One more thing: while poking around with the website design, I realized that I could put back the blogroll without changing themes. So I did it, first making sure that all the blogs I pointed to were still alive (not all are very active, though). So take a look to the right, and click away!
Ever since June of last year, traffic here at Fatties United is down, way down. We used to see a big spike after every post, and now, some posts get noticed and some don’t. For example, Part 1 of my two-part Skeptical Inquirer series didn’t cause a ripple, but Part 2 caused a nice little peak in readership.
This change is related to the switch of the Notes from the Fatosphere feed from Google Reader to Feedly. It appears that we
got dropped from the feed for some reason. I think it must be accidental, and it looks like other blogs also got dropped. In fact, the feed’s looking quite thin these days. (Another factor is that some readers lost the feed in the switch. ) I’m going to see if I can get us back on the feed. In the meantime, I still think it’s a useful way to get the word about fat positivity, so if you’re at all interested, go ahead and sign up again: http://feeds.feedburner.com/NotesFromTheFatosphereBFB
Given the continual media assault on fatness, the average person is forgiven for asking, “How can fat be good?” And yet, study after study has shown that, among people with many chronic diseases, fatter patients do better on average. This is called the “obesity paradox”, although it’s only a paradox if you believe that fatness can’t possibly be good.
But it can be. We’ve talked about it on this blog here, here, here, and here. Even anti-fat guy Kenneth Krause admitted it. But one (admittedly large) study comes out showing that this is not the case for type 2 diabetes and the media act as if that debunks the whole idea of fat as being protective. This is especially annoying since another recent study confirms the “obesity paradox” for diabetes.
The number of studies confirming that there are some health benefits to fatness is large enough such that we should no longer be debating whether the benefits exist at all. We should be running studies trying to figure out why these benefits exist, and how they can be used to help people who aren’t fat, or fat people without any illness.
I could write a lot more about this, but as I said above, we have done already, and this shit is getting old.
[Part 1 is here.]
Kenneth W. Krause has a column in Skeptical Inquirer magazine in which, lately, he has been taking on fat activists. By comparison of this page and this page, he appears to be the same guy who tried to shame fat newscaster Jennifer Livingston into losing weight for the good of society. (I’m not trying to imply that Skeptical Inquirer is hiding Mr. Krause’s other activities, just that identifying people can be tricky because different people can have the same name. Note also that the Skeptical Inquirer articles I am discussing here are not available online.)
That was in 2012. In 2013, he took his anti-fat crusade to the pages of Skeptical Inquirer. Now, before Mr. Krause gets mad at me (assuming he ever reads this) for saying that he is on an anti-fat crusade, let me state that the first of this series, in the May/June issue, is relatively even-handed about the science of fatness. He starts off discussing why the energy balance concept (calories in = calories out) is an oversimplification, and that we need a better approach to fatness. He then discusses other hypotheses for fatness (hormonal imbalance, carbohydrates, lack of will power), and shows that they are all oversimplifications. But he can’t resist a “PS we hate you” at the end, stating the usual alarmist stuff about the “obesity epidemic” and how we must do something. (I agree, if that something starts with acceptance of fat people.)
But in the Sept/Oct issue, Krause tackles head-on the idea that fat could be a good thing. He starts with the most recent Flegal study, which confirmed that people in the “overweight” BMI category (between “normal” and “obese”) have the lowest risk of death (by a small margin), and that even the biggest fatties have only a modestly elevated risk of death (29% higher). Krause latches on to Flegal’s list of potential explanations, specifically the idea that the lower risk is because “heavier patients” (Flegal’s words) get better health care because they go to the doctor earlier. That actually sounds like an argument for Health at Every Size: “overweight” people can improve their health without losing weight. (And while this may be true for those in the “overweight” category, we larger fatties have had a different experience with the medical profession.) Even better, Krause himself admits that, among those with many chronic illnesses, fatties have better outcomes than thinner people (the “obesity paradox“). But he says that these people benefit from “a little, though never a lot, of extra weight.” (Then why is it called the “obesity paradox” and not the “overweight paradox”?) He concludes this part of the column with the following:
We should of course remain open to all potential subtleties regarding adiposity and health. But given the depth and breadth of the evidence associating extreme overweight with all manner of affliction, the primary public health objective must be to prevent both obesity and pre-obesity.
First of all: “pre-obesity”? Gimme a break. Second, more research is fine, but given that today we don’t know how to prevent or get rid of fatness in a way that works over the long term for most people, and since you (Mr. Krause) believe that better health care has given “overweight” folks longer lives, why not work toward better health care for the “obese” patients as well?
The next part of his Sept/Oct column looks at various diets (Paleo, Mediterranean, and vegetarian), showing that they all have flaws and none of them is for everyone. On that we can agree. But, you guessed it, he finishes by returning to the idea that we need to keep trying to lose weight, phrasing it as a way to give fat children “an opportunity for accomplishment and not . . . an excuse for regression to mediocrity.” Excuse me, pal: Fatness is not mediocrity; there are wonderful fat people who are exceptional musicians, writers, even (that’s right) dancers and athletes. Equating fatness with mediocrity is an opinion that is not based on science.
