Should we be afraid for our health
because we're fat?

Or is the "Obesity Epidemic" a Myth,
and losing weight to get "healthy" 
just another Anti-fat Biased Hype?

Our Absurd Fear of Fat
                     By Paul Campos: January 3, 2013 New York Times

ACCORDING to the United States government, nearly 7 out of 10 American adults weigh too much. (In 2010, the Centers for Disease Control and Prevention categorized 74 percent of men and 65 percent of women as either overweight or obese.)

But a new meta-analysis of the relationship between weight and mortality risk, involving nearly three million subjects from more than a dozen countries, illustrates just how exaggerated and unscientific that claim is.

The meta-analysis, published this week in The Journal of the American Medical Association, reviewed data from nearly a hundred large epidemiological studies to determine the correlation between body mass and mortality risk. The results ought to stun anyone who assumes the definition of “normal” or “healthy” weight used by our public health authorities is actually supported by the medical literature.

The study, by Katherine M. Flegal and her associates at the C.D.C. and the National Institutes of Health, found that all adults categorized as overweight and most of those categorized as obese have a lower mortality risk than so-called normal-weight individuals. If the government were to redefine normal weight as one that doesn’t increase the risk of death, then about 130 million of the 165 million American adults currently categorized as overweight and obese would be re-categorized as normal weight instead.

To put some flesh on these statistical bones, the study found a 6 percent decrease in mortality risk among people classified as overweight and a 5 percent decrease in people classified as Grade 1 obese, the lowest level (most of the obese fall in this category). This means that average-height women — 5 feet 4 inches — who weigh between 108 and 145 pounds have a higher mortality risk than average-height women who weigh between 146 and 203 pounds. For average-height men — 5 feet 10 inches — those who weigh between 129 and 174 pounds have a higher mortality risk than those who weigh between 175 and 243 pounds.

Now, if we were to employ the logic of our public health authorities, who treat any correlation between weight and increased mortality risk as a good reason to encourage people to try to modify their weight, we ought to be telling the 75 million American adults currently occupying the government’s “healthy weight” category to put on some pounds, so they can move into the lower risk, higher-weight categories.

In reality, of course, it would be nonsensical to tell so-called normal-weight people to try to become heavier to lower their mortality risk. Such advice would ignore the fact that tiny variations in relative risk in observational studies provide no scientific basis for concluding either that those variations are causally related to the variable in question or that this risk would change if the variable were altered.

This is because observational studies merely record statistical correlations: we don’t know to what extent, if any, the slight decrease in mortality risk observed among people defined as overweight or moderately obese is caused by higher weight or by other factors. Similarly, we don’t know whether the small increase in mortality risk observed among very obese people is caused by their weight or by any number of other factors, including lower socioeconomic status, dieting and the weight cycling that accompanies it, social discrimination and stigma, or stress.

In other words, there is no reason to believe that the trivial variations in mortality risk observed across an enormous weight range actually have anything to do with weight or that intentional weight gain or loss would affect that risk in a predictable way.

How did we get into this absurd situation? That is a long and complex story. Over the past century, Americans have become increasingly obsessed with the supposed desirability of thinness, as thinness has become both a marker for upper-class status and a reflection of beauty ideals that bring a kind of privilege.

In addition, baselessly categorizing at least 130 million Americans — and hundreds of millions in the rest of the world — as people in need of “treatment” for their “condition” serves the economic interests of, among others, the multibillion-dollar weight-loss industry and large pharmaceutical companies, which have invested a great deal of money in winning the good will of those who will determine the regulatory fate of the next generation of diet drugs.

Anyone familiar with history will not be surprised to learn that “facts” have been enlisted before to confirm the legitimacy of a cultural obsession and to advance the economic interests of those who profit from that obsession.

Don’t expect those who have made their careers on fomenting panic to understand that our current definition of “normal weight” makes absolutely no sense.

Paul Campos is a professor of law at the University of Colorado, Boulder, and the author of “The Obesity Myth: Why America’s Obsession With Weight Is Hazardous to Your Health.” (2004)

At present the word Healthy
has now just become another word for
Thin or Lean or a “Normal” BMI.

