Health At Every Size

A Fat Woman's Manifesto

Judy Bagshaw, author of romantic fiction with full-figured heroines (including At Long Last, Love, published by my company, Pearlsong Press), has A Fat Woman's Manifesto that I love. I'm posting it here with her permission.

A Fat Woman's Manifesto
by Judy Bagshaw (copyright 2001)
(this big girl will NOT be pushed around any more!)

1. Diets will no longer factor at all in my life. A healthy lifestyle will!
2. Life is a banquet. I intend to get my money's worth.
3. My weight is not open for discussion -- period!
4. I'll eat anything I damn well please!
5. I will not settle for second best.
6. I will greet the world with my head up.
7. Fear will no longer rule my actions.
8. I won't put up with put-downs.
9. I won't base my self-esteem on other people's opinions.
10. I'm Fat. Get over it!

The American Heritage Dictionary defines "manifesto" as "A public declaration of principles, policies, or intentions, especially of a political nature." Since war has been declared on "obesity," I'd say manifestos  from the targeted population are particularly apt.

I'm reminded of Pattie Thomas, Ph.D.'s "Declaration of Taking Up Space," another manifesto that calls for warriors of all sizes to stand for the freedom to control one's body and help end the war on fat people.

So....what's YOUR manifesto?

Interview with Gina Kolata, author of Rethinking Thin

Kelly Brownell interviews New York Times science writer Gina Kolata, author of Rethinking Thin: The New Science of Weight Loss -- and the Myths and Realities of Dieting in an mp3 recording you can access here.

Brownell (a psychologist and co-founder and director of Yale University's Rudd Center for Food Policy & Obesity) discusses with Kolata the conflicts of interest in scientific research into "obesity," and the failure of any diet or treatment to make fat people permanently thin. Kolata even points out that no one even knows for sure if making fat people thin will make them healthier. They also discuss why people keep trying to lose weight despite such poor outcomes.

Weighty Issues on WNYC

WNYC On Demand has The Brian Lehrer Show interview with Anna Kirkland and Lara Frater available for listening online or downloading.

Kirkland is assistant professor of women's studies and political science at the University of Michigan and the author of Fat Rights: Dilemmas of Difference & Personhood. Frater is a fat activisit blogger and author of Fat Chicks Rule! How to Survive in a Thin-Centric World.

Click here and scroll down to "Weighty Issues" to listen to their interview.

A return to normality

Savannah Lee blogs about Size Acceptance Through Art History 101 with some nice links to voluptuous classical paintings.

Believe me, if you sit in an art history class, you learn that the well-upholstered body was the "norm." Not the exception....as the images click by, hour after hour, class after class, you inevitably realize--this is our natural state. This is how humans are. We're not skinny. We're like otters and seals; we're voluptuous....So the next time you see something about the "obesity epidemic," just consider it a return to normal.

Read the entire post (with its luscious links) here.

Paul Campos on the ridiculous notion of "overweight" -- and why the medical establishment's attitude toward weight is unhealthy

Paul Campos has an excellent article in The New Republic addressing the craziness of the medical establishment's pronouncements about weight.

After summarizing important findings in the Journal of the American Medical Association study by Katherine Flegal & others that included "overweight" people being healthier than so-called "normal" weight people, Campos comments that in "America's war on fat, the fact that being called "overweight" makes no medical or scientific sense is hardly a trivial point."

Although leading "obesity" experts try to rationalize the Flegal et al. findings away, their rationalizations don't hold up to the scrutiny that Campos and others provide.

Paul Campos is the author of The Obesity Myth, published in paperback as The Diet Myth. Read his New Republic article here.

British professor Patrick Basham: No evidence there's an "obesity epidemic"

In an interview in the United Kingdom's Independent, Patrick Basham (co-author of Diet Nation) challenges "obesity epidemic" claims and points out that "being fat has suddenly become politically unacceptable."

Politicians have been taken in by a cottage industry that has developed around the obesity crusade; an industry that consists of a wide range of groups, from public-health bureaucrats to big business, including the pharmaceutical industry.

