demonstrated when one spouse quits smoking or drinking, or gets a cholesterol screening or a flu shot, the other is more likely to do the same. It also works for exercise.

So if you’ve been looking for that extra motivation to hit the gym, think about what your healthy behavior could do for your spouse.

Promoting fitness is great and good, as studies show exercise to have a myriad of health benefits, which may or may not include weight-loss. But I have to question the whole “exercise is contagious!” optimism. In our household, my visits to the gym usually elicit only a hug and kiss goodbye from my reed-thin husband who prefers to vegetate on the couch. I usually have to guilt him to go out walking with me nor does he use our indoor treadmill. And rollerblading? That takes a lot more finessing. Brandon looks like a giraffe on wheels on his blades.

Here’s the problem I see with the article: It asks readers to “think about what your healthy behavior could do for your spouse.” But by the article’s very own admission, improved health isn’t exactly at the forefront of readers’ minds; rather, the article asks, “Want your spouse to lose weight?”

So, which is it? Weight-loss or wellness?

The “extra motivation,” it appears, isn’t a health concern for either oneself or one’s spouse, but rather motivation to encourage spousal weight-loss, inspired more so by aesthetics than out from health-related concerns.

The article suffers under the delusion that improved health is directly correlated to weight-loss, when numerous studies show it’s fitness, not fatness, that’s key (Go on, google it). But by myopically focusing on the numbers on our digital scales to measure our health, we ignore larger and more pressing health-related issues.

If improved health is the real intention here, why didn’t the advice begin with “Want your spouse to become healthier?” Because there are plenty of things you can do to improve the health of your family without fixating on weight-loss - like say, resolving to eat a healthier diet and improving your fitness (without the expectation that weight-loss will naturally follow), or reducing the amount of stress in your lives.

While we have the right to expect our partners to remain healthy, we do not have the right to expect them to become or remain thin. Making people feel worse about their bodies, talking about weight, worrying too much about diet and focusing on it not only encourages unhealthy relationships with food and weight, it also counter-productively encourages weight gain.

It’s somewhat ironic that Forbes‘ sage weight-loss advice comes on the heels of the tip to provide positive spousal support. Because nothing says “I love you” quite like “Get your fat ass to the gym, honey.”

Here’s a better idea for Valentine’s Day: Tell and show your spouse how much you love and value them - just as they are.

CNN.com has just released its special section on health and weight, Healthy Bodies: You are what you eat.

The subtitle of the site aptly sums up the approach CNN has taken, utilizing the simple calories in, calories out methodology to weight loss, which has been shown to be problematic and not always consistent. The site, too equates good health with thinness, ignoring the fact that fitness, not fatness, is a more accurate measure of good health. For more on this, read up on the Health at Every Size movement.

For a larger dose of self-loathing, viewers can calculate their weight to see just how fat they really are, learn about “fads in fighting flab,” and watch obesity ads geared at kids. Because you know, it isn’t as if fat kids aren’t already stigmatized and ostracized enough for their burgeoning bodies.

Wait. Still don’t hate yourself? Then, go take a look at weight-loss success stories like that of Matt McKenna who lost a whopping 264 pounds. If he can do it, you can too! Unless, of course, you’re a lesbian, in which case you’re bound to be fatter.

And if you still have any semblance of self-esteem left, go here to learn about how CNN’s very own fat-fighter Dr. Sanjay Gupta is taking on the nation’s fatties and the “obesity epidemic.”

It’s not that I don’t think losing weight is contradictory to fat acceptance - a position which has been adopted by some other fat-acceptance blogs. For some people, losing weight can be beneficial to their health, while for others it would be literally a fight against one’s own genetic make-up. Regardless, one’s own body is our own business and should not be held up for public scrutiny or display.

Rather, it’s this in-your-face, erroneous equation of health with thinness that is so very wrong and offensive on so many levels. If CNN was truly concerned about “good health,” they’d leave the fat-hatred out and include more articles on ways all people - fat and thin - can improve their health.

After reading Jaime O’Neill’s scathing, hate-filled assumptions about fat people in the Sacramento News & Review, Peggy Elam Ph.D wrote this awesome letter to the editor. Well said, Peggy. Well said.

As reported in the latest the journal Ethnicity and Disease, researchers in Philadelphia found that that body image was an important motivator for white women in seeking dieting help but not as important to black women. Overweight or obese women are more likely then their black peers to ask for dieting assistance, such as counseling from a medical professional, a doctor’s prescription, membership in a weight-loss group, or advice from a trainer, the study found.

But, instead of studying the psychology of why black women have good body image perceptions of themselves despite a culture which holds thinness next to godliness, researchers instead are now striving to modify weight-loss programs to “better address the needs of black women and other minorities” so that they, too, can feel like they’re never skinny and beautiful enough.

Dan Savage of the advice column Savage Love sets a reader straight about big women. Go here to read his delightfully scathing reply.

In case all the fat-bashing is bringing you down, here’s a refreshing story. Dave Alexander has finished 276 triathlons in 37 countries in 17 years. He’s swam 9.6 miles, cycled 448 miles, ran 104.8 miles in a recent super-triathlon in eastern Hungary. He’s also fat, weighing in at 5 feet, 8 inches tall and 260 pounds. Read tales of his amazing feats here.

I was never a runner. Even at my thinnest when I wore a slim size 4, I couldn’t run. I’d try, huffing and puffing my way down my block or on the treadmill in the gym, and all I could think about was… “When can I stop… breathe… Has it been one mile yet… breathe, breathe… Only three minutes to go!… breathe, gasp!..”

I always thought of dedicated, hard-core runners as some sort of alien-like species, far removed from normal, non-masochistic folk like me. Which is why I am so surprised to find a Health at Every Size-inspired article in Runner’s World magazine.