Those trying to lose weight often say it's for their health.
But is it?

I don’t choose to view myself as a “victim”, so haven’t written a great deal about Anti-Fat Bias which involves an ongoing victimization process.

My perspective is that: I accept that the Anti-Fat perspective is a Truth of Life within our culture.
I also accept that I’ve spent a great deal of my life being fat.

My own life experiences taught me how to establish boundaries between myself and people who demonstrate ignorant, unkind, or encoaching behavior on the issue of Fat and me…. and to emotionally move-on-past any such annoyances. As a result of my own attitudes and behaviors, after I reached about age 40 …. although still fat…., it became very rare for people to make any socially negative remarks to me about my size.

Still, my major motivation to lose weight and to maintain weight loss has a great deal to do with Anti-Fat Bias … both in myself, and in others.

Why We Diet

            By Abigail Saguy   -   Los Angeles Times,   January 4, 2013 ,   

If your resolutions for the New Year are typical, they probably include a pledge to lose weight. But if you are like most Americans, any success you have shedding pounds will be short-lived, and you'll end the year weighing more than you do right now.

So why are Americans obsessed with weight loss? Many people say they want to lose weight to improve their health, but this may not actually be their primary motivation. In one of the more interesting polls I've seen, more than three-fourths of the 231 dieters surveyed said that they would take a pill that would guarantee they would achieve or maintain their desired weight even if it would lower their life expectancy. On average, they were willing to give up 5.7 years. Moreover, 91% said that they would not take a pill that would lengthen their life by five years if it guaranteed that they would also remain overweight. This was a small sample, but it is consistent with other research. For instance, a book published just last year showed that the desire to fit in or be "normal" — rather than improving health — is the primary motivation for many people who undergo weight-loss surgery.

These findings may seem puzzling, but they are not so surprising when you consider weight-loss attempts for what they really are: efforts to protect against weight-based discrimination. The fact is, fear and loathing of fat are real, and American attitudes about fat may be more dangerous to public health than obesity itself.

Yale researchers have shown that weight discrimination in the United States has increased dramatically in the last decade and is now comparable in prevalence to rates of reported racial discrimination, especially among women. Multiple studies have documented weight bias in employment, healthcare, education and public spaces — unequal treatment based on stereotyping fat people as lazy, unmotivated, sloppy and lacking in self-discipline and competence. Heavier women are not only less likely to be hired and less likely to earn a higher salary compared with their similarly qualified thinner peers, but they are also less likely to marry or to marry a high-earning spouse. Unlike thinner women, who can more easily climb the social and economic ladder, heavy women face the prospect of downward social mobility.

When I was doing research for a book on the social understanding of fat, several heavy women told me they were often reproached for eating in public. Some tearfully shared stories of having had people actually throw food at them. Other researchers have documented a practice called "hogging," in which young men sexually prey on fat women and then, during the sex act, have their male friends jump out of hiding and humiliate them. Heavy women are routinely ridiculed in advertisements, television and film. Even children express negative attitudes about their heavier peers, a tendency that has gotten worse in the past 40 years.

Of course, there are genuine health risks associated with higher body mass. The clearest case is that of Type 2 diabetes, which becomes more likely as weight goes up. Yet as many medical researchers have pointed out, this association may not be causal. That is, it's not clear whether obesity per se causes diabetes, whether diabetes causes obesity or whether both conditions are caused by a third factor, such as poor nutrition, stress or genetic factors.

It has become increasingly clear that the link between weight and health is complicated. In some cases, higher body mass seems to protect against mortality. For instance, there is growing evidence documenting an "obesity paradox," in which elevated body mass is associated with lower mortality among people with heart disease and among those with Type 2 diabetes. And a recent report in the Journal of the American Medical Assn. concluded, after analyzing almost 100 studies, that people with body mass indexes in the overweight category were at less risk of dying in a given year. In fact, they found that even those in the moderately obese category — in which the greatest number of Americans classified as obese fall — were at no greater risk of dying than those in the normal weight category.