These organisations and individuals, with their need for ever-greater empires and funding, know only too well that warning of impending disaster captures the Government's attention. Yet in this classic case of spin, there are real victims: those people condemned by wrong-headed policies to a lifetime of yo-yo dieting and an unhealthy obsession with food and weight.

Basham points out how the BMI classification of "overweight" was downsized in 1997, immediately rendering millions of people "overweight" without having gained an ounce; the average adult weighs only "a pound or two more than those of a generation ago," and that it's really only the "morbidly obese" -- who make up a relatively small proportion of those considered "obese" -- who have gained any significant amount of weight in recent decades. [Unfortunately, Basham seems to uncritically accept and use the term "morbid obesity," possibly unaware that political scientist J. Eric Oliver, in his book Fat Politics, has reported that the term was invented by bariatric surgeon Howard Payne in the 1950s to justify his so-called "weight loss surgery," which at that time most physicians viewed askance.]

Basham also reports that there is no evidence that childhood "obesity" is even increasing, much less accelerating.

What's more, the latest UK Diet and Nutrition Survey (2000) found that caloric intake in both boys and girls aged four to 18 declined since the previous survey in 1983. There is similar data in the States: a study published in the Journal of the American Medical Association in 2004 found no statistically significant increasre in the prevalence of overweight or obese children between 1999 and 2002....Even the alleged link between excessive food intake and childhood obesity has no scientific basis. A 2002 cross-cultural review of obesity in the U.S., France, Australia, Britain and Spain found little evidence that overweight or obese children and adolescents consumed more calories than others. At least one study has found that overweight children consume fewer calories than their thinner peers do.

Basham says he is

an independent academic and not a junk-food industry lobbyist. I am a passionate combatant in this debate, because I believe that the obesity crusade is dangerous. Virtually all the literature on dieting has concluded that attempts at weight loss are largely unsuccessful and, more worryingly, that there are health risks in such behaviour.

He also points out that

recent studies have shown that adult attempts to control children's eating patterns lead to children eating more -- as well as raising the risk of body-image problems and eating disorders. It's this unintended, and uninvestigated, outcome of a weight-obsessed society that should be the cause for concern.

Read the entire article here.

Plus size artist, model & actor Velvet featured in New York Cool

Velvet, according to Julia Sirmons of New York Cool, is

probably the only woman in the history of the world who's walked the catwalk for Jean-Paul Gaultier and John Galliano, worked as a maternity nurse, been a member of one of the two contemporary dance troupes in France, played the title role in a surrealist farce and walked the red carpet at the Cannes Film Festival at a weight of 300 pounds.

Speaking to Velvet, I felt I had encountered a true creative artist, utterly devoid of pretension, who did exactly what she wanted because it had never occurred to her to do anything else. She's up for anything, accepting all projects and offers that pique her interest. It's an approach to life that can perhaps best be summed up by a quote from Helen Keller that Velvet keeps above her desk: "Life is either a daring adventure or nothing."

Read Sirmons's interview of Velvet here.

Gina Kolata on Good Calories, Bad Calories

Gina Kolata. New York Times science reporter (and author of Rethinking Thin: The New Science of Weight Loss and the Myths and Realities of Dieting) has weighed in on "carbophobia" with a review of Gary Taubes's Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease.

Taubes's book (which, as I posted earlier, John Tierney also recently wrote about in the Times) reports the poor science behind low-fat dietary religion and proposes instead that carbohydrates are evil -- err, contribute to "obesity" and disease.

Kolata acknowledges that

much of what Taubes relates will be eye-opening to those who have not closely followed the science, or lack of science, in this area....For example, he tells the amazing story of how the idea of a connection between dietary fat, cholesterol and heart disease got going and took on a life of its own, despite the minimal connection between dietary cholesterol and blood cholesterol for most people. He does not mince words. 'From the inception of the diet-heart hypothesis in the early 1950s, those who argued that dietary fat caused heart disease accumulated the evidential equivalent of a mythology to support their belief. These myths are still passed on faithfully to the present day.' The story is similar for salt and high blood pressure, and for dietary fiber and cancer.

