Getting Waisted by Monica Parker

I was asked to read and review the book Getting Waisted by and about Monica Parker, who is a fat actress and writer (whom I had never heard of before this book) who was born in Scotland and grew up in Canada. The bottom line is that I didn’t like the book and do not recommend it because nearly all its attempt at humor is with the use of fat jokes.

As a girl, Monica was picked on by children and heavily criticized by her mother for being fat. Sadly (very much so to me), Monica the adult writer makes fun of Monica the little girl. And the the worst part, to me, is that the humor isn’t a fond look back at one’s foibles; it’s as cruel as 8th graders.

Monica is shown in the book as an energetic and positive person, but not fat positive for the most part. There are only two portions of the book that are fat positive. The first is about a local TV show she hosted in Toronto in the early 1970s. It was an exercise program (with Dan Ackroyd as announcer!), so just the fact that a fat woman was doing the exercises makes it fat positive to me. And it was even explicitly so at times according to the book; she describes interviewing a diet doctor and grilling him about dieting. (The second fat positive part comes right at the end, as Monica finally gets self acceptance.)

Monica seems like a good person, and I believe her when she says that she is fat positive, or at least I believe that she’s on the path to it. But the book isn’t, not 98% of it anyway. The book’s website, http://www.gettingwaisted.com (I don’t mind linking to it because, as I said, I think she’s mostly one of the good guys), has a blurb on it that says, in part, “It’s the story of a life well-lived, but with too much time wasted on what wasn’t important and too long taken figuring out what was.” I agree: way too much time wasted.

ANY HELP FOR THIS OLD FAT LADY?

Question:

Is there an existing organization, place, or group where fat people and those who support them can unite to improve the lives of fat people?

I envision a place where fat people are encouraged to live their best possible lives where and who they are now.

I envision a place where all fat people and all people who support the rights of fat people are welcome.

I think one of the main issues that divide the fat community is the issue of weight loss. Therefore, I envision a place that is free from any weight loss dialogue. There are already places where the pros and cons of this issue are discussed.

For example, I currently have 1500 followers on Pinterest. The vast majority of my Pinterest boards are related to (what I perceive to be positive) images of fat art. I love Pinterest. I love all the wonderful images I find there. I love all the size acceptance I see there. But I’m looking for something more.

I am asking that you share your thoughts on this, and provide me with any information on resources that are currently available.

Thank you.
This Fat Old Lady

REDEFINING MY FAT ASS, WILL NOT MAKE IT ANY LESS FAT

Holy crap.  Do researchers, doctors, and scientists really believe some of the crap they are spouting?

The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have apparently been listening to all of the problems with using BMI as a diagnostic tool.

http://www.medscape.com/viewarticle/825322

Unfortunately, they think that reliance on BMI is the reason there are so many fat people:

‘Regarding obesity as simply a number reflecting BMI to then dictate the way you manage it may be a good reason why, after so many years, the prevalence rates of overweight and obesity haven’t changed much….What we’re doing is rebooting the system, essentially,’ AACE president Jeffrey I. Mechanick, MD, clinical professor of medicine at Mt. Sinai School of Medicine, New York, said at a press briefing.

I repeat, holy crap.

So AACE and ACE believe that by redefining obesity into five categories, they will be able to change the rates for overweight and obesity.

Yeah, that’ll do it.

What is funny (not ha-ha funny) is they claim their purpose is to stop focusing on weight and focus on the actual health of the patient.

Dr. Ryan and Dr. Jensen called the AACE’s attempt to refocus attention from body size to overall health effects of excess body fat ‘a good thing; healthcare providers need to accept that good (or bad) health can come in a variety of body sizes and become more competent in helping patients succeed when they need to lose weight for health reasons. It’s all about improving how people feel, function, and their health risk, not how they look.’

The focus on “a variety of body sizes” sounds nice until you get to the part about needing to lose weight for “health reasons”. They’re still treating fatness as the cause of poor health. But wait; there’s more.

Recommended treatments include lifestyle modification for obesity stage 0; intensive lifestyle modification and behavior therapy, with or without medications, for obesity for stage 1; and intensive lifestyle modification/behavior therapy and medications, with consideration of bariatric surgery, for obesity stage 2. [Emphasis added.]