So it's not as simple as many assume, and we have much to learn about what these observations mean. But it is clear that anti-fat bias in and of itself takes a toll on public health in ways many may not suspect. Fear of ridicule leads many heavier women to avoid exercising in public or even — when they are very heavy — to avoid leaving their homes, depriving themselves of social interaction. Because many heavier women experience the doctor's office as a hostile environment, they are less likely to get Pap smears, which leads to higher rates of cervical cancer among women categorized as obese. And the fear of becoming fat can lead women of all sizes to develop eating disorders and body image problems that can diminish their lives and be dangerous to their health.

What should be done about weight-based discrimination?

The answer is to call for increasing tolerance and appreciation of diverse body types. This year, before embarking on yet another diet, ask yourself why you want to lose weight. If it is to improve your health, perhaps you should focus on health-enhancing behaviors that are more directly linked to health: pledge, for example, to get more sleep, eat more fruits and vegetables, get regular physical activity, or spend more time with friends.

But if you are trying to change your body to shield against discrimination and stigma, consider making a different kind of New Year's resolution: to stand up to intolerance and bigotry in all its various forms, whether racism, sexism or fatphobia.

Abigail Saguy is an associate professor and vice chair of sociology at UCLA and the author of "What's Wrong With Fat?"(2013)

Personally, I don’t think fat bias is more prevelant today than it was 50 years ago. I think that because today more people are fat, researchers are paying more attention to the issue, and I think that in the current decade, it has become more politically incorrect for people publically air their negative opinions unless they are disguised as a helpful concern for the HEALTH of a fat person.

My own past experience ….

In my high school years – late 50s to early 60s, Jackie Kennedy look-a-likes … were the norm…and my 5’1” tall, 115-125 lb body .. was considered quite “plump .. verging on fat”. The bodies of the majority of teenage girls …(certainly the popular ones) … resembled Betty, of the tv show “Father Knows Best”.

Girls dressed up then, they didn’t wear trousers in high school or church, or at work. These were only generally acceptable when one engaged in sports, worked in the outdoors, or relaxed at home. Outfits commonly seen were the sheath dress styles worn by Jackie which hid my waist and emphasized my hips. Gathered skirts were also popular, but these also emphasized my my curves. People… my classmates, my friends, my parents often told me I was too fat, so I dressed differently from the others, in dresses cut in “princess” and “A-line” styles to make myself appear “thinner”.

During my young-adult years, when I was fat, people primarily showed weight-bias to me by disapproving facial expressions. Far too often, these looks were accompanied by negative comments .. many times strangers asked me “when I was due”, or told me that I “needed to diet”. In public places, strangers often stared at my food, and if that food appeared “fattening”, openly gave me disapproving looks and sounds, and even made personal comments such as “you shouldn’t be eating that.”. If the food appeared to be “non-fattening”, strangers would sometimes provide “encouraging” communications, which … of course …. also let me know they judged my body size as inappropriate.

Here are a very few examples of my personal experiences with weight-bias in the early to late 1960s,   Bear in mind, except for obesity… I have been in good health all my life, I’ve never had high-blood pressure, or any need to take ongoing prescription medication due to any health problem. Prior to my older years, my height was just above 5’1”, and my frame is medium. For perspective, using the BMI charts, “normal” weight for me was between 100 to 130 lbs.

Being “too fat” was never a subjective thing like as part of an eating disorder. I wasn’t a thin teenager who merely thought she was fat. My family members  (including my parents),  school mates, church friends, various acquaintenances, and our family doctor, all indicated ... both by words and actions, ... that I was too fat.

Before puberty, I was “normal” weight.  At puberty, I grew to my full  height of 5'1", and my weight shot up close to 150. At age 13, dieting brought me down to a low of 113 lbs, and I maintained a weight of around 125 lbs during most of my high school years .. by ongoing food restriction. I restricted food for myself, and my parents often restricted my food further.

I remember that at around age 16, weighing 125 lbs, my M.D. told me … and my mother … that I needed to drop some more pounds, and I should not weigh more than 105 lbs.

When I was about 17 ½ years old, also weighing about 125 lbs -- one of my girl friends enlisted in the Navy, and I went with her on one of her visits to her Recruiter. I remember saying… “Hummm, maybe I should consider enlisting”, and the Recruiter replied, “No, you’re way too fat, you’d have to lose about 20 lbs before the Navy would take you.”

