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.

Binge Eating Disorder

This post isn’t really about fatness, but I was thinking about binge eating disorder as a diagnosis. You can take a look at the diagnostic criteria here, but it seems to get into a thorny realm because one criterion is a sense of lack of control. To me, that sounds like saying “addictive behavior” while avoiding that phrase. It leads to some questions:

  • Is binge eating itself a problem, or just a symptom of a deeper problem?
  • Does this diagnosis really help people?
  • Is there an issue with the diagnosis being incorrectly applied to fat people?
  • The diagnosis also mentions distress, disgust, etc. If one binges without these feelings, does one have the disorder?

I don’t have a firm viewpoint, but I’d like to hear yours.

Fat news through July 27, 2016

We’re back, and talking about fatties again!

July 20, 2016: Emily Baines discusses a run-in between Whitney Way Thore (star of My Big Fat Fabulous Life) and comedian Kerryn Feehan (first link), when Feehan made some fat-phobic remarks during a guest appearance on a radio show where Thore interned. Thore continues to be an activist for positive body image and has a TedX talk on the subject (second link).
http://hellogiggles.com/body-shaming-comedian
https://www.youtube.com/watch?v=aaXBYcfVYZM

July 22, 2016: People with lipodystrophy, a rare genetic disorder, are thin but suffer from the same conditions that are associated with being fat such as high cholesterol, fatty liver disease, and type 2 diabetes. Scientists have found a clue into why some fat people are metabolically healthy and how this knowledge could help everyone be healthier.
http://www.nytimes.com/2016/07/26/health/skinny-fat.html

July 24, 2016: Laura Bogart is fat, and she is okay with that. She shares her journey to fat acceptance and the lessons learned along the way. (Comments on this page are the usual sort of fat shaming, though.)
http://www.salon.com/2013/07/25/i_choose_to_be_fat

July 27, 2016: Ka Leo O Hawai’i, the campus newspaper of the University of Hawai’i at Mānoa, explains that the body positive movement is not the promotion of fatness, but rather a “feel-good cause” for people who don’t fit society’s ideal.
http://www.kaleo.org/opinion/the-plus-size-movement-does-not-promote-obesity/article_b5bad950-51ea-11e6-b968-873605b52027.html

Fat news through July 15, 2016

Here’s the latest in our (roughly) weekly series, bringing you the latest news and research that affects us fatties.

July 8, 2016: A study finds that increased BMI is not associated with higher morbidity or mortality for hospitalized patients, whereas being underweight is an independent predictor for hospital complications.
http://drc.bmj.com/content/4/1/e000200.abstract

July 10, 2016: A market research firm claims that Americans are shifting their focus from weight loss and dieting to health, which is hurting the diet industry. One can only hope.
http://www.businessinsider.com/the-death-of-the-diet-industry-2016-7

July 12, 2016: Several past studies have shown a link between artificial sweeteners and increased appetite. Now, researchers in Australia show that these sweeteners trigger a neuronal fasting response, explaining the increased motivation to eat.
http://www.laboratoryequipment.com/news/2016/07/why-do-artificial-sweeteners-increase-appetite
http://www.cell.com/cell-metabolism/abstract/S1550-4131(16)30296-0

July 13, 2016: A meta-analysis of 239 prospective studies on four continents shows increased mortality among overweight and obese people. Although people with chronic disease, smokers, and those who died in the first five years of the study were filtered out, there was no correction for other confounding variables such as socioeconomic status or ethnicity.
http://press.thelancet.com/BMI.pdf

July 14, 2016: A recent study finds that one in five “healthy” weight Americans has prediabetes, a sharp increase from 20 years prior. Although abdominal fat has also increased, it does not appear to be the primary cause of this.
http://news.health.com/2016/07/14/normal-weight-may-not-protect-against-diabetes
http://www.annfammed.org/content/14/4/304.short

July 15, 2016: Diet firm Herbalife gets hit with a $200 million fine for unfair and deceptive practices, and is told it needs to restructure its business. The fine is due to Herbalife operating like a pyramid scheme.
https://www.ftc.gov/news-events/press-releases/2016/07/herbalife-will-restructure-its-multi-level-marketing-operations

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 June 7, 2016

Hey, friends! Whaliam here, along with Tante Terri, bringing you this week’s fat news, with a couple of very cool items this time. Enjoy! (or not, as applicable)

May 23, 2016: More survivors from The Biggest Loser talk about what was going on behind the scenes while they were on the show and the long term damage to their lives.
http://www.nzherald.co.nz/entertainment/news/article.cfm?c_id=1501119&objectid=11643393

June 2016: The Berkeley Public Library presents Fat Positive Summer Festival, a series of events starting June 22 featuring lecturer and fat activist Virgie Tovar, as well as a group of short films and readings.
https://www.berkeleypubliclibrary.org/fat-positive-summer-festival

June 3, 2016: Doctors’ bias towards fat people can be deadly. When a doctor blames all health issues on excess weight, real health problems go untreated and fat patients wait for treatment until small problems become serious health issues.
https://www.statnews.com/2016/06/03/weight-obese-doctors-patients

June 5, 2016: Curvy Girl Lingerie owner Chrystal believes women of all sizes have the right to feel sexy and have hot sex, and we agree!
https://www.youtube.com/watch?v=WJCTUOFi_p8

June 7, 2016: The latest CDC survey shows a slight upswing in obesity rates, particularly for women. An accompanying editorial published in JAMA wants to blame the food and restaurant industry and believes focus on prevention is the best way to move forward, despite the failure of most interventions used to date.
http://www.cnn.com/2016/06/07/health/obesity-trends-women-men-teens/index.html
http://jama.jamanetwork.com/article.aspx?articleid=2526613
http://jama.jamanetwork.com/article.aspx?articleid=2526639

June 7, 2016: Lina Cohen lets the readers of Teen Vogue know what it is like going to the doctor’s office when you are fat teen. She advocates finding doctors who respect you and treat you with dignity and preferably are onboard with HAES principles.
http://www.teenvogue.com/story/fat-shaming-doctors