Thursday, February 10, 2011

Lipid II

I seem to be surrounded suddenly by obesity discussion. I posted on it two nights ago, and suddenly a report comes out which shows an increase in obesity and unhealthy eating, particularly in young people. Hack did a show on it (which I missed, but plan to catch up on).

Spilt Milk very kindly dropped by from her blog to take me to task and pose some interesting questions about my own perceptions of obesity, body image, diet and weight. As usual I began in the comments box, hit Chapter 4 of my response and admitted that this was an issue which required its own blog.

You can read Spilt Milk’s entire response to my previous post in its comments section, but I was most interested in the questions she posed to me and I’ll answer them in sequence here.

Can the majority of people achieve long term weight loss?
This is a yes/no question in which both answers can be successfully argued as incorrect because its parameters are unclear enough to leave open debate. What is meant by “majority”, “long term” and “weight loss”? In fact, given that there is no perfect weight, why focus on loss?

Does attempting to lose weight (dieting) carry health risks?
Yes. Again, if the focus is on losing weight, instead of living healthily, then absolutely yes. But the word ‘dieting’ here needs qualification because it is an extremely loaded term. Technically, we are all ‘dieting’, we all have ‘diets’. However, the word ‘diet’ has come to mean ‘eating less’ or ‘eating plan focused on simply weight reduction as opposed to long term health’. The factor at variance is the quality and balanced of the food consumed.

Is dieting in one's lifetime associated with higher weight?
Again, this question is too broad to successfully give a yes/no answer without qualifying one's response, or clarifying the terms used.
I'm of the opinion that 'dieting' is an old-fashioned, unhelpful word for 'eating' - as old-fashioned and unhelpful as 'fat'. Taken literally, this question asks 'Is eating associated with higher weight?' to which of course the answer is 'yes', even if only because the converse is also true - 'Is not eating associated with lower weight?'
I'm going to assume that the underlying meaning of this question is more specifically:

'Is attempting to modify one's diet purely with the goal of losing weight (as opposed to overall health) associated with long-term, low health patterns; one of the indicators of which can be higher weight, particularly if an individual is already pre-disposed to higher weight?'

To which of course the answer is yes. But the implication of this question is a moral one, pointing towards a negative attitude towards impelling people to change their diets with the singular goal of losing weight. This is a straw man - no one seriously involved in this discussion would agree with telling an unhealthy person to reduce their eating or change their diet purely for a change in body shape.

Is correlation (obesity with diabetes) causation?
No. But correlation can be indication. An indicator (obesity) is more useful than a cause in this discussion because it is given equal relevance to a discussion on health to other indicators (of diabetes, for example) and can also be addressed as part of a health plan, rather the focus of it. The removal of cause also removes blame, which I believe is one of the primary reasons for FA or HAES activism.

Does social isolation cause health problems?
This is another straw man, the implication being that without a FA or HAES societal attitude, people are given the unwelcome choice between the documented health problems caused by unhealthy attempts at weight loss and the documented health problems caused by the social isolation currently visited upon fat people.

Is a 'personal responsibility' approach the best to take towards public health problems?
This is one I can't answer. Public health is a really broad area, and by definition, not personal. Hand washing is a public health issue, but requires personal responsibility for its function to succeed. Ditto immunisation.
I'm not sure obesity is a public health problem, but it can have public policy implications (increased need for treatment for ailments indicated by obesity, etc), but this is a democracy and that's what we pay our taxes for: to help each other.

What percentage of obese people are the obviously fat, 'morbidly obese' size?
(I'll answer that one - it's about 6%. The vast majority of people counted in obesity statistics are not considered very fat by societal standards.

Check out the BMI gallery at Shapely Prose to see what I mean).

I guess what I'm saying is that many assumptions underpinning 'mainstream' beliefs about fat and health can be proven wrong or at least a little wobbly. Always great to have people join in the conversation :)

I guess what I'm saying is this that in order for the whiff of denial to be eradicated from this discussion on bodies, these types of questions and implications need to be respectively answered and avoided.