At my grandmothers funeral I was 19 years old, and I weighed about 135 lbs. One of my male cousins sought me out, came up to me and volunterred the information that I was too fat, that I still looked okay, but if I gained more weight I wouldn’t, and I really needed to take off a lot of weight.

Also, when I was 19, I applied for a job of telephone operater for Pacific Bell. I passed the written tests, and went for an interview. I recall that my weight was around 135 lbs, and I was dressed in the most flattering syles available to me. The woman interviewing me told me that my " test scores were very high", but I was "too fat for the job", and I "weighed too much to pass the required physical". This was based on my appearance during the interview, as well as my job application which required me to fill in my weight, together with my height, marital status, age, number of children, and race.

When I was about 21, after my pregnancy and birth of my daughter, I weighed about 220 lbs. At my first (and only)  visit with a Dentist for a toothache, that dentist told me that I was very, very fat and if I didn’t lose weight, I ‘d be in a wheel-chair in a few years, and I probably wouldn’t live to be 30.  Recalling this event, I remember that I wasn't surprised to have a dentist make a personal comment about my weight, or surprised to hear him predict disability and death. At the time, comments such as this by relative strangers simply didn't register as inappropriate behavior.

When I was about 25, I worked night-shift as a temporary clerk for the County of Portland, Oregon. At that time, I weighed about 135 lbs, having successfully lost 100 lbs on a long-term, low-calorie diet. During my physcial for the job, the doctor said I was basically healthy, but that he could barely bring himself to let me pass the physical because I was too fat, and he poked my stomach and said, “so flabby”.  I replied by telling him  that I had just lost 100 lbs, but he just shook his head and said “you need to lose at least 25 lbs more, and do a lot of exercise .. you’re still fat.”

These are only a few examples, and such events were not unusual for the time. People in general weighed a lot less, and adults were far more willing to openly share their contempt for people who “allowed” themselves to be fat. Some tried to disguise their contempt as helpful, and there were some who genuinely wanted to help me rid myself of weight which they – and society in general -- found unacceptable.

Twenty years ago when I was a morbidly obese 271 lbs, I had a gastric bypass. My body was fat but healthy, I didn’t do it to get “healthy” or to live longer. I did it because I wanted to be successful at weight-loss and maintenance. I hoped it would make me lose all of my fat, get me to “normal” weight; relieve me of the stigma of being fat and make me more attractive to myself, and to society in general.

Of course, this surgery didn’t get me to a “normal” size, just made me a smaller obese person, and it’s taken years of dieting since then to make my size look “normal”.  Although my current weight is near the top of my BMI normal range (between 120-125 lbs),  now the population in general is about 20 to 30 lbs heavier, which makes me seem thinner by comparison. Nowadays, I often see teenagers and young aduts who are generally considered “normal weight” even though they are MUCH fatter than I was at that age. “l Sometimes I look around me in amazement, and ask myself… “Where were all these fat people when I was young? By today’s standards I looked Good.”

Maintenance is KEEPING the Weight Off. We are almost at the end of 2012, and I’ve been reviewing my own personal 2012 “diet/way-of-eating/lifestyle” Efforts and Results.

My Eating Behavior wasn’t Perfect, and my Results were even further away from Perfect. 

I’d like to be about 10 lbs lighter, and during 2012, despite many, many Efforts, I didn’t achieve the Results that I believe that my eating behavior deserved.

I was unsuccessful at losing the weight my body regained over the previous 4 years. However, Today, in the last week of 2012, I’m only about one lb higher than I was during the first week of 2012, which actually is excellent maintenance.

Behavior I’m proud of in 2012 is ... that I continued working on my weight-loss maintenance for another 12 months. I did my very best to eat in a way that would cause weight-loss and keep me from regaining my weight. I entered all my food into my computer food journal, DietPower. I entered my weights, and kept additional charts & records updated even when I felt sick-to-death of the weight Results I kept seeing.

I’ve continued to do my best to make Dieting an enjoyable Hobby.  Some of the ways I’ve done this is to continually search for new information; read diet-related books; try out new recipes, and write and make videos here at DietHobby.