Lifestyle modification doesn’t sound bad – except when you read the actual guidelines:

https://www.aace.com/files/2014-advanced-framework-for-a-new-diagnosis-of-obesity-as-a-chronic-disease.pdf

4.2       Overweight and Obesity Stage 0 are indicative of the absence of obesity-related complications. … these patients have been referred to as the ‘healthy obese’ … While therapy should be individualized …, patients … would generally be treated with lifestyle modification employing meal patterns that promote health, behavior modification, and increased physical activity primarily intended to prevent progressive weight gain … More emphasis on weight reduction and hypocaloric diets may be warranted with BMI [greater than] 30 …

4.3       … Effective treatment of these complications can generally be accomplished by moderate weight loss (e.g., 3-10% weight loss). While therapy should be individualized …, in general, patients with Obesity Stage 1 would be effectively treated with intensive lifestyle/behavioral therapy or the combination of a lifestyle modification program that emphasizes caloric reduction in conjunction with a weight loss medication. …

4.4       … Stage 2 complications … require more aggressive obesity management with a greater degree of weight loss (e.g., [more than] 10% weight loss) … While therapy should be individualized …, in general, patients with Obesity Stage 2 would effectively be treated with intensive lifestyle/behavioral therapy in conjunction with a weight loss medication or with bariatric surgery.

(Also, see Table 5 of of the proposed guidelines.)

Get it? “lifestyle/behavioral therapy” means dieting and/or exercise with a focus on weight loss (or maintenance). Two things that have been shown to be ineffective.

And while they claim their guidelines act to sever the link between being fat and being unhealthy, every one of their treatments (excuse me “Suggested Therapeutic Interventions”) includes a “Reduced Calorie Meal Plan.”

If, as they claim, there is such a thing as being fat and healthy, why are they so all-fired interested in weight reduction – even in patients who just happen to be fat?

It seems to me, what we are seeing is some major turd polishing; but no matter how shiny you make it – in the end, it’s still a turd.

WHY MY FAT ASS STILL HATES SWA

Took a trip, and flew Southwest Airlines.

I was already stressed about this; being aware of SWA’s lousy history with dealing with fat flyers.

SWA’s current policy is (http://www.southwest.com/html/customer-service/extra-seat/index-pol.html):

“Customers who encroach upon any part of the neighboring seat(s) may proactively purchase the needed number of seats prior to travel in order to ensure the additional seat(s) is available. … The purchase of additional seats serves as a notification to Southwest of a special seating need, and allows us to adequately plan for the number of seats that will be occupied on the aircraft. … Customers of size who prefer not to purchase an additional seat in advance have the option of purchasing just one seat and then discussing their seating needs with the Customer Service Agent at their departure gate. If it is determined that a second (or third) seat is needed, they will be accommodated with a complimentary additional seat(s).”

So we bought the extra seat as part of our reservation. We bought the extra seat according to SWA’s instructions for 2 people traveling/requesting 3 seats:

“…

  1. In the ‘Passengers’ field, indicate the total number of seats needed by selecting that number of adults. (For example, if one Customer of size requires two seats and is traveling with one other adult in his/her party, select ‘3 Adults.’)

 

  1. Complete the ‘Whos’ Flying?’ name fields for a Customer of size as follows: A Passenger named tom Smith would designate Passenger One as ‘Tom Smith,’ and Passenger Two as ‘Tom XS Smith’.”

 

Not rocket science. Being the precise fellow that he is, my husband Whaliam followed these instructions to the letter.

When you get to the airport, SWA requests that you:

 

  1. Domestic U.S. Travel: Customers of size may check in online or at a Self-Service Check-in kiosk to reserve their boarding positions, but they must see a Customer Service Agent to receive the required documents and be eligible for a refund after the flight.

  1. Domestic U.S. and International Travel: Customers of size must obtain a Seat Reserved Document from the Customer Service Agent at the Gate to obtain a Reserved Seat Document and Refund Advice Slip for the additional seats purchased.

 

Again, not rocket science.

And being the responsible fatty that I am, I followed these instructions to the letter.

And that is where it all went to shit.

Two Customer Service Agents, one of whom was tied up with a couple for as long as I was there, and longer – I don’t know what was going on – it’s not like you have a lot of choices when you are flying SWA. Anyhow, perhaps the busy Agent was smarter than the one I got (doubtful, though, since it took him so long to deal with whatever was going on with the other couple).

I got the other Agent. I tell her I’m flying-while-fat, I need my seat reservation and my paperwork for refund. She stares at me blankly. I reiterate. I am fat. I have (proactively) reserved an extra seat. I need the items which SWA’s website has assured me I will get from the Customer Service Agent.

