The Fat Grackle

In discussions about health, why do we have to have phrases like, “Fat people need to exercise and eat healthy,” ? Aren’t conversations about health applicable to all individual’s, not just the fat ones?

"Though a heavy weight may be the result of imprudent lifestyle habits or underlying disease in some individuals, there are also many large people who eat sensibly, exercise regularly, and have excellent health readings—and many thin people who don’t. Regardless, a low weight—or healthy lifestyle habits—shouldn’t be a requisite for respect…

Let’s switch our emphasis to encouraging health-promoting behaviors for all, and let the fat fall where it may. Everyone, fat and thin, can reduce their risk for health problems by making good lifestyle choices. It’s time for a new peace movement: one that supports people in developing healthy lifestyle habits, regardless of their size. It’s called Health at Every Size.”

— Dr. Linda Bacon (from Health at Every Size: The Surprising Truth About Your Weight)

(Dr. Bacon has multi-disciplinary training, including graduate degrees in physiology (specializing in nutrition), psychology, and exercise science. She is committed to educating people on the scientific evidence that underlies our understanding of weight.)
Quotes regarding Fat and Research

"The implications were clear. There is a reason that fat people cannot stay thin after they diet and that thin people cannot stay fat when they force themselves to gain weight. The body’s metabolism speeds up or slows down to keep weight within a narrow range. Gain weight and the metabolism can as much as double; lose weight and it can slow to half its original speed." - Studies conducted by Jules Hirsch and his colleagues, including Rudolph Leibel.

"The scientists summarized it in their paper: "The two major findings of this study were that there was a clear relation between the body-mass index of biologic parents and the weight class of adoptees, suggesting that genetic influences are important determinants of body fatness; and that there was no relation between the body-mass index of adoptive parents and the weight class of adoptees, suggesting that childhood family environment alone has little or no effect."
In other words, being fat was an inherited condition.” Study led by Albert Stunkard of the University of Pennsylvania

In another study later published by Albert Stunkard in The New England Journal of Medicine:
"The researchers concluded that 70 percent of the variation in peoples’ weights might be accounted for by inheritance, a figure that means that weight is more strongly inherited than nearly any other condition, including mental illness, breast cancer or heart disease."


"Jeffrey Friedman, an obesity researcher at the Rockefeller University, tried to come up with an analogy that would convey what science has found about the powerful biological controls over body weight.
He published it in the journal Science in 2000 and still cites it:
"Those who doubt the power of basic drives, however, might note that although one can hold one’s breath, this conscious act is soon overcome by the compulsion to breathe," Friedman wrote. "The feeling of hunger is intense and, if not as potent as the drive to breathe, is probably no less powerful than the drive to drink when one is thirsty.
This is the feeling the obese must resist after they have lost a significant amount of weight.”

This information was taken from the NY Times Healthscience Section http://www.nytimes.com/2007/05/08/health/08iht-snfat.5614611.html?pagewanted=1

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Our findings challenge the idea that all obese individuals need to lose weight,” study author Dr. Jennifer L. Kuk, assistant professor at York University School of Kinesiology & Health Science, said in a written statement. “Moreover, it’s possible that trying - and failing - to lose weight may be more detrimental than simply staying at an elevated body weight and engaging in a healthy lifestyle that includes physical activity and a balanced diet with plenty of fruits and vegetables.”

Dr. Kuk told CBS News that she hoped the study would help dispel some common misconceptions about the link between body weight and health.
"I think this is a common notion, that if you are overweight you are unhealthy and that if you are skinny you are healthy," she told CBS News. "What people need to realize is that normal-weight people can have diabetes, high blood pressure, and other cardiovascular problems."
And vice-versa.
The actual study: Applied Physiology, Nutrition and Metabolism
found here:http://www.cbsnews.com/8301-504763_162-20092559-10391704.html

____________________________________________________________________________________________________

"There’s something researchers call the “obesity paradox”—that people who are heavier tend to survive longer than thinner people with the same disease."

"When researchers at the German Institute of Human Nutrition in Potsdam-Rehbrücke looked at more than 12,000 middle-aged men and women for a study published in 2005, they found that obese men and women whose weight fluctuated over a two-year period were four times as likely to develop hypertension as the obese people whose weight remained stable. An earlier Italian study reported that women who had lost weight at least five times in five years were more likely to have high blood pressure than those whose weight remained stable."

"In general, the scientific and popular literature estimates that only about 5 percent of dieters maintain their weight loss,"

"A 2008 study, done by Harvard researchers, looked into the effects of physical activity and body mass index on coronary heart disease and found that overweight women who walked more than four hours a week had a significantly lower risk of heart disease than those who didn’t exercise. This says to me that the most important risk factor isn’t being fat; it’s being sedentary."