I’ve now maintained my current weight-loss for SEVEN years, and am now starting on year EIGHT.  As stated in the article below, avoiding obesity requires “lifelong management”, and to achieve continued Maintenance success, I can never stop my Efforts. 

There have been many days when I got tired of the whole thing, and wanted to live “normally”, but I am a “Reduced Obese” person. A person with a disability like amputed legs will always have to make “lifestyle” adjustments, and I am in the same boat. I can never expect to handle food the way a “naturally thin” person does. My own experience has taught me that eating like a “normal” person will put my body back into morbid obesity. 

“The only weight loss that matters
 is the weight you can keep off.” 

Weight Loss-Maintenance
                Dr. Arya Sharma

“We are bombarded with anecdotal instances of how easy it is to lose vast amounts of weight. Not just the ‘weight-loss industry’ … think of TV reality shows, popular magazines, and fad diets.

We celebrate people for losing weight. We seldom check to see if they are still keeping it off. I am always asked by patients, “How much weight can I lose and how fast can I lose it?” I tell them that that’s the wrong question … the only weight loss that matters is the weight you can keep off.

This is why we introduced the term ‘best weight’ … the lowest weight you can realistically maintain. Your ‘best weight’ depends on your individual circumstances. Everyone’s ‘best weight’ will be different.

The public, but also health professionals and policy makers. need to understand that when you focus on ‘weight loss’ you get ‘weight loss’ – when you focus on ‘maintenance of weight loss’ you get ‘maintenance of weight loss’.

Another point is that we often frame weight regain as ‘failure’ when it is really the only natural expected consequence of stopping the treatment for a chronic condition. Even worse, the failure is often framed in the context of the treatment.

If you take a drug … lose weight … stop the drug … regain the weight …we would attribute the failure to the drug and not to ‘stopping’ the drug. No drug or treatment works when you don’t take it.”

I tell my patients, stopping your food journal it is like stopping your medication.

The principle is that you’re never done.  The idea you’re going to do something for a while and then stop doing it is not going to work. So you’ve got to find something that works for you that you can keep on doing.

The bottom line is that obesity is a chronic condition that requires lifelong management. So don’t do anything that you can’t afford to do, or that is so time-intensive that you’re just going to run out of time to do it, or so onerous that you’re just not going to stick with it.

                                 Dr Sharma’s Obesity Notes, www .drsharma. ca

The end of October is a challenging time for me.  It marks the beginning of the holiday season of parties and events, which always includes food. Halloween kicks things off and then on to Thanksgiving, Christmas and New Years.

Holiday seasons tend to give a great many people the binge bug. From late November through New Year's Eve, the holiday season can seem like a six-week-long smorgasbord. Larger, richer meals, special desserts, a few more h’orderves, another handful of nuts, a glass of punch.

When trying for a balanced diet, It's easy to lose both the balance and the diet.

Opportunities are endlessly staged in front of us ... holiday celebrations, family gatherings and friendly festivities.

It would be great to be able to successfully diet all throughout the holiday season.

It would be good to keep from overeating on special holiday occasions. 

 I’ll settle for reducing my food celebrations to a limited few.

I am working toward making my extra food occasions into one-day-only-celebrations on the actual holiday itself. Because actually:  Halloween is one day. Thanksgiving is one day. Christmas and Christmas Eve are two days. New Year’s Eve is one day. My birthday is in there too, and that’s one day. So that totals six special Holidays for me, and one-at-a-time, I can choose not to eat myself sick on any or all of those days. Six Celebration days is just under 10% of the Sixty-three days between Halloween and New Year’s Day . While overeating 10% of the time is not ideal, it is far better than overeating 30% to 100% of the time.

Even “normal” people tend to gain 5 lbs over the holidays, and then work to take them off in the new year. Unfortunately, here in my 7th year of maintenance, while my own body seems willing to easily PUT ON additional weight, it will then absolutely refuse to drop off that regained weight later.

