Fat at college

A friend alerted me to this article in the Chronicle today. I am super mad! The gist is that students with BMI > 30 have to take an additional fitness class geared towards weight loss, and if they fail to lose enough weight to reach an acceptable BMI, they must pass another additional fitness class.

“There’s an obesity epidemic,” Mr. DeBoy says. “The data are clear that many young people are on this very, very dangerous collision course with heart disease, diabetes, and stroke—health problems that are particularly bothersome for the African-American community.”

This is not an epidemic, so can we please stop calling it that? Magazine headline writers made that up because they thought the hyperbole sounded sexy, and they didn’t care what the words actually meant. And okay, look. People stopped getting fatter here a decade ago. That shift was actually relatively minor, and correlated with an increase in height. Both height and weight have similar levels of heritability (about 80%); neither can be changed significantly through force of effort for any reasonable length of time (> 2-5 years) except in a very small minority of cases (which are thus exceptions and probably usually have something else going on, like severe malnutrition in youth, illnesses, medications, etc.); and the weak correlation between certain health risk factors and increased BMI is pretty well balanced by similar weak correlations between other health risk factors and decreased BMI, such that all-cause mortality rates of BMI classes are similar (and lowest in the “overweight” group). When it comes to those correlations, the assumption of causation is made without second thought, leading to methodologically poor studies and false conclusions. BMI is a flawed, white-European-centric, shorthand way of assessing whole populations and is next to meaningless when evaluating the health of individuals. And health problems like heart disease, diabetes, and stroke are particularly “bothersome” for the African-American community for reasons that likely have nothing to do with body size, and everything to do with availability of and access to good treatment.

On the question of whether or not obesity is a disability, as with all levels of ability, that’s a question of context. In the context of a plane seat that is 17″ wide, everyone whose seated hip dimension exceeds 17″ has a disability (which has got to be more than 50% of the population). In the context of a building with stairs and no elevators, ramps, or stairlifts, a person without the use of their legs has a disability. In the context of a store where the top shelves are too high for me to reach, like my local Whole Foods, I have a disability and need to get assistance from store employees to complete my routine shopping. So in the context of a discriminatory school policy that requires 1-2 additional pieces of coursework from anyone with a body over a certain size, those bodies present disabilities — and in this case, it’s because people created that context on purpose, which is worse. This isn’t hard.

As for the question, “Will enforced wellness like this work?” the answer depends on what it means for the program to “work.” Some students will probably lose weight temporarily, so it will appear to meet some arbitrary weight loss goals. Simultaneously, the stigma and shame associated with being singled out and made to complete additional course work on account of factors mostly beyond the student’s [long-term] control will likely negatively impact her emotional and mental well-being, and not just in the short term. Rates of depression are not potentially higher among fatter people because they’re inherently more depressed; it’s because we treat them like shit and then tell them it’s their fault.

My grandmother [probably] had breast cancer. If they had made me take on extra coursework about proper breast health in college (which then stigmatized and blamed me for my heredity!), I would have righteously fucking sued the goddamn school. And I’ve said this before, but all of you folks whose insurance covered your wisdom tooth extractions, because your puny genetics meant your teeth came in all wrong? You drove up my insurance costs. Based on my happily intact third molars, I am confident that you should have taken some wellness classes on proper dental care, you unattractive-toothed loser. Because I care about your health.

Eating

yummy

The subject of Intuitive Eating is getting discussed around the internet a lot right now, motivated in large part by Fillyjonk’s brilliant post on the subject last week. Meowser also put up a great commentary on what IE means for people who have to live with eating restrictions.

It was suggested, after I left a post-worthy-long comment at Shapely Prose, that I actually post something about this myself. Writing it has only taken me three days! My perspective on IE is a bit different from a lot of people in this conversation, mainly because I’ve never dieted and more or less eat intuitively without really thinking about it.

In my mountain of a comment at SP, I broke down the principles of IE that work for me:

* Eat when I feel physical hunger.