In fact, Taubes convincingly shows that much of what is believed about nutrition and health is based on the flimsiest science. To cite one minor example, there's the notion that a tiny extra bit of food, 50 or 100 calories a day -- a few bites of a hamburger, say -- can gradually make you fat, and that eating a tiny bit less each day, or doing something as simple as walking a mile, can make the weight slowly disappear. This idea is based on a hypothesis put forth in a single scientific paper, published in 2003. And even then it was qualified, Taubes reports, by the statement that it was 'theoretical and involved several assumptions' and that is 'remains to be empircally tested.' Nonetheless, it has now become the basis for an official federal recommendation for obesity prevention.

Yet, Kolata points out, in his zeal to convince readers that carbohydrates make people fat by driving up insulin levels, which encourages the storage of fat,

...Taubes ignores what diabetes researchers say is a body of published papers documenting a complex system of metabolic controls that, in the end, assure that a calorie is a calorie is a calorie. He also ignores definitive studies done in the 1950s and '60s by Jules Hirsch of Rockefeller University and Rudolph Leibel of Columbia, which tested whether calories from different sources have different effects. The investigators hospitalized their subjects and gave them controlled diets in which the carbohydrate content varied from zero to 85 percent, and the fat content varied inversely from 85 percent to zero. Protein was held steady at 15 percent. They asked how many calories of what kind were needed to maintain the subjects' weight. As it turned out, the composition of the diet made no difference.

Kolata doesn't buy Taubes's premise.

If low-carbohydrate diets are so wonderful, why is anyone fat? Most people who struggle with their weight have tried these diets and nearly all have regained everything they lost, as they do with other diets.

Taubes claims that carbohydrates are "addictive," she reports. And, apparently, that permanent weight loss is possible if the addiction is "'overcome with sufficient time, effort and motivation.'" Kolata isn't convinced.

And neither am I.

Granted, I haven't read Taubes's book, but I've had plenty of exposure to the belief (I don't really want to dignify it by calling it a theory or hypothesis) that carbohydrates are addictive. I've seen many fat women who were "diagnosed" as "food addicts" in a misguided attempt to apply the 12-step program of Alcoholics Anonymous to weight, and told they need to "abstain" from "addictive" foods like wheat and sugar.

They've often lost weight, yes -- and then eventually started bingeing in response to the semi-starvation, with their weight soon returning to pre-diet setpoint levels or higher. These women had plenty of motivation, if only due to the fat-shaming environment they grew up and lived in. It didn't make any difference.

Taubes's book may do a service in alerting many to the poor science behind low-fat diet orthodoxy, and how scientific consensus can cascade into erroneous and even harmful beliefs and practices. But if he's proposing a low-carb diet as a health (and weight) panacea, he may be contributing to another false informational cascade.

Informational cascades, diet and fat

In today's New York Times review of Gary Taubes's new book Good Calories, Bad Calories: Challenging the Conventional Wisdom on Diet, Weight Control, and Disease,  John Tierney makes some good points about the folly of consensus in science and how that has manifested in dietary recommendations.

Tierney starts out by recounting former surgeon general C. Everett Koop's ludicrous 1988 claim that high-fat foods like ice cream are as dangerous to health as cigarettes.

The notional that fatty foods shorten your life began as a hypothesis based on dubious assumptions and data; when scientists tried to confirm it they failed repeatedly. The evidence against Haagen-Dazs was nothing like the evidence against Marlboros.

It may seem bizarre that a surgeon general could go so wrong. After all, wasn't it his job to express the scientific consensus? But that was the problem. Dr. Koop was expressing the consensus....He was caught in what social scientists call a cascade.

We like to think that people improve their judgment by putting their minds together, and sometimes they do. The studio audience at "Who Wants to Be a Millionaire" usually votes for the right answer. But suppose, instead of the audience members voting silently in unison, they voted out loud one after another. And suppose the first person gets it wrong.

If the second person isn't sure of the answer, he's liable to go along with the first person's guess. By then, even if the third person suspects another answer is right, she's more liable to go along just because she assumes the first two together know more than she does. Thus begins an "informational cascade" as one person after another assumes that the rest can't all be wrong.