More to the point: medical discourse surrounding weight is results-focused. It simply does not have the complexity or depth to take into account the lived experience of existing in a body which it has termed to be insufficient. Medicine is purely a science. Science is based on quantifiable results, not the external realities of how those results are interpreted and utilised. Science cannot predict, explain or treat some dickbrain screaming 'You ate all the pies!' from their car window at a diabetic.

But I’m still wondering: in a Fat Acceptance or Health At Every Size disourse, can obesity or even body size can be discussed at all? Is discussing ours and each other’s bodies out completely?


Elephant In The Room: This is the one I'm not qualified to discuss, but cannot move forward without addressing. Fat is a Feminist Issue. I'm a man. The experience is and will always be different. This doesn't mean I should bow out of the discussion but it needs to be acknowledged that most of the discourse surrounding health and weight is carried by women. Before we start making rules about how obesity and weight should be discussed, it needs to be acknowledged that men's bodies and women's bodies are treated differently in our culture and so the solutions and strategies for Fat Acceptance and Healthy At Every Size activism need to take that into account - something which I'm yet to see happen.

7 comments:

  1. Fat acceptance is often linked to feminism, it's true, and the majority of prominent FA bloggers identify as women. There are some men joining in the conversation though. You might like to check out

    http://www.nicholosophy.com/
    http://red3.blogspot.com/
    http://atchka.com/

    Regarding your assertion that medicine is a science - yes, it is. But that doesn't mean that current thinking about obesity is necessarily informed by good science. (I would hesitate to say that it's all bad science! But scientists are not purely objective, alas. And health professionals often lack objectivity when it comes to treating fat patients, to the detriment of health. I disagree that medical attitudes don't influence whether or not people yell at fatties out of car windows. The fact that we are bombarded with negative messages about the 'obesity epidemic' helps people to feel justified in their bigotry. They are able to say they 'just care about your health' when in fact their concern is more of a moral and/or aesthetic one. Stuff on medical bias here: http://www.yaleruddcenter.org/resources/upload/docs/what/bias/WeightBiasStudy.pdf )

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  2. No one can get a good weight for along term without a managed diet.So one who is planning him to get healthy and smart than he must consult to a nutrition expert.That is batter than you do it by your self.

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  3. No, I don’t think we need to be discussing each other’s body size. For what reason do we need to discuss it? The reason why fat people are fat, and skinny people are skinny are due to a range of personal, medical, psychological and genetic factors. To try and “discuss” – which I think is just a pretty word for “pass judgement” – anything related to weight issues is already null and void because you can’t possibly know what the individual has going on in their mind and bodies and therefore can not be making any plausible points within your discussion.

    From the point of view of a fat person, my weight is my responsibility. I know that through varying my food and exercise regime that I will either be helping or hindering my HEALTH. Whether my weight increases/decreases or medical issues increase/decrease is for the discussion between myself and whomever I trust this information with. It is for no one else to be concerned about because they can not possibly comment adequately because they don’t know the full history and make up of MY BODY.

    This tends not to be the case though and prejudice against fat people remains to the point of being widely accepted in society. I probably have lots of anecdotes that fit to describe what I mean here, but I shall share one….

    A friend of mine and her husband are fat. They are in their late 30’s and they want a baby. They have been trying to conceive for 8 years. They’ve been refused fertility treatment and IVF from some clinics because of weight. They recently applied to become foster care parents. They desperately want the chance to have a child in their lives and would be wonderful parents. They have good jobs and secure income. Beautiful home in a great seaside suburb. Great extended family. Non smokers, non drinkers. But they were refused eligibility because of their weight.

    And I think this is one of the points the FA/HAES is trying to make….

    Not ONCE were my friends asked what their diet was like or what exercise they did or what their lifestyle was like. As soon as they told the foster care rep their respective weights, it was an automatic FAIL. My friends are, by all respects, illness free, with active lifestyles and healthy diets most of the time. I’m certain that with whatever life they do have, that they would provide a beautiful, loving home and family to any child.