In Understanding BMI, Runner’s World writer Marlene Cimons examines the highly-debated standard of BMI as an index for health. She begins:

Runners, of course, have always been concerned with their weight. At the same time, the fact is that many runners–despite consistent training over many years–will never resemble those skinny elite athletes who line up at the front in the world’s most competitive races. So what kind of impact should these new numbers have on us? And how much should we care?

Cimons goes on to quote lots of industry experts that bears repeating.

“The BMI guidelines should be used as just that–guidelines,” says Glenn Gaesser, Ph.D., associate professor of exercise physiology at the University of Virginia in Charlottesville. “If you are above the recommended BMI, you need to ask yourself: Is this genetics, or is this lifestyle? People can assess in a matter of seconds if they’re active enough or eat too much. I think it’s ridiculous to focus totally on weight and weight loss.”

Steven Blair, Ed.D., of the Cooper Institute for Aerobics Research in Dallas, agrees. “Fitness, not fatness, is the more important issue,” he says. He bases his conclusions on years of research conducted at the Cooper Institute, studying the relationship of cardiorespiratory fitness to mortality in men grouped by BMI.

That work has shown similar death rates among men of all BMI levels who were moderately or very fit. But the death rates were significantly higher among men with low fitness levels, regardless of their BMI. (Women were not included in this study due to a limited sample size, Blair says, but “we would expect to see similar results.”)

“Fitness was a more powerful predictor of mortality than BMI,” says Blair. “In fact, we found that men with low fitness levels who had a BMI less than 27 were at greater risk for death than very fit men with a BMI greater than 30.”

“There’s no question that it’s far better to be fit and still fat, than thin and unfit,” says Gaesser, author of the book Big Fat Lies: The Truth about Your Weight and Your Health (Ballantine Books, 1998). “I think regular runners who are committed to a healthier lifestyle–and who have BMIs higher than the guidelines recommend–should just say to themselves: ‘I’m naturally meant to be a little heavier,’ and not worry about it.”

Moreover, Gaesser points to an American Cancer Society study published a few years ago that examined healthy, overweight women; that is, women with absolutely no health problems, but who were fat. The study found that losing weight alone “did absolutely nothing to improve their longevity,” Gaesser says.

Last week marked end of the quarter week, with all its projects and papers due. Now that spring quarter is officially over and summer looms careless and course-free, I’ll be updating with greater Fiberall-like regularity.

For those of you with cable television, TLC had been advertising the show Big Medicine for the past couple weeks. It airs tonight at 9 p.m. eastern time. The commercials feature a bevy of morbidly obese people in their underwear in shadowed lighting so you can’t see their faces, all lamenting how being fat is the absolute worst existence in the world.

The show follows the personal stories of the severely obese who turn to Houston’s Methodist Weight Management Center as a life-changing last resort. At the heart of the operation is passionate father and son surgeon team Robert and Garth Davis, a pair who have dedicated their professional lives to raising awareness about obesity.

From the show’s blurb:

Often as gripping as the patient stories is the colorful relationship between this father and son team where old school meets new school head on… Despite these differences, the pair unites in the operating room to fight a common enemy and change lives forever.

This last line reminds me of a poster I saw while shopping the other day. A new boot camp-like fitness center is opening in a nearby shopping center, run by a man who can only be described as the love child of Rambo and Jenny Craig. “Defeat fat,” the poster declared.

In 2004, then U.S. Surgeon General Richard Carmona declared a “war” on obesity.

“As we look to the future and where childhood obesity will be in 20 years … it is every bit as threatening to us as is the terrorist threat we face today. It is the threat from within.”

Defeat fat… Common enemy… Terrorist threat… C’mon. This isn’t some communist country or radical 9/11-inspired terrorists we’re talking about here. We’re talking about our bodies. Instead of My Body Myself, we’ve gone to My Body, My Enemy.

Those with eating disorders often describe feeling alienated or disconnected from their bodies. Anorectics and bulimics, like all addicts, are masters at seeking external solutions to internal sources of emptiness and distress. Bodies becomes the enemy, something foreign to be subordinated, tamed and perfected.

The language amongst the eating disordered and these self-proclaimed soldiers against obesity is no different: it doesn’t address the underlying reasons for why someone is obese. Fixing the outside rarely fixes the inside, a point that was lost on me for many years. Like the eating disordered, many obese people suffer under the delusion that always accompanies obsession, which is to view the object of desire as the solution rather than part of the problem.

Instead of seeing our body as the “enemy,” perhaps we should make peace with it, regardless its size.

You know the old saying ‘inside every fat woman is a thin woman screaming to get out?’

Apparently, inside some thin women are fat women screaming to get out. The Associated Press reports today that even thin people can be fat on the inside, possessing internal fat surrounding vital organs like the heart, liver or pancreas.

This internal fat – invisible to the naked eye – is being dubbed TOFIs, or people who are “thin outside, fat inside,” by researchers at Imperial College, London who are conducting the study.

“The whole concept of being fat needs to be redefined,” said Dr. Jimmy Bell, a professor of molecular imaging at the college. “Being thin doesn’t automatically mean you’re not fat.”

The article goes on to report that even people with normal BMIs can have “surprising levels of fat deposits inside.” Doctors say they worry that thin people may be lulled into falsely assuming that because they’re not overweight, they’re healthy.

This type of research marks a giant leap forward in rethinking our cultural prejudices against obesity. Simply being thin doesn’t automatically make one a good healthy card carrying member of society. Fat, active people can be healthier than their skinny, inactive counterparts, researchers are finding.

“Normal-weight persons who are sedentary and unfit are at much higher risk for mortality than obese persons who are active and fit,” said Dr. Steven Blair, an obesity expert at the University of South Carolina.