* Stop eating when I feel physically satiated, or just not hungry.

These are actually the main basic tenets of IE. The rest of my bullet-points (abbreviated here) basically dealt with how to practice IE while having some restrictions or problematic mindsets about it:

* Occasionally forgetting to eat or being too busy to snack or drinking my dinner is ok. Occasionally overeating a little because something is so fucking delicious that I want a little more is also ok. Neither of those things will hurt most people. Systematically doing those things, on the other hand, can be harmful. And doing either of those things systematically tends to involve a lot of thinking and deliberate self-controlling (and alternately self-flagellating and self-praising), so that can be the heads-up that it’s happening.

* If you… can’t sense your own hunger signals because of years of disordered eating/dieting (or other reasons), maybe take a chance and test it a little….

* If certain foods make me feel sick, or would trigger an unpleasant reaction, I avoid those as much as I need to…. Since I have an illness that limits [what I can eat], I try to find ways to be satisfied and full and have energy and eat things I enjoy within those, as much as possible, so I can get past the stage of controlling and into a normal routine where it’s second-nature….

* Emotional health is really important, and includes things like the happiness or contentedness or basic sense of satisfaction that can come from pleasurable eating or satisfying a craving. Unless [you’re allergic/intolerant] or it is going to very literally trigger a dangerous binging episode**, cut yourself some slack and give in to those cravings. At the very least, you can try to let yourself seriously consider giving in, and maybe eventually you’ll stop caring….

* If you’re new to this whole concept of giving yourself what you want, and you are afraid you’ll never stop eating and you’ll devour the world if you give in even an inch… take a chance.

….These are general guidelines, and messing them up is not about guilt, blame, or failure. That means not flagellating myself for feeling guilty, either – I just notice.

See, I told you it was a long comment.

The goal, I think, is to just stop thinking about it much at all…. The goal is to just live with food as a thing you interact with in the world, like cats and fishtanks and laptops and books.

I know that’s probably a distant end-goal that might never be reached by a lot of people, but in the meantime, if now and then you can enjoy a meal or a snack or a dessert, for real without punishing yourself, that might lift your day a little. Mindfulness takes a while.

Okay, so I want to add just a few things to this today. I recently wrote a post about the false dichotomy between natural and unnatural things and behaviors. In light of that, it’s interesting to me that I might come across, as an advocate for IE, as pushing a certain behavior because it appears to be the more “natural” option. Listen to what your body tells you to do, because it knows better than Science and Medicine and those artificial man-made ideas! But that’s not quite right. On the one hand, I DO think that we should try to tune in to our bodies’ signals, because we live in those bodies and that’s how we know what’s going on with them. If how you felt in your body never changed and you never had a doctor check it out, you might never know you had developed some illness (which certainly happens sometimes, but often there are symptoms). Most health problems or changes we experience are noticed in the first place because we feel something different. Being aware of that is useful! And mostly our bodies are built to have complex feedbacks and send signals and sensations all over the place. Most people start out in life experiencing the sensations of hunger and satiety, and those are useful to notice, because they usually correspond to needing (and not needing) some sustenance.

On the other hand, that doesn’t mean some literally poisonous substances don’t taste delicious. The world is a complex place and that toxic plant may have evolved to imitate something else that we found tasty. Similarly, our very complicated brains often think about or even crave things that we don’t actually need or want. Being aware of that is useful. I think calling it “intuitive” eating can be confusing, because there is this miscommunication sometimes between what we think we want and what our bodies probably actually need. BUT. Repeated self-denial out of an obsessive need to follow proscripted rules about what is “healthy” is pretty much the opposite of health, because it’s not mentally healthy. Giving in to cravings sometimes, or even leaving open the option to satisfy a craving, is not usually going to hurt you in the long run**. And denying yourself absolutely everything you crave will hurt you: by damaging how you sense hunger and fullness; by creating a false sense of control over not only your body but your whole life that rapidly becomes a source of both brief emotional highs and painful desperation; and more simply, by never allowing yourself to just live and feel satisfied and happy.

