Diet Culture: E’s Story

Does diet culture kill?

My sister E was the oldest of five children; I was the youngest. Growing up in a house where our father was at work most of the time, and our mother was tired most of the time, E did a lot of the work of raising me.

She was one of the most independent minded people I knew. She had friends and liked doing things with them, but she made her own decisions and they weren’t always what her friends would do.

She worked hard, but always on her own terms. She would use up all her vacation, and all her sick days, and she felt no guilt about it. She felt that there was no point working if you didn’t also have fun.

She’d say what was on her mind, pretty much unfiltered. Of course, she came of age in the 1970s, when “tell it like it is” was everyone’s motto. But she also knew how to sweet talk, and she could get me to do chores like no one else could.

But for all this independence, she had one weak point: she was a fat person. She was one of the most beautiful women I knew, but because she was fat, society put her in the “such a pretty face” category. She’s been on and off diets for as long as I’ve known her. They never worked long term, until about 11 years ago.

That’s when she had weight-loss surgery. I tried as best as I could to talk her out of it, but it didn’t work. She had so much self hatred because of her fatness that she wanted more than anything to lose weight and keep it off. She felt that she’d never have a husband unless she was thin, or at least thinner than she was. She knew that I was and am attracted to fat women, and was and am married to a woman much fatter than her. That didn’t matter. She just couldn’t imagine that there were others like me out there. Or maybe it didn’t matter what others thought: it was what she thought, and she thought the worst of herself simply because of her fatness.

I saw her a few years after the surgery at our father’s burial. She was a lot thinner than she had been, although not thin at that point. But she kept on saying how bad a person she was because she still ate more than she should, in her opinion.

At that time she was living near where my dad had lived, where it’s very cold in the winter, and she didn’t spend much time with other people. She talked about being depressed, and going for days without showering or bathing.

A little bit after that, she moved back to New Jersey, where we’re from. She was able to find a fairly nice place to live within her budget, and it seem like she had gotten her life in order. But she was still talking about not bathing or showering, and being sad. Another sister, C, lived nearby, and E had friends nearby as well. But she was still lonely.

C had been sick for decades, and last year, 2015, she died. After that, phone calls from E got fewer. In November 2015, E went into the hospital. She was diagnosed with an iron deficiency, got a blood transfusion, and was sent home with supplements.

She was back in the hospital in December, this time with a gallstone that had migrated to her colon. They wound up removing her gallbladder. In January 2016, she was back in the hospital again, then again in March, and again in April. Since then she’s been in an infinite loop, going from the hospital to a rehab center and then to home, but never home more than a few days until she’s back in the hospital.

Her ailments, according to the hospital doctor who has seen her the most, come down to her not eating enough. Somehow last year, through a combination of her weight-loss surgery, depression, and drugs, she had attained the ability to starve herself. Put another way, she developed an eating disorder.

I went to visit her earlier this summer on our way to a family reunion, and at that point she was in a rehab facility. The problem was, though, she wasn’t getting better. She didn’t like any of the food offered to her, and wanted special food brought in like chocolate flavored Ensure. And sometimes she didn’t like that either.

Her mental confusion increased over that period. She could never understand why she was sick, why she kept going into the hospital, why she was losing her ability to walk and do things for herself.

Eventually E went back home, but this time she had an in-home aide to help her. And for a couple of weeks, it seemed like she was actually getting better.

But she wasn’t. She wasn’t doing the physical therapy, she still wasn’t eating enough, and she wasn’t on a path to independence. A family member decided that the in-home aide was too soft on E, and so she went back east herself to nurse E back to health.

Things didn’t go as hoped. E went back into the hospital a few days later, then to rehab, then back in the hospital. We still have hope, but she’s been in decline for a long time, and it doesn’t look good.

Is diet culture killing my sister? E was an independent woman, but she could never reconcile herself to being fat. When she found a way to starve herself, there was no turning back.

Fat news through July 5, 2016

Sorry, folks; we missed a couple of weeks. But it’s OK, we’re getting caught up right now. Also, just to let you know, we pull story links from Facebook, Tumblr, Yahoo Groups, and other places, but to be honest it’s mostly Facebook these days as there has grown a wonderful network of fat positive people who are finding great stories and studies for us.

Some more honesty: I don’t recall where I got the link about Lizzo, probably from a Facebook friend, but I was really pleased to see Tante Terri take it and run in her recent blog post. Yay, Terri!

So, off we go!