"There are millions of people who are defined as obese but are very healthy. One important study, an analysis of more than 5,000 participants in a national government sample, showed that 35 percent of obese women don’t have the constellation of health problems typically linked to higher weight. Specifically, they showed no more than one sign of these issues: high blood pressure, high triglycerides, low HDL [“good”] cholesterol, elevated glucose levels, insulin resistance and systemic inflammation. And there are some health concerns, such as osteoporosis, that are much less common in people categorized as overweight or obese."

All quotes by Dr. Linda Bacon from this source: http://www.more.com/weight-loss-diet-myth which was an interview that was found in the Health section of More magazine.

In defense of the ability to be fat and healthy

(inspired by a separate conversation)

I only offer up studies and statistics when people question the validity of the statement that fat people can be healthy (which is way different from fat is healthy). I get policed about my food choices, body size, fashion choices by complete strangers (as well as friends and family members), from people who assume that I don’t know I’m fat and that I am ignorant about about food and styles that are acceptable for my body. People do not need to assume that I’m fat because I am doing unhealthy things. Looking at me can only tell you how fat I am. It can’t tell anyone anything about how long I’ve been struggling with weight, an eating disorder, a thyroid disorder or how long I have been living a healthy lifestyle and changing things. All of that is no one’s business but mine, right? Well, not according to a lot of people.

Am I wrong for challenging the notion? Because I want women (all people really) to love themselves?

Health isn’t even a part of my belief that all people deserve to be loved as they are regardless of weight or place in life. They also deserve to be able to love themselves and be happy without qualifiers.

No one has to “buy in” to what I’m saying. I’m just saying what I feel to be true and if people want to challenge their perceptions, they are free to. If people want to reject it, they are free to.

Is The Idea Of Health At Every Size Just Permission To Be Fat? -By Margarita Tartakovsky, MS (Warning: talk of eating disorders)

That’s a question that Amy Pershing gets asked a lot! Clearly, it’s a testament to the insidious impact of the weight-loss and diet industries. Below Amy offers an eloquent answer.

If you remember, I recently interviewed Amy about binge eating disorder. Check out what she had to say about binge eating myths and challenges of recovery and her own struggles and recovery.

Amy is the executive director at PershingTurner Centers and clinical director for The Center for Eating Disorders in Ann Arbor, MI. She’s also an advocate of Health At Every Size.

 

In a recent interview I was asked “How is the idea of “health at every size (HAES)” not just permission to be fat?”As a therapist working primarily with binge eating disorder (and one who is recovered), when I hear this question I being to hyperventilate, and want to scream from the rooftop while kicking something and burning diet books. Usually when this happens it means “Amy, go do some breathing and work on letting go” or “write a blog post.” So, here we go.

Actually, I can see completely how the question came to be. Given the culture in which we find ourselves, there can hardly be another possibility. The question is of course predicated on the notion that “thin is intrinsically better than fat.”

Frankly, nothing in medical or psychological research actually bears this out. Time and again, studies show that folks in the “overweight” category of BMI live longest.

In addition, while medical issues are correlated with obesity, we have yet, in most cases, to prove causality. Psychologically, given this belief, we have the highest rates of eating disorders ever known, 80% of women dislike their bodies “a great deal,” and in several studies, women would rather lose years off their lives than be fat. Without this as a given part of our way of thinking about our physical selves, the question by this reporter makes no sense.

Interesting too is the idea that given “permission” (I think the interviewer means a moratorium on dieting), people would naturally just get fat. I find that curious. We have the highest rates of obesity ever recorded, and also the highest rates of dieting.

Strikes me that one possibility is that the more people are taught to hand eating and physical movement decisions over to someone else, say Weight Watchers or Jenny Craig, the greater the “obesity” problem has proven to be. With a 98% failure rate for diets, can you imagine buying such a product if it were a television or a car? Not hardly.

But with diets, we “blame the victim.” For clearly, if you stick with the plan, it does result in weight loss (usually). True enough. But no one can stick to an outside set of rules forever, and that is the requirement for permanent weight change.

And, again, it is all predicated on the notion that “thin” is somehow intrinsically better. Bear in mind too: If you are happy with your body, who stands to lose? I’m thinking Florine and Jenny are at the top of the list.

Imagine a system where you are encouraged to stop trying to control your body, and to just listen to its cues. Imagine eating in response to hunger and fullness most of the time (not perfectly!), and keeping a gentle eye toward nutritional needs.

How would we look over time? Female 5’9″, size zero, white and young? Or male, 6’4″ with a lean body and every muscle developed? Of course not. We would be short, tall, dark, light, old, young, round, lanky, pear-shaped, the gamut.

In my recovery from BED, I have been every weight on my 5’8″ body possible. When, at my top weight, I gave up on dieting, slowly my weight did drop. And I have been the same weight for a number of years. I am still “obese” according to my BMI, bear in mind. According to the BMI chart and the cultural message, I still have about 35 lbs to go. My body, however, seems perfectly healthy and happy right here. I figure she knows better.