As Meowser so brilliantly lays out, this does not actually conflict with needing to impose on yourself some restrictions because certain foods or eating habits might trigger problems in your particular body. There’s a balance between what you can actually intuit based on your gut and what you know about yourself from trial-and-error. And there’s a difference (though a hairy one) between not letting yourself eat peanuts because they will kill you and restricting out of an obsessive need for control over your body. As a person who grew up without any dieting or self-punishment over food, but who now lives with some dietary restrictions because of chronic digestive illness, I know how easy it is to step over that line. The difference is in the mindset. I’m no longer avoiding lactose and gluten just to control my life down to every single thing that goes in my mouth. I’m not sacrificing mental health to reach an [impossible] goal of Perfect Physical Health, because there’s no such thing anyway. I do what I have to so that I usually feel pretty good, and within those restrictions I eat what I want and when I want to. And I try to do it without guilt.

** A lot of my suggestions would be problematic for people with BED. At the same time, there was a good discussion in the SP comment thread about how many people, especially fat people, have been told or have convinced themselves they are binging whenever they just eat something pleasurable, or that enjoying a delicious dessert when they aren’t starving means they are mindless food-shoveling robots. This is not what binging actually is. We all think about food a lot and crave delicious things, even sometimes when we’re not terribly hungry, and that’s totally normal. We all occasionally finish off a whole tub of ice cream in front of a good movie, or because our hearts just got broken. That is not the reason that anyone is fat, none of those things are binging, and unless you actually are a practicing Puritan, most of us don’t believe that enjoying yourself or seeking comfort in the occasional tub of ice cream is really going to damn you straight to hell.

Fat Acceptance Primer

Okay, the trolls are rolling in after yesterday’s post got me over 500 800 hits (normally I might hit 15-20!), so I’m going to do a very brief primer on FA and then leave it at that. This is not principally a FA blog, although it is an issue I care about a great deal. But the blogosphere is full of focused FA blogs where people have already addressed and continue to address every one of these arguments every day. So I’m not usually going to focus here on knocking down every single one of your fat-hating bingo points. (As the bingo cards should demonstrate, though, we have heard most of it before.) But still, I’ll give a little background and a few links.

The idea that being fat might possibly be acceptable is clearly just shocking to people who have had nothing but the opposite message bombarding them for their entire lives. Fair enough – it can be very, very hard to step outside that box and consider another viewpoint. But there is a growing group of people of all sizes who are saying exactly that: it is and should be acceptable to have a body of any shape or size without inviting intrusion, condemnation, vilification, disrespect, abuse, or a lack of dignity. The “scientific” data (I say as a scientist, though not a medical biologist) that are presented in mainstream news articles and magazines and diet books are generally distorted in one way or another, in part because one goal of those media is to sell a product (I’m not a conspiracy theorist, but it can’t be denied that the weight loss industry is a huge part of our economy). Other reasons have to do with the fact that we like to police each other, we like a good scapegoat, and we have a tendency to vilify anything we associate (wrongly or rightly) with unabashedly living and enjoying life without self-deprivation and Puritan asceticism.

I encourage you to read Kate Harding’s sum-up of some major FA points. There have been some newer studies since it was written, but it’s a good start. There are also a large number of linked studies in this open thread, including links to some other 101-type posts. So before you start wailing about the OBESITY CRISIS BOOGA BOOGA, please just read those. I have no interest in arguing about basics with the entire internet, when you could read up yourself and then we can have a more informed and respectful discussion about all sides of this issue.

If my suggestion that long-term weight loss isn’t possible OR necessary is really deeply upsetting to you, because you or someone you care about wants to lose weight or has lost weight recently, please please read the Fantasy of Being Thin. It is a brilliant post that might turn your brain inside out a little.

