Questions about NAAFA

If you didn’t know, NAAFA is the National Association to Advance Fat Acceptance, and was the first fat rights group. It was a truly important force in the fat acceptance movement in the 1970s and the 1980s, through part of the 1990s. To put it kindly, it is less so today. Its website is; take a look if you like.

But rather than tell you about NAAFA, I’d rather ask you.

  • Had you heard of NAAFA before?
  • What’s your impression of NAAFA?
  • Is NAAFA relevant? Why or why not?
  • Should NAAFA be doing something that it isn’t?
  • Anything else you’d like to say?

Let’s discuss!


A study from August 2013 was recently published in the Journal of Health Economics.


The study looked at the impact of “weight report cards” sent to parents in Mexico.

What they found was that the behavior of the fat children did not change and there was no reduction of BMI amongst the children.

In other words, the children were still accepted and loved by their parents and life went on.

Oh the horror!

The parents still accepted their children even after they were told their child was fat.

The audacity!

In fact, the parents of the fattest children were least likely to report their child as weighing too much relative to the least-fat children.

And why is this a bad thing, you might ask (or at least I’m asking)?


“As obesity rates increase, reference points for appropriate body weights may rise, making it more difficult to lower obesity rates.”

In other words, if larger body sizes become generally accepted they might not be able to scare, guilt, and shame people into trying to losing weight.

Can I have a big round of FUCK YOU, please?

The authors conclude to give up on the weight report cards . . . Nah, just kidding! They double down, saying that the report cards need to be combined with “a set of actions helpful for reducing obesity.” Here are my problems with that:

  1. Their example “suggested action”, portion control, hasn’t been shown to work over the long term.
  2. Fat does not necessarily equal unhealthy;
  3. Creating body shame can create health problems all by itself;
  4. There is no known way to achieve significant long term weight loss for most people (and by “most” – I mean 90%+, not 51% – okay?);
  5. Making healthy food choices and keeping active are good for everyone and the health benefits can usually be achieved without weight loss; AND
  6. The best mortality outcomes are for people who are currently in the “overweight” BMI range.

Since the best mortality outcomes are for “overweight” people, it seems logical that that range of body size should be within the “reference points for appropriate body weights”. In a perfect world, all body sizes would be “appropriate” or at very least, not anyone else’s fucking business.

It seems the parents in Mexico have it going on. They know their kids are fine as they are.

I know we have NAFTA (the free trade treaty) with Mexico, but let’s not export our own fucked up agenda to Mexican fat kids and their parents.


What the fuck is wrong with these people?

The American Psychological Association has issued two “briefing sheets” advising its members how to treat fat patients – both young and old.


Both briefing sheets focus on intervention plans focusing on weight. Specifically weight loss, including weight loss surgery for adults.

Fuck you very much.

Nowhere do the briefing sheets recognize that THERE IS NO KNOWN WAY TO ACHIEVE SIGNIFICANT LONG TERM WEIGHT LOSS.

If someone goes to you for psychological help, why don’t you give them psychological help? God knows, fat people get enough judgment, hatred and prejudice from society. How do you think adding to that load is going to help?

Also, surprise, surprise. Fat people have more going on in their live than being fat. In fact, being fat does not define a fat person and their life. Fat people are not depressed because they are fat. They may be depressed by the way they are treated because they are fat, but the fat itself is not the issue, is it?

Personally, I was really lucky to find a psychiatrist who takes a weight-neutral view of my chronic depression. I once asked her why she never addressed the fact that I am fat and my mental health. She told me, “It never seemed to be an issue for you.”

She’s right. Being fat is not why I have this condition. I can’t tell you how good it was to hear that from a healthcare professional.

In my opinion the actions of the APA are merely a way for them to get on the fat-hatred gravy train. I understand that, but this is a group of people who are supposed to be focused on helping people when they are at their most vulnerable and truly need help. I am infuriated that an organization would look at this as an opportunity to kick someone when they are down – because after all, if you take an unhappy person and make them more unhappy, that just means more $$ in your pocket, right?

Well, I guess it’s good to have priorities. I just hope your patients, all of your patients, are aware of what those priorities are.

Note about the Fatosphere


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.) Feedly, which was mentioned at the time of the switchover as being the new host for the feed, is pointing to the wrong URL, it seems. The correct URL is now shown below.

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:

Skeptical Inquirer and Fatties, Part 2

[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.

Skeptical Inquirer and Fatties, Part 1

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?