    But, like pretty much everyone in the world, their HEALTH never got a look in, but their FAT is what did the talking.

    Part of what FA/HAES is trying to say is that instead of getting caught up in the “what ifs” of will they get diabetes? Will they get heart disease? Will the die young…etc. etc…..why can’t we ask, what if they live long and healthy lives? And the means to living a long and healthy life is up to the individual and nobody else. Everyone else needs to stop making broad assumptions about fat people and just love and accept everyone for who they are.

    And by the way – my male friend, who I mentioned above, was just as cut up about the fact that his weight supposedly meant that he was an illegible parent as his wife was. I suspect that fat men carry their own issues about weight, health and acceptance, similar to their female counterparts. Feminist issue? Perhaps not……

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  4. Myspiltmilk - Okay, I think I'm being mis-read here. I'm not saying that medical attitudes don't affect the way fat people are treated. I AM saying that scientific objectivity IS the problem. Science simply isn't equipped to deal with more than one objective truth at a time. Fat Activism requires a complex change to a complex set of factors and there's your battle.
    Medicine isn't designed to treat complex and frankly immeasurable factors like potential feelings of isolation resulting in an objectively measurable decrease in health and well-being.
    Science IS objective, meaning that its results can always be reproduced and be acknowledged as objective, reliable truth. A doctor knows with absolute certainty that a patient who weighs X amount will be X times more likely to suffer from ailments A, B and C. She knows this just as certainly as she does that a ball pushed towards the table edge will fall off that table.

    What she does not know with at least some or even any certainty is that the act of attempting reduce the occurrence of A, B or C will carry an objectively, demonstrably worse outcome than the effects of A, B or C. This is where some Fat Activism is coming from.

    Get a Blog - Are you a Spambot? Come on back and I'll respond.

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  5. Anonymous - I think you're defensive and I think it's making you misunderstand what I'm blogging about. I'm not discussing anyone's body, I'm not making the argue anywhere that we should. I'm on your side about this.
    Saying that discuss is a pretty word for "pass judgement" is not a helpful way to enter this conversation. If you don't want to call it "discuss" - fine. We can roll with conversation, pow-wow, interface, idea exchange, whatever you like.
    This conversation, the one I'm interested in and the one about which I'm actually very happy to receive such detailed comments like yours, is about trying to change a discriminatory attitude against a group of people who are judged by a singular, indicative, but not conclusively so, aspect of their appearance.

    The only analogy I can think of is a friend of mine who got a collapsed lung. He was one of those tall, really tall, skinny guys. No muscle bulk, no solid bones, just tall and thin. The doctors told him that tall, thin men like him were more likely to get collapsed lungs for wide range of reasons indicated (but not caused by) body type.
    They also told him that there was a simple test to measure an increased risk of a collapsed lung in tall, thin men. It was directly to do with the size and shape of his body; his wrist to be exact. If you're over about 6'3" and can wrap your thumb and ring finger around your wrist so that the thumb can overlap the ring fingernail, then you had an increased likelihood of suffering a collapsed lung.

    Can you see the analogy with body size here? An observable, objectively measurable body characteristic can (not does, just can) help predict a future outcome.

    I'm willing to bet your poor, childless friends aren't the victims of prejudice, some nasty old school marm-type sneering at their application, assuming that ALL fat people are LAZY, SLOTHFUL AND OF POOR MORAL STANDARD BECAUSE OF A DISTINCT LACK OF CONTROL. I would say that this is an insurance company in the background saying "Our scientific research shows that people of X weight and X age are more likely to suffer some of kind of obstructive health condition. Therefore, the odds are tipping towards us having to pay out at some point, sooner than with someone of lesser weight. We do not want to pay out money at all, ever. So we will refuse to accept this application."

    I'm willing to be that's the objective prejudice your friends are coming up against: this cold, heartless science, indicating, not proving, not guaranteeing, but merely having a good guess that such an outcome will occur.
    Science will never take into account the love they could have provided for an adopted child and the benefits of that love, because it's not measurable. Okay - it is measurable, but imagine trying to prove that scientifically.