A few major points worth repeating here:

  • Diets don’t work, including diet-and-exercise, “lifestyle changes” with the goal of weight loss, any of it.
  • Correlation does not mean causation. Causation might be worth exploring, but it’s not automatic. Or dictated by gut feelings (“But I just KNOW fat people eat more! It has to be true!!”).
  • Attractiveness is not a requirement of living. Certainly no one owes it to you to look better.
  • People find different things attractive, anyway.
  • You are going to die. Someday. We all are.
  • Evo psych is crap. So are “caveman” arguments.
  • You can’t tell anything about a person’s habits or health just by looking at them. No, really.
  • If you aren’t a specialist in biomechanics, please don’t try to make arguments about thermodynamics or how human joints work. It’s actually not simple physics. Your body is not a bunsen burner, as they say (who first said that, anyway?). And your skeleton is a complex thing.
  • It’s generally a good rule to stay out of other people’s business, even if you disapprove of whatever they’re doing. Unless they’re beating another person in front of you, or asking for help, it’s not your problem.

Please read and consider the comment policy before posting. Disagreement and dialog are just fine. Trolling is not.

On thin privilege

ETA: Please read the comment policy. I will not approve hateful comments. This includes fat-hating ones. And no, being fat isn’t a choice, and overweight people live the longest.

In the general blogosphere concerned with social justice issues, there’s a lot of discussion about what is privilege, how it manifests, and how it should be approached. There is not a lot of talk, however, about fat politics and fat acceptance, and how that plays out in a society that highly privileges thin people over fatter ones. That is, except for fat acceptance blogs, and the occasional feminist blog with an appreciation for FA (looking at you, Shakes!). When Fillyjonk at Shapely Prose, my favorite FA blog, asked me to write a post about thin privilege, I took up the challenge.

So, Fillyjonk recently asked me to write a guest post about thin privilege.

What’s interesting is that at first, it was really hard for me to know what to say. My first, reflexive thought was that I could just tell my own story! I mean, I’m thin and all. But I quickly shot that down. Talking about my experiences as a thin person, on a FA blog, would be an excellent demonstration of thin privilege, but it wouldn’t accomplish much else. Fat acceptance is fundamentally not ABOUT the thin experience. It’s really not about me, at all. In fact, that’s really what I should be talking about.

But I’m going to take a minute to ward off as much of the anticipated defensiveness as I can right off the bat, even though I hate feeling like I’m placating the WATM-style whining (this time with Thin!). After all, it’s not like the FA community needs a lecture on thin privilege (HEY GUESS WHAT FATTIES I GET IT NOW CAN I HAVE A COOKIEDOUGHNUT): this is really for thin people out there who haven’t really considered their own privilege.

So, do some thin people get shit for being thin? Of course! People’s bodies – especially women’s bodies – are treated like public property all the time. And standing out in any way, especially in a physical way, often just seems to invite additional ridicule and mistreatment. Maybe that’s why some thin people posit that they are the same, the fat experience and the thin experience. Getting teased and bullied for the shape and even the existence of your body, something you fundamentally can’t change, and in many cases (for both the thin and the fat) something you might try to change about yourself in hopeless and self-damaging ways – well, that shit hurts, and it’s a deeply personal, formative experience. So I think that for some thin people, there’s resentment when they hear a fat person complaining, like the fat person is trying to invalidate or one-up their own painful, skinny past. For others, there can be this pull to try to identify with the painful experiences of a fat person: to think you understand, to find a comrade who was also pushed around by the kids on the playground. I admit that I think, at first, the latter is the perspective I came from more often when I would talk with my fat friends.

Both of those reactions are, I think, understandable. But they’re rooted in privilege for one major reason: those experiences were not the same. The similarities I listed above, well, that’s probably about where the commonality ends. (There are other similar, small details, like being sized out of some clothes, but I think that covers most of it.) Sure, the thin kid and the fat kid both got teased/beat up/ridiculed/targeted through school, and that’s horrible. Both probably still get at least occasional public insults as adults. But there is a fundamental difference in the way society as a whole treats, envisions, pictures those two types of bodies. That teasing didn’t happen in the same social context, so it didn’t have the same tone or impact. And if you haven’t lived in a fat body, you simply can’t know what that experience was, or how much worse it was than your own.