November 26, 2015: Rapper and singer Lizzo’s song “My Skin” celebrates living in your own skin with a music video featuring fat women (first link). As part of the Underneath video project (second link), Lizzo talks about being a fat woman as she removes clothing, wig and makeup showing the beautiful woman underneath.
https://www.youtube.com/watch?v=WfEhyi8N__Q
https://www.youtube.com/watch?v=-8wKpyjUons

June 19, 2016: Kath Read gives JC Penney’s video for its new plus-size clothing a rave review, urging other companies to learn from what Penney is doing right in its marketing to the fat community.
https://fatheffalump.wordpress.com/2016/06/19/marketing-to-fat-women-this-is-how-you-do-it

June 22, 2016: Substantia Jones and her various projects are highlighted in an article about her current adventure, traveling through the Southern Hemisphere photographing fat people in the nude.
http://www.dailymail.co.uk/femail/article-3649964/Substantia-Jones-travels-world-photographing-naked-fat-ladies-Adipositivity-Project.html

June 24, 2016: Charlotte Cooper provides a basic do and don’t list for healthcare practitioners when dealing with a fat patient, as well as some suggestions on how the fat person can recover after a bad run-in with the healthcare profession. Also, check out NAAFA’s guidelines on the same subject (2nd link) and Stef’s list of fat friendly healthcare professionals (3rd link).
https://obesitytimebomb.blogspot.co.uk/2016/06/fat-101-for-nurses-and-health.html
http://www.naafaonline.com/dev2/about/Brochures/NAAFA_Guidelines_for_Healthcare_Providers.pdf
http://cat-and-dragon.com/stef/Fat/ffp.html

June 27, 2016: A Swedish study find that irrespective of access to health care, socioeconomic status is a predictor of all-cause and cardiovascular mortality among people with type 2 diabetes (first link). A related commentary (second link) states that addressing socioeconomic disadvantage may help us better treat type 2 diabetes.
http://archinte.jamanetwork.com/article.aspx?articleid=2530287
http://archinte.jamanetwork.com/article.aspx?articleid=2530291

June 29, 2016: An analysis of multiple data sets finds that eating butter has little or no effect on mortality, cardiovascular disease, or diabetes. An inverse (protective) effect may exist in relation to diabetes and thus more research is urged to explore the health effects of butter and dairy fat.
http://www.laboratoryequipment.com/news/2016/06/no-evidence-prove-butter-consumption-leads-chronic-disease-mortality
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0158118

June 29, 2016: Brynne Huffman’s Facebook response to a woman who dissed Brynne for wearing shorts goes viral. Here’s hoping that the woman has read it and has learned a lesson about acceptance.
http://hellogiggles.com/woman-shamed-wearing-shorts-writes-awesome-fb-post

July 5, 2016: Katie Clark explains what it means to be a fat person living in a fatphobic society and why body-shaming is not about health concerns but about buy-in to stereotypes and body policing.
http://theindependent.ca/2016/07/05/dear-fatphobics

July 5, 2016: Lindy West, author of Shrill: Notes from a Loud Woman, came out as a fat woman to friends and co-workers, confronting her boss on his derogatory comments about fat people. Talking about the discrimination faced at the workplace by fat people, she urges that employers embrace a “no body talk” policy.
http://www.fastcompany.com/3061210/the-hidden-discrimination-against-being-fat-at-work

Fat news through June 14, 2016

Courtesy of me and Tante Terri . . .

May 25, 2016: Artist and activist Kelli Jean Drinkwater presents a talk on the word “fat” and how existing in a fat body can be a radical political statement.
https://tedxsydney.com/talk/the-fear-of-fat-the-real-elephant-in-the-room-kelli-jean-drinkwater

June 2016: A letter to the editor published in Mayo Clinic Proceedings takes the publication to task for categorizing body fat percentage as a healthy lifestyle behavior in a previous article. Unfortunately, the letter continues with hand-wringing about the “war on obesity”.
http://www.mayoclinicproceedings.org/article/S0025-6196(16)30111-2/fulltext

June 8, 2016: A small study comparing weight loss intervention and weight-neutral health intervention finds that a weight-neutral intervention can yield many health benefits without weight loss, and those benefits are sustainable over a 2 year follow-up period.
http://authors.elsevier.com/sd/article/S0195666316302343

June 13, 2016: Katherine DM Clover shares her struggle upon losing thin privilege and relearning to love her body when she became a fat person.
http://www.ravishly.com/2016/06/13/summer-i-got-fat-love-story