She asks for my reservation paperwork, which I hand to her. She starts tapping away at her computer keyboard. She then tells me that Whaliam did the reservation “all wrong” – that we cannot be on the same reservation and she will have to totally redo it. WTF? I ask her if she is sure? She says she is. I tell her that I have never heard of such a thing and that the reservations were made in accordance with the website’s instructions. She looks at me like I’m an idiot. I ask her to clarify, in case I ever (am foolish enough to) fly SWA again. She tells me (contradicting the website) that the fatty needs a separate reservation for the fatty-designated seats.

She gives me my reserved seat folder and a new boarding pass (which now, instead of being in the first group, has me in the last group boarding – should I choose to not preboard).

I tell her I need the paperwork for the refund. She stares at me blankly. I reiterate. She tells me she doesn’t know of any paperwork. I tell her that it is SWA’s policy, and the website says she will give me this paperwork. I also tell her I doubt that I am the first fat person who has flown SWA, and I don’t understand why this is all so difficult. She gets on the phone. For a really long time. (Sadly I did not bring my print out of the SWA policy with me to the Agent’s desk.) Finally, another Agent shows up. She reaches in a drawer and pulls out a pad of Refund Advice Slips, tears one off, and gives me one.

I am fit to be tied. I go sit down, literally, shaking with rage, anger, shame, you name it.

And that’s when I realize that the Agent did not give me my original paperwork back. So I go back – and wait in line, because that other Agent is still fiddle-farting with the same couple. I finally get up to the (same) Agent and ask her for my paperwork back. She doesn’t want to give it to me. I explain that I might need it, according to the Refund Advice Slip (which she had just given to me). She still doesn’t want to give it to me. At least this time, I came forearmed with the SWA policy printout and the Refund Advice Slip. So she digs it out of her trash and hands it to me – still wadded up. Nice.

I must admit, though, flying home, we had absolutely no problems. I walk up to the Customer Service Agent, hand her my boarding pass print out, she taps on the computer for a few seconds, and hands me back my reserved seat and preboard packet, and the advice slip. I told her about my experience flying out of SJC, and she blamed it on SWA contracting out jobs rather than using SWA employees at some airports. I thanked her profusely for actually knowing her job.

So while SWA may have gotten their shit together on paper, if you fly SWA while fat, be sure to have a print out of their policies in your fat little hand when you go to the Customer Agent desk because it is a crap shoot as to how you will be treated.

 

MY FAT ASS IS HANDED A LOAD OF STUPID

In the for fuck’s sake column goes a study out of Korea.

http://content.onlinejacc.org/article.aspx?articleid=1864461

The researchers took 14,828 adults, ages 30 to 59, some fat and some not, but all metabolically healthy and with no known cardiovascular disease.

The participants underwent a health checkup, including cardiac tomography estimation of coronary artery calcium (atherosclerosis) .

As usual, I only have access to the abstract. But it seems everything is based on this one exam. No follow-up.

They found the fat folks tend to have more plaque build-up in their coronary arteries. However, that build-up remained “subclinical” – i.e. still within “normal” ranges.

So what is the conclusion?

MHO (metabolically healthy obese) had a higher prevalence of subclinical coronary atherosclerosis compared to metabolically healthy normal weight participants, supporting that MHO is not a harmless condition. This association, however, was mediated by metabolic risk factors at levels below those considered abnormal, suggesting that the label of metabolically healthy for obese subjects may be an artifact of the cut-off levels used in the definition of metabolic health.

 

So because a fat person has a little more (but still within the “normal” range) plaque buildup, this means that all your other numbers showing you are metabolically healthy mean nothing.

In fact, according to these researchers, the real problem is that our current definitions of metabolic health must be too high if fat people are able to achieve those numbers.

Fuck you.

The study was on people living in Korea, so presumably mostly if not all of the participants were Korean.  So the results are pretty much limited to the average person living in Korea.  By the way, South Korea has the lowest obesity rate among the member countries of the Organization for Economic Cooperation and Development. According to the findings, South Koreans were less obese than Japanese, but their overweight rate was higher than that of Japanese. (http://www.koreatimes.co.kr/www/news/nation/2009/05/113_42993.html)  So an obese person in South Korea is kind of unusual.

This is a pretty specific group of people.  Makes me wonder how the findings translate to others.

There was no follow-up to show that a subclinical level of coronary atherosclerosis in fat people will lead to anything. They can’t even tell if this is a risk for heart disease or stroke.  Much less whether fat people may naturally have these levels without any negative effect (as is the case in other conditions considered to part of the “obesity paradox”).