So “HAES” is NOT about “permission to get fat.” It is about each of us individually listening with body and mind, letting our unique bodies find the way to the weight they are happy to be, and valuing whatever the result.

It is a focus on overall health and well-being, not weight loss. Here are the basic tenets of HAES, developed by pioneer Deb Burgard, PhD:

  • Acceptance of and respect for the diversity of body sizes and shapes
  • A recognition that health and well-being are multi-dimensional, and that they include physical, social, spiritual, occupational, emotional and intellectual aspects
  • Promotion of all aspects of health and well-being for people of all sizes
  • Promotion of eating in a manner which balances individual nutritional needs, hunger, satiety, appetite and pleasure
  • Promotion of individually appropriate, enjoyable life enhancing physical activity, rather than exercise that is focused on a goal of weight loss

I find myself more and more grateful, every day that I have no idea what I will eat tomorrow. That I know my body actually wants to eat well, and feels stifled and restless if I don’t get in a run, or walk, or some playing in the sand.

The journey is not easy. Often we are explorers without a map at first, just learning how to recognize basic cues.

But for the majority of us, listening with our physical and nutritional awareness is wisdom. Listening to anyone else is like expecting someone to tell you when you need to sneeze.

Trust yourself. You have actually always known what to eat and when to move. You still do.

—-

Thanks so much, Amy, for your insightful guest post!

More on Amy:

Amy Pershing LMSW, ACSW is the founder of Bodywise, a comprehensive treatment program for binge eating and related disorders offered at both centers. She speaks nationally and writes extensively on binge eating treatment, weight stigma and the intuitive eating model. Amy maintains her clinical practice in Ann Arbor.

Fat and health

The following are quotes from an article regarding health and fat.

Fat? Who Cares! Why Weight Doesn’t Matter

By Peter Jaret

“Overweight women who walked more than four hours a week had a significantly lower risk of heart disease than those who didn’t exercise. This says to me that the most important risk factor isn’t being fat; it’s being sedentary.”

“One important study, an analysis of more than 5,000 participants in a national government sample, showed that 35 percent of obese women don’t have the constellation of health problems typically linked to higher weight. Specifically, they showed no more than one sign of these issues: high blood pressure, high triglycerides, low HDL [“good”] cholesterol, elevated glucose levels, insulin resistance and systemic inflammation. And there are some health concerns, such as osteoporosis, that are much less common in people categorized as overweight or obese.”

"There’s something researchers call the “obesity paradox”—that people who are heavier tend to survive longer than thinner people with the same disease…Why isn’t entirely clear. But the findings call into question the widely held belief that being overweight or obese is always dangerous and suggest that it may be protective in some ways."


"When researchers at the German Institute of Human Nutrition in Potsdam-Rehbrücke looked at more than 12,000 middle-aged men and women for a study published in 2005, they found that obese men and women whose weight fluctuated over a two-year period were four times as likely to develop hypertension as the obese people whose weight remained stable. An earlier Italian study reported that women who had lost weight at least five times in five years were more likely to have high blood pressure than those whose weight remained stable."

"My colleagues and I did a study, reported in the Journal of the American Dietetic Association, that confirms the usefulness of this approach. We randomly divided 78 obese chronic dieters, all female, into two groups: One followed a conventional weight-loss diet; the other enrolled in the Health at Every Size [HAES] plan, which emphasizes eating in response to hunger cues. Both programs lasted six months, and subjects were evaluated two years after the study’s beginning. By six months, 42 percent of the conventional-diet-program participants had dropped out, but only 8 percent of the HAES members had departed. The dieters did lose weight in the first six months, but two years later they had, on average, regained it all. Women in the HAES group did not lose or gain weight; they stayed the same weight throughout the two years. By the end of the study period, the HAES women showed significant improvements in their LDL [“bad”] cholesterol and systolic [the top number] blood pressure; the dieting group ended up where it had started. In addition, 53 percent of those following a diet reported feeling like failures; none of the HAES women did. So I think our message needs to encourage people to become healthy rather than focus on weight loss.”

"We need to resist the notion that being thin is the path to happiness. It isn’t. Trying to become thin can make people very unhappy. We’ve become so obsessed with weight that it’s a major revolution for people to say, “Hey, I can choose to see myself as attractive.” We’d all be much happier if we honored size diversity and focused on healthy choices, letting our weight fall naturally where it may."



Some more reading if you’re interested:

Genes take charge, and diets fall by the wayside
Obesity police busted? Study says fat folks can be healthy

Health at every size

Artificial sweeteners contributing directly to diabetes risk

“Saying everybody needs to be the same weight is like saying all people  should be the same height.” —               Linda Bacon, PhD. (via National Geographic: Health at Every Size)

Photo:Artist Unknown (let me know if you know who the artist is.)

“Saying everybody needs to be the same weight is like saying all people should be the same height.” — Linda Bacon, PhD. (via National Geographic: Health at Every Size)

Photo:Artist Unknown (let me know if you know who the artist is.)