June 14, 2016: London mayor Sadiq Khan bans ads that feature or promote unhealthy body images or are fat-shaming from the London public transportation system.
http://www.nytimes.com/2016/06/15/world/europe/london-bans-ads-with-unrealistic-body-images.html

June 14, 2016: The Aspire Assist device, a tube to the exterior of the body through which one can remove up to a third of the stomach’s contents, has been approved by the Food and Drug Administration. The second link is for a petition demanding the FDA withdraw its approval for this device.
http://www.nbcnews.com/health/health-news/fda-approves-weight-loss-stomach-pump-aspireassist-combat-obesity-n592141
https://www.change.org/p/eating-disorders-activists-demand-fda-withdraw-approval-of-the-aspire-bariatrics-assisted-bulimia-device

June 14, 2016: Researchers look at five weight-loss medications approved by the FDA and find that none of them are particularly effective.
http://www.kpbs.org/news/2016/jun/14/san-diego-scientist-compares-obesity-drugs-finds-n
http://jama.jamanetwork.com/article.aspx?articleid=2528211

Fat news through May 29, 2016

News flashes to inspire flashes of anger and (alternatively) joy, as appropriate, from Tante Terri and me.

May 8, 2016: Lindy West talks about her life starting as a baby with an “off-the-charts” large head, growing up as a fat child, and finding herself as a fat adult, as she promotes her book Shrill.
http://www.theguardian.com/lifeandstyle/2016/may/08/perfect-body-lie-believed-long-time-let-shrink-my-life-lindy-west

May 18, 2016: The Succulent Six, a fabulous group of fat women from Toronto, did a photo shoot to celebrate International No Diet Day and create a visual message on fat acceptance and fighting food shaming.
http://www.bustle.com/articles/160487-this-fat-positive-group-is-fighting-food-shaming-in-the-most-awesome-ways-photos

May 19, 2016: Buzzfeed asks members why they stopped dieting, and here are some of the answers.
https://www.buzzfeed.com/sallytamarkin/why-people-stopped-dieting

May 20, 2016: Some viewers of UK TV show This Morning complain that the show is promoting obesity after an interview with Tess Holliday. (Tess was actually promoting body positivity, which we support.)
http://www.express.co.uk/showbiz/tv-radio/672277/This-Morning-blasted-plus-sized-model-obesity-Tess-Holliday-Ruth-Langsford-Eamonn-Holmes

May 23, 2016: Facebook apologizes for banning an advertisement by Cherchez la Femme featuring a photo of Tess Holliday in a bikini because it depicts “body parts in an undesirable manner”.
https://www.theguardian.com/technology/2016/may/23/facebook-bans-photo-plus-sized-model-tess-holliday-ad-guidelines

May 23, 2016: Various scientists, doctors, and professors criticize a (non-peer reviewed) report by the National Obesity Forum that claims that adding more fat to one’s diet could cut obesity and type 2 diabetes.
http://www.bbc.com/news/health-36345768

May 25, 2016: A recent study finds that fat flyers are bothered more by the stigma they suffer when flying than by actual discomfort of small seats and seatbelts.
https://www.sciencedaily.com/releases/2016/05/160525140715.htm
http://jtr.sagepub.com/content/early/2016/04/27/0047287516643416.abstract

May 25, 2016: Based on self-reported data, a new report by the CDC estimates that 30.4% of the population (20 and over) are classified as obese, up slightly from 2014 (29.9%).
http://www.dailymail.co.uk/news/article-3609879/Americans-never-fat-Obesity-levels-climb-citizens-clinically-overweight.html
http://www.cdc.gov/nchs/nhis/releases/released201605.htm#6

May 25, 2016: Skeptic Rebecca Watson misses the point on the news regarding The Biggest Loser, in stating that the research claimed that significant weight loss is impossible, rather than very rare. She also claims the study involves too small of a group, while ignoring that this study only adds to previous research on the subject of long term weight loss.
https://www.youtube.com/watch?v=i6v0FGscZ-8

May 29, 2016: Writing for The Irish Times, Muiris Houston calls into question the wisdom of using BMI as a measure of health, since the overweight classification is associated with a lower mortality rate than any other classification.
http://www.irishtimes.com/life-and-style/health-family/the-muddy-waters-of-body-mass-index-bmi-1.2660175

Fat news through 5/12

Another batch of stories to love or to hate, rounded up by Tante Terri and yours truly.