Again, don’t get me wrong; bodies in public and especially all women’s bodies face an impossible catch-22. The line between not-thin-enough and too-thin is impossibly narrow (ha!), and a moving target, besides. That size six is wayyyyy too fat to be a model, ew so gross, but OMG, did you see how disgustingly thin those runway models are??? You either have to diet (to finally become either that really hot thin person, or at least just incrementally less-fat and therefore more acceptable), or you’re far too thin. Everybody loses. But there’s a fundamental question of degree here. In social discourse there may be pretty frequent complaints about those women who are too skinny, but it simply does not compare to the scale of fat stigma. (And I think a great deal of that discourse comes from resentment, felt entirely fairly by the vast majority of the population that doesn’t have one of those idealized bodies and has been practically disappeared from the public eye. Blaming that on thin women is, however, misdirected.) When every image of a woman in every magazine, on every tv show, in every movie and billboard and annoying Facebook ad, is not only thin but impossibly-Photoshopped-thin; when half of the reality shows on TV these days seem to be weight-loss contests; when every women’s magazine cover is screaming about diets and weight loss; when the assumed audience for every news article about health issues is universally thin, and doctors are berating and even blatantly neglecting their patients because all they can see is their own fat-hatred – well, there’s simply no comparison.

Example: Last week, I finally got around to getting a physical at my new doctor’s office. I’m not crazy about her, but she was the only doctor in my area accepting new patients when I moved here, and she’s brusque but does the job. It bothered me from the beginning that there are ads for drugs literally papering the office walls, including distorted weight loss statistics on posters advertising weight loss drugs. There is even one of those hanging from the scale (I mean, seriously?? HEY FATTIES DON’T FORGET YOU’RE A FATTY). But as a very thin person, though I hate it, that really doesn’t impact me, and I need a doctor. So at this visit, my first physical there, they measured my waist circumference, I shit you not. The nurse took the measurement and then said, “Good girl!” while she wrote it down on the chart, like I had accomplished something by having thin parents (and deserved a doggie treat for it, no less). And then the doctor, when she looked at my chart, said she was concerned that I am underweight. I said, “Yes, and so is my whole family, and I couldn’t gain weight if I tried,” and she shrugged and said, “Okay!” Based on everything else that goes on in that office, I can pretty much guarantee that if I had been fat (hell, probably even a BMI of 26) I would have been walking out of there 1) with a prescription for WW (there were ads for that, too!), 2) with an admonition to cut out the cough drops, and 3) fighting back tears.

So apparently, if you’re “too thin?” (to live? Clearly not!) – oh well! We know there’s nothing you can do about it (because for some reason, THAT has entered public awareness, but the futility and harmfulness of weight loss programs have not), and at least you aren’t fat (because while my BMI category may have the highest mortality rate, at least the movies say I’m sexy!). And while “Put some meat on your bones!” may make me want to break a window with my bare hands, it doesn’t even compare with repeated, hateful catcalls of “Whale!” or “Cow!”

When FJ asked me to write this post, she mentioned that it might mean more for people to see a post about thin privilege written by a thin person. I don’t think she meant that for the SP community (hi, choir!), but the certainly for the broader, more fatphobic internet-public that might stumble in from Salon. It makes me angry (at the world, not FJ) that because I’m not one of those fat fat fatties, I can bring some cred to this whole FA thing: look, a skinny girl who cares about fat people!! hey, what was this post about, again? Yeah, I have automatic credibility on the subject of fat prejudice, despite never having experienced it firsthand, while actual fat people are just wrong/deluded/lying. THAT makes sense.

So that fucking sucks. But maybe if enough allies write posts like this one, people will just start listening to what fat people are saying about their own lives in the first place.

(Cross-posted at Shapely Prose.)

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