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  6. Interesting read. Not sure which side of the fence that I'm sitting...

    Maybe I'm sitting in the middle - knowing that if I don't at least try to continue to keep adjusting my food and exercise that I guess I am at increased risks of (insert bad illness here). But then, in the case of our family, heart attack is genetic on every side from our relatively healthy and thin elders. Diabetes, cholesterol and high blood pressure too. If I do get one of these weight related illnesses, do I conclude it's weight? Or genetics? Or both? Or just shit luck? I don't know!

    And on the other side of the fence, I wish that I could just be seen as normal - both by the general population, and by myself. That's where I like the fat acceptance bit...that it may just allow me to feel free to love myself a little better and that just might have an impact on my weight too.

    Be interested to see what others have to say.

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  7. Shelley, I think you've said it better and clearer than most of the blogs I've seen on this. Thanks.

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An explanation of The Joy Division Litmus Test

Although it may now be lost in the mysts of thyme, the poll below is still relevant to this blog. In the winter of 2008, Mele and I went to live in Queensland. In order to survive, I bluffed my way into a job at a Coffee Club.
It was quite a reasonable place to work: the hours were regular, the staff were quite nice, it wasn't particularly taxing on my brain.
There were a few downsides: In the six weeks or so that I worked there, there was about a 90% staff turnover (contributed to by my leaving). This wasn't seen as a result of the low pay, the laughability of staff prices or the practice of not distributing tips to staff, rather it was blamed on the lack of work ethic among Bribie Island's youth.
However, one of the stranger aspects of the cultural isolation that touched our lives during our time "up there" was the fact that nobody at my work had heard of the band Joy Division.
The full explanation is available here.
But please, interact a little further and vote in my ongoing poll. The results are slowly mounting up, proving one thing: people read this blog are more well-informed about Joy Division than anyone who works at the Coffee Club on Bribie Island.

Have you heard of the band Joy Division?

Chinese food, not Chinese Internet!

Champions of Guess The Header

  • What is Guess The Header about? Let’s ask regular “Writing” reader, Shippy: "Anyway, after Franzy's stunning September, and having a crack at 'Guess The Header' for the first time - without truly knowing what I was doing mind you - I think I finally understand what 'GTH' is all about. At first I thought you needed to actually know what it was. Don't get me wrong — if you know what it is, it may help you. I now realise that it's more Franzy's way of invoking thought around an image or, more often than not, part of an image. If you dissect slightly the GTH explanatory sentence at the bottom of his blog you come up with this: “The photo is always taken by me and always connects in some way to the topic of the blog entry it heads up.” When the header is put up, the blog below it will in some obscure way have something to do with it. “Interesting comments are judged and scored arbitrarily and the process is open to corruption and bribery with all correspondence being entered into after the fact and on into eternity, ad infinitum amen.” Franzy judges it, but it's not always the GTH that describes the place perfectly that gets it. “The frequent commenters, the wits, the wags and the outright smartarses who, each entry, engage to both guess the origin and relevance of the strip of photo at the top (or “head”) of each new blog and also who leave what I deem the most interesting comment.” It generally helps if you're a complete smartarse and can twist things to mean whatever you feel they should mean - exactly the way Franzy would like things to be twisted." - Shippy Blogger and GTH point scorer.
  • Nai - 1
  • Lion Kinsman - 2
  • Will - 2
  • Brocky - 2
  • Andy Pants - 2
  • The 327th Male - 3
  • Mad Cat Lady - 3
  • Miles McClagen - 4
  • Myninjacockle - 4
  • Asheligh - 5
  • Neil - 5
  • Third Cat - 5
  • Adam Y - 6
  • Squib - 6
  • Mele - 6
  • Moifey - 7
  • Jono - 8
  • The Other, other Sam - 14
  • Kath Lockett - 15
  • Shippy - 19
  • River - 32