March 31, 2016: Researchers looking at body weight maintenance (rather than reduction) find that nutritional education had no significant impact on weight gain prevention.
https://nutritionj.biomedcentral.com/articles/10.1186/s12937-016-0150-4

May 6, 2016: Neuroscientist Sandra Aamodt explains why diets do not work and the role the brain plays in making sustained weight loss next to impossible.
http://www.nytimes.com/2016/05/08/opinion/sunday/why-you-cant-lose-weight-on-a-diet.html

May 8, 2016: Carissa (YouTube Channel FatGirlFlow) talks about confidence, what it means to her, and how she found confidence in her own life. (Adult language.)
https://www.youtube.com/watch?v=L34o39lVezM

May 9, 2016: Plus-size Frostine Shake takes her classical ballet training and incorporates it into her burlesque act and modeling career.
https://www.buzzfeed.com/alisoncaporimo/baller-ballerina

May 10, 2016: A Norwegian meta-analysis (first link) claims an association between higher BMI and all-cause mortality; yet another study in Denmark (second and third links) finds that the BMI associated with lowest all-cause mortality has increased by 3.3 over the last 35 years. We note that stigma would explain both results: stigma lowers life span for fat people, but the effect diminishes as they become more accepted.
http://www.bmj.com/content/bmj/353/bmj.i2156.full.pdf
http://www.upi.com/Health_News/2016/05/10/Obesity-may-not-take-years-off-your-life-Study/4221462907610
http://jama.jamanetwork.com/article.aspx?articleid=2520627

May 11, 2016: Body positivity is making inroads in Toronto as exemplified by Karyn Johnson, a fatshion blogger; Andrew Gurza, a disability awareness consultant; and Jill Andrew, co-founder of the Body Confidence Canada Awards, each featured in TheStar.com‘s health and wellness section.
https://www.thestar.com/life/2016/05/09/torontos-bodypositive-movement-is-growing.html

May 12, 2016: Erik Cavanaugh has become an internet sensation as a plus-size ballet dancer with amazing moves, hoping to inspire others who may not have the stereotypical dancer body.
http://www.msn.com/en-us/video/peopleandplaces/this-plus-size-male-ballerina-will-wow-you-with-his-moves/vi-BBsYrEs

Fat news through 4/15

As always, thanks to Tante Terri for working with me on these. Let’s begin!

March 14, 2016: As more children have eating disorders, often triggered by school programs such as public weighing and BMI report cards, parents are fighting to stop these school programs, which have no proven benefits, in favor of those that focus on making all children healthier.
https://psmag.com/the-youngest-casualties-in-the-war-on-obesity-70d66cd0b825

March 19, 2016: Various scientists are looking at making excess fat useful for different types of body repair because fat tissue contains the types of cells, including stem cells, that can be used to repair and/or regrow cartilage, bone, and heart tissue.
https://www.sciencenews.org/article/cells-fat-mend-bone-cartilage-muscle-and-even-heart

April 7, 2016: The editor of an internet Nazi tabloid believes that fat acceptance embraces degeneracy, and was created by Jews to brainwash white men into finding fat women attractive. The hate campaign is currently targeting plus-sized model Ashley Graham, featured on the covers of both Sports Illustrated and Maxim.
http://www.wehuntedthemammoth.com/2016/04/07/daily-stormer-jews-are-encouraging-men-to-masturbate-to-pictures-of-fat-women

April 10, 2016: This post points out how isolating being fat can feel, and calls for people to stand up when they see fat people treated in an unacceptable way, if only to let them know that they are not alone.
https://medium.com/@thefatshadow/a-call-to-action-your-fat-friend-is-going-it-alone-38cb4bc70d0c

April 11, 2016: A study finds that media bias affects how people feel about fatness. Study co-author David Frederick points out that it is important to emphasize that discrimination is not acceptable when reporting about fat people.
http://www.ocregister.com/articles/fat-711738-people-obesity.html
http://www.sciencedirect.com/science/article/pii/S0277953615302902

April 11, 2016: Designer Ashley Nell Tipton, Project Runway winner and first contestant to show a plus-size collection, talks about her fashion goals and teaming up with JC Penney for a new plus-size line of clothing.
http://www.usatoday.com/story/life/entertainthis/2016/04/11/first-look-project-runways-ashley-nell-tipton-brings-plus-sized-style-jcpenney/82759122

April 11, 2016: Featuring NAAFA’s Phyllis Warr, an article discusses why surgery for fat people is not just about dollars but about the beneficial outcome for the patient.
http://health.usnews.com/health-news/patient-advice/articles/2016-04-11/too-fat-for-surgery