As if the researchers’ conclusions weren’t biased enough, take a look at an article written based on this study:

http://consumer.healthday.com/circulatory-system-information-7/coronary-and-artery-news-356/healthy-obesity-a-myth-687342.html

What an incredible load of stupid, and blatant fat bigotry.

 

DON’T GET MY FAT ASS STARTED

A study estimates that fat children will have $19,000 more in direct medical costs over their lifetime than their non-fat peers.

http://pediatrics.aappublications.org/content/early/2014/04/02/peds.2014-0063.abstract

http://pediatrics.aappublications.org/content/early/2014/04/02/peds.2014-0063.full.pdf+html

 

The Results section of the study states:

The incremental lifetime direct medical cost from the perspective of a 10-year-old obese child relative to a 10-year-old normal weight child ranges from $12,660 to $19,630 when weight gain through adulthood among normal weight children is accounted for and from $16,310 to $39,080 when this adjustment is not made.

So if you assume the fat children will stay fat and the non-fat children will not become fat the additional direct medical costs range is $16,310 to $39,080.

If you assume the fat children will stay fat and some (I don’t know what percentages they used) of the non-fat children will become fat, the additional direct medical costs range is $12,660 to $19,630.

Like most studies of this kind, there’s just a whole lot of “ifs” going on. While they adjust for some of those non-fat 10-year olds becoming fat, not all those fat 10-year olds will stay fat. Puberty does all kinds of things to bodies.

Next, they may are assuming fat equals unhealthy. A cursory look at the paper, it seems the “Obesity Paradox” is ignored, and so is the fact that people who are in the “overweight” BMI range tend to have the lowest mortality rates.

Next, how do you predict changes in medical expenses? Those costs have sky rocketed. Will they continue to do so? How will the Affordable Health Care Act change medical expenses? How do you predict improvements in medical treatments?

Whaliam adds:

A couple of other questions come to my mind when reading this study.  First, what’s the baseline for the lifetime cost of healthcare?  If this is a $12k to $16k increase and the average lifetime cost for the non-fat is $300k, then it’s a modest increase, and should be compared with other things that cause similar increases.  Second, what’s the extra money spent on?  If it’s spent on failed weight loss attempts, then there’s a quick fix: don’t make those attempts.

Keep in mind that although even $12k is a lot of money, we’re talking about lifetime costs, so if the 10-year old kid lives to age 80, that’s 70 years, and taking the mean value of $14k, $200/per year.  Less scary.  And as I said above, we should look at other factors that cause healthcare increases, and compare these number with those.

But what bugs me the most is the final sentence of the conclusion:

Additional research is needed to include estimates of indirect costs of childhood obesity.

What is the benefit of this kind of research? It seems to me, the purpose would be to give more ammunition to the fat-haters out there. In other words, the additional costs in this study aren’t high enough to create enough prejudice against fat people (and fat children in particular); we need to pump up those numbers folks!

Instead, how about additional research is needed to find ways to improve the health of all children, fat and non-fat?

How about that?

MY FAT ASS SAYS BULLSHIT

Recently, there was a big brouha over a report that obesity rates for very young children had taken a dip. Whoo-hoo. Less fat kids. Let’s celebrate. Even though the data also showed that the obesity rates for very young children tends to go up and down like a merry-go-round.

Well, those results apparently scared a group of researchers down in North Carolina. Seems they are afraid this could be the end of fat hatred aimed at kids. The horror.

http://www.nytimes.com/2014/04/15/health/obesity-studies-tell-two-stories-both-right.html?emc=edit_hh_20140415&nl=health&nlid=16872593&_r=0

http://archpedi.jamanetwork.com/article.aspx?articleid=1856480

 

There must be some way to fan the flames of childhood obesity panic? Right?

Sure there was. Instead of looking at 10 years of data, they chose 14 years of data, and, that data bolstered their agenda! Surprise, surprise.

Not that 14 years is an odd time period of anything? Makes me wonder what happens if you go out to 15 years.

Anyhow, this “new” data shows that the obesity rates for very young kids has not dropped! Instead it is flat. That’s right. Not up, not down. Um. Yippee?

So what’s the big deal?

The big deal is pretty clear in researcher Ashley Skinner’s remark, “I want this to remain a public health issue.”

Uh-huh.

I read that as, I don’t want my funding to dry up, and I’m not going to let numbers get in the way, whether or not those numbers mean anything in the first place.

As far as I’m concerned, the 10-year study says potato, the 14-year study group says po-tah-toe, and I say bullshit.