Finally we come to the latest (Jan/Feb 2014) issue of Skeptical Inquirer. This time he limits himself to a response to a letter, and here he takes off the gloves. He starts off with this gem:
Doctors tell people to lose weight because, by definition, that’s what obese and overweight people need to do.
Did we not just talk about this? Do you (Krause) not remember the paper that showed that the “overweight” had the lowest risk of death? Isn’t it clear that these definitions are unhelpful?
He then states, “And I don’t know of any doctor, dietician, or personal trainer who has ever advised a patient or client to go on a “yo-yo” diet.” Dude, look at the scientific evidence: weight-loss diets are yo-yo diets. He goes on to state that weight loss is “not impossible”. So you recommend an intervention that works 5% of the time because it is “not impossible” that it works?
He wraps it up by suggesting that we “frustrated and angry” fatties should have sympathy for health care professionals who are only trying to help. OK. But if they really want to help, they should stop using interventions that don’t work, and try the HAES approach, which has science behind it.
Skepticism emphasizes science and facts over mysticism. I’ve blogged about fat acceptance within skepticism here and here, and about skepticism toward medicine here. While I like a skeptical approach when examining health claims, Skeptical Inquirer magazine, a leading outlet of the skeptical community, often sides against fat acceptance, as I’ll explain below.
The first fatty item in the latest (Jan/Feb 2014) issue of Skeptical Inquirer is in the “Skeptical Inquiree” column by Benjamin Radford. (An earlier but very similar version of the article is available here.) He presents the fat acceptance point of view in an overly simplified way, it seems to me, and addresses only the weaker arguments of fat activists, stating (in the newer, print version):
. . . suggesting that the measure is a “demoralizing standard by which to judge a woman’s health” is bizarre: The BMI is not a “standard [of] health” (for men or women); it is a measure of adiposity (fatness).
If only that were true in terms of how BMI is used in the field! Many of you reading this have heard a doctor say to you, “Your overall health is good, but you should still lose weight.” Yes, BMI is used to determine how fat a person is, but what Radford doesn’t say is that many (most?) doctors then go on to conclude that the fat person must lose weight, irrespective of how healthy that person is otherwise.
And then, how should one go about losing weight, when there are no weight loss methods that work for most people (certainly not dieting)? Radford doesn’t address that.
He also says (I’m paraphrasing) that BMI is not used as a tool for the oppression of women. I think what he means to say is that BMI should not (or isn’t meant to) be used that way. There’s a difference.
He says “BMI is useful [because] many people do not notice weight gain,” then goes on to say that a weight gain of 4.5 lb (2 kg) over six months went unnoticed in a study. How can he extrapolate not noticing such a slow and small weight gain to being generally unaware of one’s own fatness? Most fatties can report that there are plenty of “helpful” people out there to let them know that they are fat.
He concludes (in both versions of the article):
Many of the BMI critics’ complaints are straw man arguments stemming from a fundamental misunderstanding of what the BMI is and what it claims to do. It is not a tool used by the patriarchic medical establishment for oppressing women, nor pressuring them to conform to impossible standards of beauty. It is instead a generally useful, accurate guide to helping average men and women determine their weight status.
Oddly enough, he and I agree on what BMI is: a tool to determine level of fatness. What we disagree on is which group of people misunderstand it: not fat activists, as he states, but doctors. Instead of writing an article about how we fatties have it all wrong, why not try to educate MDs, who really are using BMI in a “bizarre” way?
As you’ll know if you read this blog regularly, I’m a fan of the idea of skepticism, of questioning received wisdom, and of applying scientific knowledge to social and political issues. Even so, the skeptical community can be cold towards the idea of fat acceptance. (I plan to address this when I blog about a couple of things I read in the latest issue of Skeptical Inquirer magazine.)
But the Skepchick blog is unusually friendly toward us fatties, as blogger Olivia shows in this post about whether exercise is the best medicine for everyone. (For example, I love walking, and I do it a fair bit as a result, but not everyone does, or can, or even should.) Olivia’s post is at times funny, empathetic toward others, and realistic about how good intentions often turn out.
Since it is New Year’s Day 2014 (or later) when most of you will be reading this, and since it’s the time for resolutions, I think it’s also time for an antidote of sorts to resolutions, especially the generic sort such as “exercise more”. Olivia’s post doesn’t address exercise as a New Year’s resolution, but I think the connection is that we should beware of making a resolution just because it is expected of us.
Free post! It’s free, in that I don’t have to put any effort into it. WP’s non-sentient robots have assembled this Year in Review post for me. If you enjoy this sort of thing, enjoy!
Here’s an excerpt:
The concert hall at the Sydney Opera House holds 2,700 people. This blog was viewed about 20,000 times in 2013. If it were a concert at Sydney Opera House, it would take about 7 sold-out performances for that many people to see it.