April 12, 2016: A doctor in the United Kingdom has been removed from the UK medical register following the deaths of six patients some of whom had undergone weight loss surgery. At least one family is suing the hospital where the surgery occurred.
http://www.standard.co.uk/news/uk/family-sue-over-weightloss-surgery-death-a3223391.html

April 13, 2016: Joni Edelman talks about why she posed naked for Substantia Jones and why she thinks it is important that photos of fat naked bodies be shared.
http://www.ravishly.com/2016/04/13/i-got-naked-camera-because-fat-bodies-need-be-seen

April 14, 2016: Drs. Janet Tomiyama and Jeffrey M. Hunger discuss their ongoing (and unpublished) research on just how ineffective BMI is as a measure of health. The end of the blog post has information on the UCLA’s Health Registry of “Obesity” (HERO).
https://healthateverysizeblog.org/2016/04/14/the-haes-files-body-mass-index-is-not-a-good-measure-of-your-health

April 14, 2016: When Glamour magazine grouped Amy Schumer with plus-sized women, Schumer said it didn’t feel right to her because she’s a size 6 to 8. Is this about her negative feelings toward fatness, or was she making a point about the visibility of fat people in the media? USA Today looks at different sides of the controversy.
http://www.usatoday.com/story/news/2016/04/12/amy-schumer-plus-size-fat-america/82940894

April 15, 2016: Read about Faith, the fat super hero, in an article in The Atlantic.
http://www.theatlantic.com/entertainment/archive/2016/04/faith/478386

Fat news through 4/8

Why two “Fat news” posts in two days? We were away last weekend and are catching up, that’s why. Read and enjoy! (Or get angry, as appropriate.)

March 4, 2016: A recent study claims that increasing BMI among African Americans is associated with an increasing risk of heart failure and heart failure hospitalization. However, all-causes mortality actually decreased with increasing BMI.
http://www.onlinejcf.com/article/S1071-9164(16)00077-4/abstract

March 18, 2016: An article looks at the evolution of the body mass index (BMI) and its connections with the concept of the average person and the rise of standardization.
https://www.psychologytoday.com/blog/the-gravity-weight/201603/adolphe-quetelet-and-the-evolution-body-mass-index-bmi

March 29, 2016: In Worthington, Ohio, firefighters are practicing with victim simulation dummies weighing up to 500 pounds to learn how to safely help and rescue very large patients.
http://www.dispatch.com/content/stories/local/2016/03/29/worthington-firefighters-practice-helping-heavier-patients.html

March 30, 2016: The research journal Obesity publishes three papers highlighting different types of errors and biases in obesity research, as well as a commentary on the three papers. One paper identifies 10 common errors and problems in obesity research and reporting, one reviews the assumption by weight management programs that non-participants will continue to gain weight, and one reviews placebo effects in obesity research.
http://onlinelibrary.wiley.com/doi/10.1002/oby.21457/epdf
http://onlinelibrary.wiley.com/doi/10.1002/oby.21449/full
http://onlinelibrary.wiley.com/doi/10.1002/oby.21255/full
http://onlinelibrary.wiley.com/doi/10.1002/oby.21456/full

April 2016: This month’s free webinar from ASDAH (Association for Size Diversity and Health) features two dietitians discussing a HAES approach to treating eating disorders.
https://www.sizediversityandhealth.org/content.asp?id=277

April 6, 2016: Connie Levitsky lost her job at a plus-size women’s clothing store because she used “fat” in a Facebook post describing her job title as “conquering the world, one well-dressed fat lady at a time.” Connie’s explanation on Facebook has been viewed over 1000 times, making her ex-employer backtrack on the firing.
http://www.cbc.ca/news/canada/edmonton/edmonton-addition-elle-employee-fired-for-using-the-word-fat-1.3524015

April 6, 2016: Tired of fat shamers and just want to flip them off? There’s a place for that. Substantia Jones (creator of the Adipositivity Project) talks about her popular Tumblr page “Fat People Flipping You Off.”
http://www.attn.com/stories/7142/fat-people-flipping-off-tumblr-slams-body-shamers

April 6, 2016: Mariah Carrillo provides her personal insight in separating her evangelical upbringing from her fat (and female) body.
http://www.bustle.com/articles/151866-why-becoming-a-fat-girl-is-the-best-thing-thats-ever-happened-to-me

April 8, 2016: Peggy Howell explains how employee wellness programs can be discriminatory, and penalize employees when results promised by the wellness program fail to materialize.
http://health.usnews.com/health-news/patient-advice/articles/2016-04-08/workplace-wellness-progams-powerful-motivators-or-discriminatory