Tierney points out that cascades

are especially common in medicine as doctors take their cues from others, leading them to overdiagnose some faddish ailments (called bandwagon diseases) and overprescrive certain treatments (like the tonsillectomies once popular for children). Unable to keep up with the volume of research, doctors look for guidance from an expert -- or at least someone who sounds confident.

[And I'll bet often those confidence-inspiring "experts" are pharmaceutical company/drug sales reps, or doctors who are funded by industries manufacturing and selling drugs and surgical supplies. See Kathleen Slattery-Moschkau's comedic film Side Effects, based on her experiences as a pharmaceutical sales rep.]

Tierney's article goes on to describe how the fat-is-bad theory and low-fat diet recommendations became popular despite many scientists' cautions.

The scientists, despite their impressive credentials, were accused of bias because some of them had done research financed by the food industry. And so the informational cascade morphed into what the economist Timur Kuran calls a reputational cascade, in which it becomes a career risk for dissidents to question the popular wisdom.

With skeptical scientists ostracized, the public debate and research agenda became dominated by the fat-is-bad school....But when the theories were tested in clinical trials, the evidence kept turning up negative. As Mr. Taubes notes, the most rigorous meta-analysis of the clinical trials of low-fat diets, published in 2001 by the Cochrane Collaboration, concluded that they had no significant effect on mortality.

Taubes claims that low-fat diet recommendations led Americans to switch to high-carbohydrate diets that led to "obesity" and disease. [That's true in my experience -- I recall when a popular Vanderbilt University-affiliated diet guru in Nashville began promoting high carb/low fat diets in the early 1980s, and I began making an effort to eat more complex carbohydrates thinking that was better for weight control. Yeah, I was still dieting back then.]

But, Tierney notes, Taubes acknowledges that the hypothesis that carbohydrates contribute to "obesity" and disease is unproven, and "the low-carb diet fad could turn out to be another mistaken cascade." (Emphasis mine.)

Read the full article here. Get more on the "low-fat, low-fact cascade" on Tierney's blog here.

The New York Times on fashion models, dieting & smoking

In an article published in today's New York Times  Fashion Diary ("Still Too Thin, and Getting Younger"), Guy Trebay writes about the bodies walking runaways getting younger and younger. And they're using drugs, cigarettes and dieting to stay thin.

Despite the outcry last year about the South American models who died from eating disorders, the supposedly resulting monitoring of U.S. models' weight is apparently not being done -- or not being enforced, Trebay reports.

Not only that, but he declares that the "Chanel pouchettes" (guess that's fashionese for itty bitty purses) of fashion models can be found to contain "currently common tools of the trade like Vicodin, clenbuterol and Marlboro Lights."

Vicodin, of course, is the prescription painkiller Eminem liked so much he immortalized it on "The Slim Shady LP," and a drug better appreciated in the fashion business for its appetite-suppressing powers than for the truly unappetizing truth that it is only slightly less addictive than heroin. Clenbuterol is a steroid used by athletes, horse trainers and models to reduce body fat (one study of clenbuterol in horses showed significant weight reduction in a matter of weeks). "A lot of girls are using it now to keep their weight down," said Kelly Cutrone, the founder of People's Revolution, a fashion production company.

The one thing you will never hear anyone utter a peep of concern about when it comes to models is smoking. Yet it's pretty common knowledge that they smoke more than long-haul truckers, road workers or Sylvia Sidney in "Beetlejuice."

Trebay also reports that University of Florida researchers who analyzed the dieting and smoking practices of 8,000 adolescents recently published a study establishing "a connection between dieting, smoking and drug use" among girls. They found that "dieting seemed to lead to smoking and for reasons any model could explain: nicotine suppresses the appetite."

Trebay points points out that animal studies have linked food deprivation to the use of stimulants.

When the fashion industry is used to its next fit of moral dudgeon and wakes up again to the problems of underweight girls and the largely hidden abuse of things like clenbuterol, it will be worth reminding them that there is good science demonstrating that when you starve an animal, you make it a lot more vulnerable to self-abuse. (Emphasis mine.)

He may be speaking to the fashion industry, but I hope all those who have declared "war on obesity" and have launched "childhood obesity prevention" campaigns are also listening.

Read the entire article here.