Nowadays, losing weight is extremely difficult for me. As an older, short, normal-weight, sedentary, reduced-obese, female, my daily calorie burn is so low (daily average about 1050 calories) that I can’t manage to drop it down more than a couple of hundred calories (daily average about 850 calories), and …. according to my own recollection, and my detailed personal records……, doing that makes my body extra hungry, and it also becomes very tired and sleepy, which causes me to lie around more, and sleep longer, and my responsive behavior works to drop my metabolism down near the level of my diet calorie intake….resulting in little or no weight-loss. It’s a vicious cycle, which I’m trying to figure out how to overcome.

If I can lose a bit of weight between now and the end of the year, 

it will be great,
but my own 2012 Holiday goal is to gain zero lbs between now and the end of the year.

                                                 
In the video located at the bottom of this article, USTV anchor, Jennifer Livingston, delivers a well-thought out response to an attack on her physical appearance by an e-mail bully, who declared that Jennifer was a bad model for viewers because of her obesity, and that “Obesity is one of the worst choices a person can make and one of the most dangerous habits to maintain“.

The statement that obesity is a "choice", implies that the opposite is also true. It is a widely held notion that  anyone can simply "choose" not to be fat, despite the fact, that the vast majority of people who "choose"  to lose  weight, actually end up putting it back on (and more). The belief that anyone can lose weight and keep it off if only they "choose"  to do so, is  widely accepted. Even people who have been battling their weight all their lives tend to take the concept as TRUTH.

Most obese people blame themselves for their excess weight, and blame themselves for not trying hard enough or for failing again. It is one thing for the non-obese public to think of obesity as a self-inflicted matter of choice, but it is something entirely different, for a person who has spent an enormous amount of time and effort on losing weight, over and over again, to blame themselves for failing to make the right “choice”.

I know about the difficulty of losing weight and maintaining weight loss from my own personal lifetime experience.  Managing weight is not easy, and the truth is, that....despite the current hype ... weight has never actually been a good measure of health or of a healthy life style anyway.

Is obesity a choice?  The term “choice” implies that one has the freedom to choose from different options which are available to them, and the power to make that option a reality.

We make many different choices during our Lifetime, both small and large. We choose what Results we would prefer to see in our lives. Married or Single? Children? Education? Career? Our small daily Behavior choices have a great deal with determining our lifetime Results… but not everything.

I chose to get up and get dressed today. I chose to blog here. I chose to get married. I chose to get an doctorate. I chose to become a lawyer. I chose to spend 25 years practicing law. I chose to be a homeowner. I chose to become financially secure. It turned out that I had the power, through my actions, to make these choices into reality for myself. Some choices don’t carry that power with them.

I have the freedom to choose to fly like a bird, but I don’t have the ability to make it happen. I can follow through with my choice by jumping from a high-rise building, but the physical law of gravity will interfere to keep me from attaining success.

Most people “choose” to be healthy. Few people “choose” to have cancer, or heart disease, but it happens…to people of all ages ... even to non-smoking, marathon-running, normal-weight, organic-eaters.

Obesity belongs in the Health category. The condition of obesity involves genetic predisposition, an environment of stress, sleep deprivation, sedentary employment, abundant and omnipresent energy dense foods, unhealthy body-image promoting media, and one’s individual physiological and psychological makeup.

Some people have bodies that can overcome their health environment, and some don’t.
After surgery, radiation, and chemotherapy, some people with cancer go into remission. Most don’t.
After dieting, and even surgery, some obese people become normal weight and maintain there.
Most don’t.

Much of the 25 years I spent as a lawyer, my personal appearance and attitude was similar to what we see of Jennifer Livingston in the video below, except that often I was even heavier. Although 20 years of Therapy didn’t make me thin, it did teach me to love and respect myself fat. I am pleased to see the self-respect that Jennifer portrays here.

I spent a great deal of my life being Obese. At present, I am fortunate enough to be normal weight. I didn’t “chose” to be fat, and then change my mind and “choose” to be normal weight. Always, being normal weight was my personal “choice”. From age 9 to here in my 60s, I’ve worked for my entire life ... through dieting, therapy, exercise, and even surgery and more dieting  … to make that option into a personal reality. The weight I am now is a Result of everything I’ve experienced, and all of my lifetime actions linked together. Before this present time, I was obese, not because I "chose" the option of obesity, but because I did not have the power to make the option of normal-weight a reality.